BACKGROUNDLenalidomide has emerged as an important treatment for patients with multiple myeloma (MM). However, its role in the management of MM is still controversial and requires further clarification. The aim of this study was to evaluate efficacy and safety of lenalidomide for MM using a meta-analysis.

METHODSWe searched the electronic databases including: PubMed, EMBASE and the Cochrane Center Register of Controlled Trials. Seven randomized clinical trials were identified, which included a total of 2357 patients with MM who received lenalidomide-containing, noncontaining lenalidomide regimens or placebo as induction therapy or maintenance therapy. The outcomes included overall response (OR) rate, complete response (CR) rate, 3-year progression-free survival (PFS) rate, 3-year overall survival (OS) rate, and different types of treatment-related adverse events. We calculated the risk ratios (RRs) as well as their 95% confidence intervals of these outcomes and pooled the results using RevMan 5.2 software.

RESULTSFor patients with previously untreated MM, OR rate and CR rate was significantly higher in lenalidomide-containing group than the control group. For relapsed or refractory MM patients, lenalidomide-containing regimens significantly improved the OR rate, CR rate, 3-year PFS rate and 3-year OS rate. With regard to MM patients after autologous stem cell transplantation, lenalidomide maintenance therapy significantly improved 3-year PFS rate but did not result in improved 3-year OS rate. In terms of toxicities, lenalidomide therapy has a higher rate of Grade 3-4 grade cytopenias, infection, deep-vein thrombosis, and diarrhea. Furthermore, the incidence of second primary malignancies was significantly higher in the lenalidomide group.

CONCLUSIONSThe lenalidomide-containing regimens as induction therapy clearly increased response rates and improved intervals of survival with acceptable toxicity rates for patients with MM. However, when physicians choose to use the lenalidomide as maintenance therapy, whether the benefits outweigh the risks should be taken into account.

Angiogenesis Inhibitors ; adverse effects ; therapeutic use ; Humans ; Multiple Myeloma ; drug therapy ; Randomized Controlled Trials as Topic ; Thalidomide ; adverse effects ; analogs & derivatives ; therapeutic use ; Treatment Outcome

Objective To observe the clinical efficacy and safety of dantrolone sodium capsules in thethrombolytic therapy of acute stroke.Methods One hundred and thirty-six patients with acute stroke were randomly divided into control and treatment groups with 68 cases per group. Control group was given routine thrombolytic therapy + low molecular weight heparin calcium 0. 4 m L per, q12 h, subcutaneous injection for 10 days + aspirin 100 mg per time, qd, orally for 3 months.Treatment group was given dantraline sodium capsules 25 mg per time, qd, orally for 3 months after thrombolytic therapy, on the basis of control group. The clinical efficacy, American institutes of health stroke scale (NIHSS) scores and adverse drug reactions were compared between two groups. Results After treatment, the total effective rates of treatment and control groups were 77. 94％ (53 cases/68 cases) and 54. 41％ (37 cases/68 cases) with significant difference (P < 0. 05) . The NIHSS scores of treatment and control groups were (16. 07 ± 1. 18) and (18. 27 ± 1. 21) at 7 days after thrombolytic therapy, and those were (12. 15 ± 1. 06) and (16. 84 ± 1. 10) at 3 months after thrombolytictherapy. The differences were statistically significant between two groups (all P < 0. 05) . The adverse drug reactions of control group were gastrointestinal reaction, hematuria, sleepiness and asymptomatic cerebral hemorrhage, which in treatment group were gastrointestinal reaction, lethargy, fatigue, dizziness, asymptomatic cerebral hemorrhage and hematuria. The total incidences of adverse drug reactions in treatment and control groups were 17. 65％ and 13. 24％without significant difference (P> 0. 05) . Conclusion Dantraline sodium capsule is effective in thrombolytic therapy for acute stroke, without increasing the incidence of adverse drug reactions.

This study was purposed to investigate the expression of c-fes gene in leukemia patients and its clinical significance. The expression of c-fes mRNA in bone marrow cells from 121 cases of acute and chronic leukemia patients, and the expression of c-fes mRNA in peripheral blood mononuclear cells of 20 normal persons were detected by real time-quantitative reverse transcription polymerase chain reaction (RQ-PCR). The results showed that the level of c-fes mRNA in AML patients was higher than that in normal controls [(48.017 +/- 57.170) x 10(-3) vs (0.152 +/- 0.398) x 10(-3)] (p < 0.0001); but there was no significant differences of level of c-fes mRNA between samples of ALL and normal controls(0.047 +/- 0.068) x 10(-3) vs(0.152 +/- 0.398) x 10(-3) (p>0.05); the level of c-fes mRNA in CML patients was higher than that in normal persons (21.605 +/- 24.818) x 10(-3) vs (0.152 +/- 0.398) x 10(-3) (p < 0.0001). The positive expression rate of c-fes gene in CML-CP patients (80%) was higher than that in CML-AP patients (66.7%) and CML-BP (28.6%) patients. In AML patients, c-fes gene was expressed higher in M(2) (80.77%) and M(3) (92.86%) patients. The remission rate of AML (except M(3))patients who had expression of c-fes gene was 81.08%, which was higher than that of patients with no expression of c-fes gene (40.00%). It is concluded that c-fes gene expression was found in myeloid leukemias, whereas low or no expression in lymphocytic leukemias. The differentiation of myelocytic cells may be related to c-fes gene. All AML (except M(3))patients with high level of c-fes mRNA may get good prognosis.
Adult ; Case-Control Studies ; Female ; Gene Expression ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; genetics ; Leukemia, Myeloid ; genetics ; Leukemia, Myeloid, Acute ; genetics ; Male ; Prognosis ; Proto-Oncogene Proteins c-fes ; genetics ; RNA, Messenger ; genetics

OBJECTIVETo investigate the prevalence and natural outcome of late-life depression in the community and to analyze the risk-prediction models.

METHODSA community in Hang Zhou was selected as a trial. A total of 1 275 persons aged 60 or more in this community were screened by PHQ-9 questionnaire; SCID was used for interviewer to diagnostic interview the people whose PHQ-9 was more than 10 points, 50 % of those whose PHQ-9 was from 5 to 9 points and 5 % of those whose PHQ-9 was less than 5 points, then all those who accepted diagnostically interview were interviewed by PHQ-9 every 3 months in one year, and were diagnostic interviewed by SCID in the last month. Logistic regression analysis was used to explore depressive risk factors in 12 months.

RESULTSThere were 141 (11.1%) persons whose PHQ-9 score was more than 10 points, 298 (23.4%) whose PHQ-9 score were 5-9 points, and 836 (65.5%) whose PHQ-9 score were 0 to 4 points in the preliminary survey, 93 were major depressive disorder (MDD). The prevalence of late-life depression was 7.3%. Compared with the PHQ-9 score in one year, 17.6% of those with no depressive symptoms emerged depression; 50% of those who had depressive symptoms declined, 9% developed to significant depressive symptoms, and 41% did not change; 12% of those with significant depressive symptoms were found no depression, 24% reduced, and 64% still had depression. The significant predictors were the accumulation of disease, social support, educational level, daily capacity and baseline of depression.

CONCLUSIONThe prevalence of late-life depression was high. The rates of recognition, diagnosis and treatment were low. The natural outcome after a year did not relieve apparently. Specialist-community health partnership management model is one of the important ways to prevent and treat late-life depression.

Aged ; Aged, 80 and over ; Depression ; diagnosis ; epidemiology ; etiology ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Male ; Mass Screening ; Middle Aged ; Prevalence ; Prognosis ; Risk Factors ; Surveys and Questionnaires

BACKGROUNDThe use of transanastomotic stents for Roux-en-Y hepatojejunostomy (RYHJ) in liver transplantation (LT) remains controversial. The aim of this retrospective study was to assess the role of transanastomotic stent for RYHJ in LT.

METHODSRYHJ for biliary reconstruction in LT was performed in 52 patients. Twenty-five patients had bile duct reconstruction by RYHJ with transanastomotic stents (S group), while 27 patients underwent the same procedure without transanastomotic stents (non-S group). The two groups were compared in terms of post-LT biliary complications and survival.

RESULTSThe incidences of bile leakage, anastomotic stricture, non-anastomotic stricture, biliary sludge/lithiasis and biliary infection were 12% (3/25), 9.5% (2/21), 23.5% (4/17), 11.8% (2/17), and 24% (6/25), respectively in the S group, and 0, 0, 20.0% (5/25), 10.0% (2/20), and 16.7% (4/24), respectively in the non-S group. One and three year survival rates were 48.0% (12/25) and 34.0% (8/23), respectively, in the S group and 57.7% (15/26) and 38.9% (7/18), respectively, in the non-S group. There was no significant difference between the two groups in terms of the incidence of various biliary complications and survival (P > 0.05).

CONCLUSIONThe routine use of transanastomotic stents is not necessary for RYHJ for biliary reconstruction in LT.

Adult ; Anastomosis, Roux-en-Y ; Female ; Humans ; Liver Transplantation ; methods ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Treatment Outcome

40 IU/ml were used as cut-off points.(4) TSH level was higher in subjects with positive thyroid autoantibodies than those without antibodies (P

Rabies is a zoonosis caused by rabies virus for which no effective treatment is available.The main preventive measure is vaccination with human rabies vaccine before or after rabies exposure.With progress in science and technology,the production process of human rabies vaccine has continually advanced,thereby increasing vaccine quality,and providing a safer,more effective means of rabies prevention and control through increasing human resistance to rabies.New human rabies vac-cines have made breakthroughs in basic research and clinical research.However,the problems of poor vaccine compliance and low vaccination rates must urgently be addressed.China must actively explore effective coping strategies,accelerate the upda-ting of existing immunization procedures,effectively increase the rabies vaccination rate,and achieve the goal of eliminating ra-bies by 2030 as soon as possible.

Objective To investigate the depression in relatives of liver transplant (LT)recipients and explore its influencing factors.Methods LT recipients received LT in our center from January 2003 to December 2008 were introduced; the depression in relatives of these LT recipients were assessed by Self-rating Depression Scale (SDS) and compared with that of general population.Results The scores of depression in relatives of LT recipients was (39.06± 11.20) and was statistically significantly higher than that of the norm (33.46±8.55,n=1000,P＜0.05).Among them,41 relatives had no depression,6 mild depression and 3 moderate depression; none had severe depression.The incidence of depression in this group was 18％.Conclusion The level of depression in relatives of LT recipients is higher than that of general population; and much attention should be paid to the relatives of LT recipients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Autoantibodies ; blood ; China ; epidemiology ; Female ; Humans ; Hypothyroidism ; epidemiology ; Iodine ; administration & dosage ; urine ; Male ; Middle Aged ; Prevalence ; Thyroid Gland ; immunology ; Thyrotropin ; blood

BACKGROUNDThe etiologic agent of severe acute respiratory syndrome (SARS) has been confirmed to be a novel coronavirus (CoV), namely SARS-CoV. Developing safe and effective SARS-CoV vaccines is essential for us to prevent the possible reemergence of its epidemic. Previous experiences indicate that inactivated vaccine is conventional and more hopeful to be successfully developed. Immunogenicity evaluation of an experimental inactivated SARS-CoV vaccine in rabbits was conducted and reported in this paper.

METHODSThe large-scale cultured SARS-CoV F69 strain was inactivated with 0.4% formaldehyde and purified, then used as the immunogen combined with Freund's adjuvant. Eight adult New Zealand rabbits were immunized four times with this experimental inactivated vaccine. Twelve sets of rabbit serum were sampled from the third day to the seventy-fourth day after the first vaccination. The titers of specific anti-SARS-CoV IgG antibody were determined by indirect enzyme-linked immunosorbent assay, and the neutralizing antibody titers were detected with micro-cytopathic effect neutralization test.

RESULTSRapid and potent humoral immune responses were induced by the inactivated SARS-CoV vaccine in all the eight test rabbits. Titers of both specific IgG antibody and neutralizing antibody peaked at about six weeks after first vaccination, with the maximum value of 1:81 920 and 1:20 480, respectively. After that, serum antibody levels remained at a plateau or had a slight decrease, though two boosters were given in the succedent 4 to 5 weeks. Cross neutralization response existed between SARS-CoV F69 strain and Z2-Y3 strain.

CONCLUSIONSThe inactivated SARS-CoV vaccine made from F69 strain owns strong immunogenicity, and the cross neutralization response between the two different SARS-CoV strains gives a hint of the similar neutralizing epitopes, which provide stable bases for the development of inactivated SARS-CoV vaccines.

Animals ; Antibodies, Viral ; blood ; Immunoglobulin G ; blood ; Neutralization Tests ; Rabbits ; SARS Virus ; immunology ; Vaccines, Inactivated ; immunology ; Viral Vaccines ; immunology