Introduction: Gout is one of the most common inflammatory arthritis in Malaysia. It is due to persistent hyperuricemia that leads to the formation and deposition of intra- and periarticular monosodium urate crystals either due to excessive production or insufficient excretion of uric acid. Incidence and prevalence of gout is increasing worldwide, with a higher rate among men compared to women. Malay is the largest ethnic group in Malaysia, followed by Chinese and Indian. SLC2A9 is a renal urate transporter that controls renal uric acid excretion and genetic variants in SLC2A9 are associated with the risk of gout in several populations. This study aimed to test if the SLC2A9 variant (R265H, rs3733591) is also associated with gout among Malays in Malaysia. Methodology: A total of 89 patients with gouty arthritis and 100 normal subjects who consented and were recruited in this study. The serum urate and creatinine were measured. The SNP genotyping was performed using PCR-RFLP method for rs3733591 and BST 1236 was used as a restriction enzyme to cut the targeted amplicons. Result: SLC2A9 variant was associated with gout, p-value of 0.007, OR=4.713 [95%CI 1.530-14.513], however this association was not significant after adjustment for age and gender with p=0.465 (OR=1.950; 95%CI[0.325-11.718]). Conclusion: Our data suggest that the genetic variant of SLC2A9 may contribute to the susceptibility of gout among Malays in Malaysia.

BACKGROUND:Different fixtures can be used for the internal fixation treatment of patients with posterior ankle fractures in clinic, however, different internal fixation methods wil produce different biomechanical effect. OBJECTIVE:To compare and analyze the biomechanical properties of mini steel plate internal fixation and tension screw internal fixation in the treatment of posterior ankle fracture. METHODS:The clinical data of 95 patients with posterior ankle fractures were retrospectively analyzed. Al patients were treated with internal fixation. Mini steel plate group (n=48 cases) and tension screw group (n=47 cases) were divided according to the internal fixation methods. RESULTS AND CONCLUSION:The fixation effect of these two groups was simulated and analyzed using three-dimensional finite element model. The results showed that when the posterior ankle joint fracture block spreaded to the distal tibial articular surface of more than 25%, the mean pressure of internal fixation failure of tension screw group was significantly less than that of the mini steel plate group (P<0.05). When the posterior ankle joint fracture block spreaded to the distal tibial articular surface of 25%or less, the mean pressures of internal fixation failure of tension screw group was significantly greater than that of the mini steel plate group (P<0.05). The excel ent and good rate of ankle joint internal fixation of tension screw group was significantly higher than that of the mini steel plate group (P<0.05). In these two groups, there were no internal fixation material related adverse events during the treatment. These results demonstrate that the clinical effect of tension screw internal fixation for the treatment of posterior ankle fractures was better than that of the mini steel plate internal fixation, but the use of mini steel plate for internal fixation was more appropriate when the posterior ankle joint fracture block spreaded to the distal tibial articular surface of more than 25%.

Digestive endoscopic diagnosis and treatment technology in the development of ethical issues are :the expansion of endoscopic treatment indications , violation of patient choice;Health care costs increase , the pa-tient cannot enjoy medical equality;Staff is uneven , the patient can′t enjoy the fair medical treatment;Paternalistic doctor-patient relationship , ignore the patient′s autonomy and so on .Puts forward some Suggestions to solve these problems:people-oriented , fully respect patients option;Standard medical behavior , advocates the equal medical treatment;Standardized training for everyone to enjoy fair medical treatment;Build the good doctor -patient rela-tionship , respect the autonomy of patients .

ObjectiveTo observe the effect of pus-draining and bloodletting with sharp-hook needle in repairing the skin lesions in acne vulgaris of nodules type.MethodTwenty pairs of skin lesions caused by acne vulgaris of nodules type were divided into a treatment group and a control group. The treatment group was intervened by pus-draining and bloodletting with sharp-hook needle, while the control group was by pus-draining with sharp-hook needle. Two facial skin lesions of same size were selected from each patient to respectively receive pus-draining and bloodletting with sharp-hook needle or pus-drainage alone. The changes of lesion size and hardness in a week were observed and compared.ResultThe reducing of lesion size was more significant in the treatment group than that in the control group (P<0.05), and the improvement of hardness of the lesions in the treatment group was also more significant in the treatment group than that in the control group (P<0.05).ConclusionPus-draining and bloodletting with sharp-hook needle can produce amore significant effect in repairing skin lesions in acne vulgaris than pus-draining alone.

Objective To explore the effect of mifepristone on the application of bleeding after abortion . Methods 64 cases of portal diagnostic case ,all of the artificial vaginal bleeding profusely not more than ten days ,B ultrasound examination of the uterine cavity was normal or low echo is less than 10mm ×10mm,were randomly divided into treatment group and control group ,each of 32 cases.The treatment group oral mifepristone 25mg,every day two times,and with oral roxithromycin ,motherwort capsule ,for five days .The control group oral roxithromycin ,motherwort Gongxuening Capsule and ,for five days.Results The treatment group after five days of vaginal bleeding need again clear palace number(1 cases)was less than that of the control group (12 cases),group of uterine bleeding quantity in-creased treatment in the course of treatment (0 cases) was significantly lower than that of the control group (5 cases). The treatment group again curettage rate (3.1%) was significantly lower than that of the control group (37.5%),the difference was statistically significant effect of the two groups (χ2 =11.68,P<0.05).Conclusion The efficacy of mifepristone in the treatment of bleeding after abortion ,reduced the incidence of Qing Dynasty palace again ,reduce the patient′s physical and psychological harm , but also to avoid the unnecessary disputes , is worth the clinical promotion.

Objective: To observe the clinical efficacy of treating cervical spondylosis with combined acupuncture and cupping therapies. Method: The patients in the treatment group (30 cases) were treated with combined acupuncture and cupping therapies; and the patients in the control group (30 cases) were treated with acupuncture therapy alone. Then the clinical efficacy was observed after 30 days of treatment. Result: The χ2 test showed that there was significant difference (P＜0.01) between the two groups in recovery rate, total effective rate, relapse rate after six months, and average treatment course. Conclusion: Combined acupuncture and cupping therapies is a better therapy for cervical spondylosis with a shorter treatment course and low relapse rate.

Gastrointestinal tract is the most common involved site of primary extranodal non-Hodgkin lymphoma (NHL).Compared with intranodal NHL,treatment of primary gastrointestinal tract NHL is different.Combinational chemotherapy is the best choice for diffuse lesion.Surgery is used to control the local lesion,and is important in the control of the complications of GI tract.Radiation therapy is used to eliminate the remaining lesions and control serious local lesion.H.pylori eradication should be used for those who had H.pylori infection.Here we reviewed recent progress of treatment in PGI-NHL.

Objective To discuss changes and curative effect of serum interleukin-2 and 6 and tumor necrosis factor-α (TNF-α) of burning mouth syndrome (BMS) patients before and after medical treatment.Methods 50 cases of BMS patients were selected as case group,and who were given Clonazepam tablets (2mg) and Fluoxetine capsules (20 mg) one time daily for 4 weeks.Observe and compare the changes of serum IL-2 and 6,and TNF-αof patients in two groups before and after 4 weeks' medical treatment,and proceeded with the clinical curative effect observation.Moreover,30 cases of healthy subjects who just took the physical examination in medical examination center(MEC) at that moment was the control group.Results The serum IL-2 and IL-6,and TNF-αlevels of patients in case group before medical treatment was obviously higher than those in control group (t =4.31,2.97,3.84,all P ＜0.01).After 4 weeks' medical treatment,serum IL-2 and IL-6,and TNF-αlevels of patients had obviously declined than before (t =2.88,2.34,3.21,P ＜ 0.05 or P ＜ 0.01).After 4 weeks' medical treatment,there were 6 cured cases,14 cases with significant effect,and 24 cases with curative effect,and the total clinical efficiency reaches 88.0％ (44/50).Conclusion BMS patients have abnormal elevation of serum IL-2 and 6,and TNF-α,which may be the sensitive serological indicators of the early diagnosis of BMS.The changes of serum IL-2 and IL-6,and TNF-α levels may be the index of follow-up curative effect and prognosis observation.

Objective To observe the intrapartum analgesic effect of Doula GT-4a pulse acting working station and the influence of it on labor and mother-to-child. Methods The observation group use intrapartum analgesia of 98 primigravida,and the control group was other 98 primigravida without intrapartum analgesia in the same delivery period. Two groups of gravidas were delivering by a high qualification of midwife while your cervix expand for 2 ～3cm. The observation group was given with GT-4a pulse acting working station. Results The analgesia VAS scores of the observation group,significantly different with that of the control group:The first stage of labor active period accelerated significantly,the second stage of labor was shortened. The cesarean section rate,the vaginal birth rate and the neonatal mild choking rate significantly declined compared with the control group. Though there were no statistical differences between two groups with the third stage of labor, postpartum hemorrhage, and neonatal severe choking rate.Conclusion The andlgesie effect of doula combined with GT-4 pulse theraphy for labor was good. It reduced cesarean section rate, improved maternity quality and had no adverse effects.