Objective To investigate the clinical characteristics of methylmalonic acidemia.Methods Methylmalonic acidemia diagnosis and treatment of 12 cases of clinical data were collected,the clinical manifestations,laboratory examinations,gas chromatography/tandem mass spectrometry analysis of the measurement results of urine organic acids,blood gas analysis,glucose,lactic acid,ammonia and other characteristics were sumarized,and the clinical features and outcome of the situation were also sumarized.Results 1 year old first visit eight cases,12 cases,8 cases from rural areas;12 cases of major treatment complained of anorexia,poor spirit hospitalized one case;respiratory infection hospitalized five cases; seizure hospitalized three cases;weight gain admission,one case;vomiting admitted three cases,three cases of drowsiness,coma admitted one case,the movement behind the main complaint admitted two cases.After hospitalization check urine organic acid analysis found significantly increased methylmalonic acid,respectively,while ammonia,lactic acid increased,high blood sugar,high uric acid,low albumin,urine protein abnormalities,abnormal urine ketone bodies,abnormal increased anion gap,video science and abnormal electrophysiological examination.Diagnosed with methylmalonic acidemia,according to the case were given VitB12,betaine,folic acid,L-carnitine,limiting protein intake and other treatment.Symptomatic treatment improved in seven patients,two patients were lost;automatically discharged one case,two cases of death.Conclusion Methylmalonic acidemia based on clinical characteristics,so early detection,early diagnosis,early treatment will help to improve prognosis.

The injury of vascular endothelium,activation of coagulation and exist of fibrinolysis in patients with acute leukemia caused the coagulation disorders.It would appear hypercoagulation status or thrombosis,and the incidence was about 10 ％- 40 ％.It appeared in the early phase of this disease,chemotherapy or infection,and may have no clinical symptoms or signs.The routine coagulation index was also very difficult to detect this hyper coagulation state.Therefore,monitoring in different phrase the content of plasma AT-Ⅲ,vWF and DD in acute leukemia provided the evidence for early diagnosis,prevention and cure of acute leukemia.

Medical electron linear accelerator and Gamma-ray stereotactic radiotherapy system,two kinds of large scale medical equipment,both have an medical treatment on patient by imposing a high-level of radiation.The accuracy of deferent dose and validity of therapy programe play a very important role to patients'security and treatment effect.Both the military and local governments Pay a lot of attention to the two kinds'allocation and quality control.As technical administrative department.the Medical Equipment Application Quality Test and Research Center of PLA analyse current situation of the two kinds detailedly and point out the existing problems based on quality of the two kinds of equipment used in military medical agencys.

Since the implementation of the Trial Measures of Degrees in Clinical Medicine in 1998,the application for clinical M.D.degree for in-service doctors has been considered as way of continued education for medical practitioners.To guarantee the quality of this education mode,Peking University Health Science Center adopted measures and achieved outcomes that are parallel to that of full-time M.D.programs.-service doctors at,This paper introduces the experience of PUHSC and proposes measures for MD program of in-service doctors in terms of quality control,informatization,etc..

Hematopoietic stem cell transplantation (HSCT) is the only effective curative therapy for patients with certain hematological diseases. Haploidentical HSCT has been practiced worldwide for approximately twenty years. Significant improvements on this therapy were made in China within the past decade, with the novel non-in-vitro, T-cell-depleted haploidentical HSCT system. This review de-scribes the current situation and provides a prospective overview of these novel HSCT systems in China.

Diffuse large B-cell lymphoma(DLBCL),the largest category of lymphoma,is a clinically and biologically heterogeneous disease entity.Immunophenotype,tissue microarray and molecular studies underline the extreme heterogeneity of DLBCL and suggest a subclassification of the tumor.This review summarizes the morphological,immunophenotypic,cytogenetic and molecular genetic features of DLBCL relevant to the precise prognostic previsions.

Eph,the largest subfamily of tyrosine kinase receptor, could be divided into two groups,EphA and EphB.Ephs play a role in the embryonic development and differentiation of the nervous and vascular systems. In recent years,a large number of ephrins and Ephs had been found to be overexpressed in numerous human tumors,and have relation to development and prognosis of cancers.Down-regulated of EphA3 and EphA7 in cancers,was attributed to the hypermethylaiton of CpG island in promoter region.

Objective:Ephs have been found to be over-expressed in numerous human tumors,and relate to the development and prognosis of cancers.The expression of EphA7 in colon cancer cell lines and primary colorectal cancers was detected.The role of EphA7 in the development of colorectal cancer was investigated. Methods:Quantitative reverse transcription-polymerase chain reaction was used to detect the expression of EphA7.Methylation specific PCR and bisulfite sequencing were used to examine the methylation status of EphA7.pEGFP-EphA7 plasmid was constructed and was transfected into HCT116 which lost the expression of EphA7.Gene chip was analyzed for the expression of genes between transfectant and mock cell. Results:Down-regulation of EphA7 was observed in cell lines of primary colorectal cancers,and the evidence of aberrant methylation was found in CpG island of EphA7 promoter.The methylation status of EphA7 gene was related to sex,differentiation and location of colorectal cancers.Some genes were up or down regulated in pEGFP-EphA7 transfectant. Conclusion: EphA7 gene may be involved in the carcinogenesis of colorectal cancer.The hypermethylation of CpG island is an important mechanism leading to the down regulation of EphA7 in colorectal cancer.

This review summarized the biological activities of natural saponins,introduced its action mechanisms,clinical applications and research progresses in cardiovascular system,antitumor,immunological enhancement,blood sugar suppression,contraception,antifugal and insecticide,etc,and prospected its exploitations.

Objective To evaluate the prevention and treatment of prosthetic infections after tension free hernioplasty. Methods The clinical date of 12 prosthetic infections admitted from May 2005 to May 2008 were analyzed retrospectively. Patch was inserted under prefascial retromuscular site in 8 cases, between fascial edges in 2, Mesh plug and patch Lichentstein in one each. As for the material used there were flat knitted polypropylene in 7 cases, polytef in 1 case and composite prosthesis in 4 cases. Treatments were based on prothetic materials and levels infected. Infectious patchs were removed completely in 8 cases and partially removed in 2 cases, Open dress change with patchs left in situ in 2 cases. 3 cases in 10 cases of removed patchs were given immediate suturation with closed drainage. Results Infection was cured in all cases without mortality. There was no hemorrhage and injury of bladder during the procedures. No retention of urine, pain and other complications during postoperation. Change of dressing was made from 7 days to 6 months( median 2 weeks). Selected antibiotic was used from 3 to 7 days (average 4.5 days). All patients were followed up from 18 to 78 months (average 38.5 months) without hernia recurrence and infection. Conclusion It was most important to prevent infections after tension-free hernioplasty. Management should be individualized according to different type of patch used and the surgical procedure in hernia repair.