Relapse/refractory multiple myeloma must be the main tough for the current clinical therapy,thus at the 56th American Society of Hematology annual meeting the latest treatment studies for the disease in 2014 were described in detail,including the joint application of drugs,the new drug clinical research,the safety and efficacy that could be inspiring.This chapter shows the mechanism of these new drug action,as well as the methods and side effects.

The statistical index of diagnosis coincidence was the base for the evaluation of diagnostic quality. By the problem analysis of diagnostic coincidence assessing, we were to establish standard criteria uniform and strict methods of evaluation; to enhance diagnosis coincidence rate, and to make full use of statistical index.

Evidence-Based Medicine ; Humans ; Neuronavigation

There is still a certain recurrence rate after extensive lymphadenectomy even to patients with node-negative gastric cancer.It promotes the researchers to use a more sensitive and effective way to track tumor cells which are missed,especially lymph node micrometastases.With the development of detection tech-nology,the diagnostic rate of micrometastasis is significantly increased.There are so many controversies about the impact of lymph node micrometastases that no consensus on the clinical treatment can be reached.In recent years,with the rise of endoscopic therapy,how to balance the relationship between the quality of life and the safety makes the research of micrometastases more urgent.

Objective To observe the clinical efficacy of different doses of warm needling in treating knee osteoarthritis (KOA). Method Sixty-seven KOA patients were randomized into group A of 16 cases, group B of 17 cases, group C of 18 cases, and group D of 16 cases. Group A, B, and C were intervened by warm needling, 1 moxa cone for group A, 2 cones for group B, and 3 cones for group C. Group D was intervened by intra-articular injection with Sodium hyaluronate. The Visual Analogue Scale (VAS) and Lysholm Knee Scoring Scale (LKSS) were evaluated before and after intervention.Result The VAS and LKSS scores were significantly changed in the four groups after intervention (P<0.01). After intervention, the VAS and LKSS scores in group B and C were significantly different from that in group A (P<0.05,P<0.01). After intervention, the VAS and LKSS scores in group B and C were significantly different from that in group D (P<0.05,P<0.01).Conclusion Warm needling is an effective method in treating KOA, and warm needling with 2 moxa cones can produce the best effect.

Objective To compare the effect of inhaled corticosteroids and montelukast in children with asthma .Methods Data were obtained from Pubmed ,Embase and Central databases ,CNKI and VIP .Only randomized controlled trials (RCT ) that evalua-ting inhaled corticosteroids and montelukast for children were included .The Cochrane collaboration risk bias tools was used to eval-uated the quality of literature .Results The patients with inhaled corticosteroids had a better effect in FEV 1% and PEF than pa-tients with montelukast ,the incidences of adverse drug reactions had no statistically significant difference .The patients with inhaled corticosteroids combined with montelukast had a better effect in FEV 1% or PEF than patients with inhaled corticosteroids only . Conclusion The effect of inhaled corticosteroids is better than montelukast ,the effect of inhaled corticosteroids combined with montelukast is better than inhaled corticosteroids only ,and has drug safety .

[Objective]To investigate the clinical result of the Chinese traditional medicine combed with western medicine treatment for proximal humerus malunited fracture.[Method]Twenty-nine patients including 24 men and 5 women with malunion of proximal humerus were treated with the locking proximal plate.The average age of patients was 41.6 years old(from 21 to 53 years old).According to Neet classification on X ray,20 cases were two-part fractures and 9 cases were three-part fractures.These patients were treated by combination of Chinese traditional and western medicine,with the help of the functional training.All patients with proximal humerus malunited fracture were treated by operations with locking proximal humerus plate.A herbal bath was used to bathe after surgery.[Result]All 29 cases were available for follow-up.The average time for bony union on X ray was 9.6 weeks(from 8 to 12 weeks).Nonunion was not found in all cases.According to the Neer scoring system,there were 23 excellent cases,4 good case and 2 fair case.The excellent and good rate was 93.1%.[Conclusion]In dealing with proximal humerus malunited fracture,the advantages of the locking proximal humerus plate are minimally invasive with reliable fixation,few complication and the high bone union rate.A herbal bath can fasten recovering the function of the shoulder.Chinese traditional medicine combined with western medicine treatment can make satisfactory result and it is an effective method to recover the function of the shoulder.

Timing of puberty showed a dramatic decrease in the past decades,and it depends on the gene,nutrition,environment,social economics,and so on.Childhood obesity affects both the timing of puberty and sex hormone levels.However,the influence of obesity on the timing of puberty has gender differences.Current studies show that childhood obesity accelerates the onset of puberty in girls,but it still has controversy in boys.Mechanisms of concrete have not clear,may be related to the subjectivity of standard of male sexual development and the correlation of body mass index as a substitute for male obesity is poor.Through literature review at home and abroad,this article will explain the influence of obesity on the timing of puberty,sex hormone levels and its gender differences,further explore the possible mechanisms of body fat participate in starting the gonad axis,and provide new research direction on the switch for the gonad axis.

Objective To explore the correlative factors of asthma after bronchiolitis.Methods Clinical data from 115 hospitalized patients with bronchiolitis were collected from Jan.2002 to May 2003,including age,gender,incidence season,family asthma history,birth weight,eczema,severity of bronchiolitis,pathogen,total and specific immunoglobulin E(IgE),overweight,smoking during pregnancy and feeding patterns;and the data of respiratory tract infection and wheezing onset in those cases were collected by clinic sevice and telephone follow-up in post-discharge for 5 years;the pollution status in living environment(coal dust and mine especially) and animal contact history(especially cats and dogs) were recorded.And the independent effect of risk factors was obtained,Logistic regression models were created for each outcome variable.Results Thirty-nine(33.9%) cases of 115 children with brochiolitis developed into asthma.There were significant differences between asthma and non-asthma group in family asthma history,recurrent lower respiratory tract infection(LRTI) under 1 year old,onset age,severity extent and obesity(P =0,0,0.004,0.004,0.020,respectively).The factors that contribute to the risk of asthma onset were incidence season,severe bronchiolitis,parental asthma,eczema and recurrent LRTI(OR=0.49,3.82,6.12,3.76 and 3.14,respectively P=0.000 7,0.026 0,0,0.030 9,0.000 5).But,the factors of gender,birth weight,congenital heartdisease,pollution status in living envi-ronment,animal contact history,feeding patterns,smoking during pregnancy,age when occured bronchioliyis,blood IgE and overweight had not correlated with asthma after bronchiolitis.Conclusions Severe bronchiolitis,parental asthma,eczema and recurrent LRTI under 1 year old correlate with development of asthma after bronchiolitis,however,falling ill in winter may be a protective factor in the progression of airway inflammation.

Objective To explore the factors affecting severity of infants with bronchiolitis in hospital.Methods Data were collected from hospitalized case of bronchiolitis including age,gender,birth weight,incidence season,overweight,severity of bronchiolitis,clinical manifestation,pathogen,total and specific immunoglobulin-E (IgE),X-ray appearance,family asthma history,eczema,feeding patterns,congenital heart disease,countryside dwelling and length of stay.All cases were divided according severity extent into 2 groups.Then one-factor analytical method was used between 2 groups,and risk factors for these outcomes were identified by Logistic regression analysis.Results 1.Nearly 56%(506 of 904) of children were considered as obesity.2.The positive rate of the virus infection identified from 904 infants with bronc-hiolitis was 78.3%.Of them,the respiratory syncytial virus (RSV) infection accounted for 43.5%,cytomegalovirus (CMV) for 47.6%,coxsackie b virus (CBV) for 7.9%,Mycoplasma pneumonia (MP) for 1.8%,adenovirus (ADV) for 1.7% and epstein-barr virus (EBV) for 0.15%,respectively.3.There were notable differences between mild group and severe group in age,pathogen,birth weight,countryside dwel-ling,congenital heart disease and hospital day(?2=3.47,19.62,2.32,2.61,-4.71,69.23 P=0.001,0.006,0.02,0,0,0).There was a significant association between severe bronchiolitis and young age,low birth weight,congenital heart disease,countryside dwelling and hospital days (OR=0.840,0.542,15.412,5.305 and 1.173,respectively P=0.013 3,0.049 7,0.000 3,0,0.000 2).Conclusions 1.Obesity may have great risk for bronchiolitis.2.Except for RSV,CMV,CBV,ADV,MP and EBV all were pathogens associated with childhood bronc-hiolitis.3.The factors that contribute to increase risk of severe bronchiolitis are young age,low birth weight,congenital heart disease and countryside dwelling.And length of stay may estimate severity of infants with bronchiolitis in hospital.