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.

Objective To observe the effect of capecitabine alone against breast cancer failing in treatment with different receptor expression. Methods Ninety-six cases of breast cancer patients failing in treatment with different receptor expression were collected. They were treated with capecitabine alone, 1 000-1 250 mg/m2, D1-14, 21 d for 1 cycle. All the treatment was repeated 3 cycles at least. According to age, menopausal status, Eastern Cooperative Oncology Group (ECOG) scores, estrogen and progesterone receptor status, human epidermal growth factor receptor-2 expression, number of chemotherapy cycle, the patients were divided into difference groups. χ2 test was used to do single factor analysis and the independent factor affecting the progression free survival time (PFS) was analyzed by Cox regression model. Results The rate of objective effect in 96 breast cancer patients was 51.0%(49/96). PFS was 2-46 months, and median time was 7.0 months. In hematologic toxicity:Ⅰdegree was in 4 cases,Ⅱdegree in 3 cases, andⅢdegree in 5 cases. In digestive tract toxicity:Ⅰdegree was in 5 cases, andⅡdegree in 4 cases. In hand foot syndrome: I degree was in 3 cases, Ⅱ degree was in 1 case, and Ⅲ degree in 1 cases. Cox regression model showed that the number of chemotherapy cycle was the independent factor affecting the PFS (OR = 6.45, 95% CI 3.04- 13.71, P<0.01). Conclusions The treatment of breast cancer with capecitabine alone has good curative effect, and the number of chemotherapy cycles number is the independent influencing factor of RFS.

ObjectiveTo observe the effect of pus-draining and bloodletting with sharp-hook needle in repairing the skin lesions in acne vulgaris of nodules type.MethodTwenty pairs of skin lesions caused by acne vulgaris of nodules type were divided into a treatment group and a control group. The treatment group was intervened by pus-draining and bloodletting with sharp-hook needle, while the control group was by pus-draining with sharp-hook needle. Two facial skin lesions of same size were selected from each patient to respectively receive pus-draining and bloodletting with sharp-hook needle or pus-drainage alone. The changes of lesion size and hardness in a week were observed and compared.ResultThe reducing of lesion size was more significant in the treatment group than that in the control group (P<0.05), and the improvement of hardness of the lesions in the treatment group was also more significant in the treatment group than that in the control group (P<0.05).ConclusionPus-draining and bloodletting with sharp-hook needle can produce amore significant effect in repairing skin lesions in acne vulgaris than pus-draining alone.

Digestive endoscopic diagnosis and treatment technology in the development of ethical issues are :the expansion of endoscopic treatment indications , violation of patient choice;Health care costs increase , the pa-tient cannot enjoy medical equality;Staff is uneven , the patient can′t enjoy the fair medical treatment;Paternalistic doctor-patient relationship , ignore the patient′s autonomy and so on .Puts forward some Suggestions to solve these problems:people-oriented , fully respect patients option;Standard medical behavior , advocates the equal medical treatment;Standardized training for everyone to enjoy fair medical treatment;Build the good doctor -patient rela-tionship , respect the autonomy of patients .

BACKGROUND:Surgical treatment is mostly adopted in the treatment of III-IV pelvic organ prolapse, in which, the appropriate patch can be used to implement the pelvic floor reconstruction so as to reconstruct the pelvic anatomic relationship and restore the normal pelvic organ function. OBJECTIVE: To verify the efficacy and biocompatibility of the non-absorbable mesh reconstruction of the pelvic floor in III-IV pelvic organ prolapse. METHODS: Totaly 127 female cases of III-IV pelvic organ prolapse were enroled, aged 31-81 years. Of the 127 cases, 65 cases undergoing vaginal hysterectomy and anterior and posterior vaginal wal repair served as control group, another 62 cases undergoing pelvic floor reconstruction using non-absorbable mesh acted as observation group. The two groups were observed in the perioperative period and then folowed up for 12 months. POP-Q measurement, pelvic floor function and adverse reactions were observed in the two groups. RESULTS AND CONCLUSION:The operation time and blood loss in the observation group were less than those in the control group (P < 0.05). After 12 months of folow-up, the results of POP-Q measurement were significantly improved in the both groups compared with the previous (P< 0.05), but there was no difference between the two groups. In addition, pelvic floor static tension, dynamic tension and contraction force were stronger in the observation group than the control group (P < 0.05). In the observation group, there were six cases of mesh corrosion, one case of infection and one case of dysuria. It is indicated that the non-absorbable mesh reconstruction of the pelvic floor can effectively restore the pelvic energy in patients with III-IV pelvic organ prolapse, but there are some adverse reactions such as mesh corrosion.

Objective: To observe the clinical efficacy of treating cervical spondylosis with combined acupuncture and cupping therapies. Method: The patients in the treatment group (30 cases) were treated with combined acupuncture and cupping therapies; and the patients in the control group (30 cases) were treated with acupuncture therapy alone. Then the clinical efficacy was observed after 30 days of treatment. Result: The χ2 test showed that there was significant difference (P＜0.01) between the two groups in recovery rate, total effective rate, relapse rate after six months, and average treatment course. Conclusion: Combined acupuncture and cupping therapies is a better therapy for cervical spondylosis with a shorter treatment course and low relapse rate.

Gastrointestinal tract is the most common involved site of primary extranodal non-Hodgkin lymphoma (NHL).Compared with intranodal NHL,treatment of primary gastrointestinal tract NHL is different.Combinational chemotherapy is the best choice for diffuse lesion.Surgery is used to control the local lesion,and is important in the control of the complications of GI tract.Radiation therapy is used to eliminate the remaining lesions and control serious local lesion.H.pylori eradication should be used for those who had H.pylori infection.Here we reviewed recent progress of treatment in PGI-NHL.

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 evaluate the application of Autar scale in the assessment of the risk of thrombosis related to peripherally inserted central catheter (PICC) in patients with lung cancer.Methods 1 252 cases of lung cancer with PICC between January 2008 and December 2012 in Shanghai Chest Hospital were enrolled as the control group,who received routine PICC insertion and maintenance.1 322 cases of lung cancer patients with PICC catheterization between January 2013 to May 2016 in the same hospital were recruited as the observation group,who were divided into low-risk,middle-risk and high-risk groups based on the scores of Autar scale,and given grading nursing intervention accordingly.Results In the control group,PICC-related thrombosis occurred in 38 cases (3.04％).In the observation group,PICC-related thrombosis occurred in 12 cases (0.91％),the incidence in the low-risk,middle-risk,and high-risk groups was 1.25％ (5 cases),1.04％ (5 cases),and 0.45％ (2 cases),respectively.The incidence of thrombosis is lower in the observation group than in the control group (P ＜ 0.05).Conclusions Aurar scale may help anticipate the risk of PICC-related upper extremity venous thrombosis in patients with lung cancer.Preventive nursing and treatment measures in lung cancer patients at high risk may effectively reduce the incidence of PICC catheter-related thrombosis.