Objective Extramedullary plagmocytoma at diagnose or during the course of multiple myeloma is rare.In order to know this entity better and explore new therapy for it,by combining with literature review,we conducted a retrospective study to describe the clinical and laboratory features of this entity and the outcome of these manirestation.Methods From January 2001 to July 2007,123 multiple myeloma patients were treated in our hospital.We analysed the clinical features of patients with extramedullary plagmocytoma at diagnose or during the course of multiple myeloma.The response to therapy was evaluated according to the EBMT criteria.Results 9 eligible patients out of 123 with MM were retrieved from the hematology department of Beijing Chaoyang hospital.The median age was 55(range:48～66)with a female/male ratio of 1/8.One patients was found to have Extramedullary and extraosseous tumor at the time of MM diagnose,and eight patients developed Extramedullary tumor during the course of the disease.Multiple sites were usually involved.Resistance to traditional chemotherapy wag frequent.With a median follow-up of 19 months(range:3～47),2 patients are alive.Median time from progression of disease to diagnose of Extramedullary disease was 4 and a half months.The median interval from diagnosis of Extramedullary disease to death was 2 months and OS was 23 months.Conclusion Extramedullary plasmocytoma is a rare manifestation of MM,with a cumulative incidence of 7.3% of MM in our department.Multiple sites are usually involved.The resistance to the traditional chemotherapy is frequent and the prognosis is very poor.The new therapy is necessarily explored.

Objective To investigate the effects of right or left transaction of cervical sympathetic trunk (TCST) on left ventricalar remodeling (LVRM) after acute myocardial infarction in rats and the mechanism. Methods Sixty-four adult mule pathogen-free SD rats (230-250 g) were randomly divided into 4 groups (n=16 each): group Ⅰsham operation (group S) ; group Ⅱ LVRM; group Ⅲ left TCST and group Ⅳ right TCST. Myocardial infarct was induced by ligation of left anterior descending branch (LAD) of coronary artery in group Ⅱ, Ⅲ and Ⅳ. Left and right TCST were performed immediately after myocardial infarct was successfully induced in group Ⅲ and Ⅳ respectively. In group S LAD and cervical sympathetic trunk were exposed but not ligated and transected. The animals were killed at 4 weeks after ligation of LAD and TCST. The weight of left ventricle was measured and left ventricle weight index calculated, Left veatricular myocardial tissue volume (V_t), the volume density of myocardial cells (V_v) and myocardial cell volmne (V_c) were quantitatively analyzed by stereological method. The c-fos mRNA expression in myocardium was determined by RT-PCR. Results The left ventricle weight index, V_t, V_c and c-fos mRNA expression were significantly increased in group LVRM (Ⅱ), left and right TCST (Ⅲ, Ⅳ) as compared with group S. Left ventricle weight index, V_v, V_t, V_c and c-fos mRNA expression were all significantly decreased in fight TCST group (Ⅳ), while left ventricle weight index, V_t, V_c and c-fos mRNA expression were significantly increased in left TCST group (Ⅲ) as compared with LVRM group (Ⅱ). Conclusion Right TCST down-regulates the increase in c-fos mRNA expression after acute myocardial infarction and inhibits the left ventricular remodeling while left TCST up-regulates the c-fos mRNA expression and promotes the development of left ventricular remodeling.

Objective:To investigate the relationship of family history , psychosocial factors of PD (Parkinson's Disease) in a rural population in north China. Methods: A case control study was conducted in rural population in China. Cases (n=77) have been diagnosed by a two-phase screening by neurologists and interviewers in May, 2000. Controls (n=154), randomly selected from the same cohort, who were matched with patients (control/cases ra-tio=2) for sex, age (?5 years). Information of participants' characteristics came from the interview in 2001. Data was analyzed by using conditional logistic regression by SAS 6.12. Results: Family history (OR=13.54) .negative life events (OR=3.02), interpersonal communication (OR=2.10) were associated with a significantly elevated risk for the onset of PD. Conclusion: These results indicate that family history, psychosocial factors were risk factors of PD.

Objective To observe vasculogenic mimicry (VM) of human choroidal melanoma cell line OCM-1 cultured in vitro and the expression of PI3K and EphA2 protein,as well as to explore the possible mechanisms.Methods OCM-1 cells were cultured in vitro and stained with periodic acid Schiff (PAS) on days 7,which aimed to observe the formation of PAS-positive cyclic structures,that is,VM formation.Then immunohistochemical staining was performed to detect PI3K and EphA2 on day 1,4,7 and the results were observed.Ressults On day 4 of 3-demintional culture,most of OCM-1 cells were polygonal and the cytoplasm was abundant;the nuclei were round and the nucleoli were visible.A small part of the tumor cells were long spindle.It was found that several long spindle cells were connected to each other to form hemicyclic structure.After 7 days,a large number of tumor cells became long spindle,growing along the collagen scaffold,and long protrusions appeared,forming a ring structure.PAS staining showed that the tumor cells were mostly arranged in a row,and tumor cells imitated the formation of body blood vessels,resulting in cell band and pipeline-like cell layers,with one layer of extracellular matrix (PAS-positive substance) making up the ring structure.Moreover,the expression levels of PI3K and EphA2 on day 4 and 7 were significantly higher than those on day 1 (all P ＜ 0.05),and their expression levels on day 7 were higher than those on day 4 (all P ＜ 0.05).Conclusion EphA2 and PI3K may play an important role in the VM formation in 3-dimentional culture of human choroidal melanoma cell line OCM-1.

OBJECTIVE:To find out a cost-efficient antibiotic prophylaxis of p ul monary and esophageal surgery by way of pharmacoeconomic analysis METHODS:To c ompare the efficacy and cost between short-term and long-term of prophylactic uses of ceftriaxone in pulmonary and esophageal surgery by randomized controlled study and cost-effectiveness analysis RESULTS:Single-dose ceftriaxone regim en and four-dose ceftriaxone regimen were equally effective in preventing posto perative infections in pulmonary and esophageal surgery,the average cost per pa tients for single-dose ceftriaxone regimen(1 257 84?769 67)yuans was signi ficantly lower than that for four-dose ceftriaxone regimen(1 786 69?652 83 ) yuans,P

Objective To investigate incidence,diagnosis and treatment strategy of delayed esophageal complications after anterior cervical spine surgery.Methods The clinical data of 2316 patients who had undergone anterior cervical spine surgery from January 2001 to December 2011 were analyzed.The delayed esophageal complications were defined as esophageal perforation,esophago-tracheal fistula,esophago-cutaneous fistula,diverticulum of esophagus,esophagopleural fistula and esophageal stenosis that occurred 2 weeks after spine surgery.Results Delayed esophageal complications occurred in 4 patients,and the incidence was 0.17％.Esophageal perforation occurred in 2 patients; the incidence was 0.09％.Case 1 was a 31-year-old man who was found to have esophageal diverticulum and perforation 7 years after anterior cervical spine surgery.Then he underwent removal of implant,excision of diverticulum,and repair of esophagus with sternohyoid muscle flap and omohyoid muscle flap.Case 2 was a 46-year-old man who was found to have esophageal diverticulum 3 years after cervical spine surgery.He also underwent removal of implant,excision of diverticulum,and repair of esophagus with sternohyoid muscle flap and omohyoid muscle flap.Case 3 was a 58-year-old woman who was found to have esophageal diverticulum 5 years after cervical spine surgery.She underwent removal of implant,excision of diverticulum,and repair of esophagus with sternocleidomastoid muscle flap.Case 4 was a 56-year-old woman who was found to have esophageal perforation 3 years after cervical spine surgery.She underwent removal of implant and repair of esophagus with sternocleidomastoid muscle flap.All 4 patients recovered after operation.Conclusion The incidence of delayed esophageal complications after anterior cervical spine surgery is low,and the diagnosis is difficult.X-ray,digestive tract radiography,and gastrointestinal endoscopy are the main diagnostic tools.Surgical treatment is the main and effective management.

Objective To analyze and evaluate neoadjuvant chemotherapy's value and significance in combining with surgical treatment for limited small cell lung cancer(LD-SCLC).Methods A total of 94 LD-SCLC patients underwent complete resections combined with chemotherapy between January 2000 and January 2011 in Shanghai Pulmonary Hospital.Among these cases,initial two cycles of neoadjuvant chemotherapies were performed for all pathologically confirmed patients (Group A),and initial operations followed by adjuvant chemotherapy were administered to patients without pathology (Group B).The survival rate was analyzed by log-rank test and Kaplan-Meier method.Multivariate analysis of the prognostic factors was performed using Cox's regression model.Results Group A included 43 cases and Group B included 51 cases.The mean age was (56.37 ± 10.18) years.According to the 6th edition of Tumor,Node,Metastasis(TNM) classification of lung cancer,54 cases were at stage Ⅰ or Ⅱ,40 cases were at stage Ⅲ.Overall 5-year survival(5-YS) was 27％.The 5-YS for patients with stage Ⅰ-Ⅱ was notably better than that of stage Ⅲ (34％ vs 20％,P =0.033).For patients with stage Ⅲ,the 5-YS of Group A was significantly better than that of Group B(34％ vs 12％,P =0.020),besides median overall survival for Group A and Group B were 46 and 15 months(P =0.009).Furthermore,the results of multivariate analysis showed that neoadjuvant chemotherapy,surgery and histopathology of SCLC were independent factors that strongly affected survival and prognosis.Conclusion In combined surgical treatment for LD-SCLC,neoadjuvant chemotherapy obviously improved the prognosis of patients with stage Ⅲ.Therefore,it was very important and necessary that pre-surgical neoadjuvant chemotherapy was administered to resectable stage Ⅲ LD-SCLC patients.

Objective To investigate the expression of lung keratinocyte growth factor receptor (KGFR) in rats with acute spinal cord injury (ASCI) in different time points and its role in lung edema.Methods Thirty-two adult Wistar rats weighing 240 g to 260 g were assigned to experimental group (n =16) and control group (n =16) according to the random number table.Each group consisted of time points of 24 hours,3 days,1 week and 2 weeks after the modeling (4 rats per time point).A rat model of ASCI in experimental group was induced at C7 segment by dropping a weight of 10 g from the height of 2.5 cm (Allen' s method).In control group,laminas were removed only,leaving spinal cord at C7 intact.Rats were sacrificed at each time point for measurement of lung wet/dry weight ratio,Western blot analysis of expression of lung KGFR protein and RT-qPCR detection of lung KGFR mRNA expression.Results After ASCI in rats,the expressions of lung KGFR protein and mRNA began to drop at 24 hours (0.23 ±0.06,0,012 1 ±0.002 3),reached the trough at 3 days (0.17 ±0.04,0.008 5 ±0.001 7)and picked up at 1 week.Expression of lung KGFR mRNA in experiment group showed statistically significant difference from that in control group at 24 hours and 3 days (P ＜ 0.05),whereas in each time point the difference of KGFR protein expression between experiment and control groups was statistically significant(P ＜0.05).Variation trend of KGFR expression was in parallel with the severity degree of pulmonary edema.Conclusion Lung KGFR presents significant down-regulation in ASCI rats and this may be associated with the development of pulmonary edema after ASCI.

Traditional Chinese medicines (TCM) is one of the most important sources of new drugs.The rapid development of modern science and technology has brought new opportunities for TCM.Admittedly,new academic theory is getting into a golden period of innovation.Key technologies that enbody TCM features and adapt to modern drug-screening requirements are urgently needed.After five years' endeavor,the authors' group has made great progress in the new theories and methodologies for the discovery of bioactive compounds from TCM.In this review,a total of five key technologies:library-bioactivity-structure integration,biological and chemical fishing technology,ligand-and receptor-based virtual screening,profile-bioactivity relationship and the technology for discovering bioactive equivalent combinatorial components (BECCs),were introduced.In the text,several valuable demonstrations over the TCM-based drug discovery were provided,for uncovering the scientific basis of TCM and accelerating the process of TCM modernization.

Objective To evaluate the role of CT imaging in staging of hypopharyngeal and laryngeal carcinoma.Methods 85 patients with hypopharyngeal or laryngeal carcinoma proved by operation were examined contrast-enhanced CT scan.The CT images were analysed by two experienced radiologists who were unknown pathologic results,in combination with the clinical data,the TNM staging of tumors were evaluated,then the results were compared with that of pathology,and Wilcoxon rank sum test was used for statistical analysis.P value less than 0.05 was considered statistically significant.Results The accuracy of the staging of lesions was 70.1% based on clinical data alone,while the clinical informations in combination with CT,the accuracy reached 87.1%,that was of significant statistically(P=0.001).Conclusion CT imaging is useful in staging of hypopharyngeal and laryngeal carcinoma,especially when it is combined with clinical data.