Multiple myeloma (MM) is a malignant plasma cell disease which occured predominantly in the elderly.In recent years,due to the application of small molecular proteasome inhibitor and immunomodulator,MM has become a chronic disease with good response to new treatments rather than a deadly disease that is lack of effective treatments.However,the occurrence of drug resistance makes MM less likely to be cured,which is one of the biggest challenges in MM clinical treatment.This article will review the mechanisms of acquired resistance to bortezomib in MM,including target genes modification,bypass signaling and so forth.

BACKGROUND:Zirconia al-ceramic crowns have been widely accepted in the clinic because of its excelent mechanical properties, biocompatibility and aesthetic performance. OBJECTIVE: To investigate the clinical efficacy of zirconia al-ceramic crowns prepared using computer-aided design/computer-aided manufacturingversusconventional method. METHODS:Eighty-seven patients who used zirconia al-ceramic crowns, consisting of 56 males and 31 females, aged 21-56 years were included in this study. Among these patients, 42 patients were subjected to tooth repair with zirconia al-ceramic crowns prepared using computer-aided design/computer-aided manufacturing technique (experimental group) and 45 patients received tooth repair with zirconia al-ceramic crowns prepared using conventional method (control group). At the end of the 6th month after zirconia al-ceramic crown repair, denture surface texture, the color of the restoration, anatomic appearance of prosthesis, marginal integrity, denture health and patient’s satisfaction were investigated between the experimental and control groups. RESULTS AND CONCLUSION:After repair with zirconia al-ceramic crowns, patient satisfaction rate of the color of the restoration and total patient satisfaction rate in the experimental group were significantly greater than in the control group (100%vs. 78%, 95%vs. 82%,P < 0.05). The anatomic appearance of prosthesis in the experimental group was superior to that in the control group (P < 0.05). There were no significant differences in denture surface texture, the color of the restoration, and marginal integrity between the experimental and control groups (P > 0.05). Discoloration, cracks and chipping and other adverse reactions were observed in neither experimental group nor control group. These findings suggest that the zirconia al-ceramic crowns prepared using computer-aided design/computer-aided manufacturing technique exhibit good aesthetic performance, stability and biocompatibility.

Wenchuan earthquate brought great misfortune to people,but this disaster has evoken human beings' moral power greatly.Love is the source of moral power,altruism is basic point of moral power and charity is performence of moral power.In this paper,we discuss moral powers' meanings and founctions in three aspects: great devotion of love,altruistic sacrifice and all kinds of charity without the boundary of counties and field.

Health Promotion ; Humans ; Occupational Health

Objective To detect the phenotype and genotype of 11 vancomycin-resistant enterococci(VRE).Methods Disk diffusion test,microdilution broth method,VITEK-2 and Etest were used to determin the susceptibility of 11 VRE to vancomycin and teicoplanin. MIC to 10 antimicrobial agents were determined with microdiluton broth method. vanA, vanB ,vanC_1, vanC_2 were detected with multiplex PCR and were further confirmed by DNA sequencing. TEM, tetM,ermB,aac(6′)/aph(2′′),ant(6)- I,aph(3′)-Ⅲ were detected with PCR.Results Susceptibilities of 11 VRE to vancomycin and teicoplanin were different in four vitro susceptibility testing methods. VRE showed resistance to erythromycin(9/11),ciprfloxacin(7/11),levofloxacin(7/11),rifampin(8/11) and chloramphenicol(7/11). HLGR and HLSR is 10/11 and 9/11 respectively. 1 VanA,4 VanB,5 VanC_1 and 1 VanC_2 were detected and their phenotypes confirmed to the genotypes. High rate of TEM(8/11), tetM(6/11), ermB(7/11), aac(6′)/aph(2′′)(7/11), ant(6)- I(5/11) and aph(3′)-III(9/11) were detected in 11 VRE.Conclusions VRE screening test and the determination of MIC are reliable in finding VRE. PCR is precise and specific in the testing and confirmation of VRE. The high rates of drug resistance genes showed the complicated mechanisms of drug resistance in VRE.

Objective:To establish a method of in vitro cultivation of epithelial cells of keratocystic odontogenic tumors(KCOT).Methods: Tissue block and enzyme digestion techniques were used for primary cultivation of KCOT cells.The cells were grown in keratinocyte-serum free medium(K-SFM).The biological characteristics of the cultivated keratinocytes were identified by phase microscopic observation and by immunohistochemistry of cytokeratin,vimentin,cytokeratin10 and 14.Results: KCOT keratinocytes could survive for 30-50 days in K-SFM after passing 2-4 generations.Cells were polygon and showed typical slabstone-like appearance.Immunostaining showed positive staining for cytokeratin antibody,and negative for vimentin.Conclusion: KCOT epithelial cells could be serially cultured in vitro in K-SFM by techniques suggested in this study.

Objective To investigate the effect of hepatitis B virus X protein (HBx) on the induction of eytochrome P450 (CYP) 3A4 by 1α, 25-(OH)2D3 in HepG2 cells in vitro. Methods HepG2 cells were transiently transfected with plasmid pEGFP-N1 (control) or co-transfected with recombinant HBx eukaryotic expression plasmid pcDNA3-X and pEGFP-N1. All HepG2 cells were divided into four groups: control group (without transfection), plasmid pEGFP-N1 transfection group, plasmid pEGFP-N1 transfection plus 1α ,25-(OH)2D3 group, plasmid pcDNA3-X and pEGFP-N1 co-transfection plus 1α ,25-(OH)2D3 group. The expression of CYP3A4 in HepG2 cell was induced by 0.35 μ mol/L 1α ,25-(OH)2D3 for 72 h, and mRNA levels and protein levels of CYP3A4 in the cells were detected by reverse transcriptase-polymerase chain reaction (RT-PCR) assay and Western-blot assay, respectively. The comparison between groups was done by F test. Results CYP3A4 mRNA level in plasmid pcDNA3-X and pEGFP-N1 co-transfection plus 1α ,25-(OH)2D3 group was 1.52 folds of control group, while that in plasmid pEGFP-N1 transfection plus 1α, 25-(OH)2D3 group was 3.97 folds (F= 4.72, P<0. 05). Similarly, intracellular CYP3A4 protein expression in plasmid pcDNA3-X and pEGFP-N1 co-transfection plus 1α , 25-(OH)2D3 group increased to 2.1 folds of control group, while that in plasmid pEGFP-N1 transfection plus 1α,25-(OH)2D3 group increased to 5.9 folds (F=4.68, P<0.05). Conclusion HBx interferes with the induction of CYP3A4 by 1α , 25-(OH)2D3 in HepG2 cell line, which suggests that HBx has suppressive effect on the expression of CYP3A4.

Endotoxemia is due to the infection of bacteria or lesions which release a lot of toxins into the blood,or the infusing of large amount of endotoxin-contaminated liquid.It can cause systemic inflammatory response syndrome,sepsis,or multiple organ dysfunction syndrome.Endotoxemia is a common and complex problem in modern emergency medicine.Early diagnosis and timely blocking not only can prevent further infection but also plays a positive role in the prevention and treatment of sepsis and its complications.In recent years,progresses have been made in the treatments of endotoxemia by hemoporfusion.The direct adsorption of endotoxin and inflammatory cytokines in blood can quickly reduce their concentration.This can not only weaken their own activity but also inhibit the release of other harmful cytokines,so as to improve the symptoms of infection.So far,the specific hishaffinity adsorbents having the clinical value are still at the exploratory stage.Although these materials were found effective in the treatments of endotoxemia,in-depth study need to be carried out on their clinical criteria in order to acquiremore satisfied results.

· AlM: To analyze the clinical data of 54 cases misdiagnosed as optic neuritis and to explore measures to reduce misdiagnosis
· METHODS: This retrospective study comprised 54 patients that had been misdiagnosed as optic neuritis from September 2000 to June 2013. The misdiagnosis features were summarized.
· RESULTS:Many diseases can easily be misdiagnosed as optic neuritis, including ischemic optic neuropathy, intracranial tumors, optic nerve vasculitis, myelinated nerve fibers, and so on.
· CONCLUSlON: The measures to reduce misdiagnosis consisted of detailed history collection, perfect physical examination and comprehensive expertise of fundus disease.

Objective To explore the clinical and laboratory features,and gene diagnosis method of Menkes disease (MD).Methods The clinical and laboratory features and gene diagnosis method of 2 infants with MD were reviewed.Results (1) Clinical features:both infants mentioned in this article were male.Their clinical manifestations were both began at 3-4 months age,including peculiar kinky hair,pale skin,pudgy cheeks,inguinal hernia,vessel abnormality,epilepsy and mental retardation.(2) Laboratory features:the ceruloplasmin concentrations significantly reduced to be ＜ 20 mg/L and 47 mg/L,respectively.The magnetic resonance angiogram images of case 1 showed the abnormal tortuosity of his intracranial vessels.The magnetic resonance images of case 2 showed a rapid progress from normal to severe brain atrophy within half a year.(3) Gene diagnosis:the sequencing of ATP7A gene in case 1 showed a nonsense mutation of c.2110 C ＞ T.The pathogenicity of this mutation had not been reported previously at home and abroad.The sequencing of the gene panel without pathogenic mutation was detected in case 2.But the multiplex ligation-dependent probe amplification test showed a gross deletion of ATP7A gene containing 8-12 exons.This mutation had been documented as a pathogenic mutation of MD.Both mothers of 2 patients were heterozygous mutation carriers of normal phenotype.Conclusions MD is a multisystemic disease caused by ATP7A gene mutation resulting in copper metabolism disorder.MD is inherited as an X-linked recessive trait.MD is characterized by kinky hair,connective tissue abnormalities and progressive neurodegeneration.Clinical diagnosis can be made on the basis of clinical features,findings of blood biochemical examination,and radiological findings.Gene sequencing and multiplex ligation dependent probe amplification test are the main technique widely used for genetic diagnosis.