[Objective] To explore the predictive value of HALP score for prognosis in patients with multiple myeloma (MM). [Methods] A retrospective analysis was conducted on laboratory indicators and related clinical data of newly diagnosed multiple myeloma (NDMM) patients, treated at the Affiliated Hospital of North Sichuan Medical College from January 2016 to October 2023, prior to their first treatment. The HALP score was calculated, and the optimal cutoff value for HALP was determined using X-tile software. Survival analysis was performed using Kaplan-Meier curves for high HALP and low HALP groups. Univariate and multivariate analyses were conducted using the Cox regression model, and a forest plot was generated using Graphpad Prism to illustrate factors that may impact patient prognosis. The predictive ability of HALP score combined with β2-microglobulin and ECOG score for prognosis in MM patients was evaluated using receiver operating characteristic curve (ROC) analysis. [Results] A total of 203 MM patients were included, with the optimal cutoff value for HALP score being 29.15 (P<0.05). Among them, 101 patients were in the low HALP score group, and 102 patients were in the high HALP score group. The results of univariate and multivariate analysis using the Cox regression model showed that a HALP score <29.15 was an independent risk factor for progression-free survival (PFS) and overall survival (OS) (P<0.05). ROC curve analysis indicated that the combination of HALP score with β2-microglobulin and ECOG score had a higher predictive value for prognosis in MM patients compared to using HALP score alone. [Conclusion] The HALP score is closely related to the prognosis of patients with NDMM. A low HALP score indicates a poorer prognosis, while the combination of HALP score with β2-microglobulin and ECOG score provides a higher predictive value when assessed together.

Objective To analyze the management and treatment situation for patients with psychosis in China in 2016,and compare with those data in 2014 and 2015,in order to provide a reference for policy making and services delivering.Methods Descriptive method was used to analyze the information system usage and the demographic characteristics,registration,management and treatment situation of the patients with psychosis.Data was obtained from ‘National Information System for Psychosis’ and traced from 1st August 2011 to 31st December 2016.Results By the end of 2016,the information system was applied by 2 801 counties (98.14％,2 801/2 854) to register patients with psychosis in China,5401 150 patients were registered,and prevalence of registered psychosis was 3.96‰ (5 401 150/1 362 466 686).In 2016,4 873 977 patients received the follow-up services by primary health care workers,and 3 665 720 patients were followed up regularly (at least once per 3 months).The follow-up rate and regular follow-up rate were 90.24％ (4 873 977/5 401 150) and 67.87％ (3 665 720/5 401 150) respectively.Moreover,2 528 143 patients were treated by antipsychotics,and 1 594 562 patients took medication regularly (according to the prescriptions).The medication-taking rate and regular medication-taking rate were 51.87％ (2528 143/4873977) and 32.72％ (1 594562/4873977) respectively.3 265 761 patients were in stable condition during the whole year and the rate of being stable was 68.68％ (3 265 761/4 754 801),which was positively correlated with follow-up rate,regular follow-up rate,medication-taking rate and regular medication-taking rate(r=0.578,0.733,0.495,0.536,all P＜0.05).Comparing with 2015,there are extra 27 counties and 479 645 more registered patients in 2016 and all indicators above were higher in 2016.Duration of untreated schizophrenia,bipolar disorder,delusional disorder,schizoaffective disorder,psychotic disorder with epilepsy,mental retardation with psychotic symptoms was 3.89,4.40,3.06,3.01,5.64,16.56 years respectively,all of which were shorter than 2015.Conclusions Services for patients with psychosis were significantly improved in 2016.The coverage of the system was expanded and the number of registered patients increased sustainably,and at the same time the duration of untreated psychosis decreased continuously with better management and treatment.

Objective To analyze the management and treatment situation for patients with psychosis in China in 2016,and compare with those data in 2014 and 2015,in order to provide a reference for policy making and services delivering.Methods Descriptive method was used to analyze the information system usage and the demographic characteristics,registration,management and treatment situation of the patients with psychosis.Data was obtained from ‘National Information System for Psychosis’ and traced from 1st August 2011 to 31st December 2016.Results By the end of 2016,the information system was applied by 2 801 counties (98.14％,2 801/2 854) to register patients with psychosis in China,5401 150 patients were registered,and prevalence of registered psychosis was 3.96‰ (5 401 150/1 362 466 686).In 2016,4 873 977 patients received the follow-up services by primary health care workers,and 3 665 720 patients were followed up regularly (at least once per 3 months).The follow-up rate and regular follow-up rate were 90.24％ (4 873 977/5 401 150) and 67.87％ (3 665 720/5 401 150) respectively.Moreover,2 528 143 patients were treated by antipsychotics,and 1 594 562 patients took medication regularly (according to the prescriptions).The medication-taking rate and regular medication-taking rate were 51.87％ (2528 143/4873977) and 32.72％ (1 594562/4873977) respectively.3 265 761 patients were in stable condition during the whole year and the rate of being stable was 68.68％ (3 265 761/4 754 801),which was positively correlated with follow-up rate,regular follow-up rate,medication-taking rate and regular medication-taking rate(r=0.578,0.733,0.495,0.536,all P＜0.05).Comparing with 2015,there are extra 27 counties and 479 645 more registered patients in 2016 and all indicators above were higher in 2016.Duration of untreated schizophrenia,bipolar disorder,delusional disorder,schizoaffective disorder,psychotic disorder with epilepsy,mental retardation with psychotic symptoms was 3.89,4.40,3.06,3.01,5.64,16.56 years respectively,all of which were shorter than 2015.Conclusions Services for patients with psychosis were significantly improved in 2016.The coverage of the system was expanded and the number of registered patients increased sustainably,and at the same time the duration of untreated psychosis decreased continuously with better management and treatment.

Objective To analyze the management and treatment situation for patients with psychosis in China in 2015, and compare with those in 2014, in order to provide a reference for policy making and services delivering. Methods Descriptive method was used to analyze the system usage and registration, management and treatment situation of the patients with psychosis, using the data obtained from"National Information System for Psychosis"in China and all provinces (including municipalities and autonomous regions), date traced from 1st August 2011 to 31st December 2015. Comparison and analysis were performed on the data in 2014 and 2015. Results By the end of 2015, the information system was adapted by 2774 districts/counties, accounting for 97.20% of the total county-level administrative areas (2774/2854), higher than that of 95.58% in 2014. There were 52000 registered users in the system;4921505 patients were registered, and registered rate was 0.361% (4921505/1362466686). In 2015, 4252022 patients were provided with follow-up services by primary health care staff, and the management rate was 86.40% (4252022/4921505). 2211835 patients were followed up regularly, with the management rate of 44.94% (2211835/4921505). Moreover, 2071111 patients were treated by taking antipsychotics, with the medication-taking rate of 48.71% (2071111/4252022), and 1293133 patients took medication regularly, with the regular medication-taking rate of 30.41% (1293133/4252022);2547824 patients were in stable condition and the stable disease rate was 61.31%(2547824/4155963). Compared with 2014, the registered rate, management rate, regular management rate, medication rate and regular medication rate were in an increasing trend, with the increase rates of 13.91%, 17.18%, 25.65%, 2.51%, 25.12%respectively;the stable disease rate in the patients at home were in a decreasing trend, down by 9.36%. Conclusion In 2015, the coverage of the information system was expanded. The number of registered patients was sustainably growing. The level of patient management and medicine-taking were improved, and the duration of untreated psychosis was shortened. However, the conditions of illness should be further controlled.

Objective To analyze the management and treatment situation for patients with psychosis in China in 2015, and compare with those in 2014, in order to provide a reference for policy making and services delivering. Methods Descriptive method was used to analyze the system usage and registration, management and treatment situation of the patients with psychosis, using the data obtained from"National Information System for Psychosis"in China and all provinces (including municipalities and autonomous regions), date traced from 1st August 2011 to 31st December 2015. Comparison and analysis were performed on the data in 2014 and 2015. Results By the end of 2015, the information system was adapted by 2774 districts/counties, accounting for 97.20% of the total county-level administrative areas (2774/2854), higher than that of 95.58% in 2014. There were 52000 registered users in the system;4921505 patients were registered, and registered rate was 0.361% (4921505/1362466686). In 2015, 4252022 patients were provided with follow-up services by primary health care staff, and the management rate was 86.40% (4252022/4921505). 2211835 patients were followed up regularly, with the management rate of 44.94% (2211835/4921505). Moreover, 2071111 patients were treated by taking antipsychotics, with the medication-taking rate of 48.71% (2071111/4252022), and 1293133 patients took medication regularly, with the regular medication-taking rate of 30.41% (1293133/4252022);2547824 patients were in stable condition and the stable disease rate was 61.31%(2547824/4155963). Compared with 2014, the registered rate, management rate, regular management rate, medication rate and regular medication rate were in an increasing trend, with the increase rates of 13.91%, 17.18%, 25.65%, 2.51%, 25.12%respectively;the stable disease rate in the patients at home were in a decreasing trend, down by 9.36%. Conclusion In 2015, the coverage of the information system was expanded. The number of registered patients was sustainably growing. The level of patient management and medicine-taking were improved, and the duration of untreated psychosis was shortened. However, the conditions of illness should be further controlled.

[ ABSTRACT] AIM:To investigate the different dose of perindopril on cardiac function in the rabbits with ische-mic cardiac dysfunction .METHODS:Male rabbits weighing 2.5~3.0 kg ( n=30) were randomly divided into 3 groups (n=10):high dose perindopril group (HD group), low dose perindopril group (LD group) and cardiac dysfunction group (CD group).The Left anterior descending coronary artery of the rabbits was ligatured for model preparation .In HD group, the rabbits were treated with perindopril split normal saline solution (1 g/L)2 mL· kg-1 · d-1 .In LD group, the rabbits were treated with perindopril split normal saline solution (0.33 g/L)2 mL· kg -1 · d-1.In CD group, the rabbits were treated with normal saline solution 2 mL· kg-1 · d-1 .Four weeks after treatment , the cardiac function was measured via echocardiography , the mRNA expression of angiotensin-converting enzyme 2 ( ACE2 ) and angiotensin type 2 receptor (AT2R) was analyzed by real-time PCR, serum angiotensin (Ang)-(1-9) and Ang-(1-7) levels were detected by ELISA. RESULTS:Compared with CD group , the cardiac function of the 2 groups treated with perindopril was significantly im-proved (P<0.01), and more improvement in HD group was observed than LD group (P<0.05).The serum angiotensin ( Ang)-(1-9) and Ang-(1-7) level and the mRNA expression of ACE 2 and AT2R in the 2 groups treated with perindopril were significantly improved (P<0.01).Compared with LD group, the mRNA expression of ACE2 and AT2R and the ser-um levels of Ang-(1-9) in HD group were significant improved (P<0.05), while no difference of serum Ang-(1-7) level was observed.Correlation analysis revealed that the improvement of the cardiac function was associated with serum Ang -(1-9) level, mRNA expression of ACE2 and AT2R (P<0.01), but has no significant correlation with serum Ang-(1-7) lev-el.CONCLUSION:High dose of perindopril may improve more cardiac function in ischemic cardiac dysfunction model in rabbits.The mechanism may relate to increasing serum Ang-(1-7) level to activate AT2R.

[ ABSTRACT] AIM:To investigate the effects of transplantation of bone marrow mesenchymal stem cells ( BMSCs) modified by bcl-2 gene on myocardial cell apoptosis, angiogenesis and cardiac function in the rabbit after acute myocardial in-farction ( MI) .METHODS:The rabbit BMSCs were isolated, cultured and purified in vitro.The BMSCs were transfected with adenovirus or adenovirus-Bcl-2.The rabbit model of MI was established by ligation of left anterior descending branch. The rabbits were injected with Ad-Bcl-2-BMSCs ( MI+Bcl-2-BMSCs group) , Ad-BMSCs ( MI+BMSCs group) and DMEM ( MI group) in infarction marginal zone 2 weeks after ligation.The cardiac function was evaluated by echocardiography.The apoptosis of myocardial cells was measured by TUNEL.The mRNA expression of VEGF was detected by real-time PCR.The expression of CD31 was examined by immunohistochemical staining, and new blood capillaries were counted at 4 weeks after BMSCs transplantation.The correlation of the above values with cardiac function was analyzed.RESULTS: The cardiac function was better, the apoptotic rate was lower, the mRNA expression of VEGF and the capillary density were higher in both MI+Bcl-2-BMSCs group and the MI+BMSCs group than those in MI group, and those in MI+Bcl-2-BMSCs group in-creased more obviously .The left ventricular ejection fraction ( LVEF) had a negative correlation with the myocardial cell ap-optosis rate.A positive correlation with the mRNA expression level of VEGF and the capillary density was also observed. CONCLUSION:The transplantation of BMSCs modified by bcl-2 gene significantly reduces the myocardial cell apoptosis, promotes angiogenesis, improves heart function of the rabbits with MI.

Objective To compare the efficacy of Graves disease animal models induced by thyroid stimulating hormone receptor (TSHR) plasmid DNA (pcDNA3.1-TSHR) and by TSHR A subunit recombinant adenovirus(Ad-TSHR289),and to investigate the influence of duration for preparing animal model induced by Ad-TSHR289 on Graves hyperthyroidism and its related indices.Methods The plasmid group and the adenovirus group were set up respectively.The plasmid group:21 female BALB/c mice were randomly divided into model group (n =12) and control group (n =9).The model group were injected intradermally with pcDNA3.1-TSHR 50 μg,once every 3 weeks,totally 3 times.Then 4 weeks after the last immunization,the mice were euthanized to obtain blood for testing TSHR antibody (TRAb),total T4,and thyroid tissue for histological examination.The controls were injected with the same dose of pcDNA3.1 in the same way.The adenovirus group:52 female BALB/c mice were divided into 10-week model group (n =8),14-week model group (n =10) and 18-week model group (n =8),and the respective controls (n =8,n =10,n =8) were set up.All model groups were injected intramuscularly with Ad-TSHR289,three times at three weekly intervals.Then the mice were euthanized at 4,8 and 12 weeks to test TRAb,total T4 level and to observe the change of thyroid histology.The controls were treated with the same dose of Ad-lacz in the same way.Another 8 mice were scheduled to test the dynamic variation of TRAb before and after the 3 times immunization.Results In the plasmid model group,only two of 12 mice developed weak antibody responses against TSHR,and no elevated total T4 level and no hyperplasia changes of thyroid were observed.In the 10-week model group,all mice had high level TRAb [(807.65 ± 136.33)U/L,Six-eighths mice had hyperthyroidism exhibited hyperplasia changes.In the 14-week model group,the TRAb level [(650.12 ± 192.88) U/L]and the incidence of hyperthyroidism (3/10) were lower than those in 10-week group.Histologically,the degree of thyroid hyperplasia lightened to a small extent,but its positive rate did not decline.In the 18-week model group,only 2 of 8 mice displayed slightly elevated TRAb level,and no mice showed increased total T4 level.Additionally,thyroid tissues of 2 mice were mildly abnormal.Compared with the model groups at different time,the change of antibody levels of the mice for TRAb dynamic observation exhibited the similar trend.Conclusions Being good at repeatability and high incidence of hyperthyroidism,the animal model of Graves disease induced by Ad-TSHR289 is still an ideal research tool presently.The duration of model ean be maintained 18 weeks,and 10 weeks is the best period to snstain characteristic of Graves disease.

BACKGROUND:Bone marrow stem cell transplantation can improve heart function and prevent ventricle remodeling.At present,the adult bone marrow stem cells used for transplantation primarily included bone marrow mononuclear cells (BM-MNCs) and mesenchymal stem cells (MSCs),and endothelial progenitor cells.The curative effects and precise mechanisms of transplantation of various bone marrow stem cells remain unknown.OBJECTIVE:To compare the effects of transplantation of autologous BM-MNCs and MSCs via the coronary artery on ventricle remodeling subsequent to acute myocardial infarction (AMI). DESIGN,TIME AND SETTING:Randomized controlled animal experiment performed at the Center for Clinical Research,Hebei Provincial People's Hospital,Electron Microscope Room,Hebei Medical University between March 2005 and December 2006.MATERIALS:Thirty-six male Jizhong pigs,were randomly divided into 4 groups:control group (n = 6),infarct model group (n = 10),BM-MNC group (n = 10),and MSC group (n = 10).METHODS:Porcine autologous BM-MNCs were isolated by gradient density centrifugation,and MSCs were obtained by adherence method.Prior to transplantation,both BM-MNCs and MSCs were colloidal gold labeled.Except the infract model group,pigs in the other 3 groups were developed into AMI models by oppressing the left anterior descending branch with balloon catheter.Ninety minutes after modeling,(6.0±1.3)×107 autologous BM-MNCs and (4.5±2.1)x 107 MSCs were respectively transplanted into pigs in the BM-MNC group and the MSC group via the coronary artery and cultured for 28 days.MAIN OUTCOME MEASURES:Observation of pathological changes of cardiac muscle tissue by light and electron microscope;Examination of cardiac function by ultrasonograph;Detection of the number of blood vessels and apoptotic myocardial cells,and expression of nuclear factor-κB (NF-κB) and troponin Ⅰ and its correlation to cardiac function by immunohistochemistry;Detection of mRNA expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in the cardiac tissue as well as its correlation to cardiac function by reverse transcription-polymerase chain reaction (RT-PCR).RESULTS:In the MSC group,there was proliferation of a great deal of blood vessels as well as growth of abnormal cell masses around the coronary vessels,while the BM-MNC group exhibited the "budding" of many capillary vessels.Prior to transplantation,cardiac function indices were basically similar among each group (F = 1.550,P＞0.05).Twenty-eight days after transplantation,left ventricular ejection fraction was significantly lower in the control,BM-MNC,and MSC groups than in the infarct model group (F = 5.30,P＜0.05),while endocardial fractional shortening was significantly higher (F = 10.67,P＜0.01).Compared with the infarct model group,the number of blood vessels in the infarct zone and infarct border zone was increased in the BM-MNC group (F=29.56-34.87,P＜0.01) and had no apparent change in the MSC group.In the BM-MNC and MSC groups,apoptotic myocardial cells in the infarct zone and infarct border zone were significantly reduced (F=14.31-35.34,P＜0.01 ) and troponin I expression rate was significantly increased (F=19.05,P＜0.01 ),as compared with the infarct model group.In addition,NF-κB positive rate in the infarct border zone was significantly lower in the BM-MNC and MSC groups than in the infarct model group (F=19.05,P＜0.01).VEGF gene expression level in the infarct border zone was significandy higher in the BM-MNC group than in the infarct model group and MSC group (F = 49.41,P＜0.01).bFGF gene expression level in the infarct border zone was significantly higher in the MSC group than in the infarct model and BM-MNC groups (F=4.71,P＜0.01).LVEF was negatively correlated to myocardial cell apoptosis rate and NF-κB level (r=-0.441 1,P＜0.05;r=-0.579 6,P＜0.01 ).LVEF was positively correlated to number of blood vessels,VEGF and bFGF expression (r=0.775,P＜0.01;r=0.565 1,P＜0.05;r=0.573 5,P＜0.05).CONCLUSION:Transplantation of both autologous BM-MNC and MSC via coronary artery can improve the condition of left ventricular remodeling subsequent to myocardial infarction.The improvement of cardiac functions is related to the increase of blood vessels,VEGF and bFGF expression,the decrease of myocardial cell apoptosis and NF-κ B level in cardiac muscle tissues after stem cell transplantation.BM-MNC transplantation better promotes blood vessel proliferation and VEGF expression in the cardiac tissue but produces worse effects on bFGF gene expression than MSC transplantation.

Objective We investigated the effect of Guhong on the capability of brain to resist ischemia.Methods MCAO model was established in SD rats.TTC staining was performed in Guhong group with intraperitoneal injection and routine MCAO model group.Infarction volume was compared.Immunochemistry was performed to observe Caspase 3 expression in peri-infarct cortice of both of the groups.Results Guhong intraperitoneal injection significantly reduced the infarction volume(P﹤0.05).Caspase 3 expression was lower in Guhong group as compared with the model group.Conclusion Guhong may strengthen the capability of brain to resist ischemia.Anti-apoptosisinduced by Guhong may be the one of the underlied mechanisms.