Bone disease is a major morbidity factor in patients with multiple myeloma and significantly affects their overall survival.A complex interplay between malignant plasma cells and other marrow cells results in the generation of a microenvironment to enhance both tumor growth and bone destruction.Bisphosphonates have consistently reduced the incidence of skeletal-related events in patients with multiple myeloma.However,their use is burdened with side-effects,including the risks of osteonecrosis of the jaw and kidney failure,suggesting that they should be discontinued after prolonged administration.New molecular targets of cell cross-talk in myeloma bone marrow are therefore under intensive investigation and new drugs are exploring in preclinical and clinical studies of myeloma bone disease.This review would focus on novel agents in myeloma bone disease.

Bruton tyrosine kinase (BTK) is a non-receptor tyrosine kinase which belongs to the Tec kinase family and plays an important role in B cell receptor signaling.Nowadays,BTK has been a nove] target for treating some B cell malignancies.Recently,some studies have confirmed that BTK inhibitor,PCI-32765 (ibrutinib),can effectively treat chronic lymphocytic leukemia,mantle cell lymphoma and so on.This review will discuss the preclinical and clinical development of this BTK inhibitor in B cell malignancies.

BACKGROUND:There are various internal fixators in treatment of distal femoral fracture. The commonly used fixators are locking compression plate, anterograde intramedul ary nails and retrograde intramedul ary nails. However, the efficacy of three common fixation is controversial.
OBJECTIVE:To compare the effect of locking compression plate, anterograde intramedul ary nails and retrograde intramedul ary nails for treatment of distal femoral fracture, and to select the appropriate internal fixation method.
METHODS:From May 2007 to November 2007, 118 patients with distal femoral fractures were treated with internal fixation in the hospital and their clinical data were analyzed retrospectively. Among them, 38 cases received locking compression plate, 21 cases received anterograde intramedul ary nails, and 59 cases received retrograde intramedul ary nails. The intraoperative blood loss, operative time, fracture healing time and rate of good postoperative recovery of knee joint in three groups were compared.
RESULTS AND CONCLUSION:Al the involved 118 patients were fol owed up for 14-26 months, average 20 months. No patients developed infection. Except one case delayed bone defect healing due to the fractures and was completely healed after bone fil ing at 19 weeks, the other cases healed within 4.5 months. There was no significant difference in fracture healing time among three groups (P>0.05). Intraoperative blood loss and operation time in anterograde intramedul ary nail group and retrograde intramedul ary nail group were superior to locking compression plate group. In addition, anterograde intramedul ary nail group was superior to retrograde intramedul ary nail group, with significant difference (P<0.05). Kolment grading fine rate in locking compression plate, anterograde intramedul ary nail and retrograde intramedul ary nail groups was 76.3%, 52.4%and 76.3%respectively. Retrograde intramedul ary nail fixation is firm, stable and reliable, with less intraoperative blood loss, shorter operation time, smal trauma, and easy fracture reset, especial y in the recovery of knee joint function. Compared with locking compression plate and anterograde intramedul ary nail, retrograde intramedul ary nailing treatment of distal femoral fractures has more advantages.

Objective To investigate the chemical constituents in the vines of Piper hancei for obtaining a more comprehensive understanding on its effective components. Methods Compounds were separated by column chromatography with silica gel and polyamide, and their structures were elucidated by spectral analysis and chemical evidence (IR, UV, MS, (~1H-NMR), (~(13)C-NMR)). Results Nine compounds were isolated from the chloroform extract fraction. Their structures were identified as: futoamide (Ⅰ), trichostachine (Ⅱ), retrofractamide A (Ⅲ), pipercide (Ⅳ), guineensine (Ⅴ), piperine (Ⅵ), piperettine (Ⅶ), piperovatine (Ⅷ), and (2E, 4E)-N-isobutyl-7-(3, 4-methylenedioxyphenyl)-hepta-2, 4-dienamide (Ⅸ). (Conclusion )Compounds Ⅱ-Ⅳ and Ⅶ-Ⅸ are isolated from the plant for the first time.

AIM: To develop a RP-HPLC method of determining ginsenoside Rg1 and ginsenoside Re in Wu-(shenqi) Oral Liquid(Radix et Rhizoma Ginseng,Radix Astragali,Fructus Ligustri Lucidi,etc.). METHODS: Hypersil-C_(18) column was used at 30 ℃.The mobile phase consisted of acetonitrile-water(103∶400) with 0.05% H_3PO_4.The detection wavelength was set at 203 nm.The flow rate was 1.0 mL/min. RESULTS: The linear ranges for ginsenoside Rg1 and ginsenoside Re were 0.188-6.016 ?g(r=0.999 9) and 0.197-6.323 ?g(r=(0.999)),respectively.Its average recoveries were 99.53% with RSD of 0.96% and 99.13% with RSD of 0.62%,respectively. CONCLUSION: This method is simple,accurate,reproducible,and can be used for the determination of ginsenoside Rg1 and ginsenoside Re in Wushenqi Oral Liquid.

Objective Proximal humerus fracture is the most common upper-arm osteoporotic fracture in elderly patients and the result of treatment directly affects the physiological function of the shoulder .This article discusses the clinical effect of the locking proximal humeral plate ( LPHP) combined with anti-osteoporosis drugs in the treatment of osteoporotic comminuted proximal humerus fractures in elderly patients . Methods This study included of 47 elderly osteoporotic patients with comminuted proximal humerus fractures treated from April 2009 to March 2012 and with complete follow-up data.According to the Neer classification , the patients were divided into groups A (LPHP treatment, n=23, including 13 cases of three-part fractures and 10 cases of four-part fractures) and B (LPHP+anti-osteoporosis drugs, n=24, including 13 cases of three-part fractures and 11 cases of four-part fractures). Results All the patients were followed up for 14 to 38 (mean 23.6) months.The postoperative healing time was significantly shorter in group B than in group A ([96.57 ±2.59]d vs [115.91 ±2.73]d, P<0.05), and the excellence rate was remarkably higher in B than in A (91.7%vs 78.3%,P<0.05). Conclusion With the advantages of short healing time and high excellence rate , LPHP+anti-os-teoporosis drugs is superior to simple LPHP in the treatment of osteoporotic comminuted proximal humerus fractures in elderly patients.

Aim To detect the effect of Bio on impro-ving insulin resistance and explore its molecular mech-anism. Methods The HepG2 liver cells were derivat-ed by high concentration insulin to establish the insulin resistance cell model, and the cells were intervened by Bio. The glucose consumption was measured by glu-cose oxidase and peroxidase ( GOD-POD) assay. The expression of PPARγmRNA was detected by RT-PCR. The expression of PPARγ protein was detected by Western blot method. Results The glucose consump-tion was significantly decreased in the insulin resist-ance cells after incubated with 1 . 72 × 10 -5 mol · L-1 insulin ( P<0. 05 ) . 10 -5 ,10 -6 ,10 -7 mol · L-1 Bio increased the glucose consumption 135%,62%,39%separately in the insulin resistance cells. RT-PCR a-nalysis of PPARγ showed that Bio raised the PPARγmRNA. Western blot analysis displayed that the pro-tein of PPARγ with Bio was increased. Conclusion Bio can improve the insulin resistance of the HepG2 cells, and the molecular mechanism may be relevant with raising PPARγ expression.

To study xanthones from the barks of Garcinia xanthochymus, the constituents were isolated by normal-phase and reverse-phase silica gel column chromatography from the EtOAc extract. Their structures were elucidated by spectral analysis. Three new xanthones were purified and identified as 1,2,5-trihydroxy-6-methoxyxanthone (1), 1,4,6-trihydroxy-5-methoxyxanthone (2), 1,2,7-trihydroxy-4-( 1,1-dimethylallyl) xanthone (3).

To study the chemical constituents of aerial parts of Laggera pterodonta (DC.) Benth., the air-dried aerial parts of this plant were powered and extracted with boiling water and purified by silica gel column chromatography and recrystallized. Eleven compounds were obtained from L.pterodonta. They were identified as to be 6-O-β-D-glucopyranosyl-carvotanacetone (1), pterodontic acid (2), 1β-hydroxy pterondontic acid (3), pterodontoside A (4), pterodondiol (5), pterodontriol B (6), 5-hydroxy-3,4′,6,7-tetramethoxyflavone (7), artemitin (8), chrysosplenetin B (9), quercetin (10) and β-sitosterol (11). Compound 1 is a new monoterpene glucoside. Compounds 10 and 11 were isolated from this plant for the first time. Compounds 2 and 5 showed moderate activity against bacteria including Staphylococcus aureus, Pseudomonas aeruginosa, Bacillus subtilis, Mycobacteium phlei and Bacillus circulans by paper disc diffusion method, while they both displayed no activity against Escherichia coli.

To study the chemical constituents of the Entada phaseoloides (L.) Merr., seeds of Entada phaseoloides were extracted with 70% ethanol at room temperature. Isolation and purification were performed by silica gel, reversed-phase silica gel column chromatography and semi-preparative HPLC. Structures of the pure compounds were established on the basis of spectral analysis. Four sulfur-containing amide compounds were isolated from the n-BuOH-soluble fraction and identified as entadamide A-beta-D-glucopyranosyl-(1-->3)-beta-D-glucopyranoside (1), entadamide A (2), entadamide A-beta-D-glucopyranoside (3) and clinacoside C (4). Compound 1 is a new compound. Compound 4 is isolated from the genus Entada for the first time.