Objective To identify the reason and preventive methods from misdiagnosed cases of multiple myeloma(MM) initially manifested as lumbago.Methods Medical history and clinical data of 25 MM patients in department of hematology in our hospital were retrospectively analyzed to explore the clinical characteristics,misdiagnosis and prognosis of them.Results The 25 patients with initial presentation of lumbago were most misdiagnosed as bone and joint diseases,including 6 cases of lumbar disc,7 cases of lumbar compression fractures,6 cases of osteoporosis.And 1 cases of bone tuberculosis,3 patients of rheumatoid arthritis.And there were 2 cases of bone metastases,who were later diagnosed when anemia,neutropenia,thrombocytopenic and renal dysfunction appeared.The average misdiagnosed time was 7 months with a range of 3 months to 13 months.The median survival time was (29.2 ± 5.2) months in this group of patients.Conclusion MM,with the first manifestation of lumbago,has a single clinical manifestation and is often misdiagnosed as bone and joint diseases.Specialists who are not from hematology department should raise awareness and vigilance of the disease.Laboratory examinations results should be referred to in the diagnosis.Sum up experience in order to improve the early diagnosis of this disease and to effectively improve patient's prognosis and quality of life.

Food protein-induced enterocolitis syndrome(FPIES) is a series symptoms of recurrent vomiring and diarrhea caused by non-IgE-mediated food allergy to cow milk and soy in infants.The most common causative foods of FPIES are cow milk,soy and rice.Symptoms start within first days to 12 months of life.The sensitivity is usually outgrown by 3 years of age.The most common clinical symptoms observed include recurrent vomiting,diarrhea,fecal bloody,lethargy,pallor,etc.The diagnosis relies on history,clinical features,food eliminate,and oral food challenges.The food elimination is the mains treatment of FPIES management.

OBJECTIVE:To evaluate economic effectiveness of 3 kinds of antimicrobial drugs for acute lithiasic cholecystitis,and to provide reference for rational use of antimicrobial drugs in biliary disease surgery.METHODS:A multicenter prospective randomized controlled study was conducted in 493 clinical cases of acute lithiasic cholecystitis.Cost-effectiveness analysis of cefoperazone/sulbactam sodium(therapy A n=180),cefuroxime(therapy B n=148) and levofloxacin(therapy C n=165) for acute lithiasic cholecystitis were carried out.RESULTS:Effective rates of three kinds of therapeutic regimens 95.56%,73.65%,84.24%,respectively.CONCLUSION:Incremental cost-effectiveness analysis of three kinds of therapeutic regimens shows therapy A is economical and the best choice for acute lithiasic cholecystitis compared with group B and C.

A Review] The neuroendocrine-immunoregulatory network is fundamental to the maintenance of homeostasis. In this article, the authors present an overview of the role of neuroimmunoregulatory mechanism in the occurance and development of some diseases, which may have important therapeutic implication for the clinics.

Objective Understanding current situation of pharmaceutical service before and since the ongoing health reform in community health institutions of China,and providing practical evidences to the government.Methods Adopting some indicators to comparative study the pharmaceutical care in 2008 and 201 1 in community health service institutions of China.Results From 2008 to 201 1, pharmaceutical service quality in general has greatly improved in community health institutions of China. For example,average number of drugs per prescription descended from 2.5 1 to 2.23.Percentage of prescriptions with an antibiotic descended from 43.98 to 32.08.Percentage of prescriptions with a hormone descended from 7.13 to 4.67.Percentage of prescriptions with two or more antibiotics descended from 1 1.24 to 7.31.These four indicators before and since the reform have statistical significance (P values are:0.003,0.001,0.003,0.004 respectively).But there are still inadequacies:from 2008 to 201 1,the average prescription cost descended from 59.63 to 5 1.18 yuan.Percentage of prescriptions with an IV drip descended from 34.84 to 30.41.These two indicators have not statistical significance(P values are 0.182,0.236 ).Conclusion To improve the quality of pharmaceutical service in community health institutions,the government should increase financial input to the community health institutions.

Early diagnosis,early treatment and the correct therapeutic approch are the keys for metastatic nasopharyngeal carcinoma(NPC) treatment.Currently,PET-CT is the best modality for distant metastasis staging of NPC.Cispalatin-based chemotherapy is the standard treatment method of metastatic NPC.Molecular targeted therapy is possible to further increase curative effect.When the lesions are limited,local palliative treatment may improve prognosis if patient's illness is controled by chemotherapy.

Early detection of HCC is critical for a good prognosis. Therefore, the development of tumor markers that can detect HCC at even earlier stages is urgent. Recent researches show that the human cervical cancer oncogene, gamma-glutamyl transferase mRNA, human telomerase reverse transcriptase mRNA, the proteins such as glypican-3, golgi protein 73, vascular endothelial growth factor and transforming growth factor-β1 could serve as markers for early detection of HCC.

The p53 gene is one of the most common targets for genetic abnormalities in human tumors. Restoring wild - type p53 gene (wt-p53) into cancer cells which have p53 deletion is a strategy in cancer gene therapy. In order to explore the feasibility of this hypothesis, we selected a gastric cancer cell line BGC823 which was confirmed having deletion of chromosome 17pl3 and decreased expression level of p53 mRNA . We transfected construct pC53SN3 containing wt - p53 into BGC823 cell line with lipofectin mediated gene transferration, and G418 resistant colonies were characterized by using analysis of PCR, Southern blot hybridization, Northern blot hybridization and Western blot hybridization. These data showed that exogenous wt-p53 had successfully transferred into BGC823 cells and obtained high expression. The cell growth rates in regular medium and soft agar were inhibited from 30 to 40 percent in the BGC823 cells transfected with wt - p53. The tumorigenicity in nude mice showed that one of four mice failed to form tumor and three of them delayed to form tumor from 7 to 14 days comparing with monk and parent BGC823 cells. These results suggested that exogenous wt -p53 could suppress the growth ability and tumorigenicity of human gastric cancer cells. The method of using lipofectin mediated wt-p53 gene transfection may have a potentially therapeutic effect on human gastric cancer.

The effects of compound oral fish oil preparation on the increase of intelligence were studied. Step-down test, normobaric hypoxia test and loaded swimming test in mice were used. The results indicated that during the administration period (15 d and 30 d), the oral preparation containing fish oil 3. 6 g/kg and 7. 2 g/kg increased both learning and memory abilities, promoted the tolerance of normal mice to hypoxia as well as swimming fatigue.

Objective To investigate the anti-rejection effect of T cell vaccination combined with FK506 of heterogenic transplantation on rat nerve. Methods SD rats were vaccinated by the spleen cells of BABL/c mice; T cell vaccines were activated and vaccinated in the spleen cells of these SD rats. The SD rats of nerve transplantation recipient were vaccinated with T cells combined with FKS06. The mixture lymphocytes culture, microcytotoxicity assay, histological alteration of nerves, humid weights of tibial anterior muscle were observed to confirm the anti-rejection effect of T cell vaccination combined with FK506 treatment. Results The humid weights of tibial anterior muscle of the vaccinated rats combined with FKS06 treatment were statistically different from those in control group (P ＜ 0.05), and so as the index of rejection (e.g. lymphocytes transformation efficiency) (P ＜ 0.05). Conclusion T cell vaccination combined with FK506 treatment can inhibit the rejection of heterogenic transplantation on rat peripheral nerve.