Notch signal pathway can regulate the morphogenesis,apoptosis and cellular proliferation of normal tissues and organs,which plays an important role in regulating hematopoietic cells proliferation and differentiation in bone marrow microenvironment.The occurrence and development of multiple myeloma(MM)are closely related to the bone marrow microenvironment in which many signal pathways are involved.Recent studies show that Notch signal pathway promotes the development and progression of many cancers including MM,which plays key roles in tumor invasion and drug resistance.This review focus on the recent findings on Notch signal pathway in MM,and reveals that Notch signal pathway will be identified as a potential new therapeutic target in MM.

Stroke has become the leading cause of death in Chinese residents. As the cornerstone of the primary and secondary prevention of ischemic stroke, aspirin can prevent the occurrence and recurrence of ischemic stroke in a certain extent. However, some patients stil have vascular events after taking aspirin regularly or higher platelet aggregation rate. This phenomenon is caled aspirin resistance or aspirin low reactivity. This article reviews the occurrence, detection methods, and treatment measures of aspirin resistance in patients with ischemic stroke.

Objective To investigate the relationship between single nucleotide polymorphisms (SNPs) of UGT1 A6 and aspirin response in a cohort of Chinese Han population.Methods A total of 323 ischemic stroke patients consecutively registered in Nanjing Stroke Registry Program from September 2011 to October 2014 were enrolled.Three SNPs (rs6759892,rs2070959 and rs1105879) of UGT1A6 were genotyped in these ischemic stroke patients.Association of genotypes and aspirin response was evaluated by generalized linear model.Indicated with the inhibition rate of platelets,aspirin response was assessed by thromboelastograph.Results The mutation allele (G) of rs2070959 was positively related to platelets inhibition (β =0.084,P =0.010,Pcorrected =0.029),especially in male (β =0.098,P =0.006,Pcorrected =O.019).The dominant models of rs6759892,rs1105879 were also modestly related to aspirin response (P=0.015,Pcorrected=0.046 in both SNPs) in male.Thus the polymorphisms of UGT1A6 showed a relationship with aspirin response,especially in males.Conclusions The results indicated that genetic polymorphism of UGT1A6 might have an effect on individuals' aspirin response,especially in males.These findings can help clinicians to optimize the antiplatelet therapy for ischemic stroke patients.

Ginsenosides in the decoction of Radix Ginseng, Radix Ginseng with Flos Lonicerae, Radix Polygoni Multiflori or Radix Astragali have been investigated by high performance liquid chromatography (HPLC) and electrospray ionization mass spectrometric method (ESI-MS). Change of the content of ginsenosides was nonlinear in diverse combinative proportion of Radix Ginseng with Flos Lonicerae, while the stripping of ginsenosides was promoted by a small amount of Radix Polygoni Multiflori. In the combinative decoction of Radix Ginseng with Radix Astragali, ginsenosides contents were increased compared to single decoction of Radix Ginseng. Besides, ferric reducing antioxidant power (FRAP) method was developed for determination of the total antioxidative activity of n-butanol and water-soluble extracts from the decoction. The experimental results showed that antioxidative activity was better in the combinative decoction than that in single decoction, and the FRAP values of n-butanol extract were also greater compared with that of water extract.

Objective To compare changes in dental arch and soft and hard tissue produced by the Damon Q self-ligating bracket and 3M metal bracket with non-extraction treatment in maxillary mild-to-moderate crowding cases. Meth-ods Eighty seven patients were selected in our study, who were assigned to 4 groups by the crowding degree of maxillary and appliance type:ⅠandⅡcrowding degree using Damon Q self-ligating bracket groups (41 cases);ⅠandⅡcrowding de-gree 3M metal bracket groups (46 cases). We measured lateral cephalometric radiographs and dental casts at both beginning and end of treatment. Paired t-tests and group t-tests were used in statistical analysis to compare the alteration in dental arch and soft and hard tissue. Results There was significant increase in width and length of maxillary dental arch by non-extraction treatment withⅠandⅡcrowding degree maxillary, but the results of both groups were not of statistical difference. To compare hard and soft tissue in two groups withⅡcrowding degree maxillary, the reduction of nasolabial angle, angle of inclination of upper lip, angle of upper lip and lower lip had obvious statistical significance and it is more prominent in self-ligating bracket group than in conventional bracket group. Conclusion Using non-extraction treatment, when maxillary crowding is moderate, ,Damon Q self-ligation bracket group result in more prominent changes of upper lip protrusion than 3M bracket with more marked crowding . Therefore, clinical doctors should pay more attention to choose bracket and treat-ment system for patients with marked crowding of maxillary dentition.

The method of flying through the air is a qi-promoting and qi-circulating technique commonly used in clinical acupuncture. It includes four methods: the blue dragon wagging its tail, the white tiger shaking its head, the green turtle probing the cave and the red phoenix winging to the source and functions to circulate bodily meridian qi. The method of flying through the air was firstrecorded in Golden needle Fu. Later and modern doctors developed it on the basis of Golden needle Fu. This article straightens up the historical origin and development of four methods of flying through the air.

Objective To explore the value of minimal residual disease with acute myeloid leukemia in prognostic evaluation and its correlation with cell morphology and genetics.Methods A total of 105 patients with acute myeloid leukemia (AML) (non M3) was used as the research subjects to evaluate the correlation between the level of minimal residual disease (MRD) and the degree of cellular morphological remission,and cytogenetics.According to the different levels of MRD,78 patients of cell morphology complete remission (CR) were grouped to evaluate the one-year recurrence rate after the first chemotherapy treatment.Results The correlation was evaluated between MRD level and morphological remission in 105 patients with AML after initial chemotherapy.In the degree of cellular morphological remission cell evaluation showed 78 (74.29％) cases of CR,27 (25.71％) cases of partial remission (PR) or non remission (NR).Among 78 cases of CR,MRD negative rate was 66.67％ (52/78),MRD was 33.33％ (26/78);and 27 cases of NR or PR,MRD was 100％ (27/27).The correlation between MRD level and cytogenetic evaluation,cytogenetic prognosis group and prognosis of middle group and poor prognosis group,and the negative rate of MRD were 66.67％,45.90％,and 35.29％,without significant difference (P ＞ 0.05).Seventy eight patients with CR were divided into two groups according to the level of MRD to evaluate the recurrence rate of the 1 year,the recurrence rate of the positive group was significantly higher than that of the negative group (P ＜ 0.05).Conclusions With the development of hematology,the meaning of CR deeply,using flow cytometry method to detect the MRD,MRD positive cells relapse earlier than the traditional morphology,it has important clinical significance for guiding treatment and early prediction of recurrence of CR AML.

A survey on professional knowledge levels was conducted from April to October 2019 among 388 general practitioners (GPs) from 46 community health service centers and 30 township health centers of 6 provinces selected by stratified random sampling method. The overall knowledge test score was 31.82—84.09(56.94±9.19) points, and the pass rate was 36.3% (141/388). There were significant differences in test scores among participants with different types of work units, regions, provinces, marital status, educational background, professional titles, types of employment, length of service, and training status (all P<0.05). Multivariate regression analysis showed that educational background ( B=-2.835), professional title ( B=-8.867), and participation in professional course training ( B=2.214) were the influencing factors of knowledge level (all P<0.05). The pass rates in knowledge of prevention/health management (13.7%, 53/388) and policies and regulations (12.1%, 47/388) were low. The results show that the levels of professional knowledge among GPs working in grassroots health institutions are relatively low, and suggest that continuing education should be strengthened to improve the professional knowledge level of GPs in primary care institutions, particularly, knowledge of health policies and regulations, disease prevention and health management.

Objective Meningovascular syphilis is the intima inflammation of blood vessels caused by the syphilitic infec-tion, which is associated with the occurrence of ischemic stroke.The study analyzed the clinical, imaging features and prognosis for meningovascular syphilis so as to improve its diagnosis and treatment. Methods 14 patients diagnosed with meningovascular syphilis were collected prospectively from December 2007 to March 2015 in the neurological department of Jinling Hospital.The patients were followed for a period of 21.5(range 10.2~37.9)months,and the prognosis were evaluated. Results Patients with meningovascular syphilis presented with dizziness, hemiplegia, hemidysesthesia and cognitive decline.Lesions showed multiple, scattered on MR ima-ging, intracranial vascular stenosis was seen in the CTA/MRA, and the laboratory examination had characteristic changes.With a large dose and sufficient courses of penicillin treatment, meningovascular syphilis may hopefully get predominant effects.78.57%patients got good prognosis(modified Rankin Scale ,mRS≤2)at 3 months and 85.71% patients got goodlong-term prognosis(mRS≤2). Conclusion Meningovascular syphilis was usually presented as acute onset, lacks the specific clinical and neuroimaging manifesta-tions.Most patients has favourable prognosis after treatment of syphilis with full course of penicillin.

Objective Hypertension is a leading modifiable risk factor for cardiovascular disease .However , a lot of hyper-tension patients hold inactive attitudes to hypertension treatment .The purpose of this study was to investigate the relationship between previous treatment of hypertension and stroke severity in acute ischemic stroke . Methods We retrospectively analyzed the clinical data of 653 in-hospital ischemic stroke patients with hypertension between January 2011 and December 2014 .According to the National Institutes of Health Stroke Scale (NIHSS) at admission, the stroke patients were divided into a mild group (NIHSS≤3) and a severe group (NIHSS >3) and, based on their history of hypertension treatment , allocated to a regular treatment, an irregular treatment, a non-treatment , and an unawareness group .We studied the relationship of previous hypertension treatment with stroke severity by Spearman correlation analysis and identified the potential factors associated with stroke severity by multivariate logistic regression anal-ysis. Results Previous treatment of hypertension was positively correlated with stroke severity (r=0.146, P=0.000 2).Compared with the patients of the regular treatment group , those in the irregular treatment group (OR: 2.21; 95%CI:1.39 -3.52; P =0.001), non-treatment group ( OR: 2.18; 95%CI: 1.41 -3.36; P =0.0004) and unawareness group (OR:1.80;95%CI:1.12-2.88; P=0.015) tended to have more severe stroke. Conclusion Previous treatment of hypertension is closely related to the severity of ischemic stroke .