Arsenic Poisoning ; diagnosis ; Humans ; Occupational Diseases ; diagnosis ; Occupational Exposure ; adverse effects

Objective:To explore the clinical effect of lenalidomide combined with anti-B-cell maturation antigen chimeric antigen receptor T cell (anti-BCMA CAR-T) in the treatment of relapsed/refractory multiple myeloma (RRMM).Methods:The clinical data of a patient with RRMM who underwent lenalidomide combined with anti-BCMA CAR-T therapy in Henan Province Hospital of Traditional Chinese Medicine in January 2020 were analyzed. Clinical manifestations, diagnosis and treatment were also analyzed, and the related literature was reviewed.Results:The patient was a 51-year-old man who was diagnosed as IgD-λ multiple myeloma (MM) in October 2015. The patient achieved remission after 10 courses of chemotherapy regimens including immunomodulators and proteasome inhibitors, followed by autologous hematopoietic stem cell transplantation. MM relapsed after 14 months of transplantation. His disease continued to progress after multiple chemotherapy regimens and mouse or human-derived anti-BCMA CAR-T therapy. After a conditioning chemotherapy regimen of fludarabine and cyclophosphamide, the patient took lenalidomide on day 1 and was infused human-derived anti-BCMA CAR-T cells on the next day. Grade 3 cytokine releasing syndrome (CRS) appeared after infusion, and was resolved after symptomatic treatment. Very good partial response (VGPR) was achieved on day 14 after anti-BCMA CAR-T treatment. VGPR had been maintained for more than 3 months by press time.Conclusion:Lenalidomide combined with anti-BCMA CAR-T therapy is feasible and effective in the treatment of RRMM.

Objective To develop a spectrophotometry in tetra component complex system of A1-CAS-CTMAB-OP for the determination of aluminum in floured food.Methods The sample was processed by combustion and the content of aluminum in foods was determined by spectrophotometry with Al-CAS-CTMAB-OP as color system.Results A linear relationship between the aluminum content and absorbency was in the range of 0.04～0.32 ?g/ml with the regression equation equating to A =3.551 2x-0.005 34,the correlation coefficient was 0.997 6,the detection limit was 0.001 4 ?g/ml and the recovery rate was in the rang of 98.6%～ 103.2%.Conclusion This method has been applied successfully to determine the aluminum in floured food for its special features, such as simple,rapid and accuracy.

BACKGROUND:Laminoplasty and laminectomy are the most commonly used treatment methods for multilevel cervical spondylotic myelopathy, which is more common in elderly patients. C5 nerve root palsy is the common postoprative complication after posterior cervical repair. OBJECTIVE:To compare the incidence of C5 nerve root palsy after laminoplasty with mini-titanium plate fixation and laminectomy with internal fixation in repair of multilevel cervical spondylotic myelopathy. METHODS:Total y 134 patients with multilevel cervical spondylotic myelopathy from August 2010 to December 2014 were enrol ed, and then divided into laminoplasty group (n=45) and laminectomy group (n=89) owing to different ways of repair. Patients in the laminoplasty group were treated with laminoplasty with mini-titanium plate fixation, and patients in the laminectomy group were treated with laminectomy with internal fixation. C5 nerve root palsy condition after repair was recorded and evaluated. The cervical lordosis angle (Cobb angle) and cervical curvature index were compared. The Japanese Orthopaedic Association score was used for neurological assessment. RESULTS AND CONCLUSION:Al patients in both groups were fol owed up for more than 6 months. There were no significant differences in cervical lordotic angle and cervical curvature index at the first week before and after the treatment between these two groups (P>0.05). The Japanese Orthopaedic Association scores of patients after 6 months of treatment were significantly improved compared with that before treatment in these two groups (P<0.05). There were 2 cases of C5 nerve root palsy after the treatment of laminoplasty, the occurrence rate was 4%(2/45);there were 10 cases of C5 nerve root palsy after the treatment of laminectomy, the occurrence rate was 11%(10/89);there was significant difference between these two groups (P<0.05). These results suggest that compared with laminectomy fixation, the incidence of C5 nerve root palsy was lower after the laminoplasty with mini-trianium plate fixation, which can be widely used in decompression repair treatment of multilevel cervical spondylotic myelopathy.

Objective To measure and analyze the radiation dose for patients undergoing nuclear medicine examination,and to characterize radiation exposure of patients by using the estimated effective dose.Methods Patients undergoing nuclear medicine examinations were classified and the radiation doses from radiopharmaceuticals to patients were measured and calculated.Meanwhile,radiation exposure from computed tomography (CT) procedure was calculated on the basis of CT protocols and patients' information.The effective doses to patient from both the radiopharmaceutical and CT scan radiation were calculated and the factors influencing patient radiation doses were analyzed.Results For the patients undergoing positron emission tomography-computed tomography (PET-CT) examination,the average effective doses from positron radiopharmaceutical 18F-fluorodeoxyglucose (18F-FDG),18F-fluoro-l-thymidine (18 F-FLT),11C-choline,11 C-methylmethionine (11 C-MET) and 11 C-acetate (11 C-Ac) were (5.06 ± 0.73),(4.74±1.29),(1.71 ±0.05),(3.18±0.69) and (1.08±0.19) mSv,respectively.CTscan caused average effective dose was (8.80 ± 0.58) mSv.If a full diagnostic CT investigation was performed,the effective dose might be up to 27 mSv.Whereas for emission computed tomography (ECT) examinations,the average effective dose to the patients irradiated by single photon radiopharmaceutical 99Tcm-methylenediphosphonate (99Tcm-MDP),99Tcm-macroaggregated albumin (99Tcm-MAA),99Tcm-diethylentriaminpentaacetic acid (99 Tcm-DTPA),99Tcm-methoxyisobutyl isonitrile (99 Tcm-MIBI) and 99Tcm-pyrophosphate (99Tcm-PYP) were (4.63 ± 0.01),(1.71 ± 0.01),(1.18 ± 0.01),(7.19 ± 0.03) and (4.18 ± 0.01) mSv,respectively.Conclusions Radiopharmaceutical irradiation caused effective dose to the patients undergoing nuclear medicine examinations is from 1.08 to 7.19 mSv,while CT scan cause average effective dose is 8.80 mSv in PET-CT examination.

0.2 g/L)with normal diets. Conclusions Living donor liver transplantation for hepatic complications of Wilson's disease can cure and correct the underlying metabolic defect. It is a lifesaving therapy in children with fulminant Wilsonian hepatitis and has many unsurpassed advantages.

Objective To analyze the relation between ~(99)Tc~m-DTPA renal dynamic imaging and pathological changes in patients with lupus nephritis (LN).Methods Ten normal control and 29 patients with LN underwent ~(99)Tc~m-DTPA renal dynamic imaging.The LN patients were divided into two groups:silent LN (SLN) group,18 patients;and obvious LN (OLN) group,11 patients.For each case,glomerular filtration rate (GFR),peak time (t_p),half excretion time (t_(1/2)) and the excretion rate at 20 min (R_(20)) were calculated.Assessment of renal function on the scintigraphic images was evaluated by nuclear medicine physicians.The t-test,Fisher'exact probability and R×C association were used for data analysis.Results There were significant differences between normal people and two goups of LN in tp(t=5.3,9.3,both P＜0.05),t_(1/2)(t=6.9,12.0,both P＜0.05)and R_(20)(t=10.1,12.1,both P＜0.05).As to GFR,there was significant decrease in OLN patients(t=4.1,P＜0.05),but not in SLN patients(t=1.7,P＞0.05).Diagnoses of renal function by renal dynamic imaging were compared with the renal pathological changes (r=0.2273,P＜0.05).Conclusions ~(99)Tc~m-DTPA renal dynamic imaging is useful for evaluation of the early stage renal function for LN patients and to diagnose LN patients with no symptom of renal impairment.It may help to assess the degree of renal parenchymal damage while obviating the need for renal biopsy in these patients.

Child, Preschool ; Humans ; Male ; Neurofibromatosis 1 ; genetics ; Pedigree

Objective To evaluate the methods and consequences of surgical technique in the treatment of Stanford A aortic dissection.Methods 108 patients with type Standford A aortic dissection underwent surgery in our study,including urgent surgery in 53 and selective surgery in 55.The operation was performed under deep hypothennic circulatory arrest (DHCA) in 85 cases.Surgical procedures included ascending and semi arch replacement or total arch replacement (some cases combined with stented graft implanted into the descending aorta),"elephant trunk" procedure.Concomitant procedures included repair of intimal tear in arch or descending aorta,Bentall procedure,aortic valve replacement,Cabrol or modified Cabrol procedure,aortic valvuloplasty,mitral valvuloplasty or mitral valve replacement,tricuspid valvuloplasty and CABG.Results In-hospital mortality was 6.5% (7 of 108 patients).The mor- tality was 7.5% (4 of 53 patients) in urgent surgery group and in elective surgery group was 5.4% (3 of 55 patients).Ninety six percent survived patients were followed up for 1 month to 13.3 years [mean (3.2?1.3) years] and 2 deaths occurred during the fel- low-up period.3 patients underwent re-operatian.Conclusion The choice of surgical procedures depend on the location of intimal tear for Stanford A aortic dissection.The better operative effects can be expected with proper surgical indication,perfecting surgical technique,and enhancing postoperative treatment.

Child, Preschool ; Fatal Outcome ; Female ; Humans ; Respiratory Tract Infections ; complications ; Shock, Septic ; etiology ; Streptococcal Infections ; complications