Allogeneic stem cell transplantation (allo-HSCT) is probably the only treatment for multiple myeloma (MM) with a curative potential.However,the application of allo-HSCT is limited by the high transplant-related mortality (TRM).Although the introduction of reduced intensity conditioning (RIC) has lowered the TRM associated with myeloablative conditioning,there is no improvement in survival of allo-RIC compared to autologous stem cell transplantation (auto-HSCT).New strategies are discussed with the aim of lowering transplant toxicity and boosting the graft-versus-myeloma effect,and these are urgently needed to make allo-RIC safer and more effective for myeloma patients.In this review,results from studies of allo-HSCT in MM are presented.

For transplantation-eligible multiple myeloma patients,induction treatment of triple drug regimens followed by the collection of hematopoietic stem cells is generally recommended.For transplantationeligible patients,high-dose melphalan remains the standard regimen.Consolidation after transplantation has shown an improvement in response rates.Maintenance therapy with bortezomib or lenalidomide (or both in very-high-risk patients) is a reasonable option for long-term disease control and improvement in overall survival.Application of new agents into therapy of multiple myeloma should result in improved outcomes and long-term disease control.

Objective To evaluate the effect of dexmedetomidine postconditioning combined with limb ischemic postconditioning on myocardial ischemia-reperfusion (I/R) injury in rats.Methods Fifty male Sprague-Dawley rats,aged 2-3 months,weighing 275-335 g,were randomly divided into 5 groups (n =10 each) using a random number table:sham operation group (group S);I/R group;dexmedetomidine postconditioning group (group DP);limb ischemic postconditioning group (group LP);dexmedetomidine postconditioning combined with limb ischemic postconditioning group (group DLP).Myocardial I/R was induced by occlusion of the left anterior descending branch of coronary artery for 30 min followed by 180 min reperfusion.At 15 min before reperfusion,dexmedetomidine 50 μg/kg was injected intraperitoneally in DP and DLP groups,while normal saline 0.5 ml was injected intraperitoneally in I/R and LP groups.In LP and DLP groups,the animals underwent 10 min ischemia of bilateral hind limbs starting from 10 min before reperfusion,followed by reperfusion.Blood samples were taken from the internal carotid artery at 180 min of reperfusion for determination of the plasma creatine kinase-MB (CK-MB) and glutathione peroxidase (GSH-Px) activities and the concentrations of cardiac troponin I (cTnI),malondialdehyde (MDA),interleukin-1beta (IL-1β),IL-6 and tumor necrosis factor-alpha (TNF-α).Myocardial specimens were obtained at 180 min of reperfusion for determination of the myocardial infarct size.Results Compared with group S,the plasma CK-MB activity,myocardial infarct size and plasma cTnI,MDA,TNF-α,IL-1β and IL-6 concentrations were significantly increased,and GSH-Px activity was significantly decreased in I/R,DP,LP and DLP groups (P＜0.05).Compared with group I/R,the plasma CK-MB activity,myocardial infarct size and plasma cTnI,MDA,TNF-α,IL-1β and IL-6 concentrations were significantly decreased,and the GSH-Px activity was significantly increased in DP,LP and DLP groups (P<0.05).Compared with DP and LP groups,the plasma CK-MB activity,myocardial infarct size and plasma cTnI,MDA,TNF-α,IL-1β and IL-6 concentrations were significantly decreased,and the GSH-Px activity was significantly increased in group DLP (P ＜ 0.05).Conclusion Dexmedetomidine postconditioning combined with limb ischemic postconditioning provides better efficacy than either alone in reducing the myocardial I/R injury in rats,and the mechanism may be related to the inhibition of lipid peroxidation and systemic inflammatory responses.

Objective To evaluate the decompression performance of anti pressure ulcer cushions with different materials and structures. Methods The common cotton cushion, sponge cushion, 3D fabric cushion, and upper 3D fabric and lower sponge cushion were analyzed by XSensor pressure sensor testing system. The pressure distribution, the pressure peak and the average pressure were analyzed to compare the decompression performance and the comfortable capability. Results and Conclusion The upper 3D fabric and lower sponge cushion can en-sure the decompression performance with excellent permeability. Both decompression and air comfort permeability should be the future di-rection of ulcer cushions research and production.

Stem cells are those with long-term self-renewal and produce differentiated cells at least one end of the cell capacity. Stem cell transplantation can be used for the treatment of many kind of liver diseases which includes acute liver failure, inherited metabolic liver diseases, as well as end-stage liver disease. This Article summarizes the types of stem cell types applied for treatment of liver diseases, stem cell tracing technology, as well as the clinical application of stem cells. It also discusses the problems existed and the research focus.

Objective To explore the expression and its clinical significance of immunoglobulin G4 (IgG4) in inflammatory bowel disease (IBD) by detecting the expression of IgG4 in the serum and intestinal mucosa of patients with IBD.Methods From March 2015 to August 2016,68 patients with ulcerative colitis (UC),132 patients with Crohn's disease (CD) and 52 healthy controls were collected.The serum levels of IgG4 were detected by immunonephelometry.The expression of IgG4 in intestinal mucosa was analyzed by immunohistochemistry.Five high power fields (HPF) were randomly selected in each specimen.C-reaction protein (CRP) and erythrocyte sedimentation rate (ESR) of patients with UC,patients with CD and healthy controls were detected.The extent of disease,clinical type,disease activity scores (UC scored by Mayo score system,CD scored by Crohn's disease activity index (CDAI)) and current treatment were collected.The correlation between IgG4 expression and CRP,ESR,Mayo score and CDAI were analyzed.Independent sample t test,Chi square test and Pearson's correlation were performed for statistical analysis.Results The results of immunonephelometry indicated that the serum levels of IgG4 of patients with UC,CD and healthy controls were (0.79±-0.61),(0.69±0.59) and (0.41±0.32) g/L,respectively;all were lower than standard level 1.35 g/L.The results of immunohistochemistry revealed that the number of IgG4 positive cells in the colonic mucosa of active UC and CD patients were higher than that of healthy controls ((15.42±12.47)/HPF,(18.65±12.46)/HPF and (4.71±4.14)/HPF),and the differences were statistically significant (t=5.392 and 8.450,both P＜0.05).There was no statistically significant difference in mucosal IgG4 expression between UC,CD patients at remission phase and healthy controls ((4.72±4.23)/HPF,(5.30±4.87)/HPF and (4.71±4.14)/HPF,both P＞0.05).There was no statistically significant difference in mucosal IgG4 expression between UC and CD patients at active phase and remission phase (both P＞0.05).The case number of active patients,CRP,ESR and Mayo scores of IgG4 positive UC patients were all higher than those of IgG4 negative group(x2 =5.499,t=2.811,3.471 and 4.676;all P＜0.05).The number of active patients,CRP,ESR and CDAI of IgG4 positive CD patients were all higher than those of IgG4 negative group(x2 =4.341,t=3.842,3.892 and 2.935,all P＜ 0.05).In UC patients,the number of IgG4 positive cells was positively correlated with CRP,ESR and Mayo scores (r=0.382,0.381 and 0.470;P=0.001,0.003 and P＜0.01).The number of IgG4 positive cells was positively correlated with CRP,ESR and CDAI in CD patients (r=0.199,0.209 and 0.201;P=0.022,0.016 and 0.021).Conclusions The expression level of IgG4 significantly increased in the intestinal mucosa of IBD patients correlated with the activity of disease.The expression level of [gG4 may be one of the parameters to evaluate the activity of IBD.

Objective·To investigate the role of collagen triple helix repeat containing-1 (CTHRC1) in ovarian cancer cell metastasis and the related mechanism. Methods·The expression of CTHRC1 in ovarian cancer cells was detected by Western blotting. The cell line which had high expression of CTHRC1 was transfected with a CTHRC1 specific shRNA, and the lenti-CTHRC1 was used to overexpress CTHRC1 in the cell line whose expression of CTHRC1 was very low. Then the expression of Slug and MMP-2 was assessed. Transwell assay was used to determine the migration and invasion capability of ovarian cancer cells after transfection. Results·The expression of CTHRC1 in HO8910 cells was the lowest, while the CTHRC1 protein level was dramatically increased after transfection of lenti-CTHRC1. Meanwhile, there was a distinct rise of the migration and invasion ability, as well as the expression of Slug and MMP-2 (all P<0.05). Conversely, CaOV3 cells had a higher protein expression of CTHRC1. By using lenti-shCTHRC1, a remarkable knockdown of CTHRC1 was obtained. Likewise, the capability of migration and invasion was decreased, and the Slug and MMP-2 expression was reduced (all P<0.05). Conclusion·CTHRC1 might positively regulate Slug and MMP-2 to promote ovarian cancer cell metastasis.

Objective:To analyze identify method of mild cognitive impairment. Methods:The Wechsler Adult Intelligence Scale-Chinese Revised (WAIS-RC) and Wechsler Memory Scale-Chinese Revised (WMS-RC) were examined in 150 patients with memory complaints. 63 individuals whose intelligence quotient (IQ) and memory quotient (MQ) over 85 were designated as normal elderly group;and 33 individuals whose IQ scores over 85 and MQ score between 70 and 84 as mild cognitive impairment(MCI-1) group; and 25 individuals whose IQ scores over 85 and MQ scores between 55 and 69 as MCI-2 group; 29 individuals whose IQ scores and MQ scores less than 85 and conformed with DSM-Ⅳ as Alzheimer disease group.Results: Picture short memory and mental control (B)showed the highest identification between the 2 MCI groups and normal elderly group. Besides, visual reproduction played an important role in mild memory decline (MCI-1) group. Tactile memory, logical memory and associated learning played an important role in moderate memory decline (MCI-2) group.Conclusion: Picture short memory and mental control (B) contribute to identify MCI speedily and effectively.

Objective:To assess clinical validity of the Chinese version of Mattis Dementia Rating Scale (DRS) in differentiating dementia of Alzheimer type (AD). Methods:Administered the DRS, mini-mental state examination (MMSE) and clinical dementia rating(CDR) to 61 outpatients with AD and 104 healthy elderly subjects in Shanghai.Results:There was significant correlation between DRS and the total score,and DRS and MMSE.DRS of the AD group had significant correlation with CDR.Its significant correlation with CDR suggested satisfactory concurrent validity of the scale. The optimal DRS cutoff score for AD according to education level revealed a sensitivity of 85%～94% and a specificity of 90%～94%.Conclusion:The DRS is a clinically valid test for the detection of AD and its severity of cognitive impairment.

Objective To study the optimal dose of esmolol for maintaining cardiovascular stability in patients with hypertension during tracheal extubation. Methods In post-anestheisa care unit, hypertensive patients after general anesthesia meeting the extubation criteria were included. Patients were divided into 2 groups according the age: group Ⅰ (>65 years old for the elderly hypertensive, 21 cases), and groupⅡ(≤65 years old for the non-elderly hypertensive, 22 cases). All the patients received esmolol bolus before sputum suction and tube extraction, and the tracheal extubation were extubated 2 minutes after esmolol bolus. The systolic blood pressure, diastolic blood pressure and heart rate were was recorded before tracheal extubation, 2 min after esmolol bolus, at the time of sputum suction extubation, 1 min after tracheal extubation, 3 min after tracheal extubation and 5 min after tracheal extubation. Esmolol dose was determined by the up and down method. Initial dose was 0.5 mg/kg, in accordance with the arithmetic dose (0.2 mg/kg) increasing or decreasing progressively. In negative results (the systolic blood pressure at extubation or 5 min after extubation ≥ 20% of the base, or the systolic blood pressure at sputum suction extubation>180 mmHg, 1 mmHg=0.133 kPa) esmolol dose increased progressively, and in positive results (the systolic blood pressure at extubation or 5 min after extubation<20%of the base) esmolol dose decreased progressively. When the crosspoint (from positive to negative result) reached 6, the study was terminated. Results The median effective doses of esmolol for maintaining cardiovascular stability in groupⅠand groupⅡwere (0.6 ± 0.1) and (0.8 ± 0.1) mg/kg. Conclusions Esmolol can maintain cardiovascular stability in patients with hypertension during tracheal extubation. Median effective dose decreases in older hypertensive patients.