Humans ; Multiple Myeloma ; Neoplasm Recurrence, Local

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 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.

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.

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.

Objective To investigate the Survivin and Cyclooxygenase-2 (COX-2) expression and their relationship in cervical carcinoma tissues and to investigate the relationship with the genesis and devclopment of cervical carcinoma.Methods The expression of Survivin and COX-2 was assayed by immunohistochemical technique in 60 cervical carcinoma and 30 normal cervical tissue specimens.The relation with its clinical pathology characters were analysed.Results Survivin and COX-2 expression in the tissues of cervical carcinoma [76.7 ％ (46/60),63.3 ％ (38/60)] were higher than that in normal cervical tissues evidently [6.7 ％ (2/30),10.0 ％ (3/30)] (P ＜ 0.05).The COX-2 expression in cervical carcinoma was positively associated with lymph node metastasis (P ＜ 0.05),but no correlation was found between COX-2 expression and age,clinical stages,grades and invasive depth (P ＞ 0.05).Any correlation between Survivin expression and classical prognostic factors of cervical carcinoma was found.Moreover,these two proteins were positively correlated.Conclusion The Survivin and COX-2 might play important roles in the development of cervical carcinoma.

Objective To evaluate the short-term therapeutic effects for patients with primary liver cancer using three-dimensional stereotactic conformal radiotherapy(3D-CRT).Methods Twenty-eight patients with primary hepatic cancer were treated with 3D-CRT(the average overall dose was 38Gy,localized by Elscint twin flash slice CT,radiotherapy plan was designed by Leibinger three-dimensional radiotherapy planning system and operated on Varian 600C/D liner accelerator).The average follow-up time was 12 months(5-17mon.).Tumor volume response rate,rate of free from tumor progression and survival rate were analyzed.The adverse effects were studied simultaneously.Results According to follow-up CT results 3 months after radiotherapy,2 cases had full responses with disappearance of the tumors,while partial responses with decreased tumors mass were seen in 22 cases,and no response in 4 cases.Tumor volume response rate was 85.7%.The last follow-up CT results showed that in 5 patients there was tumor progression in planning target volume(PTV),in 10 cases there was intrahepatic progression but not in PTV,and in 4 cases extrahepatic tumor growth.Intrahepatic tumor free rates 6 months and 12 months after radiotherapy were 66.5% and 38.4%,respectively.6-month survival rate after radiotherapy was 88.6%,12-month survival rate was 70.5% after radiotherapy.During 3 months of radiotherapy,manifestations of subacute radiation injuries occurred in six patients:gastrointestinal hemorrhage in 2 cases,jaundice in 3 cases and subacute radiation hepatitis in 1 patient.No survivors suffered from long-term liver injury.Conclusions With little adverse effect,3D-CRT could raise the control rate of the hepatic tumor,and also short-term survival rate.There fore,3D-CRT is a valuable treatment for patients with primary liver cancer.

Objective To evaluate the therapeutic effects and adverse effects of three-dimensional conformal radiotherapy(3D-CRT) for elderly patients with non-small cell lung cancer(NSCLC).Methods From August 2001 to October 2006,36 patients over 70 years old with NSCLC were treated with 3D-CRT.Leibinger treatment planning system was used for drafting radiotherapy plan,the prescription dose was 40-80Gy(median,60Gy).Twenty-four patients received hypofractionated radiation every two days in 8-12 fractions at a dose of 5-8Gy per fraction;12 patients accepted conventional fractionated radiation with 30-40 fractions during 6 to 7 weeks.With median follow-up time of 11 months(range,5-54 mon.),tumor volume response rate,1-year and 2-year survival rate were investigated,adverse effects of the treatment were also recorded in present research.Results Of the 36 patients,clinical symptoms were improved in 33 cases,while no changes were observed in 3 cases.According to follow-up CT results 2-3 months after radiotherapy,8 patients showed complete response(CR),22 cases with partial response(PR),with the overall tumor response rate of 83.33%(30/36).In this group,1-year and 2-year survival rate was 66.67% and 36.11% with median survival time of 8 months(range,2-53 months).No patients suffered from serious adverse effects.Conclusions 3D-CRT was an effective and safe treatment for elderly patients with NSCLC,which could raise the survival rate and improve the quality of life with little adverse effects.

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.