With the application of gene editing in medical treatment,food engineering,environmental protection,agriculture and forestry,it gives rise to a wide range of potential social risks.Both the advanced aspects and defects of this technology bring complicated social conflicts.It is undoubtedly crucial to coordinate the conflict of interests of all parties,improve the legal system and avoid the harmfulness and blindness of gene editing.Meanwhile,only that the ethical,legal and social concerns are introduced will govern the technical risk as a necessary condition in order to attain a virtuous cycle of technological improvement and social prosperity.

Objective To analyse clinical characteristics of patients with epilepsy induced by playing Mah-jong.Methods The medical records of 14 epileptic patients who were admitted at the Epilepsy Center of PUMC Hospital chief complaint of Mah-jong induced epileptic seizures from 1996 to 2000 were retrospectively reviewed.Results 12 patients showed generalized tonic-clonic seizures and 2 patients showed partial seizures with secondary generalization. Interictally, normal EEG were found in 13 patients, and one patient was discharged. None patients recept anticonvulsant therapy for preventing seizures. Conclusion Mah-jong induced epilepsy, a reflex epilepsy, is probably related to thinking,spatial task and decision making while playing mah-jong. It is benign, and could be easily prevented by stopping playing Mah-jong.

Objective: To develop a narcissistic personality questionnaire for non-clinical Chinese people. Methods: The questionnaire was developed on the basis of data from open questionnaire, interview and Narcissistic Personality Inventory. Six hundred and twelve participants finished a Narcissism Questionnaire, Self-Esteem Scale, Trait Anxiety Inventory, and Satisfaction with Life Scale. Results: ①An exploratory factor analysis revealed three factors labeled authority, superiority, and selfadmiration; and a confirmatory factor analysis suggested that the goodness-of-fit indexes of this three-factor model was satisfactory; ②Cronbach alpha coefficients of narcissism questionnaire and its three factors ranged from 0.796 to 0.929; ③Consistent with previous studies, males were more narcissistic than females; ④Narcissism was pos- itively correlated with self-esteem, negatively correlated with anxiety and was not associated with satisfaction of life; selfesteem mediated the relationship between narcissism and anxiety. Conclusion: The self developed questionnaire illustrated satisfactory internal consistency reliability, construct validity, and criterion-related validity.

Results of experimental studies with guinea pig showed that a strong blast may produce concussion of the vestibular apparatus. The parts injured include saccule and utricle and their maculas, semicircular canals and their cristas,and the nerves related to these organs.The most common pathological changes were hemorrhage, detachment of sensorial epithelium, collapse of membranous labyrinth, loss of oto-liths and degeneration of sensorial epithelial cells.The authors believe that these vestibular damages are produced by the combined action of strong noise and shock wave, being transmitted through the oral and round windows into the inner ear, producing a violent fluctuation of endolymph.

Objective To observe the therapeutic effect of tramadol combined with fentanyl in patient controlled intravenous analgesia after nucleotomy of intervertebral disc.Methods 60 patients under general anesthesia,scheduled for nucleotomy of intervertebral disc,were randomly divided into three group(n=20):group tramadol(group T),group fentanyl(group F) and group tramadol+fentanyl(group TF).All patients were received patient controlled intravenous analgesia by loading dose+background dose+PCA bolus dose.The BP,HR,RR,VAS at 6,12,24,48h of postoperation were observed.The sedation score in 24h,average effective-press times and drug dose in 48h of postoperation were recorded.The incidence of nausea and vomiting during 24h of postoperation were observed.Results It had no significantly difference of BP,HR,RR,VAS among three groups.The average effective-press times of group TF (8?2) were significantly less than those of group T (14?3) and group F (12?3).The drug dose of 48h was tramadol (17.9?1.5)mg/kg(group T),fentanyl (16.8?1.5)?g/kg(group F) and tramadol (11.5?0.7)mg/kg+fentanyl (9.1?0.7)?g/kg(group TF).The drug dose of group TF showed significant difference compared with others.The sedation score in group F was the highest,it had significant difference compared with the other two group.The frequency of nausea and vomiting in group T was significantly more than that in others.Conclusion Tramadol or fentanyl gived alone can afford the same satisfied analgesic effect on nucleotomy of intervertebral disc.But there is high nausea-vomiting frequency in tramadol and strong sedation frequency in fentanyl.Tramadol combined with a little opioid fentanyl can afford more satisfying analgesic effect,and is provided with advantage in less drug and side-effect.

BACKGROUND: Kyphoplasty-assisted bone cement augmentation can be used in lumbar pedicle screw fixation of osteoporotic patients.OBJECTIVE: To assess the fixation strengths of loosened sacral screws augmented with kyphoplasty-assisted and traditional bone cement techniques.METHODS: Fresh sacra were harvested from nine osteoporotic cadavers. After testing bilaterally placed unicortical and bicortical pedicle screws, two unicortical pedicle screws with the traditional and kyphoplasty-assisted cement augmentations were established on the same sacrum. Following 2000 cyclic compression loading to screw head on a MTS machine, their maximum pull-out forces were recorded and compared. RESULTS AND CONCLUSION: The bone mineral densities of nine specimens were ranged from 0.61 to 0.77 g/cm2 (0.71 g/cm2 in average). The mean maximum pull-out forces of unicortical and bicortical screws, and traditional and kyphoplasty-assisted cement screws were 203, 325, 437, and 565 N, respectively. The pull-out force was significantly higher in bicortical screw compared with unicortical (P < 0.05); however, these two fixations exhibited markedly lower pull-out strength compared with two cement augmentation techniques (P < 0.05). The pull-out strength was significantly higher in kyphoplasty-assisted cement augmentation group compared with traditional bone cement technique (P < 0.05). In addition, a significant positive correlation was exhibited between bone mineral density and pull-out force for the four fixations (P < 0.05). Results demonstrated that traditional and kyphoplasty-assisted cement augmentations can serve as the salvage technique for loosening sacral screw. However, kyphoplasty-assisted augmentation can provide higher stability.

Objective To investigate the clinical effect of glassfiber post with all-ceramic-crown for incisors restoration, providing some references for our clinical application. Methods 82 patients (100 teeth defect) in our department from October,2008 to October, 2009 were divided into group A and group B with 50 incisors in each. Glassfiber post with all - ceramic - crown was used in group A, and metal post with porcelain-fused-to-metal in group B. After one year follow-up, we observed the clinical effect. Results 49 cases were effective and 1 case failed in group A. 42 cases were effective and 8 cases failed in group B.There was statistically significant difference between the two groups. Conclusions Glassfiber post with all-ceramic-crown is better in convenient handling and good colour for incisors compared to metal post with porcelain-fused-to-metal.

Objective The study aimed to compare the vector system with the hand instrument in the pain severity during scaling and root planning.Methods 60 periodontal patients were randomly divided into two groups for supportive periodontal therapy (SPT):the experimental group (using vector system) and the control group (using gracey instruments),with 30 cases in each group.And the painfulness after SPT was evaluated by Visual Analogue Scale (VAS).Results 66％ patients felt mild pain during the supportive periodontal therapy with the application of vector system,while 36％ patients felt mild pain in the control group.24 patients in the experimental group accepted vector system for SPT and 23 patients in the experimental group felt less fear of the treatment.Conclusions Patients will feel less discomfort with the application of the vector system,therefore better compliance will be reached.And the cooperation of the doctors and nurses has great impact on the treatment effect.

Objective To evaluation the method of rapid detection of Methicillin-resistant Stphylococcus aureus (MRSA) ST239 clones with multiplex PCR assay and investigation of the epidemic status of MRSA blood stream infections in Hefei area.Methods Antibiotic susceptibility testing were applied to MRSA isolates from bloodstream infection,rapid screening and confirmation of MRSA ST239 clones by using multiplex PCR,Multilocus Sequence typing (MLST) and Staphyloccoccal Cassette Chromosome mec(SCCmec) typing.Results 51 of 106 clinic isolates Staphylococcus aureus were identified as MRSA,accounting for 48.1％.The resistance rate of MRSA to erythromycin,aminoglycosides and quinolone were significantly higher than Methicillin Sensitive Staphylococcus aureus (MSSA).Both MRSA and MSSA had a high sensitivity to cotrimoxazole,the sensivity rates were 86.3％ and 94.5％,respectively; 47 of 51 isolates of MRSA that detected by MRSA ST239 rapid screening were ST239 clones.Randomly selected 20 positive screening stains were confirmed as MRSA-ST239-SCCmec Ⅲ by MLST and SCCmectyping.Conclusions In Hefei area,nearly half of MRSA bloodstream infections in clinical isolates are MRSA-ST239-SCCmeclⅢ type and serious multidrug-resistance.The rapid detection of ST239 clones by multiplex PCR is a reliable and effective method for large-scale screening in laboratory.

Objective To assess the efficiency and reliability of clinical genetic diagnosis of methylmalonic acidemia(MMA) using new generation sequencing platform (HiSeq2000).Methods 1.Nine patients diagnosed with clinical signs of MMA were recruited.DNA library from the patients were mixed with designed gene capture probe.The whole exons region of 48 genes related to organic acid metabolism were screened using the gene capture combined with high-throughput sequencing.2.The joints were removed and the low quality data were filtered,the data were analyzed by means of SNP and InDel.To avoid the false positive,the abnormal sites were verified using the Sanger sequencing method.3.The detection of the organic acid in the urine was performed through gas chromatography-mass spectrometry and other auxiliary examinations.Results 1.Gene mutation:7 gene mutations of MMACHC were identified in 7 patients.Seven mutations:c.482G ＞ A,c.567_568insT,c.609G ＞ A,c.440_441del,c.80A ＞ G,c.315C ＞ G,c.90G ＞ Awere screened.The mutation c.440_441del had not been reported before,and others were all related to the disease.Two gene mutations of mutase apoenzyme(MUT) were identified in 1 case,all of which were introns:.c.754-1G ＞ C,c.1677-1G ＞ A.The novel mutation was c.754-1G ＞ C.No gene mutation was identified in 1 patient.2.Clinical manifestation:all of the patients were development delay,but the degrees were different;3 patients with convulsion; 1 patient with headache and central facial paralysis;1 patient with repeated intractable metabolic acidosis;1 patient with repeated hemolysis.Electroencephalogram of the all patients were abnormal;the result of cranial MRI of the 8 patients were abnormal;In all patients,urine level of methylmalonic acid significantly increased (273.4-146 022.8 times).Blood homo cysteine of 8 patients were significantly increased(27.13-396.84 μmol/L,normal ＜ 20 μmol/L).3.Sanger sequencing:there were no false positive exists.Conclusions 1.There were not a correlation between the clinical manifestation and gene mutation of the patients with MMA.The c.609G ＞ A was the hotspot mutation of MMACHC gene in Chinese patients with MMA and homocysteinemia.2.The mutations c.440_441del and c.754-1G ＞ C were presumed to be novel mutations.3.Gene capture technology combined with next-generation sequencing technology could be used to interrogate the wealth of data available in the human genome and lay the foundations for counseling of gene.This platform can be readily and timely adopted by clinical molecular diagnosis of MMA and represents a high throughput,high sensitivity,high efficiency and other characteristics approach for screening common genetic diseases.