Multiple myeloma(MM) was the second malignant hematological disease in many countries. There had continuing change in diagnostic criteria in MM, along with the more treatment methods and the understand of this disease. From 1975 to 2013, the change of diagnostic criteria experienced three stages. Firstly, we emphasized the numerical value in 1975, secondly, we emphasized the clonal characteristics of plasma cell and wakened the numerical value because of the FACS and immunofixation widespreadly used, thirdly, we emphasized the number again because of the differentiation of primary amyloidosis. Along with these changes, the target population had changed also, 20%patients cannot be diagonsed if using criteria of 1975, and some asymptomatic MM may be diag-nosed with MM in the future.

The research articles related to the doctor-patient relationship (DPR) from 1984 to 2013 were retrieved from the China National Knowledge Infrastructure (CNKI) database.By analy zing the developmental stage of such studies,the paper sources,citations,the citation and the funding,we found that the design and the methodology of past studies on the DPR were deficiency.The researchers with different academic backgrounds are needed to develop the sociological theory on the DPR in China.Finally,some suggestions on how to deepen our understanding on the DPR were posted.

Vasovagal syncope is the most common cause of syncope in children. Its pathogenesis is related to hemodynamics, vasodilation, cerebral blood flow abnormalities, nerve and changes in humoral factors. Body iron deficiency also cause these changes. This paper summarizes the intrinsic link between serum iron deficiency and these changes.

The detection of sperm DNA damage, as an important supplement to semen routine examination strategies, has been applied in some clinical andrology laboratories. What factors may lead to sperm DNA damage remains one of the concerns among many andrologists. Present studies show a variety of factors of sperm DNA damage, including age, environmental pollutants such as organophosphorus and organochloride pesticides, plasticizer, heavy metals such as lead, carcinogens such as polycyclic aromatic hydrocarbons (c-PAHs) and zearalenone (ZEA), male reproductive system diseases or systemic diseases such as varicocele, infection, tumor, spermatogenesis and maturation dysfunction, spinal cord injury and endocrine disorders, seasons and temperature, lifestyle, abstinence time, semen refrigeration, semen handling in vitro, and certain medications. Among them, spermatogenesis and sperm maturation dysfunction may be the most secretive factors, which are involved in the molecular mechanisms of sperm chromatin packaging and restructuring, such as the transformation of histone to protamine, single nucleotide polymorphism of genes, and the role of telomere, which may be one of the hotspots in the future studies of sperm DNA damage. Relevant researches in the future are expected to focus on the prevention of sperm DNA damage and clarification of its specific pathogenic mechanisms so as to provide some evidence for its treatment.
Age Factors ; Chromatin ; chemistry ; DNA Damage ; Environmental Pollutants ; toxicity ; Humans ; Male ; Protamines ; Semen ; drug effects ; Specimen Handling ; Spermatogenesis ; Spermatozoa ; drug effects ; Telomere ; physiology ; Varicocele ; complications

Objective To investigate the association of Lys656Asn polymorphism in leptin receptor gene with serum triglyceride level.Methods The genotypes of Lys656Asn polymorphism in LepR gene were maped by polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP) assay in 232 unrelated subjects of Shanghai Chinese population.The clinical data were also analyzed.Results No significant difference of genotype frequency of Lys656Asn polymorphism in LepR gene was observed between obese and non-obese groups.In obese group,"G" Allele was associated with increased triglyceride level(1.74?0.91 vs 0.95?0.32)(P

Objective To explore the protective effect and mechanism of ligustrazine against ischemia-reperfusion injury of retina from neonatal rats.Methods Thirty-two neonatal rats were randomly divided into normal,model,solvent control and ligustrazine treatment group.Experimental model of retinal ischemia-reperfusion injury was established by increasing intraocular pressure through intracameral infusion.In the ligustrazine treatment group,ligustrazine was given by intraperitoneal injecting before 30 min ischmia and after reperfusion 2 hours,10 mg/kg.In the solvent control group,the same voluminal solvent(isotonic Na chloride)was given by the same way before 30 min ischmia and after reperfusion 2 hours.The neonatal rats were executed by aeroembolism after reperfusion 6 hours.The content of malon dialdehyde(MDA) and the superoxide dismutase(SOD) activity were measured by spectrophotometer.Results 1.The content of MDA in model group was significantly higher than that in normal group(t=4.80 P0.05).The SOD activity in model group was significantly lower than that of normal group(t=4.58 P0.05).Conclusion Ligustrazine can protect experimental retinal from ischemia-reperfused injury by increasing SOD activity and decreasing the content of MDA in neonatal rats.

Objective To evaluate the efficacy and safety of TACE combined with Apatinib versus TACE monothcrapy in the treatment of advanced hepatocellular carcinoma (HCC).Methods A total of 44 patients with advanced HCC were enrolled and divided randomly into group A (n=22) and group B (n=22).The patients in group A were treated with TACE monotherapy while group B were treated with TACE combined with Apatinib.The serum alpha fetoprotein (AFP) levels were compared between the two groups three months after treatment.The objective response rate (ORR) after 3,6,9 and 12 months,the progression-free survival (PFS) and incidence of adverse reactions were also compared.Results The serum AFP levels decreased apparently in two groups three months after treatment,and statistic differences were observed in each group (Z=-2.289,-2.953,both P ＜0.05),while no statistic differences was obtained between the two groups after treatment (Z=-0.126,P＞0.05).No statistic differences were found in ORR between the two groups 3 and 6 months after treatment (both P ＞0.05),while statistic differences were manifested after 9 and 12 months (both P ＜0.05).The medium PFS in group A significantly lower than that in group B (x2 =6.576,P=0.01).The apatinib-related adverse reactions including hypertension,hand-foot syndrome and proteinuria in group B were higher than those in group A,and statistically significant difference were obtained (allP＜0.05).The adverse reactions were relieved after symptomatic treatment.Conclusion TACE combined with apatinib may improve the mid-long term efficacy in patients with advanced HCC.And the relatively safety of TACE combined with apatinib is confirmed.

Diagnostics is the bridge from basic medicine to clinical medicine.For the students contacting the clinic for the first time,we take measures to cultivate the consciousness of showing love to patients and dedicating yourself to work.It is beneficial to cultivate the students'ability in clinical practice.

Objective:To investigate the correlation between the microsatellite polymorphisms in ob gene 3′flanking region with obesity in Chinese Han ethnicity in Shanghai.Methods: The genotypes of polymorphisms in ob gene 3′flanking region were determined by PCR in 232 Chinese Han subjects(including 130 obese patients and 102 normal controls).The clinical data,including height,weight,waist circumference,hip circumference,body mass index,waist-to hip ratio(WHR),blood glucose,serum insulin,blood lipids,and uric acid,were compared between the 2 groups.Results: No significant difference of genotype frequency(Ⅰ/Ⅰ 0.115,Ⅰ/Ⅱ 0.331,Ⅱ/Ⅱ 0.554 vs Ⅰ/Ⅰ 0.059,Ⅰ/Ⅱ 0.333,Ⅱ/Ⅱ 0.608) and allele frequency(Ⅰ 0.281,Ⅱ 0.719 vs Ⅰ 0.225,Ⅱ 0.775) of ob gene 3′flanking region was observed between the 2 groups.In obese group,patients with Ⅰ+Ⅱ genotype was associated with increased WHR compared with those with Ⅱ/Ⅱ genotype(0.91?0.05 vs 0.86?0.03,P=0.047).Logistic regression analysis showed that WHR was independently correlated with ob gene polymorphisms(P=0.042).Conclusion: Polymorphisms in ob gene 3′ flanking region are correlated with central obesity in obese patients of Chinese Han ethnicity in Shanghai.

Objective To study the induction and detection methods of Staphylococcus aureus viable but non-culturable state (VBNC).Methods Staphylococcus aureus (ATCC13565) of 107 cfu/ml was induced by low temperature at 4 ℃,freezing at-20 ℃ and adding copper ions from 0.01 mmol/L to 0.05 mmol/L,Staphylococcus aureus was tested,and explored the resuscitation conditions by stepwise heating-heating and chemokinesis.Results Frozen 72 h at the temperature of-20 ℃ or added 0.015 mmol/L Cu2+ for 4 days of culture could induce staphylococcus aureus into the state of VBNC.Adding 0.5% tween-20 or 1% catalase for 24 h of culture could make the strain in VBNC achieve recovery.Conclusion Staphylococcus aureus can be induced into the VBNC and the recovered Staphylococcus aureus is the same as the normal bacteria in colony morphology and physiological and biochemical response in the common test medium.