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Background: The purpose of the study was to investigate the effects of the pregnane X receptor (PXR)*1B polymorphisms on CYP3A4 enzyme activity and postoperative fentanyl consumption in Chinese patients undergoing gynecological surgery. Methods: A total of 287 females of Han ethnicity, aged 20 to 50 years old, ASA I or II, scheduled to abdominal total hysterectomy or myomectomy under general anesthesia were enrolled. The analgesic model used was fentanyl consumption via patient-controlled intravenous analgesia (PCIA) in the post-operative period. Additionally, pain was assessed using a visual analog score (VAS). Pain scores, occurrence of adverse reactions and consumption of fentanyl were recorded during the 24 h postoperative period. The enzyme activity of CYP3A4 was evaluated by measuring the plasma ratio of 1'-hydroxymidazolam to midazolam 1 h after intravenous administration of 0.1 mg/kg midazolam. PXR genotyping was performed by direct DNA sequencing and the PXR*1B haplotype was analyzed via PHASE V.2.1 software. Results: The polymorphism frequency of PXR11156A > C/11193 T > C and 8055C>T were 49.6 and 49.3%, and the rate of PXR*1B haplotype was 48.8% in our study. None of the pain scores, consumption of fentanyl 24 h post-operatively or enzyme activity of CYP3A4, showed differences among different genotypes. Conclusions: PXR11156A > C, PXR11193T > C, PXR8055C > T or the PXR*1B haplotype do not appear to be important factors contributing to CYP3A4 activity and interindividual variations in postoperative fentanyl consumption in Han female patients undergoing gynecological surgery. [ABSTRACT FROM AUTHOR]

Heterogeneity in adaptation outcomes among adolescents following major disasters needs further elaboration. Both ongoing stressors and positive psychological changes should be concerned in evaluating the heterogeneity. This study examined the prospective trajectories of posttraumatic stress disorder (PTSD) symptoms among adolescent survivors following the Yancheng Tornado in China and the associations of academic burnout and posttraumatic growth (PTG) with the differential trajectories. A total of 246 adolescent survivors were recruited and administered psychometric instruments at 6, 9, 12, and 18 months after the tornado. In the conditional model with predictor variables gender, school grade, academic burnout, PTG, subjective fear, and property loss, three trajectories of PTSD symptoms emerged: recovery (43.5%), recurrent dysfunction (37.0%), and delayed dysfunction (19.5%). The results indicated the importance of considering academic-related experiences together with disaster-related experiences in evaluating the prospective adjustment among adolescents following major disasters. Our findings point to feasible directions for both clinical and school-based interventions for addressing poorer adjustment among adolescents after major disasters. [ABSTRACT FROM AUTHOR]