Tumor stem cells have abilities of high proliferation,serf-renewal and multi-directional dif-ferentiation ;which is closely responsible for tumor' s survival and recurrence. A minor portion of myeloma stem cells exist in multiple myeloma. The research of myeloma stem cells' origins, phenotypic analyses, signaling pathways, drug resistance and other biological characteristics will do great efforts to the effective therapy of mul-tiple myeloma.

Objective To investigate the clinical significance of serum lactic dehydrogenase (LDH)alteration in patients with acute leukemia (AL). Methods Serum LDH of 156 AL patients including untreated 63,completely remission (CR) 46 and relapsed 47 were measured by biochemistry analyzer. R banding technique was used for karyotype analysis this three groups were divided according to poor, good and normal prognostic chromsome. The correlation between LDH level with AL periods, chromsome groups, peripheral WBC counts and leukemia subtypes were analysed. Results The LDH level of AL patients untreated (P50 399 U/L) and relapsed (P50 265 U/L) were significantly higher than those CR (P50 153 U/L), P ＜0.05. LDH level were closely correlated with peripheral WBC counts (rs=0.604) and leukemia cells of bone marrow (rs=0.538, both P ＜ 0.01), and both were also correlated with leukemia subtypes (LDH in subtypes L2, M4 were higher than other subtypes of AL, P ＜ 0.01). The refractory and relapsed AL patients had higher LDH level (P50 538 U/L) than the others (P50 294 U/L) when they were diagnosed. And those with poor prognostic chromsome also had higher LDH level (P50 778 U/L) than those with good (P50 306 U/L) and normal prognostic chromsome (P50 405 U/L, P ＜0.01). Conclusion LDH level increased obviously in untreated AL patients and decreased in CR ones. It was correlated with different periods, subtypes and grade malignancy of AL So LDH level can be considered as an important indicator for therapeutic effects and prognosis for AL patients.

This paper reports the determination of sex of human blood stains in threecriminal cases by the DNA amplification technique.The results fit the cases de-tails and gave the scientific evidence for the justice.The blood stains were dige-sted with proteinase K.The protein was extracted with the phenol-chloroform.The DNA was precipitated with NaCl and ethyl alcohol.Amplification of DNAwas carried out using two pairs of primer Y1.1 Y1.2 and Alu9.1 Alug.2 and heatstable FD polymerase.The amplified products were subjected to agarose gel(con-taining ethidium bromide)electrophoresis.Sex of blood stains was determinedaccording to the amplified products.PCR technique is rapid to perform,sensitiveand simple.No special equipments and isotope labelled probe are required.

Objective To investigate the pathophysiology mechanism in belching by using high resolution manometry combined with impedance monitoring.Methods Ten belching patients (four male and six female,ages ranged from 28 to 50 years) received high resolution manometry combined with impedance monitoring.The characters of esophageal motility at rest,swallowing and belching and the possible mechanism of belching were analyzed.Results Nine of 10 patients had esophageal peristaltic dysfunction,displaying as non-peristaltic contraction such as non-conduction contraction,interrupt contraction and dropping contraction.The pressure of the lower esophageal sphincter (LES) of three patients decreased.LES of one patient had incomplete relaxation.Nine of 10 patients were supragastic belching,in which air moved rapidly into esophagus and reversed exited from the mouth in one second.Among nine supragastic belching patients,the pleural pressure of seven patients increased during inspiration,upper esophageal sphincter relaxed and air was mistaken into the esophagus.The pharyngeal muscle contracted in two patients and the air was forced into esophagus.Of all the patients,intragastric and esophageal pressure increased through abdominal muscles and diaphragm contraction and air exited from the mouth.Conclusions The results of this study indicated that there was esophageal peristaltic dysfunction in belching patients.There was no frequently air swallowing in excessive belching patients,the typical belching model was supragastic belching.

Objective To investigate the effect of autonomic nervous dysfunction on pathogenesis of gastro-esophageal reflux disease(GERD).Methods Autonomic nervous function(ANF) was assessed by cardiovascular reflex tests in healthy volunteers and patients with GERD;Based on the ANF test results,the relationship between the impairment degree of autonomic nerve and the esophageal motility or the reflux esophagitis or the score of reflux symptoms was investigated.Results ① 59.5% of patients with GERD have abnormal ANF and the rate in GERD patients is much higher than that in healthy volunteers,parasympathetic nerve impairment is predominant.② The score of reflux symptoms in patients with normal ANF is significantly lower than that in patients with abnormal ANF(6(2,7.6)vs 9(4.1,17),P

Objective To evaluate influencing factors of the long-term maintenance therapy in patients with gastroesophageal reflux disease (GERD).Methods 156 Patients with GERD were divided into on-demand therapy group and continuous therapy group by their treatment,according to symptom relief and improvement of quality of life in the course of therapy.The relationship between treatment and course,symptoms, esophageal motility,24-h pH monitoring and endoscopic findings were analysed.Results (1)5 Patients showed no response to acid suppression therapy and were excluded.For the 151 patients,92 were in on-demand therapy group,and 59 were in continuous therapy group.(2)The disease course and symptoms score in on-demand therapy group were significantly longer and higher than those of continuous therapy group (P

Objective To investigate the feasibility and reliability of perfusion nutrient load test (P-NLT) in evaluating gastric accommodation and hypersensitivity.Methods Forty-one healthy volunteers randomly received either drinking nutrient load test (D-NLT) or P-NLT (through nasalgastric tube) in separate day within one week.Meanwhile,intragastric pressure (IGP) was recorded and 2D ultrasonography (2DUS) was used to measure both the proximal gastric area (PGA) and proximal gastric volume(PGV) during NLT.Visual analogue scale was used to evaluate satiety during NLT.Ten healthy volunteers experienced second P-NLT within 3 months.Results The amount of nutrition liquid was higher in P-NLT than in D-NLT at minimal and maximal satiety(P <0.01).However,there was no difference in the IGP between P-NLT and D-NLT at minimal and maximal satiety (P>0.05).The PGA and PGV at maximal satiety were significantly higher in P-NLT than DNLT (P <0.01),but no difference existed at minimal satiety between two methods (P >0.05).The amount of nutrition liquid at maximal satiety was significantly correlated with PGA and PGV at maximal satiety in both P-NLT and D-NLT (PGV:r = 0.771 vs r = 0.500;PGA:r = 0.600 vs r =0.430).In P-NLT group,there was no significant difference among age,BMI and gender with respect to IGP and maximal volume (MV) (P >0.05).Whereas no difference was found in threshold volume (TV) and MV between the first and the second P-NLT studies (P >0.05).Conclusions It suggests that P-NLT might be more accurate than D-NLT in predicting gastric accommodation in healthy volunteers without any influence such as swallowing air,taste and psychological disturbance.It has a good repeatability.P-NLT is a potential method in assessment of proximal gastric accommodation and MV might be more suitable for assessment gastric accommodation.

Aim To explore the hemodynamic change of elderly isolated hypertension(EISH). Methods Color doppler ultrasonography were applied to examine thirty EISH patients and twenty eight elderly healthy subjects. The left ventricular systolic function as well as hemodynamic parameters were measured. Results The indices of left ventricular systolic function in EISH group such as SV,CO,EF and CI were obviously higher than those of control group(P<0.05),Linear relevant analysis show that pulse pressure was remarkable related to SV,CO,EF and CI in EISH group,with r value 0.43,0.56,0.46,0.45 respectively.Conclusion EISH patients apparently had ventricular systolic dysfunction and hemodynamic abnormality. Pulse pressure may be associated with development of sysytolic dysfunction.

Objective To analyze the differences with the expression of glucocorticoids receptor isoforms ( GRα, GRβ, GRγand GR-P ) and cytokines [ IL-6, macrophage migration inhibitory factor (MIF), IFN-γand IL-10] between patients with systemic lupus erythematosus (SLE) and rheumatoid ar-thritis ( RA) , and to further understand their correlations with disease activities.Methods Fifty-five pa-tients with SLE, forty-nine patients with RA and thirty-eight healthy subjects were recruited in this study. All patients were steroid-naive.The expression of GRα, GRβ, GRγ, and GR-P in peripheral blood mononu-clear cells at transcript levels were determined by real-time PCR.Enzyme-linked immunosorbent assay was used to detect the expression of IL-6, MIF, IFN-γand IL-10 in serum samples.Results The percentages of GRαin all subjects were the highest among four isoforms of GR, followed by GR-P, GRγand GRβ.Com-pared with healthy subjects, patients with SLE or RA showed significantly decreased expression of GRα( P<0.05), but increased expression of GR-P (P<0.05).The percentages of GR-P in patients with RA were higher than those in patients with SLE (P<0.05).The expression of GRαwas negatively correlated with SLE disease activity index (SLEDAI) and disease activity score 28 (DAS28).SLE or RA patients with high disease activity showed lower expression of GRαthan those with low disease activity.The levels of IL-6, IFN-γand MIF in patients with SLE or RA were significantly higher than those in healthy subjects ( P<0.05).A negative correlation was observed between the expression of IL-6 and GRαin patients with SLE (P<0.05).The expression of IFN-γwas negatively correlated with GRαin patients with RA (P<0.05). Conclusion There were significant differences with the expression of GR isoforms among patients with SLE, patients with RA and healthy subjects, indicating the change of internal environment in patients might be in-volved in GR alternative splicing.GRαwas the predominant isoform and was negatively correlated with dis-ease activities.Oversecretion of cytokines resulted in a decreased expression of GRα.This study would be useful for the diagnosis of the disease status and for monitoring clinical treatment.

Objective To determine the postprandial acid distributions in patients with gastroesophageal reflux disease (GERD), and their potential relationship with esophageal acid exposure. Methods Esophageal and gastric pH were recorded in a 1 h fasting segment and a 4 h postprandial segments using a triple-channel pH catheter with three antimony electrodes, which were positioned 5 cm proximal to the upper margin of LES(LES-5 cm), 5 cm and 10 cm distal to the upper margin of LES(LES+5 cm and LES+10 cm), respectively. Esophageal acid exposure and gastric integrated acidity (IA) were calculated for each ambulatory pH study. Ten healthy subjects (HS) and 10 patients with GERD were enrolled. Results (1) Total postprandial IA had a trend to be lower at LES+5 cm than at LES+10 cm in HS, but there was no significant difference between the two positions in patients with GERD. (2)Two hours after meal, there was no significant difference of gastric IAs and baseline in HS. Whereas gastric IAs in patients with GERD returned back to a higher level than baseline: LES+5 cm: 5.4 (1.8-6.8) mmol/L?h vs 1.8(0.3-3.1) mmol/L?h (P