Objective Bortezomib plus dexamethasone (BD) and bortezomib,epirubicin plus dexamethasone (PAD) are both front-line regimens of multiple myeloma.This study aimed to assess the efficacy and safety of BD versus PAD regimens in multiple myeloma.Methods All 208 patients with newly diagnosed multiple myeloma using either BD or PAD front-line regimens were enrolled between November 2006 and July 2014.Front-line chemotherapy regimens were 2-7 cycles.Response rates,overall survival,progression-free survival,and adverse effects were retrospectively analyzed.Results (1) In PAD group,the overall response rate was 82.9％ [complete response(CR) 28.6％,very good partial response(VGPR) 12.9％],which was similar as that in BD group [70.3％ (CR 26.8％,VGPR 5.1％),P =0.049].The estimated median progression-free survival was 34.0 months in PAD group versus 25.0 months in BD group (P =0.010).(2) The triplet regimen has a higher accumulated response rate along with chemotherapy cycles,but it didn't show any difference with the doublet regimen.(3) In elderly patients (＞ 65 years old),the overall response rates in two groups had no significant difference (P =0.769),while in patients ≤65 years old,PAD regimen were more effective than BD regimen (P =0.037).(4) Grade 3 and 4 adverse events were recorded with a higher number of patients in the PAD group than those in the BD group.Conclusions Compared with BD regimen,PAD regimen improves the initial response rates,especially deep responses,as well as progression-free survival in patients with newly diagnosed multiple myeloma.However,more severe toxicities are accordingly higher.In elderly patients,overall response rate,estimated median progression-free survival,and median overall survival are all comparable in both regimens.

[Objective] To explore and analyze Professor ZHANG Yonghong's clinical experience in treating cerebral tumor.[Methods]Through the clinical study with the teacher to collect and collate the relevant information and medical records, from the etiology and pathogenesis of cerebral tumor, governance and other aspects of the specific analysis and discussion on Professor ZHANG Yonghong's treatment of this disease, academic point of view and clinical experience,it summed up the law of condemnation, and to the case of evidence,through regular follow-up, observing the treatment effect. [Results]Professor ZHANG Yonghong views that the pathogenesis of cerebral tumor can be summarized as Qi deficiency, phlegm and blood stasis, internal movement of the liver, and confusion of the body. Its pathologic factors are related to wind, fire, phlegm, blood stasis and poison. In the treatment of cerebral tumors, it is advocated to improve Qi, nourish Yin, promote positive Qi, and break loose to remove cancer toxins. On the basis of the selection of invigorating the spleen and protecting the stomach, the rational use of invigorating the Qi and nourishing the Yin and combining with the drugs of eliminating evils and removing toxin, in order to achieve the goal of strengthening the anti -cancer. The two cases both achieved good results by strengthening the body resistance, eliminating evils and removing toxin.[Conclusion]Professor ZHANG Yonghong stressed that strengthening of the body resistance is a primary treatment when the treatment for cerebral tumor. We should pay attention to replenishing Qi and nourishing Yin, eliminating evils and removing toxin are adjuvant therapy. The spleen and stomach should be protected throughout the treatment, and patient's mood are also important. It is of great significance to instruct TCM to treat cerebral tumor.

Placenta accreta spectrum (PAS) refers to the condition that placental trophoblast cells directly invade the myometrium,which is one of the most dangerous complications in obstetrics,but the pathogenesis has not been clarified.In recent years,the incidence of PAS was increasing,which has become the major reason leading to postpartum hemorrhage,perinatal emergency hysterectomy and maternal death.Available studies suggested that the occurrence of PAS was related to the following three interconnected factors:the loss of decidual membrane,enhanced trophoblast invasiveness and abnormal recasting of uterine spiral artery.This review focused on these three factors and tried to illustrate the pathophysiology of PAS.

Objective To evaluate the risk factors and sonographic findings of pregnancies complicated by placenta increta or placenta percreta. Methods Totally, 2219 cases were retrospectively analyzed from 20 tertiary hospitals in China from January 2011 to December 2015. The data were collected based on the original case records. All cases were divided into two groups, the placenta increta (PI) group (79.1％, 1755/2219) and the placenta percreta (PP) group (20.9％, 464/2219), according to the degree of placental implantation. The risk factors and sonographic findings of placenta increta or percreta were analyzed by uni-factor and logistic regression statistic methods. Results The risk factors associated with the degree of placental implantation were age, gravida, previous abortion or miscarriage, previous cesarean sections, and placenta previa (all P<0.05), especially, previous cesarean sections (χ2=157.961) and placenta previa (χ2=91.759). Sonographic findings could be used to predict the degree of placental invasion especially the boundaries between placenta and uterine serosa, the boundary between placenta and myometrium, the disruption of the placental-uterine wall interface and loss of the normal retroplacental hypoechoic zone(all P<0.01). Conclusions Previous cesarean sections and placenta previa are the main independent risk factors associated with the degree of placenta implantation. Ultrasound could be used to make a prenatal suggestive diagnosis of placenta accreta spectrum disorders.