Objective To study the curative effects and adverse effects of the thalidomide combined with COMP chemotherapy in treating multiple myeloma(MM).Methods 42 patients were initially diagnosed as MM and 27 patients were refractory and relapsed MM.The small dose of thalidomide combined with COMP management and COMP management alone were used.The effective rate and adverse effects were analyzed.Changes of M-protein in serum,percentage of plasma cells in bone marrow and the level of hemoglobin were also analyzed in both pre-treatment and post-treatment periods.Results In 42 patients who were initially diagnosed as MM,the effective rate was 40.9% for 22 patients treated by chemotherapy alone and 70.0% for 20 patients treated by the thalidomide combined with chemotherapy.Statistic difference was observed between those two group.As to the 27 patients who were refractory and relapsed MM,the effective rate was 42.9% for 13 patients treated by chemotherapy alone and 84.6% for 14 patients treated by the thalidomide combined with chemotherapy.Statistic significance was present between them.Adverse effects were less and tolerated.Conclusion Treatment of small dose of thalidomide combined with COMP chemotherapy could significantly improve the effective rate with less adverse effects.

[Abstract ] Objective Bioinformatics provides a lot of valuable information for online prediction of new genes.In this study, we predicted the biological function of ubiquitin-conjugating enzyme 2S ( UBE2S) based on bioinformatics. Methods The UBE2S gene was screened and cloned from the cDNA library of human HepG2 cells.The relationship of the structure and function of UBE2S was explored based on the full-length cDNA library.MEGA5.05, CLUSTALW2 and SWISS-MODEL were used to study the phylogeny, conservation, and 3D structure of UBE2S. Results The UBE2S gene encoded a polypeptide of 241 residues with a predicted molec-ular weight of 23 770 and an isoelectric point of 8.81.The UBE2S protein contained no transmembrane locus and the probabilities of their functions of growth factors, cation channel and structural protein were 8.904, 0.313, and 0.291.The analysis of BLASTp showed that the isolated UBE2S had a 90-97%identity with the other species. Conclusion Analysis of the structure and function of the UBE2S protein can not only provide more information about its gene family but also pave the way for further experimental studies on the molecular mechanism of the consequent hepatocellular carcinoma.

Objective To evaluate the curative effect and complications of percutaneous puncture kyphoplasty in the treatment of vertebral compression fracture in the elderly. Methods 19 cases of vertebral compression fracture in the elderly patients with disc 25 PKP technology applications were diagnosed with the accurate positioning,local anesthesia a small incision of about 0. 3cm later puncture path through vertebral pedicle to the wound vertebra,After perspective is the accurate lateral, putting into high-pressure balloon, injecting the contrast agent into the balloon with high-pressure syringe gradually. The wound vertebra is blackmai until a high degree of vertebral distraction to the recovery basis under the C-arm, and then taking the balloon out after pumping the contrast agent out. Bone cement is mixed well and injected into the cavity of the wound vertebra slowly which is the result of balloon dilation,during that time under the control of bone cement inside the wound vertebra,then puting the working column out and surgery completed. Results The low back pain of 19 patients immediately disappeared or significantly reduced after the operation, and 8 postoperative patients is up that day, 11 cases is up the following day. The degree of the wound vertebra is recovered by X-ray examination, and the bone cement evenly distributed within the wound vertebra, no spills. This group of patients are followed up for an average of 18 months(1 ～24 months) ,using visual analog and digital method to determine changes in Iow back pain. The data are paired t test,P ＜ 0.01. It have significant difference of views.Conclusion Percutaneous kyphoplasty accurate cervical disc herniation and effective disarmament of the symptoms and signs, with trauma and rapid recovery, fewer complications, shorter course of treatment and so on, and it is a safe and effective way in the treatment of vertebral compression fracture in the elderly.

Objective To study the clinic effect and safety of MEAD chemotherapy regimen for adult patients with relapsed or refractory acute lymphocyte leukemia. Methods Between July 2006 and July 2009,twenty-two adult patients with relapsed or refractory acute lymphocyte leukemia received MEAD regimen (mitoxantrone 6 mg/d dl-3 iv drip,cytarabine 100 mg/d dl-5 iv drip,etoposide 100 mg/d dl-5 iv drip,dexmethasone 10 mg/d dl-8 iv drip). Results The complete remission (CR) rate of adult patients with relapsed or refractory acute lymphocyte leukemia was 31.8 %,the partial remission(PR) rate was 22.7 % and the overall response (OR) rate 54.5 %. The cumulitive CR rate was 50.0 %,and the PR rate 40.9 % after two times MEAD chemotherapy regimen. The main adverse effect was different level of myelosuppression,and other toxicity of vital organ was mild. Conclusion MEAD regimen is effective and can be tolerated for adult patients with relapsed or refractory acute lymphocyte leukemia,and its side effect is mild.

Objective:To understand the statistics of SCI papers in hospitals of Shandong Province during 2009 to 2018.Methods:Web of Science was used to analyze the SCI papar information including the Annual publication volume change, source publications, research directions, collaboration institutions, counries and regions, funding institutions, conferences, as well as highly cited papers.Results:In the past ten years, 27 559 articles were published in total and kept increasling year by year, especially in 2011 to 2015 the uplift was about 30%-40%. All these papers were published in more than 2 700 journals. 23% papers were published in top 10 journals, whose Impact Factors were between 1-5. Papers in the field of oncology counted the most for 23.252%. Shandong University ranked NO.1 regarding collaboration instituions for it has many academically well performed affiliated hospitals as well asteaching hospitals. Doctors in Shandong Province cooperated a lot with the United States and other countries. 56.3% papers were financially assisted by various fundings and the National Natural Science Foundation of China predominated the most. 1 331 papers came from international conferences.There were 75 highly cited papers in the past 10 years.Conclusions:The quantity and quality of SCI papers were increased continuingly because of the guidance and promotion of scientific research policies, as well as the hospitals’ investments. It is necessary to emphasize on the high quality of scholar outputs and improve the scientific research management in the future.

[Objective]To discuss the clinical effect of fludarabine and busulfan (Bu+Flu) as a low toxicity myeloablative conditioning regimen for allogeneic peripheral blood stem cell transplantation (allo-HSCT)in leukemia patients.[Methods]Clinical data of 13 patients with hematological malignancies receiving conditioning regimen with Bu+Flu for allo-HSCT were analyzed retrospectively.Conditioning regimen was Bu+Flu,compalriot mismatched and unrelated transplantation combined with rabbit anti-human thymocytes immune globulin (ATG).CsA+short course of methotrexate or CsA + mycophenolate mofetil were used to prevent graft-versus-host disease (GVHD).DNA sequencing of short tandem repeat (STR)polymorphism analysis method was performed for identification of donor stem cells implantation.[Results]13 patients all tolerated with this conditioning regimen well,no serious complications occurred.Neutrophil engraftment was at 9-15 days (median 11 days),platelet engraftment at 8-25 days (median 13 days).10 patients achieved hematopoiesis reconstitution with their full donor chimerisms confirmed by STR-DNA analysis.Acute GVHD occurred in 5 cases,accounting for 38.5％.Chronic GVHD occurred in 4 cases of 10 patients could be assessed,accounting for 40.0％.Severe GVHD more than Ⅱ degree did not happen.1-39 months (median time 11 months)of follow-up revealed the overall survival rate of 76.9％(10/13),disease-free survival of 61.5％ (8/13).The causes for death were relapse in all.[Conclusion]The conditioning regimen with Bu+Flu has low toxicity,well tolerance and better effect.

Objective To analyze the diagnostic value of ultrasonic cardiogram in vegetation of 37 cases of infective endocarditis. Methods Ultrasonic cardiogram (including transesophageal echocardiography) was applied to observe the form, size, echo, distribution and valvular functions of valvular vegetation. Results The number of attached sites was the most in aortic valve group of 13 cases by ultrasonic cardiogram, and the second most was in mitral valve of 12 cas-es. The size (the biggest 1.0 cmí2.1 cm and the smallest 0.2 cmí0.2 cm), form and the mode of activity of the vegeta-tion, or characteristics of perforation of cardiac valve and rupture of chordae tendinca as well as haemodynamic changes were evaluated, and systolic and diastolic functions were measured. Conclusion Ultrasonic cardiogram is of great signif-icance in the diagnosis and location of vegetation of infective endocarditis, treatment decision-making and prognosis judgment.

OBJECTIVETo report on the result of thalassemia screening and genetic diagnosis for pregnant women from Guiyang region.

METHODSPrenatal screening for thalassemia was carried out based on erythrocyte parameters and hemoglobin electrophoresis. Single-tube multiplex GAP-PCR and PCR-reverse dot blot hybridization were performed on suspected cases to identify common alpha- and beta- thalassemia mutations, and direct sequencing was used for identifying rare mutations.

RESULTSAmong 13 738 pregnant women, 1745 (12.70%) were suspected as thalassemia. In terms of native place, the provinces with highest screening-positive rates were Guangxi, Guangdong, Jiangxi and Guizhou. And the ethnic groups with highest screening-positive rates were Zhuang, Li, and Buyi. Among 801 women subjected to genetic testing, 457 (57.05%) were diagnosed with thalassemia. In total 9 genotypes of alpha- thalassemia were detected, with the most common genotypes being --/alpha alpha (63.35%), - alpha/alpha alpha (19.37%) and - alpha/alpha alpha (8.90%). Eleven genotypes of beta- thalassemia were detected, with the most common genotypes being CD17/N (42.91%), CD41-42/N (32.46%) and IVS-II-654/N (11.94%). Two cases were detected with rare beta-thalassemia mutations (CD54-58/N and IVS-I-130/N).

CONCLUSIONThe screening-positive rate of thalassemia among pregnant women in Guiyang region is relatively high. The rates have shown substantial difference in terms of native place and ethnic group. Thalassemia-related mutations in Guizhou region have a diverse spectrum, which showed certain difference from those of other regions.

Adolescent ; Adult ; Female ; Genotype ; Humans ; Middle Aged ; Pregnancy ; Prenatal Diagnosis ; methods ; Thalassemia ; genetics ; Young Adult

OBJECTIVETo analyze the clinical characteristics of protracted bacterial bronchitis (PBB) in children.

METHODThe clinical data of patients seen from October, 2010 to March, 2014 in Department of Respiratory Diseases of our hospital were retrospectively analyzed. Inclusion criteria were over 4 weeks cough, receiving fiberoptic bronchoscopy, positive bacterial culture and (or) the increased percentage of neutral granulocytes in bronchoalveolar lavage fluid (BALF).

RESULTTwenty eight patients were involved, 26 were male (93%) and two were female (7%). The median age of patients was 8.5 months. The median duration of cough was four weeks. The average length of hospital stay was (8.3 ± 3.9)days. The main clinical feature was wet cough in 28 cases, wet cough with wheezing was seen in 21 cases. The wet cough phase distribution was irregular in 21 cases. The crackles with wheeze (in 21 cases) was main signs of PBB. The percentage of CD3⁻ CD16⁺ 56⁺ cells increased in peripheral blood. The fiberoptic bronchoscopic manifestations of PBB were luminal mucosal edema. Eleven patients also had airway malacia. The neutrophil median in BALF was 0.2. The positive rate of bacterial culture of BALF was 36%. The main bacteria were Streptococcus pneumoniae (50%) and Haemophilus influenzae (30%). The main treatment for PBB patients included amoxycillin/clavulanate potassium and second-generation cephalosporins. The average duration of treatment was (17.3 ± 3.2)days, the prognosis was good.

CONCLUSIONPBB is common in male infants. Persistent wet cough with wheezing was the main characteristic of PBB. PBB is commonly accompanied by immune dysfunction and airway malacia, and the pathogens were Streptococcus pneumoniae and Haemophilus influenzae.

Bacterial Infections ; drug therapy ; pathology ; Bronchitis ; drug therapy ; microbiology ; pathology ; Bronchoalveolar Lavage Fluid ; Bronchoscopy ; Cough ; Female ; Haemophilus influenzae ; isolation & purification ; Humans ; Infant ; Male ; Respiratory Sounds ; Retrospective Studies ; Streptococcus pneumoniae ; isolation & purification

Objective:To investigate the technical points and clinical application of combined infratemporal fossa approaches (CIFA) by analyzing the clinical results with CIFA for lesions involved skull base.Methods:A retrospective study was performed on 11 patients underwent CIFA for skull base lesions dissection from December 2014 to January 2019 in the department of otolaryngology, Peking Union Medical College Hospital. There were 6 male and 5 female patients, with age range of 16-72 years old and median age of 53 years old. Five patients underwent CIFA Type B and D, and the other 6 underwent CIFA A and B. All patients were followed up regularly by CT and MRI to observe possible recurrence.Results:Among the 5 patients with CIFA Type B and D, 3 were giant cell tumor and 2 were giant cell reparative granuloma, and median maximum cross-section size was 42 mm×46 mm (range from 37 mm×18 mm to 56 mm×53 mm). Among the 6 patients with CIFA Type A and B, 4 were paraganglioma of head and neck, 1 was schwannoma of skull base, 1 was petrous cholesteatoma, and median maximum cross-section size was 43 mm×36 mm (range from 24 mm×22 mm to 63 mm×35 mm). Nine patients underwent complete resection of the tumor in the first stage. In 2 patients, the extracranial parts were removed in the first stage, and the intracranial part was removed in the second stage. Tympanum and ossicular reconstruction were done in one of the CIFA Type B and group D, and 1 year′s postoperative hearing was mild conductive hearing loss. There was no cerebrospinal fluid leakage of all patients. All the 5 patients with normal facial nerve function before surgery recovered to H-B grade Ⅰ to Ⅱ within 3 months after surgery. Among the 4 patients whose preoperative facial nerve function were grade Ⅱ, 2 recovered to grade I after surgery and the other 2 were still grade Ⅱ. For the patient whose preoperative facial nerve function was grade Ⅴ, his postoperative recovery was grade Ⅲ. There was 1 patient whose pre-operative FN function was H-B grade Ⅲ, and the post-operative FN function was grade Ⅵ due to FN resection. Except for 2 cases with cochlear involved before surgery, cochleae of the other 9 cases were preserved. The follow-up time was 14 to 58 months. No recurrence was observed in all patients.Conclusions:The CIFA can safely and completely remove the extensive lesions that invade the skull base, and the facial nerve function can be well protected and recovered intro-and post-operation. Appropriate use of combined IFA can not only achieve good exposure and complete resection of lesions, but also create conditions for functional reconstruction.