Monoclonal protein (M protein) is a serum surrogate used to conduct diagnostic, prognostic, and therapeutic evaluations of monoclonal plasma cell proliferative disorders. Two basic methods, namely, serum protein electrophoresis and immunofixation elec-trophoresis, are employed to detect and characterize M protein. Although these techniques have considerably improved, M protein quantification exhibits several drawbacks. In serum protein electrophoresis, M protein can migrate to various locations, and low M pro-tein levels cannot form a typical peak;as a consequence, additional problems in measurements arise. In 2009, a novel immunoassay in-volving a heavy/light chain (HLC) was developed. HLC recognizes immunoglobulins with specific heavy and light chain isotypes. The ra-tio between an involved monoclonal immunoglobulin and an uninvolved background polyclonal immunoglobulin can be calculated through immunoglobulin quantitation by using isotype-specific light chains. This review summarizes relevant parameters that provide diagnostic, prognostic, and therapeutic data regarding monoclonal plasma cell proliferative disorders.

BACKGROUND: It has been widely accepted that both bone marrow-derived mesenchymal stem cells (MSCs) and hematopoietic stem cells (HSCs) have the capacity to differentiate into neural lineages. Some scholars believe that in addition to HSCs and MSCs, bone marrow (BM) also harbors a highly mobile population of CXCR4+ tissue committed stem cells (TCSCs), including skeletal muscles, heart, liver, and neural tissue. OBJECTIVE: To make sure that neural tissue-committed stem cells (NTCSCs) reside in the bone marrow, and to establish a purification and culture method for bone marrow-derived NTCSCs.DESIGN: Opening animal study.SETTING: Department of Anatomy, the Second Military Medical University of Chinese PLA. MATERIALS: Adult Sprague-Dawley (SD) rats (pathogen-free) were provided by the Animal Center of the Second Military Medical University of Chinese PLA. Dulbecco's modified eagle's medium (DMEM)/F12, B27, N2 and epidermal growth factor (EGF, Invitrogen Company), basic fibroblast growth factor (bFGF, CytoLab Ltd), rabbit anti-rat Nestin,CXCR4, β-Tublin Ⅲ, glial fibrillary acidic protein (GFAP, Santa Cruz Company), mouse anti-rat microtubule associated protein 2ab (MAP2ab) (Clone11-5B), cyclic nucleotide 3'phosphohydrolase (CNPase, Clone AP20, NeoMarkers Company), fluorescent(fluorescein isothiocyanate, Cy3) marker reagents (Wuhan Boster Bioengineering Co., Ltd), nuclear fluorescent dyes 4,6-diamidino-2-phenylindole(DAPI)(Sigma), immunohistochemistry reagents (Vector Laboratories Company) , and NycoPrepTM separation liquid (1.077A, Axis-Shield Company) were used in this study.METHODS: This study was performed in the Department of Anatomy, the Second Military Medical University of Chinese PLA from January 2004 to December 2006. Bone marrow was harvested from bilateral femurs and tibias of 2-3 weeks SD rats. Mononuclear cell layer was isolated by NycoPrepTM separation liquid and suspended in DMEM/F12(1:1)serum-free medium supplemented with 2% B27,1% N2, 20 μg/L bFGF, 20μg/L EGF, 1×105 U/L penicillin and 100 mg/L streptomycin. NTCSCs were isolated and propagated by suspensive growing from adherent cells in bone marrow in DMEM/F12 free-serum medium. MAIN OUTCOME MEASURES: NTCSCs were identified by immunocytochemistry for CXCR4, a marker of TCSCs and nestin, a marker of neural stem cells, and neural lineages marker protein after differentiation of cellular spheres. RESULTS: The NTCSCs spheres expressed nestin, a neural stem cell marker as well as CXCR4, a marker of TCSCs. The NTCSCs' spheres were naturally differentiated in DMEM medium with 15% fetal bovine serum. The differentiated cells expressed β-Tublin Ⅲ, MAP2ab, CNPase and GFAP, markers of neural lineages. CONCLUSION: NTCSCs reside in bone marrow and naturally differentiate into neural lineages in vitro.

BACKGROUND: It is proved that acupuncture can remarkably promote recovery of nervous function after spinal cord injury (SCI). Previous studies in our groups have been proved that electro-acupuncture can inhibit apoptosis in early period of SCI, but the mechanism is unclear yet.OBJECTIVE: To study the effect of electro-acupuncture on expressions of apoptosis inhibitory gene Bcl-2 mRNA and protein with hybridization in situ and immunohistochemistry and discuss the possible mechanism of apoptosis inhibited by electro-acupuncture in early SCI.DESIGN:Opening animal study.SETTING: Department of Anatomy, the Second Military Medical University of Chinese PLA; Shanghai Acupuncture & Moxibustion and Meridian Research Center.MATERIALS:Adult male SD rats of pathogen-free aged 2-3 months were selected in this study. Bcl-2 hybridization in situ kit was provided by Wuhan Boshide Biotechnology Company Limited and Bcl-2 antibody (1:200) was provided by Santa Cruz Biotechnology Company.METHODS: The experiment was completed at the Laboratory of Anatomy of the Second Military Medical University of Chinese PLA from July 2004 to December 2005. All experimental rats were randomly divided into model group, electro-acupuncture group, methylprednisolone group and sham operation group. T10 spinal cord was injuried by the modified Allen's method and treated with electro-acupuncture immediately, and then the expressions of Bcl-2 mRNA and protein were evaluated with hybridization in situ and immunohistochemistry combined with image quantitative analysis.MAIN OUTCOME MEASURES: ① Expressions of Bcl-2 mRNA and protein in early SCI; ② effect of electro-acupuncture on expressions of Bcl-2 mRNA and protein.RESULTS: The rats were supplied when they died during the experiment,and all 42 rats were involved in the final analysis. ① Moderate expression of Bcl-2 mRNA and protein was observed in the sham operation group.Expression of Bcl-2 mRNA was increased in model group at 6 hours after SCI, but expression ofBcl-2 protein was not changed. At 24 hours after SCI, both expressions of Bcl-2 mRNA and Bcl-2 protein were increased.Expression of Bcl-2 mRNA and protein was higher in electro-acupuncture group than that in mo del group (P ＜ 0.05), and there was no significant difference from that in methylprednisolone group. ② Amount of positive Bcl-2 mRNA cells was increased in electro-acupuncture group and methylprednisolone group at 6 hours after treatment, and gray value was decreased.There was significant and remarkably significant difference from those in sham operation group and model group, respectively (P ＜ 0.05-0.01). After 24-hour treatment, amount of positive Bcl-2 mRNA cells was increased in electro-acupuncture group and gray value was decreased.There was significant and remarkably significant difference from those in sham operation group and model group, respectively (P ＜ 0.05-0.01). ③ After 24-hour treatment, amount of immunohistochenistry positive Bcl-2 cells was increased in electro-acupuncture group and gray value was decreased. There was significant and remarkably significant difference from those in sham operation group and model group, respectively (P ＜ 0.05-0.01).CONCLUSION: Electro-acupuncture can up-regulate the expressions of Bcl-2 mRNA and protein so as to inhibit apoptosis in early SCI.

OBJECTIVE: To evaluate the short-term efficacy and investigate the factors of specific immunotherapy (SIT) efficacy of allergic rhinitis. METHOD: Fifty-seven patients with allergic rhinitis to dermatophagoides pteronysinus were included to receive SIT. Pair t-test was used to compare the symptom scores, visual analogue scores (VAS) and medication scores in patients before SIT and into maintain treatment statement to evaluate the clinical efficacy. T-test and Spearman correlation analysis were used to analyze the correlation between gender, age,reaction condition of skin prick test (SPT) and serum sIgE and the efficacy of SIT. RESULT: SIT was able to significantly reduce the symptom scores, VAS and medication scores. But the correlation between gender, age, SPT, and sIgE and theefficacy of SIT were not significant. CONCLUSION SIT is effective in the short-term treatment of AR. Further research is needed to investigate the factors that impact the efficacy of SIT.
Animals ; Humans ; Immunoglobulin E ; blood ; Immunotherapy ; Pyroglyphidae ; Rhinitis, Allergic ; therapy ; Skin Tests

Objective To investigate the case characteristics of immune liver injury induced by camrelizumab,and to provide reference for clinical safety of drug use.Methods According to keywords,the case reports of immune liver injury induced by camrelizumab published from the establishment of the database to August 2023 were retrieved and screened,and the data were extracted and analyzed.Results A total of 12 literatures were selected,involving 12 patients,including 7 males and 5 females.Among them,age 43-76 years old,the average age was(62.92±10.19)years old,and most of them developed immune liver injury within 1 month.The primary diseases were all malignant tumors,and the main dosage of camrelizumab was 200mg intravenously,once every 3 weeks;The main immune liver injury was grade 3.After drug withdrawal and corresponding symptomatic treatment,the symptoms improved in 3 cases(25.00%),recovered in 5 cases(41.67%),and did not recover in 4 cases(33.33%).Conclusion Camrelizumab can cause immune liver injury,which can lead to death in severe cases.Therefore,clinical rational use of camrelizumab should be strengthened,the awareness of immune-related adverse events should be improved and pay attention to the immunological liver injury caused by camrelizumab.

OBJECTIVETo evaluate the usage of Mayo staging system in Chinese patients with primary light chain (LC) amyloidosis.

METHODClinical data, treatment and outcome of 162 primary LC amyloidosis patients with Mayo Clinic staging in Peking Union Medical College Hospital from January 2009 to June 2015 were retrospectively analyzed.

RESULTSThe median age of 162 patients with Mayo Clinic 2004 stage was 57 (20-81) y, of them 62.3% were male. The number of patients with stage I to III were 44 (27.2%), 69 (42.6%), and 49 (30.2%), respectively. The median overall survival was not reached, 23 months and 12 months in patients with Mayo Clinic 2004 stage I, II, and III, respectively (P<0.001). Among 128 patients with Mayo Clinic 2012 stage, 48 patients (37.5%), 32 patients (25.0%), 32 patients (25.0%) and 16 patients (12.5%) were staged as Mayo Clinic 2012 stage 1 to 4, and the median OS was not reached, not reached, 13 months and 3 months, respectively (P<0.001).

CONCLUSIONMayo Clinic staging systems had important prognostic value in patients with primary LC amyloidosis.

Adult ; Aged ; Aged, 80 and over ; Amyloidosis ; diagnosis ; Female ; Humans ; Immunoglobulin Light-chain Amyloidosis ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Young Adult

Objective: To evaluate the clinical characteristics and outcomes of very high risk patients with primary immunoglobulin light-chain amyloidosis (pAL) at a single center in China. Method: Clinical data, treatment and outcome of 205 pAL patients in Peking Union Medical College Hospital from January 2009 to February 2016 were retrospectively analyzed. A 'very high risk’ group includes patients with Mayo 2004 stage Ⅲb and Mayo 2012 stage 4. Results: Of 205 patients, 34 (16.6%) were defined as very high risk pAL patients. The median age at diagnosis was 57 (20-84) years, and 22 patients (64.7%) were male. All 34 patients were diagnosed with cardiac involvement, multi-organ involvement was observed in 15 patients (44.1%) , and 27 (81.8%) had New York Heart Association Class Ⅲ or Ⅳ. Median values of serum cTnI, NT-proBNP, and free light chains difference were 0.25 μg/L, 11 733 ng/L, and 403 mg/L, respectively. Eight (24.2%) had more than 10% plasma cell on the bone marrow aspirate. Sixteen (47.1%) patients received bortezomib based chemotherapy and overall hematologic response rate was 58.3%. Median overall survival (OS) was 4 months. The estimated OS at 3, 6, 12, and 24 months was 51.3%, 44.0%, 35.2%, and 29.6%, respectively. Fourteen (41.2%) patients died within 3 months after the diagnosis. The estimated 1-year survival rate for the patients who got hematologic response, without hematologic response, and palliative treatment was 90.9%, 11.1%, and 0, respectively (P<0.001) . Conclusion Patients with very high risk pAL had very poor prognosis and the early death rate remained high. Those patients who obtained hematologic remission would have significantly better outcomes.

Objective:To analyze the effect of dexmedetomidine combined with esketamine anesthesia on non-cardiac surgery for coronary heart disease and the effect on hemodynamics,stress response and postoperative complications of patients.Method:A total of 106 patients with coronary heart disease who were going to undergo laparoscopic abdominal surgery from Oct 2021 to Nov 2022 in our hospital were selected and randomly divided into the control group and the observation group,with 53 cases in each group.All patients underwent conventional surgical treatment.The control group was given dexmedetomidine anesthesia,while the observation group was given dexmedetomidine combined with esketamine anesthesia.The surgical indicators,incidence of postoperative complications,diastolic blood pressure(DBP),systolic blood pressure(SBP),pain visual analog scale(VAS),Ramsay sedation score,and the levels of oxide dismutase(SOD),malondialdehyde(MDA),cortisol(Cor)and blood glucose(GLU)were compared between the two groups.Results:There was no statistically significant difference in the operation time between the two groups(P＞0.05),but the postoperative sufentanil dosage of the observation group was lower than that of the control group,and the number of effective compressions was higher than that of the control group(P＜0.05).At 12 h postoperatively,there was no significant difference between the VAS score and Ramsay sedation score of the two groups(P＞0.05),and the VAS score and Ramsay sedation score in the observation group were better than those in the control group at 4 h and 8 h postoperatively(P＜0.05).The levels of MDA,GLU and Cor in both groups increased and the level of SOD decreased at 4 h postoperatively(P＜0.05),and the level of SOD in the observation group was higher than that of the control group,and the levels of MDA,GLU and Cor were lower than those of the control group(P＜0.05).Before anesthesia,there was no statisti-cally significant difference in hemodynamic indexes between the two groups(P＞0.05).Compared with before anesthesia,there were changes in HR,SBP,DBP,and RR of the two groups at the end of the operation and 24 h after the operation(P＜0.05),and the HR,SBP,DBP,and RR of the observation group were better than those of the control group(P＜0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P＜0.05).Conclusion:Dexmedetomidine combined with esketamine anesthesia can effectively stabilize the hemodynamics of patients,reduce postoperative stress response,and reduce postoperative complications.

Talaromyces Marneffei infection is rarely reported in patients with chronic active Epstein-Barr virus (EBV) infection. We reported an old man with chronic fever, pleomorphic rash, cough, EBV viraemia, and secondary hemophagocytic syndrome. Repeated histological biopsy and culture of skin lesions revealed Talaromyces Marneffei. This patient was diagnosed as chronic active EBV infection, and Talaromyces Marneffei infection. After treated with glucocorticoid steroids and anti-fungal therapy, the patient finally recovered. EBV infection is usually seen in immune compromised patients, who are susceptible to opportunistic pathogens rarely as Talaromyces Marneffei in this case.

Objective:To evaluate the in vitro cross-neutralization of serum antibodies in human and mice immunized with inactivated SARS-CoV-2 vaccine against Delta and Beta variants. Methods:Human serum samples after a second and a third dose of inactivated SARS-CoV-2 vaccine and mouse serum samples after a two-dose vaccination were collected. The neutralizing antibodies in the samples against SARS-CoV-2 strains of prototype, Delta and Beta variants were detected using micro-neutralization assay in biosafety level Ⅲ laboratory. The seroconversion rates and geometric mean titers (GMTs) of antibodies were calculated.Results:The seroconversion rates of antibodies in human serum samples against different SARS-CoV-2 strains were all above 95%. After two-dose vaccination, the GMTs of neutralizing antibodies against the prototype, Delta and Beta strains were 109, 41 and 15, respectively. The GMTs decreased by 2.7 folds and 7.3 folds for the Delta and Beta variants as compared with the prototype strain. After the booster vaccination, the GMTs of neutralizing antibodies against the prototype, Delta and Beta strains were 446, 190 and 86, respectively. The GMTs of neutralizing antibodies against Delta and Beta variants decreased by 2.3 folds and 5.2 folds as compared with that against the prototype strain. The seroconversion rates of antibodies against different SARS-CoV-2 strains in mouse serum samples were all 100%. The GMTs of neutralizing antibodies against the prototype, Delta and Beta strains were 2 037, 862 and 408, respectively. The GMTs decreased by 2.4 folds and 5.0 folds for the Delta and Beta variants.Conclusions:Inactivated SARS-CoV-2 vaccine could induce a certain level of neutralizing antibodies against Delta and Beta variants in both human and mouse models. Moreover, a third dose of vaccine induced higher levels of neutralizing antibodies against Delta and Beta variants in human. This study provided valuable data for the clinical application and protective evaluation of the inactivated SARS-CoV-2 vaccine.