BACKGROUND: Cancer stem cell is a minority population of cancer cells in multiple myeloma possessing the properties of stem cells: self-renewal, multi-directional differentiation and long-term proliferation, which mediating disease initiation, relapse, progression and drug resistance.OBJECTIVE: To review characteristics of biology, phenotypic analyses, sorting and identification in clonogenic myeloma cells, the signaling pathways with in myeloma stem cells and the target therapy related.METHODS: Application of computer search Medline database (1999-01/2009-04), using "multiple myeloma stem cells, heterogeneity, phenotypic analysis, signaling pathways, target therapy" as key words; application of computer search CNKI database (1999-01/2009-04) and CBM Database (1999-01/2009-04) using "multiple myeloma stem cells, heterogeneity, stem cell separation and identification, signal transduction, targeted therapy as key words".RESULTS AND CONCLUSION: We collected for 126 literatures on the multiple myeloma stem cell-related, which include 30 Chinese articles and 96 English articles, excluding published earlier, repeated, and similar studies into 30 sub-standard literatures. Now widely recognized that multiple myeloma stem cells may be derived from normal stem cells, the accumulation of mutations and by gene mutation in regaining self-renewal capacity of progenitor cells or fully differentiated mature cells. Circulating clonotypic memory B-cell populations have self-renewal and multi-directional differentiation potential, which represent the cancer stem cells in multiple myeloma. The exact phenotype of multiple myeloma cancer stem cells has not been definitively established and researched remains. At present, both the side population cells and aldehyde dehydrogenase (ALDH) activity assays were mainly capable of isolating multiple myeloma cancer stem cells. Which to possess self-renewal ability by Hedgehog ,Wnt and Notch signaling pathways. When these signal transduction pathways appear abnormal, leading to the occurrence of the tumor and tumor cell growth in non-controlled. Against the cancer stem cell targeted therapy is a new and important direction of selective therapeutic strategies. Cancer stem cell specific surface markers and signal transduction pathways can be used as anti-cancer stem cells to control tumor development targets.

BACKGROUND: Cancer stem cell is a minority population of cancer cells in multiple myeloma possessing the properties of stem cells: self-renewal, multi-directional differentiation and long-term proliferation, which mediating disease initiation, relapse, progression and drug resistance. OBJECTIVE: To review characteristics of biology, phenotypic analyses, sorting and identification in clonogenic myeloma cells, the signaling pathways with in myeloma stem cells and the target therapy related. METHODS: Application of computer search Medline database (1999-01/2009-04), using "multiple myeloma stem cells, heterogeneity, phenotypic analysis, signaling pathways, target therapy" as key words ;application of computer search CNKI database (1999-01/2009-04) and CBM Database (1999-01/2009-04) using "multiple myeloma stem cells, heterogeneity, stem cell separation and identification, signal transduction, targeted therapy as key words" . RESULTS AND CONCLUSION: We collected for 126 literatures on the multiple myeloma stem cell-related, which include 30 Chinese articles and 96 English articles, excluding published earlier, repeated, and similar studies into 30 sub-standard literatures. Now widely recognized that multiple myeloma stem cells may be derived from normal stem cells, the accumulation of mutations and by gene mutation in regaining self-renewal capacity of progenitor cells or fully differentiated mature cells. Circulating clonotypic memory B-cell populations have self-renewal and multi-directional differentiation potential, which represent the cancer stem cells in multiple myeloma. The exact phenotype of multiple myeloma cancer stem cells has not been definitively established and researched remains. At present, both the side population cells and aldehyde dehydrogenase (ALDH) activity assays were mainly capable of isolating multiple myeloma cancer stem cells. Which to possess self-renewal ability by Hedgehog ,Wnt and Notch signaling pathways. When these signal transduction pathways appear abnormal, leading to the occurrence of the tumor and tumor cell growth in non-controlled. Against the cancer stem cell targeted therapy is a new and important direction of selective therapeutic strategies. Cancer stem cell specific surface markers and signal transduction pathways can be used as anti-cancer stem cells to control tumor development targets.

Objective To investigate hemoglobin A1c(HbA1c) and homocysteine (Hcy) in nondiabetic elder patients with coronary heart disease (CHD),and explore their clinical value.Methods Eighty-six non-diabetic elder patients with CHD [45 cases with acute coronary syndrome (ACS) and 41 cases with stable angina pectoris (SAP)] and sixty elder patients without diabetes mellitus and coronary heart disease as control group were selected.The plasma levels of HbA1c and Hcy in all groups were detected and analyzed.Results The levels of HbA1c and Hcy in CHD group were significantly higher than those in control group (P ＜0.05),and levels of HbA1c and Hcy in ACS group were both higher than SAP group (P＜0.05).The change of HbA1c and Hcy had positive correlation (r =0.34,P ＜0.05).Conclusions The levels of HbA1c and Hcy were higher in non-diabetic elder patients with CHD than those without CHD,and might correlate with atherosclerosis.HbA1c and Hcy might be markers of cardiovascular risk.

Objective:Spectrophotometer is a device to be verified obligatory in hospital. This article introduced some techniques to avoid ordinary mistakes in measurement. Methods:We introduced principle and verification regulation of spectrophotometer. Such methods as parameter configuration, proper maintenance can reduce our mistakes. Results: This article analyzed some common problems in measurement and also offered solutions. Conclusion: In the measurements of spectrophotometers, because the operators have less spectrophotometer operation experience, they often get inaccurate data which lead to an error. Conclusion: To avoid these mistakes, strictly regulate operations in spectrophotometer’s verification and proper routine maintenance are necessary.

AIMTo develop a rat model of insulin resistanc e,and to study the effect of puerarin injection on expression of protein kinase B in insulin resistanc e rats. METHODS30 SD rats were randomly divded into two groups. The model group were given the high fat diets(0 30 pig fat, 0 10 sucrose, 0 0 3 cholesterol) for 8 weeks. Then 9 rats of the group had been choosen as the pu erarin treatment group and were given abdominal injection (100 mg?kg -1 ?d -1 ) for 4 weeks. By the end of the experiment, Western blot and computer i mage pattern analyze system were used to analysis expression of PKB in skeletal muscles. RESULTS(1) The model group showed a hyperglycemia, hype rinsulinism and obviously visceral obesity by high fat-feeding, the insulin res istance index (ISI) decreased while the HOMA insulin resistance index (HOMA-IR) increased compared to the normal group, insulin resistance was induced in this way; (2) Compared with the pathology control group:fasting blood glucose (FBG), fasting insulin (FINS), visceral fat mass and the HOMA insulin resistance index (HOMA-IR) of the treating group were significantly decreased whereas the insuli n index (ISI) enhanced. Expression of PKB was markedly increased by puerarin tre atment. CONCLUSIONPuerarin injection can significantly elevate e xepression of PKB and ameliorate the state of insulin resistance. Improved biolo gic effect of insulin and prevention of the deleterious effect of fat may be in volved in the mechanism concerned.

Objective To explore the clinical and molecular biological characteristics of spinocerebellar ataxia type 3(SCA3).Methods Clinical manifestation and brain MRI data of 12 patients with SCA in two families were analyged.The polymorphic CAG repeated time in the encode region of SCA3,SCA1 and SCA7 genes were compared in 15 family numbers without abnormal presentations,and 12 healthy persons of controls.Results Among 27 numbers of 4 generations in the two families had 12 patients,male and female were affected,average onset was 32 years old.The main clinic features included gait ataxia,ambiguity in speech and action clumsiness.Brain MRI showed remarkable atrophy on cerebellum and brain stem.In the two families,the CAG lengths of SCA1 and SCA7 were normal in all numbers.The repeated times of CAG of SCA3 were 11~39 in two control groups,65 ~87 in 10 cases,diagnosed as SCA3 patients.The child Ⅳ2 of family 1 was 8 years old,the repeated times of CAG of SCA3 were repeats 21 and 64 times,repectively.He might be a asymptomatic patient,because he was too young to onset the disease.Conclusions SCA3 is an autosomal dominant genetic disease.The clinical manifestations are ataxia and dysarthria.The detection of repeated times CAG can provide an effective way for the genetic and asymptomatic diagnosis.

AIM: To establish a normal HPLC fingerprint chromatogram of herba Taraxaci in Henan Province. METHODS: 40 different kinds of herba Taraxaci were determined by RP-HPLC.Methanolthe solution of NaH_2PO_4(0.02 mol/L)(pH=3.8) gradient elution were adopted as a mobile phase,80 min the recording chromatogram chart and 1.0 mL/min of the velocity of flow detection wavelength was at 323 nm,column temperature was at 35℃. RESULTS: 9 steady mutual peaks were indicated. CONCLUSION: This method is simple,credible and of good reproducibility,can be used to identify and evaluate herba Taraxaci.

Chimeric antigen receptor (Car) T cells, not only have the characteristics of strong specific recognition of tu-mor antigens, but also have destruction and high affinity advantages, thus receiving more attention. Although it has played a lot of advantages in anti-tumor, it still has some shortcomings, which needs to be further optimized to improve the safety of its clinical application. In this study, The cell structure and biological function, treatment process, application development and application risk of Car T cells are reviewed, which provide references for further clinical immunotherapy of Car T.

Objective Toestablishthe concept and structure elements of the nurse humanistic practiceability. Methods Using documentandtheoretical analysis to definethe concept of the nurse humanistic practiceability. And usestructuralanalysis to explain the structural elementsto formDelphiexpert consultationquestionnaire, which was investigated for 18 experts in 5provinces includingnursing education, nursing management, nursing clinicalcare,medical humanitiesandhumanistic medicine,and eventually established thetheory and structure model of the nurse humanistic practiceability. Results The effective recovery rates of the questionnaire were 81.8%(18/22)and 100%(18/18). The authority coefficients were 0.924, and the total consistency coefficients were 0.307 and 0.367 with statistical significance. TheDelphi expert consultation has established the concept, six-level structural elementsand15sub-elements. And for the first-class,the average value was 3.94-5.00,the coefficients variation of was 0.00-0.20;for the secondclass,the average value was 3.89-5.00,the coefficient variation were 0.00-0.19. Conclusions The study onconceptand structure elements of nurse humanistic practice ability has completed, which provide theoretical basis for improvement of nurse humanistic practice ability.

Objective To investigate the prevalence of vitamin D deficiency in patients in geriatric intensive care unit and the impact of vitamin D deficiency on the prognosis.Methods 213 hospitalized patients admitted into geriatric intensive care unit of Xinhua Hospital,Shanghai from June 2012 to December 2013 were included in the historical cohort study.Serum 25-hydroxyvitamin D [25 (OH)D] was examined in all the subjects.Main laboratory findings,the incidence of multiple organ dysfunction syndrome (MODS),Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score and mortality rate of 30-day kept in hospital were compared among patients with different serum 25-hydroxyvitamin D level.Potential risk factors for mortality were analyzed by multivariate logistic regression analysis.Results 25(OH)D deficiency was identified in 82 patients (38.5％),25(0H)D insufficiency in 90 patients (42.3％),and 25(OH)D sufficiency in 41 patients (19.2％).Compared with 25(0H)D sufficiency group,25(0H)D deficiency group showed the increased levels of APACHE Ⅱ score,plasma lactic acid,C reactive protein (CPR),the incidence of MODS and mortality rate (21.65±-8.89 vs.17.05±8.03,1.89±0.76 mmol/L vs.1.86±1.03 mmol/L,101.08±48.23 mg/L vs.92.48±38.56 mg/L,42.7％ vs.19.5％,30.5％ vs.9.8％,all P＜0.05).Multiple logistic regression analysis suggested that 25 (OH)D deficiency was an independent risk factor for mortality.25(OH)D levels were negatively correlated with length of stay in geriatric intensive care unit (r=0.18,P＜0.05).Conclusions Vitamin D deficiency is highly prevalent among patients admitted into geriatric intensive care unit.Vitamin D deficiency is associated with disease severity and may be an independent risk factor for mortality.