Objective To retrospectively analyze the therapeutic effect and adverse reactions of lenalidomide combined with cyclophosphamide and low-dose dexamethasone (RCD) in the treatment of multiple myeloma (MM). Methods Forty-five patients with MM was divided into treatment group (25 cases) and control group (20 cases) according to non-randomized concurrent control method: the former was treated by RCD, and the latter accepted melphalan combined with prednison and thalidomide (MPT). Results The overall response rates (ORR) for the treatment group and the control group were 84.0%(21/25) and 65.0%(13/20)respectively (P > 0.05), and high quality response (CR + VGPR) rates were 64.0%(16/25) and 30.0%(6/20) respectively (P<0.05). The relapse rates and 3-year overall survival rates were 24.0%(6/25) and 55.0%(11/20), 76.0%(19/25) and 45.0%(9/20), respectively (P<0.05). Compared with those of the control group, the incidence of thrombopenia and neutropenia was higher, and treatment-related toxicities were lower in treatment group (P<0.05). Conclusions RCD may be more effective, and adverse reactions can be tolerated. The therapy method is worthy to be recommended.

Objective To study the application of the linear sampling method(LSM) in 2D electromagnetic inverse scattering imaging and to mainly discuss the imaging quality of LSM with partial-view data.Methods Get the norm of solution vector to the equivalent integral equation using numerical calculation in every sampling point at imaging region,and represent the norm with gray to reconstruct the scattering shape.Results Under all incident angles [0,360?] and all observation angles [0,360?],the imaging quality of the far-field pattern of scattering wave was obtained very well.But when reducing the range of the incident angles and observation angles,the imaging quality declined.Particularly,the imaging quality in the case of both incident angles and observation angles being at the same side of the observed object,were much better than both in opposite sides.Furthermore,the profile of the object was imaged more clearly as its position corresponding to the orientation of the incident/observation angle.Conclusion Although the imaging quality will decline with partial-view data in electromagnetic inverse scattering,the effectiveness of imaging with LSM still deserves attention.

Objective To understand the level of neonatal pain knowledge and attitudes of neonatal and obstetric department nurses, in order to supply the clinical basis for neonatal pain management. Methods Self-designed questionnaires to fill out on-site were distributed to 107 neonatal and obstetric department nurses (of which 40 were from neonatal department, 67 from obstetric department) for neonatal pain knowledge and attitudes. Results About question of neonatal pain, the average percentage of correct answers in the neonatal group was 75.5%, higher than 66.3% of the obstetric group, in the neonatal group, correct rate of seven questions was more than 80%,while in the obstetric group the correct rate of only one question was more than 80%, and 5 questions correct response rate was significantly lower than that of the neonatal group, the difference was significant. All nursing staff considered it essential or necessary to carry out the nursing knowledge of pain-related training. 95.0%(38/40) of neonatal nurses believed that they could properly assess the extent of neonatal pain, but only 83.6% (56/67) for the obstetric group, the difference between the two groups was significant. 97.5% (39/40) of neonatal nurses believed that they could make the right judgments on neonatal crying, and only 85.1%( 57/67) in the obstetric nurses, the difference between the two groups was significant.Conclusions Neonatal pain has gradually been recognized and paid attention to by the clinical front-line medical staff, they believe that it is necessary to receive training on neonatal pain, knowledge of neonatal pain of neonatal nurses is better than obstetric nurses.

Objective To explore the development of pulmonary function of normal toddlers between 1 and 3 years old.Methods Totally 115 normal toddlers were divided into 2 groups according to their age,i.e,1 ～ 2 years old,2～3 years old.The indicator of small and big airway examine respiratory system static compliance,total airway resistance and functional residual volume were observed.Results No significant difference was found between male and female toddler( P ＞0.05 ).Between the two groups,the difference of respiratory rate was not significant( 27 vs 26,t =1.512,P ＞0.05 ).The values of tidal volumes in the 2 ～ 3 years group was notably higher than in the 1 ～ 2 years group(0.123 vs 0.091,t =8.586,P ＜ 0.01 ),but the values of tidal volumes per kilogram body weight was not significantly different (0.0091 vs 0.0087,t =1.958,P ＞ 0.05 ).The peak tidal expiratory flow in the elder group was similarly distinctly higher than that in the other group.The measured tidal breathing flow volume loops were both displayed uncharacteristic ellipse.The rations of inspiratory time to total respiratory time,the volume to reach peak tidal expira-tory flow to total expiratory volume,tidal expiratory flow at 25％ remaining expiration to peak expiratory flow and mid-tidal expiratory flow to mid-tidal inspiratory flow were not significantly different between two groups (P ＞ 0.05 ).Butthe ratio of peak tidal flow to tidal volume( 1.257 vs 1.095,t =2.099,P ＜ 0.05 ) and the respiratory system resistances( 2.698 vs 2.071,t =3.762,P ＜0.01 )were evidently lower in the elder group than in the younger.The respiratory system compliances(0.353 vs 0.254,t =4.296,P ＜0.01 ) and functional residual capacities(0.272 vs 0.212,t =8.469,P ＜0.01 ) were significantly higher in the elder group than that in the younger,but the values per kilogram body weight was not significantly different( P ＞0.05 ).It was shown that the values of tidal volume,peak tidal expiratory flow,respiratory system static compliance,residual volume were significantly different(0.0198 vs 0.0198,t =0.000,P ＞0.05),between two groups.The values of each parameter mentioned above were increased with age,and were positively correlated with body weight(γ=0.457,0.849,0.572,0.319 all P＜0.01 ).Conclusion Tidal breathing flow volume loop could show functions of small and large airways and partially replace the maximum expiratory flow loop.The parameters were stable in toddlers and could be used as reasonable index to evaluate the pulmonary function changes in pulmonary diseases.The ventilatory function,residual volume,respiratory system static compliance and peak tidal flow were increased with the age,which coincides with the rule of development of toddlers.

Objective To investigate the features of the memory function disturbance in patients of generalized seizures and the correlation between the memory function and proton magnetic resonance spectroscopy(1H-MRS).Methods The clinical memory scale of 45 general seizures and 20 normal age and sex-matched controls wss measured and a1 H-MRs was performed in the bilateral hippoeampal.The levels of NAA.Cho.Cr and the ratios of NAA/Cr+Cho were compared between these two groups.Meanwhile,tHe correlation coefficients was calculated and the results of clinical memory scale scoreB and the level of NAA,Cho.Cr and the ratios of NAA/Cr+Cho in groups were compared.Results As compared with the controls.the scores of pointing memory(17.19±5.86),associational learning(20.00±6.77),image free memory(18.44±6.62),association memory of portrait(13.19±6.62)and memory quotient (MQ,79.07±20.20)excepts insignificant figure recognition wcrc significandy decreased in patients of seizures(t=4.794-10.224,all P<0.01);The scores of scale and MQ of both the group of patients who wok antiepileptic drugs(AEDs)and the group of patients whose frequency exceeded 3 per month were significantly lower than the group who didn't take AEDs and the group whose frequency was lower than 3 per month(t=3.267-6.537,all P<0.01).The volumes of hippocampal formations(2.45 ±0.25 on left and 2.56 ±0.31 on right),the level of NAA(12.93 ±1.73 on left and 11.88 ±1.69 on right),Cho(15.02 ±0.86 on left and 14.94 ±0.96 on right),Cr(11.86 ±0.71 on left and 10.71 ±0.42 on right)and the ratios of NAA/Cr+Cho(0.48 ±0.08 on left and 0.39 ±0.07 on riht)in the group of pailents of generalized seizures were significantly difference than those in the controls(t=4.103-5.768,all P<0.01).Patients with seizures showed significant correlation between tlle scores of all items.MQ in clinical memory scale and NAA,NAA/Cr+Cho ratio(r=0.489-0.727,all P<0.01),and inverse correlation between the scores and MQ and Cho of in the bilateral hippocampal(r=-0.604-0.484,all P<0.01).However,there was no correlation between the scores and MQ and Cr of in the bilateral hippocampal.Condusions The patients of the general seizures do have the problem of the disturbance of short-term memory including acoustic memory and some visual memory.Both the high frequency of seizure and AEDs could affect the short-term memory function.The correlation between the scores of all the items and MQ in clinical memory scale proved that lack of nerve cell and hyperplasia of gliocyte was one of the reasons of the short-term memory disorder in epileptic.

Objective To assess health-related quality of life and the mood disorder in adults with epilepsy,and to evaluate factors contributing to the quality of life.Methods Quality of life was measured by the Quality of Life in Epilepsy Inventory(QOLIE-31)and the World Health Organization Quality of Life Assessment-Bref(WHOQOL-BREF).Psychotic conditions were evaluated by Self-rating Depressive Scale (SDS)and Self-rating Anxious Seale(SAS).The multivariate analysis was used to assess the determinant factors.Results The study included 141 epilepsy patients in the teat group and 59 sex,age,and education matched normal controls. WHOQOL-BREF scores in the physical and psychological aspects were significantly lower in epilepsy patients(12.7 ±1.8 and 12.4±1.9,respectively)than those in the normal controls(15.1 ±2.3 and 13.9 ±1.9,respectively,t value were 11.75 and 8.625.both P<0.05).The survey reported that 57.4 % of the epilepsy patients suffered with depression.and 39.7 % anxiety.The patients with both anxiety and depression scored lower in all aspects in QOLIE survey except medical effect.Multivariate analysis showed that factors that effect the overall quality of life in order were anxiety.depression and disease duration.Conclusion Our results support that complications of anxiety and depression and long disease duration are key factors affecting the quality of life in epilepsy patients.

Objective To observe colorectal tumor's growth in hyperglycemia mice and its vascular endothelial growth factor (VEGF)'s expression, insulin-like growth factor-1 (IGF-1)'s variation of blood through the experiment, then to ascertain whether type 2 diabetes mellitus (T2DM) danger factors to promote colorectal cancer happen and progress or not. Methods The mouse model of colorectal cancer combined T2DM was established. The volume of tumor was observed. After 5 weeks, all mice were executed and IGF-1 in the blood and the expression of VEGF in the tumor tissue was examined. Results The average tumor volume of colorectal tumor-diabetes group [(1628.5±882) mm3] were larger than that of colorectal tumor group [(1950.2±726) mm3] (P <0.05), and its expression IGF-1 of blood [(105.33±32.32) ng/ml] were higher than that of the control group [(69.83±25.57) ng/ml] and colorectal tumor group [(70.17±25.27) ng/ml] (P <0.05). The expression of VEGF [(70.0±11.5)%] in colorectal tumor-diabetes group were significantly higher than that of colorectal tumor group [(42.9±7.5)%] (P <0.05), too. Conclusion The model of T2DM and transplanted colorectal tumor can be duplicated successfully in ICR mice. Diabetes mellitus may be one reason of promoting colorectal cancer progress. Besides high blood glucose, its mechanism is the high level of IGF-1 which can inhibit apoptosis, promote cell differentiation and hyperplasia, and through inducing VEGF duplicating, heighten its expression, promote the tumor vessel growth, lead to tumor happen and metastasis.

Objective To explore the correlation of electrophysiological features with clinical manifestation in patients with diabetic peripheral neuropathy (DPN).Methods The clinical data of 306 patients with DPN undergoing nerve conduction study (NCS) during May 2013 to June 2015 were retrospectively analyzed.Among 306 patients,304 were type 2,and 2 were type 1 diabetes with a mean age of 64.1 years and disease duration of 1 week-31 years.The relationship between the electrophysiological features and clinical manifestations was evaluated.Nerve conduction studies and F-wave and in sympathetic skin response were analyzed.Results ① NCS in lower limbs presented more abnormalities than that in upper limbs.There was the highest prevalence of not elicited sensory potential in Tibial nerve [56.9％(174/306),x2 =175.9] and the highest prevalence of not elicited motor potential in peroneal nerve [7.8％(24/306),x2 =1 103.1].Amplitude abnormality was more severe in sensory nerve than that in motor nerve[41.4％ (507/1 224) vs.10.8％ (132/1 224),x2 =559.2].The ratio of abnormal motor conduction velocity or distal latency was higher than that of amplitude decreased [22.9％ (280/1 224) vs.10.8％(132/1 224),x2 =1 077.4].② The abnormal ratios of the shortest F-wave latency was lower than that of the prolonged distal latency in median and tibial nerve [5.4％ (33/612) vs.20.6％ (126/612),x2 =607.6].③ The abnormal ratio of sympathetic skin response (SSR) in lower limbs were higher than that of upper limbs [40.2％ (246/612) vs.27.3％ (167/612),x2 =129.4,P ＜ 0.001],abnormal ratio of amplitude was higher than that of the prolonged latency [30.1％ (368/1 224) vs.4.7％ (58/1224),x2 =1040.5,P ＜0.001].Among the 99 cases presenting abnormal SSR in upper limbs,32 cases were normal in conventional NCS.Among the 127 cases presenting abnormal SSR in lower limbs,7 cases were normal in conventional NCS.④Disease course and glycosylated hemoglobin values were positively correlated with the distal motor latency,and negatively correlated with the nerve conduction velocity and amplitude.Conclusion Electrophysiological features of DPN is mainly shown in axon of the distal sensory nerve.Long duration and hyperglycemia may lead to more abnormalities in electrophysiological tests.

OBJECTIVE To know the clinical antibacterial use by line category in pediatric outpatients and emergency departments.METHODS The antibacterial use by line category from the 38998 prescriptions of pediatric outpatient and emergency departments of a hospital from Jul 1st to Dec 31st 2008 according to the medicament amount and frequency were surveyed and analyzed.RESULTS First-line antibacterial drug DDDs accounted for 37.4% and 24.7% of the total amount;second-line drug DDDs accounted for 48.7% and 40.8% of the total amount and the third-line drug DDDs accounted for 13.9% and 35.0% of the total amount.The top three by total amount were cefmetazole sodium injection,azithromycin sodium injection and Cefuroxime sodium injection.According to the sorting method of DDDs,the top three were cefprozil dry suspension,azithromycin sodium injection and amoxicillin sodium clavulanate potassium injection.CONCLUSIONS Frequency of the third-line antibacterial drug using is relatively high.Clinicians have a tendency to skip a line category in using drugs.Effective measures should be taken to strengthen the management of antibacterials.

Objective:To explore the clinical effect and safety of modified microvascular decompression (MVD) on the recurrent trigeminal neuralgia.Methods:50 patients with recurrent trigeminal neuralgia from 2010 to 2015 in the Center of Cranial Nerve of Shanghai Jiaotong University (including Shanghai Tongren Hospital and Xinhua Hospital) were retrospectively analyzed,patients before 2012 were given regular MVD (MVD group,n=22),patients after 2012 were given improved MVD (modified MVD group,n=28).MVD group was given trigeminal nenre root decompression by traditional MVD,the method was described as follows:the skin,myofascial was cutted in turn along the first incision,the scar tissue on the edge of bone window was separated,and the bone window was appropriately expanded until the dura mater was fully exposed.Then dura mater was cutted open to sharply dissect the arachnoid,Meckel cavity was probed up to neurological brain regions (REZ),the trigeminal nerve segment was closely examined to separate the responsible blood vessels of oppressive nerve and the Teflon pad of cotton imbedding at the first operation.Modified MVD group was given detection of intracranial trigeminal nerve and its surrounding structures,dissection of brainstem extended segment of trigeminal neuralgia,and the compression of superior cerebellar artery to brainstem extended segment of trigeminal neuralgia was fended off.The postoperative remission rate,recurrence and complications between two groups were compared.Results:The postoperative remission rate in modified MVD group was 100.0％,which was significantly higher than that of the MVD group (P＜0.05).There was no statistical significance in the incidence of postoperative complications between two groups (P＞0.05).The recurrence rate at 1 year after surgery in modified MVD group was 0％,which was significantly lower than that of the MVD group (22.7％,P＜0.05).Conclusions:Decompression of trigeminal nenrerootcombined with brainstem extended segment of trigeminal neuralgia in MVD for recurrent trigeminal neuralgia could effectively relieve the pain,reduce the risk of postoperative recurrence,and wouldn't increase the postoperative complications.