Autologous stem cell transplantation (ASCT) has been considered as frontline therapy for patients with multiple myeloma (MM) based on the increased rate of response and prolonged progression-free survival compared with conventional chemotherapy.In the recent years,the favorable results shown by newdrug-based multidrug inductions,consolidations,and long-term maintenance approaches have challenged the role of ASCT.Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has shown to be a potentially curative treatment for MM.However,the effectiveness of high-dose conditioning with conventional allo-HSCT is compromised by transplant-related mortality (TRM).Nonmyeloablative transplantation has showed reduced TRM and promising graft-versus-myeloma effects,but rates of acute and chronic graft-versus-host disease remain high.This article provides an overview of clinical trials and aims to define the role of stem cell transplantation in the era of novel agents.

Objective:To explore the relationship among child neglect,resilience and loneliness.Methods:Child Neglect Scale,Resilience Scale for Chinese Adolescents,and UCLA Loneliness Scale were used to investigate 225 junior middle school students.Results:① Regression analysis showed that Child neglect degree positively predicted their loneliness (?=0.614,P

ObjectiveTo investigate the influence of time management disposition and academic self-efficacy on learning engagement among nursing baccalaureate degree students,and to establish a model of this influence. MethodsLearning engagement scale,the questionnaire of academic self-efficiency,and adolescence time management disposition scale were used to investigate a total of 467 nursing baccalaureate degree students. ResultsThe total score of learning engagement was (52.83±10.45).There were differences in learning among students in different grades and leaning motives,while the interaction of them was not difference in learning engagement.Both academic self-efficacy and time management disposition could positively influence learning engagement directly,and time management disposition could also indirectly influence learning engagement through the academic self-efficacy. ConclusionsThe educators should make efforts to improve time management ability and self-efficacy so as to strengthen the nursing baccalaureate degree students' learning engagement in colleges.

The immunomodulatory drugs (IMiD) thalidomide and lenalidomide,and the proteasome inhibitor (PI) bortezomib have dramatically improved clinical outcomes for patients with relapsed/refractory multiple myeloma(MM).But a part of patients become refractory or intolerant to these agents.Numerous agents are currently in clinical development,including new IMiD (pomalidomide),new PI (eg,carfilzomib,MLN9708,and marizomib),histone deacetylase inhibitors (eg,panobinostat and vorinostat) and signal transduction modulators (eg,perifosine),and have demonstrated promising anti-myeloma activity in patients with relapsed/refractory MM,particularly in those who are refractory to approved novel agents.This article describes antimyeloma agents currently available or in clinical development for relapsed/refractory patients.

Objective To study the expression of Ephrin‐B4 receptor (EphB4) in hepatocellular carcinoma (HCC) and its clinical significance ,and to analyze the effect of EphB4 on the proliferation of HCC cells .Methods The expression level of EphB4 in HCC tissues and matched paracancerous liver tissues of 60 cases of HCC patients was assessed by reverse transcriptase‐polymer‐ase chain reaction (RT‐PCR) and immunohistochemistry .The correlation between the expression of EphB4 in HCC tissues and clin‐ical pathologic parameters was analyzed by chi‐square test .Univariate survival analysis was carried out by Kaplan‐Meier Log‐rank test .The effect of EphB4 on the viability of HCC cells was furtherly analyzed by MTS .Results The results of RT‐PCR showed that the mRNA level of EphB4 in HCC tissues (1 .39 ± 0 .80) was significantly higher than in matched paracancerous liver tissues (0 .56 ± 0 .33) ,the difference was statistically significant (P< 0 .01) .Data from immunohistochemistry showed that the positive rates of EphB4 protein in HCC tissues and matched paracancerous liver tissues were 81 .7% and 23 .3% ,respectively .Moreover ,the expression of EphB4 in HCC tissues was relevant to AFP level ,tumor size and TNM stage(P<0 .05) .The three‐year survival rate of HCC patients with positive expression of EphB4 protein was 22 .5% ,and that of HCC patients with negative expression of EphB4 protein was 54 .5% ,the difference was statistically significant (P<0 .05) .Overexpression of EphB4 significantly enhanced the ability of hepatocellular carcinoma cell proliferation (P<0 .05) .Conclusion EphB4 expression was significantly up‐regulated in HCC ,which was associated with HCC progression and prognosis ,and EphB4 could promote the proliferation of HCC cells ,which could be used as a marker of HCC progression .

Objective:To study the synergy inhibition effects of Oxymatrine combine with 5-FU on proliferation and apoptosis of SGC7901 human gastric cancer cells and its mechanism. Methods:SGC7901 cells were treated by different concentrations of Oxymatrine with or without 10. 0 mg/L 5-FU for 24,48 and 72 h. The cells proliferative vitality was detected by MTT assay,and the ap-optosis of SGC7901 cells was detected by HOECHST stain. Immunohistochemistry was applied to examine the protein expression of VEGF. The transcriptions of VEGF mRNA were distinguished by RT-PCR technique. Results:Compared with control group,middle dose and high dose concentration of Oxymatrine groups,and groups of its combined with 5-FU can inhibit the proliferation and induced the apoptosis of SGC7901 cancer cells. Compared with 5-FU group, the inhibition rate and apoptosis rate were significantly increased in groups of Oxymatrine combined with 5-FU. The mRNA and protein expression of VEGF were significantly decreased in groups of Oxymatrine and it combined with 5-FU. Conclusion:Synergy inhibition effects of Oxymatrine combine with 5-FU on proliferation and apoptosis of SGC7901 human gastric cancer cells were found,which may be related to strengthen the effects of Oxymatrine of inhibiting angiogenesis relate with down-regulating the expression of VEGF.

Objective:To develop specific anti-AML T cells in vitro,and to study their biological characteristics and functions.Methods:Peripheral blood or bone marrow mononuclear cells (MNCs) were isolated from 12 patients with AML,and co-cultured with cytokine combinations in 96 well plates to be induced into dendritic cells (DCs).Cell morphology was observed under an inverted microscope during the first week and immunophenotype was detected by flow cytometry at day 7.Cytokine combination was replaced with high dose IL-2 at day 7 to promote specific anti-AML T cells.T cell phenotype was detected after 4 to 5 weeks.Lactate dehydrogenase (LDH) release assay was used to determine T cell killing activity.Results:After being cultured with cytokine combinations,the typical dendritic appearance with delicate membrane projections was observed.CD80,CD86 and HLA-DR markers were significantly upregulated(P

Objective To investigate the effect of Icariin ( ICA) experimental IgA nephropathy in rats and to explore related mechanisms .Methods Experimental IgA nephropathy rat model was established and then model rat were treated with or without different doses of ICA .Then, urine RBC, Urine protein and urine NAG were analyzed; IgA precipitation was detected with immunofluorescence staining;the protein level of NF-κBp65 and MCP-1 were examined by immunohistochemical staining;the mRNA level of IL-4, IL-10 and IL-13 were determined by quantitative PCR .Results The concentrations of urine RBC, Urine protein and urine NAG were reduced after ICA treatment , as companied by a decrease of IgA precipitation .Moreover, ICA treatment also decreased the protein level of NF-κBp65 and MCP-1, and the mRNA level of IL-4, IL-10 and IL-13.Conclusions ICA exerts a certain degree of efficacy on the treatment of experimental IgA nephropathy through regulating NF-κBp65 and MCP-1 expression and the immunoregulation mechanism .

Objective Microporous polysaccharide hemostatic powder ( MPPHP) is a most commonly used hemostatic mate-rial, but reports are rarely seen on its application in posterior spinal orthopedic surgery.The present paper aimed to investigate the val-ue of MPPHP in stopping bleeding in posterior spinal surgery. Methods Twenty-four 5-month-old New Zealand rabbits were equally randomized to an experimental and a control group.An 8 cm-long wound was made in the back muscle of animals to establish the model of spinal posterior surgery.MPPHP was applied to the wound of the experimental rabbits but none to that of the controls.Comparisons were made between the two groups of animals in the bleeding time, in vitro coagulation time, intra-operative blood loss, and results of pre-and post-operative blood routine and histopathological examinations. Results Statistically significant differences were observed between the experimental and control groups in the mean bleeding time ([15.36 ±1.42]s vs [347.58 ±32.43]s, P<0.05), in vitro coagulation time ([235.41 ±21.08]s vs [722.16 ±40.35]s, P<0.05), and intra-operative blood loss ([1.61 ±0.24]g vs [2.86 ± 0.37] g, P <0.05).After operation, the experimental animals showed a significantly higher count of erythrocytes than the controls ([5.68 ±0.46] ×106/L vs [4.47 ±0.43] ×106/L, P<0.05)and a higher level of hemoglobin than the latter ([12.67 ±1.18]g/L vs [10.64 ±1.05]g/L, P=0.00).There were no significant differences in the effectiveness and excellence rates of hemostasis between the experimental and control groups (100%vs 83.33%and 83.33%vs 66.67%, P>0.05).Pathological examination revealed mild bleeding and a small number of red blood cells in the muscle interstitium and blood vessel lumen of the experimental rabbits as compared with the controls. Conclusion Intraoperative topical ap-plication of MPPHP can reduce blood loss and achieve rapid and efficient hemostasis in posterior spinal surgery without affecting wound healing.

BACKGROUND:At present, few studies concerned pulmonary infection after treatment of senile fracture. For special parts of senile patients, there are no studies on complications of pulmonary infection in perioperative period after hip fracture. OBJECTIVE:To study risk factors for pulmonary infection in patients with senile hip fractures in perioperative period. METHODS:The data of 46 senile hip fracture patients with perioperative pulmonary infection were retrospectively analyzed. A matched case-control study was conducted in 46 senile hip fracture patients without pulmonary infection in the same hospital and the same period. The difference in perioperative various clinical indexes was compared between the two groups. Risk factors of pulmonary infection received Logistic regression analysis. RESULTS AND CONCLUSION:Multivariate analysis screened out 14 possible perioperative pulmonary infection factors:chronic obstructive pulmonary disease, smoking, diabetes mel itus, heart disease, mechanical ventilation, intraoperative bleeding amount, erythrocyte infusion, operation time, preoperative low body mass index (body mass index<18.5 kg/m2 ), serum albumin<35 g/L, electrolyte disturbance, time of entering intensive care unit and length of stay. Logistic regression analysis displayed that chronic obstructive pulmonary disease (OR=23.317;95%CI:2.702-60.312;P=0.000), entering intensive care unit (OR=7.890;95%CI:2.624-76.012;P=0.008), mechanical ventilation (OR=35.210;95%CI:8.464-131.203;P=0.017) and operation time (OR=12.122;95%CI:5.154-99.098;P=0.012) were independent risk factors for perioperative pulmonary infection in patients with senile hip fracture. These data indicated that one should be alert to the possible occurrence of pulmonary infection in senile hip fracture patients with the presence of chronic obstructive pulmonary disease, entering intensive care unit and mechanical ventilation.