ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the effect of VKORC1, CYP2C9, GGCX, PROC, EPHX1 and CYP4F2 gene polymorphisms on Warfarin maintenance dose variation in Chinese Han Population.</p><p><b>METHODS</b>Four hundred eighty-eight patients with prosthetic heart valves, atrial fibrillation or pulmonary thromboembolism and achieved stable Warfarin dose were enrolled. TaqMan probe or direct sequencing were used to genotype Y9VKORC1, CYP2C9, GGCX, EPHX1 and CYP4F2 gene polymorphisms. Demographic characteristics, stable therapeutic dose of Warfarin and concomitant medications were collected for all patients. The effect of VKORC1, CYP2C9, GGCX, PROC, EPHX1 and CYP4F2 gene polymorphisms, demographic characteristics and concomitant medications on Warfarin daily maintenance dose were analyzed with statistical method.</p><p><b>RESULTS</b>VKORC1 and CYP2C9 gene polymorphisms could explain more than 50% Warfarin maintenance dose variation in recruited patients, while CYP4F2 gene polymorphisms could only explain 1%. GGCX, PROC and EPHX1 gene polymorphisms had no impact no Warfarin maintenance dose. VKORC1 and CYP2C9 gene polymorphisms have a greater impact on Warfarin maintenance dose compared with demographic characteristics and concomitant medications.</p><p><b>CONCLUSION</b>VKORC1 and CYP2C9 gene polymorphisms have a significant impact on Warfarin maintenance dose in Chinese Han population.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Aryl Hydrocarbon Hydroxylases , Genetics , Asian People , Ethnology , Genetics , Atrial Fibrillation , Drug Therapy , Ethnology , Genetics , Cytochrome P-450 CYP2C9 , Cytochrome P-450 Enzyme System , Genetics , Cytochrome P450 Family 4 , Dose-Response Relationship, Drug , Epoxide Hydrolases , Genetics , Polymorphism, Single Nucleotide , Protein C , Genetics , Pulmonary Embolism , Drug Therapy , Ethnology , Genetics , Treatment Outcome , Vitamin K Epoxide Reductases , Genetics , WarfarinABSTRACT
<p><b>OBJECTIVES</b>To establish an algorithm to predict the warfarin maintenance dose in Chinese Han population and validate the accuracy of this algorithm.</p><p><b>METHODS</b>A total of 488 Chinese Han patients, hospitalized in Fuwai hospital and had a stable dose of warfarin and a target international normalized ratio (INR) of 1.5 to 3.0, were recruited. Indications for warfarin use included prosthetic heart valve, atrial fibrillation and pulmonary embolism. These patients were divided into derivation group (n = 323) and validation group (n = 165) according to the enrollment time. A warfarin maintenance dose algorithm was established based on genetic information, demographic characteristics and concomitant medications by multiple linear regression analysis in derivation group. In the validation group, we evaluated the accuracy of our algorithm by comparing the predicted dose with the actual dose.</p><p><b>RESULTS</b>Our algorithm included VKORC1-1639G > A, CYP2C9*3 and CYP4F2 genotype, age, Body hight, body weight, amiodarone and digoxin use (R(2) = 0.652, P < 0.001) .In the validation group, the average predicted dose by our algorithm had no statistical difference with the actual dose [(3.51 ± 1.03) mg vs. (3.53 ± 1.41) mg, P = 0.779]. Our algorithm identified 100 out of 165 (60.6%) patients in the validation group, whose predicted dose of warfarin was within 20% of the actual dose, and predicted warfarin dose was underestimated in 17.6% (29/165) patients and overestimated in 21.8% (36/165) patients.</p><p><b>CONCLUSION</b>Our algorithm based on VKORC1, CYP2C9 and CYP4F2 polymorphisms can help to predict the warfarin maintenance dose in Chinese Han Population.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Algorithms , Asian People , Genetics , China , Cytochrome P-450 CYP2C9 , Genetics , Cytochrome P-450 Enzyme System , Genetics , Cytochrome P450 Family 4 , International Normalized Ratio , Models, Theoretical , Polymorphism, Genetic , Vitamin K Epoxide Reductases , Genetics , Warfarin , Therapeutic UsesABSTRACT
ObjectiveThe pre-hospital data of 839 emergency patients who were admitted to Naxiang Emergency Center of Shanghai from Dec 11 2006 to Jun 11 2007 were analyzed.The first five causes of emergency call were trauma,diseases of newborns,neuron-system diseases.eardio-vascuIar diseases and digestive diseases.The epidemiological data including gender,age of patients,distance to emergency site,duration of ambulance dispatch,results of first aid.etc were also presented in the paper.These data would be helpful for improving pre-hospital medical care of emergency patients.
ABSTRACT
Objective: To explore the alternatives for T-tube placement in surgical treatment of bile duct stones.Methods: Fourty-nine patients with bile duct stones have been performed retrograde transhepatic biliary drainages(RTBD)since 1991.Among them,37 cases were placed the drainage tubes through the right hepatic lobes by retrograde punctures;the other 12 cases with intrahepatic stones were placed the drainage tubes through the intrahepatic bile duct stumps following partial hepatectomies.All the CBD exploration incisions were primarily closed.Results: (1)RTBD by retrograde puncture:Two postoperative complications(5.4%,pneumothorax and biliary hemorrhage)occured.Both cases were cured by medical therapy.The drainage tubes were removed on the 8th postoperative day.(2)RTBD through intrahepatic ducts:Four cases had residual stones(30%)which had been cleared up by combination of extraction and intraluminal lithotripsy.Nineteen cases(38.8%)had the gallbladders preserved.Postoperative cholangiographies showed that all the gallbladders were smooth and well-filled and the extrahepatic bile ducts were in normal shapes.Extrahepatic bile ducts and all the preserved gallbladders did not show any deformity and stone formation by ultrasonography during 6 months to 9 years'following-up.Conclusion: RTBD by retrograde puncture has the advantage of shorter period of bearing drainage tubes;RTBD through intrahepatic duct stump after partial hepatectomy makes it easier to extract postoperative residual stones.Both methods have no negative impacts on the anatomies of both the extrahepatic bile duct and the gallbladder.
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Objective: Observing the effect of injecting 5- Fu into the mass of breast hyper-plasia. Methods: We randomly divide the 80 mastopathy patients into two groups ,40 patients ac-cepted the 5- Fu local injection (experiment group),and 40 patients taken orally rubixiaopian and ta-moxifen(control group). The clinical effects of the breast pain and breast lump were observed. Re-sults: The total effect of 5- Fu local injection into the lump of the mastopathy patients was 92.5 % , while control group was 75.0% , its difference was significant(P0.05)in the treatment of mastopathy lump. Conclusion: 5- Fu local injection had obvious effects to breast pain and breast lump of mastopathy.