Objective To study whether bortezomib combined with dexamethasone can relieve bone pain of patients with multiple myeloma and to see whether bortezomib have effect on bone metabolism through determining the concentration of bone turnover marks.Methods 59 cases of patients with multiple myeloma treated with BD and 38 cases of patients treated with VADM were observed before and after chemotherapy to compare the alleviation of bone pain,the improvement of the ability to move and the occurrence of skeletal related events between the two groups.The plasma from 25 patients were collected before and after chemotherapy when they were in hospital each time and the concentrations of TRACP-5b,BALP and DKK1 in plasma were determined by ELISA.Results BD group was better than VADM group in the rate of alleviation of bone pain,the improvement of the ability to move and the incidence of skeletal related events(75.7% vs 50%,64.9% vs 20.8% and 13.8% vs 57.8%,all P

Objective To study the clinical features and risk factors of invasive fungal infection (IFI) in multiple myeloma ( MM) . Methods Three hundred and fifty-seven cases of MM were retrospectively analyzed for IFI, clinical features, complicating diseases, treatment of fungus and side effect of anti-fungal drugs. Results Forty-four cases ( 12. 3% ) of IFI were diagnosed. Three of them were diagnosed definitely, 8 clinically and 33 probably. Ten cases incurred IFI in (he induction therapy, 4 in platform, 27 in progress and 3 in the treatment with autologous stem cell transplantation. The lung was the commonest site of infection ( 50. 0% ) . The total effective rates of amphotericin B liposome, voriconazole, itraconazole, caspofungin and fluconazol were 83. 3% , 75. 0% , 78. 9% , 75. 0% and 57. 1% respectively (P= 0.493). In a multivariate analysis, independent factors significantly associated with IFI were diabetes (P=0.035, OR 2. 527, 95%CI 1.005-6.052), dialysis (P=0. 022,OR 2. 768, 95%CI 1. 161-6. 600), persistent agranulocytosis (P = 0.019, OR 3.215, 95% CI 1.200-7.407), broad-spectrum antibiotic therapy (P = 0.009,OR 3. 350,95% CI 1.353-8.295) and fludarabine treatment( P = 0. 001,0R 4. 669, 95% CI 1.813-12.023). Conclusions Patients with MM are in high risk of IFI. The lung is the commonest site of infection. The therapeutic effect was similar with itraconazole, voriconazole, caspofungin and amphotericin B liposome in MM patients with complicating IFI. The risk factors for IFI in MM were diabetes, dialysis, persistent agranulocytosis and the use of broad-spectrum antibiotics and fludarabine.

Objective To investigate the distribution of human papillomavirus (HPV) type 16 in women cervical infection in eastern Guangzhou, polymorphism of E6/E7 gene and association of gene dosage with disease progression. Methods Flow-through hybridization and gene chips were applied in HPV sub-type identification to screen out HPV-16 positive samples from cervical epithelium samples. HPV-16 E6/E7 gene was amplified through PCR with specific primers. The PCR products were cloned into pMD18-T vectors and fragments were determined through sequencing. Polymorphism analysis were performed through align-ment tools. Fluorescence quantitive PCR were used for the detection of viral E6 gene and L1 gene. Results Thirty-six (4.5%) HPV-16 positive samples were screened out through flow-through hybridization from 806 cervical epithelium samples. HSIL and above happened in 18 (50.0%) of the 36 HPV-16 positive patients. Within E6/E7 gene sequences from 7 selected samples, we found 15 sites with variances and 8 of them would cause coding amino acid change. HIL group (A, 11 cases) and LSIL group (B, 14 cases) possess significantly different gene dosage of both viral E6 gene and LI gene (P <0.05). The ratios of L1/E6 be-tween the 2 groups was not significantly different(P=0.19). Conclusion HPV-16 cervical infection oc-curs in 4.5% women (17-62 years old) in eastern Guangzhou. HIL or above accompany with half of the HPV 16 infected women. Viral load is probably associated with cervical HSIL, though L1/E6 ratios do not suggest viral integration.

AIM: To observe if there is a synergistical effect on induction of apoptosis when arsenic trioxide alone or combination with bortezomib in KM3 cells. METHODS: KM3 cells were treated with arsenic trioxide alone or combined with bortezomib, the numbers of viable cells were determined by trypan blue exclusion. Cell growth inhibition was examined by MTT method. The cells were simultaneously stained with annexin V-FITC and PI and apoptosis was determined by bivariate flow cytometry using a FACScan. Reverse trascriptional-PCR (RT-PCR) method was used to examine the change of p65 mRNA and Western blotting to measure the expression of protein p65, p-p65, caspase-3, -8, -9, and poly ADP-ribose polymerase (PARP). RESULTS: Arsenic trioxide inhibited the cell growth and induced apoptosis. The mechanism was responsible for the activation of caspase-mediated induction of apoptosis. A synergistic effect of combination with bortezomib on apoptosis was observed. CONCLUSION: Arsenic trioxide inhibits KM3 cell growth and induces apoptosis with a synergistical effect when cotreated with bortezomib.

Objective To discuss current detection of food intolerance in health check-up populations and the influence of food intolerance on immune system and inflammation parameters.Methods Serum levels of 14 kinds of food-specific IgG antibodies were analyzed by using enzyme linked immunosorbent assay (ELISA) among 257 healthy check-up adults.White blood cell count,eosinophils,globulin,erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),rheumatoid factor (RF),antinuclear antibodies (ANA) and T cell function were compared between the positive group and the negative group.Student's t test and Chi-square test were used for data analysis.Results Food-specific IgG antibodies were found in 134 participants (52.14％).The most common intolerant foods were egg,crab and milk.Moderate to severe food intolerance was caused by egg or milk.There was significant difference in eosinophils and serum globulin between the positive and the negative group (t =-0.07,x2 =8.91,both P ＜0.05).However,no difference was observed in white blood cell count,ESR,CRP,RF,ANA and T cell function between two groups (all P ＞ 0.05).Conclusion Eosinophils and serum globulin may significantly increased in people with food intolerance,although white blood cell count,ESR,CRP,RF,ANA and T cell function could be normal.

Objective A retrospective study to evaluate the feasibility of the sequential treatment of extrahepatic bile duct calculus and acute gallstone pancreatitis using the technique of combination of duodenoscope, laparoscope and choledochoscope in one anesthetic session. Methods 112 patients with extrahepatic bile duct calculus (including 23 patients associated with acute gallstone pancreatitis) were treated using this technique. The data were analyzed. Results The technique was successfully carried out in 102 patients but 10 patients had to be treated by conventional open operation.For the patients treated by this technique, 16 patients were treated by endoscopic sphincterotomy (EST) plus choledochotomy. The stones were removed through a choledochoscope, and the bile duct was drained by a T-tube (LCTD). 18 patients were treated by endoscopic retrograde cholangiopancreatography plus laparoscopic cholecystectomy (LC). The choledocholiths were removed by a choledochoscope through the cystic duct. 22 patients were treated by choledochotomy, and the calculus was removed through a choledochoscope and the bile duct was primarily sutured. 46 patients were treated by endoscopic nasobiliary drainage (ENBD) plus LC, choledochotomy. The calculi were through a choledochoscope and followed by primary suture of the bile duct. The mean time of endoscopic treatment, LC and postoperative hospital day were 35 min, 110 min and 6.5 d respectively. None of the 102 patients died after operation. 9 patients developed complications of ERCP or EST including acute pancreatitis (n=6), hemorrhage of papilla duodeni (n=2) and duodenal perforation (n= 1). 11 patients developed biliary fistula after primary suturing of the choledochus and they recovered with drainage; 2 patients developed residual or recurrent biliary fistula after the T tube was removed and they recovered after drainage via a [aparoscope. During follow-up for 1 to 3 years using ultrasonic or MRCP examinations, 3 cases of stones were found and they were removed by EST. There was no stenosis of common bile duct. Conclusions Our results suggested that the three-endoscope-combination in one anesthetic session for the treatment of extrahepatic bile duct calculi and acute gallstone pancreatitis was safe and efficacious. Moreover, this technique reduced the complications of EST. This technique increased the success rate using minimal invasive surgery.

Social network analysis has been a study hot spot in academic circle in recent years and is applied in several fields.After a brief description of its basic theories and study methods, its application in domestic medical and health field were analyzed with its key study hot spots summarized and its problems pointed out, in order to provide the methods that can learned in domestic medical and health studies.

The distribution of authors, institutions that published papers, and key words in CNKI-covered papers on library information service model was analyzed, which showed that there are a number of high production authors in China engaged in studies on library information service model but the number of cooperative studies is few, aca-demic libraries are active in performing related studies but public libraries seldom participate in such studies, the related studies are focused on the application of information technologies and the personal demands of users.

Objective To compare effects and toxicities of DVd and VAdM regimen for newly diagnosed multiple myeloma.nethods 17 newly diagnosed active multiple myeloma received DVd treatment,dexamethasone(20 mg/d)on days 1～4 as an intravenous infusion.16 newly diagnosed active multiple myeloma on days 1～4 plus melphalan(12 mg/d)as an intravenous infusion.Results Objective response rates(DVd,76.5%;VAd,81.3%,P=0.737)were similar between the two treatment groups.In the DVd group,the mean time to max response was shorter than the VAdM group[(3.2±1.7)months vs.(4.6±1.0)months,P=0.039].DVd was associated with low Grade 3/4 neutropenia(23.5% vs.68.8%,P=0.015),less use of G-CSF(11.8% vs.62.5%,P=0.004),less use antibiotic(11.8% vs.37.5%,P=0.118),lower incidence of hospitalization for adverse events(37.5% vs.17.6%,P=0.259),but more hand-foot syndrome.Coilcinsion The DVd regimen demonstrated similar efficacy compared with VAdM,while with less toxicity and supportive care,which might be used as a modified VAd regimen for newly diagnosed myeloma.

The functional framework of information management system for regional medical and health institutions was established according to the 5 application systems (public health, medical service, medical support, drug supply support and general management ) and the target to develop 2 databases ( a resident electronic health records data-base and a resident electronic medical records database ) and an operational network put forward in the overall framework of health information construction during The National Twelfth-5 Year Plan Period, based on the functional position of health institutions at different levels.The difficulties to realize the target of the national 3521 project and its prospects were pointed out.