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.

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 study the enlightenments of precision medicine, personalized medicine, stratified medi-cine, individualized medicine, P4 medicine on the medical cause in China. Methods Core papers on precision medicine, personalized medicine, stratified medicine, individualized medicine, and P4 medicine were retrieved from SCI core collection and PubMed. The concepts of precision medicine, personalized medicine, stratified medi-cine, individualized medicine, P4 medicine were analyzed by the VOSviewer. Results The concept of personalized medicine and individualized medicine can be used alternatively and is a coverage concept. The concept of stratified medicine and precision medicine is similar and is an inclusive concept. P4 medicine is a participatory medical model for patients. Tumor, chemotherapy, cells, diabetes mellitus, pharmacogenomics, and variants are the hot spots in precision medicine. Tumor, genomics, and public policy have a tendency to be integrated. Conclusion The develop-ment of precision medicine in China needs the design at the national top level, scientific policy-making, integration of scientific research system and resources, implementation of step by step strategy, overcoming of medical difficul-ties in order to realize personalized medicine at last.

The p53 gene is one of the most common targets for genetic abnormalities in human tumors. Restoring wild - type p53 gene (wt-p53) into cancer cells which have p53 deletion is a strategy in cancer gene therapy. In order to explore the feasibility of this hypothesis, we selected a gastric cancer cell line BGC823 which was confirmed having deletion of chromosome 17pl3 and decreased expression level of p53 mRNA . We transfected construct pC53SN3 containing wt - p53 into BGC823 cell line with lipofectin mediated gene transferration, and G418 resistant colonies were characterized by using analysis of PCR, Southern blot hybridization, Northern blot hybridization and Western blot hybridization. These data showed that exogenous wt-p53 had successfully transferred into BGC823 cells and obtained high expression. The cell growth rates in regular medium and soft agar were inhibited from 30 to 40 percent in the BGC823 cells transfected with wt - p53. The tumorigenicity in nude mice showed that one of four mice failed to form tumor and three of them delayed to form tumor from 7 to 14 days comparing with monk and parent BGC823 cells. These results suggested that exogenous wt -p53 could suppress the growth ability and tumorigenicity of human gastric cancer cells. The method of using lipofectin mediated wt-p53 gene transfection may have a potentially therapeutic effect on human gastric cancer.

The effects of compound oral fish oil preparation on the increase of intelligence were studied. Step-down test, normobaric hypoxia test and loaded swimming test in mice were used. The results indicated that during the administration period (15 d and 30 d), the oral preparation containing fish oil 3. 6 g/kg and 7. 2 g/kg increased both learning and memory abilities, promoted the tolerance of normal mice to hypoxia as well as swimming fatigue.

Objective To investigate the role of sex hormones and interleukin (IL)-6 in the pathogenesis of primary Sjgren′s syndrome (pSS). Methods Serum specimen of 21 postmenopausal patients with pSS and 21 postmenopausal healthy women were collected. Serum estradiol (E2) and testosterone (Te) were estimated by the commercial radioimmunoassay kits, whereas serum dehydroepiandrosterone sulfate (DHEAS) were measured by enzyme-amplified chemiluminescence assay. Enzyme linked immunosorbent assay kits were used to determine levels of IL-6 in serum. Results The DHEAS and the Te level in serum were lower in postmenopausal patients with pSS than in healthy controls (P0.05). The level of IL-6 in pSS patients was higher than that in controls (P0.05). Conclusion Primary Sj(?)gren′s syndrome, in which an altered metabolism of sex hormones has occured, appears to be influenced by the change of the levels of sex hormones and IL-6 in serum.

OBJECTIVE:To evaluate economic effectiveness of 3 kinds of antimicrobial drugs for acute lithiasic cholecystitis,and to provide reference for rational use of antimicrobial drugs in biliary disease surgery.METHODS:A multicenter prospective randomized controlled study was conducted in 493 clinical cases of acute lithiasic cholecystitis.Cost-effectiveness analysis of cefoperazone/sulbactam sodium(therapy A n=180),cefuroxime(therapy B n=148) and levofloxacin(therapy C n=165) for acute lithiasic cholecystitis were carried out.RESULTS:Effective rates of three kinds of therapeutic regimens 95.56%,73.65%,84.24%,respectively.CONCLUSION:Incremental cost-effectiveness analysis of three kinds of therapeutic regimens shows therapy A is economical and the best choice for acute lithiasic cholecystitis compared with group B and C.

The purpose of the medical moral education is to make medical undergraduates form stable feature of the medical moral education psychology.While the traditional medical moral education has not been achieving the aim.Many studies of psychology has presented that it is important for study,training and medical moral of medical undergraduates by using implicit learning.In order to achieve the aim and ensure the result of medical moral education.we should take advantage of implicit learning to develop the medical moral education.

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.