The present paper reports the clinical observations on 45 cases of multiple myeloma. In 35 patients, the tumors were immunologically typed as type IgG in 16, IgA type in 9, 2 each of ?, ? type light chain disease (LCD) and double light chain disease (D-LCD). 2 of IgD type, 1 each of non-secreting type (n-SMM) and ? heavy chain disease (?HCD). Further immunological subtyping dis-closed that most of the cases belonged to IgG. ? and IgA1 ? types.

Objective To find out the situation of laboratory testing capacity of fluoride in drinking water in Guizhou Province.Method Assessment of fluoride detection capabilities in nine cities (states) and 31 countylevel laboratories of the province in 2010 was carried out,the test results of individual indicators were evaluated using a single Z-score method,and the determination was based on the fluoride ion selective electrode method of Drinking Water Saritary Standard Test Method (GB/T 5750.5-2006) or fluorine reagent spectrophotometry.Results The feedback rate of fluoride measurement results was 100％,the satisfactory rate of laboratory results was 82.5％,the suspicious rate of results was 7.5％(33/40),and the unsatisfied rate was 10.0％(3/40).Conclusion The fluoride detection capability of most laboratories that participated in the proficiency test has met the requirements,and 10 percent of the laboratory's capacity needs to be improved.

Objective To detect the changes in the expression of discoidin domain receptor 2(DDR2)and matrix metalloproteinase (MMP)-13 in different stages of cartilage and synovium damage of osteoarthritis rats.The relation between DDR2 and the degree of cartilage damage was explored.Methods Modified papain knee joint injection approach was adopted to establish animal model of OA.The expression and distribution of protein of DDR2 and MMP-13 were checked in articular cartilage and synovium at different stages of OA.Results The expressions of DDR2 in articular cartilage and synovium of experimental groups were different from those of the normal group (P＜0.01).They were higher in cartilage than those in the corresponding synovium.The expressions of MMP-13 demonstrated the same characteristics with those of DDR2,r=0.93(P＜0.01).Conclusions The important role of DDR2-MMP-13 in cartilage damage has been proven in the pathogenic process of OA.The upregulated expressions of DDR2 in articular cartilage and synovium have a detrimental effect on cartilage degeneration.

Objective Investigating the relationship between the incidence of Primary Acute Cerebral Infarction (PACI) and seasonal variation to employ measures to prevent PACI with climate change. Methods A retrospective analysis of patients diagnosed with PACI between 2009 and 2013 in the department of Neurology of Second hospital of Tian Jin Medi-cal University (n=1 198 patients) was carried out. Combined with the general clinical data, we analyzed seasonal, monthly and weekly variation among PACI incidents. Results The incidence of PACI increases over years between 2009 to 2013 (P ＜ 0.01). Significant difference of incidents of PACI was observed between each season (P=0.047). Incidence of PACI peaked in winter(30.33 ± 9.63/month), while bottomed in spring(21.83 ± 5.36/month). Significant difference of incidents of PACI was also observed between each months(P=0.010). The monthly incidence was highest in January and February (33.25 ± 9.62/month)and lowest in March and April(20.75 ± 4.89/month). The seasonal variation was only found in the pa-tients who are complicated with pulmonary infection (P＜0.01) regardless of the presence or absence of other risk factors, such as smoking, drinking ,hypertension, coronary heart disease, and diabetes mellitus. The weekly variation of PACI was on-ly significant in patients younger than 65 years old(P=0.043). The peak incidence among a week was Monday(17.86%),and incidence bottomed on Friday (13.36%). Conclusion Our study revealed that the incidence of PACI increase over year be-tween 2009 to 2013 and it shew a characteristic variation with respect to season, month and week. Based on these results, we can formulate prevention measures accordingly.

Objective To investigate the clinical value of laparoscopic hysteromyomectomy.Methods The clinical data of 98 cases of laparoscopic hysteromyomectomy(LM)and 76 cases of transabdominal Myomectomy(TAM)were retrospectively analyzed and comparison was made on the operative time,operative blood loss,postoperative blind enema time,body temperature recovery time,the rate of postoperative complicating disease and hospitalization after operation.Result Though the mean opertative time is the same,the mean operative blood loss,the mean body temperature recovery time,postoperative blind enema time,and the mean hospitalization was smaller in LM group than in TAM group(P＜0.05).Conclusion Laparoscopic hysteromyomectomy has the advantage of minimal invasion,short in-hospital days,fast recovery and low complication rate,which is an ideal treatment of hysteromyoma.

The relationship between tumour necrosis factor-alpha (TNF-alpha) gene polymorphism and inhibitory effects of triptolide on TNF-alpha production from peripheral blood mononuclear cells (PBMC) of healthy humans was investigated. Genomic DNA from 41 healthy people was typed for TNF-alpha--308 polymorphism by allele-specific polymorphism chain reaction (AS-PCR). The TNF-alpha concentration in the supernatant was measured by ELISA. The results showed that the production of TNF-alpha from TNF-alpha--308 non-G/G genotype PBMC was higher than that from TNF-alpha--308 G/G genotype PBMC after stimulated by LPS. Triptolide could lower the production of TNF-alpha from G/ G genotype PBMC, but had no effect on the level of TNF-alpha from non-G/G genotype PBMC. It was concluded that TNF-alpha gene polymorphism was related to the TNF-alpha production from triptolide-inhibited PBMC culture in healthy humans.

Objective To learn the economic operation and the existing problems of county TCM hospitals in Chongqing from 2012 to 2014.Methods 2012-2014 data of annual health financial report were used to conduct descriptive statistics and analysis of the current operation benefit, operating efficiency, debt paying ability, development ability, and cost management ability.Results From 2012 to 2014, the annual incomes of TCM county hospitals in Chongqing were 2.802, 3.412, and 4.385 billion RMB; the annual expenses were 2.813, 3.343, and 4.347 billion RMB; the ratios of income and expense about medical treatment were 0.86, 0.90, and 0.92; the ratios of income and expense of medicine were 1.16, 1.15, and 1.11; the outpatient amounts were 5.45, 5.87, and 6.99 million; the hospital discharge amounts were 330.4, 405.2, and 469.3 thousand; the charges per patient were 153.40, 177.12, and 188.71 RMB; the charges pre bed were 465.83, 533.14, and 571.02 RMB; medical expenses per patient were 4923.26, 5416.77, and 5576.01 RMB; the current ratios were 1.00, 1.06, and 1.09; the asset-liability ratios were 62.25%, 63.79%, and 61.37%; the annual growth rates of total assets were 14.06 % and 24.54%, and the annual growth rates of net assets were 19.44% and 21.70% during 2013 to 2014; 100-yuan hygienic materials and medicine consumption were 51.23, 51.10, and 50.07 RMB during 2012 to 2014; the management fee rates were 18.55%,15.44%, and 14.82%.Conclusion The general economic running of county TCM hospitals in Chongqing is stable and financial balance moves towards rationality; social benefit, expand capacity and cost management ability are enhanced gradually. However, the problems about insufficient government finance input, small medical income elasticity, poor debt paying ability, and diseconomies of scale still exist.

Objective To evaluate the clinical effect of laparoscope and open surgery for treatment of gynecological diseases. Methods 620 female patients with gynecological diseases were divided into two groups randomly (Group A: n = 310, Group B: n = 310). Group A was treated by laparoscopic surgery, Group B was treated by open abdominal surgery. The clinical effects of laparoscope and open abdominal surgery were compared between the two groups. Results Group A had better results in intraoperative blood loss, recovery time of intestine and stomach function, get out of bed time and hospitalization time than that in group B, there were significant difference (P < 0.01). The gastrointestinal reaction rate after operation, the anodyne utilization, the complication incidence rate was 9.7 %, 5.2 %, 3.9 % respectively, it is lower than that in group B; and wound healing was better in group A than group B, with statistical difference (P < 0.01). There was no significant difference in operation time between the two groups (P > 0.05). Conclusions Laparoscopic surgery has better effects for treatment of gynecological diseases than open abdominal surgery.

Objective To explore the influence of seasonal variations on acute cerebral infarction outcome. Meth-ods We collected data from acute cerebral infarction patients in the Second Hospital of Tianjin Medical University from January 2009 to February 2012. All cases were classified by months and seasons into different groups to analyze the season-al variations retrospectively. Results (1) The percentage of good outcome of acute cerebral infarction show significant dif-ference between each month(P<0.01). The percentage of good outcome was highest in August(92.1%), lowest in Decem-ber(78.1%), second lowest in April(81.9%). The percentage of good outcome in summer(91.6%)was higher than spring (87.2%), autumn(86.4%)and winter(83.9%)(P<0.05). (2) Among those patients converted to bad outcome more pa-tients was attacked by cerebrovascular accident in winter(68.3%)than in summer(43.2%), and more patients was combined with a pulmonary infection in winter(69.5%)than in summer(48.6%)and in autumn(49.3%)(P<0.05). (3) Seasonal effect in acute cerebral infarction outcome was obvious in those≥65 years of age(P<0.05). Conclusion Seasonal changes are associated with the outcome and severity of acute cerebral infarction.

AIM: To determine whether triptolide induce apoptosis of synovial cells in collagen - induced arthritis(CIA) in rats. METHODS: The male Wistar rats were used to make CIA models by immunized with Bovine collagen Ⅱ ( BC Ⅱ )in Freund's complete adjuvant (FCA). A total of 20 CIA rats were randomly divided into 2 groups, triptolide group (10 rats) and CIA control group (10 rats). Triptolide group were administered with triptolide at 40 μg/kg body weight intramuscularly every three days. CIA control group andanother 10 age - matched normal rats were given normal saline instead. The rats were sacrificed on the 31st day after the triptolide administration. The pieces of synovium of the rat knee joints were harvested. The synovium was examined by HE staining and electron microscope. The apoptosis was tested by TUNEL and flow cytometer. RESULTS: The earlier phase of apoptotic synoviocytes were observed under the electron microscope. The flow cytometry showed that the percentage of the apoptotic cells was (3.98 ± 1.16)% in the triptolide group, (1.83 ± 0.82)% in the CIA control group, and (0.87 ±0.24)% in the normal group (P＜0.01: triptolide vs control group). While the percentage of the cells in DNA synthesis phase was (3.3± 1.2)% in the triptolide goup, (8.0± 1.4)% in the CIA control group, and (3.4 ± 0.7)% in the normal group.There is significantly different in the apoptosis changes between the triptolide group and the CIA control group ( P ＜ 0.01: triptolide vs CIA control group). The TUNEL labeling demonstrated that the percentage of the apoptotic cells was (4.5 ± 1.0)% in the triptolide group, (2.2 ± 1.0) % in the CIA control group, and ( 1.0 ± 0.4) % in the normal group. The difference of apoptotic rate between the triptolide group and the CIA control group is significant ( P ＜ 0.01). CONCLUSION: This study demonstrates that triptolide can induce apoptosis in CIA rats, which may be one of the mechanisms that triptolide treats the rheumatoid arthritis.