Objective To identify the reason and preventive methods from misdiagnosed cases of multiple myeloma(MM) initially manifested as lumbago.Methods Medical history and clinical data of 25 MM patients in department of hematology in our hospital were retrospectively analyzed to explore the clinical characteristics,misdiagnosis and prognosis of them.Results The 25 patients with initial presentation of lumbago were most misdiagnosed as bone and joint diseases,including 6 cases of lumbar disc,7 cases of lumbar compression fractures,6 cases of osteoporosis.And 1 cases of bone tuberculosis,3 patients of rheumatoid arthritis.And there were 2 cases of bone metastases,who were later diagnosed when anemia,neutropenia,thrombocytopenic and renal dysfunction appeared.The average misdiagnosed time was 7 months with a range of 3 months to 13 months.The median survival time was (29.2 ± 5.2) months in this group of patients.Conclusion MM,with the first manifestation of lumbago,has a single clinical manifestation and is often misdiagnosed as bone and joint diseases.Specialists who are not from hematology department should raise awareness and vigilance of the disease.Laboratory examinations results should be referred to in the diagnosis.Sum up experience in order to improve the early diagnosis of this disease and to effectively improve patient's prognosis and quality of life.

Food protein-induced enterocolitis syndrome(FPIES) is a series symptoms of recurrent vomiring and diarrhea caused by non-IgE-mediated food allergy to cow milk and soy in infants.The most common causative foods of FPIES are cow milk,soy and rice.Symptoms start within first days to 12 months of life.The sensitivity is usually outgrown by 3 years of age.The most common clinical symptoms observed include recurrent vomiting,diarrhea,fecal bloody,lethargy,pallor,etc.The diagnosis relies on history,clinical features,food eliminate,and oral food challenges.The food elimination is the mains treatment of FPIES management.

Early diagnosis,early treatment and the correct therapeutic approch are the keys for metastatic nasopharyngeal carcinoma(NPC) treatment.Currently,PET-CT is the best modality for distant metastasis staging of NPC.Cispalatin-based chemotherapy is the standard treatment method of metastatic NPC.Molecular targeted therapy is possible to further increase curative effect.When the lesions are limited,local palliative treatment may improve prognosis if patient's illness is controled by chemotherapy.

Early detection of HCC is critical for a good prognosis. Therefore, the development of tumor markers that can detect HCC at even earlier stages is urgent. Recent researches show that the human cervical cancer oncogene, gamma-glutamyl transferase mRNA, human telomerase reverse transcriptase mRNA, the proteins such as glypican-3, golgi protein 73, vascular endothelial growth factor and transforming growth factor-β1 could serve as markers for early detection of HCC.

Objective To study the enlightenments of precision medicine, personalized medicine, stratified medi-cine, individualized medicine, P4 medicine on the medical cause in China. Methods Core papers on precision medicine, personalized medicine, stratified medicine, individualized medicine, and P4 medicine were retrieved from SCI core collection and PubMed. The concepts of precision medicine, personalized medicine, stratified medi-cine, individualized medicine, P4 medicine were analyzed by the VOSviewer. Results The concept of personalized medicine and individualized medicine can be used alternatively and is a coverage concept. The concept of stratified medicine and precision medicine is similar and is an inclusive concept. P4 medicine is a participatory medical model for patients. Tumor, chemotherapy, cells, diabetes mellitus, pharmacogenomics, and variants are the hot spots in precision medicine. Tumor, genomics, and public policy have a tendency to be integrated. Conclusion The develop-ment of precision medicine in China needs the design at the national top level, scientific policy-making, integration of scientific research system and resources, implementation of step by step strategy, overcoming of medical difficul-ties in order to realize personalized medicine at last.

Objective To investigate the role of sex hormones and interleukin (IL)-6 in the pathogenesis of primary Sjgren′s syndrome (pSS). Methods Serum specimen of 21 postmenopausal patients with pSS and 21 postmenopausal healthy women were collected. Serum estradiol (E2) and testosterone (Te) were estimated by the commercial radioimmunoassay kits, whereas serum dehydroepiandrosterone sulfate (DHEAS) were measured by enzyme-amplified chemiluminescence assay. Enzyme linked immunosorbent assay kits were used to determine levels of IL-6 in serum. Results The DHEAS and the Te level in serum were lower in postmenopausal patients with pSS than in healthy controls (P0.05). The level of IL-6 in pSS patients was higher than that in controls (P0.05). Conclusion Primary Sj(?)gren′s syndrome, in which an altered metabolism of sex hormones has occured, appears to be influenced by the change of the levels of sex hormones and IL-6 in serum.

Objective To investigate the anti-rejection effect of T cell vaccination combined with FK506 of heterogenic transplantation on rat nerve. Methods SD rats were vaccinated by the spleen cells of BABL/c mice; T cell vaccines were activated and vaccinated in the spleen cells of these SD rats. The SD rats of nerve transplantation recipient were vaccinated with T cells combined with FKS06. The mixture lymphocytes culture, microcytotoxicity assay, histological alteration of nerves, humid weights of tibial anterior muscle were observed to confirm the anti-rejection effect of T cell vaccination combined with FK506 treatment. Results The humid weights of tibial anterior muscle of the vaccinated rats combined with FKS06 treatment were statistically different from those in control group (P ＜ 0.05), and so as the index of rejection (e.g. lymphocytes transformation efficiency) (P ＜ 0.05). Conclusion T cell vaccination combined with FK506 treatment can inhibit the rejection of heterogenic transplantation on rat peripheral nerve.

Progress in Cocaine toxicology research,especially in i ts toxicological mechanisms on the central nervous and cardiac-cerebral vascular systems, was reviewed in the last 5 years.The main problems with the current resear ch work and the future research direction were pointed out.

After a description of the 6 types of reference management software ( EndNote, Mendeley, F1000Workspace, NoteExpress, King of medical literature and NoteFirst), their basic functions were comparatively analyzed.

Unregistered drug use,also called off-label drug use,has become a universal phenomenon in clinical practice worldwide.At present,there is still no definite laws and regulations in the field of off-label medication in China.The article gives an overview about the current criterion for prescription in China,the definition of off-label use,analysis of this situation and causes,how to regulate this practice to protect the patient's rights and safety,and also doctor's rights of prescription.