Multiple myeloma is a more common malignant disease in blood medicine,which is characterized by hyper-proliferation and accumulation of malignant plasma cells in the bone marrow,resulting in a large number of monoclonal immunoglobulins and their fragments,leading to damage to the terminal organs.Of which about 80％ of patients have multiple myeloma bone diseases (MBD),which seriously affected the quality of life and prognosis of patients.We have found that the main cause of MBD are contributed to inhibition of osteoblasts,activation of osteoclast and affecting the occurrence by a variety of cytokines and pathways.This article will review and introduce the occurrence and development of MBD related to the latest factors and treatment.

Objective　To study the characteristics of serious central nervous system(CNS) involvement in childhood systemic lupus erythematosus.Methods　We made a comparison on the level of ANA、dsDNA and positive rate of Sm、C3 between primary and secondary CNS involvement and analysed the clinical manifestations between two groups.Results　The level of ANA、dsDNA and ositive rate of Sm、C3 were not related with SLE encephalopathy;EEG was useful to the diagnosis of SLE.Conclusion　The differiential diagnosis between primary and secondary CNSD in volvement of SLE must be analysed according to clinical manifestations and other laboratory findings.

Objective To evaluate myocardial coronary flow reserve of syndrom X by real-time myocardial contrast echocardiography(MCE). Methods Ten patients with syndrome X and seven normal subjects were involved in the study. Real-time MCE was performed with acoustic contrast SonoVue,and the peak video density (A), and re-turgor velocity of microvessel (β), and the product of A ×β of quiescent condition and after adenosin loading were detected,and also the coronary flow reserve (CFR, the ratio of A xβ circa-adenosin loading). Results There was no significant difference of A between syndrom X and contrast group in quiescent condition, the β and product of A x β of patients with syndrome X were lower than those of contrast group, the CFR of syndrome X was obviously less than that of contrast group.Conclusions Myocardial microvessel function is abnormal in syndrome X, real-time MCE is useful for evaluate myocardial coronary flow reserve.

Echinococcosis is a severe zoonosis parasitic disease and mainly caused by the larvae of Echinococcus granulosus and E. multilocularis. Because of the limitation of operation level,such as recurrence and death,the drug treatment is still the most important method in our country. Meanwhile,the annual number of drug treatments is far greater than surgical treatments. Drugs play a significant role in the preoperative reduction of lesions,reducing pain,extending the life of patients .This article re-views the status of animals treatment and clinical treatment of echinococcosis treated by the benzimidazole drugs and their new formulations,provides the basis for exploring the development direction of anti-echinococcosis drug treatment research.

Objective To explore the reference value of interleukin(IL)-33 and tumor necrosis factor-alpha(TNF)-α in early diagnosis,illness evaluation and prognosis of acute pancreatitis(AP) by dynamically monitoring the serum levels of IL-33 and TNF-α.Methods A total of 86 patients with AP were selected as objectives which were divided into two groups according the severity of illness which include 59 cases of mild AP group(MAP) and 27 cases of severe AP group(SAP),52 cases of systemic inflammatory response syndrome(SIRS) group and 34 cases of non SIRS group distinguished by SIRS,75 cases of survival group and 11 cases of death group identified by prognosis of AP.All of patients were assessed by Bedside Index of Severity in Acute Pancreatitis(BISAP) score within 48 h after admission and detected the serum levels of IL-33 and TNF-α at the first day,third day,seventh day and fourteenth day during hospital.A total of 63 healthy persons were recruited into control group.Results The serum levels of IL-33,TNF-α and BISAP score of SAP group and MAP group were higher than those of the control group in different monitoring time,but the SAP group increased more obviously than MAP group.The serum levels of IL-33 and TNF-α of SAP group were higher than those of MAP group at the first day,third day,seventh day and fourteenth day during hospital,and the differences between them had statistical significance(P<0.05).The serum levels of IL-33 and TNF-α of SAP group increased to peak at the third day and reduced gradually after conventional treatment(the seventh day in the hospital).The serum levels of IL-33 and TNF-α of SIRS group were significant higher than those of non SIRS group(P<0.05).The serum levels of IL-33,TNF-α and BISAP score of death group were significant higher than those of survival group(P<0.05).Spearman correlation analysis suggested that there were positive correlations between BISAP and the serum levels of IL-33 and TNF-α of AP patients.Conclusion There is an important clinical value to the early diagnosis,severity classification,guiding clinical treatment and the assessment of prognosis of AP by dynamically monitoring the serum levels of IL-33 and TNF-αof AP patients.

To study the use of data mining techniques in analyzing the syndrome discipline of generalized anxiety disorder (GAD).

Objective To analyze the correlation between chronic diseases,depression and activities of daily living (ADL) in the elderly,and to explore the risk factors of depressive symptoms and ADL.Methods Randomized multi-stage sampling method was used to select 504 elderly (aged ≥65 years old) in Jining City.The participants were then investigated and assessed by using Geriatric Depression Scale15,Katz-Activity of Daily Living (Katz-ADL) and Lawton instrumental ADL (Lawton-IADL).Results The prevalence of chronic diseases was 74.01％ among the elderly who lived in Jining City.The positive rate of depressive symptom was 7.14％ and the rate of ADL or IADL limitation was 19.05％ and 66.67％,respectively.The positive rate of depressive symptom and the rate of ADL or IADL limitation of the male were lower than those of female (x2 values were 18.15,12.31 and 30.18,respectively; all P＜ 0.05).The number of chronic diseases was a risk factor of depressive symptom and ADL limitation (odds ratio (OR) =1.71 or 1.53,respectively).ADL and IADL limitations were also the risk factors of depressive symptom (OR =3.15 or 9.36,respectively).Over adjustment of gender and age,the impact of the number of chronic diseases on depressive symptom,ADL and IADL and the influence of ADL and IADL limitations on depressive symptom showed no statistical significance.Conclusions Gender and age may be fundamental risk factors of depressive symptom and ADL and IADL limitations in the elderly.Family members and society workers should improve ADL and positive emotion and reduce the likelihood of depressive symptom among aging population.

Objective To compare the effectiveness and safety of glucocorticoid versus intravenous injection of human immunoglobulin (IVIG) in treatment of with acute primary immune thrombocytopenia (ITP) in children. Methods PubMed, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, Chinese biomedical literature database (CBM), Chinese Journal Full Text Database (CNKI) and Wanfang database were searched. The bibliography was screened according to the inclusion and exclusion criteria,and the target literatures were selected. The data were extracted and the quality of included literatures was evaluated. Revman 5 . 3 software was used to make meta-analysis. Results In 1500 papers searched, 8 papers met the inclusion criteria. Meta-analysis showed that there was a statistical signiifcance in platelet count (PLT,>20 × 109/L) after being treated for 48 h between glucocorticoid group and IVIG group (RR=0 . 77 , 95%CI:0 . 67~0 . 89 ). In subgroup analysis, there were statistical signiifcance in methylprednisolone (MP) 30 mg/kg versus IVIG 1 g/(kg·d)× 2 d, and metacortandratin (PDN) 4 mg/kg versus IVIG 1 g/(kg·d)× 2 d (RR=0 . 66 , 95%CI:0 . 47-0 . 91;RR=0 . 79 , 95%CI:0 . 66-0 . 95 ). After treatment for 24 h and 72 h, the platelet count>20 × 109/L were signiifcantly different in glucocorticoid group and in IVIG group (RR=0 . 69 , 95%CI:0 . 53-0 . 91;RR=0 . 82 , 95%CI:0 . 74-0 . 90 ). Moreover, after treatment for 24 h, 48 h and 72 h, the platelet count>50 × 109/L were signiifcantly different between glucocorticoid group and IVIG group (RR=0 . 38 ,95%CI:0 . 21-0 . 69;RR=0 . 53 , 95%CI:0 . 41-0 . 69;RR=0 . 80 , 95%CI:0 . 70-0 . 93 ). There was no difference in the incidence of splenic resection between two groups (RR=5 . 41 , 95%CI:0 . 95-30 . 74 , P=0 . 06 ). Conclusion The probability of platelet count to reach>20 × 109/L in the initial treatment with glucocorticoid of acute ITP patients were 32%lower than that with IVIG. With the initial therapeutic target being platelet count>50 × 109/L in 3 days, the effect of IVIG was better.

[ ABSTRACT] AIM:To study the influence of Raptor on the invasion ability of glioma cells.METHODS: The technique of RNA interference was used.U87 cells were transfected with Raptor restricted siRNA plasmid, and the expres-sion level of Raptor in the transfected cells was detected by Western blotting.The invasive ability of the cancer cells in vitro was determined.The phosphorylation level of ARK5 and the expression of MMP-2 and MMP-9 were detected by Western blotting.The expression levels of Raptor in the tumor samples of low-grade gliomas ( WTO grade I and grade II) and high-grade gliomas (WTO grade III and grade IV) were also analyzed by immunohistochemical staining.RESULTS: Raptor siRNA was transfected into U87 cells and the cells were named siRaptor/U87 cells.The cells transfected with the control plasmid was named Scr/U87 cells.The expression level of Raptor in siRaptor/U87 cells was lower than that in Scr/U87 cells.The results of in vitro invasion assay showed that the number of siRaptor/U87 cells penetrating the Matrivgel matrix membrane was less than that of Scr/U87 cells (P<0.01).The protein expression of MMP-2 and MMP-9, and phosphoryl-ation of ARK5 protein in the cells in the experimental group were lower than those in control group.The correlation between the expression of Raptor in gliomas and the degree of deterioration was also observed ( P<0.01) .CONCLUSION: The expression of Raptor may contribute to the invasion ability of glioma cells by phosphorylation of ARK5 and increase in the levels of MMP-2 and MMP-9.

Objective To investigate the effect of acupuncture at point Neiguan on mouse myocardial hypertrophy.Methods Thirty-sixty healthy C57BL6 mice were randomized into blank, model and treatment groups, 12 rats each. In the treatment group, an acupuncture needle was inserted into point Neiguan and retained for 15 min, once daily. After nine days of treatment, the ratios of cardiac weight/tibial length were compared between the groups. Left ventricular myocardial tissues were processed by Masson trichrome staining in every group of mice. The differences in myocardial fiber arrangement and collagen fiber distribution between the groups were observed under the ordinary optical microscope in 100 times of field of vision. Sarcomere structure, myofibril arrangement, collagen fibers and mitochondria in injured myocardial tissues were observed by transmission electron microscopy. Results Heart rate increased significantly in the model group and decreased significantly in the acupuncture group compared with the blank group. Cardiac weight and the ratios of cardiac weight/tibial length increased significantly in the model and acupuncture groups compared with the blank group (P<0.01) and decreased significantly in the acupuncture group compared with the model group (P<0.01). In the model group, myocardial tissues had compensatory hypertrophy with incontinuous status, and myocardial transverse striations had severe disorder/disruption, karyopyknosis appeared and cytoplasmic eosinophilic change became obvious in few of the rats. The results were better in the acupuncture group than in the model group. In the model group, part of myofibrils had focal fusion, interstitial collagen fibers proliferated and mitochondria had swelling and compensatory increase. The results were also better in the acupuncture group than in the model group.Conclusions Acupuncture at point Neiguan can reduce the production of collagen fibers and mitochondria, improve the arrangement of sarcomere structure and delay the progression of myocardial hypertrophy.