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 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.

With the aggravation of population aging and the change of social convention,especially after the introduction of two-children policy,some families wish to have two children can not be achieved due to various reasons.Therefore,they use assisted reproductive technology to achieve fertility aspirations.Surrogate is a controversial topic in the assisted reproductive technology,the contradictions between the normal reproductive rights of the infertile woman and the women who have lost their children but passed the age of childbearing and the bad ethical consequences and rights disputes of surrogacy.How to avoid the bad ethical consequences and meet the demand of reasonable surrogate is the major issue worthy to be discussed.

Objective To detect exon deletions/duplications in the DMD gene in Duchenne and Becker muscular dystrophy pedigrees using multiplex ligation-dependent probe amplification method,and explore the usefulness of multiplex ligation-dependent probe amplification analysis as a method for genetic diagnostics in patients with Duchenne and Becker muscular dystrophy.Methods Exon deletions/duplications in the DMD gene were analyzed by multiplex ligation-dependent probe amplification for two pedigrees with Duchenne muscular dystrophy and Becker muscular dystrophy.Patients and carriers were diagnosed by multiplex ligation-dependent probe amplification.Results The pedigree with Duchenne muscular dystrophy was caused by DelEx45-50 mutation,while the pedigree with Becker muscular dystrophy was caused by Dup Ex3-4 mutation.Patients and carriers were diagnosed by multiplex ligation-dependent probe amplification method.Conclusion Exon deletions/duplications in the DMD gene can be indicated by probe copies using multiplex ligation-dependent probe amplification method under standard operating procedure.Multiplex ligation-dependent probe amplification should be considered as a rapid and accurate clinical method for an initial mutation analysis of DMD gene with exon deletions/duplications.

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.

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.

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.

Objective Understanding current situation of pharmaceutical service before and since the ongoing health reform in community health institutions of China,and providing practical evidences to the government.Methods Adopting some indicators to comparative study the pharmaceutical care in 2008 and 201 1 in community health service institutions of China.Results From 2008 to 201 1, pharmaceutical service quality in general has greatly improved in community health institutions of China. For example,average number of drugs per prescription descended from 2.5 1 to 2.23.Percentage of prescriptions with an antibiotic descended from 43.98 to 32.08.Percentage of prescriptions with a hormone descended from 7.13 to 4.67.Percentage of prescriptions with two or more antibiotics descended from 1 1.24 to 7.31.These four indicators before and since the reform have statistical significance (P values are:0.003,0.001,0.003,0.004 respectively).But there are still inadequacies:from 2008 to 201 1,the average prescription cost descended from 59.63 to 5 1.18 yuan.Percentage of prescriptions with an IV drip descended from 34.84 to 30.41.These two indicators have not statistical significance(P values are 0.182,0.236 ).Conclusion To improve the quality of pharmaceutical service in community health institutions,the government should increase financial input to the community health institutions.

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.

Unregistered drug use,also called off-label drug use,has become a universal phenomenon in clinical practice worldwide.At present,there is still no definite laws and regulations in the field of off-label medication in China.The article gives an overview about the current criterion for prescription in China,the definition of off-label use,analysis of this situation and causes,how to regulate this practice to protect the patient's rights and safety,and also doctor's rights of prescription.