With advances on drug genomics of leukemia,the drug toxicity has been found to be associated with the drug metabolism gene polymorphisms in children with acute lymphoblastic leukemia.Current researches are to focuse on how to find a genotype to predict methotrexate toxicity effectively and treat patients individually.This review illustrates the association between three drug-metabolizing enzyme gene polymorphisms including methylenetetrahydrofolate reductase,reduced folate carrer and glutathione S-transferase and toxicity of methotrexate.

Objective To explore the clinical value of Holter heart rate turbulence in diagnosis of patients at high risk for coronary heart disease.Methods 110 patients with suspected coronary artery disease,according to the results of coronary angiography (CAG),were divided into CAG positive group (67 cases) and CAG negative group (43 cases).Heart rate turbulence and heart rate variability were analyzed in two groups.The atrial fibrillation,atrial flutter,and pseudo-differential interference were removed,the qualified ventricular contraction was selected.Two parameters of HRT,the initial shock value (TO) and turbulence slope value (TS) were calculated.Results The average value of TO and TS was (0.36 ± 0.15) ％,(1.98 ± 0.52) ms/RR in positive group,those in the negative group were (-0.87 ± 0.36) ％ and (4.83 ± 0.65) ms/RR,there were statistically significant differences between two groups (t =1.953,1.976,all P ＜ 0.05).After 1 year follow-up,9 cases (13.44％) died in positive group,2 cases (4.65％) died in negative group,the difference was statistically significant (x2 =5.476,P ＜ 0.05).Conclusion The heart rate turbulence with dynamic cardiogram can help to early diagnose the patients at high risk of coronary heart disease.It was important to improve the survival rate of patients.The method is simple,inexpensive,effective,which is worth promoting in the clinic.

Objective To explore the efficacy and safety of hormone replacement therapy with combination of Fosamax and simple use of Fosamax in osteoporosis and steopenia of perimenopausal women.Methods One hundred and thirteen perimenopausal women with osteoporosis accepted treatment in Outpatient Clinic of Panyu Convalescent Hospital of Guangzhou from December 2010 to June 2014 were chosen and divided into the control group (n=55) and the observation group (n=58) according to therapeutic method.The control group was treated with Fosamax alone while the observation group was treated with HRT basing on the simple use of Fosamax.The therapeutic effect,lumbar and hip bone mineral density(BMD) level,tibial ultrasound velocity (SOS) and T values of tibia,gonadal hormone concentrations,endometrial thickness and adverse reaction of the two groups before and after the therapy were compared.Results (1) The total effective rate of the observation group after the treatment was 93.10％,significantly higher than tbat of the control group (78.18％,x2=3.829,P=0.034).(2) Before and after treatment in two groups,there were statistically significant differences in terms of lumbar spine BMD,hip BMD,SOS of tibia,blood follicle stimulating prime (FSH) and estradiol(E2) (P＜0.05),and there were statistically significant differences between the two groups after the treatment in terms of lumbar spine BMD,hip B MD,SOS of tibia,FSH and E2 (t =3.389,5.012,3.997,5.829,3.902;P=0.035,0.028,0.033,0.024,0.038).(3) There was statistically significant differences in term of the incidence of adverse reactions between the observation group and the control group (6.90％ vs.16.36％;x2=8.273,P=0.012).Conclusion Compared with alone use of Fosamax,the therapeutic effect of hormone replacement therapy with combination of Fosamax and in osteoporosis and steopenia of perimenopausal women is more significant with low occurrence rate of adverse reaction.It is worth popularization.

Objective:To study the role of APACHEⅡscore pre-operation to infusion of blood preparation during the periods of hepatectomy.Methods:The correlation between APACHEⅡscore pre-operation and infusion of erythrocyte suspension and plasma were analyzed retrospectively in 104 cases who suffered from hepatectomy.Results:Those whose APACHEⅡscore were less than 5 had significantly lower volume of bleeding and lower infusion of erythrocyte suspension and plasma during the operation than those whose APACHEⅡscore were not less than 5(P

0.05),the clinical control rate were 67.65% and 52.94% (P

Objective To evaluate the value of hysteroscope in the diagnosis of the cause of perimenopausal uterine bleeding. Methods 158 patients were checked with HS.Orientation biopsy and diagnostic uterine curettage were performed. Results The rate of the sensitivity of HS for endometrial illness was 87.8%(79/90),endometrial ployp 96.20%(25/26),submucous fibromyoma 3/4,endometrial proliferation 62.5%(20/32),Endometrial cancer 3/5. Conclusions Endometrium can be directly seen with HS.The conbination of HS with uterine curettage and pathological examination is an optimal method in early diagnosis of the cause of PUMB.

Objective To analyze the laser lacryocystoplasty combined with antimetabolites in the treatment of lacrimal duct obstruction clinical curative effect. Methods 72 cases of lacrimal duct from July 2015 to February 2017 in our hospital for treatment of COPD patients as the research object, 84 eyes (23 eyes with nasolacrimal duct obstruction and chronic dacryocystitis 16 eyes in tears tubular obstruction and 45 eyes). All patients underwent laser angioplasty combined with tired to anti metabolic drug treatment, postoperative flushing of lacrimal duct, and for a period of 3 months of follow-up of patients, analysis of clinical treatment in this group of patients with complications of surgery. Results After 3 months of treatment , 71 eyes were cured, accounting for 84.52％; 10 eyes were better, accounting for 11.90％; 3 eyes of treatment failure, accounting for 3.57％. patients in this group had 1 cases of orbital hematoma in nerve block anesthesia, symptomatic treatment returned to normal 1 weeks after surgery, the complication rate was 1.19％. Conclusion The application of laser lacryocystoplasty combined with anti drug metabolism of lacrimal duct obstruction were treated with simple operation, obvious curative effect and low complication rate advantages, has the value of clinical application, but should strictly control the application of Dose Mitomycin, postoperative flushing of lacrimal duct, and good antibacterial prophylaxis, and to reduce the The incidence of the disease and the effect of clinical treatment.

Objective To investigate the effect of entecavir in the treatment of chronic severe hepatitis B and the influence on peripheral blood T cell subsets and liver function.Methods 100 patients with chronic severe hepati-tis B were selected as research subjects,who met the inclusion criteria.The patients were randomly divided into the observation group(50 cases)and control group(50 cases),then the clinical effects were assessed after treatment. Results The CD +4 ,CD +4 /CD +8 of the observation group and control group after treatment were (40.65 ±5.06)%and (35.32 ±5.18)%,(1.83 ±0.35)% and (1.30 ±0.26)%,which were significantly higher than before treat-ment,the differences were statistically significant(t =7.762 and 5.192,6.319 and 3.392,all P <0.05),the CD +8 levels were (22.13 ±4.85)% and (27.24 ±4.66)%,which were significantly lower than before treatment,the differences were significant(t =8.553,3.667,all P <0.05).The CD +4 ,CD +4 /CD +8 of the observation group were significantly higher than the control group,the differences were statistically significant(t =3.479,5.413,all P <0.05),the CD +8 was significantly lower than the control group,the difference was significant(t =3.551,P <0.05). The ALT,AST,HBV-DNA of the observation group and control group after treatment were (45 ±17)U /L and (90 ± 22)U /L,(55 ±20)U /L and (86 ±25 )U /L,(2.71 ±0.50)copy/mL and (4.62 ±0.53)copy/mL,which were significantly lower than before treatment,the differences were statistically significant(t =10.568 and 6.773,9.935 and 7.035,6.339 and 3.448,all P <0.05).The ALT,AST,HBV-DNA of the observation group were significantly lower than the control group,the differences were statistically significant(t =3.662,3.514,3.604,all P <0.05). Conclusion Entecavir can effectively suppress viral replication,enhance immune function and improve liver func-tion,and has better security in the treatment of 50 patients with chronic severe hepatitis B,which is worthy of clinical use.

Objective:Through research of corneal transparency and related influential factors,the authors try to look for some clinical variety regulations after penetrating keratoplasty(PKP) in order to enhance the rate of surgery success.Methods:104 blind patients due to corneal disease (107 eyes) undergone PKP were followed up on months 1,3,6,12,18,24 and 36.Clarity of cornea,corneal endothelial cells and all kinds of complications were recorded besides regular examinations.Results:Grafts were transparent in 82 of 107 eyes on month 1(76.6%),in 69 of 90 eyes on months 6 (76.7%),in 51 of 81 eyes on months 12(63%),in 26 of 40 eyes on months 12 (65%) after PKP.Corrected vision were improved especially in patients of grafts transparency.Vision of patients with transparent grafts were more than 0.1 in 67 of 82 patients(82%) on month 1,in 59 of 63 patients(94%) on months 3,in 66 of 69 patients(96%) on months 6.Conclusion:PKP is an important method to corneal disease blind patients.Rejection was the major cause affecting graft transparency.