Objective To explore the clinical feature and prognosis of multiple myeloma with heart failure as initial manifestations.Methods 12 patients of multiple myeloma with heart failure as initial manifestations were analyzed and followed up.Results Twelve patients,9 men and 3 women,with mean age of 48～69(58.4?5.2)years older were enrolled.The first symptoms of the patients were almost the same,with different degree of dyspnea and tachypnea.Anaemia and proteinuria were 83.3% and 75% respectively in 12 patients.ECG showed that 8 patients had low voltage in the limb leads,with present poor R wave progression in the precordial leads and ST-T changes in 6 patients.UCG showed that 10 patients had enlarged left atrium(41.6?4.2)mm,8 patients had increased thickness of the interventricular septums and left ventricular walls as well as diffuse weakness of the wall motion.Followed up for(4.0?3.7)months,all of the patients(100%)died.Conclusion Multiple myeloma with heart failure as initial manifestations is rare clinically,but has fast aggravation and bad prognosis.Pro-brain natriuretic peptide(Pro-BNP)and cardiac troponin are subtile markers for judging the prognosis of patients with multiple myeloma.

Objective To observe the effect of motivation of endothelial progenitor cells (EPCs) by granulocyte colony-stimulating factor (G-CSF) on cardiac function in patients with myocardial infarction (MI). Methods Eighty MI patients were sellectedand then were divided into a conventional treatment group (n = 40) and a EPC motivation group (n = 40). EPCs were detected by flow cytometry. Results The rate of EPCs was increased from (0.11 ± 0.04)% in the baseline to (5.32 ± 1.06)% (P < 0.05). Before treatment, 6MWT, LVEF, and LVEDD did not differ significantly between the conventional treatment group and the EPC motivation group (P > 0.05); after treatment, 6MWT, LVEF, and LVEDD were significantly increased in both groups (P < 0.05 and P < 0.01). However, 6MWT, LVEF, and LVEDD were higher in the EPC motivation group than in the conventional treatment group (P <0.05). The clinical effectiveness rate was higher in the EPC motivation group than in the conventional treatment group (90.0% vs. 75.0%, P < 0.05). There was no significant difference between the two groups in adverse reactions (7.5%vs. 10.0%, P > 0.05). Conclusions G-CSF can markedly motivate EPCs, which is beneficial for improvement of cardiac function in MI patients.

Pancreatic cancer is a highly lethal disease in gastrointestinal malignant tumors.The mortality of pancreatic cancer closely parallels its incidence.Most patients with pancreatic cancer remain asymptomatic until the disease reaches an advanced stage.There is no program for screening patients at high risk of pancreatic cancer.Although CT,MRI,positron emission tomography,endoscopic ultrasonography,and endoscopic ultrasonography-guided fine-needle aspiration offer high diagnostic ability for pancreatic cancer,it cannot be found at the early stage easily.Surgical resection is regarded as the only potentially curative treatment and adjuvant chemotherapy is given after surgery.This article reviews epidemiology,risk factors,diagnosis and treatment for pancreatic cancer by summarizing relevant literature.

Gastric cancer is one of the most common malignant gastrointestinal tumors.Docetaxel alone or combination with other drugs can attenuate the progress of disease,prolong the overall response rate and the median overall survival rate in advanced gastric cancer.However,the incidence of toxicities is high.Moreover,there is no uniform standard for dosage and course for docetaxel treatment.Currently,its efficacy is not definite.