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.

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 assess the depression and cognition function in patients with severe obstructive sleep apnea (OSAHS) , and to study the relationship between the depression and severity of OSAHS, cognition disorders. Methods A total of 74 OSAHS patients (OSAHS group) and 39 normal controls ( control group) which all diagnosed by polysomnography (PSG) were chosen, and they were assessed the state of depression by self-rating depression scale ( SDS) and for cognition disorders by mini-mental state examination ( MMSE ). Results The score of SDS in OSAHS group was significantly higher than that in the control group(P<0.01). In patients with OSAHS , the score of SDS was positively correlated with apnea hyponea index ( AHI) , which was negatively correlated with mean level of SaO_2 ( MSaO_2 ) and the lowest SaO_2 ( LSaO_2 ) (P<0.01 ). The score of MMSE in OSAHS group was significantly lower than that in the control group, which was negatively correlated with AHI(P<0.01) and positively correlated with MSaO_2 and the lowest LSaO_2(P<0.01 ). The score of SDS was negatively correlated with MMSE( r= -0.505, P<0.01). Conclusion OSAHS patients exit depression and cognition disorders, which was correlation to intermitten hypoxemia in frequently.

Objective To investigate essentiality of bone scintigraphy in patients with renal cellcarcinoma.Methods The clinical data of 152 patients with confirmed renal cell carcinoma from Jan uary 1999 to June 2007 were retrospectively analyzed.There were 106 men and 46 women with a meanage of 56 years (range 11-86 years).The tumor size was 1.5-20.0 cm (mean 6.0 cm).Accordingto the TNM and AJCC staging classification,88 patients had stage I,included of T1a in 47 cases,T1bin 41; 38 had stage Ⅱ; 16 had stage Ⅲ,included of T3a,in 10 cases,T3b in 6; and 10 had stage Ⅳ.Histological grade was well differentiated in 90 cases,moderately in 43,poor in 19.Ten clinical pa thology factors were evaluated by Logistic analysis to present the significant factors related to osseousmetastatic lesions.Results Overall osseous metastatic lesions were present in 22 of the 152 patients(14.5%).Of the 126 patients with clinically localized,11 cases (8.7%) had osseous metastatic le sions.Of the 16 patients with clinically advanced,5 eases (31.2%) had osseous metastatic lesions.Ofthe 10 patients with metastasis,6 cases(60%) had osseous metastatic lesions.Clinical stage was re lated to osseous metastatic lesions by Logistic analysis.The incidence of osseous metastatic lesionswas 40.9% in localized renal cell carcinoma patients with bone pain.Conclusions Bone seintigraphymay be omitted in patients with clinically localized renal ceil carcinoma(stage Ⅰ,Ⅱ) unless bone pain is pres ent.Bone scintigraphy should be performed in patients with stage Ⅲ or Ⅳ regardless of symptoms.

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.

Objective: To investigate the relationship between attachment to pets and psychosecial develop-ment of children. Methods: Totally 147 children pet owners from grade 3 to grade 5 were selected from 11 primary schools in Beijing. They were asked to complete the Lexington Attachment to Pets Scale, Self Description Question-naire, Children's Loneliness Scale, and 2 dimensions of Children Social-life Adjustment Scale. Results: Attach-ment to pets was positively correlated with self-concept, pro-social orientation and living ability of daily life (r=0.47, 0.42, 0.34, Ps < 0.001), and negatively correlated with loneliness (r=-0.28, P <0.01) . Even the variables including study performance, interrelationship and socioeconomic status of family were taken as covari-ares, the higher attach group was better than lower attach group in self-concept, pro-social orientation, living abili-ty of daily life [(163.81±17.81)vs.(138.36±27.71), (46.19±4.25)vs.(40.64±6.93), (39.05±4.17)vs.(33.77±6.51); Ps<0.001] and loneliness [(28.53±11.08)vs.(34.79±10.96); P <0.01].Conclusion: There is apparent relationship between pet attachment and psychosocial development in children.

Case report form (CRF) is a key document for data collection in clinical trials. A well-designed CRF is required for database construction, data accuracy, data query/cleaning, CRF completion and statistical analysis. A well-defined process or SOP should be in place for CRF design. Data collection should fully meet the demand of study protocol. The layout of CRF should be clear with well-structured fields and standard coding for fields.
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