Objective To explore the outcome of monoclonal gammopathy of undetermined significance (MGUS). Methods The data from 14 MGUS patients in our hospital including clinical features, outcome and change of M protein concentration were analyzed retrospectively. Results The MGUS didn't have the clinical manifestations of multiple myeloma (MM), the time of outcome from MGUS to MM was about 4-20 years (mean time, 10 years). The most types of MM were IgA and IgG, 6 cases were IgA type, 6 cases were IgG type and 2 cases were light chain type. The concentration of immune globulin in general showed an upward trend year by year. A few showed fold lines ascend. Conclusions The elevated monoclonal immunoglobulin may develop into MM after many years. We must follow up frequently to avoid error diagnosis and missed diagnosis.

Objective To explore the cytogenetic characteristics of acute myeloid leukemia(AML) patients.Methods The karyotype analysis was performed in 178 AML using the short-term culture of bone marrow cell and G-banding technique.Results Among the 178 patients,171 had enough metaphases for analysis and 128(74.9%)had clonal karyotypic abnormalities.Twenty-seven patients were secondary to myelodysplastic syndrome (MDS-AML),with 25 (92.6%) patients carrying clonal karyotypic abnormalities.Among the remaining 144 patients of de novo AML,103(71.5%)had clonal karyotypic abnormalities.The rate of abnormal clonal karyotype was higher in MDS-AML than that of de novo AML (P=0.021).Among the 171 patients,41(24.0%)were in favorable risk group,80(46.8%)in intermediate risk group and 50(29.2%)in adverse risk group.t(15;17)was the most common chromosomal aberration.The maiority intermediate risk chromosomal aberration was;normal karyotype.The most common cytogenetic abnormality among adverse group was a complex karyotype.Adverse cytogenetic aberrations,such as -5/5q-,-7/7q-,frequently occurred in conjunction with one another as part of a complex karyotype.Totally 75 patients were 60 years or older,among them,16.0%were in favorable risk group,48.0%in intermediate risk group and 36.0%in adverse risk group.Among 96 younger patients,30.2%were in favorable risk group.45.8%in intermediate risk group and 24.0%in adverse risk group.The rate of favorable risk chromosomal aberration was lower in elder patients than in younger(P=0.03 1).The rate of adverse risk chromosomal aberration and the rate of monosomal karyotype were higher in MDSAML than in de novo AML patients(P<0.001).Conclusions The most common favorable,intermediate and adverse chromosomal aberrations were t(15;17),normal karyotype and complex karyotype respectively.The karyotype was poor in MDS-AML and elder AML patients.

Objective To explore the karyotype distribution in elderly patients with acute leukemia (AL) and compare the prognostic characteristics of karyotype by age grouping.Methods Chromosomal karyotypes were analyzed in 215 cases with AL using the short-term culture of bone marrow cells and G-banding technique.Results There were 202 cases with enough mitosis for analysis and 149 cases(73.8％)with abnormal clone in 215 patients with AL.The rates of abnormal clone were 73.0％ (27/37),74.4％(64/86) and 73.4％ (58/79) in patients aged ≤30,31-59 and ≥60 years,respectively,and no difference were found among age groups (P=0.982).Among 171 patients with acute myeloid leukemia (AML) with detected mitosis,there were 41 better-risk cases (24.0 ％) with most frequent aberration of t(15;17) accounting for 65.9 ％,80 intermediate-risk cases (46.8 ％ ) with principal of normal karyotype accounting for 53.8 ％,and 50 poor-risk cases (29.2 ％)with complex karyotype occupied by 84.0％.The karyotype percentage of better-risk,intermediaterisk and poor-risk were 50.0％,36.4％ and 13.6％ in patients aged ≤30 years,24.3％,48.7％ and 27.0％ in aged 31-59 years,and 16.0％,48.0％ and 36.0％ in aged ≥ 60 years,respectively.The rate of better-risk karyotype was higher in patients aged ≤30 years than the other two groups (P=0.021and P=0.001) and the ratio of poor-risk karyotype higher in patients aged ≥ 60 years than in patients aged ≤30 years (P=0.046).Among 29 patients with acute lymphoblastic leukemia (ALL),10 cases had poor-risk and 19 cases had intermediate-risk karyotype.Conclusions Karyotype analysis provides an important basis for risk assessment and the rate of poor-risk karyotype may increase with the ageing in patients with AML.

Objective To evaluate the effect of a modified culture method on the karyotype anomalies detection rate in elderly patients with multiple myeloma (MM),and to explore the relationship between clinical characteristics and chromosome anomalies in multiple myeloma.Methods Two culture methods were applied on the bone marrow samples which obtained from 28 MM patients.One method was used to culture cells for 24 hours with interleukin 6 (IL-6) 10 μg/L and granulocyte-macrophage colony-stimulating factor (GM-CSF) 40 μg/L,and the other for 6 days.Karyotype was analyzed by G-banding technique.Results In the 24-hour culture group,no metaphases cell was found in 4 cases (14.3 ％),karyotype anomalies were found in 6 cases in the other 24 cases,and the detection rate was 25.0％ (6/24).In the 6-day culture group,no metaphases cell was found in 1 patient (3.6％),karyotype anomalies were found in 15 cases in the other 27 patients,and the detection rate was 55.6％ (15/27).There was a significant difference in the detection rate of karyotype anomalies between the two groups (x2 =4.89,P ＜ 0.05).In 27 cases with enough metaphases in the 6-day culture group,20 cases were newly diagnosed or in progression,among whom karyotype anomalies were found in 14 cases (70.0％,14/20),and 7 cases were in stable phase,among whom karyotype anomalies were found in 1 case (14.3％,1/7).The detection rate of abnormal karyotype was higher in newly diagnosed or in progressive patients than in stable patients (P ＜0.05).Conclusions 6-day culture method can improve the detection rate of karyotype anomalies in elderly patients with multiple myeloma,which is better than 24-hour culture method.The detection rate of karyotype anomalies is higher in newly diagnosed or in progressive patients than in stable patients.

Objective:To investigate the relationship between the degree of basilar artery stenosis and the short-term prognosis in patients with isolated pontine infarction.Methods:One hundred and thirty-seven patients with isolated pontine infarction within 1 month after symptom onset admitted to our hospital from April 2016 to April 2018 were consecutively included.Based on modified Rankin scale(mRS)socres, patients were divided into the good outcome group(mRS score≤2)and the poor outcome group(mRS score>2). Venous blood samples were taken for biochemical testing on admission or the next day.Baseline National Institutes of Health Stroke Scale(NIHSS)scores and demographic data were recorded and compared between the two groups.The degree of basilar artery stenosis was assessed by magnetic resonance angiography(MRA), and subjects were divided into the non-stenosis, mild stenosis, middle stenosis and severe stenosis subgroups.Results:There were 108 patients in the good outcome group and 29 in the poor outcome group.The baseline NIHSS score(2.71±0.22 vs.7.10±0.59, t=6.99, P<0.01)and total cholesterol[(4.29±0.101)mmol/L vs.(4.76±0.17)mmol/L, t=2.21, P=0.03]were lower in the good outcome group than in the poor outcome group.The proportion of patients without stenosis was higher(76 or 70.4% vs.5 or 17.2%, χ2=26.70, P<0.01)and the proportion of patients with severe stenosis were lower(4 or 3.7% vs.7 or 24.1%, P=0.002)in the good outcome group than in the poor outcome group.Binary logistics regression analysis showed that baseline NIHSS score( OR=1.658, 95% CI: 1.327-2.071, P=0.000)and degree of basilar artery stenosis( OR=2.071, 95% CI: 1.159-3.701, P=0.014)were risk factors for the short-term prognosis. Conclusions:The degree of basilar artery stenosis is a risk factor for the short-term prognosis in patients with isolated pontine infarction, and patients with severer stenosis will have a poorer prognosis.

Objective:To evaluate the clinical efficiency and prognostic factors of autologous peripheral blood stem cell trans-plantation (APBSCT) in 30 cases of multiple myeloma (MM). Methods:Two of the 30 patients received the second treatment of APB-SCT because of relapse after the first treatment. Thus, a total of 32 case-times of APBSCT were studied. Combination chemotherapy was inducted regularly before APBSCT (11 patients used bortezomib as an induction drug), and chemotherapy combined with the G-CSF regimen was used to mobilize peripheral blood stem cells. Preconditioning was based on melphalan. Results:Mononuclear cells in harvest were 6.41 × 108/kg, and CD34+cells in harvest were 4.75 × 106/kg. The median times of neutrophil and platelet engraftment were 9.5 and 11 d, respectively. The complete remission (CR) and very good partial remission (VGPR) rates were 37.5%and 34.4%af-ter APBSCT, respectively. The median overall survival (OS) was 67.27 months in all patients, and the median progression-free survival (PFS) was 29.77 months. The median PFS rates were 29 and 20 months in the patients who achieved CR and PR, respectively, and the median PFS was not observed in the patients who achieved VGPR. Statistical differences in PFS were detected between the CR+VGPR and PR groups (P=0.025). The CR rates were 63.6%and 23.8%in the bortezomib (bortezomib-based chemotherapy) and non-bortezo-mib groups (P=0.034), respectively. The median OS and PFS were not obtained in the bortezomib group, whereas the median PFS was 22 months in the non-bortezomib group (P=0.045). Conclusion: MM patients treated with bortezomib-based chemotherapy followed by APBSCT had prolonged PFS. APBSCT can improve the response and survival of MM patients.

Objective To investigate the correlation between hemoglobin level and health status of the elderly living in communities in Beijing.Methods A random cluster sampling method was used to select residents living in communities of Beijing city,and a cross-sectional study was carried out by questionnaires,scene testing and blood sample collection.WHO-formulated criteria were applied for diagnosing anemia.The health indicators in questionnaires included visual impairment,physical disability,decreased health,self-care,fatigue,anorexia,independent walking distance,exercise frequency,intelligence status and computing power.Results Complete information was obtained in a total of 1 948 elderly people,including 790 cases of male and 1 158 cases of female,with an average age of(73.9±6.1)years and a median age of 74 years(65-100).The mean level of hemoglobin in the 1 948 people was(135.65 ± 14.48) g/L,with (142.56 ± 15.56) g/L in male and (130.95 ± 11.53) g/L in female.Hemoglobin level was significantly lower in female than in men (t =54.739,P＜ 0.01).Hemoglobin level was decreased with aging,and negatively associated with appetite,physical strength,walk assistance,visual acuity and physical ability(r=-0.055,-0.067,-0.071,-0.114,-0.095;P =0.022,0.005,0.004,0.000,0.000),while positively associated with health status,activities in daily life,athletic ability,exercise frequency and intelligence (r =0.073,0.126,0.122,0.066,0.124;P =0.002,0.000,0.000,0.006,0.000).Conclusions The hemoglobin level of the elderly decreases with aging and is associated with health status and quality of life in the elderly,which should be taken care seriously.

Objective: To understand the characteristics and causes of pesticide poisoning in Xuzhou city, and provide basis for formulating prevention and control measures. Methods: The cases of pesticide poisoning in Xuzhou City from 2005 to 2017 were collected from "Pesticide Poisoning Report Card" . The data were analyzed and assessed by EpiData. The SPSS 22.0 software was used for statistical analysis. Results: During the thirteen years, there were a total of 8092 cases of pesticide poisoning, among which, the number of occupational pesticide poisoning was 1 408, accounting for 17.4% of the total number of cases, 14 patients died, the case fatality rate was 0.1%. There were 2, 992 cases of male poisoning, accounting for 36.97% of the total number of cases, and 5, 100 cases of female poisoning, accounting for 63.03%. There were 6684 non-productive pesticide poisonings, accounting for 82.6% of the total number of cases; 387 deaths occurred, and the mortality rate was 5.8%. Among non-productive poisonings, the incidence of oral pesticide poisoning was 84.3%, and the incidence of accidental poisoning by pesticides was 15.7%. Organophosphorus pesticides poisoning cases accounted for the majority of oral pesticide poisoning cases. The overall incidence of pesticide poisoning showed a downward trend. The age of non-productive pesticide poisoning cases was mainly 15-44 years old, and the number of cases of poisoning were 4 029 cases (60.28%) . With the increase of age, the mortality rate of poisoning cases was higher, especially for those over 60 years old who died of oral pesticide poisoning (40.1%) . The peak of pesticide poisoning began to increase in the second quarter and reached its peak in the third quarter. Conclusion Although the cases of pesticide poisoning reported in Xuzhou City have been declining in recent years, the situation is still severe. The proportion of oral pesticide suicide accounts for a large proportion, and the mortality rate of elderly and female is relatively high, and the government should pay more attention. Workers should conduct safety education and psychological counseling to improve the knowledge and consciousness of safe use of pesticides.

Objective: To investigate the association between the single nucleotide polymorphisms of rs12212067 in FOXO3 gene and the susceptibility to occupational noise-induced deafness in a Chinese Han population. Methods: A total of 1 066 cases of noise exposure workers from a large chemical fiber factory in Jiangsu Province were selected as the study subjects. All subjects’ basic data and field exposure data were collected through questionnaires and occupational health surveys. The subjects were divided into case group (531 persons, double ear high frequency average hearing threshold>25 dB) and control group (535 persons, double ear high frequency average hearing threshold≤25 dB) according to their results of pure tone hearing test .2ml fasting venous blood was collected for DNA extraction and genotyping was performed by TaqMan-PCR technique. Results: Genotyping results suggested that the GT+GG genotype is a risk factor for occupational noise-induced deafness, with an adjusted OR 95% confidence interval of 2.044 (1.51-2.78) . After the noise exposure intensity was stratified, the adjusted OR values and the 95% confidence intervals of noise intensity ≤85, 85-92 and>92 dB respectively 2.43 (1.52-3.90) , 2.17 (1.03-4.59) and 1.74 (1.07-2.83) . Conclusion GT-GG genotype in rs12212067 of FOXO3 gene may be a risk factor for occupational noise-induced deafness.

Objective To analyze the interventional effect of systematic nursing on hy-pothermia plasma ablation in the treatment of rhinallergosis.Methods A total of 82 patients with rhinallergosis admitted in our hospital from January 2013 to January 2014 were given hypothermia plasma ablation and randomly divided into control group performed with routine nursing measures and intervention group added with systematic and comprehensive nursing measures,41 cases for each.The clinical efficacy of both groups were compared during follow-up duration.Results Af-ter 1-year follow-up,28 were excellent and 7 effective in control group,with effective rate being 8 5 .3 6 % ,while 3 5 were excellent and 5 effective in intervention group with effective rate being 97.55%,and the difference was significant (P <0.05).Conclusion Systematic and comprehen-sive nursing interventions can improve the prognostic efficacy of hypothermia plasma ablation in the treatment of rhinallergosis,which deserves to be widely used in clinic.