Objective To observe the curative effects and toxicity of low-dose bortezomib plus thalidomide and chemotherapy in treatment of multiple myeloma. Methods 35 patients with initial, refractory or relapsed MM received at least two cycles of treatment with bortezomib at 1.1 mg/m2 intravenously on days 0,3, 7, and 10, and by daily oral thalidomide escalated from 50mg to 150 mg and chemotherapy. The chemotherapy regimens included MP, VAD and AD regimen which was chosen according to the status of patients. Results After a median follow-up of 20 months, the overall response rate was 82.8 %, complete remission (CR)48.6 %, very good partial remission (VEPR) 17.1%, and partial remission 17.1%. The 3-year PFS and OS were 60.92 % and 72.41% separately. ORR and OS were same in initial and refractory or relapsed MM patients. Grade 3 or 4 adverse events including debility (3/35), nausing and vomiting (8/35), constipation (4/35), peripheral sensory neuropathy (3/35), neutropenia (10/35) and thrombocytopenia (12 %) were observed.Conclusion The regimen of low-dose bortezomib plus thalidomide and chemotherapy is a highly effective and safety regimen for MM patients. The maintenane therapy with thalidomide may prolong PFS.

Objective To understand Shenzhen Longgang,guangming and longhua new district four district hospital ICU pa-tients with secondary pulmonary tuberculosis merger lower respiratory infection of pathogenic bacteria distribution and drug resistance status of provide a reference for clinical diagnosis and rational use of antibiotics therapy.Methods Random selec-tion from February 2013 to October 2015 in the three district hospital ICU diagnosis of secondary pulmonary tuberculosis patients with lower respiratory infection in 593 cases of sputum specimen pathogenic bacteria culture and drug susceptibility results were retrospectively analyzed.Results 593 cases of ICU secondary pulmonary tuberculosis patients with respiratory tract infection of the communist party of China isolated 617 strains of pathogenic bacteria,fungi accounted for 49.6% (306/617),gram negative bacilli accounted for 40.4% (249/617),gram positive cocci accounted for 10.0% (62/617).Fungal in-fection main pathogens for white smooth candida yeast and candida yeast,respectively accounted for 44.2% (273/617)and
4.5% (28/617),gram negative bacillus mainlyKlebsiellaPneumoniae,Pseudomonasaeruginosa,and H.influenzae,respec-tively accounted for 16.7% (103/617),12.0% (74/617)and 7.3% (45/617),gram-positive cocci mainly for Saphylococcus aureus and Epidermisstaphylococcus and Hemolyticstaphylococci,respectively accounted for 4.5% (28/617),3.2% (20/617)and 0.9% (5/617).Pathogenicbacteria isolated from the multiple drug resistant bacteria,present different levels of resistance to commonly used antimicrobial agents.Conclusion ICU patients with secondary pulmonary tuberculosis merger of lower respiratory tract infection pathogens to fungi and gram-negative bacilli,the most commonWhite candida,Klebsiella pneumoniae,and Pseudomonasaeruginosa,and different levels of resistance to commonly used antimicrobial agents.

Objective To investigate the correlation between spot albuminuria to creatinine ratio (ACR) and 24 h urinary protein excretion in women with preeclampsia and determine the optimal cut-off values of spot ACR in mild preeclampsia and severe preeclampsia.Methods Twenty-eight women with mild preeclampsia and 22 with severe preeclampsia at Nanfang Hospital,Southern Medical University between October 2010 and June 2011 were recruited.Maternal serum cystatin,uric acid,mea nitrogen,creatinine and albumin levels were collected and analyzed.Twenty-four hours urinary protein excretion was measured with immunoturbidimetric assay and ACR with automatic analyzer DCA2000.The correlation between ACR and 24 hours urinary protein excretion was explored.And the optimal cut-off values of the spot ACR for mild and severe preeclampsia were determined with receiver operating characteristic curve.Results ( 1 )Maternal serum biochemical parameters:uric acid levels in mild and severe preeclampsia were (359 ± 114)μmol/L and (450 ± 132) μmol/L,while cystatin levels were ( 1.3 ±0.3) mg/L and ( 1.6 ±0.5) mg/L respectively.The differences were statistically significant ( P ＜ 0.05 ).Serum urea nitrogen,creatinine and albumin in mild preeclampsia were(3.6 ± 1.6) mmol/L,(52 ± 38 ) μmol/L and ( 33 ± 3 ) g/L,while in severe preeclampsia were( 6.2 ± 3.1 ) mmol/L,( 78 ± 59 ) μmol/L and ( 29 ± 6 ) g/L respectively.There were no statistical significant differences ( P ＞ 0.05 ).(2) Twenty-four hours urinary protein excretion and ACR:24 hours urinary protein levels in mild and severe preeclampsia was (700 ± 160) mg and (4800 ±2200) mg (P＜0.05).ACR in mild and severe preeclampsia was (72.7 ± 12.4) mg/mmol and (401 ±245) mg/mmol respectively (P ＜ 0.05 ).(3) There was a strong correlation between the spot ACR and 24hours urine protein excretion ( r =0.938 ; P ＜ 0.05 ).( 4 ) The optimal spot ACR cut-off point for the diagnosis of preeclampsia:the optimal spot ACR cut-off point was 22.8 mg/mmol for 300 mg/24 hours of protein excretion in mild preeclampsia,the area under curve was 0.956,with a sensitivity,specificity of 82.4％,99.4％ respectively.And the optimal spot ACR cut-off point was 155.6 mol for 2000 mg/24 hours of protein excretion in severe preeclampsia,the area under curve was 0.956,with a sensitivity,specificity of 88.6％,91.3％ respectively.Conclusions Compared with 24 hours urinary protein excretion,the spot ACR may be a simple,convenient and accurate indicator of early diagnosis of preeclampsia.Spot ACR may be used as a replacement for 24 hours urine protein excretion in assessment of preeclampsia.The optimal spot ACR cut off points were 22.8 mg/mmol for mild preeclampsia and 155.6 mg/mmol for severe preeclampsia.

AIM: To establish the experimental acute pulmonary embolism(APE) model and observe the left and right ventricular pressure-volume relationship in different overload situations. METHODS: The present study consisted of seven anesthetized mongrel dogs that were divided into the control group, moderate APE group and severe APE group according to the various phase and different pressure load during the experiment. APE model was induced by suture piece injection through right cardiac catheterization. The hemodynamic indexes were measured by the simultaneous cardiac catheterization and echocardiography.RESULTS: (1) In the group with moderate APE, the pressure-volume relationship of right ventricle tended to right-upward shift, the area of chart increased, the shape of chart transformed form triangle to rectangle. The mild parallel leftward shift, the area of chart decreased mildly and no change of chart shape was observed in the pressure-volume relationship of left ventricle. (2) In the group with severe APE, the chart of right ventricular pressure-volume relationship tended to right-upward shift continuously, the area of chart decreased. The chart of the left ventricle tended to left-downward shift and no change of chart shape was observed in the pressure-volume relationship of left ventricle, the area of chart decreased. The erose shape of charts was also found.CONCLUSION: The chart of ventricular pressure-volume relationships is a practical and reliable method to evaluate left and right ventricular hemodynamic in APE.

AIM: To Screen and identify differentially expressed genes that involved in apoptosis model in rat cerebellar granule neurons (CGNs).METHODS: The rat cerebellar granule neurons were isolated and primarily cultured. Fluorescent differential display RT-PCR (FDD RT-PCR) was performed to screen differentially expressed ESTs in the apoptosis model of primarily cultured rat CGNs. ESTs were subcloned into pGEM-T EasyTM vector and then sequenced. Alignment assay in non-redunant database was applied for encoding information. Reverse Northern blotting was used to appraise the results from DDRT-PCR.RESULTS: 164 pieces of differentially expressed ESTs were obtained by FDDRT-PCR. 17 of them were subcloned and sequenced. 5 ESTs of 17 were confirmed to be positive results by reverse Northern blotting. CONCLUSION: DD-PCR is a rapid, simple-operation and sensitive method for screening differentially expressed genes, which would contribute to the molecular mechanisms of apoptosis/survive of CGNs.

AIM: To clone the full-length of 75A EST. METHODS: After the extraction of total RNA from primary cultured rat cerebellar granule cell of 7DIV in the medium containing 25 mmol/L KCl, T_4 DNA ligase-mediated 5' RACE was used to retrieve 5' unknown sequence of 75A EST, and the first round 5' RACE PCR product was subcloned into pGEM-T easy vector for sequence and homogeneous analysis. RESULTS: The first round of 5' RACE produce a 2.5 kb band, and 75A EST was identified to be partial sequence of Neuron-derived orphan receptor (Nor1) gene. After two more rounds RACE, we firstly cloned the full-length of Nor-1 cDNA. CONCLUSION: T_4 DNA ligase mediated 5' RACE is an efficient method to retrieve information about the 5' termini of mRNAs, and lay a foundation for further study which role Nor1 play in the cerebellar granule cell differentiation or survive.

Objective To develop the Assessment Scale for Patient Safety Culture in ICU and do psychometric test.Methods The Assessment Scale for Patient Safety Culture in ICU was developed based on literature review,qualitative interview,and two-round Delphi consultation.The reliability and validity were tested among 235 chnical nurses and doctors in ICU.Results A 45-item questionnaire was originally developed and eleven of them were deleted after subjective screening,project analysis and exploratory factor analysis.Seven factors were extracted with cumulative contribution rate of 59.347％.The scale of total Cronbach's alpha coefficient was 0.909; the split half reliability was 0.832.Each dimension of Cronbach's alpha coefficient was between 0.481～0.909,and the split half reliability was 0.481～0.866.All had significance in statistics above.Conclusions The Assessment Scale for Patient Safety Culture in ICU has good reliability and validity,which can be used to evaluate the ICU patient safety culture atmosphere domestically.

Objective To analyze the differential gene expression profiling of liver in rats subjected to hemorrhagic shock(HS) and sham hemorrhage shock(SHAM) by gene chip technology, thus to evaluate the possible molecular pathogenesis of HS. Method 20 male Wistar rats were randomly divided into a SHAM group and a HS group, with 10 rats in each group. Hepatic gene expression profiles were detected by oligonucleotide microarrays of 5705 mouse genes in two groups for three times. Genes with ratio(R) > 2 were identified as up-regulated and R < 0.5 were identified as down-regulated. Biological function of differentially expressed genes was analyzed and 9 genes were selected to undergo semi-quantitative RT-PCR. Results Among the total 5705 probes detected,86 genes showed differential expression in HS group comparison with SHAM group. The expression levels of 72 genes were up-regulated while those of 14 genes were down-regulated significantly. Differentially expressed genes were classified according to their biological function: transport genes, transcription regulator genes, signaling genes, response to stress genes, metabolic genes, development genes and cell adhesion genes. Conclusions cDNA microarray is an efficient and high-throughout method to survey gene expression profiles in HS.The variation of those gene expressions might be a potential pathogenic mechanism for HS that may offer a novel target for further study of therapeutic strategies of HS.

Objective To discuss the treatment effect and application value of salmon calcitonin nasal spray in the patients with postmenopausal osteoporosis.Methods 130 patients with postmenopausal osteoporosis were divided into observation group and control group by random number method,65 cases in each group.The control group was given calcium and alfacalcidol treatment,the observation group received in combination with salmon calcitonin nasal spray treatment.The clinical effect of the two groups was recorded.Results The total effective rate of the treat-ment group was 95.38%,which of the control group was 84.62%,the difference between the two groups was statisti-cally significant (χ2 =4.188,P<0.05 ).After treatment,the tuberosity bone mineral density,femoral neck BMD, L1 -4 lumbar spine bone mineral density of the observation group were (0.69 ±0.15)g/cm2,(0.77 ±0.21)g/cm2, (0.98 ±0.26)g/cm2,which of the control group were (0.52 ±0.08)g/cm2,(0.64 ±0.13)g/cm2,(0.81 ± 0.15)g/cm2,the differences between the two groups were statistically significant (t=8.062,4.243,4.566,all P<0.05).After treatment,the calcitonin,beta collagen fragment,osteocalcin of the observation group were (2.97 ± 0.86)ng/L,(0.11 ±0.01)ng/mL,(7.18 ±1.14)ng/mL,which of the control group were (2.41 ±0.43)ng/L, (0.35 ±0.08)ng/mL,(15.89 ±3.53)ng/mL,the differences between the two groups were statistically significant (t=4.695,24.000,18.930,all P<0.05).Conclusion Salmon calcitonin nasal spray in the treatment of patients with postmenopausal osteoporosis can reduce pain,inhibit osteoclast activity,promote bone formation,prevent bone loss and increase bone mass,it is safe and worthy of popularizing in clinical application.

Objective To explore the clinical effect and toxicity of daunorubicin combined with cytarabine (DA regimen) and idarubicin combined with cytarabine (IA regimen) for the treatment of patients with acute myeloid leukemia (AML) as induction chemotherapy. Methods The clinical data of 84 newly diagnosed AML patients (except M3) treated with DA or IA regimen were analyzed retrospectively. DA regimen group included 32 patients (17 males and 15 females with median age of 46 years), while IA regimen group included 52 patients (29 males and 23 females with media age of 49 years). Efficacy index was complete remission (CR), total efficiency and adverse reactions after one course of chemotherapy rate. Results In DA regimen group,the CR rate was 65.6 %(21/32), and the total efficiency rate was 75.0 %(24/32), while in IA regimen group, the CR rate was 71.2 %(31/52), and the total efficiency rate was 80.8 %(42/52), respectively, but, the differences of media survival and 5-year survival rate were not statistically significant (16.8 months vs. 24.9 months, 26 % vs. 44 %, both P>0.05). The main side effect in the two groups included hematologic (bone marrow suppression) and non-hematologic adverse reactions, with no significant difference between the two groups (all P>0.05). Conclusion For newly diagnosed AML patients, remission rate and total efficiency of DA regimen are same as IA regimen after one course treatment, and adverse events between the two regimens do not differ significantly.