Objective To examine the efficacy and adverse reactions of bortezomib-based chemotherapy in treatment of multiple myeloma (MM).Methods Twenty-eight patients with multiple myeloma received a joint chemotherapy containing bortezomib.The efficacy was determined according to EBMT criteria.Results 28 patients received the chemotherapy,20 patients were newly diagnosed and 8 patients were relapsed or refractory.25 patients can be evaluateed efficacy.The total response rate was 100 ％ (25/25),consisting of 5 patients with complete response (CR),10 patients with almost complete remission (nCR),10 patients with partial remission (PR).The main side effects include peripheral neuropathy,thrombocytopenia,gastrointestinal disorders and viral infections.These side effects were improved by symptomatic treatment and generally did not affect the treatment.Conclusion For the newly diagnosed and relapsed or refractory multiple myeloma cases,bortezomib-based chemotherapy is a safe and effective therapeutic drug with rapid onset,high treatment response rate,and adverse reaction can be tolerated.

Objective: To investigate the relationship between human papilloma virus (HPV) gene types and cervical diseases. Methods:The subjects included women with HPV who were diagnosed in the Outpatient Department of the Third Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) from March 1, 2010 to January 31, 2011. A total of 21 HPV DNA types were found in the women using DNA flow-though hybridization genotyping technique, and a questionnaire-type survey was conducted on these pa-tients. In this study, 256 cases of normal or inflamed cervix, 34 cases of cervical intraepithelial neoplasia I (CINⅠ), 61 cases of CINⅡor CINⅢ, and 9 cases of cervical cancer were analyzed. Results:The HPV infection rates were 18.4%in the normal cervical or inflam-mation group, 67.6%in the CINⅠgroup, 96.7%in the CINⅡor CINⅢgroup, and 100%in the cervical cancer group. The HPV in-fection rate was higher in the CIN I group than in the normal HPV infection or inflammation group (P<0.001) and was higher in the CIN Ⅱ or CIN Ⅲ groups than in the CIN I group (P<0.001). The main types of infection were HPV16 (44.2%), HPV58 (24.2%), HPV52 (11.6%), and HPV33 (8.4%) in the CIN groups. The main type of infection was HPV16 in the cervical cancer group (88.9%). Conclusion: Cases of cervical lesions are increasing. With this prevalence of HPV, considerable attention should be focused on HPV16-, 58-, 52-, and 33-related infections and cervical lesions. Among them, HPV16 infection is the primary cause of disease progres-sion and carcinogenesis.

Objective To investigate the effects of clinical pathway-based teaching methods in clinical teaching of hematology. Methods Interns, which studied in department of hematology, were classified non-randomized into two groups. The interns in experimental group received idiopathic thrombocytopenic purpura (ITP) clinical pathway-based teaching. And the interns in the control group received the seventh edition textbook of medicine-based traditional teaching. All interns were oral tested when they finished two weeks period clinical studied of hematology. Meanwhile, a questionnaire designed for clinical pathway-based teaching was included in this test only for the experimental group. Results There were 32 interns recruited in the group of clinical pathway-based teaching and 38 interns in the control group of traditional teaching. There were statistically significant differences between the two groups in the fields of the key points about history of diseases ( = 0.0017), assessment of diagnostic criteria and differential diagnosis ( =0.0074), selection of laboratory examination items ( <0.0001) for ITP. The group of clinical pathway-based teaching achieved higher scores than the control group. However, there was no statistically significant difference between the two groups in the field of selection of first-line treatment measure of ITP ( = 0.1155) . Moreover, the control group achieved higher scores than the group of clinical pathway-based teaching in the field of how to treat ITP patients with first-line treatment failure ( =0.0003) . In addition,there were 93.8%interns in the experimental group accepted the new clinical pathway-based teaching tool in the survey. The open-ended question survey showed the clinical pathway teaching method was more simple, intuitive and standardizing than the traditional one. Conclusion The ITP clinical pathway, as an interns teaching tool of hematology, is helpful for understanding more clearly the diagnosis and treatment of ITP. However, an in-depth explanation is necessary combination with textbook of medicine study in the clinical teaching of ITP.

Objective To evaluate the clinical efficacy and safety of flexible fiberoptic bronchoscopy (FFB) and bronchoalveolar lavage (BAL) in treatment of neonatal atelectasis.Methods Eligible patients, who were diagnosed as neonatal pulmonary atelectasis and admitted consecutively to the neonatal intensive care unit of the Children's Hospital of Hebei Province from January 2013 to January 2015, were included in the study.They were randomly assigned to FFB group (n=30) and control group (n=28).Newborns in the FFB group received BAL under FFB, while those controls received tracheal irrigation after intubation.The duration of lung recruitment, oxygen exposure and antibiotic administration, hospital stay, culture results of respiratory secretions, prognosis and total expenses during hospitalization were compared between the two groups.Complications of FFB were also recorded.Chi-square test and t-test were performed for statistical analysis.Results (1) In the FFB group, atelectasis occurred in the upper fight lobe (n=26), upper lobes of both sides (n=1), lower right lobe (n=2) and lower left lobe (n=1), while in the control group, atelectasis occurred in the upper right lobe (n=26), lower left lobe (n=1) and middle right lobe (n=2) (x2=0.094, P ＞ 0.05).(2) The positive rate of bacteria culture results showed no difference between bronchoalveolar lavage fluid in FFB group and tracheal secretions in the controls [43％(13/30) vs 32％(9/28), x2=0.770, P ＞ 0.05].(3) The duration of lung recruitment, antibiotic administration and hospital stay of the FFB group were all shorter than those of the control group [(4.7±3.4) vs (7.4±6.6) d, (14.0±4.5) vs (20.3±10.9) d, (15.1±4.7) vs (21.8±12.3) d, t=-5.718, 8.604 and 7.733, all P ＜ 0.05].(4) Among babies in the FFB group, nine experienced fever and returned to normal after physical cooling;three showed more shadow in chest X-ray with aggravated dyspnea during a short period, and relieved 12 hours later;two had minimal hemorrhage from tracheal mucous membrane;one showed crying hoarse.Serious complications, such as pneumothorax, massive bleeding or cardiac arrest, did not occurred.No death or refuse of treatment was reported.Conclusion FFB and BAL is much more effective than tracheal irrigation after intubation in treatment of neonatal atelectasis without any severe complications.

Objective To summarize the pathogenic spectrum and antimicrobial susceptibility of hospital-acquired bloodstream infections (HABSI) in children,and to provide evidence for clinical antiinfection treatment.Methods During January 2004 to December 2011,the clinical data and drug susceptibility results of 168 children who were diagnosed with HABSI based on positive results of pathogen tests were reviewed retrospectively in Yuying Children's Hospital affiliated to Wenzhou Medical College.Results A total of 171 strains were isolated from blood specimens of the 168 children.The majority of HABSI occurred in the intensive care unit (73.7 ％),followed by department of hematology (22.6％).Gram-positive bacteria,gram-negative bacteria and fungi accounted for 53.8％,34.5％ and 11.7％,respectively.The predominant pathogens were Stagphylococcus epidermidis (14.1％),followed by Klebsiella pneumonia (13.5 ％),Staphylococcus haemolyticus (7.6％),Staphylococcus aureus (6.4％),Enterococcus faecium (6.4％) and Escherichia coli (6.4 ％).Staphylococcus aureus and Staphylococcus epidermidis resistant to methicillin were detected in 9.1 ％ and 91.7 ％ of specimens,respectively.Staphylococcus and enterococcus which were resistant to vancomycin or linezolid were not detected.The isolation rates of Klebsiella pneumoniae and Escherichia coli with extended-spectrum beta-lactamases (ESBL) were 95.7％ and 72.7％,respectively.One hundred and sixty cases (95.2 ％) had underlying diseases including premature birth and low birth weight (60.7％).One hundred and twenty-six cases (75.0％) underwent invasive procedures.The peak incidence of HABSI occurred in children less than 3 months old (75.6％).Conclusions HABSI is most common in infants younger than 3 months old,with underlying diseases or undergone invasive procedures.The pathogens are mainly gram-positive bacteria.Very low birth weight infants can acquire unusual infection of Kodamaea ohmeri.Thus,it is essential to strengthen the prevention of hospital-acquired infection.

Objective To explore the infiltration and apoptosis of eosinophilia(EOS)and the influence of death receptor(Fas) and B cell lymphoma-2 (Bcl-2) expression after Belamcanda and Ephedra Decoction on asthma rats.Methods40 healthy rats of Holland were selected as the research subjects,they were divided into four groups: control group,asthma model group, dexamethasone group,Belamcanda and Ephedra Decoction group with 10 rats in each group.Rat asthma model was prepared by repeated stimulation of egg protein,the symptoms of asthma in each group were evaluated;the number of EOS infiltration in lung tissue was detected by staining method;EOS apoptosis was detected by methyl thiazolyl tetrazolium(MTT) method;Blot Western was used to detect the expression of Fas and Bcl-2 protein;the flow cytometry was used to detect the apoptosis of EOS in rat.ResultsCompared with the rats in the model group, dexamethasone group, Belamcanda and Ephedra Decoction group rats asthma symptoms were significantly reduced, scores were significantly lower (P< 0.05),there was no significant difference between Dexamethasone group and sheganmahuang Decoction group.In the asthma model group,the number of EOS infiltration and EOS% in venous blood and lung tissue were significantly higher than those in control group,EOS apoptosis rate was significantly lower than that of the control group (P< 0.05).In Dexamethasone group,Belamcanda and Ephedra Decoction group infiltration number of EOS and EOS% were significantly lower than that of model group but higher than the control group, the apoptosis rate of EOS protein was significantly higher than the model group and the control group (P< 0.05),there was no significant difference between Dexamethasone group and sheganmahuang Decoction group.The expression of Fas in dexamethasone group,Belamcanda and Ephedra Decoction group was significantly higher than the control group and model group (P< 0.05),Bcl-2 protein was significantly lower than the control group and model group (P< 0.05),there was no significant difference between Dexamethasone group and sheganmahuang Decoction group.Cell flow cytometry showed that the control group had no cell apoptosis,a large number of apoptotic cells were appeared after Belamcanda and Ephedra Decoction treat with.ConclusionBelamcanda and Ephedra decoction can induce apoptosis of EOS expression,it may be associated with the upregulation of Fas, downregulation of Bcl-2 expression.

Objective To construct multiple myeloma mucin MUC1-2VNTR gene eukaryotic expressing vector,which provided the basic material for further study of multiple myeloma DNA vaccine.Methods MUC1-2VNTR coding gene as target gene,and a KOZAK sequence was inserted before it.Hind Ⅲ and Xba Ⅰ restriction enzyme site were inserted on both ends.Then the whole sequence was synthesized and cloned into pcDNA3.1/myc-his B vector,and the recombinant vector was identified by restriction enzyme digestion and DNA sequencing.Results Synthesized MUC1-2VNTR gene was 140 bp.Restriction enzyme digestion and DNA sequencing confirmed pcDNA3.1/MUC1-2VNTR/myc-his B including the whole exact translation frame region and MUC1-2VNTR gene.Condnsion The pcDNA3.1/MUC1-2VNTR/myc-his B has been successfully constructed,which provides the basic material for further studies of MUC1 mucin function and multiple myloma DNA vaccine.

Objective To observe the expressions of RANTES , FKN and IP-10 at mRNA and pro-tein levels in human lung epithelial cells (A549) infected by respiratory syncytial virus (RSV), and to eval-uate the changes of them interfered with 15-deoxy-delta12,14prostaglandin J2(15d-PGJ2), rosiglitazone or 2-chloro-5-nitrobenzanilide ( GW9662 ) .Methods A549 cells were seeded in 6-well culture plates and cul-tured overnight in F12K culture solution.Then they were randomly divided into five groups , including group A (15d-PGJ2+RSV group), group B (rosiglitazone+RSV group), group C (DMSO+RSV group), group D (GW9662+rosiglitazone+RSV group) and group E (cell control group).Cells and supernatants were harves-ted from each group at different time points (12 h, 24 h and 48 h) of culture.The expressions of RANTES , FKN and IP-10 at mRNA and protein levels were measured by ELISA and real-time quantitative RT-PCR analysis.Results The expressions of RANTES , FKN and IP-10 at mRNA and protein levels in group C were significantly higher than those in group E at time points of 12 h, 24 h and 48 h (all P<0.05).In group C, the expressions of the three chemokines at mRNA level reached a peak at 24 h, but began to de-crease at 48 h, which showed no statistical significance compared with those at 12 h (all P>0.05).Moreo-ver, the expressions at protein level were peaked at 48h, and had significant difference with those expressed at 12 h and 24 h (all P<0.05).Compared with group C, the expressions of the three chemokines both at mRNA level and protein level were decreased in group A and B as the dose was increased (all P<0.05), and the lowest levels were observed with the intervention of 20 μmol/L of 15d-PGJ2 in group A and 30μmol/L of rosiglitazone in group B .Conclusion The expressions of RANTES , FKN and IP-10 at mRNA and protein levels were increased with RSV infection , and the peaks of mRNA level and protein level were respectively achieved at 24 h and 48 h after infection.PPARγagonists played an anti-inflammatory role through inhibiting the expressions of the three chemokines both at mRNA level and protein level in a dose -de-pendent manner .

Objectives To evaluate the clinical value of neoadjuvant chemotherapy (NACT) in the treatment of local advanced cervical cancer. Methods We searched the clinical trials on the treatment of local advanced cervical cancer with NACT followed by surgery versus initial surgery on English and Chinese published literatures from the main medical data resources (MEDLINE, PUBMED, ELSEVIER ScienceDirect, CNKI). The data about positive pelvic nodes, interstitial infiltration, vascular invasion, positive surgical margin, 3-year overall survival (OS), 3-year disease-free survival (DFS), 5-year OS, 5-year DFS were extracted from these papers, and a meta-analysis was applied. Result The hazard ratio (HR) of positive pelvic nodes on NACT group versus control group was 0. 54(95% CI 0. 33 ～0. 86), HR of interstitial infiltration was 0. 45(95% CI 0. 24 ～0. 86), HR of vascular invasion was 0. 25(95% CI 0. 16 ～0. 38), all differences were statistically significant. And HR of positive surgical margin was 0. 45 ( 95% CI 0. 21 ～0. 99), P = 0. 05, which indicated the difference was not statistically significant. And there were also no significant difference on the HR of 3-year OS, 3-year DFS, 5-year OS and 5-year DFS, and their RR were 1.18(95% CI 0. 84 ～ 1.66) ,1.31 (95% CI 0. 96 ～ 1.78) ,0. 89(95% CI 0. 68 ～ 1.15) ,and 0. 99(95% CI 0. 71 ～ 1.93) respectively. Conclusion For local advanced cervical cancer, NACT could reduce pathological risk factors but it did not improve the survival.

OBJECTIVE Aim to explore the value and the selection of observation target of P1 component in children with cochlear implant(CI). METHODS 13 children(4.37±0.73 years old) with right side CI and one year of regular post-CI rehabilitation were recruited as CI group. 15 gender and age (4.25±0.84)years matched children with left side external and middle ear malformation were selected as control group. We collected their AEP which showed their reaction to 1000 Hz pure tone and analyzed the P1 component. RESULTS The cut off value between CI group and control groupwas 10.4mV for P1 Amplitude(P1A) and 110.5 mV for P1 Latency(P1L). More precisely, the values of CI group were above the cut off value while the values of control group were below it. Whether choosing P1A or P1L as dividing standard, the AUC were between 0.5 and 0.9(AUC: P1A0.733, P1L0.800), which showed medium distinguishing significance. P1L component showed greater You-den index(0.590>0.471) and sensitivity(0.923> 0.538) while P1A showed greater specificity(0.933>0.667). CONCLUSION P1L shows greater ability in distinguishing the difference between CI group and control group while P1A has advantage in determining their common feature. Generally, P1L shows higher value in studying CI children. We need to make choice between P1A and P1L in different situation and use P1A and P1L standard in series or parallel.