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.

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 .

BACKGROUND:Surgical treatment is mostly adopted in the treatment of III-IV pelvic organ prolapse, in which, the appropriate patch can be used to implement the pelvic floor reconstruction so as to reconstruct the pelvic anatomic relationship and restore the normal pelvic organ function. OBJECTIVE: To verify the efficacy and biocompatibility of the non-absorbable mesh reconstruction of the pelvic floor in III-IV pelvic organ prolapse. METHODS: Totaly 127 female cases of III-IV pelvic organ prolapse were enroled, aged 31-81 years. Of the 127 cases, 65 cases undergoing vaginal hysterectomy and anterior and posterior vaginal wal repair served as control group, another 62 cases undergoing pelvic floor reconstruction using non-absorbable mesh acted as observation group. The two groups were observed in the perioperative period and then folowed up for 12 months. POP-Q measurement, pelvic floor function and adverse reactions were observed in the two groups. RESULTS AND CONCLUSION:The operation time and blood loss in the observation group were less than those in the control group (P < 0.05). After 12 months of folow-up, the results of POP-Q measurement were significantly improved in the both groups compared with the previous (P< 0.05), but there was no difference between the two groups. In addition, pelvic floor static tension, dynamic tension and contraction force were stronger in the observation group than the control group (P < 0.05). In the observation group, there were six cases of mesh corrosion, one case of infection and one case of dysuria. It is indicated that the non-absorbable mesh reconstruction of the pelvic floor can effectively restore the pelvic energy in patients with III-IV pelvic organ prolapse, but there are some adverse reactions such as mesh corrosion.

Objective To investigate the different chemotherapy regimens on bone marrow inhibition and immunity of patients with advanced non small cell lung cancer.Methods Forty-six patients with advanced non-small cell lung cancer were randomly divided into NP group (Changchun vinorelbine plus cisplatin,n =23) and DP group(docetaxel,cisplatin,n =23).The bone marrow suppression and immune function were analyzed before chemotherapy and after 2 cycles chemotherapy.Results The median survival time(MST) in NP group and DP group were 10.3 months and 6.2 months respectively (x2 =2.987,P ＜ 0.005),and 1-year survival rates were 52.17％ and 30.43％ respectively (x2 =2.693,P ＜ 0.005).After chemotherapy,blood platelet number in DP group was (108.87 ± 15.63) x 109/L,lower than that in NP group ((128.17 ± 15.3) x 109/L,t =3.819,P ＜ 0.05).CD3 +,CD4 +,CD8 +,CD4 +/CD8 + and NK cell rate in NP group before chemotherapy were (61.17 ±9.13)％,(36.99±7.83)％,(26.94 ±6.14)％,(1.93 ±0.21)％,(30.12 ±8.62)％ respectively,and (52.82 ±8.19)％,(33.22 ±6.92)％,(23.21 ±5.64)％,(1.53 ±0.11)％,(28.07 ± 8.17)％ after chemotherapy.There were significantly lower than that before chemotherapy significant (t =2.097,3.217,2.251,3.027,2.717;P ＜0.05).CD3+,CD4+,CD8+,CD4+/CD+ 8 and NK in DP group before chemotherapy were (62.82 ±9.13)％,(38.82 ±9.19)％,(27.81 ±7.97)％,(1.82 ±0.13)％,(31.82 ±7.48)％ respectively,higher than that after chemotherapy ((50.76 ±8.19)％,(28.92 ±8.13)％,(20.82±8.93)％,(1.36±0.16)％,(29.12±7.31)％; t =2.347,2.591,3.857,2.438,2.157; P＜ 0.05).Compared with the DP group,CD4 +,CD8 +,CD4 +/CD8 + in NP patients increased significantly (t =2.591,3.785,2.438 ; P ＜ 0.05).CD3 +,NK in two groups were not statistically significant (t =0.027,0.323 ;P ＞ 0.05).Conclusion The less decrease of the immune function was seen in terms of NP chemotherapy compared with DP of patients with advanced non-small cell lung cancer.Therefore,NP chemotherapy is proved to the better chemotherapy regimens.

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 compare the clinical value of automatic coagulometer and automatic biochemistry analyzer for the de-tection of antithrombin Ⅲ(AT-Ⅲ)in acute myocardial infarction and cirrhosis.Methods 55 cases of acute myocardial infarction and cirrhosis patients were investigated in the study,the healthy people was normal control.The concentration of AT-Ⅲwas detec-ted with automatic coagulometer and automatic biochemistry analyzer at the same time.Results The concentration of AT-Ⅲ detec-ted with automatic coagulometer was (251.2±58.5 )mg/L,(228.0 ±22.6)mg/L in acute myocardial infarction and cirrhosis pa-tients,the concentration of AT-Ⅲ detected with automatic biochemistry analysis was (255.6±54.3)mg/L,(230.3±23.1)mg/L in acute myocardial infarction and cirrhosis patients,and the concentration of AT-Ⅲwas significantly lower than that in normal control (P <0.05).The concentration of AT-Ⅲ detected with two detection methods in acute myocardial infarction patients was signifi-cantly lower than that in cirrhosis patients(P <0.05).There were significant difference between automatic coagulometer and auto-matic biochemistry analyzer for the detection of antithrombin Ⅲ(AT-Ⅲ).Conclusion The detection of AT-Ⅲ with automatic coag-ulometer and automatic biochemistry analyzer could diagnose and identify acute myocardial infarction and cirrhosis.

Objective To observe the effects and toxicity of paclitaxel liposome combined with cisplatin in the treatment of ad-vanced non-small cell lung cancer .Methods 80 cases of patients of advanced non-small cell lung cancer were randomly divided into study group and control group ,40 cases in each group .Study group was treated with paclitaxel liposome (135 mg/m2 ,IV drip 3 h , first days) ,control group received paclitaxel(135 mg/m2 ,IV drip 3 h ,first days) ,the two groups combined with cisplatin 75 mg/m2 ,IV drip ,for 3 days ,take 21 days as one cycle .Results The study group CR 0 .0% (0/40) ,PR 27 .5% (11/40) ,RR 27 .5% (11/40);control group CR 0 .0% (0/40) ,PR 25 .0% (10/40) ,PR 25 .0% (10/40) ,(P>0 .05) .The research group of rash ,muscle and joint pain ,peripheral neuropathy was significantly lower than that of the control group (P<0 .05) .The research group of progres-sion-free survival was 5 .3 months(95% CI 3 .713 -6 .408) ,the median survival period was 9 .3 months(95% CI 8 .337 -9 .907);control group of progression-free survival was 4 .6 months(95% CI 3 .187 -5 .547) ,the median survival period was 9 .4 months (95% CI 7 .787-11 .602) ,the two groups had no statistical significance (P>0 .05) .Conclusion Paclitaxel liposome combined with cisplatin in treatment of advanced non-small cell lung cancer clinical efficacy and long-term efficacy of taxol and quite ,but with less allergic reaction .

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.