Objective To evaluate the diagnosis value of digestive tract clinical symptoms in multiple myeloma.Methods 21 patients with multiple myeloma with digestive tract symptoms as initial clinical manifestations were analyzed.Results In 21 patients,52% below 50 years(hepatomegaly and splenomegaly was 73%),abdominalgia and diarrhea,hematocytopenia,proteinuria were 57%,90% and 67%,respectively.Conclusion Digestive tract symptoms,especially hepatomegaly and splenomegaly,occur mostly in younger patients.Hematocytopenia and proteinuria are important clue in diagnosis of multiple myeloma.Digestive tract symptoms are the common clinical manifestations,but not chief clinical features in multiple myeloma.

Objective To determine the correlation between serum asymmetric dimethylarginine (ADMA) and non-spoon-shaped blood pressure of non-dialysis chronic kidney disease (CKD) patients,also to observe the impact of the serum ADMA level on the structure and function of left ventricle.Methods One hundred and twenty cases of non-dialysis CKD patients underwent 24-hour ambulatory blood pressure monitoring were divided into three groups:CKD1-2,CKD3,CKD 4-5.Serum ADMA concentration was measured using liquid chromatograph and other clnical data such as uric acid (UA),left ventricular mass index (LVMI),24 h urine protein,and high-sensitivity C-reactive protein (hs-CRP) were collected for further statistical analysis.Results (1) With the decline of renal function,ADMA concentration was increased,from CKD 1-2 (1.70±0.48) μmol/L rose to CKD 4-5(4.46±1.56) μmol/L (P ＜ 0.05).(2)There were 42 cases of CKD patients with hypertension and 78 cases of CKD patients with normal blood pressure.The serum ADMA levels in hypertension group was significantly higher than those in non-hypertensive group [(3.53±1.70) μmol/L vs (2.01±0.65) μmol/L,P ＜ 0.05].(3)There were 50 cases of non-spoon-shaped normotensive CKD patients and 28 cases of spoon-shaped normotensive CKD patients.Serum ADMA level and LVMI in non-spoon-shaped group were significantly higher than that in spoon-shaped group when kidney functions appeared to be equal (P ＜ 0.05).(4)Serum ADMA level was positively correlated with UA(r=0.352,P ＜ 0.01),LVMI (r =0.345,P＜ 0.05),24 h urine protein(r =0.200,P ＜ 0.05),and high-sensitivity C-reactive protein (r =0.309,P ＜ 0.01),but negatively correlated with the left ventricular ejection fraction (LVEF)(r =-0.329,P ＜ 0.01) and estimated glomerular filtration rate (eGFR)(r =-0.011,P ＜ 0.01).Multiple regression results showed that eGFR,UA,LVMI,hs-CRP,24 h urine protein were associated with ADMA level.The regression equation was Y =1.991-0.011 × [eGFR] + 0.002 × [UA] + 0.008 × [LVMI] + 0.036 ×[hs-CRP]-0.084× [24 h urinary protein].Conclusions Serum ADMA level begins to increase in early stage CKD and it progressively increases with the decline of renal function,also the non-spoonshaped blood pressure ratio and the left ventricular damage increase.Kidney function,urine protein and microinflammatory state may impact on the serum ADMA level.

Objective To investigate the expression and diagnostic significance of DOG1,CD117and CD34 in gastrointestinal stromal tumors.Methods Expressions of DOG1,CD117 and CD34 were determined by immunohistochemical techniques (EnVision) in 60 cases of gastrointestinal stromal tumors (GIST) and 14 cases of other mesenchymal tumors.Results Expression of DOG1 in GIST was significantly higher than in other mesenchymal tumors (P =0.000).Expression of DOG1 in GIST from stomach was significantly higher than that from intestines.The expression rates of DOG1,CD117 and CD34 in GIST were 95％,95％,and 83.3％,respectively.Expression of DOG1 was significantly higher than CD34 (P =0.040),but no significant difference between DOG1 and CD117 (P =1.000).The expression rates of DOG1 in CD117-positive,CD34-positive tumors were 94.7％ and 94.1％,respectively.All the CD117-negative,CD34-negative tumors expressed DOG1,3 cases which were negative for CD117 and CD34 expressed DOG1.Conclusions DOG1 is a novel marker for GIST,It is necessary to the combined detection of the expression of DOG1,CD117 and CD34,which will further improve the diagnostic accuracy of GIST.

Objective To evaluate the efficacy of surgical excision combined with iodine-125 implants intmcavitary radiotherapy for neumglioma Method After excision,27 patients with nenroglioma were implanted with the iodine-125 into the tumor bed or the residual tumor tissues.Results Of all cases,there were no operative mortality and no serious complication.The survival time of 25 cases exceeded 6 months and 1 glioblastoma recurrence,22 cases exceeded 12 months,3 glioblastoma and 1 astrocytoma Ⅲgrade recurrence.There were 19 cases exceeding 24 months,15 cases no recurrence,3 cases died for cere bral hernia because of giving.up further tremment,1 case surviving.Conclusions Surgical excision Combined with iodine-125 implants intracavitary radiotherapy can improve partial control rate,prolonged the survival time of patients with neuroglioma,and complications is rare.It is an efficient therapy for neu roglioma

Objective To investigate the association of vascular calcification,fetuin A and Creaction protein (CRP),and explore the influence on cardiovascular events.Methods Sixty peritoneal dialysis (PD) patients were enrolled in this study.Carotid intima-media thickness (cIMT),fetuin A and CRP,along with the other serum related parameters were detected to find out their influence on vascular calcification in PD patients.The relationship between cIMT,fetuin A,CPR and cardiovascular events was analyzed in PD patients with 18 months followed-up.Results Of the 60 PD patients,carotid intima-media thickness (cIMT) was increased in 38 patients(63.3％).Compared with the non-increased cIMT patients,serum fetuin A concentration was significantly decreased(P ＜ 0.05),CRP(P＜0.01) and calcium × phosphate products(P＜0.05) were significantly increased in the highincreased cIMT group.Compared with the low-increased cIMT patients,fetuin A concentration was obviously lower(P ＜ 0.05) and calcium×phosphate products were obviously higher(P ＜ 0.05) in the highincreased cIMT group.Linear regression analysis discovered an obvious negative correlation between CRP and fetuin A(R2 =0.629,F=47.522,P ＜ 0.01),as well as fetuin A and calcium×phosphate products (R2=0.299,F=11.948,P=0.002).Multiple regression analysis indicated that fetuin A was independently negatively correlated with cIMT(B=-0.019,t =-6.042,P ＜ 0.01).At 18 months,there were 36 newly-happened cardiovascular events and among which 6 cases died.Logistic regression analysis found that increased cIMT was risk factor to cardiovascular events in PD patients(OR=3.691,95％CI 1.467-9.258,P=0.006).Conclusion Decreased fetuin A and increased calcium×phosphate products deteriorate carotid calcification in PD patients.Micro-inflammation of PD patients represented by high CRP levels may increase calcium×phosphate products by depressing the fetuin A level,and in the end will stimulate carotid calcification.Increased cIMT is a risk factor for cardiovascular events.

Objective To investigate the relationship between fetuin A and left ventricular function and their influences on residual renal function(RRF) in peritoneal dialysis patients.Method Eighty patients recently initiating peritoneal dialysis were enrolled into this study and were divided into high fetuin A group and low fetuin A group accordin to the value of serum fetuin A concentration.Hemoglobin,high sensitive C reactive protein(hsCRP),calcium,phosphorus,albumin,lipoproteins and left ventricular myocardial performance index(LV-MPI) were examined.All these patients were followed up for 12 months,to discover the parameters' differences between two groups and to investigate the association between fetuin A and left ventricular function and RRF.Results At the beginning of the study,there was no difference of hsCRP,calcium,phosphorus,albumin,lipoproteins and LV-MPI,estimated glomerular filtration rate (eGFR) between two groups;After 12 months follow-up,MPI was obviously shorter (P ＜ 0.05) and RRF was obviously higher (P ＜ 0.05) in high fetuin A group than thosein low fetuin A group.Compared with the beginning of the study,LV-MPI was significantly increased and eGFR was significantly decreased after 12 months follow-up (both P ＜ 0.05) in low fetuin A group,but no obviously change of LV-MPI or eGFR was found in high fetuin A group after followup.Pearson correlation analysis discovered an obvious negative correlation between fetuin A and MPI (r=-0.680,P ＜ 0.01).Multiple regression analysis indicated that eGFR had positive correlation with fetuin A (B=0.058,t=3.679,P＜ 0.01) and negative correlations with MPI (B=-0.511,t=-2.903,P=0.007),age(B=-0.144,t=-4.013,P＜0.01).Diabetes was risk factor to loss of RRF (B=-2.031,t=-2.759,P ＜ 0.05).Conclusion Fetuin A has very close relationship with left ventricular function.Decreased serum fetuin A level and decreased left ventricular function are risk factors to the loss of the RRF in ERSD patients.

Objective To investigate the protective effect of carnosine on radiation-induced lung injury in mice.Methods A total of 108 C57/BL female mice were randomly divided into 4 groups:control group without treatment,irradiation alone group,irradiation + carnosine group (15 mg·kg-1·d-1),and carnosine alone group (15 mg· kg-1· d-1).There were 18 mice in control group and 30 mice in every other group.Whole lung anterior chest was irradiated with a single dose of 13 Gy 10 MV X-rays.The mice were administered with carnosine (15 mg· kg-1· d-1) at 30 minutes before irradiation and then garaged once a day until the end of the experiment.The control group was given with saline.At 7,28,and 56 d after irradiation,6 mice of control group and 10 mice of each other group were killed.A portion of lung tissues were stained with HE and other part of lung tissues were used to detect the levels of SOD.Meanwhile,TGF-β1 and TNF-α in the serum were detected with ELISA.Results Different levels of inflammation factors were expressed in the lung tissues of irradiation group and irradiation + carnosine group at 56 d after irradiation,but the inflammation in the irradiation + carnosine group was significantly lighter than that in the irradiation group.Among (7,28 and 56 d) after radiation,TGF-β1,TNF-α,and SOD levels in different groups had significant differences.At the same time point after irradiation,the level of SOD in lung tissue of irradiation + carnosine group was significantly higher than that of irradiation group (F =4.33,4.19,3.34,P ＜0.05),but the levels of TGF-β1 and TNF-α in serum were reduced.Conclusions Carnosine can prevent and inhibit radiation-induced lung injury in mice by increasing SOD and reducing TGF-β1 and TNF-α.

Epidermal growth factor receptor (EGFR) is found to express at high levels in a variety of solid tumors including gliomas. This study was to examine the effect of an EGFR-tyrosine kinase inhibitor (AG1478) alone or in combination with cisplatin (CDDP) on the growth of glioma cells (U87). U87 glioma cells were treated with AG1478 (10 μmol/L) or CDDP (25 μmol/L) as a single agent or in combination for 24 or 48 h. The expression of EGFR and the components in its downstream signaling pathway [extracellular signal-regulated kinase (ERK), protein kinase B (AKT)] in U87 glioma cells was detected by Western blotting. Cell growth, cell cycle distribution and cell apoptosis were determined by MTT method and flow cytometry, respectively. The results showed that CDDP could induce the activation of EGFR and the components in its downstream signaling pathways in a concentration-dependent manner. The combined treatment of AG1478 with CDDP could inhibit the proliferation of U87 glioma cells, arrest the cell cycle and promote cell apoptosis. In the EGFR signaling pathway, AG1478 decreased the phosphorylation of ERK, AKT and EGFR in U87 glioma cells. It was concluded that the combined treatment of AG1478 and CDDP may exert synergistic inhibitory effects on the growth of glioma cells by suppressing the activities of EGFR, AKT and ERK.

Objective To investigate the distribution of nail disorders in patients with a chief complaint of nail abnormalities. Methods From May 2007 to May 2010, patients who attended the dermatology outpatient clinic with a chief complaint of nail abnormalities were included in this study. Routine dermatological examination together with fungal culture, microscopic and pathological examination of affected nails was carried out to clarify the diagnosis of nail disorders. The results were statistically analyzed. Results Of the 2776 cases,onychomycosis accounted for 45.28% (1257), followed by paronychia (479, 17.26%) and psoriasis (122,4.39%). Conclusion In this region, patients with a chief complaint of nail disorders are most likely to suffer from nail infections.

Objective To summarize the clinical manifestations, diagnosis, and treatment of infantile Sandhoff disease. Methods The clinical data of one case with infantile Sandhoff disease were reviewed retrospectively. The related literatures were reviewed. Results The girl aged 1 year and 2 months suffered from psychomotor regression and intractable convulsions. The parents were consanguineous marriage. The fundus microscopy showed fundus erythema. Brain magnetic resonance imaging showed an abnormal signal of long T2WI and identical T1WI at left pons, white matter edema, and diffuse demyelination. No abnormal karyotype was observed. A chromosome microarray suggested multiple large homozygous chromosomes segments. The second generation gene sequencing showed deletion of c.1263_1268delTGAAGT:P. (Glu422_Val423del) deletion in exon 11 and a shear mutation of c.1614_2A>G:P? in intron 13 of HEXB gene which were carried by her parents respectively . The activity of HexA, HexA & HexB were 84 and 112 nmol?mg?1?h?1, respectively. Finally, this girl was diagnosed of infantile Sandhoff's disease. After treatment with valproate, levetiracetam combined with antiepileptic and glucocorticoids, episodes of convulsions were decreased gradually, and the reaction was better than before. In 5 months of follow up, the condition was stable, and no progression and no seizures exist. Her mother got pregnant again and received an amniocentesis on her 21+6 weeks of pregnancy, and results suggest that the fetus had the same mutation as this girl. Conclusions Sandhoff's disease is a type of rare hereditary lysosomal disease, characterized by progressive neurological impairment. Currently there are no effective treatments. Genetic testing is helpful in the diagnosis and prenatal diagnosis.