Objective To discuss the etiology,clinical features,diagnosis and treatment measures of female pseudohermaphroditism.Methods Five Cases,of female pseudohermaphroditism were collected.The etiology,clinical features,diagnosis and treatment measures were discussed.Results One case induced by exogenous androgenic hormones,4 cases induced by congenital adrenal hyperplasia.All the 5 cases presented with abnormal development of vulva and the sex chromosomes karyotype of 46XX.The combined treatment ofreconstructive surgery (5 cases)and supplementary glucocorticoid (4 cases)wefe performed.After 3months,the levels of adrenocorticotrophic hormone and virosterone were normal.Followed up for 1-10 years,The postoperative appearance of external genitalia was similar to the normal.The secondary sex characters were improved obviously,3 cases were mainly feminilism,2 cases existed different degree of psychologic obstacle.Conclusions The diagnosis and treatment in the early stage are very important.The combination treatment of surgery and medicine for the patients with female pseudohermaphroditism is satisfied.

A novel PCR-based mutagenesis method was reported, in which there is no need to purify megaprimers or design a special flanking primer. This method used one mutagenic primer and two sequencing primers (T_m≤58℃) as flanking primers. After first round PCR, 12.5 μl first PCR production was directly added into 50 μl second PCR system as template and megaprimer, and 10 rounds of asymmetrical PCR at high temperature of annealing (68 ℃ ) was to add in initiation of second PCR. This additional step greatly has increased the efficiency of mutagenesis via 600 bp or 800 bp long megaprimer. The results demonstrated that this method can achieve high fidelity, 97%～ 98% efficiency, high yield.

Objective:The regulatory mechanisms of LCRG1 gene expression is undear,this study was to investigate the transcription regulation of the promoter of human LCRG1 gene by transcription factors Sp1 and Egr-1.Methods:Analysis of putative binding sites of transcription factors in the promoter of human LCRG1 gene by online program MatInspector,Co-transfection with the expression plasmids of the known transcription factors such as Sp1、wtEgr-1、mtEgr-1with the LCRG1 reporter construct analyze potent transcription factor for enhancement of the promoter activity.Results:SP1 and Egr-1 transcription factor binding site sites were predicted in the region by bioinformatics analysis,mtEgr-1 can enhance the promoter activity.Conclusion:mtEgr-1 may be involved in the regulatory mechanisms of LCRG1 gene expression

OBJECTIVE:To explore the ward round model of clinical pharmacists.METHODS:The ward round model of clinical pharmacists was designed and explored based on clinical practice.RESULTS & CONCLUSION:Clinical pharmacists can engage in ward rounds either in cooperation with physicians or alone in special department,or by targeting at those patients using certain drugs.Each model has its distinctive characteristics and clinical pharmacists can choose suitable model based on their own level as well as the conditions in software,hardware and environment so as to facilitate rational administration.

Objective To investigate serum T_3? T_4? TSH alterations after hemithyroidectomy in patients suffering from thyroid benign nodules.Methods Forty-eight patients were divided into two groups by age of 45.All patients were treated with hemithyroidectomy and without substitutional therapy after operation.The levels of serum TT_3? TT_4? FT_3? FT_4? TSH were assessed on day 5, first month, 3rd month, 6th month and one year after operation and compared with pre-operative levels.Results The change of serum T_3? T_4 was not significant; while the levels of serum FT_3? FT_4 in patients over 45 years decreased on day 5 post-op and on the first month ( F=7.853, F=4.247, P

OBJECTIVE To study incidence of metallo-beta-lactamase(MBL)-producing Pseudomonas aeruginosa and their drug sensitivity.METHODS A total of 323 isolates of P.aeruginosa from Nanshan District of Shenzhen between Jun 2007 and Jun 2008 were subjected to susceptibility testing against various antibiotics and identified by ATB-Expression.Imipenem and meropenem resistant isolates were selected for the detection of MBL production by disc synergia test.Enhancement of inhibition zone around imipenem and meropenem discs impregnated with EDTA was found to confirme MBL production.RESULTS Totally 323 P.aeruginosa were isolated and MBL-producing accounted for 46(14.3%),drug resistance rate to imipenem and meropenem was respectively 45.4% and 26.3%.Colistin was the most sensitive to P.aeruginosa(96.9%).CONCLUSIONS Our findings show it needs to detect MBL producers,judiciously use carbapenems to prevent their spread.

Objective:To observe the clinical efficacy of skin needling plus heat-sensitive moxibustion in treating chronic facial paralysis. Methods:Sixty patients with chronic facial paralysis were divided into an observation group and an acupuncture group by using the random number table, 30 in each group. Patients in the observation group were given skin needling plus heat-sensitive moxibustion; while patients in the acupuncture group were given conventional acupuncture. Results:Three treatment courses later, the total effective rate was 93.3% in the observation group versus 86.7% in the control group, and the difference was statistically significant (P<0.05). Conclusion:Skin needling plus heat-sensitive moxibustion can produce a more significant efficacy than conventional acupuncture in treating chronic facial paralysis.

Objective To observe the clinical efficacy of fire acupuncture plus herbal medicine in treating acute gouty arthritis. Method Eighty-nine patients with acute gouty arthritis were randomized into a treatment group of 45 cases and a control group of 44 cases. The treatment group was intervened by fire acupuncture plus orally taking herbal medicine, while the control group was by oral administration of Diclofenac sodium and Allopurinol. The average pain score was observed before and after intervention, and the clinical efficacies were compared between the two groups.Result The total effective rate was 95.6% in the treatment group versus 81.8% in the control group, and the difference was statistically significant (P<0.05). The average pain score was significantly changed in both groups after intervention (P<0.01). After treatment, there was a significant difference in comparing the average pain score between the two groups (P<0.05).Conclusion Fire acupuncture plus herbal medicine is an effective approach in treating acute gouty arthritis.

Objective To investigate the characteristics and risk factors of abdominal lymph node metastasis in thoracic esophageal squamous cell cancer.Methods The clinical data of 586 patients with thoracic esophageal cancer who underwent surgery via transabdominal and transthoracic approaches between June 2009 and June 2014 at the Sichuan Cancer Hospital were retrospectively analyzed.All the patients received resection of esophageal cancer and lymph node dissection, and the transabdominal right thoracic approach or cervico-thoracicabdominal triple incision was selected according to the condition of patients.No.18, 19, 20 lymph nodes were dissected seperately and No.16, 17 and lesser curvature lymph nodes were separated.All the specimens of lymph nodes were detected by regular pathological examination.Measurement data with normal distribution were presented as x ± s and count data were described as rate.Comparisons of rate between 2 specimens and among the multiple specimens were respectively analyzed using the chi-square test and partition of chi-squared.The multivariate analysis was done using the logistic regression.Results The number of lymph node dissected in 586 patients was 12 524 with an average number of 20 ± 11 per case, and the rate of lymph node metastasis was 55.63％ (326/586).The number of mediastinal lymph node dissected was 7 012 with an average number of 12 ± 5 per case, and a rate of mediastinal lymph node metastasis was 40.96％ (240/586).The number of abdominal lymph node dissected was 5 512 with an average number of 9 ± 8 per case, and a metastasis rate was 31.74％ (186/586).The abdominal lymph node metastasis rate of the upper, middle and lower thoracic esophageal cancer were 13.73％ (14/102), 31.51％ (92/292) and 41.67％ (80/192), respectively, showing a significant difference among the above 3 indexes (x2 =25.91, P ＜ 0.05).The lymph node metastasis rate in No.16, 17, 18,19, 20 and lesser curvature lymph nodes were 12.80％ (75/586), 16.89％ (99/586), 1.71％ (10/586),0.68％ (4/586), 1.71％ (10/586) and 2.05％ (12/586), respectively, with a significant difference among the above 6 indexes (x2 =287.95, P ＜ 0.05).The results of univariate analysis showed that the tumor location,surgical procedure, T stage, N stage, G stage, pathological stage and mediastinal lymph node metastasis were risk factors affecting abdominal lymph node metastasis of thoracic esophageal cancer (x2 =24.02, 23.97, 37.87,136.85, 38.79, 7.70, 154.27, P ＜ 0.05).The tumor in the lower thoracic portion, N3 stage and stage Ⅳ were independent risk factors affecting abdominal lymph node metastasis of thoracic esophageal cancer in the multivariate analysis (RR =5.80, 2.36, 2.76, 95％ confidence interval: 1.022-1.813, 1.317-3.950, 1.652-12.351, P ＜ 0.05).Conclusions Abdominal lymph node metastasis is common in thoracic esophageal cancer in which No.16 and 17 lymph nodes predominate, and it is easy to occur in patients with lower thoracic esophageal cancer, and advanced N stage and pathological type.

The incidence of toxic keratopatby is increasing yearly.Due to the shortage of specific clinical manifestations,the diagnosis and treatment of the disease are relatively difficult,hence toxic keratopathy has received extensive attention of the domestic and abroad scholars.In recent years,with the development of ophthalmic examination technology and progress of instruments,its mechanism,diagnosis and treatment have been newly cognized.These three aspects will be reviewed in this article.