Objective:To investigate the application values of bone marrow morphology, bone marrow immunohistochemistry, flow cytometry, fluorescence in situ hybridization (FISH) and cytogenetic testing in newly diagnosed multiple myeloma.Methods:A total of 280 patients with multiple myeloma who were newly diagnosed in Tianjin KingMed Diagnosis Center from September 2018 to August 2019 were collected. The bone marrow biopsy was carried out according to the routine method, and bone marrow morphology, bone marrow immunohistochemistry, flow cytometry immunophenotyping, FISH and cytogenetic testing were performed. The detection results of each method were compared.Results:In 280 patients, the bone marrow immunohistochemistry results showed that the median ratio of plasma cells was higher than those of bone marrow morphology (20 cases, 0.675 vs. 0.300) and flow cytometry (47 cases, 0.650 vs. 0.147), and the differences were statistically significant ( Z = -3.883, P < 0.01; Z = -5.947, P < 0.01). Flow cytometry results showed that the positive rates of CD38, CD138, κ, λ, CD56 and CD19 were 100.0% (280/280), 100.0% (280/280), 57.5% (161/280), 42.5% (119/280), 62.1% (174/280) and 19.3% (54/280); bone marrow immunohistochemistry results showed that the positive rates of CD38, CD138, κ, λ and CD56 were 98.9% (277/280), 98.2% (275/280), 57.5% (161/280), 42.5% (119/280) and 62.1% (174/280); there was no statistical difference between the two detection methods in the detection coincidence rate of the same detection index (all P > 0.05). Among patients who underwent FISH detection, the detection rate of gene abnormalities was 69.9% (93/133); the detection rate of abnormalities by direct fluorescence in situ hybridization (D-FISH) was 42.9% (57/133); the detection rate of abnormalities by CD138 immunomagnetic sorting myeloma cells (MACS)-FISH was 82.7% (110/133). Among patients who underwent G-band karyotyping, the detection rate of abnormal karyotype was 38.5% (85/221). FSIH, especially MACS-FISH, had a higher detection rate of cytogenetic abnormalities than G-band karyotyping, and the difference was statistically significant ( χ2 = 65.697, P < 0.05). Conclusion:The comprehensive application of bone marrow morphology, bone marrow immunohistochemistry, flow cytometry, FISH (especially MACS-FISH), cytogenetic testing and other detection methods is more helpful for the diagnosis of multiple myeloma, and may be useful for prognostic judgment.

Objective:To evaluate the changes in glucose metabolism in the prefrontal cortex during long-term cognitive dysfunction induced by neuropathic pain in developing rats.Methods:SPF healthy male Sprague-Dawley rats, aged 4 weeks, weighing 80-100 g, were used in this study.The model of neuropathic pain was established by using spared nerve injury in anesthetized rats.The mechanical paw withdrawal threshold (MWT) was measured at 1 day before establishing the model (T 0) and 1, 3, 7, 14, 28, 42 and 56 days after establishing the model (T 1-7). According to the results of MWT compared between T 5 and T 0, the rats were divided into neuropathic pain group (group NP) and non-neuropathic pain group (group NNP). Open field test and novel object recognition test were performed at T 7 to assess anxiety-like behavior and cognitive function.Positron emission tomography/computed tomography imaging was performed to determine the standard uptake value of 18F-fluorodeoxyglucose in the prefrontal cortex.Then the rats were sacrificed, and prefrontal cortex was removed for determination of the expression of glucose transporter 3 using Western blot and immunofluorescence. Results:Compared with the baseline at T 0, the MWT at T 1-2 in group NNP and at T 1-7 in group NP were significantly decreased ( P<0.05). Compared with group NNP, the MWT at T 1-7 were significantly decreased, the time of staying at the central region at T 7 was shortened, the percentage of time for exploring the novel object was decreased, the percentage of novel object exploration was decreased, the standard uptake value of 18F-fluorodeoxyglucose in prefrontal cortex was decreased, and the expression of glucose transporter 3 in prefrontal cortex was down-regulated in group NP ( P<0.05). Conclusion:Long-term cognitive dysfunction induced by neuropathic pain may be related to decreased glucose metabolism in the prefrontal cortex of the developing rats.

Objective:To evaluate the relationship between P2X 7 receptors and nucleotide-binding oligomerization domain-like receptor containing pyrin domain 3 (NLRP3)/interleukin-1beta (IL-1β) pathway in spinal neurons in the development of inflammatory pain (IP) in rats. Methods:SPF healthy adult male Wistar rats, weighing 180-220 g, were used in this study.Forty rats in which intrathecal catheters were successfully implanted were divided into 5 groups ( n=8 each) using a random number table method: control group (group CON), group IP, IP plus dimethyl sulfoxide (DMSO) group (group IP-DMSO), IP plus P2X 7 receptor antagonist A740003 group (group IP-A) and IP plus P2X 7 receptor agonist ATP group (group IP-ATP). Rats were anesthetized with pentobarbital sodium 40 mg/kg.IP was induced by injecting complete Freund′s adjuvant 50 μl into the right ankle joint cavity, while group CON was injected with the equal volume of normal saline instead.On 1 day before establishing the model, immediately after establishing the model, and on 1, 2 and 3 days after establishing the model, 1% DMSO 10 μl was intrathecally injected once a day in group IP-DMSO, A740003 0.1 nmol(dissolved in DMSO 10 μl) was intrathecally injected once a day in group IP-A, and ATP 150 nmol(dissolved in DMSO 10 μl) was injected intrathecally once a day in group IP-ATP.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured on 3 days after establishing the model.Enzyme-linked immunosorbent assay was used to determine the prostaglandin E2 (PGE2) concentrations in right ankle tissues and IL-1β concentrations in cerebrospinal fluid (CSF). Then rats were sacrificed, and the lumber segments (L 4-6) of the spinal cord were removed for determination of the expression of NLRP3, casepase-1, IL-1β (by Western blot) and co-expression of P2X 7 receptors with neuron-specific nucleoprotein (NeuN) and NLRP3 and with NeuN (by immunofluorescence). Results:Compared with group CON, PGE2 contents in ankle tissues were significantly increased in group IP, and the MWT was significantly decreased, the TWL was shortened, the concentrations of IL-1β in CSF were increased, and the expression of NLRP3, caspase-1 and IL-1β was up-regulated in the other four groups ( P<0.05). Compared with group IP, the MWT was significantly increased, the TWL was prolonged, the concentrations of IL-1β in CSF were decreased, and the expression of NLRP3, caspase-1 and IL-1β was down-regulated in group IP-A ( P<0.05), the MWT was significantly decreased, TWL was shortened, the concentrations of IL-1β in CSF were increased, and the expression of NLRP3, caspase-1 and IL-1β was up-regulated in group IP-ATP ( P<0.05), and no significant change was found in the parameters mentioned above in group IP-DMSO ( P>0.05). P2X 7 was co-expressed with NeuN, and NLRP3 was co-expressed with NeuN. Conclusion:P2X 7 receptors in spinal neurons are involved in the development of inflammatory pain by activating NLRP3/IL-1β signaling pathway in rats.

Objective To investigate the protective effect of Ulinastatin on liver function after precise hepatectomy.Methods Fifty-six patients of hepatocellular carcinoma undergoing hepatectomy were divided into Ulinastatin group (U group,28 cases) and control group (group C,28 cases).Results There were no significant differences in liver function and inflammatory factors between the two groups on the 1 st day before the surgry (P＞ 0.05).Serum ALT levels of (231 ±29;140 ±21;56 ± 13;42 ±6) U/L,were lower than group C (267 ± 29;158 ± 23;69 ± 18;53 ± 8) U/L,all P ＜ 0.05;serum AST levels were (175 ±23;94 ±25;47 ± 16;36 ± 8) U/L,lower than group C (191 ± 17;139 ± 16;64 ± 15;46 ±11) U/L,all P＜0.05;Serum TBIL levels were (30 ±6;39 ±9;31 ±9;21 ±6) μmol/L,lower than group C (34 ± 6;46 ± 7;35 ± 8;26 ± 7) μmol/L,all P ＜ 0.05;Serum hs-CRP levels were (52 ± 22;112 ±23;71 ± 16;42 ± 13) rg/L,lower than group C (69 ±23;129 ±25;72 ± 15;49 ± 15) mg/L,all P ＜ 0.05;serum IL-1 β levels were (7.8 ± 0.9;11.1 ± 1.5;8.9 ± 1.6;5.6 ± 0.9) pg/ml,lower than group C (9.2±1.3;13.0 ±2.1;11.1 ±1.4;7.3 ±0.8) pg/rml,all P ＜0.05;Serum IL-6 levels were (187 ±30;76 ±25;46 ± 15;26 ±8) pg/ml;lower than group C(260 ±36;92 ± 16;53 ± 11;30 ±8) pg/ml,all P ＜ 0.05;Serum TNF-α levels were (17 ± 4;12.0 ± 2.4;8.6 ± 2.4;6.7 ± 2.0) pg/ml,lower than group C (25 ± 4;18.7 ± 3.3;15.0 ± 3.1;9.6 ± 1.7) pg/ml,all P ＜ 0.05.Conclusion Ulinastatin protects liver function in perioperative patients undergoing precise hepatectomy.

Objective To study the inhibitory effects of TPP,a desmosdumotin-C B ring para-fluoro modified derivative,on human breast cancer MCF-7 cell proliferation,and investigate the possible mechanisms.Methods MTT assay was used to measure the proliferation suppression of MCF-7 cells after treated with 1.0,2.5,5.0,10.0,and 20.0 μg/mL TPP for 48 h,and then the cell apoptosis rate and expression rate of NF-κB P65 positive cells were tested by flow cytometry after 20.0 μg/mL TPP treatment for 0,24,and 48 h.Results MTT assay showed that,after treatment for 48 h,1.0,2.5,5.0,10.0,and 20.0 μg/mL TPP all exhibited the inhibitory effects and showed a dose-dependent relationship.Flow cytometry results showed that 20.0 μg/mL TPP induced cell apoptosis after treatment for 24 and 48 h.TPP (20.0 μg/mL) significantly reduced the rate ofNF-κB P65-positive cells in MCF-7 cells after treatment for 48 h.Conclusion TPP could inhibit the proliferation of MCF-7 cells,which may be induced by cell apoptosis.Down-regulation of NF-κB is possible to be related with apoptosis.

Objective To systematically evaluate the clinical efficacy of Lanqin Oral Liquid(LOL)and ribavirin on infantile hand-foot-mouth disease(HFMD).Methods The randomized controlled trials(RCT)of LOL and ribavirincombined for treating HFMD were retrieved from EMbase, PubMed, CNKI, CBM and VIP(from establish to Oct 2014), the methodological quality of included literature was evaluated, and data analyses were performed with RevMan 5.2 software.Results Fifteen studies involving 2 016 patients were ultimately identified.The meta-analysis results showed that the effective rate of LOL group was superior to that of the control,OR(95%CI)was 5.80 (3.94, 8.52), and there were significant differences in the antifebrile time, erythra regression time, herpes regression time and oral ulcer regression time between the groups,MD (95%CI): -1.29 (-1.45,-1.13), -1.88 (-2.44,-1.33), -1.57 (-2.36,-0.78), -1.57 (-2.07,-1.08), respectively. Conclusion Based on the present clinical evidence, the meta-analysis results indicate that LOL and ribavirin treating HFMD is effective and safe. However, due to the uneven quality of these included studies, this conclusion need more large sample size and high-quality clinical RCTs to be confirmed.

To introduce the application of CBL teaching method on neuroanatomy teaching in undergraduate of con -tinue education school .Cases selection and reconstruction , designing problems , organization , implementation and standardized teaching were analyzed .Finally, we discussed the advantages and disadvantages of CBL teaching method.

Objective To investigate the effects of UDP glucuronosyltransferase (UGT) 1A9 I399 C ＞ T single nucleotide polymorphism on postoperative sedation with propofol in patients undergoing breast surgery.Methods One hundred and fifty-two ASA Ⅰ or Ⅱ female patients,aged 20-50 yr,weighing 50-70 kg,scheduled for elective benign breast tumor excision under general anesthesia,were enrolled in this study.The polymorphic sites of the UGT1A9 I399 C ＞ T allele were analyzed by polymerase chain reaction-restriction fragment length polymorphism.The patients were assigned to one of 3 groups according to their genotypes:wild homozygote (C/C) group,mutation heterozygote (C/T) group and mutation homozygote (T/T) group.During induction and maintenance of anesthesia,propofol was given by target-controlled infusion with the plasma concentration (Cp) of 3μg/ml.Blood samples were taken at 60 min after target-controlled infusion of propofol was started for determination of the Cp of propofol using high-performance liquid chromatography.The time when OAAS was 4 after stopping the infusion of propofol was recorded and the BIS value and effect-site concentration of propofol were also recorded at this time.The time when BIS value was 80 was recorded and the effect-site concentration of propofol was also recorded at this time.Results Genotyping analysis revealed that genotype distribution of UGT1A9 I399 C ＞ T polymorphism was C/C 24 cases,C/T 96 cases and T/T 32 cases.The T allele frequency was 53％.The C allele frequency was 47.4％.There was no significant difference in the Cp of propofol,time when OAAS was 4,BIS value and effectsite concentration of propofol when OAAS was 4,time when BIS value was 80 and effect-site concentration of propofol when BIS value was 80 among the three groups (P ＞ 0.05).Conclusion UGT1 A9 I399C ＞ T single nucleotide polymorphism is not the genetic factor contributing to the individual variation in the patient' s response to postoperative analgesia with propofol in patients undergoing breast surgery.

Objective To investigate the effects of CYP3A4* 1G genetic polymorphism on fentanyl pharmadynamics after intravenous injection in healthy female velunteers,Methods Twenty-eight healthy female volunteers aged 18-25 yr weighing 45-70 kg were enrolled in this study.The CYP3A4 * 1G genetic polymorphic sites were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).The volunteers were assigned into 3 groups according to their genotypes:group Ⅰ wild homozygote ; group Ⅱ mutation heterozygote and group Ⅲ mutation homozygote.Fentanyl 5 μg/kg was injected iv over 1 min.Pain threshold was measured using electrical stimulation before and at 45,150 and 240 min after fentanyl injection.Results Pain threshold was significantly higher at 45 and 150 min after iv fentanyl injection in mutation homozygote group than in mutation heterozygote group and wild homozygote group.There was no significant difference in pain threshold between mutation heterozygote group and wild homozygote group.Conclusion CYP3A4* 1G genetic mutation can enhance the analgesic efficacy of fentanyl after intravenous injection in healthy female volunteers.

One hundred and thirteen newly-diagnosed type 2 diabetic patients were treated with rosiglitazone for 16 weeks. Glucose tolerance was restored in 46 cases ( group A), but not restored in 67 cases (group B). Compared with group B,the patients of group A were younger and had shorter course of diabetes and lower body mass index (BMI,P＜0.05); Homeostasis model assessment for β-cell function (HOMA-β) and earlyphase insulin secretion in group A were better than those of group B before and after treatment respectively (P＜0. 05 ) ,while homeostasis model assessment for insulin resistance ( HOMA-IR )in group A was lower than that of group B before treatment (P＜0. 05 ). In conclusions, rosiglitazone improved insulin resistance of type 2 diabetes patients, thus facilitated restoration of β-cells function and glucose tolerance. The related factors of glucose tolerance restoration included age ,diabetes duration, BMI, HbA1 c, β-cells function, and insulin resistance.