The prognosis for patients multiple myeloma(MM)has improved substantially over the past decade with the development of new,more effective chemotherapeutic agents and regimens that possess a high level of anti-tumor activity.In spite of this important progress,however,nearly all MM patients ultimately relapse,even those who experience a complete response to initial therapy.This summarize provided detailed recommendations on management of relapsed disease,with sections dedicated to diagnostic evaluation,determinants of therapy,and general approach to patients with specific disease characteristics.In addition,the article provided a summary of evidence from clinical trials that have significantly impacted the field,including those evaluating conventional therapies,as well as both autologous and allogeneic stem cell transplantation.Finally,perspective is provided regarding new agents and promising directions in management of relapsed MM.

Objective:To evaluate the cytotoxicity of propolis and calcium hydroxide for human gingival fibroblast.Methods:Human gingival fibroblast(HGF)was incubated in culture solution containing propolis or calcium hydroxide at different concentrations.The relative growth rates(RGR)were examined by method of MTT assay and cytotoxicity was classified by the five-class method.Then the results were statistically analysed.Results:The cytotoxicities of both 0.1% to 0.6% propolis and calcium hydroxide solutions at different concentration were all graded as first or second class.There was no statistical difference between them.Conclusion:Propolis and calcium hydroxide have weak cytotoxicity for HGF and they are all safe as local application for oral diseases.

Objective:To evaluate bacteriostasis effect of domestic-made water-soluble propolis on prevotella intermedia(Pi),fu-sobacterium nucleatum(Fn)and mixture bacteria of Pi and Fn in vitro.Methods:With agar dilution,minimal bactericidal con-centrations(MBC)of propolis for Fn,Pi and mixture bacteria were determined.Results:MBC of propolis for Fn,Pi or mixture bacteria were 0.025%,0.025%,0.05% respectively.Conclusion:Propolis shows the favourable antibacterial activity against the main anaerobic bacterium in infectious root canal which it has a value of application for disinfecting root canal.

Objective:To establish the identification method of Jianpigao Tablets.Methods: The microscopic identification and TLC were used. Results: 8 herbs in Jianpigao Tablets can be identified by microscopic identified. Radix Codonopsis, Rhizoma atractylodis macrocephalea and Radix glycyrrhizae can be identified respectively by TLC.Conclusions: The method is accurate and simple, and can be used for quality control of Jianpigao Tablets.

OBJECTIVE: To observe the clinical efficacy and toxic effects of irinotecan (CPT-11) combined with 5-fluorouracil/leucovorin (5-Fu/LV) in the treatment of advanced colorectal cancer. METHODS: Among 31 cases of advanced colorectal cancer, 30 cases were evaluable. All patients received 2 weeks of therapy regimen: CPT-11 180 mg?m-2 i.v. gtt d1, LV 200 mg?m-2 i.v. gtt d1～2, 5-Fu 400 mg?m-2 i.v. and 5-Fu 600 mg?m-2 i.v. gtt for 22 h, d1～2. A treatment course last for 14 days. 6 weeks later, clinical efficacy was evaluated. RESULTS: Complete remission was observed in 1 case and partial remission 11 cases. The remission rate (RR) was 40%. Stable disease was reported in 14 cases and disease progression 4 cases. Medium time to progress (TTP) was 6.5 months and medium survival time(MST) was 13.9 months. Major toxic reactions were delayed diarrhea (Ⅲ/Ⅳ grade of 30%) and neutropenia (Ⅲ/Ⅳ grade of 26.6%). CONCLUSION: The regimens of CPT-11 combined with 5-Fu / LV have high response rate and tolerable toxicity in treatment of advanced colorectal cancer. It can be use as first or second line chemotherapy for advanced colorectal cancer.

Objective: To compare the cross-section area (CSA) and the immunoreactivity of conjugated-ubiquitin in soleus extrafusal and intrafusal fibers after simulated-microgravity and to demonstrate the role of muscle spindle in muscle atrophy induced by simulated microgravity. Methods: The immunohistochemical technique (ABC) and image analysis were used to assess the conjugated-ubiquitin immunostaining and the cross-sectional area of intrafusal and extrafusal fibers of soleus in simulated-microgravity rats. Results: 1 Tail-suspension caused a progressive loss of soleus mass. Mean fiber CSA of extrafusal fibers were (7 ± 2)%, (21 ± 4)% and (32 ± 7)% smaller after 3 days, 7 days and 14 days suspension, respectively. While the CAS of intrafusal fibers (bag + chain fibers) were (14 ± 3)% (P < 0.05), (30 ± 7)% (P < 0.01) and (44 ± 10)% (P < 0.01) smaller after 3 days, 7 days and 14 days suspension. 2 The immunoreactivity of conjugated-ubiquitin both in extrafusal and intrafusal fibers increased after tail-suspension. The immunoreactivity of intrafusal fibers increased 1 day after suspension and reached the hightest level at 3 days after tail-suspension. The immunoreactivity of extrafusal fibers increased after 3 days suspension and reached the highest level after 7 days tail-suspension, which was lower than that in intrafusal fibers after 3 days tail-suspension. Conclusion: These results suggest that soleus atrophy of intrafusal fibers caused by tail-suspension is earlier and more severe than that in extrafusal fibers.

Motor dysfunction is one of the leading problems after stroke. The evidence existed that motor performance is largely affected by the location and volume of white matter especially the pyramidal tract, but not the cortex. The remodeling of contralesional primary motor output tract highly correlated with motor improvement. The unaffected pyramidal tract axons regenerate and cross into the affected side after ischemia can promte motor recovery after ischemia. Exercise and other rehabilitation may play a role on remodeling of pyramidal tract subsequent after cerebral infarction.

Objective To detect the serum level of interleukin (IL)-1 1, lymphocyte subsets and NK cells in patients with idiopathic thrombocytopenic purpura (ITP), and explore the related factors in the pathogenesis of ITP. Methods The serum level of IL-11, lymphocyte subsets and NK cells were detected by double antibody sandwich enzyme linked immunosorbent assay (ELISA) and flow cytometry in 50 ITP patients (ITP group) and 30 controls (control group). Results The platelet in ITP group [ (30.21 ± 19.40) ×109/L] was lower than that in control group [ (207.21 ± 31.55 ) × 109/L] obviously (P ＜ 0.05 ); the serum level of IL-11 in ITP group [(255.72 ± 163.43) ng/L] was significantly higher than that in control group [ (40.60 ± 5.57 ) ng/L ] (P ＜ 0.05 ). The correlation analysis indicated that the blood serum levels of IL- 11 had negative relationship with the platelet (r = -0.557 ,P ＜ 0.05). The percentage of CD3+ and CD4+ T lymphocyte percentage, CD4+/CD8+ in ITP group were lower and the percentage of CD8+ T lymphocyte was higher than those in control group obviously (P ＜ 0.05 ). The percentage of CD3- CD(16+56) +NK cell in ITP group was lower than that in control group (P ＜ 0.05). Conclusion IL-11, lymphocyte subgroup and NK cell change correlate with ITP morbidity closely, and the IL-11 level and the platelet possibly have the negative feedback control action.

Takayasu arteritis (TA) is a devastating vasculitis of the aorta and its major branches,coronary and pulmonary arteries.The clinical manifestations in children are less specific than in adnlts:the disease in children presents with fever,arthralgias,vomiting,weight loss and hypertension.Conventional angiography,which is recognized as the golden standard in evaluating vascular lesions in TA,combined with computer tomography angiography (CTA),magnetic resonance angiography (MRA),ultrasonography,could not only provide important information for early diagnosis,but also detect disease activity.New immunosuppressive agents and biological therapies,such as TNF-a blocking agents,have been verified to be effective although corticosteroids and conventional immunosuppressive agents are still basic treatment.