Objective To summarize the types and reasons of misdiagnosis in multiple myeloma (MM),and the approaches of avoiding misdiagnosis by analyzing the misdiagnosis data in MM.Methods 197 references of misdiagnosed MM were retrieved from Wanfang medicine net by using the key words multiple myeloma and misdiagnosis from the year 2000 to 2012,and 62 of them with complete data and statistical certainty from level 2 or higher national hospitals were analyzed and summarized.Results In 62 references,2110 patients were misdiagnosis.There were more than 160 misdiagnosed MM.The shortest time of delay in diagnosis was one week,and the longest was tcn years.The rate of misdiagnosis in MM was 56.44 ％ (1406/2491).The onset age of the youngest was 16 years old and the oldest was 87 years old.A difference of nearly 20 years was found between the maximum and minimum average age of onset.MM was misdiagnosed as 10 kinds of diseases.They were including bone joint disease 32.23 ％ (680/2110),other blood diseases 11.75 ％ (248/2110),infection 14.5 ％ (306/2110),solid tumor 6.35 ％ (134/2110),kidney disease 18.58 ％ (392/2110),digestive system disease 3.13 ％ (66/2110),rheumatism 4.64 ％ (98/2110),heart disease 4.64 ％ (57/2110),nervous system disease 2.99 ％ (63/2110),endocrine disease 0.38 ％ (8/2110).Conclusion MM could occur in all ages except children and may be mistaken for a variety of diseases.It is key to prevent misdiagnosis by strengthening the comprehensive understanding of MM by taking detailed history,careful physical examination,comprehensive laboratory examination,and comprehensive clinical thinking.

AIM: To investigate effect of autogenous conjunctival flap transplantation in the treatment of severe fungal corneal ulcer.
METHODS: A total of 83 cases ( 83 eyes ) with severe fungal corneal ulcer treated in our hospital from Jan. 2013 to Jan. 2016 were selected. Among them, 36 cases ( 36 eyes) were treated with drug therapy, and 47 patients(47 eyes ) were treated with autogenous conjunctival flap transplantation, two group did fungal culture and identification, observed the two groups treatment effect.RESULTS:The effective rate of surgical treatment group was 89%, significantly higher than that of drug treatment group, the difference was statistically significant ( P <0.05 ); The effective rate of surgical treatment of filamentous bacteria was 92%, which was significantly higher than that of drug treatment, the difference was statistically significant(P<0. 05). The effective rates of surgical treatment and drug treatment of yeast were 80%and 78%, the difference was not statistically significant( P<0. 05).
CONCLUSION: Autologous conjunctival flap transplantation in the treatment of severe fungal corneal ulcer has good curative effect. The operation is simple, worthy of recommendation method. Filamentous bacterial corneal ulcer without good drug therapy effect, surgical treatment should be performed in a timely manner to improve the curative effect.

Objective To explore the clinical features of pulmonary tuberculosis complicated with DM and related factors. Method The manifestations of 87 newly diagnosed PTB patients with type 2 DM(DM-PTB group) at two hospitals in Tianjin during October 2003 to October 2004 were compared to 88 PTB patients without DM who were randomly choosen from the same hosipital.The factors related to sputum-positive TB or cavity were explored through unconditional logistic regression model. Results DM-PTB patients showed significanly lower frequencies of cough(66.7% vs 83.0%),toxicity symptoms(37.9% vs 62.5%) and haemoptysis(16.1% vs 33.0%) than those of PTB group.Positive-sputum(63.2% vs 34.1%),cavity(56.3% vs 13.6%),wide lesions and bilateral lesions on chest radiographs was more common in DM-PTB group than in PTB one.Introversion(OR=1.582, 95%CI:1.063 ～2.355),type 2 DM(OR =2.186,95% CI:1.082 ~4.420)and cavity(OR =2.793,95% CI:1.308 ～5.964)were factors independently associated with positive-sputum TB.The factors related to cavity included diabetes(OR=14.199,95%CI:5.376~ 37.501),cough,postive sputum and lore-up lobe lesion.Conclusion This study confirmed that clinical manifestations and chest radiographs of PTB patients complicated with type 2 DM significantly departed from the typical presentation.Type 2 DM seems to have a negative effect on postive-sputum and cavity.So it should be alarmed that DM-PTB patients who tend to have untypical clinical symptom and higher rate of positive sputum become the reservoirs of infection to cause the transmission of TB.

With social progress and improvement of human health consciousness,the medical device industry of China has been fast developing,and a new request for the specialized talents cultivation has been put forward.Based on the consideration of the development of medical device industry and the students,a cultivating mode for the medical engineering talents is explored in this paper through the major course reform,training double-quality teachers and cooperation between industry,university and research institutes.

Adolescent ; Adult ; Aged ; Aspartate Aminotransferases ; metabolism ; Case-Control Studies ; Electrocardiography ; Endosulfan ; poisoning ; Female ; Humans ; Lactate Dehydrogenases ; metabolism ; Male ; Middle Aged ; Young Adult

ObjectiveThe purpose of the present study was to discuss the method to avoid spillage by means of adding chemotherapeutic drugs into sealed transfusion bottles.Methods90 penicillin sealed bottles of the same batch number were randomly divided into the test group and the control group,each with 45 bottles.Standard method according to Basic Nursing was used to add chemotherapeutic drugs into transfusion bottles in the control group.Drugs were added into transfusion bottles under negative pressure in the test group.The operating time was measured,the spillage volume of puncture site was calculated and microbial detection of syringe was observed in the two groups.ResultsThere was a significant difference in the spillage volume of puncture site between the two groups (P<0.01),but no difference was seen in the operating time and microbial detection of syringe (P>0.05),ConclusionsThe spillage volume of puncture site was reduced significantly by means of adding chemotherapeutic drugs into transfusion bottles under negative pressure.This can decrease chemotherapeutic professional exposing risks and drug wastage.

Abortion, Induced ; adverse effects ; Adult ; Female ; Humans ; Medicine, Chinese Traditional ; Pain, Postoperative ; therapy ; Pregnancy

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Child ; Female ; Humans ; Lymphocyte Count ; Male ; Middle Aged ; Myelodysplastic Syndromes ; blood ; T-Lymphocytes, Helper-Inducer ; Young Adult

Objective To discuss the relationship between serum folic acid (Fa),homocysteine (Hcy),Vitamin B12 (VB12) in pregnent women as well as neonatal umbilical cord blood and fetal growth restriction.Methods We selected 44 delivery mothers and their infants inpatient from February to November in 2010.Serum Hcy,Fa,VB12 were measured by enzyme-linked immunosorbent assay.According to the birth weight neonates were classified into fetal growth restriction (FGR),appropriate for gestational age (AGA),large for gestational age (LGA).We recorded fetal birth weight,height,head circumference,abdomen circumference,placenta weight,body mass index (BMI),Rohrer index,delivery method,gender and evaluated neonatal growth state.Results ( 1 ) Serum Fa,VB12 of pregnant women in FGR group were less than those in AGA and LGA group (P ＜0.05).Hcy of pregnant women in FGR group was higher than that in AGA,LGA group (P ＜0.05).Serum VB12 of umbilical cord blood in FGR group was less than that in AGA,LGA group.Hcy in FGR group was higher than that in AGA,LGA group ( P ＜ 0.05).Serum Fa in pregnant women was correlated positively with Fa,VB12 in umbilical cord blood ( P ＜0.01 ),as well as serum VB12 in pregnant women was correlated positively with that in umbilical cord blood ( P ＜ 0.01 ).( 2 ) Serum Hey in pregnant women and umbilical cord blood was negatively correlated with neonatal growth parameters (P ＜0.01 ).Serum Fa in pregnant women was positively correlated with birth weight ( P ＜ 0.05 ).Serum VB12 in pregnant women was positively correlated with neonatal head circumference and abdomen circumference ( P ＜0.05).(3) Placenta weight in FGR group was less than that in AGA,LGA group (P ＜0.01).There wasn't correlation between placenta weight and birth weight,height,head circumference,abdomen circumference,BMI in FGR group (P ＞ 0.05 ).There is a significant positively correlation between placenta weight and birth weight,height,head circumference,abdomen circumference,BMI in AGA,LGA group (P ＜0.01 ).(4)Rohrer's body index: In FGR group the index was less than 2.00 at the gestational age of ≤37.The index was less than 2.20 at the gestational age of ＞ 37.The ratio of height and head circumference was more than 1.36 in three groups.Conclusion Lack of the Fa and VB12 may induce hyperhomocysteinemia in period of pregnancy.FGR may be corelated with the increasing Hcy level.Serum Fa,VB12 and Hcy had important influence on the fetal physical condition at the later period of pregnancy.Placenta weight may play an important role in the fetal growth and development.

ObjectiveTo observe the effect of early rehabilitation on poststroke anxiety and depression.Methods137 stroke patients with hemiplegia were divided into the rehabilitation group (70 cases) and control group (67 cases). All patients in both two groups were given routine clinical treatment, but the patients in the rehabilitation group were given regular early rehabilitation. All patients were evaluated with Bathel Index (BI), Fugl-Meyer Motor Scale (FMMS), Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) before and 3 months after treatment.ResultsAfter 3 months treatment, the scores of HAMD, HAMA, BI and FMMS of patients in the rehabilitation group increased significantly compared with those before treatment ( P<0.05～0.01), and those in the control group ( P<0.05). The scores of BI and FMMS of patients in the control group after treatment also increased significantly compared with those before treatment ( P<0.05). The incidences of depression and anxiety of the rehabilitation group were 22.86% and 5.71%, those of the control group were 40.30% and 16.42%, there was a significant difference between two groups( P<0.05).ConclusionThe early rehabilitation can obviously decrease anxiety and depression of stroke patients with hemiplegia.