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 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 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 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.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Humans ; Male ; Varicocele ; therapy

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.

OBJECTIVE:To investigate the efficacies and safety of paclitaxel (PTX) versus Taxotere (TXT) and fluorouracil (5-FU) versus cisplatin (DDP) (PCF vs.DCF regimens) in the treatment of advanced gastric cancer (AGC).METHODS:60 cases of AGC were divided into two groups according to different regimens.The patients in group PCF (n=30) received 35～50 mg?m-2 PTX via ivgtt for 3 hours on the 1st,8th,15th day.The patients in group DCF (n=30) received 35 mg?m-2 TXT via ivgtt for 1 hour,on the 1 st,8th,15th day.Both groups were given 750 mg?m-2 5-FU with continuous infusion administration from the 1st to 5th day and 20 mg?m-2 DDP via ivgtt for 2 hours from the 1st to 5th day with treatment course of 28 d.Recent efficacy and safety were evaluated after two cycle of treatment and long-term efficacy were followed up continuously.RESULTS:Overall response rate (ORR) was 50.0% for group PCF and 46.6% for group DCF.Disease control rate (DCR) was 66.6% in group PCF and 63.3% in group DCF.The median survival time (MST) was 10.4 months in group PCF and 9.6 months in group DCF.One-year survival rates were 35.7% for group PCF and 34.4% for group DCF.There was no statistically significance in recent and long-term efficacy between two groups.Grade Ⅲ/Ⅳ toxicities represented as bone marrow depression,nausea,vomiting and alopecia in two groups.Grade Ⅳ neutropenia and the overall incidence of anemia,DCF was significantly higher than the PCF group.CONCLUSION:PCF and DCF regimens have similar response in the treatment of advanced gastric cancer.Drug toxicity of two regimes are different while both of them are tolerable well.

OBJECTIVE:To probe into the safety of influenza A/H1N1 vaccine. METHODS:1 200 medical staff who were vaccinated influenza A/H1N1 vaccine on Oct. 27 th of 2009 were followed up on next day. Those cases of severe hematuria and proteinuria were analyzed and reported. RESULTS:A 32 years old woman developed abdominal pain,lumbago,accompanied by frequent urination,urgency of urination and odynuria in 20 hours after vaccinated influenza A/H1N1 vaccine. Routine urine tests showed dark red turbid urine,RBC(+ + +),proteinuria(+ + +). 20 days later,the index of routine urine test returned to normal. CONCLUSION:Hematuria and proteinuria caused by influenza A/H1N1 vaccine shows rare adverse reaction while great importance should be attached to it.