Objective To study the efficacy of intravitreous injection (IVI) or sub-Tenaninfusion (STi) of triamcinolone acetonide (TA) for diabetic macular oedema. Design Retrospective cases series. Participants 37 cases (37 eyes) with diabetic macular oedema confirmed by fundus fluorescence angiography (FFA) and optical coherence tomography (OCT). Methods Patients were received 4mg TA by single intravitreous injection or 40mg TA by three times sub-Tenoninfusion at 0d, 2w, 4w. The best corrected visual acuity, fundus examination, intraocular pressure, fundus fluorescence angiography were further analyzed, and the retinal thickness of macular fovea were measured by OCT. Main Outcome Measures The visual acuity, thickness of retinal macular fovea, ocular pressure was measured. Results 32 cases (32 eyes) completed the 24 week followed-up. In group IVI, the visual acuity before and after injection was 0.10±0. 03, 0.24±0.06(F=15.459, P=0.000) respectively; and retinal thickness of macular fovea is(460.73±46.33)μm,(394.53±41.43)μm (F=25. 282, P=0.0000) respectively. But in group STi, the visual acuity before and after injection is 0.11±0.04, 0.18±0.07(F=6.989, P=0.000) accordingly; and retinal thickness of maculur fovea is (454.76±56.28)μm,(424.94±42.69)μm (F=5.145, P=0.000) respectively. There was obvious statistical significance between two methods at same time point(all P<0.05). The serious, irreversible complications had not been found in all patients during follow-up. Conclusion Triamcinolone acetonide by single intravitreous injection or repeatedly sub-Tenoninfasion are good ways to relieve diabetic macular oederna, IVA-TA is more effective, and STi-TA safer. (Ophthaimol CHN, 2009, 18: 246-250)

Objective To investigate the clinic effect of using three-dimensional conformal radiotherapy combining with Sanyangxuedai in treating advanced non-small cell lung cancer.Methods Grouping 100 patients with advanced non-small cell lung cancer randomly into a control group and a treatment group,with 50 patients in each.The control group was treated with three-dimensional conformal radiation therapy,the treatment group was treated on the basis of the control group with a ioint Sanyangxuedai.The clinical effects were compared in the two groups.Results The three-dimensional conformal radiotherapy combining with Sanyangxuedai had more better treating indications than using three-dimensional conformal radiotherapy only and the results had statistical significances(χ~2=12.01,P＜0.05).Conclusion The three-dimensional conformal radiotherapy combining with Sanyangxuedai had beaer clinical efrect in treating advanced non-small cell lung cancer.

Objective To observe the clinical effect of treating advanced esophageal carcinoma with three-dimensional conformal radiotherapy combined with chemotherapy and traditional Chinese medicine.Methods 36 cases with advanced esophageal carcinoma were randomly divided into a eontrol group and a treatment group.The control group was treated with conventional radiotherapy combined with chemotherapy,and the treatment group was treated with three-dimensional conforrnal radiotherapy combined with chemotherapy and traditional Chinese medicine.The short-term effect,toxicity and long-term effect were observed,and cause of death was analyzed.Results The complete remission rate in the treatment group was significantly higher than that of the control group(P＜0.05).The toxicity of the treatment group was markedly decreased.One and three years'survival rate between the two groups had a significant difierent(P＜0.05),but five years'survival rate between the two groups had no significant difference(P＞0.05).Local uncontrolled rate and recurrence rate in the treatment group were significantly lower than those in the control group(p＜0.05).Conclusion The treatment of three-dimensional conformal radiotherapy combined with chemotherapy and traditional Chinese medicine on advanced esophageal carcinoma was better than conventional radiotherapy combined with chemotherapy.

Objective To explore the dynamic changes of von willebrand factor(VWF)and Pseleetin in the finger-replanted patients,and the relationship between the prognosis of the surgery and hypercoagulability.Methods From December 2004 to December 2006,eishty finger-replanted patients were recruited to our study.with 40 healthy volunteers as controls.Plasma VWF and P-selectin were detected by enzyme-linked immunosorbent assay(EUSA)in both controls and patients before or after replantation.Results The VWF and P-selectin levels had significant differences between the replantations and controls(F=14.76,11.76,P＜0.01).The VWF levels in the patients of 1,4,8,16 hours after replantation were(1 715±493),(1 396±549),(1 266±504),(1 163±436)U/L respectively,all markedly higher than the controls(P＜0.01).The P-selectin levels in patients of 1,4,8,16,24 hours after operation were(14.7±2.6),(12.5±3.0),(11.8±3.2),(11.1±3.0)、(10.5±2.6)μg/L,significanfly higher than the controls(P＜0.01).The VWF levels in patients of pre-replantion and the 1,4,8,16,24,48,72 hours after replantation were(854±209),(1 535±389),(1 177±407),(1 040±283),(958±216),(829±193),(777±151),(713±137)U/L in successful group,and were(1 202±164),(2 333±243),(2 146±161),(2 039±244),(1 865±170),(1 645±283),(1 427±331),(1 188±262)U/L in unsuccessful groups.They were all significantly different at the same test-time points between two groups(t=4.44,5.12,6.10,8.43,10.17,8.85,5.10.4.61,P＜0.05).The P-selectin levels in patients of 1,4,8,16,24,48,72 hours after replantation were(13.9±2.5),(11.2±2.0),(10.2±1.6),(9.6±1.2),(9.2±0.9),(9.5±0.6),(9.3±0.4)μg/L in successful group,and(17.2±1.0),(16.9±1.0),(17.0±1.3),(16.1±1.1),(14.9±1.5),(13.8±1.4),(12.8±1.2)μg/L in unsuccessful group.Significant difference existed at the same testtime points between two groups again(t=5.22.9.91,10.35,12.79,9.46.9.45,9.33,P＜0.01).After replantation,both VWF and P-selectin were rapidly elevated and went to the summit 4 hours later,then declined to pre-replantation level about 24 to 48 hours later after replantation.Conclusions VWF and P-selectin were associated with the hypercoagulability.Dynamic monitoring VWF and p-selectin may be useful in determining the existence of hypercoagulability and the therapy of anti-coagulability.

Objective To retrospectively analyze the outcomes and adverse effects of sequential therapy of BTD and MPT regimen for the newly-diagnosed multiple myeloma patients no eligible for high dose chemotherapy and stem cell transplantation. Methods Thirty-six patients were involved in this study and the patients were treated with tandem therapy of BTD and MPT regimen. The patients were treated with BTD regimen as induced therapy no less than 2 cycles. When the patients got PR or above PR,they were treated with MPT regimen as consolidation therapy which was no less than 2 cycles. Then,the patients who achieved PR or partial PR were received MPT chemotherapy regimen as consequent treatment. After that,low dose thalidomide was used as maintenance therapy. The outcomes and adverse effects were retrospectively evaluated. Results Thirty-six patients were treated with BTD regimen as induced therapy. The results were that 7 patients (19.4 %) achieved CR,8 (22.2 %) VGPR,14 (38.9 %) PR and the OR rate was 80.6 %. The patients (n=29) who achieved no less than PR was treated with MPT regimen as consequent therapy. The results were that four patients were in progression and the others were stable. Twenty-five patients were treated with low dose thalidomide as maintenance therapy. The median progression-free survival (PFS) did not reached yet until last follow-up (median follow-up time was 16.5 months). One-year overall survival rate was expected 86.0 % and 3-year expected overall survival rate was 77.0 %. The main regimen-associated toxicities included thrombocytopenia,peripheral neuropathy (PN),Herpes Zoster,gastrointestinal symptoms,anemia,neutropenia,constipation,fatigue,rash and so on. The incidence of grade 3 and 4 adverse events was low. Conclusion Sequential therapy of BTD and MPT regimen can be used as the front-line therapy for the newly-diagnosed multiple myeloma patients no eligible for high dose chemotherapy and stem cell transplantation.

Objective To evaluate the efficacy and safety of lenalidomide(Len)-based regimens in the treatment to patients with multiple myeloma (MM). Methods Twenty-five multiple myeloma patients who received Len-based regimens were enrolled in this study. There were 5 newly-diagnosed MM patients, 13 relapsed/refractory (rel/ref) MM and 7 MM patients at plateau after treatment. The newly-diagnosed patients received R-PAD regimen, rel/ref MM received R-MD and the patients at plateau(maintenance treatment group) due to more than 2 grade peripheral neuropathy (PN) received Len monotherapy. Results All of the five newly-diagnosed MM achieved complete remission (CR) (100 %) after 2 courses of theatment; of 13 rel/ref patients (76.92 %) achieved overall response, including 3 (23.08 %) achieving CR, 2 (15.38 %) very good partial response (VGPR), 5 (38.46 %) partial response (PR) and the overall response rate was 76.92 %. Two of the other three no response patients had stable disease(SD) and one had progress disease(PO). The seven patients in maintenant treatment group maintained remission in an average follow-up period of 38 weeks and their PN was relieved in various degrees. Conclusion R-PAD regimen is a highly active regimen for newlydiagnosed MM and R-MD regimen is a promising regimen for rel/ref MM, especially for the patients with serious PN; Len may be a good choice as maintenant chemotherapy for the patients with PN.

Objective To evaluate the efficacy and safety of lenalidomide in a real-world clinical practice in Chinese patients with multiple myeloma (MM).Methods It was a prospective,multi-center,observational study.A total of 165 consecutive patients with MM treated with lenalidomide-based regimens were enrolled in 12 hospitals from June 2013 to November 2015.Relevant information was recorded,such as baseline clinical data,cytogenetic abnormalities,treatment regimens,and duration of treatment,safety,and survival.Results (1)There were 126 relapsed and refractory MM (RRMM) patients,25 newly diagnosed patients and 19 maintenance patients.The evaluable RRMM patients accounted for 120 cases,among which 74 cases(61.7％) reached the partial response (PR) or above,and a very good partial response (VGPR) in 16 patients (13.3％),a complete response (CR) in 14 cases (11.7％),a strictly complete response (sCR) in 4 cases (3.3％).Thus,a VGPR or above in 34 patients accounted for 28.3％.(2)The median follow-up was 13 months,the median time to progression 12 months.The median survival after receiving lenalidomide was 19 months,and the median overall survival (OS) was 62 months.(3) The univariate analysis in 120 RRMM patients suggested that prognostic factors for significant improvement in PFS included normal karyotype,international staging system (ISS) Ⅰ-Ⅱ,t(4;14) negative (detected by fluorescence in situ hybridization),non-bortezomib resistance and response to previous regimens.As to OS,nonbortezomib resistance,response to previous regimens and non-primary refractoriness were positive factors.Multivariate analysis showed that the response to previous regimens (PR or better) was an independent good prognostic factor for progress-free survival (PFS),non-bortezomib resistance and non-primary refractoriness for OS.(4) Grade 3 or 4 adverse events that occurred in more than 10％ of all enrolled patients were neutropenia (12.7％),leukocytosis (11.5％) and thrombocytopenia (12.7％).Owing to intolerance of toxic side effects,7 cases withdrew lenalidomide.Conclusions No matter what combination,regimens containing lenalidomide are effective to RRMM patients with overall response rate 61.7％,a time to progression 12 months and an overall survival 62 months.The toxicity is quite tolerable and manageable.In addition,the response to previous treatment (reached PR or above) is the independent good prognostic factor for PFS,non-bortezomib resistance and non-primary refractoriness for OS.Clinical trail registration Clinicaltrials.gov,NCT01947309

Objective:To verify the predictive value of the Second Revision of the International Staging System (R2-ISS) in newly diagnosed patients with multiple myeloma (MM) who underwent first-line autologous hematopoietic stem cell transplantation (ASCT) in a new drug era in China.Methods:This multicenter retrospective cohort study enrolled patients with newly diagnosed MM from three centers in China (Beijing Chao-Yang Hospital, Capital Medical University; the First Affiliated Hospital, Sun Yat-Sen University, and the Second Affiliated Hospital of Naval Medical University) from June 2008 to June 2018. A total of 401 newly diagnosed patients with MM who were candidates for ASCT were enrolled in this cohort, all received proteasome inhibitor and/or immunomodulator-based induction chemotherapy followed by ASCT. Baseline and follow-up data were collected. The patients were regrouped using R2-ISS. Progression-free survival (PFS) and overall survival (OS) were analyzed. The Kaplan-Meier method was used to analyze the survival curve and two survival curves were compared using the log-rank test. Cox regression analysis were performed to analyze the relationship between risk factors and survival.Results:The median age of the patients was 53 years (range 25-69 years) and 59.5% (240 cases) were men. Newly diagnosed patients with renal impairment accounted for 11.5% (46 cases). According to Revised-International Staging System (R-ISS), 74 patients (18.5 %) were diagnosed with stage Ⅰ, 259 patients (64.6%) with stage Ⅱ, and 68 patients (17.0%) with stage Ⅲ. According to the R2-ISS, the distribution of patients in each group was as follows: 50 patients (12.5%) in stage Ⅰ, 95 patients (23.7%) in stage Ⅱ, 206 patients (51.4%) in stage Ⅲ, and 50 patients (12.5%) in stage Ⅳ. The median follow-up time was 35.9 months (range, 6-119 months). According to the R2-ISS stage, the median PFS in each group was: 75.3 months for stage Ⅰ; 62.0 months for stage Ⅱ, 39.2 months for stage Ⅲ, and 30.3 months for stage Ⅳ; and the median OS was not reached, 86.6 months, 71.6 months, and 38.5 months, respectively. There were statistically significant differences in PFS and OS between different groups (both P<0.001). Multivariate Cox regression analysis showed that stages Ⅲ and Ⅳ of the R2-ISS were independent prognostic factors for PFS ( HR=2.37, 95% CI 1.30-4.30; HR=4.50, 95% CI 2.35-9.01) and OS ( HR=4.20, 95% CI 1.50-11.80; HR=9.53, 95% CI 3.21-28.29). Conclusions:The R2-ISS has significant predictive value for PFS and OS for transplant-eligible patients with MM in the new drug era. However, the universality of the R2-ISS still needs to be further verified in different populations.