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.

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.

Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressive, fibrosing interstitial pneumonia of unknown etiology , a median survival time of which is 2 to 3 years.The diagnosis and treatment are important for IPF in time.Krebs von den lungen-6(KL-6), Surfactant protein-A(SP-A) and Surfactant protein-D(SP-D) are acceptable biomarkers in clinical for idiopathic pulmonary fibrosis in Japan,which have shown good sensitivity at diagnosis IPF and predict the prognoses for patients with IPF . However , the differential diagnosis of IPF from other interstitial lung diseases is still challenging .Other biomarkers are being developed , one of which would have the best specificity and sensitivity at diagnosis IPF.Those biomarkers about pathogenesis of IPF includes alveolar epithelial cell dysfunction , fibrogenesis and immune dysregulation are shown .They are potential to account for underlying disease mechanisms , accelerated drug development and advance clinical management.

Objective To investigate the applying comparative values of anticoagulant and thrombolytic Sak-hirudin fusion protein used in cardiopulmonary bypass.Methods From february 2013 to July 2014,selected nitinol sheet into uncoated group (group A),base coated group (chitosan,group B),chitosan/ Sak group (group C),chitosan/hirudin group (group D),chitosan/Sak-hirudin fusion protein group (group E),there were included in the fresh round of blood hemolysis,the blood cell hemolysis rates were calculated.Meanwhile used the healthy newborns umbilical vein endothelial cells were added into various categories nitinol sheet for cell compatibility testing.Results The samples hemolysis rates in the 5 groups were around 1.5% and the RBC,WBC and PLT counts compared in the 5 groups were showed no differences (P <0.05).The ex-tent of proliferation and adhesion in the group E were significantly lower than the other four groups,compared to significant differences (P <0.05).There were no differences to compare group A and group B (P >0.05).Randomized double-blind cell count result shows that the group C,D and E compared to the group A,B were more significant differences (P <0.05), at the same time,the group E compared to the group C,D differences were statistically significant (P <0.05).Conclusion Compared to Staphylokinase and hirudin alone,Sak-hirudin fusion protein used in cardiopulmonary bypass can play stronger anticoagulant and antithrombotic effects,its safety and ensures the effectiveness that interventional treatment of cardiovascu-lar disease.

K. There was no significant difference in the yield among the treatments of N+K, CK, P, N+P, and N, but the results of these five treatments were significantly higher than that of P+K and K. In addition, cichoric acid content did not considerably changed after treatment of various fertilizer combinations. For the second harvest date the yield of N, N+K, P, and N+P were 47.7%, 35.4%, 33.8%, and 12.3% higher respectively than that of CK, the yield of N+P+K, P+K, and K were 7.7%, 10.8%, and 28.5% lower respectively than that of CK. There was significant difference in the yield between the treatment of N and CK, the yield of K was significantly lower than that of CK. Conclusion The results indicate that cichoric acid content is not significantly affected by the treatment of various fertilizer combinations and the yield is strongly influenced by N fertilizer, weakly by P fertilizer, on the contrary the application of potassium chloride results in a decrease in yield.

0.05],but significant difference existed in children with HSPN compared with HSP and control group[(3.01?1.52) g/d vs (0.05?0.02) g/d or (0.04?0.02) g/d Pa

Objective To explore the effect of endothelin-1(ET-1) and C-reactive protein(CPR) on vascular endothelial cell dysfunction in simple obese children.Methods Thirty-nine simple obese children in the First Hospital of Huangshi City were chosen from Jan.2006 to Jun.2008 as experimental group (obese group) and 21 healthy children as healthy control group with the same age and gender were enrolled in the study.The levels of plasma ET-1 and serum CRP were tested by radioimmunoassay.Data were analyzed with t test and linear correlation analysis.Results Compared with plasma ET-1 level in healthy control group[(43.5?10.2) ng?L-1],the level in obese group[(57.8?19.7) ng?L-1] had significant difference(t=3.704,P

Objective To analyze current status of research on pulmonary embolism and changes of its knowledge in domestic academic literatures.Methods Totally,2319 domestic papers on pulmonary embolism were collected by computerized retrieval from CHKD system during the period of 1994 to 2006 with a key word of"pulmonary embolism",and were classified and summarized according to their type,contents,author's affiliation.Results Number of papers on pulmonary embolism increased quickly in recent 13 years,especially in the last five years,from 25 papers in 1994 to 430 in 2006.Most of the papers in the early stage were case reports,and the number and proportion of original articles increased obviously after 1997.Contents of the papers were mainly about clinical manifestation and examinations of pulmonary embolism,but papers on its auxiliary examinations,laboratory examinations,clinical nursing care,animal experiments,and so on were all increased.Authors of the papers were from varied departments of hospitals,mainly in the department of internal medicine,especially in the departments of cardiology and respiratory diseases,followed by the divisions of medical imaging,radiation and nuclear medicine.Papers were mainly submitted by authors from affiliated hospitals of medical schools and hospitals at city-level,and papers submitted by gross-roots hospitals such as county hospital and clinic also increased.Conclusion Significant success in diagnosis and treatment of pulmonary embolism has been achieved domestically in recent 13 years,which has been recognized popularly by Chinese physicians.

Objective To investigate the advantage of separate bolus injection technique in CT urography (CTU) improving the display of the whole urinary tract.Methods Sixty cases of CTU examination,were divided into observation group and control group by random digits table with 30 cases each,observation group used separate bolus injection technique and control group used single bolus injection technique.The scanning included routine scanning,cortical phase,medullary phase and lag phase.Reconstruction of lag phase displayed the whole urinary tract.Then the image quality was compared between two groups.Results The whole urinary tract showed excellent in 12 cases (40.0％,12/30),good in 17 cases (56.7％,17/30),normal in 1 case (3.3％,1/30) in control group,which showed excellent in 23 cases (76.7％,23/30),good in 7 cases (23.3％,7/30) in observation group,there was significant difference in excellent rate between two groups (P ＜ 0.01).The CT value of starting of ureter was (238.6 ± 82.5) HU,middle-lower ureter was (245.9 ± 112.3) HU in control group and (239.0 ± 93.8),(235.3 ± 74.6) HU in observation group,there was no significant difference between two groups (P ＞0.05).There was no difference in developing of urolithiasis between two bolus injection techniques.Conclusion The application of separate bolus injection technique in CTU examination can reduce the dose of the first contrast material and contrast material reaction,and receive high-quality image of the whole urinary tract.