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.

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 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.

Comparative proteomies is to compare the differential expression of overall protein profiles in different time and space,to identify differential proteins or protein groups on the expression amount,expression level,and modification status and to further investigate the differential proteins and their function.The aim of this paper is to introduce the application of comparative proteomies in coloreetal carcinoma on the level of cell,tissue,and body fluid.

ObjectiveTo compare the sensitivity among three diagnostic criteria for multiple myeloma.MethodsA total of 220 patients with multiple myeloma were studied retrospectively to compare thesensitivity, aswellastheirclinicalmanifestations, cellmorphologyinbonemarrowand immunophenotype.Results (1) The sensitivity of domestic diagnostic criterion in 1975 was 79.1％ (174/220) and there were some drawbacks in type identify.The sensitivity of WHO diagnostic criterion in 2001 was 97.3％ (214/220) and the sensitivity of domestic diagnostic criteria in 2011 was 100％. (2) Immunoglobulin level in 12.7％ (28/220) patients was ＜ 30 g/L,plasma cells count in bone marrow in 13.6％ (30/220) was ＜ 10％ ; 2.7％ (6/220) patients had not met the standard in immunity globulin and bone marrow plasma cells count.(3) The immunophenotype was CD38 positive ( 100％ ),restricted light chain (kappa/lambda) and CD19 100％,CD138 (98.2％,216/220) negative.ConclusionsAmong the three diagnostic criteria,the highest was 2011 domestic diagnostic criteria.Comprehensive analysis include clinical manifestations,cell morphology,immunophenotype will contribute to the diagnosis for multiple myeloma.

The 80th American Diabetes Association(ADA)Scientific Sessions was held online from June 12 to 16, 2020. There was some hot debates on the topics of diabetes related complications in the annual meeting of ADA. Endocrinologists and cardiologists debated and presented different perspectives. This paper will summarize the debates on the following five topics: (1)Microvascular and macrovascular complications of diabetes are distinct pathophysiologic entities.(2)Guideline recommendations for cardiovascular risk and disease management in type 2 diabetes.(3)Drawing the line between primary and secondary prevention—necessary or too simplistic? (4)Should metformin be considered first-line therapy for individuals with type 2 diabetes with established arteriosclerotic cardiovascular disease(ASCVD)or at high risk for ASCVD? (5)Primary cardiovascular prevention with sodium-glucose co-transporter 2(SGLT2)inhibitors or glucagon-like peptide-1(GLP-1)receptor agonists.

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

A new round of public hospital reform demands higher requirement of public welfare and average medical expenditure control per visit.This paper introduced the practice of controlling the average medical expenditure per visit,and explored the control outcomes of the average medical expenditure per visit at the public hospitals.The measures proposed include supervision of key indexes,multi-angle control strategies formulation,multi-aspect effective pathway implementation,information feedback system improvement and high-cost medical consumables control.

The bcr-abl negative myeloproliferative neoplasms (MPN) include polycythemia vera (PV),essential thrombocythemia (ET) and primary myelofibrosis (PMF).Along with the detecting of JAK2 V617F gene mutation in MPN patients,a series of small molecules drugs that targeted to the mutation have been investigated in clinical trials.Ruxolitinib is the inhibitor of JAK1/2,which has been proved by USA Food and Drug Administration (FDA) and the European Medicines Agency (EMA) to treat patients with intermediate-2 or high-risk PMF or post-PV MF or post-ET MF and PV patients who are intolerant or resistant to hydroxycarbamide,attributed to a number of clinical trials,especially in COMFORT-Ⅰ and COMFORT-Ⅱ.As a result,the MPN patients have new hope for the treatment.

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.