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Objective:To analyze and compare the clinical efficacy of robot-assisted and conventional navigation-assisted percutaneous minimally invasive pedicle screw placement in the treatment of thoracolumbar fractures and to provide reference for clinical treatment decisions.Methods:A literature search was performed in China National Knowledge Infrastructure(CNKI),VIP,Wanfang and English databases PubMed and Web of science by using the keywords"vertebral pedicle screws,"and"robot"in Chinese and"robot"and"pedicle screws"in English.The search time in both Chinese and English was from the establishment of the database to December 2022.The relevant clinical studies on robot-assisted and traditional navigation-assisted percutaneous minimally invasive pedicle screw placement for the treatment of thoracolumbar cone fractures were collected.Cochrane Scale and Newcastle-Ottawa Scale(NOS)were used to evaluate the quality of literatures and meta-analysis was carried out.The clinical effects of robot-assisted and traditional navigation-assisted surgery was compared.Results:A total of 15 articles were included in the study.Compared with traditional navigation-assisted percutaneous minimally invasive pedicle screw placement,robotic-assisted surgery resulted in shorter operative time[WMD=-11.45,95% CI(-18.94～-3.95),P＜0.05],less intraoperative bleeding[WMD=-19.11,95% CI(-27.51～-10.70),P<0.001],higher screw placement accuracy[number of grade A nails:RR=1.20,95% CI(1.16～1.25),P<0.001;number of grade A+B nails:RR=1.09,95% CI(1.07～1.11),P<0.001],and fewer complications[RR=0.35,95% CI(0.13～0.93),P＜0.05].The difference in hospitalization time was not statistically significant(P>0.05).Conclusion:In percutaneous minimally invasive pedicle screw placement for the treatment of thoracolumbar fractures,robot-assisted surgery has advantages over navigation-assisted surgery in terms of operative time,intraoperative bleeding,placement accuracy and complications.
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The essence of asymptomatic syndrome differenciation is that the disease is in a special stage or state. To perform traditional Chinese medicine （TCM） diagnosis when there was no symptoms for differentiation is a key scientific issue in current TCM diagnosis and treatment. The reasons include limitations in doctor-patient behaviors and relationships， as well as limitations in cognitive thinking. To address such situations， the following strategies can be adopted from a thinking perspective，i.e. grasping the occurrence and development of diseases based on a holistic concept， using dialectical thinking to summarize the laws of diseases， integrating clinical practice with experiential thinking， and introducing new thinking modes through interdisciplinary collaboration. These strategies help TCM practitioners make accurate diagnoses in the absence of obvious symptoms， thereby providing better medical services for patients.
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Objective:To analyze the risk factors of medical damage liability in the ambulance management in China, and provide reference for strengthening such management and improving the pre-hospital emergency system.Methods:The judgment documents released by China Judgment Online from 2013 to 2022 regarding damages incurred by improper ambulance management, were used as the sample. Based on the setting of such elements as software, hardware, environment, and liveware in the SHEL model, the text analysis method was applied to encode the text content at three levels according to " main category-sub category-risk behavior" by means of NVivo 12.0 software.Results:A total of 136 valid sample documents were included, finalizing such four main categories as software, hardware, environment, and liveware. Also finalized were 11 subcategories and 30 risk behaviors. The subcategories included the professional awareness and ability of pre-hospital emergency managers, the professional awareness of medical staff, the professional quality and ability of medical staff, as well as vehicle equipment among others. A total of 187 reference points were identified for coding risk behaviors. Risk behaviors with higher reference points included failure of pre-hospital emergency managers to dispatch vehicles (45), incomplete, malfunctioning, or no backup equipment in vehicles (20), failure of medical staff to take treatment measures in vehicles (18), failure to dispatch accompanying medical staff or stretchers (14), and insufficient medication (14), and fall of patients or medical equipment incurred by sudden braking of the drivers (6) among others.Conclusions:Insufficient ambulance equipment, shortage of human resources in the emergency system, inadequate equipment and medication in emergency vehicles, and safety issues for drivers are risk factors in the management of ambulances in China. It is recommended to expand the first aid talent team and enhance first aid capabilities; Reasonably deploy ambulance vehicles and improve the emergency networks; Develop a list of pharmaceutical equipment and establish an early warning mechanism; Strengthen the multi-party coordination, improve the efficiency of referral, further reduce the probability of risk, ensure the quality of emergency treatment, and enhance the effectiveness of pre-hospital emergency treatment.
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From the perspective of cybernetics， this study investigated the fundamental principles of empirical thinking in traditional Chinese medicine， encompassing six stages： experience input and storage， experience extraction and activation， experience combination and reconstruction， judgment and decision-making based on experience， and experience evaluation and feedback. The potential limitations of empirical thinking in clinical applications were analyzed， mainly manifested as “individuality”， “superficiality”， “conservatism”， “prioritizing commonality over individuality”， and “cognitive inertia”. To overcome these limitations， this paper also explored strategies and methods for clinical error-correction from four points： the integration of rational and empirical thinking， the reinforcement of feedback mechanisms and transcendent correction， the integration of individualization and quantity-quality balance， and the management and transference of tacit knowledge under empirical thinking.
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Red blood cells(RBCs)are an excellent choice for cell preparation research because of their biocom-patibility,high drug loading,and long half-life.In this study,doxorubicin(DOX)was encapsulated with RBCs as the carrier.The biotin-avidin system binding principle was used to modify biotinylated cyclic arginine-glycine-aspartic acid(cRGD)onto RBC surfaces for accurate targeting,high drug loading,and sustained drug release.The RBC drug delivery system(DDS)was characterized,and the concentration of surface sulfur in the energy spectrum was 6.330％.The physical and chemical properties of RBC DDS were as follows:drug content,0.857 mg/mL;particle size,3339 nm;potential value,-12.5 mV;and cumu-lative release rate,81.35％.There was no significant change in RBC morphology for up to seven days.The results of the targeting and cytotoxicity studies of RBC DDS showed that many RBCs covered the surfaces of U251 cells,and the fluorescence intensity was higher than that of MCF-7 cells.The IC50 value of un-modified drug-loaded RBCs was 2.5 times higher than that of targeted modified drug-loaded RBCs,indicating that the targeting of cancer cells produced satisfactory inhibition.This study confirms that the RBC DDS has the characteristics of accurate targeting,high drug loading,and slow drug release,which increases its likelihood of becoming a clinical cancer treatment in the future.
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【Objective】 To establish a management information system (referred to as the system) for plasma collection stations in Zhejiang province, so as to explore the current situation of plasma donors and implement effective supervision in Zhejiang. 【Methods】 The system was developed and connected to four plasma collection stations that were officially operating in Zhejiang in terms of plasma station setting and approval, as well as the publicity, recruitment and management of plasma donors, information management of the whole process of plasma collection, management of deferral plasma donors, plasma quality management and administrative supervision etc. Relevant plasma donor information was uploaded to the system by each plasma station, and information before (January 2016 to December 2020) and after (January 8, 2021 to June 2021) the system was collected. Information included the number of plasma donors/donations, demographic information of eligible plasma donors in the past 5 years, the type of plasma donors, and the deferral donors after the system was activated. The online approval of Plasma Donation Certificate and the intelligent supervision of key points of plasma apheresis stations in Zhejiang were also conducted. The frequency and composition ratio were described, and chi-square test was used for statistical analysis. 【Results】 The system (V1.0) was established and was officially launched on January 8, 2021, realizing the interconnection of blood donation and plasma donation information as well as the unified management of 24 quality indicators. Since the system was applied (January 8, 2021-June 2021), the proportion of donors both donated blood and plasma over the province was 3.56 (832/23 389), and 352 deferred donors were masked by the system. And 30.11% (106/352) , who intended to donate plasma, were deferred due to insufficient interval after blood donation; 11.65% (41/352) due to permanent masking in blood donations; 23.86% (23.86%) , who intended to donate blood, were deferred due to insufficient interval after plasma donation ( 84/352); 34.38% (121/352) due to permanent masking in plasma donations. The median approval rate of four plasma stations applying for Plasma Donation Certificate before the system (January 1, 2016 to January 7, 2021) and after the system (January 8 to June 2021) were 93.38% (10 609/11 361) vs 99.50% (2 602/2 615). Before the system was put into launch, the ratio of male to female donors and the proportion of regular donors showed an overall upward trend, while the age decreased slightly. The median proportion of women in the past 5 years was 61.52 %, significantly higher than that in last 6 months after the launch(58.86%). 【Conclusion】 The application of the system can realize information interconnection between blood centers and plasma collection stations in Zhejiang as well as the real-time supervision of plasma collection process, which is helpful to overcome the shortcomings in plasma donor management.
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Objective To investigate the clinical features of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant infection and abnormal liver function in Guangdong Province, China. Methods The patients with SARS-CoV-2 Delta variant infection who belonged to the same chain of transmission in Guangdong Province (Guangzhou and Foshan) and were admitted to Guangzhou Eighth People's Hospital, Guangzhou Medical University from May 21 to June 18, 2021 were enrolled in this study, and the judgment criteria for liver function were alanine aminotransferase (male/female) > 50/40 U/L, aspartate aminotransferase > 40 U/L, total bilirubin > 26 μmol/L, gamma-glutamyl transpeptidase > 60 U/L, and alkaline phosphatase (ALK) > 125 U/L. Abnormality in any one item of the above criteria was defined as abnormal liver function, and such patients were included in analysis (the patients, aged < 18 years, who had a mild or moderate increase in ALP alone were not included in analysis). Clinical data were compared between the patients with normal liver function and those with abnormal liver function, and the etiology and prognosis of abnormal liver function were analyzed. The Mann-Whitney U test was used for comparison of continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. Results Among the 166 patients with SARS-CoV-2 Delta variant infection, 32 (19.3%) had abnormal liver function with mild-to-moderate increases in liver function parameters, and compared with the normal liver function group, the abnormal liver function group had a significantly higher proportion of critical patients ( χ 2 =38.689, P < 0.001) and significantly higher age and inflammatory cytokines [C-reactive protein type, serum amyloid A, and interleukin-6 (IL-6)](all P < 0.05). Among the 32 patients with abnormal liver function, 13 patients had abnormal liver function on admission (defined as primary group), while 19 patients had normal liver function on admission but were found to have abnormal liver function by reexamination after treatment (defined as secondary group). For the primary group, the evidence of abnormal liver function was not found for 3 patients (3/13, 23.1%), and the possibility of toxic liver injury directly associated with SARS-CoV-2 infection was considered. Among the 19 patients in the secondary group, 9 (47.4%) had mild/common type and 10 (52.6%) had critical type, and all critical patients had the evidence of liver injury indirectly caused by the significant increases in C-reactive protein type, serum amyloid A, and IL-6 and hypoxemia; the evidence of abnormal liver function was not found for only 1 patient (1/19, 5.3%), and the possibility of toxic liver injury directly associated with SARS-CoV-2 infection was considered. All 32 patients with abnormal liver function had [JP2]significant reductions in liver function parameters after treatment including liver protection. Conclusion As for the patients with SARS-CoV-2 Delta variant infection who belong to the same chain of transmission in Guangdong Province, the critical patients show a significantly higher proportion of patients with abnormal liver function than the patients with other clinical types, and other factors except SARS-CoV-2 infection and indirect injury caused by SARS-CoV-2 infection are the main cause of liver injury.
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Objective:To investigate the arsenic content in internal and external environment of the people in drinking-water-borne endemic arsenic poisoning areas in Shaanxi Province, the status quo of the disease and the management and services of the existing patients, so as to provide a theoretical basis for evaluating the effect of prevention and control measures on drinking-water-borne endemic arsenic poisoning.Methods:From 2019 to 2020, in accordance with the requirements of the "Notice of Shaanxi Provincial Health Commission on Issuance of Monitoring Plans for Key Endemic Diseases such as Kashin-Beck Disease" and "Monitoring Plans for Drinking Water Arsenic Poisoning in Shaanxi Province", investigation was carried out in all villages of drinking-water-borne endemic arsenic poisoning in Mianxian County of Hanzhong City, Shanyang County and Zhen'an County of Shangluo City to understand the operation of water improvement project. One terminal water sample was collected to determine the content of arsenic in water, and permanent population of the whole village who are and/or had been exposed to excessive arsenic water in the past were examined for arsenic poisoning and the disease condition was determined according to the standard of "Diagnosis of Endemic Arsenicosis" (WS/T 211-2015). Five villages were randomly selected, and 50 people were selected from each village. Real-time urine sample was collected to determine the content of urinary arsenic. At the same time, management and services of the existing arsenic poisoning patients was investigated.Results:A total of 13 villages were investigated, all of which had been improved in water quality, and all 13 water improvement projects were operating normally, with arsenic content < 0.01 mg/L. A total of 12 577 people were examined, and 417 cases of arsenic poisoning were detected, with a detection rate of 3.32%. No new arsenic poisoning case and arsenic-related skin cancer case had been detected. A total of 260 urine samples were detected, and the geometric mean value of urinary arsenic (< 0.001 mg/L) was lower than the safety guideline value of human urinary arsenic (0.032 mg/L). The existing arsenic poisoning patients (417 cases) were included in health management and contracted services.Conclusions:Shaanxi Province has reached the elimination standard of drinking-water-borne endemic arsenic poisoning. In the future, more attention should be paid to the management of water improvement project, as well as to strengthen health promotion and management services for existing patients to consolidate the effects of prevention and control.
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The outbreak and spread of novel coronavirus disease 2019(COVID-19)with pandemic features,which is caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),have greatly threatened global public health.Given the perniciousness of COVID-19 pandemic,acquiring a deeper understanding of this viral illness is critical for the development of new vaccines and therapeutic options.In this review,we introduce the systematic evolution of coronaviruses and the structural characteristics of SARS-CoV-2.We also summarize the current diagnostic tools and therapeutic strategies for COVID-19.
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Objective:To explore the correlation among childhood trauma, obsessive-compulsive symptoms, and implicit and explicit memory in patients with obsessive-compulsive disorder(OCD).Methods:Fifty-two OCD patients were enrolled, and the childhood trauma was investigated by using the childhood trauma questionnaire short-form(CTQ-SF). The degree of obsessive-compulsive symptoms was assessed by using the Yale-Brown obsessive symptoms scale (Y-BOCS). In addition, the abilities of implicit memory and explicit memory were tested by vocabulary perception speed tasks and vocabulary recognition tasks.According to the scores of CTQ-SF, the patients were divided into abuse group( n=26) and neglect group( n=26). SPSS 22.0 software was used for t-test and Pearson correlation analysis. Results:Results of obsessive-compulsive symptoms, implicit memory, and explicit memory showed no differences between the abuse group and the neglect group( t=-1.959-1.839, P>0.05). The scores of obsessions symptoms(12.52±4.61) were positively correlated with the total scores of CTQ-SF (40.10±10.20)( r=0.331, P<0.05). On the subscale, the scores of obsessions were positively correlated with the scores of physical abuse(7.89±3.02), sexual abuse(6.47±2.28)( r=0.373, P<0.01, r=0.356, P<0.05). There was a negative correlation between the scores of physical abuse and the accuracy of explicit memory(68.75±13.33)( r=-0.281, P<0.05). The scores of physical neglect(8.98±2.67) was positively correlated with implicit memory response time(4 285.94±2 067.42)( r=0.314, P<0.05). Conclusion:Obsessions in patients with OCD are related to traumatic childhood experiences, especially physical abuse and sexual abuse.Physical trauma may influence the level of implicit and explicit memory in patients with OCD.
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Objective:Based on the analysis of the Nobel Prize in Physiology or Medicine from 1946 to present, summarize key factors of biomedical research management at universities, to provide suggestions for the improvement of biomedical research management in China.Methods:Using the official website of Nobel Foundation as database, combined with documents and literature review, data of the Nobel Prize in Physiology or Medicine, which including the nationality of the winners, the age at which the Nobel Prize were made, the employer as well as the discipline were analyzed.Results:An evaluation system based on peer review plays important roles in scientific and technological innovation.The breakthrough works are usually achieved by the scientists in their youth, however, the time for the recognition of their work is gradually increasing.The interdisciplinary research is more and more important.Conclusions:By analyzing the Nobel Prize in Physiology or Medicine, China needs to establish a comprehensive talent evaluation system that focus on training young scholars and strengthen cross-disciplinary integration to improve the biomedical research management.
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Objective:To investigate the characteristics of attentional bias in adolescents with anxiety disorder.Methods:Totally 40 adolescents with anxiety disorder who met the DSM-5 diagnostic criteria were recruited as the case group, 40 normal adolescents matched with the case group in terms of gender, age and education level were served as the control group.Symptom was assessed by the screen for child anxiety related emotional disorders (SCARED), and attention bias was assessed by attention bias test on both groups.All data were analyzed using SPSS 21.0.Results:(1) In the test of attentional bias, the negative reaction of the case group was lower than the neutral response((647.14±94.44)ms, (661.08±112.07)ms), and the attention bias value of the case group was higher than the control group((13.93±33.27)ms, (-0.13±18.49)ms), the differences were statistically significant (both P<0.05). (2) In the total score and each factor score of SCARED, total score of SCARED was negatively correlated with the negative accuracy rate ( r=-0.38), and the separation anxiety score was negatively correlated with the negative accuracy rate ( r=-0.52), social terrorism scores were negatively correlated with negative accuracy ( r=-0.45) and neutral accuracy ( r=-0.43) (all P<0.05). The correlation between somatization, generalized anxiety and school terror with attention bias test were not significant( P>0.05). Conclusion:Adolescents with anxiety disorder are more concerned with negative stimuli, and it is difficult to shift attention from negative stimuli to others.The avoidance to neutral stimuli may be a risk factor for the severity of symptoms in adolescents with anxiety disorders.
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Percutaneous vertebral augmentation is the most commonly used minimally invasive surgery in the treatment of osteoporotic vertebral compression fractures(OVCF).The efficacy and safety have been widely recognized,however,there are still some complications of percutaneous vertebral augmentation.And the most common complication is bone cement leakage,which can lead to nerve root and spinal cord injury,increase the risk of secondary fractures of adjacent vertebral,and even cause serious complications such as pulmonary embolism.The diagnosis,classification,hazard,influence factors and preventive measures of bone cement leakage in vertebral augmentation for OCVF are reviewed in this paper,which will provide reference for prevention and treatment of bone cement leakage in clinical practice.
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Objective@#To investigate the effect of antiviral therapy on the progression of liver cirrhosis and related predictive factors through a retrospective analysis of patients with compensated hepatitis C cirrhosis.@*Methods@#The patients with compensated hepatitis C cirrhosis who were treated in our hospital from 2004 to 2015 were divided into sustained virologic response (SVR) group, non-SVR (NSVR) group, and untreated group. The baseline features of patients with or without liver cirrhosis were compared to identify the predictive factors for the progression of liver cirrhosis. The changes in platelet count, spleen sizes, Model for End-Stage Liver Disease (MELD) score, Sequential Organ Failure Assessment (SOFA) score, and Child-Turotte-Pugh (CTP) score were analyzed, and the incidence rate of liver cancer was compared between groups. A one-way analysis of variance, the Kruskal-wallis H test, the two-independent-sample t test, the chi-square test, and a multivariate logistic regression analysis were used for data analysis based on data type.@*Results@#A total of 89 patients with compensated liver cirrhosis were enrolled, among whom 42 received the antiviral treatment with interferon and ribavirin (30 were treated with pegylated interferon-α and 12 were treated with ordinary interferon) and 47 did not receive any antiviral therapy. Among the patients who received the antiviral treatment with interferon and ribavirin, 20 achieved SVR and 22 did not achieve SVR. Compared with baseline values, platelet count in the SVR group and the NSVR group was increased by (44.93 ± 32.66)×109/L and (9.73 ± 28.83)×109/L, respectively, and platelet count in the untreated group was reduced by (19.76 ± 54.5)×109/L; the three groups had a significant change in platelet count (F = 14.731, P < 0.001). Spleen size was reduced by 0.91 ± 1.09 cm in the SVR group and increased by 0.20±0.84 cm and 1.11 ± 1.69 cm in the NSVR group and the untreated group, respectively; the three groups had a significant change in spleen size (F = 14.943, P < 0.001). The three groups had no significant changes in MELD, SOFA, and CTP scores (P > 0.05). One patient (5.00%) in the SVR group, 5 (22.73%) in the NSVR group, and 6 (12.77%) in the untreated group progressed to liver cancer (χ 2 = 13.787, P = 0.001). The univariate analysis showed that SVR, HCV RNA, total bilirubin, and albumin were predictive factors for disease progression, and the multiple logistic regression analysis demonstrated that SVR and total bilirubin were predictive factors for disease progression.@*Conclusion@#Interferon combined with ribavirin has a marked clinical effect in the treatment of compensated hepatitis C cirrhosis with good short- and long-term efficacy.
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Objective To investigate the relationship between dystrobrevin binding protein 1 (DTNBP1) gene polymorphisms and cognitive function in patients with recurrent depressive disorder.Methods 49 recurrent depressive disorder patients and 60 age-,gender-and education-matched normal controls were recruited in this case-control study.Clinical symptoms were evaluated by HAMD and Wechsler adult memory scale,Wisconsin card sorting test,trail making test(TMT),verbal fluency test (VFT),S troop colorword test were used to evaluate cognitive function.The gene polymorphisms of DTNBP1 were determined by PCR-RFLP technique.SPSS 16.0 was used for statistical analysis.Results The distributions of genotypes in the patients and controls were consistent with Hardy-Weinberg equilibrium(P＞0.05).The time in trail making A task (73.4±30.5 vs 56.2± 11.7),the digital Span (9.6±2.3 vs 8.1±3.0),visual reproduction (9.6±2.3 vs 7.4±3.1),paired association learning (9.7±2.2 vs 6.1±4.2) and Spilling forward (9.1 ±2.4 vs 7.2±2.9) in Wechsler adult memory scale,the categories completed (1.8 ± 1.6 vs 2.5 ± 1.8),total trials (47.6± 1.1 vs 47.3± 0.7) and error numbers (28.5±5.3 vs 24.1±9.3) in WCST performs,and the word meaning interference score (18.4±9.0 vs 25.3±9.5) in Stroop color-word test were monitored.Patients with the genotype of rs9476867 G/G got higher interference number than patients with DTNBP1 rs9476867 C/G and C/C,and patients with the genotype of rs16876738 A/G spent more time to finish TMT-A than patients with rs16876738 G/G and A/A.G/G single nucleotide polymorphism (SNP) of rs9476867 and A/G SNP of rs16876738 affected attention ability.Conclusion DTNBP 1 gene polymorphisms are correlated with cognitive function in recurrent depressive disorder patients.
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Objective To investigate the event-based prospective memory(EBPM)and time-based prospective memory(TBPM)in schizophrenia patients with concomitant metabolism syndrome,and to provide theory basis for early intervention and treatment.Methods According to inclusion standard,50 schizophrenia patients with concomitant metabolism syndrome and 50 schizophrenia patients without metabolism syndrome matched in age,gender and education were assessed with a neuropsychological battery of tests including EB-PM and TBPM tasks.Results In the EBPM task,there was significant difference between schizophrenia pa-tients with and without metabolism syndrome (3.46±0.91 vs 3.86±0.81, t=-2.326, P=0.022).A statistically significant difference in TBPM was observed between schizophrenia patients with and without metabolism syn-drome (3.02±1.12 vs 3.78±0.89, t=-3.770, P=0.000).Conclusion The schizophrenia patients with me-tabolism syndrome have severer prospective memory impairment than those without metabolism syndrome.
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As an income redistribution mechanism, the design of Urban Resident Basic Medical Insurance ( URBMI) should reflect the inclination to take care of vulnerable populations, such as people with chronic diseases and low incomes. Therefore, whether the healthcare services of vulnerable populations have been improved, is the most important indicator to determine the effectiveness of the URBMI. Using the DID model, this paper analyzes healthcare service utilization of invulnerable and vulnerable populations before and after the establishment of URBMI ( including both outpatient and inpatient) , based on the idea that these two populations have different socio-economic and health status. Then, based on the gap between the healthcare service utilization changes of different groups, we can measure the equity in URBMI. The results show that the establishment and implementation of URBMI has indeed narrowed the gap of invulnerable and vulnerable populations with different socio-economic and health status; health-care service utilization of vulnerable populations has increased significantly, and health status has significantly im-proved. From vertical and horizontal perspectives, the results prove that the establishment of URBMI has improved the equity of healthcare service utilization among different populations across China.
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Objective To explore the influence of CYP1A2 and CYP2D6 gene polymorphism on blood concentration,therapeutic efficacy and adverse effects of anti-depression drug duloxetine on depression patients in southern region of Fujian.Methods 82 patients with depression were selected from southern region of FuJian, China,and all participates received duloxetine for two weeks.Blood concentrations of duloxetine were detected by HPLC-MS,and CYP1A2 and CYP2D6 genotypes were determined by sequencing with the amplified PCR products from peripheral blood DNA.The therapeutic efficacy and adverse effects of duloxetine were evaluated by Hamilton depression scale (HAMD) and treatment emergent symptom scale (TESS) respectively.Results Subjects were divided into GG,GA and AA three groups based on CYP1A2 * 1C genotyping.There was no significant difference in blood concentrations of duloxetine, dose-corrected blood concentrations, the reduction rate of HAMD and the reduction rate of TESS among the three groups.Results were the same with CYP1A2 * 1F,which were divided into CC, CA and AA three groups.Subjects was divided into CC, CT,TT three groups based on CYP2D6 * 10 locus genotyping.Blood concentrations of duloxetine were (13.89±3.22) ng · ml-1 , (16.08±4.24) ng · ml-1 , (17.25±4.62) ng · ml-1 respectively and there was significant difference(F=3.21, P＜0.05).CC group was significantly lower than TT group(P＜0.05) , and CT group was lower than TT group but without significant difference (P＞0.05).Dose-corrected blood concentrations were (304.84± 103.76), (368.13± 143.49), (444.50± 195.58) respectively and there was significant difference(F=4.19, P＜0.05), and CC group was significantly lower than TT group (P＜0.05).The reduction rate of HAMD were 0.42±0.11,0.46±0.11,0.52±0.09 respectively and there was significant difference (F =6.29, P＜0.05), and CC and CT group was significantly lower than TT group(P＜0.05).The reduction rate of TESS were 1.14±0.66,1.48±0.69, 1.69±0.69 respectively and there was significant difference(F=3.38, P＜0.05).CC group was significantly lower than TT group(P＜0.05).Conclusion Among the 3 loci studied,only CYP2D6 * 10 locus within CYP2D6 gene can affect blood concentration,efficacy and adverse effects of duloxetine,which indicate that CYP2D6 gene polymorphism may contribute to therapeutic efficacy of duloxetine on depression in southern region of Fujian.
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Objective To explore the effect of CYP2D6 gene polymorphism on blood concentration,therapeutic efficacy and adverse effects of anti-depression drug venlafaxine.Methods 69 cases of patients with depression were selected randomly from southern region of FuJian,China.The blood concentration of venlafaxine was detected by HPLC,and the CYP2D6 genotype was determined by sequencing with the amplified PCR products from peripheral blood DNA.The therapeutic efficacy and adverse effects of venlafaxine were evaluated by Hamilton depression scale(HAMD) and treatment emergent symptom scale(TESS) respectively.Results Subjects was divided into CC,CT,TT three groups based on rs16947 locus genotyping.The blood concentrations of venlafaxine were (157.35±15.63) ng/ml,(70.17±5.11) ng/ml,(115.72± 10.2) ng/ml respectively and there was no significant difference (F=1.257,P=0.301).The dose-corrected concentrations and normalized concentrations were not significantly different (F=1.683,1.547,P＞ 0.05).Similarly,the reduction rate of HAMD (CC:(40.6 ± 7.23) ％,CT:(51.7±7.09)％,TT:(42.8±14.1)％) and TESS scores (CC:1.3±0.21,CT:1.3±0.36,TT:1.2±0.28) were not significantly different either (P＞0.05).In 69 samples in this study,genotyping of rs3892097 locus only found GG type,and no further examination was performed.Genotyping divided rs1065852 locus into CC,CT,TT three groups.The blood concentrations of venlafaxine were (42.87±9.9) ng/ml,(64.25 ± 13.59) ng/ml,(181.56± 14.15) ng/ml respectively,and there was significant difference among the three groups (F=4.893,P=0.016).The dose-corrected concentrations and normalized concentrations were also significantly different (F=3.985,3.648,P＜0.05).The reduction rate of HAMD (CC:(42.6±8.23) ％,CT:(48.8± 10.8) ％,TT:(63.4±9.15) ％) was not significantly different (F=2.961,P=0.07).The difference of TESS scores was similar to that of HAMD reduction rate.Conclusion Among the 3 loci studied,only rs1065852 locus within CYP2D6 gene can affect its enzyme activity and then influence the therapeutic efficacy and adverse effects of venlafaxine.