The 48th annual meeting of the American Society of Clinical Oncology (ASCO) was held in Chicago from June 1-5 2012 and the risk-adapted therapy of multiple myeloma (MM) was discussed.MM is a heterogeneous disease and all patients should be accepted risk-adapted therapy. According to cytogenetic abnormalities, MM patients are divided into three groups,standard risk, intermediate risk and high risk.Patients with standard risk may received 4 cycles Rd regimes (lenalidomide plus low dose dexamethasone) or VCD regimes (bortezomib,cyclophosphamide,dexamethasone) for induction therap.Patients with intermediate risk may received 4 cycles VCD regimes for induction therapy.Patients with high risk may received 4 cycles VRD regimes (bortezomib,lenalidomide,dexamethasone) for induction therapy.After induction treatment,patients can received autologous hematopoietic cell transplantation or consolidation/maintenance therapy. The determination of which patients are eligible for autologous hematopoietic cell transplantation according age,comorbidities and performance status.

Multiple myeloma is a malignancy of plasma cells and renal function impairment is one of common complications of multiple myeloma.Light-chain deposition in renal tubules which induces renal tubular disease is the major pathogenesis of renal impairment.The renal function impairment should be estimated based on glomerular filtration rate in multiple myeloma patients. Bortezomib with high-dose dexamethasone is effective to myeloma patients with renal impairment and improves renal function.Treatment experience of thalidomide is limited,but it can be used at the standard dosage to patients with renal failure.Lenalidomide is effective and can reverse renal impairment of several myeloma patients when this agent is used at reduced doses according to renal function.

Many complex symptoms are observed in multiple myeloma and the most common symptom is bone damage, decreased renal function, increased infection susceptibility, anemia and peripheral neuropathy. Moreover some patients have other accompanying disease, such plasmacytoma and amyloidosis.Symptoms in multiple myeloma are the important basis for initiating anti-myeloma therapy. This paper is to review the pathophysiology of the complication of multiple myeloma and its treatment.

Objective To investigate the effect of mouse nerve growth factor on humoral immunity in children with severe hand foot mouth disease. Methods 92 patients with severe hand foot mouth disease were selected from June 2010 to September 2012 in the hospital, and randomly divided into two groups.The indexes of blood cell analysis, humoral immunity, cytokines and T lymphocyte subsets were compared after treatment.Results After treatment, compared with control group, the numeration white blood cell, neutrophil and lymphocyte of observation group were lower (P<0.05), IgM, IgG and IgA were higher (P<0.05), IL-1, IL-6 and IL-10 were lower (P<0.05), CD4 +and CD8 +were higher (P<0.05).Conclusion Mouse nerve growth factor can significantly improve the each index of humoral immunity cytokines and T lymphocyte subsets level in children with hand foot mouth disease, which has the great significance in clinical.

Objective To explore the clinical application of the special use of antibacterial drugs in Department of hepatobiliary surgery by analyzing the typical cases of the use of antibiotics.Methods This paper analyzes and comments on the typical cases of the use of special antibiotics in Department of hepatobiliary surgery.Results Department of hepatobiliary surgery the special use level of antibacterial drugs,should be based on the pathogenic characteristics of drug resistance and drug sensitivity test results and timely adjustment of antimicrobialtherapy,severe infection should be given sufficient medicines in a timely manner,should adjust the antibiotics dose according to liver and kidney function,drug dose attention to drugs with narrow therapeutic index,combined medication,caution should be avoided unnecessary repeat medication.Conclusion Through the analysis of the typical cases of the special use of antibiotics in Department of hepatobiliary surgery,it can promote the rational use of antibiotics.

Objective To explore antiviral efficacy, safety and blocking of mother-to-infant transmission by administrating telbivudine in pregnant patients with chronic hepatitis B (CHB) throughout pregnancy. Methods Sixty-four cases of female patients were enrolled. The study participants were divided into the telbivudine treatment group (n = 31) and the control group (n = 33). Data were recorded from beginning of administration to ending pregnancy, as well as notation of any adverse reactions. The neonates and infants were evaluated in HBV infection, parameters of growth and development. Results The recovery rates of ALT, respectively, were 90.32% vs. 57.58% (P = 0.003), 93.55% vs. 62.50% (P = 0.003) at 24 weeks and ante partum and the HBVDNA-negative conversion rates, respectively, were 48.39% vs. 3.03% (P = 0.000), 83.87%vs. 6.06% (P = 0.000), 90.32% vs. 6.25% (P = 0.000) respectively, at 12, 24 weeks of pregnancy and at ante partum between the treatment and control groups. The HBsAg-positive and HBVDNA-positive rates of the infants, respectively, were 12.90% vs. 37.50% (P = 0.025) and 0 vs. 21.88% (P = 0.018) at birth, and respectively, were all 0 vs. 18.75% (P = 0.035) and 0 vs. 18.75% (P = 0.035) at 1, 6, 12 months old between the treatment and control groups. The treatment group showed lower incidence of intrauterine HBV infection (0 vs. 18.75%, P = 0.035). The gestational ages, fetal weights and Apgar scores were not significant different in the children born in the mothers from the two groups. Conclusions Telbivudine administration showed a good antiviral curative effect and effectively blocked mother-to-infant transmission in women with CHB. The treatment was safe and caused no obvious adverse reaction.

OBJECTIVE: To analyze the expression of Maspin and Ki67 in EN-NK/TCL and the significance. METHOD: The expressions of Maspin and Ki67 were detected by immunohistochemistry in 34 cases of EN-NK/TCL and 11 cases of chronic sinusitis. RESULT: Maspin was low expressed in EN-NK/TCL, Ki67 was highly expressed in EN-NK/TCL. Negative correlation was found between the expression of Maspin and Ki67 in EN-NK/TCL. CONCLUSION The combined examination of Maspin and Ki67 has important significance in the diagnosis in EN-NK/ TCL.
Biomarkers, Tumor ; metabolism ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; metabolism ; Lymphoma, Extranodal NK-T-Cell ; metabolism ; Serpins ; metabolism

Objective To observe the clinical effects of conventional liver protection (control group) and sequential artificial liver therapy after 131Iodine (131 I treatment) based on the conventional liver protection in hypertensive patients with subacute liver failure. Methods The comparison of therapeutic effects of routine hepatoprotective therapy and sequential artificial liver therapy after 131Iodine (131 I treatment) based on the conventional liver protection and the thyroid hormone recovery situation in 35 patients diagnosed with hyperthyroidism and subacute hepatic failure were retrospectively analyzed. Results The thyroid hormone of 16 patients in the control group did not decrease after one month of treatment compared with that before treatment, and 10 patients died. Thyroid hormone levels in 19 patients in the treatment group decreased significantly after treatment for one month compared with that before treatment and 4 patients died. The mortality of the treatment group was significantly lower than that of the control group (P＜0. 05). Conclusion Sequential artificial liver treatment after 131I treatment in patients with hyperthyroidism and subacute hepatic failure treated with conventional hepatoprotective therapy can improve the survival rate of patients and rapidly reduce the level of thyroid hormone.

Purpose To explore the accuracy of ALK fused gene expression by immunohistochemistry ( IHC) in non-small cell lung cancer ( NSCLC) patients, and to investigate the clinical and pathological features of ALK-positive NSCLC patients. Methods By u-sing rabbit monoclonal D5F3 antibody, ALK IHC was performed on 234 NSCLC patients. ALK positive cases were confirmed by reverse transcription-polymerase chain reaction ( RT-PCR) . Results The positive incidence of ALK by IHC in 234 NSCLC specimens was 8. 97% (21/234), the positive rate of ALK fused gene verificated by RT-PCR was 5. 98% (14/234). There was significant difference with histological type, age, stage (P<0. 05), but no significant difference with gender, smoking history, tumor differentiation. Of 21 cases of ALK-positive NSCLC patients, the consistency of IHC and RT-PCR was 0 when IHC was ( +) , however, when IHC was or immunohistochemical score was >120, the consistency rate was 100%. Conclusion Although immunohistochemical expres-sion of ALK fused gene may have a certain false positive, IHC or immunohistochemical score> 120 show very high value for ALK fused gene RT-PCR followed by ALK immunohistochemistry in lung cancer is a economical and feasible method for the valuation of ALK fused gene.

Objective To screen the optimum conditions carrying murine melanoma B16 cells in spaceflights without cares.MethodsMurine melanoma cells were cultured on micocarriers and grouped depending on cells concentration, serum concentration, microcarrier number and temperature.After 33 days, B16 cells were stained by Giemsa, observed with phase-contrast microscope and counted for surviving percentage.ResultsThe optimum conditions,in which the surviving percentages were 8% and 10%, were obtained in the experiments.B16 cells were carried in the 20th recoverable satellite orbiting 18 days under the optimum conditions. After recovering, 110 strain monocloned cells were survived and the surviving percentage was 1.1%.ConclusionThe optimum conditions carrying murine melanoma B16 cells in spaceflights without cares seems to be obtained,and it did improve the surviving time and percentage of cells in spaceflights without cares.