Multiple myeloma is a malignancy of plasma cells,which is still incurable now.Despite dramatic improvement of the response rate and overall survival have been made due to the application of target therapy and stem cell transplantation,the treatment effect is difficult to maintain,nearly all patients will eventually relapse and become refractory.At relapse,the challenge is to select the appropriate treatment for each patient.The decision will be both disease-dependent and patient-dependent.

Humans ; Multiple Myeloma ; Neoplasm Recurrence, Local

Objective To understand the influencing factors of satisfaction degree with nursing in our hospital by investigation in satisfaction degree in central injection room.Methods 252 patients were selected in our hospital from January to December 2011 as the research object,questionnaires were used to investigate the patients,and the influencing factors of satisfaction degree of nursing work were analyzed.Results Among the patients who accepted the investigation,patients' satisfaction scores were correlated with the patients' age,education level,income level,inpatient department,hospital stay time and whether they accepted an operation.Conclusions Nursing staff should pay attention to and strengthen the nursing work quality and efficiency,improve the satisfaction degree with nursing of clinical patients.

Objective To analyze the application of antibiotics in the national essential drug list used by women in obstetric medical institutions at all levels of Western Hunan ( Basic Medical and Health Institutions Part,2009 version).Methods Medical records were reviewed respectively from May,2010 to December,2010.Results The rate of the use of antibiotics in the essential medicines list in township hospitals was more than 50％,which was higher than that of the secondary and tertiary hospitals.Conclusion The management of the use of medicine in the essential medicines list in hospitals at all levels should be strengthened to control the delivery cost.

Objective To explore the relationship bewteen serum cystatin C (Cys-C )and glomerular filtration rate(GFR) in creatinine-blind range elderly patients. Methods From Jan.2002 to Dec.2003,in the Affiliated Hospital of Luzhou Medical College,the study was performed in 86 elderly patients with chronic renal disease.Serum Cys-C was determined by particle-enhanced immunoturbidimetry.Serum creatinine(Scr) was determined by auto-analyzer.Creatinine clearance rate(Ccr) was estimated by CockCroft-Cault formula.For statistical evaluation,linear regression analysis was used. Results Concentration of Cys-C increased in 56 patients(56.1%).When Ccr was higher than 59mL/min,concentration of Cys-C increased in 44.2% patients.Significant positive correlation was observed between Cys-C and Scr( r =0.89, P

Objective To study the influence of ENH Ⅰ of HBV on immune response of HBV DNA vaccine. Methods DNA fragments of HBsAg and HBsAg-ENH Ⅰ region of HBV, after being amplified by PCR using the complete genome DNA of HBV adr subtype, were inserted into VR1012 vectors. The recombinant plasmids were transfected into COS-7 cells and HepG2 cells, and injected into Balb/C mice. The expression of COS-7 cells, HepG2 cells and the cellular and humoral immune response of mice were determined with Western blot, ELISA and ELSPOT. Results HBsAg was expressed by transfected HepG2 cells and COS-7 cells. The quantity of expression by HepG2 cells increased apparently when transfected by that combined with ENH Ⅰ. In transfected COS-7 cells, there was no significant difference in the expression of HBsAg between those transfected by two recombinant plasmids. The HBsAb and the HBsAg specific CTL were found in mice in the second week after immunization, and there was no marked difference between those immunized by two recombinant plasmids. Conclusions When inserted into HBV DNA vaccine, ENH Ⅰ can promote the expression of HBsAg in transfected HepG2 cells, but can not affect the expression of transfected COS-7 cells and the immune response of immunized Balb/C mice.

Objective:To investigate the effects of extracts of aqueous joint during CIA development on the HUVEC proliferation in vitro and expression of VEGF Methods: 3H TaR incorporation was used to estimate the HUVEC proliferation by extracts of aqueous joint and VEGF, and was used cultured in an absolutely serum free medium Results:Extracts of aqueqous joint during CIA development stimulated proliferation of HUVEC and this proliferation was inhibited by the anti VEGF neutralizing antibody Conclusion:The expression of VEGF in the extracts of the aqueous joint during an early stage of CIA development increased and expressed biologically active

Objective To study the efficacy and side effects of Ganciclovir combined with L-ornithine-L-aspartate on infant cytomegalovirus(CMV) hepatitis.Methods Sixty infants with CMV hepatitis hospitalized in our hospital from Dec.2009 to Dec.2010 were treated with ganciclovir combined with L-ornithine-L- aspartate.The parameters observed in the study included the pre-and post-treatment data on total Bilirubin (TBIL),alanine aminotransferase (ALT),alkaline Phosphatase (AKP)and the retraction of liver and spleen,as well as the adverse reactions of the treatment.Results The treatment significantly decreased serum TBIL (t =5.74,P ＜ 0.05 ),ALT( t =2.92,P ＜ 0.05 ) and liver( t =8.27 P ＜ 0.05 ) and spleen volume ( t =5.03,P ＜0.05).However,side effects such as liver damage and rash occurred occasionally during the ganciclovir treatment.Intravenous infusion of L-omithine-L-aspartate caused side effects such as vomiting and other mild gastrointestinal reactions.Conclusion The treatment of Ganciclovir combined with L-ornithine-L-aspartate on infant cytomegalovirus hepatitis created good efficacy and can be considered as the first treatment choice.Though it is relatively safe,adverse reactions should be monitored during the treatment.

Objective To observe the clinical characteristics of polypoidal choroidal vasculopathy (PCV).Methods Two hundreds fifty-four PCV patients (306 eyes) were enrolled in this study.All the patients were examined for corrected visual acuity (BCVA) testing,slit-lamp microscope,indirect ophthalmoscopy,fundus photography,fluorescein angiography,indocyanine green angiography and optic coherence tomography.Results The patients included 152 males (59.8％) and 102 females (40.2％) ; the age was from 38 to 91 years,with a mean age of (65.4±8.9) years.Bilateral lesions were observed in 52 patients (20.5％) and unilateral lesions were observed in 202 patients (79.5％).BCVA varied from nonlight perception to 1.2.BCVA was lower than ＜0.1 in 167 eyes (54.6％),≥0.1 but ＜0.3 in 92 eyes(30.1％) and ≥0.3 in 47 eyes (15.4％).Vitreous hemorrhage was observed in 61 eyes (19.9％).In 202 patients with unilateral PCV lesions,drusen can be observed in the contralateral eyes of 68 patients (33.7％),exudative age-related macular degeneration changes in the contralateral eyes of 24 patients (11.9 ％),and central serous chorioretinopathy history was positive in the contralateral eyes in nine patients (4.5％).In 306 eyes,there were 43 eyes (14.1％) with high permeable choroid.PCV lesions located at macula area in 199 eyes (65.0％),under the temporal retinal vascular arcade in 49 eyes (16.0％),and peripapillary in 15 eyes (4.9％).PCV lesion formation was single in 110 eyes (35.9％),cluster in 176 eyes (57.5％),string in three eyes (1.0％),branch in four eyes (1.3％),and both single and cluster polyps in 13 eyes (4.2％).There were 125 eyes (40.8％) with sub-neuroretinal fluid,121 eyes (39.5％) with hemorrhagic pigment epithelium detachment,and 73 eyes (22.9％) with serous pigment epithelium detachment.Conclusion PCV patients have higher bilateral incidence and female prevalence,and lower rate of peripapillary lesions.

10 minutes).The average cycle length(CL) at the RAA was 30.6?4.6 msec vs.105.2?32.0 msec at other atrial sites(P