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.

Colorectal Neoplasms ; diagnosis ; prevention & control ; rehabilitation ; therapy ; Combined Modality Therapy ; Duty to Recontact ; Humans ; Neoadjuvant Therapy ; Quality Control

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.

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.

To investigate the effects of comprehensive and integrated therapy on the recovery of facial nerve function,60 patients with post-stroke facial nerve injury were divided into two groups:Group A (control group) was administered a simple conventional medication,and Group B underwent acupuncture by total considered therapy and was administered a simple conventional medication.Thirty patients were enrolled in each group.The Portmann modified clinical symptom score,intracranial hemodynamics,and electrophysiological parameters were analyzed before and after treatment.Thirty days later,the clinical symptom score in Group B increased significantly compared with that in the control group ( Group B,17.0 ±2.5 ; Group A,13.0 ±2.0; P ＜0.01 ).Group B showed significant improvements in middle cerebral artery blood flow [ Group B,(90 ± 17 ) cm/s; Group A,( 52 ± 15 ) cm/s ; P ＜ 0.01 ],facial nerve conductivity [Group B,latency of the ipsilateral orbicularis muscle,(3.35 ± 0.67) ms; Group A (3.95 ±0.58) ms;P ＜ 0.01 ].These results indicate that the total considered therapy improved the recovery of post-stroke facial nerve function and that this improvement was related to the increase in intracranial blood supply.

Objective To discuss changes and curative effect of serum interleukin-2 and 6 and tumor necrosis factor-α (TNF-α) of burning mouth syndrome (BMS) patients before and after medical treatment.Methods 50 cases of BMS patients were selected as case group,and who were given Clonazepam tablets (2mg) and Fluoxetine capsules (20 mg) one time daily for 4 weeks.Observe and compare the changes of serum IL-2 and 6,and TNF-αof patients in two groups before and after 4 weeks' medical treatment,and proceeded with the clinical curative effect observation.Moreover,30 cases of healthy subjects who just took the physical examination in medical examination center(MEC) at that moment was the control group.Results The serum IL-2 and IL-6,and TNF-αlevels of patients in case group before medical treatment was obviously higher than those in control group (t =4.31,2.97,3.84,all P ＜0.01).After 4 weeks' medical treatment,serum IL-2 and IL-6,and TNF-αlevels of patients had obviously declined than before (t =2.88,2.34,3.21,P ＜ 0.05 or P ＜ 0.01).After 4 weeks' medical treatment,there were 6 cured cases,14 cases with significant effect,and 24 cases with curative effect,and the total clinical efficiency reaches 88.0％ (44/50).Conclusion BMS patients have abnormal elevation of serum IL-2 and 6,and TNF-α,which may be the sensitive serological indicators of the early diagnosis of BMS.The changes of serum IL-2 and IL-6,and TNF-α levels may be the index of follow-up curative effect and prognosis observation.

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 .

Objective To compare the clinical value of automatic coagulometer and automatic biochemistry analyzer for the de-tection of antithrombin Ⅲ(AT-Ⅲ)in acute myocardial infarction and cirrhosis.Methods 55 cases of acute myocardial infarction and cirrhosis patients were investigated in the study,the healthy people was normal control.The concentration of AT-Ⅲwas detec-ted with automatic coagulometer and automatic biochemistry analyzer at the same time.Results The concentration of AT-Ⅲ detec-ted with automatic coagulometer was (251.2±58.5 )mg/L,(228.0 ±22.6)mg/L in acute myocardial infarction and cirrhosis pa-tients,the concentration of AT-Ⅲ detected with automatic biochemistry analysis was (255.6±54.3)mg/L,(230.3±23.1)mg/L in acute myocardial infarction and cirrhosis patients,and the concentration of AT-Ⅲwas significantly lower than that in normal control (P <0.05).The concentration of AT-Ⅲ detected with two detection methods in acute myocardial infarction patients was signifi-cantly lower than that in cirrhosis patients(P <0.05).There were significant difference between automatic coagulometer and auto-matic biochemistry analyzer for the detection of antithrombin Ⅲ(AT-Ⅲ).Conclusion The detection of AT-Ⅲ with automatic coag-ulometer and automatic biochemistry analyzer could diagnose and identify acute myocardial infarction and cirrhosis.

Objective To explore the effect of mifepristone on the application of bleeding after abortion . Methods 64 cases of portal diagnostic case ,all of the artificial vaginal bleeding profusely not more than ten days ,B ultrasound examination of the uterine cavity was normal or low echo is less than 10mm ×10mm,were randomly divided into treatment group and control group ,each of 32 cases.The treatment group oral mifepristone 25mg,every day two times,and with oral roxithromycin ,motherwort capsule ,for five days .The control group oral roxithromycin ,motherwort Gongxuening Capsule and ,for five days.Results The treatment group after five days of vaginal bleeding need again clear palace number(1 cases)was less than that of the control group (12 cases),group of uterine bleeding quantity in-creased treatment in the course of treatment (0 cases) was significantly lower than that of the control group (5 cases). The treatment group again curettage rate (3.1%) was significantly lower than that of the control group (37.5%),the difference was statistically significant effect of the two groups (χ2 =11.68,P<0.05).Conclusion The efficacy of mifepristone in the treatment of bleeding after abortion ,reduced the incidence of Qing Dynasty palace again ,reduce the patient′s physical and psychological harm , but also to avoid the unnecessary disputes , is worth the clinical promotion.