Multiple myeloma (MM) is a heterogeneous disease.The prognosis of MM varied a lot among different patients.One of the main basis of risk stratification is genetic abnormality,which including the number or structure anomaly of chromosomes,genetic aberrations,signaling pathway disorders and epigenetic changes.The risk stratification is being revised with the development of FISH,gene-expression profiling and next-generation sequencing.These combined approaches would hopefully transform the current one-for-all care into a more tailored,individual therapeutic strategy for MM patients and would finally improve their quality of lives.

Researches on monoclonal gammopathy of undetermined significance (MGUS) and smoldering muhiple myeloma (SMM) are at a low level although their incidence is high.This review discusses curent biological insights in MGUS/SMM and discusses how the integration of novel biological markers,molecular imaging,and clinical monitoring of MGUS/SMM could facilitate the development of early treatment strategies for high-risk SMM (early myeloma) patients in the future.

Objective To evaluate the effect and safety of glucocorticosteroids in prevention of post-ERCP pancreatifis(post-endo- scopic retrograde cholangiopancreatography pancreatitis,PEP).Methods The database of Cochrane Library(issue 4,2006),Medline (1966-2007.1),EMBASE(1986-2007.1)and CBM(1978-2007.1)were searched.The cited literature of obtained articles and some core English and Chinese medical journals(July,2006-Jan,2007)relevant to gastro-enterolngy were also searched by hand.All random- ized controlled trials(RCT)comparing glucocorticosteroids to placeboes in prevention of PEP were included.Data collection and literature evaluation were performed by two reviewers independently.RevMan 4.2.8 was used for statistical analysis.Result Six RCTs were includ- ed in meta-analysis which showed no statistical difference for the incidence of overall PEP between the glucocorticosteroids group and place- bo group(RR=1.11,95%CI 0.89-1.39).Stratified by severity of PEP,four trials were included.Meta-analysis showed no statistical difference for the incidence of mild to moderate PEP and severe PEP between the two groups(RR=1.17,95%CI 0.91-1.51 for mild- moderate PEP;RR=1.79,95%CI 0.69-4.65 for severe PEP).Stratified by therapeutic ERCP,three RCTs were included.Meta-analy- sis showed no statistical difference for the incidence of PEP between the two groups(RR=1.24,95%CI 0.91-1.67).3 trials as to inter- im-analysis were excluded by sensitive analysis.Meta-analysis also showed no statistical difference for the incidence of PEP between the two groups(RR=0.73,95%CI 0.44-1.20).Conclusion Based on current evidence,glucocorticosteroids is not beneficial in preventing the occurrence of PEP.Further high quality study is needed to disclose the efficacy of glucocorticosteroids in prevention of PEP.

Gastrointestinal endoscopy plays a major diagnostic and therapeutic role in most gastrointestinal disorders.However,limited data of clinical safety is available in pregnant patients.Large studies,preferably prospective,with follow-up of fetal outcome are needed to determine fetal safety of endoscopy.This article briefly analyzed the literature on the research progress of gastrointestinal endoscopy during pregnancy,which offered an evident base for diagnosis and treatment in digestive diseases.

Objective To evaluate the association of serum uric acid and the incidence and prognosis of kidney diseases systematically, so as to provide reference for the treatment and prevention of kidney diseases. Methods Literatures related to the associations between serum uric acid and incidence and prognosis of kidney diseases were selected from the Chinese Biomedical Literature Database ( CBM) (January 1982 to March 2010), EMBASE (January 1966 to March 2010) and Medline (January 1950 to March 2010) for cohort studies. Two researchers independently screened the studies, assessed the risk of bias of included studies using the Newcastle-Ottawa Quality Assessment Scale for Cohort Studies and extracted data. Stata 10. 0 was used to calculate the pooled relative risk. Results Twenty-one eligible cohort studies were selected, of which 11 on incidence of kidney diseases (n =276 801 ) , and 10 on the prognosis of kidney diseases ( n = 3004). Meta analysis was performed based on data influencing incidence and prognosis factors of kidney diseases except for serum uric acid. The results showed, (1) uric acid and incidence of kidney diseases: hyperuricemia could increase the risk of kidney diseases ( RR = 1. 49, 95% CI 1. 27-1. 75) ; (2) uric acid and prognosis of patients with kidney diseases:hyperuricemia could deteriorate the kidney function (RR = 1. 35, 95%CI 1. 12-1.63) and increase the risk of mortality (RR = 1.67, 95% CI 1.29-2.16). Conclusion Uric acid is an independent risk factor for incidence of kidney diseases and poor prognosis of patients with kidney diseases. Further high quality clinical trials with long-term follow up should be conducted to determine whether lowering uric acid levels would be of clinical benefit in the prevention and treatment of kidney diseases, so as to provide direct evidence for clarifying correlation between uric acid and kidney diseases and the prevention and treatment for patients with high uric acid.

Objective To observe the dilated cardiomyopathy ( DCM ) in non-Keshan disease areas in Shandong Province and assess scientifically the effectiveness of prevention and control measures on Keshan disease (KSD). Methods According to the scheme of DCM condition survey of our country in non-Keshan disease areas, seven representative counties(cities, areas) were chosen by their similarities in natural environment, production and life style to KSD areas; one or two townships ( towns ) were chosen in each county ( city , area ); one village was selected as a survey point in each township ( town ) . In each survey point , about four hundred and twenty natural populations were checked by asking detailed history, physical examination, and electrocardiography (ECG) tracings, and suspicious people were taken chest X-ray examination and cardiac ultrasound(UCG). The samples of inside and outside environmental were collected in partial residents and the selenium contents were detected by 2,3-diaminonaphthalene fluorometric method. At the same time the income, food of inhabitant and other basic information were collected. Results ① In 13 survey villages, sixty-four hundred and sixty-three residents were surveyed and 2 DCM cases and 111 similar potential KSD cases were detected, the detection rate was 1.75%(113/6 463). ② Sixty-four hundred and sixty-three residents were traced by ECG and the incidence of abnormal ECG was 20.4%(1 318/6 463), and sinus bradycardia, T-wave changes, sinus tachycardia, ST-T changes, occasional ventricular beating earlier, complete right bundle branch block, left anterior branch block, room premature beat, left ventricular high voltage, auriculo-ventricular block, et al were common. ③Samples of hair(260), wheat(260), corn (240) and soil (104) were collected, and the selenium contents were (0.353 ± 0.082), (0.035 ± 0.009), (0.024 ± 0.008) and (0.164 ± 0.019)mg/kg, respectively. Annual per capita income of each survey point was 2 500-8 670 yuan, and the residents’ main staple food was flour. Conclusion The results of DCM condition in non-Keshan disease areas of Shandong Province are stable and have provided a scientific basis for drawing up the national standard of eliminating KSD.

Adult ; Cardiomyopathies ; epidemiology ; prevention & control ; Cardiomyopathy, Dilated ; epidemiology ; prevention & control ; Child ; China ; epidemiology ; Enterovirus Infections ; epidemiology ; prevention & control ; Environmental Monitoring ; Humans ; Male

Objective To investigate the clinical diagnostic value and pathogenesis of serum protein identification in Keshan disease (KD).Methods A total of 65 chronic KD patients were selected as the patient group in KD endemic areas,while 29 cases of dilated cardiomyopathy (the DCM group),62 healthy cases from KD endemic areas (control 1 group) and 28 healthy cases from non-endemic areas (control 2 group) were selected as controls.Liquid chip time of flight mass spectrometry (ClinProtTM MALDI-TOF-MS) was used to determine the expression of proteins/peptide peaks.ClinProTools 2.2 software was used to analyze the protein profiles to determine differentially expressed proteins/peptide peaks.The Genetic Algorithm (GA),QuickClassifer Algorithm (QC) and Supervised Neural Network Algorithm (SNN) methods were used to screen marker proteins.Matrix-assisted laser desorption/ionization time-of-flight Mass Spectrometry technique (MALDI-TOF/TOF) was also used as a secondary mass spectrometry to identify differentially expressed peptides.Results Between the KD and control 1 groups,34 differentially expressed proteins/peptides and 5 marker proteins were identified,while 52 differentially expressed proteins/peptides and 5 marker proteins were identified between the KD and control 2 groups,and there were 67 differentially expressed proteins/peptides and 5 marker proteins between the KD and DCM groups.During secondary mass spectrometry,two peptides for mass-to-charge ratio (m/z) 2 079 and 1 465 were obtained,peptide of matching β-globin showed low expression while peptide of matching fibrinogen showed high expression in the KD patients.Conclusions Serum marker proteins can be used as biomarkers for diagnosis and differentiation of KD.β-globin and fibrinogen play an important role in the development of KD myocardial injury.

Objective To provide more valuable information for diagnosis of dilated cardiomyopathy (DCM),we detected differentially expressed proteins in serum from patients with DCM and healthy people and protein biomarkers were selected.Methods During the period from march 2011 to may,a total of 29 samples of resident patients with DCM from Qilu Hospital of Shandong University,Jinan Central Hospital and Jinan First Peoples Hospital and 30 local healthy people in Jinan were selected as DCM and control groups,respectively.Serum samples from these patients with DCM and controls were detected by ClinProt MALDII-TOF-MS.ClinProTools 2.2 software was used to get mass spectrometric data.The ClinPrott discrimination model was established to screen out differentially expressed proteins as potential biomarkers.Results Via comparing proteins/polypeptides peaks of DCM patients and healthy controls,57 of all 73 peaks were found to be significantly different between the two groups.Compared with the control group,35 peaks were up-expressed while the other 22 peaks were downexpressed.Five peaks were screened out as protein biomarkers.They were mass-to-charge ratio (m/z):4 247.95,4 209.37,1 058.69,1 074.78,and 2 364.71.The sensitivity and specificity of ClinPrott discrimination model was 99.14％ and 99.16％,respectively.Conclusion Patients with DCM have expressed serum proteins differently and we have found five protein markers which might have some value for diagnosis of DCM.

Objective To analyze the relationship between the estimated glomerular filtration rate (eGFR) and 10-year car‐diovascular disease risk (10y CVDR) in Chongqing college staff .Methods The physical examination data of the staff in two univer‐sities including 2630 persons were collected in April 2013 .The eGFR and 10y CVDR of each staff were calculated according to the standardized formula .The differences of 10y CVDR among different eGFR level groups were analyzed .Results The average age of all the staff were (51 .76 ± 14 .53) years old ,which in males was significant higher than that in females (P<0 .01) .The smokers , hypertension patients and diabetes patients accounted for 16 .00% ,15 .20% and 4 .10% respectively .The smokers ,hypertension and diabetes patients in males were significantly more than than those in females (P<0 .05) .The height ,weight ,BMI ,systolic pressure , diastolic pressure ,serum creatinine ,triglyceride ,LDL and blood glucose in males were significantly higher than those in females (P=0 .000) ,while HDL in males was significantly lower than that in females (P=0 .000) .The median of 10y CVDR was 1 .25% , males were significantly higher than females (2 .85% vs .0 .40% ,P<0 .01) .The median of 10y CVDR for the following groups were 0 .74% ,2 .25% ,5 .58% and 14 .39% respectively :eGFR≥90 mL · min-1 · 1 .73 m2 ,75 mL · min-1 · 1 .73 m2 ≤eGFR<90 mL · min-1 · 1 .73 m2 ,60 mL · min-1 · 1 .73 m2 ≤eGFR<75 mL · min-1 · 1 .73 m2 ,and eGFR<60 mL · min-1 · 1 .73 m2 .The results of the one‐way analysis of variance showed that compared to the 10y CVDR of the group with eGFR≥90 mL · min-1 · 1 .73 m2 ,which of the other three groups were all significantly increased .Conclusion eGFR is a significant factor impacting 10y CVDR . The lower the eGFR level ,the higher the risk of the 10y CVDR .