Objective To investigate the diagnosis,differential diagnosis,treatment and prognosis of solitary plasmacytoma (SP) and summarize its clinical features for pathological and clinical application.Methods Reviewed the data of 18 patients diagnosed with SP from January 2005 to August 2013.The clinical features,diagnosis,treatment and prognosis were analyzed retrospectively.Results All 18 cases were pathologically confirmed with SP and met the diagnostic criteria of SP.In 18 patients,12 patients were male and 6 patients were female.Four cases of lesion were located at lumbar,each 2 cases of lesion were located at mandible and ribs,each 1 case of lesion was located at sacrum and occipital bone,3 cases of lesion were located at nasal cavity and maxillary sinus,2 cases of lesion was located at pars nasalis pharyngis,each 1 case of lesion was located at parotid,parasternal and peritoneal cavity.All patients were followed up for 54 months,2 patients were died,3 patients were local recurrence,2 patients were transformed to multiple myeloma,others were survival with no tumor.Conclusions As early as possible to diagnose is the key to treat SP.The final diagnosis of SP is based on the histopathological findings and the optimal treatment for patients with SP is surgery combined with moderate dose radiotherapy.

AIM: To investigate the clinical effect of small incision lenticule extraction (SMILE) for super high myopia.METHODS: Totally 64 cases (128 eyes) patients with super high myopia, were randomly divided into observation group and control group, 32 cases (64 eyes) in each group.The two groups were separately treated with SMILE or femtosecond laser LASIK (FS-LASIK).We calculated the effectiveness index and safety index by contrastive observation of clinical effects in all patients included uncorrected visual acuity, best corrected visual acuity and postoperative spherical equivalent at preoperative and postoperative 1d, 1wk, 1, 3 and 6mo.RESULTS: The safety index: the observation group and the control group at 6mo after operation were respectively 1.10±0.10 and 1.08±0.12, the difference between the two groups was not statistically significant (P>0.05).The validity index: the observation group and the control group at 6mo after operation were respectively 1.08±0.12 and 1.06±0.14 and there was no significant difference between the two groups (P>0.05).Postoperative spherical equivalent at 6mo in the observation group was 0.09±0.36D, that in the control group was 0.36±0.46D.After 6mo, the count of spherical equivalent refraction within ±0.50D were 58 eyes (90.1%) in observation group and 49 eyes (76.6%) in the control group, within±1.0D were 64 eyes (100%) and 60 eyes(93.8%).CONCLUSION: SMILE is safe and effective in the treatment for super high myopia.The postoperative visual acuity and diopter can be stabilized earlier by comparing with FS-LASIK.

Objective:To investigate the effects of serum sICAM-1 and sVCAM-1 in renal allograft recipients with infection, acute rejection and CsA-induced nephrotoxicity for the clinical significance of early diagnosis and differential diagnosis.Methods:The sequential monitoring of serum sICAM-1 and sVCAM-1 were conducted by ELISA technique in 86 patients before and after renal transplantation.Results:The levels of serum sICAM-1 and sVCAM-1 increased in the first three day posttransplantation, decreased and stabilized after one to two weeks,increased one to three days prior to the clinical diagnosis in acute rejection and decreased with effective treatment,increased in infection and had no significant difference in CsA-induced nephrotoxicity.Conclusion:Sequential monitoring of serum sICAM-1 and sVCAM-1 of renal allograft recipients can be used to estimate the function of graft,as markers of the early diagnosis and differential diagnosis of acute rejection.

Objective:To investigate the effect of anti-CD25 monoclonal antibody in preventing acute rejection after renal transplantation.Methods:71 patients were randomly divided into two groups;treatment gourp( n =26)and control group( n =45).The treatment group received anti-CD25 monoclonal antibody twice before and after renal transplantation.The occurrence of rejection postoperation and renal function and T lymphocyte subtypes were sequentially monitored.Results:The occurrence of aute rejection in treatment group in 1,3,6 and 12 months after renal transplantation was 7.7% ,19.2%,23.1% and 30.8%,while it was 15.6%,28.9%,35.6% and 46.7% in control group.There was significant difference between the two groups( P0.05 ).Conclusion:It suggests that anti-CD25 monoclonal antibody reduce the occurrence of acute rejection and have no influence on T lymphocyte subtypes.

Objective To explore the effect of Linggui Zhugan decoction on the level of serum inflammatory factors , blood lipid and oxidation with coronary heart disease (CHD).Methods 123 cases of patients diagnosed as CHD and met criterions were collected from May 2013 to February 2015 in cardiovascular department of our hospital.They were divided into two groups according to different treatment modalities, observation group and control group.General information of the two groups were comparable, The patients of two groups reveived conventional treatments such as taking aspirin enteric-coated tablets, rosuvastatin, nitrate.The patients of observation group received Linggui Zhugan Decoction on the basis of conventional treatments.The serum levels of TC, TG, LDL-C, HDL-C, TNF-α, IL-6, IL-1β, SOD, MDA were recorded before and after treatment.Results The serum levels of TC, TG, LDL-C of observation groups were lower than those of control group after treatment (P<0.05).And the serum levels of HDL-C of observation groups were higher than those of control group after treatment (P<0.05).There was significant improvement in the serum levels of TNF-α, IL-6, IL-1β, MDA and SOD of two groups after treatment than those before treatment (P<0.05).The serum levels of TNF-α, IL-6, IL-1β, MDA of observation group were lower than those of control group after treatment ( P<0.05 ) , while the SOD serum levels of observation group were higher than those of control group after treatment (P<0.05).Conclusion Linggui Zhugan decoction could significantly improve the levels of blood lipids and decrease the levels of inflammation and oxidative stress in patients of CHD with significant effect.

Objective To evaluate the curative effect of conjoined tendon transfer for coracoclavicular ligament reconstruction in the treatment of Rockwood grades Ⅲ-Ⅳ acromioclavicular joint dislocation,c Methods A retrospective case control study was performed for 64 cases of acromioclavicular joint dislocation admitted from October 2007 to August 2014.There were 53 males and 11 females,with age of (43.8 ± 10.5) years (range,23 to 65 years).Rockwood grade Ⅲ was seen in 27 cases and grade-Ⅳ in 37.According to the treatments,26 cases underwent proximally based conjoined tendon transfer for coracoclavicular ligament reconstruction combined with clavicular hook plate (ligament reconstruction group) and 38 cases only treated with clavicular hook plate (internal fixation group).Visual analogue scale (VAS),Constant shoulder score and postoperative complications were compared between the two groups before and after operation.Results All patients were available for a mean follow-up of 3.7 months (range,2 to 4 months).VAS was (7.58 ± 1.03) points in ligament reconstruction group and (7.15 ± 1.03)points in internal fixation group before surgery (P ＞0.05),and was (2.38±0.94)points in ligament reconstruction group and (2.08 ± 0.99) points in internal fixation group 3 months after operation (P ＞ 0.05).Constant shoulder score was (86.46 ± 6.59) points in ligament reconstruction group and (87.68 ± 6.59) points in internal fixation group after operation (P ＞ 0.05).Six cases (16％) had recurrent joint dislocation in internal fixation group,while none of the patients in ligament reconstruction group had recurrence (P ＜ 0.05).Conclusion Improved procedure of proximally based conjoined tendon transfer for coracoclavicular ligament reconstruction can effectively reduce the recurrence rate of acromioclavicular joint dislocation.

Competition of teaching skills is regarded as an effective means to develop teacher's ability in teaching.This article briefly described a teaching competition at a medical school from participant identification,requirement clarification,training before competition,evaluation index screening and interviewer selection.Meanwhile the article further analyzed and analyzed the problems arising from the competition and proposed measures to promote teachers' awareness and ability of teaching.

ObjectiveTo investigate the common pathogenic bacteria and antimicrobial resistance status in neonatal ward to provide guidance for rational clinical medication. MethodsData of 2306 cases in neonatal ward from July 2008 to June 2010 whose body fluid were cultured with positive results of common bacteria were collected. The change of the bacteria and drug resistance was analyzed. Results Among 10 017 body fluid samples, 80 species consisted of 2306 strains of bacteria were found. Enterobacteria accounted for about 53.8％ (1241/2306), Klebsiella pneumoniae subsp. pneumoniae (430/1241, 34.6％) and Escherichia coli (341/1241, 27.5％) were the most common ones,and among which 68.1％(293/430)strains of Klebsiella pneumoniaesubsp.pneumoniae and 59.5 ％ (203/341 ) strains of Escherichia coli were extended-spectrum β-lactamases (ESBLs) producing strains, which were significantly lower than those[78.1％ (118/151) and 82.6％(76/92) respectively]during 2003 to 2005 (U=-2.32 and -4.11, P＜0.05 respectively).Methicillin-resistant Staphylococcus aureus(MRSA)detectionrate was 8. 5％(23/272)in Staphylococcus, which was lower than that (17.7％, 15/85) in year 2004 to 2006 (U= -2.4, P＜0. 05). Methicillin-resistant coagulase-negative Staphulococcus (MRCNS) detection rate was 63.5％(157/247), which was higher than that (32.6％, 97/298) in year 2004 to 2006(U=7.54,P＜0.05).The common pathogens of nosocomial infection were Klebsiella pneumoniae subsp.pneumoniae,Escherichia coli , Acinetobacter baumannii and Pseudomonas aeruginosa ; while common pathogens of community infection were Staphylococcus aureus, Klebsiella pneumoniae subsp.pneumoniae and Escherichia coli. Multiple drug-resistant infections in hospital were significantly higher than those in community. Drug susceptibility results showed that the resistance of Staphylococcus haemolyticus,Acinetobacter baumannii and Klebsiella pneumoniae subsp.pneumoniae were especially severe.ConclusionsOpportunistic infections and drug resistant strains increased. The increasing of MRCNS and drug-resistant of Acinetobacter baumanniishouldbepaidmore attention.Comprehensive measures might reduce the production of ESBLs bacteria. The choice of antibiotics should be based on drug susceptibility test.

Objective To evaluate the impact of different anatomical landmarks on registration in imaging-guided radiation (IGRT) for lung cancer. Methods For 20 patients with non-small cell lung cancer receiving stereotactic body radiotherapy (SBRT) in Fudan University Cancer Hospital, 100 frames of kilo-voltage cone-beam computed tomography scanning were evaluated in this study. The spine, carina and tumor were selected as landmarks for registration, respectively. Results of registration using different landmarks were documented and compared. Results The average set-up errors in the left-right, superiorinferior and anterior-posterior directions were -0. 08 cm ±0. 32 cm, -0. 16 cm ±0. 45 cm and 0. 06 cm ±0. 23 cm with the spine for registration;0. 06 cm ±0. 34 cm, -0. 13 cm ±0. 45 cm and -0. 02 cm±0.23 cm with the carina;and -0. 17 cm ±0.25 cm, 0.03 cm ±0.47 cm and 0. 15 cm ±0.38 cm with tumor. The registration results between using the carina and tumor as landmarks were statistically significant different (q=4.61, P=0. 002 ;q = 2. 23 , P=0. 118;q=3.44, P=0. 017). The registration results were equal when using the spine and tumor as landmarks ( q = 1.85, P = 0. 195; q = 2. 54, P = 0. 075; q = 1.89,P=0. 185), as well as using the carina and tumor as landmarks (q=2.76, P=0. 054;q=0.31, P=0. 826 ;q = 1.55, P = 0. 276). Conclusions For early stage lung cancer, the spine and tumor can be used equally as registration landmarks in imaging-guided SBRT. The carina is not suggested for its poor reproducible position.