Objective To assess the clinical performance of plasma exchange (PE) followed by chemotherapy treatment for multiple-myeloma patients with high-viscosity syndrome and renal dysfunction.Methods 20 cases of multiple-myeloma patients with high viscous syndrome and various levels of renal dysfunction,were randomly divided into PE-chemotherapy group (the experiment groups) and chemotherapy-only group (the control group).In the experiment groups,the patients received PE via blood cell separators for 3 times (2 600±580 mLeach time,1 day interval) followed by VAD regimens chemotherapy (0.5 mg vincristine continuous intravenous drip for 12 h,adriamycin 10 mg continuous intravenous drip for 12 h and dexamethasone 40 mg qd1-4).In the control group,patients received standard VAD regimen.After 2 cycles of chemotherapy,globulin (GLB),blood sedimentation (ESR) and hemorheology properties were compared between the two groups before and after treatment.Results The symptoms of high viscosity syndrome(gingivial blood/nosebleed,dizziness and extremities numbness)in the treatment group were significantly improved compared with that in the control group (P＜ 0.05).Before and after therapy,the GLB (g/L) were 80.0± 19.6 vs 30.0±10.5 in the treatment group and 85.5±21.5 vs 53.5± 16.0 in the control group (P＜0.05),respectively;the Cr (μmol/L) were 359.0±30.5 vs 105.0±25.0 and 362.0±39.6 vs 190.0±43.0,respectively(P＜0.05);the ESR (mm/h) were 80.0±22.5 vs 12±0.6 and 83.0±23.6 vs 30.0+3.6 (P＜0.05),respectively;the whole blood high shear reductive viscosity were 16.2±2.1 vs 8.5±0.6 and 15.8±2.0 vs 12.8±0.8 (P＜0.05),respectively;the whole blood middle shear reductive viscosity were 19.0±0.5 vs 10.8±0.6 and 20.0±0.6 vs 15.2±0.8 (P＜0.05),respectively;the whole blood low shear reductive viscosity were 50.3±2.9 vs 28.1±1.2 and 52.7±3.5 vs 40.2±3.5(P＜0.05),respectively.Conclusion Plasma exchange treatment combined with sequential chemotherapy presents better clinical performances compared to the chemotherapy-only solution for multiple-myeloma patients with high viscosity syndrome and renal dysfunction.

BACKGROUND: Many studies have suggested that artificial joint replacement has a greater advantage in the treatment of cases of elderly osteoporosis, comminuted fractures and unable to internal fixation or failure of internal fixation. OBJECTIVE:To analyze the curative effect of cemented artificial femoral head arthroplasty for treatment of elderly unstable intertrochanteric fracture. METHODS: Totaly 18 patients with unstable intertrochanteric fracture, aged>75 years, were enroled and underwent cemented artificial femoral head arthroplasty. At 3 months after replacement, the curative effect was evaluated according to the Harris hip joint function score method. The early complications after replacement and long-term complications of prosthesis were observed by folow-up. RESULTS AND CONCLUSION:Al these 18 patients were folowed up for 13 to 34 months, and had no infections, pressure sores, femoral shaft fractures and other complications. X-ray films showed that the frauture healed wel, without prosthesis infection, dislocation, loosening, sinking and breaking. After 3 months of replacement, al patients returned to pre-injury level of walking function. The curative effect was excelent for eight cases, good for seven cases, fair for two cases, poor for one case. These results demonstrate that cemented artificial femoral head arthroplasty for treatment of elderly unstable intertrochanteric fracture has good biocompatibility and stability, and can restore the limb function of patients. 

Objective To explore the effects of parent-adolescent conflict and cohesion on relational aggression among junior students.Methods Parent-adolescent Conflict Questionnaires,Parent-adolescent Cohesion Questionnaires,and the Relational Aggression Questionnaires were used in investigating 392 junior students.Results The level of relational aggression of junior students was low (22.52±5.15).There was no differences between relational aggression of male students (22.93± 5.43) and female students (22.00± 4.73) (P＞ 0.05),and of grade 1 students(22.72±5.14)and grade 2 students(22.64±5.67),grade 3 students(21.93±4.22) (P＞0.05).The students' relational aggression showed a significantly positive correlation with frequency and intensity of parent-adolescent conflict(r=0.269,r=0.307,r=0.268,r=0.271,P＜0.01),and negative correlation with father-adolescent cohesion(r=-0.171,P＜0.01).Parent-adolescent cohesion was negative predictor of relational aggression(β=-0.123,P＜0.05),and the intensity of parent-adolescent conflict was positive predictor(β=0.301,P＜0.01).Conclusion Parent-adolescent conflict and cohesion have significant effect on relational aggression among junior students.