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.

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.

Objective Understanding current situation of pharmaceutical service before and since the ongoing health reform in community health institutions of China,and providing practical evidences to the government.Methods Adopting some indicators to comparative study the pharmaceutical care in 2008 and 201 1 in community health service institutions of China.Results From 2008 to 201 1, pharmaceutical service quality in general has greatly improved in community health institutions of China. For example,average number of drugs per prescription descended from 2.5 1 to 2.23.Percentage of prescriptions with an antibiotic descended from 43.98 to 32.08.Percentage of prescriptions with a hormone descended from 7.13 to 4.67.Percentage of prescriptions with two or more antibiotics descended from 1 1.24 to 7.31.These four indicators before and since the reform have statistical significance (P values are:0.003,0.001,0.003,0.004 respectively).But there are still inadequacies:from 2008 to 201 1,the average prescription cost descended from 59.63 to 5 1.18 yuan.Percentage of prescriptions with an IV drip descended from 34.84 to 30.41.These two indicators have not statistical significance(P values are 0.182,0.236 ).Conclusion To improve the quality of pharmaceutical service in community health institutions,the government should increase financial input to the community health institutions.

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.

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.

With the aggravation of population aging and the change of social convention,especially after the introduction of two-children policy,some families wish to have two children can not be achieved due to various reasons.Therefore,they use assisted reproductive technology to achieve fertility aspirations.Surrogate is a controversial topic in the assisted reproductive technology,the contradictions between the normal reproductive rights of the infertile woman and the women who have lost their children but passed the age of childbearing and the bad ethical consequences and rights disputes of surrogacy.How to avoid the bad ethical consequences and meet the demand of reasonable surrogate is the major issue worthy to be discussed.

Objective To detect exon deletions/duplications in the DMD gene in Duchenne and Becker muscular dystrophy pedigrees using multiplex ligation-dependent probe amplification method,and explore the usefulness of multiplex ligation-dependent probe amplification analysis as a method for genetic diagnostics in patients with Duchenne and Becker muscular dystrophy.Methods Exon deletions/duplications in the DMD gene were analyzed by multiplex ligation-dependent probe amplification for two pedigrees with Duchenne muscular dystrophy and Becker muscular dystrophy.Patients and carriers were diagnosed by multiplex ligation-dependent probe amplification.Results The pedigree with Duchenne muscular dystrophy was caused by DelEx45-50 mutation,while the pedigree with Becker muscular dystrophy was caused by Dup Ex3-4 mutation.Patients and carriers were diagnosed by multiplex ligation-dependent probe amplification method.Conclusion Exon deletions/duplications in the DMD gene can be indicated by probe copies using multiplex ligation-dependent probe amplification method under standard operating procedure.Multiplex ligation-dependent probe amplification should be considered as a rapid and accurate clinical method for an initial mutation analysis of DMD gene with exon deletions/duplications.

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.

Objective:To evaluate the efficacy of omeprazole and cimetidine in the prophylaxis of stress ulcer bleeding to provide evidence for clinical therapy in China. Methods:The randomized controlled trials were searched in PubMed, Medline, CNKI, Wan-fang and Vip database with the key words of omeprazole, cimetidine and stress ulcer. Two evaluators assessed the quality and reviewed the data independently. RevMan 5. 2 software was used for Meta-analysis. Results:Seventeen randomized controlled trials were includ-ed involving 892 patients for omeprazole group and 888 patients for cimetidine group. The results of Meta-analysis showed that the difference between the two groups after the treatment was statistically significant by comparing the incidence of stress ulcer bleeding (OR=0. 23,95% CI:0. 17-0. 32;P<0. 000 01). The incidence of stress ulcer bleeding of omeprazole group was significantly lower than that of cimetidine group. Conclusion:Existing literature analysis shows that omeprazole is more effective than cimetidine in the stress ulcer bleeding prophylaxis.

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.