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.

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.

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.

OBJECTIVE To investigate the genotyping of ?-lactamases and aminoglycoside modifying enzymes on Acinetobacter baumannii isolated in Shaoxing. METHODS Thirty nine strains of A.baumannii were isolated from hospitalized patients,and drug-resistant genes were detected by PCR. RESULTS The detection rates of ?-lactamases coding genes of TEM and OXA-23 groups were 33.3% and 51.3%,The detection rates of aminoglycoside modifying enzymes coding genes of aac(3)-Ⅰ,aac(6′)-Ⅰ and ant(3″)-Ⅰ were 64.1%,64.1% and 74.4%,respectively.The others were not found in all 39 isolates tested. CONCLUSIONS The study showed that it is more serious for A.baumannii carrying ?-lactamases and aminoglycoside modifying enzymes coding genes in Shaoxing.

Elderly acute myeloid leukemia (AML) accounted for 35 % of all AML with the increased incidence year by year, and the median onset age is 67 years old. Generally, AML patients require strong chemotherapy, but older patients often cannot tolerate intense chemotherapy due to the viscera dysfunction. It is still lack of unified treatment clinically. Reports on treatment of elderly AML in the 57th American Society of Hematology (ASH) annual meeting covered multiple fields, in which the traditional induction chemotherapy, demethylation drug alone or in combination with other drugs, and novel drugs were an involved. This article reviewed the latest research on the elderly AML in the 57th ASH annual meeting.

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.

〔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.