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.

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.

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 80th American Diabetes Association(ADA)Scientific Sessions was held online from June 12 to 16, 2020. There was some hot debates on the topics of diabetes related complications in the annual meeting of ADA. Endocrinologists and cardiologists debated and presented different perspectives. This paper will summarize the debates on the following five topics: (1)Microvascular and macrovascular complications of diabetes are distinct pathophysiologic entities.(2)Guideline recommendations for cardiovascular risk and disease management in type 2 diabetes.(3)Drawing the line between primary and secondary prevention—necessary or too simplistic? (4)Should metformin be considered first-line therapy for individuals with type 2 diabetes with established arteriosclerotic cardiovascular disease(ASCVD)or at high risk for ASCVD? (5)Primary cardiovascular prevention with sodium-glucose co-transporter 2(SGLT2)inhibitors or glucagon-like peptide-1(GLP-1)receptor agonists.

Objective: To investigate the correlation between the microsatellite polymorphisms in ob gene 3′ flanking region with obesity in Chinese Han ethnicity in Shanghai. Methods: The genotypes of polymorphisms in A gene 3′ flanking region were determined by PCR in 232 Chinese Han subjects (including 130 obese patients and 102 normal controls). The clinical data, including height, weight, waist circumference, hip circumference, body mass index, waist-to hip ratio (WHR), blood glucose, serum insulin, blood lipidsland uric acid, were compared between the 2 groups. Results: No significant difference of genotype frequency (I/I 0.115, I/ II 0.331, II/II 0.554 vs I/I 0.059, I/II 0.333, II/II 0.608) and allele frequency (I 0.281, II 0.719 vs I 0.225, II 0.775) of A gene 3′flanking region was observed between the 2 groups. In obese group, patients with I + II genotype was associated with increased WHR compared with those with II/II genotype (0.91±0.05 vs 0.86 ± 0.03, P=0.047). Logistic regression analysis showed that WHR was independently correlated with A gene polymorphisms (P=0.042). Conclusion: Polymorphisms in ob gene 3′ flanking region are correlated with central obesity in obese patients of Chinese Han ethnicity in Shanghai.

Objective To explore the protective effect and mechanism of ligustrazine against ischemia-reperfusion injury of retina from neonatal rats.Methods Thirty-two neonatal rats were randomly divided into normal,model,solvent control and ligustrazine treatment group.Experimental model of retinal ischemia-reperfusion injury was established by increasing intraocular pressure through intracameral infusion.In the ligustrazine treatment group,ligustrazine was given by intraperitoneal injecting before 30 min ischmia and after reperfusion 2 hours,10 mg/kg.In the solvent control group,the same voluminal solvent(isotonic Na chloride)was given by the same way before 30 min ischmia and after reperfusion 2 hours.The neonatal rats were executed by aeroembolism after reperfusion 6 hours.The content of malon dialdehyde(MDA) and the superoxide dismutase(SOD) activity were measured by spectrophotometer.Results 1.The content of MDA in model group was significantly higher than that in normal group(t=4.80 P0.05).The SOD activity in model group was significantly lower than that of normal group(t=4.58 P0.05).Conclusion Ligustrazine can protect experimental retinal from ischemia-reperfused injury by increasing SOD activity and decreasing the content of MDA in neonatal rats.

Objective:To investigate the correlation between the microsatellite polymorphisms in ob gene 3′flanking region with obesity in Chinese Han ethnicity in Shanghai.Methods: The genotypes of polymorphisms in ob gene 3′flanking region were determined by PCR in 232 Chinese Han subjects(including 130 obese patients and 102 normal controls).The clinical data,including height,weight,waist circumference,hip circumference,body mass index,waist-to hip ratio(WHR),blood glucose,serum insulin,blood lipids,and uric acid,were compared between the 2 groups.Results: No significant difference of genotype frequency(Ⅰ/Ⅰ 0.115,Ⅰ/Ⅱ 0.331,Ⅱ/Ⅱ 0.554 vs Ⅰ/Ⅰ 0.059,Ⅰ/Ⅱ 0.333,Ⅱ/Ⅱ 0.608) and allele frequency(Ⅰ 0.281,Ⅱ 0.719 vs Ⅰ 0.225,Ⅱ 0.775) of ob gene 3′flanking region was observed between the 2 groups.In obese group,patients with Ⅰ+Ⅱ genotype was associated with increased WHR compared with those with Ⅱ/Ⅱ genotype(0.91?0.05 vs 0.86?0.03,P=0.047).Logistic regression analysis showed that WHR was independently correlated with ob gene polymorphisms(P=0.042).Conclusion: Polymorphisms in ob gene 3′ flanking region are correlated with central obesity in obese patients of Chinese Han ethnicity in Shanghai.

Objective To study the induction and detection methods of Staphylococcus aureus viable but non-culturable state (VBNC).Methods Staphylococcus aureus (ATCC13565) of 107 cfu/ml was induced by low temperature at 4 ℃,freezing at-20 ℃ and adding copper ions from 0.01 mmol/L to 0.05 mmol/L,Staphylococcus aureus was tested,and explored the resuscitation conditions by stepwise heating-heating and chemokinesis.Results Frozen 72 h at the temperature of-20 ℃ or added 0.015 mmol/L Cu2+ for 4 days of culture could induce staphylococcus aureus into the state of VBNC.Adding 0.5% tween-20 or 1% catalase for 24 h of culture could make the strain in VBNC achieve recovery.Conclusion Staphylococcus aureus can be induced into the VBNC and the recovered Staphylococcus aureus is the same as the normal bacteria in colony morphology and physiological and biochemical response in the common test medium.

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.

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.