Among the genes involved in epilepsy,the SCN1 A gene represents one of the most commonly mutated human epilepsy genes, refers to be as super culprit gene, SCN1 A mutations cause epilepsy phenotype heterogeneity, diversity of clinical manifestations, the light performance of febrile seizures, it shows severe infant severe myoclonic epilepsy.By retrieving SCN1 A in gene mutation database, about 900 gene mutatation are associated with epilepsy syndrome.This article reviews the importance of SCN1 A gene mutation associates with epilepsy syndrome,and the importance of genetic screening SCN1 A.

The etiology of neuroblastoma is related with hereditism,enviroment and matabolic factors.By now,it has been confirmed that N-myc amplification,chromosome abnormality,and some certain gene mutations are related with neuroblastoma.However,since the development of molecular biology,some single nucleotide polymorphismes in certain genes have been established to play an important role in neuroblastoma.It is necessary to summarize the latest studies about single nucleotide polymorphism in neuroblastoma.

This study explores the association between physician-patient communication and healthcare service quality,and relevant factors.The physician-patient communication belongs to medical behaviors,and plays a key role in the improvement of physician-patient relationship and the overall healthcare service quality.The consults of physician-patient communication were affected by many factors including physicians' attitude,and usage of words and behaviors,in which the positive attitude and behaviors are key solution to the improvement physician-patient relationship.Therefore the urgent matters are to strengthen standardized management of physician-patient communication,and set up related regulations and effective measure.

Asphyxiation by an inhaled foreign body is a leading cause of accidental death among children younger than three years.The species of foreign body aspiration are many and varied.Immediately after inhalation the child starts to cough,wheeze,or have laboured breathing.The clinical manifestation will be different when foreign body stays in different part of bronchial tree.It's extremely easy to cause misdiagnosis.No matter whether aspiration or not,bronchoscopy should be taken.The bronchoscopy is not only the means of diagnosis,and removes the foreign body at the same time which helps to treat timely.

Objective To investigate clinical effect of pinaverium bromide combined with probiotics in the treatment of patients with irritable bowel syndrome (IBS).Methods 156 patients with IBS were randomly divided into observation group and control group.Cases in control group received pinaverium bromide tablets,and cases in observation group received bifid triple viable capsule plus pinaverium bromide tablets.Duration of treatment was 4 weeks in both groups.Clinical efficacy was evaluated after treatment.Results Total effective rates of observation group and control group were respectively 85.9％ and 70.5％.Total effective rate of observation group was significantly better than that of control group(x2 =8.557,P ＜ 0.05).The systolic pressure of anorectum was significantly lower than that of control group after treatment(t =4.432,P ＜ 0.01),but resting pressure and diastolic pressure were not significantly different after treatment(t =0.812,0.142,all P ＞ 0.05).First sensation volume,defecating sensation volume and pain volume in observation group were significantly lower than those in control group (t =3.440,4.671,3.697,all P ＜ 0.01).Conclusion Treatment of IBS with pinaverium bromide combined with probiotics is effective,and it can improve the anorectal dynamic and isceral sensitivity in patients with IBS.

arotid artery atherosclerosis is closely associated with ischemic stroke.Carotid artery intimamedia thickness is an important indicator of carotid artery atherosclerosis.Magnesium is involved in the in vivo metabolism of a wide variety of processes.Studies have shown that magnesium can decrease carotid intimamedia thickness.This article reviews the relationship between magnesium levels and carotid artery atherosclerosis in different populations.

Objective To explore the reasons of the failure of primary arteriovenous fistula (AVF)surgery and the preventive measures in patients with end-stage renal disease.Methods A total of 819patients with end-stage renal disease who accepted primary AVF surgery were selected.The data of hemoglobin (Hb),albumin (ALB),cholesterol (CHOL),parathyroid hormone (PTH),fasting blood glucose and blood pressure were collected before surgery,while the diameters of radial artery and cephalic vein were measured by upper extremity vascular ultrasound.Results Seven hundred and forty-two patients with AVF surgery were successful,and 77 patients were failed.The age,the ratio of diabetes,hypertension and blood pressure ＜ 120/70 mm Hg (1 mm Hg =0.133 kPa) in AVF failed patients was higher than that in AVF successful patients[(61.3 ± 13.4) years vs.(45.6 ± 11.2) years,46.8％(36/77) vs.31.7％ (235/742),26.0％ (20/77) vs.19.5％ (145/742),36.4％ (28/77) vs.9.2％ (68/742)],and there was significant difference (P＜0.05 or ＜0.01).The diameters of radial artery and cephalic vein in AVF failed patients was lower than that in AVF successful patients [(1.35 ± 0.64) mm vs.(1.98 ± 0.47) mm,(2.13 ± 0.81)mm vs.(2.47 ± 0.74) mm],and there was significant difference (P＜ 0.01).The level of PTH in AVF failed patients was higher than that in AVF successful patients [(782.39 ± 423.85) ng/L vs.(378.83 ± 352.21) ng/L],and there was significant difference (P ＜ 0.05).Logistic regression analysis showed that blood pressure,diabetes,PTH,the diameters of radial artery and cephalic vein was the risk factor of AVF failed.Conclusion AVF surgery failed is highly correlated with the patient s blood pressure,th primary disease,the vessel diameter,

Psychotherapy is a sort of arts based on science following the general principles of social science and natural science.Meanwhile,the content of psychotherapy,the process of the practice,and the relationship be-tween the help-seekers and the helpers reflect substantial humanistic connotation and are bound up with cultural and subcultural transmission and reality context.This paper is a commentary on the article written by an Indonesian fel-low T.Citraningtyas discussing the mother's role in the matriarchal society and its modern meanings.We discussed that the phenomenon of being cultural extinctionalso presents in China.Although the main stream in Chinese cul-ture is still patriarchic familism,the remainder of matriarchal society still exists in the basic emotional models of parent-child relationship.The deprivation and frustration related with filial piety and kinship may cause the conse-quence of cultural extinctionin the individual level.Referring the theory of Wen-Shing Tseng on the mechanisms of the cultural influence on psychopathology,from the perspective of understanding psychology,we emphasized the importance of cultural empathy and recommended the systemic clinical thinking way of empathic considering and contextualizing.Last but not least,we discussed the second case of the overseas migrant workers and their left-at-home childrenin this article within Chinese context.Moreover,besides the 61 million left-at-home children in rural areas,there are a large amount of substitute-raised children by their grandparents who might be also in the risk of being impaired physically and psychologically.This problematic phenomenon may relate to the living stress and the cultural encouragement as well.By providing a critique discussion with the related theories of correlation of the in-secure attachment with psychological disorders in childhood and adulthood,this commentary encouraged humble learning from our Indonesian fellows and appealed for greater appreciation of separate mothers and their children a-mong Chinese clinicians.

Objective To evaluate the clinical value and safety of radiotherapy combined with tyrosine kinase inhibitors (TKI) in non-small cell lung cancer (NSCLC) with brain metastasis driven by epidermal growth factor receptor (EGFR) mutation.Methods A retrospective cohort of 21 non-small cell lung cancer (NSCLC) patients with EGFR mutation-driven brain metastasis was recruited.10 patients (treatment group) were randomly selected for radiotherapy combined with TKI treatment,and 11 patients (control group) were treated with radiotherapy.Tumor size was measured and clinical efficacy was evaluated by MRI in the four weeks after radiotherapy.Since then,a clinical response was evaluated every three months until disease progression,and the median overall survival time was calculated.Results The objective remission was 8 cases in treatment group and 4 cases in control group.The disease control was 9 cases in treatment group and 8 cases in control group.The median overall survival time of treatment and control groups was 11.2 months and 6.4 months,respectively.Adverse reactions in treatment group mainly contained nausea,diarrhea and rash,which all were tolerated.Conclusion Radiotherapy combined with TKI is superior to radiotherapy alone in effect and safety for treatment of NSCLC with EGFR mutation-driven brain metastasis.

〔Abstract〕 The paper introduces the definition of mobile health care app , sorts out the research status of mobile health care App from aspects such as classification , contents and quality , supervision , standards and requirements and problems such as low quality , lack of supervision, unsafe data and indefinite definitions , and proposes suggestions from the angle of developers , users, markets, etc.