Objective To investigate the clinical characteristics in an elderly patient with sellar multiple myeloma.Methods Clinical features,laboratory data and radiologic profile of an elderly patient with sellar multiple myeloma were collected.Results The patient was an 85-year-old male.The main clinical manifestations were fatigue,poor appetite and polyuria.Laboratory examinations showed a significant decrease in blood sodium,several anterior pitu-itary hormones and an increase in total protein,mass of pituitary lesion and concentration of prolactin.During etio-logical screening,it was found that the blood immunoglobulin G(IgG)level was significantly increased,the blood M protein was positive and the bone marrow smear showed myeloma cells accompanied by multiple osteolytic lesions in the bones of the whole body.Considering the diagnosis of multiple myeloma,the pituitary lesion was likely to be the extra-medullary involvement.Conclusions The intrasellar plasmacytoma is not common.The disease onset is insidious with clinical features and imaging findings lacking specificity.Therefore,diagnosis relies on biopsy which poses risks for elderly patients and increases diagnostic challenges leading to misdiagnosis.

Objective:To explore the value of octreotide suppression test(OST) in predicting the efficacy of somatostatin receptor ligands(SRLs) in the treatment of active acromegaly.Methods:The clinical data of 76 patients with active acromegaly from 2011 to 2020 was retrospectively analyzed. OST was carried out as follows: After an overnight fasting and baseline sampling of growth hormone(GH), 100 μg octreotide was subcutaneously injected, and sampling for GH was obtained every 2 hours for 8 hours. All patients were treated with SRLs for at least 3 months. A good GH response is defined as a post-treatment random GH<1 μg/L or >80% fall compared with the baseline GH. A good insulin-like growth factor Ⅰ(IGF-Ⅰ) response is defined as IGF-Ⅰ<1.3 upper limit of normal(ULN) or >50% reduction compared with the baseline. If both GH and IGF-Ⅰ fulfill the criteria of a good response, it is defined as a good GH and IGF-Ⅰ response.Results:The baseline level of GH during OST was 15.00(6.38, 34.20) μg/L, the median time to reach the nadir GH was(3.65±1.65) hours, and the nadir GH level was 1.47(0.50, 4.19) μg/L. The median GH suppression rate was 89.12%(72.71%, 95.09%). When the cutoff value of GH suppression rate in predicting a good GH response was 89.32%, the area under the curve(AUC) was 0.74, with a sensitivity of 81.80% and specificity of 66.00%. When the cutoff value of GH suppression rate in predicting a good IGF-Ⅰ response was 93.14%, the AUC was 0.64, with a sensitivity of 50.00% and specificity of 75.60%. When the GH suppression rate was 90.71%, the AUC was 0.78, with the sensitivity of 83.30% and specificity of 70.00% in predicting a good GH and IGF-Ⅰ response. Compared with GH/IGF-Ⅰ non-responders, GH/IGF-Ⅰ responders displayed lower nadir GH during OST, higher GH suppression rate and IGF-Ⅰ reduction rate, and lower ratio of IGF-1 to ULN( P<0.05). Conclusion:GH suppression rate during the OST is a valuable predictor to evaluate the efficacy of SRLs in patients with acromegaly, with the highest sensitivity and specificity when the cutoff value is 90.71%.

Objective: To investigate the key factor(s) of hepatitis B virus X protein (HBx) promoting B7-H6 gene activation. Methods: The DNA fragments of the B7-H6 promoter were amplified from the human genomic DNA using polymerase chain reaction(PCR). Products of PCR were digested by KpnI and HindⅢ, and inserted into luciferase reporter vector (pGL3-Basic). The correctness of the recombinant plasmid pGL3-B7-H6 was confirmed by sequencing. Human hepatoma cell line HepG2 were co-transfected with pGL3-B7-H6 and the eukaryotic expression vectors (pCMV-HBs、pCMV-HBc and pCMV-HBx), and the relative luciferase activity was detected.The different dose of HBx expression plasmids were transfected into the HepG2 cells, and the expression of B7-H6 protein were determined by Western blot. Results: A period of 2.2 Kb of B7-H6 promoter region were successfully cloned into pGL3-Basic, which was confirmed by DNA sequencing. The relative luciferase activity was significantly higher in the cells transfected with pGL3-B7-H6 than that in the cells transfected with the empty vector pGL3-Basic (5.24±1.25 vs. 1.12±0.31, P=0.005). The relative luciferase activity in HepG2 cells co-transfected with pGL3-B7-H6 and pCMV-HBx was remarkably increased compared with the control group (17.60±3.36 vs. 6.73±1.36, P=0.001). Western blot further demonstrated that HBx protein can significantly enhance B7-H6 protein expression. Conclusions Hepatitis B Virus X proteins enhanced B7-H6 promoter activity and promoted B7-H6 protein expression.

Objective To investigate the expression of chemokine receptors CCR4,CCR6,CXCR3 on Th17 cell,and analyze the correlation between chemokine receptors and serum biochemical parameters of liver function test and hepatitis B virus (HBV) DNA load in peripheral blood of chronic hepatitis B (CHB) patients.Methods Thirty patients with CHB (CHB group) and 15 healthy persons (control group) were enrolled in the study.CCR4,CCR6,CXCR3 expression levels on Th17 cell were assayed by flow cytometry.The correlation between chemokine receptors and alanine aminotransferase (ALT),total bilirubin (TBil),and HBV DNA load were analyzed using Pearson' s correlation analysis,respectively.Results CCR4,CCR6,CXCR3 expression levels on CD4 + Th17 cell in CHB group were higher than that of control group.Moreover,the difference between them was statistically significant (P ＜ 0.05).CCR4,CCR6 expression levels on CD8 + Th17 cell in CHB group were higher than that of control group (P ＜ 0.05).Although CXCR3 expression level on CD8 + Th17 cell in CHB group was higher than that of control group,there was no significant difference between them (P ＞ 0.05).CCR4,CCR6 expression levels were positively correlated with serum ALT,HBV DNA load,respectively (P ＜ 0.05),but were not correlated with TBil (P ＞ 0.05).Conclusion Expression levels of chemokine receptor on Th17 cell were increased in patients with CHB and were positively associated with degree of liver inflammation.Therefore,CCR4,CCR6 expression on Th17 cell might be involved in liver injury resulted from Th17 cell.

Objective To evaluate the efficacy of Leukotriene receptor antagonists in treatment of patients with asthma and allergic rhinitis(AR).Methods This study was a 24-week,randomized,control open trial in which 100 children,who were diagnosed as mild to severe persistent coexisting asthma and AR,were enrolled.All cases were collected from pediatric out-patient department of the First Affiliated Hospital of Guangzhou Medical College from October 1st,2005 to April 30th,2006 and were divided into three groups.Montelukast group(1 group):inhated budesonide turbuhaler and oral singulair(5mg/Qn);Intranasal corticosteroids group(2 group):inhaled budesonide turbuhaler and intranasal budesonide nasal spray(64?g/Qd);Control group(Control group):only inhaled budesonide turbuhaler.Efficacy was assessed by recording daytime and nighttime symptom scores,nasal symptom scores,the times of acute episode,the symptomfree days,the requirement for the weekly beta 2-receptor agonist and the medication scores,using a daily diary card and the recording work were repeated per fo ur weeks in totally six months.Lung function(forced expiratory volume at 1 s inpredicted normal,FEV1%) and nasal eosinophil count had been tested three times:before treatment,after treatment of 8th and 24th week.Results 1 group and 2 group,compared with the prior treatment(P0.05);1 group was more statistically significant than 2 group in improving FEV1(P