Objective To analyze the immunological feature of the multiple myeloma. Methods The serum of 117 cases were detected by serum protein electrophoresis and immunofixation electrophoresis;and analyzed quantitatively immune globulin(IgG、IgA、IgM) ,total protein and albumin. Results Monoclone protein peak was found in 67 patients out of 117 patients tested(57.3%) ,it located mainly at γ border. Immunoglobulin G was found in 62 patients out of 117 patients tested(53.0%). Immunoglobulin A was 19 cases(16.3%) ,Immunoglobulin M was 12 cases(10. 1%) ,DL was 2 cases(1.7%) ,free light chain was 22 cases(18.8%). Homotypic immunoglobulin level increased notably and non-correspond constituent was low in immunoglobulin test. The protein quantified displayed that total protein increased and albumin decreased in different level. Conclusion The seroimmunological index played a crucial role in diagnois,clinical stage and prognosis of MM.

Objective To observe the effect of motor imagery on unilateral spatial neglect (USN) in stroke patients. Methods 40 stroke patients with USN were divided into treatment group (n=20) and control group (n=20). Both groups received routine physical therapy training,while the treatment group received motor imagery in addition. All the patients were assessed with Chinese Behavioral Inattention Test (CBIT), Mini-mental State Examination (MMSE), Fugl-Meyer assessment (FMA) and modified Barthel index (MBI) before and 8 weeks after treatment. Results The scores of CBIT, MMSE, FMA and MBI were better in the treatment group than in the control group (P<0.01).Conclusion Motor imagery combined with routine physical treatment can improve the function of stroke patients with USN and their activities of daily living.

Objective To observe the effect of community-based rehabilitation stroke unit on the function of stroke patients. Methods 94 patients with stroke were divided into intervention group (n=47) and control group (n=47). The control group accepted routine community home care, while the intervention group accepted community-based rehabilitation stroke unit care. They were assessed with modified Barthel index (MBI), simple Fugl-Meyer assessment (FMA) and Social Disability Screening Schedule (SDSS) before and after intervention. Results There was not significant difference between the groups in scores of MBI, FMA and SDSS (P>0.05) before intervention. All the scores improved significantly in both groups (P<0.01) 3 months after intervention, and improved more in the intervention group than in the control group (P<0.05). Conclusion Community-based rehabilitation stroke unit can improve the functional recovery of stroke patients.

Objective (1) To investigate the glucose and lipid metabolism 6-12 weeks after delivery in women with hyperglycemia during pregnancy. (2) To find out factors associated with the prognosis of women with hyperglycemia during pregnancy. (3) To investigate the feasibility of the diagnostic criteria set by the International Association of Diabetes and Pregnancy Study Group according to the follow-up data of women with hyperglycemia in pregnancy. Methods Clinical data of 262 women with hyperglycemia during pregnancy delivered in our hospital from January 1, 2007 to December 31, 2009 were collected. All patients underwent oral glucose tolerance test (OGTT) at 6-12weeks after delivery. They were divided into two groups according to the postnatal status of glucose and lipid metabolism. Multivariate Logistic regression model was used to analyze the factors affected glucose and lipid metabolism after 6-12 weeks of delivery. Results (1) Among the 262 women, 92(35.1%) were reported with abnormal glucose metabolism at 6-12 weeks of delivery, including one (0. 4 % ) woman with impaired fasting glucose, 81 (30. 9 % ) with impaired glucose tolerance, 4( 1.5 % )with impaired fasting glucose+impaired glucose tolerance and 6 (2. 3%) with diabetes mellitus.glucose levels in OGTT (OGTT 2hPG and the OGTT 3hPG) were risk factors for postpartum 0. 181-0. 918)]. (3) All markers of lipid metabolism were detected in 250 women with hyperglycemia during pregnancy at 6-12 weeks after delivery, the rate of abnormal postnatal lipid metabolism was 63.2%(158/250). In the abnormal group (n= 174), the most common abnormal marker was hypercholesterolemia (n = 126, 50. 4 % ), followed by high levels of low-density lipoprotein-cholesterol (n = 102, 40. 8 %), hypertriglyceridemia (n= 60, 24. 0 %) and low levels of high-density lipoproteincholesterol (n= 11, 4. 4 %). (4) Logistic regression model showed that elevated OGTT 2hPG was the risk factor for postpartum abnormal glucose metabolism [OR= 1. 364 (95%CI: 1. 063-1. 751)], while 0. 169-0. 851)]. Conclusions Women with hyperglycemia during pregnancy are more likely to present with abnormal glucose and lipid metabolism which commonly coexisted with insulin resistance.The risk factors for the postpartum abnormal glucose metabolism in mothers with hyperglycemia during pregnancy include early diagnosis, OGTT 2hPG and OGTT 3hPG, while the protective factor is breastfeeding. The risk factor for the postpartum dyslipidaemia in mothers with hyperglycemia during pregnancy is OGTT 2hPG, while the protective factor is high-density lipoprotein-cholesterol level in pregnancy.

Objective To investigate the values and characteristics of 75 g oral glucose tolerance test (OGTT) in women with different pre-pregnancy body mass index (BMI) and to evaluate the risk of gestational diabetes mellitus (GDM).Methods Medical records of 9 803 pregnant women attending the Peking University First Hospital and delivered between July 1, 2011 and December 31, 2013 were retrospectively analyzed.The frequency of adverse pregnancy outcomes across different degrees pre-pregnancy BMI was calculated.We divided participants into 4 groups based on pre-pregnancy BMI, underweight: BMI＜18.5 kg/m2 (1 221 cases), normal weight: 18.5-23.9 kg/m2 (6 594 cases), overweight: 24-27.9 kg/m2 (1 549 cases), obesity: ≥28.0 kg/m2 (439 cases).The diagnosis of GDM was made when any one of the values was met or exceeded in 75 g OGTT.The characteristics of 75 g OGTT and the incidence of GDM were analyzed.Results (1) The average age, pre-pregnancy weight, height and pre-pregnancy BMI of the participants was (30.5±3.7) years, (57.7±9.0) kg, (162.8±4.9) cm and (21.8±3.2) kg/m2, respectively.All the values of 75 g OGTT were presented normal distribution.(2)There was statistical difference in the glucose levels among women with different pre-pregnancy BMI.The fasting, 1-hour, 2-hour glucose were (4.55± 0.34), (7.31 ± 1.54), (6.38± 1.23) mmol/L in underweight women, (4.65 ±0.38), (7.70± 1.59), (6.70± 1.27) mmol/L in normal weight women, (4.82±0.47),(8.29±1.67),(7.04±1.29) mmol/L in overweight women and (4.94±0.48), (8.56 ± 1.64), (7.10 ± 1.35) mmol/L in obesity women (P＜0.01).(3) The incidence of GDM was 21.76％(2 133/9 803) in our study.There were 1 374 cases (64.42％, 1 374/2 133)with only one abnormal OGTT value while 759 cases (35.58％, 759/2 133)with two or more abnormal values.The incidence of GDM in women with underweight, normal weight, overweight and obesity was 12.53％(153/1 221),19.71％(1 300/ 6 594),32.73％ (507/1 549) and 39.41％ (173/439), respectively (P＜0.05).Meanwhile, the incidence of women with two and more abnormal OGTT value in GDM was increased as the pre-pregnancy increasing.Conclusion The risk of GDM is increased as pre-pregnancy BMI increasing, and the risk of GDM increases significantly in women with pre-pregnancy overweight or obesity.

Objective To investigate the adverse reactions by stereotactic body radiation therapy(SBRT)for advanced hepatocellular carcinoma and summarize nursing experience.Methods Forty-one patients with advanced hepatocellular carcinoma from the radiation department of Sun Yat-sen University Cancer Center from July 2010 to May 2012 were enrolled in this retrospective study.The adverse reactions were closely observed and the patients were given pertinent nursing.Results The effectiveness rate was 56.2%.During the therapy,36 patients developed nausea/vomiting of grade 1-2,taking up 87.8%,18 had grade 1-3 elevation of liver enzymes,taking up 43.9%,16 had grade 1-2 decrease of white blood cells,taking up 39.0%,8 had grade 1 anemia,taking up 19.5%and 21 had grade 1-2 decrease of blood platelet,taking up 51.2%.The adverse reactions were contained satisfactorily through careful observations and pertinent nursing.Conclusions The toxic reactions by SBRT are nausea,vomiting,enzymes elevation and decrease of whole blood cell.Therefore,nurses need to observe these toxic reactions carefully and give pertinent care to the patients so as to prevent the complications,especially radiation-induced liver injury.

Objective To explore the mechanism of insulin resistance regulated by fibroblast growth factor 21 (FGF21)and identify its role in oxidative stress.Methods High-fat diet-induced obese mice were treated with FGF21 ,and hepatic oxidative stress markers such as iNOS and insulin signaling molecules such as IRS-1 and Akt were assessed by Western blot and co-immunoprecipitation.Meanwhile,liver steatosis was assessed in liver sections stained with oil red O.Results Obese mice in FGF21 group showed reduced body weight,blood glucose and serum insulin levels,and improved insulin sensitivity as measured by glucose tolerance testing (GTT)and insulin tolerance testing (ITT)compared with obese mice in vehicle group.Meanwhile,FGF21 treatment in obese mice decreased protein expressions of iNOS and TNF-α,and increased insulin-stimulated IRS-1 tyrosine phosphorylation and Akt Ser-473 phosphorylation,indicating that FGF21 inhibited hepatic oxidative stress and restored impaired insulin signaling.Additionally,we found significantly reduced lipid accumulation in liver sections stained with oil red O in FGF21-treated obese mice.Conclusion Our results support the notion that FGF21 is an important regulator of insulin resistance and that FGF21 may reduce lipid accumulation in the liver,restore hepatic insulin signaling and improve insulin sensitivity in obese mice,at least in part,by inhibiting hepatic oxidative stress.Therefore,FGF21 has a potential value in clinical application.

Humans ; Metabolic Syndrome

Objective To observe the effect of Hydroxychloroquine (HCQ) on the apoptosis of peripheral blood mononuclear cells (PBMCs) of Systemic lupus erythematosus (SLE) patients and on the level of Th17 cells and IL-17.Methods The peripheral blood of 20 incipient SLE patients in active stage were taken,and PBMC were separated for cell culture.Using HCQ and Chlorambucil (CLB) as an intervention,and after cultured for 24 h and 48 h,the apoptosis of PBMC and the level of Th17 were tested using Flow cytometry (FCM),the supernatants were collected to test for the level of cytokine IL-17 by ELISA.One-way ANOVA was used and SNK-q was used in the comparison between every two groups.Results There was significant difference in the apoptosis rate of mononuclear cells between the HCQ and CLB group at 24 h [HCQ:(10.3±0.7)％,CLB:(8.5±1.1)％] and48 h [HCQ:(13.9±0.6)％,CLB:(11.8±0.8)％] (P＜0.05).There was significant difference between HCQ [24 h:(0.81±0.13)％,48 h:(0.73±0.45)％] and CLB group [24 h:(0.78±0.26)％,48 h:(0.68±0.20)％] in Th17 percentage (P＜0.05).The levels of IL-17 in the supematants of the HCQ group [24 h:(26.3±0.97)％,48 h:(24.2±0).91)％] and CLB group [24 h:(24.6±0.7)％,48 h:(22.6±1.1)％] were significandy different between the two groups(P＜0.05).Conclusion HCQ has apoptosis-induction effect on PBMC,and it can decrease the number of Th17 and IL-17 level in the PBMCs.

Objective To analyze the nutritional status of patients with continuous ambulatory peritoneal dialysis and explore reasonable and effective nursing measures.Methods Nutritional assessment was performed in 60 patients with continuous ambulatory peritoneal dialysis,using subjective integrated nutritional assessment,dietary analysis,measurement of biochemical indexes of the human body to analyze the factors that might affect the nutritional status of patients.Results 60 cases of malnutrition occurrd in 20 patients (33.3per cent),mainly due to insufficient protein and energy intake,inadequate dialysis,peritoneal inflammation,metabolic acidosis,psychosocial factors and not using erythropoietin,and so on.Conclusions Measures such as emphasis paid to malnutrition status of continuous ambulatory peritoneal dialysis patients,giving guidance of rational diet,performing full implementation of nursing measures according to the related factors,can improve the nutritional status of patients and improve patients' quality of life.