Vasovagal syncope is the most common cause of syncope in children. Its pathogenesis is related to hemodynamics, vasodilation, cerebral blood flow abnormalities, nerve and changes in humoral factors. Body iron deficiency also cause these changes. This paper summarizes the intrinsic link between serum iron deficiency and these changes.

Multiple myeloma(MM) was the second malignant hematological disease in many countries. There had continuing change in diagnostic criteria in MM, along with the more treatment methods and the understand of this disease. From 1975 to 2013, the change of diagnostic criteria experienced three stages. Firstly, we emphasized the numerical value in 1975, secondly, we emphasized the clonal characteristics of plasma cell and wakened the numerical value because of the FACS and immunofixation widespreadly used, thirdly, we emphasized the number again because of the differentiation of primary amyloidosis. Along with these changes, the target population had changed also, 20%patients cannot be diagonsed if using criteria of 1975, and some asymptomatic MM may be diag-nosed with MM in the future.

The research articles related to the doctor-patient relationship (DPR) from 1984 to 2013 were retrieved from the China National Knowledge Infrastructure (CNKI) database.By analy zing the developmental stage of such studies,the paper sources,citations,the citation and the funding,we found that the design and the methodology of past studies on the DPR were deficiency.The researchers with different academic backgrounds are needed to develop the sociological theory on the DPR in China.Finally,some suggestions on how to deepen our understanding on the DPR were posted.

The detection of sperm DNA damage, as an important supplement to semen routine examination strategies, has been applied in some clinical andrology laboratories. What factors may lead to sperm DNA damage remains one of the concerns among many andrologists. Present studies show a variety of factors of sperm DNA damage, including age, environmental pollutants such as organophosphorus and organochloride pesticides, plasticizer, heavy metals such as lead, carcinogens such as polycyclic aromatic hydrocarbons (c-PAHs) and zearalenone (ZEA), male reproductive system diseases or systemic diseases such as varicocele, infection, tumor, spermatogenesis and maturation dysfunction, spinal cord injury and endocrine disorders, seasons and temperature, lifestyle, abstinence time, semen refrigeration, semen handling in vitro, and certain medications. Among them, spermatogenesis and sperm maturation dysfunction may be the most secretive factors, which are involved in the molecular mechanisms of sperm chromatin packaging and restructuring, such as the transformation of histone to protamine, single nucleotide polymorphism of genes, and the role of telomere, which may be one of the hotspots in the future studies of sperm DNA damage. Relevant researches in the future are expected to focus on the prevention of sperm DNA damage and clarification of its specific pathogenic mechanisms so as to provide some evidence for its treatment.
Age Factors ; Chromatin ; chemistry ; DNA Damage ; Environmental Pollutants ; toxicity ; Humans ; Male ; Protamines ; Semen ; drug effects ; Specimen Handling ; Spermatogenesis ; Spermatozoa ; drug effects ; Telomere ; physiology ; Varicocele ; complications

Comparative proteomies is to compare the differential expression of overall protein profiles in different time and space,to identify differential proteins or protein groups on the expression amount,expression level,and modification status and to further investigate the differential proteins and their function.The aim of this paper is to introduce the application of comparative proteomies in coloreetal carcinoma on the level of cell,tissue,and body fluid.

ObjectiveTo compare the sensitivity among three diagnostic criteria for multiple myeloma.MethodsA total of 220 patients with multiple myeloma were studied retrospectively to compare thesensitivity, aswellastheirclinicalmanifestations, cellmorphologyinbonemarrowand immunophenotype.Results (1) The sensitivity of domestic diagnostic criterion in 1975 was 79.1％ (174/220) and there were some drawbacks in type identify.The sensitivity of WHO diagnostic criterion in 2001 was 97.3％ (214/220) and the sensitivity of domestic diagnostic criteria in 2011 was 100％. (2) Immunoglobulin level in 12.7％ (28/220) patients was ＜ 30 g/L,plasma cells count in bone marrow in 13.6％ (30/220) was ＜ 10％ ; 2.7％ (6/220) patients had not met the standard in immunity globulin and bone marrow plasma cells count.(3) The immunophenotype was CD38 positive ( 100％ ),restricted light chain (kappa/lambda) and CD19 100％,CD138 (98.2％,216/220) negative.ConclusionsAmong the three diagnostic criteria,the highest was 2011 domestic diagnostic criteria.Comprehensive analysis include clinical manifestations,cell morphology,immunophenotype will contribute to the diagnosis for multiple myeloma.

A new round of public hospital reform demands higher requirement of public welfare and average medical expenditure control per visit.This paper introduced the practice of controlling the average medical expenditure per visit,and explored the control outcomes of the average medical expenditure per visit at the public hospitals.The measures proposed include supervision of key indexes,multi-angle control strategies formulation,multi-aspect effective pathway implementation,information feedback system improvement and high-cost medical consumables control.

Objective To investigate the association of Lys656Asn polymorphism in leptin receptor gene with serum triglyceride level.Methods The genotypes of Lys656Asn polymorphism in LepR gene were maped by polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP) assay in 232 unrelated subjects of Shanghai Chinese population.The clinical data were also analyzed.Results No significant difference of genotype frequency of Lys656Asn polymorphism in LepR gene was observed between obese and non-obese groups.In obese group,"G" Allele was associated with increased triglyceride level(1.74?0.91 vs 0.95?0.32)(P

Diagnostics is the bridge from basic medicine to clinical medicine.For the students contacting the clinic for the first time,we take measures to cultivate the consciousness of showing love to patients and dedicating yourself to work.It is beneficial to cultivate the students'ability in clinical practice.

Objective To evaluate the efficacy and safety of TACE combined with Apatinib versus TACE monothcrapy in the treatment of advanced hepatocellular carcinoma (HCC).Methods A total of 44 patients with advanced HCC were enrolled and divided randomly into group A (n=22) and group B (n=22).The patients in group A were treated with TACE monotherapy while group B were treated with TACE combined with Apatinib.The serum alpha fetoprotein (AFP) levels were compared between the two groups three months after treatment.The objective response rate (ORR) after 3,6,9 and 12 months,the progression-free survival (PFS) and incidence of adverse reactions were also compared.Results The serum AFP levels decreased apparently in two groups three months after treatment,and statistic differences were observed in each group (Z=-2.289,-2.953,both P ＜0.05),while no statistic differences was obtained between the two groups after treatment (Z=-0.126,P＞0.05).No statistic differences were found in ORR between the two groups 3 and 6 months after treatment (both P ＞0.05),while statistic differences were manifested after 9 and 12 months (both P ＜0.05).The medium PFS in group A significantly lower than that in group B (x2 =6.576,P=0.01).The apatinib-related adverse reactions including hypertension,hand-foot syndrome and proteinuria in group B were higher than those in group A,and statistically significant difference were obtained (allP＜0.05).The adverse reactions were relieved after symptomatic treatment.Conclusion TACE combined with apatinib may improve the mid-long term efficacy in patients with advanced HCC.And the relatively safety of TACE combined with apatinib is confirmed.