BACKGROUND:Autologous hematopoietic stem celltransplantation is an effective treatment for multiple myeloma. After chemotherapy, autologous hematopoietic stem celltransplantation becomes a standard therapeutic regimen for multipla myeloma, and numerous units and centers have reported that. How to reduce toxic and adverse reactions of the drugs, transplantation-related complications and improvement of long-term survival have been present foci.
OBJECTIVE:To summarize the new progress of autologous hematopoietic stem celltransplantation in the treatment of multiple myeloma.
METHODS:We retrieved PubMed and China National Knowledge Infrastructure database, Vip database, Wanfang database, free medicaljournals.com source for articles published from January 2006 to November 2012 concerning autologous hematopoietic stem celltransplantation in the treatment of multiple myeloma. The key words were“autologous hematopoietic stem celltransplantation, multiple myeloma”. A total of 46 articles were included.
RESULTS AND CONCLUSION: Large-dose chemotherapy combined with autologous hematopoietic stem celltransplantation for multiple myeloma obtained better outcomes compared with the traditional chemotherapy. However, many patients could not relieve after single autologous hematopoietic stem celltransplantation, and the disease recurred final y. Al ogeneic hematopoietic stem celltransplantation was limited by donor source, and treatment-associated fatality rate was high, so its use was confined. Therefore, present new development direction included twice autologous hematopoietic stem celltransplantation, autologous transplantation combined with al ogeneic transplantation with reduced-intensity conditioning regimens as wel as drug on the basis of single autologous hematopoietic stem celltransplantation. Novel drug proteasomes inhibitor and immunomodulator in inducer remission, pretreatment and sustaining stages obviously improved total reaction rate of multiple myeloma therapy and long-term survival.

BACKGROUND: The previous methods for the repair of tendon defect include end-to-end method, autologous tendon graft, tendon al ograft or artificial tendon transplantation, but each method has its advantages and disadvantages. OBJECTIVE: To investigate the feasibility of constructing tissue-engineered tendon by rabbit bone marrow mesenchymal stem cells as seed cells which were induced by bone morphogenetic protein 12 and with col agen-polyglycolic acid composite as frameworks in the repair of rabbit tendon defects. METHODS: Bone marrow was separated from rabbit proximal femur to harvest cells, and the cells were passaged to the second generation and induced with 10 μg/L bone morphogenetic protein 12. Then the passage 2 cells were implanted into the prefabricated tissue-engineered tendon on the polyglycolic acid stitch with certain percentage together with col agenⅠsolution. The rabbits were used to establish the Achil es tendon defect models, and different methods were used to repair Achil es tendon defect: tissue-engineered tendon, col agenⅠ-polyglycolic acid stitch and end-to-end suturing in silk. Morphology, mechanics and shistopathology of the tissue-engineered tendon were observed. RESULTS AND CONCLUSION: Pathomorphological observation of histological section after 12 weeks showed that multiple fusiform fibroblasts were homogeneously distributed in col agen in the direction of stress mechanics.Fibrocytes increased obviously, new smal vessels could be seen and col agen was found aligned compactedly. In col agen Ⅰ-polyglycolic acid stitch group, a part of fibroplasia hyperplasia accompanied by granulation tissue formation could be seen, the col age fibers were in loose filamentous network and the cells were distributed disorderly and unevenly. Granulation tissue formed around the fibrous tissue in the silk group. Biomechanics strength in bone morphogenetic protein 12+polyglycolic acid group was better than that in the col agen Ⅰ-polyglycolic acid group, and there was significant difference when compared with suture silk group. The biomechanics strength of the bone morphogenetic protein 12+polyglycolic acid group was lower than that of normal tendon. It is possible to construct a tissue-engineered tendon with autologous bone marrow mesenchymal stem cells as seed cells induced by bone morphogenetic protein 12 and with the col agen-polyglycolic acid as the framework. Constructed tissue-engineered tendon has biomechanics characteristics and can be used to repair Achil es tendon defect.

Objective To evaluate the clinical value of 16-slice spiral CTA for the diagnosis of lower extremity arterial disease.Methods A total of 103 patients with arterial disease at the lower extremities were submitted to 16-slice spiral CTA.A scanner with a slice thickness of 5 mm,pitch 1.15 mm,increment 1.0 mm,and overlapping 30% was used.Totally 90-100 ml of contrast agent was injected at a rate of 3 ml/s.The scanning was started with a Smartprep auto-trigger and persisted for 20-30 s.The reconstructed images were reformed by means of maximum intensity projection,volume rendering technique,and multiplanar reformation.Results The reconstructed images of the 103 cases were clearly demonstrated by CTA,which showed arteriosclerotic occlusion in 64 patients,arteriostenosis in 32,aneurysm in 4,and normal vessels in 3.Among the 103 patients,40 received surgical treatment,which confirmed the results of CTA.Conclusion Lesions in the lower extremity arteries can be well demonstrated by 16-slice spiral CTA,which can serve as a pre-surgery screening and evaluation.

Objective To explore into the superiority of the treatment of clavicle-hook plate for acromioclavicular dislocation and the fracture of the distal end of clavicle.Methods Select 35 clinical cases with the acromioclavicular dislocation and the fracture of the distal end of clavicle, and then evaluate the function of the joint and the union of fracture.Results All the fractures got fully union, no joint re-dislocation, and got 100% excellent and good result.Conclusion Clavicle-hook plate is the perfect fixation in the treatment of the acromioclavicular dislocation and the fracture of the distal end of clavicle.

Bioeleotrical activities of human cerebral cortex which control and regalate movements get to increase during voluntary movements, the metabolic level of the cells of motor areas change at the same time,and consequently regiond cerebrd blood flow (rCBF)changes. Different changes of rCBF indicate the range of motor areas with which the relavant movemats are involved.And studies of this take great significance in finding out the basic active regalarity and features of human brain. In this artide motheds of the determination of rCBF an introduced briefly, and changes and distribution of rCBF of rCBF of each cortical moter area during different types of volantary movements are discribed. Keywords：regional cerebral blood flow; voluntary movements; cerebral corrical motor areas

Influenced by the intensity, volume of exercise, the basic metabolic features of skeletal muscle are changed to such structural and functional adaptations as there are increases in the amount of contractile components, muscle glycogen and myoglobin, in the volume and quantity of mitochondria and in the density of capillary in skeletal muscle, which result in enhanced aerobic metabolism, contraction efficiency and prolonged time defore failure. It is also pointed out that the structural changes and decrease of function of sarcoplasmic reticula during acute exercise are important reasons for skeletal muscle fatigue , whereas, high- intensity training can improve sarcoplasmic reticulum function and its Ca2＋ -intake rate, so that to improve the physiological efficacy of excitation- contraltion coupling. So it is put forward that anti- resistance training, as a means of exercise therapy, can efficiently increase muscle strength and prevent muscle atrophy. Keywords：exercise;muscle metabolism;contractile protein;sarcoplasmic reticulum;mitochondria;oxygen restore;exercise therapy

PurposeTo explore the value of gemstone spectral imaging (GSI) in diagnosis of thyroid nodule hemorrhage.Materials and Methods Seventeen patients with surgery and pathology confirmed thyroid nodule hemorrhage underwent thyroid spectrum CT scan. The CT value, iodine concentration value, water concentration value and the effective atomic ordinal value as well as spectral curve slope of hemorrhagic nodules and surrounding normal thyroid tissue were measured respectively.Results Hemorrhagic thyroid nodules showed equal or high CT value, low concentration of iodine, high concentration of water, low spectral curve slope, and low effective atomic ordinal value on spectral CT imaging. There were statistically significant differences in concentration of iodine value, concentration of water value, and spectral curve slope between hemorrhagic nodules and surrounding normal thyroid tissue (Z=-5.438,-4.679 and-5.317,P<0.01), and there were statistically significant differences in CT value and effective atomic ordinal value (Z=-2.097 and-2.230,P<0.05).Conclusion Energy spectrum CT scan is important in detection and accurate diagnosis of thyroid nodule hemorrhage.

BACKGROUND: It is reported that there is special physiological effect of Neiguan (Luo-connecting point, P6) acupuncture on the cardiovascular system. Instead of acupuncture, irradiation of the Neiguan point with He-Ne laser can improve the cardiac function of senile patients with coronary heart disease (CHD).OBJECTIVE: To study the effect of irradiation of Neiguan acupoint with He-Ne laser on the circulatory system of senile patients with coronary heart disease.DESIGN: Auto-control study.SETTING: Henan Provincial General Hospital of the Chinese People's Armed Police Force.PARTICIPANTS: Forty senile patients with coronary heart disease hospitalized in the General Hospital of Henan People's Armed Police Force for rehabilitation from 2000 to 2001 were selected. There were 28 males and 12 females, aged from 66 to 85 with the average age of 70. The course of their disease was from 2 years to 20 years. Among the patients, 15 were complicated with essential hypertension and 7 were with hyperlipemia.METHODS: He-Ne laser, with wavelength of 632.8 nm and power of 5 mw, was used to irradiate directly the Neiguan acupoint once a day, 15 minutes in each time and 20 times as a whole course. Indexes of hemodynamics were detected before the treatment, just after the first treatment and after the first course of treatment.MAIN OUTCOME MEASURES: ① Cardiac work total (CWT), left heart work effective (LWE) and left cardiac index (LCI); ② Left heart total pumping force (LTPF), left heart jetting pressure (JP), left heart effective pumping force (LEPF) and pressure of efflux (EPE); ③ Consumption myocardium oxygen (CMO) and coronary compliance (CMR); ④ Modulus of elasticity of the cardiac muscle (VE).RESULTS: All 40 senile patients with coronary heart disease entered the final analysis without any loss. ① Comparison between the first time of post-treatment and the pre-treatment: The data of CWT, LCI, and LWE were decreased [(534.086 ±90.923), (616.587 ±137.426) J/minute;(4.821±0.622), (5.469±1.144) L/minute.m2; (116.528±22.476), (136.603 ±30.796) J/minute, P ＜ 0.05 or P ＜ 0.01]. Parameter of CMO was decreased but parameter of CMR was increased [(22.783±4.174), (25.255±6.125) mL/minute,(180.108±31.210), (157.031±35.056) g/cm4s2, P ＜ 0.01]. ② Comparison between post-first course and pretreatment: Parameters of CWT were decreased [(489.291±118.434), (616.587±137.426) J/minute, P ＜ 0.05],those of CMO were also decreased but th ose of CMR were increased [(22.472±6.011), (25.255±6.125) mL/minute, (193.757±51.704),(157.031±35.056) g/cm4s2, P ＜ 0.01].CONCLUSION: The treatment of coronary heart disease with He-Ne laser beam instead of needling may induce heating effect, biological effect and electromagnetic field, which can excitated the physiological function of meridian in order to improve cardiac load and myocardial oxygen consumption, to increase the oxygen supply and the utilization rate of tissue, improve relaxation-contraction function of coronary artery and promote the blood supply and circulation of coronary artery.

Objective To test amyloid beta protein(Aβ)40 and Aβ42 levels in CSF and apolipoprotein E (ApoE) genotype in patients with Alzheimer's disease(AD) and study whether or not the Aβ is related to the severity of dementia and the genotypes of ApoE.Methods 48 AD patients including 27 cases of mild type and 21 cases of serious type and 35 normal controls were selected.Aβ40 and Aβ42 in CSF and ApoE genotype were analyzed.Results Aβ40 levels were ( 12.3 ±4.6) μg/L,( 11.7 ±4.1 ) μg/L,( 12.6 ±4.9) μg/L and ( 11.0 ±3.7) μg/L(t = 1.377,0.705 and 1.385 ,all the p values were greater than 0.05) and Aβ42 levels were ( 105.3 ±25.4) ng/L,(110.7 ±21.7) ng/L,(96.9 ±23.9) ng/L and (123.5 ±29.6) ng/L(t=3.006,2.832,and 3.488,all the p values less than 0.01 ),in AD group,mild AD group,moderate to serious AD group and normal controls,respectively.Aβ40 levels were (11.9 ± 5.2) μg/L vs.(10.5 ± 3.8) μg/L in AD and controls with ApoEε4(t=0.696,P＞0.05) and (12.6 ±4.5) μg/L vs.(11.4 ±3.4) μg/L without ApoEε4(t = 1.008,P＞0.05).Aβ42 levels were (99.7 ± 23.8) ng/L vs.( 129.6 ± 31.0) ng/L in AD and controls with ApoEε4( t =1.632,P ＞ 0.05 ) and ( 110.4 ± 28.4) ng/L vs.( 129.6 ± 31.0) ng/L in those without ApoEε4 ( t = 2.110,P ＜0.05 ).Conclusions The CSF level of Aβ is abnormal in AD,and it is related to the severity of the disease and the ApoE genotypes.

10.3969/j.issn.2095-4344.2013.26.013