Introduction: Gout is one of the most common inflammatory arthritis in Malaysia. It is due to persistent hyperuricemia that leads to the formation and deposition of intra- and periarticular monosodium urate crystals either due to excessive production or insufficient excretion of uric acid. Incidence and prevalence of gout is increasing worldwide, with a higher rate among men compared to women. Malay is the largest ethnic group in Malaysia, followed by Chinese and Indian. SLC2A9 is a renal urate transporter that controls renal uric acid excretion and genetic variants in SLC2A9 are associated with the risk of gout in several populations. This study aimed to test if the SLC2A9 variant (R265H, rs3733591) is also associated with gout among Malays in Malaysia. Methodology: A total of 89 patients with gouty arthritis and 100 normal subjects who consented and were recruited in this study. The serum urate and creatinine were measured. The SNP genotyping was performed using PCR-RFLP method for rs3733591 and BST 1236 was used as a restriction enzyme to cut the targeted amplicons. Result: SLC2A9 variant was associated with gout, p-value of 0.007, OR=4.713 [95%CI 1.530-14.513], however this association was not significant after adjustment for age and gender with p=0.465 (OR=1.950; 95%CI[0.325-11.718]). Conclusion: Our data suggest that the genetic variant of SLC2A9 may contribute to the susceptibility of gout among Malays in Malaysia.

The mortality cases caused by influenza virus are offen associated with the secondary bacterial infection, Streptococcus pneumoniae infection in particularly. The mechanisms underlying the interaction between the virus and the bacteria are unclear at present. The damage of normal protective epithelial layer and changes in airway function caused by influenza virus provides increased numbers of attachment sites and culture spaces for the bacteria. The effect of influenza on immune system is a further opportunity for subsequent bacterial infection. The synergistic effect between influenza virus and Streptococcus pneumoniae might not be unidirectional. The bacteria caused the secondary infection could enhance the pathogenicity of the virus. The bacterium-derived proteases could cleave hemagglutinin to its active components that are required for infectivity of the virus. The effect of the bacteria on the virus could enhance the lethality of the primary viral disease, which can explain why antibiotic therapy was less successful to treat the influenza patient with subsequent bacteria infection. Effective strategies to prevent and treat the severe diseases could be suggested based on the knowledge of interaction between virus and bacteria.

BACKGROUND:Different fixtures can be used for the internal fixation treatment of patients with posterior ankle fractures in clinic, however, different internal fixation methods wil produce different biomechanical effect. OBJECTIVE:To compare and analyze the biomechanical properties of mini steel plate internal fixation and tension screw internal fixation in the treatment of posterior ankle fracture. METHODS:The clinical data of 95 patients with posterior ankle fractures were retrospectively analyzed. Al patients were treated with internal fixation. Mini steel plate group (n=48 cases) and tension screw group (n=47 cases) were divided according to the internal fixation methods. RESULTS AND CONCLUSION:The fixation effect of these two groups was simulated and analyzed using three-dimensional finite element model. The results showed that when the posterior ankle joint fracture block spreaded to the distal tibial articular surface of more than 25%, the mean pressure of internal fixation failure of tension screw group was significantly less than that of the mini steel plate group (P<0.05). When the posterior ankle joint fracture block spreaded to the distal tibial articular surface of 25%or less, the mean pressures of internal fixation failure of tension screw group was significantly greater than that of the mini steel plate group (P<0.05). The excel ent and good rate of ankle joint internal fixation of tension screw group was significantly higher than that of the mini steel plate group (P<0.05). In these two groups, there were no internal fixation material related adverse events during the treatment. These results demonstrate that the clinical effect of tension screw internal fixation for the treatment of posterior ankle fractures was better than that of the mini steel plate internal fixation, but the use of mini steel plate for internal fixation was more appropriate when the posterior ankle joint fracture block spreaded to the distal tibial articular surface of more than 25%.

Objective To investigate the different chemotherapy regimens on bone marrow inhibition and immunity of patients with advanced non small cell lung cancer.Methods Forty-six patients with advanced non-small cell lung cancer were randomly divided into NP group (Changchun vinorelbine plus cisplatin,n =23) and DP group(docetaxel,cisplatin,n =23).The bone marrow suppression and immune function were analyzed before chemotherapy and after 2 cycles chemotherapy.Results The median survival time(MST) in NP group and DP group were 10.3 months and 6.2 months respectively (x2 =2.987,P ＜ 0.005),and 1-year survival rates were 52.17％ and 30.43％ respectively (x2 =2.693,P ＜ 0.005).After chemotherapy,blood platelet number in DP group was (108.87 ± 15.63) x 109/L,lower than that in NP group ((128.17 ± 15.3) x 109/L,t =3.819,P ＜ 0.05).CD3 +,CD4 +,CD8 +,CD4 +/CD8 + and NK cell rate in NP group before chemotherapy were (61.17 ±9.13)％,(36.99±7.83)％,(26.94 ±6.14)％,(1.93 ±0.21)％,(30.12 ±8.62)％ respectively,and (52.82 ±8.19)％,(33.22 ±6.92)％,(23.21 ±5.64)％,(1.53 ±0.11)％,(28.07 ± 8.17)％ after chemotherapy.There were significantly lower than that before chemotherapy significant (t =2.097,3.217,2.251,3.027,2.717;P ＜0.05).CD3+,CD4+,CD8+,CD4+/CD+ 8 and NK in DP group before chemotherapy were (62.82 ±9.13)％,(38.82 ±9.19)％,(27.81 ±7.97)％,(1.82 ±0.13)％,(31.82 ±7.48)％ respectively,higher than that after chemotherapy ((50.76 ±8.19)％,(28.92 ±8.13)％,(20.82±8.93)％,(1.36±0.16)％,(29.12±7.31)％; t =2.347,2.591,3.857,2.438,2.157; P＜ 0.05).Compared with the DP group,CD4 +,CD8 +,CD4 +/CD8 + in NP patients increased significantly (t =2.591,3.785,2.438 ; P ＜ 0.05).CD3 +,NK in two groups were not statistically significant (t =0.027,0.323 ;P ＞ 0.05).Conclusion The less decrease of the immune function was seen in terms of NP chemotherapy compared with DP of patients with advanced non-small cell lung cancer.Therefore,NP chemotherapy is proved to the better chemotherapy regimens.

Objective:To analyze and recognize the important role of metrology in the quality management of medical equipment, and discuss how to do well medical metrology work. Methods: To fully recognize the importance of medical metrology, to analyze existing problems, to provide solutions for the problem and to do well the measurement work in combination with the status quo of medical measurement in the medical equipment management.Results: The metrology work can be done well by the attention of leadership, establishing administration of metrology management, establishing and improving the measurement management system, and strengthening the construction of information management.Conclusion: All of leaders in different levels and departments should pay full attention to the measurement work, find the problems, take effective measures for improving measurement management ability, and ensure the quality of diagnosis and treatment.

The researches on ocular dominance have been continuing deeply last decade years since the concept was first described by means by Porta in 1593.Based on the neurophysiology and molecular biology,it is confirmed that the procedure of ocular dominance involves sublayer 4C of the visual cortex,N-Methyl-D-aspartate (NMDA)-receptor,a-calmodulin kinase Ⅱ (aCaMK Ⅱ),synapses and about candidate gens.Meanwhile,ocular dominance theory plays an important guiding role in optometry,laser-assisted in situ keratomileusis and cataract operation.In this review,the mechanism and clinical application of ocular dominance were summarized.

Incidence and mortality of colorectal cancer(CRC) are rising.There were one million and twenty-three thousand new cases and five hundred and twenty-nine thousand deaths in 2002,which were 8.3% and 7.5% more than that in 2000,respectively.Incidence and mortality of CRC take the third and forth place in all cancers.Mortality in China has increased by 70.7% since 1991,by 4.71% per year in average.Therefore,CRC is one of the heat points in cancer research.In this paper,we focused on the progress in treatment for rectal cancer.Sphincter-preserved resection has an increasing proportion in surgical procedures,owing to improvement of technique,TME and the staplers.Above all,the most important reason seems to be the popular opinion that distal margin of 1 to 2 centimeters is safe enough.TME acts as a "gold standard" in rectal cancer resection,due to its magnificent potential in controlling local recurrence which had decreased from 35%-45% to 3%-11%.Microsurgery is a band-new technique.Laparoscopic colon resection is satisfactory with selective cases.Extended resection results in improving 5-year survival of advanced rectal cancer distal to the reflection to 68%.Further improvement of the outcome depends on multiple modality regimens.Neoadjuvant chemoradiotherapyshows an exciting prospect in some trials.But more multicenter clinical trials are needed to solve the remaining problems.

Objective To observe the intrapartum analgesic effect of Doula GT-4a pulse acting working station and the influence of it on labor and mother-to-child. Methods The observation group use intrapartum analgesia of 98 primigravida,and the control group was other 98 primigravida without intrapartum analgesia in the same delivery period. Two groups of gravidas were delivering by a high qualification of midwife while your cervix expand for 2 ～3cm. The observation group was given with GT-4a pulse acting working station. Results The analgesia VAS scores of the observation group,significantly different with that of the control group:The first stage of labor active period accelerated significantly,the second stage of labor was shortened. The cesarean section rate,the vaginal birth rate and the neonatal mild choking rate significantly declined compared with the control group. Though there were no statistical differences between two groups with the third stage of labor, postpartum hemorrhage, and neonatal severe choking rate.Conclusion The andlgesie effect of doula combined with GT-4 pulse theraphy for labor was good. It reduced cesarean section rate, improved maternity quality and had no adverse effects.

Medical students participating in chnieal medical early is one of the good ways to cultivate students'all-around qualities From freshman year medical students begin to enter chnical medical service system and make clinical practice in spare time,They are also trained to link theory with practice to caltivate clinical thinking ability,strengthen its humanistic care idea and doctor-patient communication ability so that medical students will know the sacred profession of being adatov and from the idea of sewing patients work of the sacred doctor,set up'professional service to patients'concept.