The clinical application of biological immunotherapy such as chimeric antigen receptor T cells (CAR-T) and novel targeted therapy has explored a new therapy for multiple myeloma (MM) treatment. Targeting B-cell maturation antigen (BCMA), allogeneic CAR-T, antibody-drug conjugate (ADC) and bispecific antibody targeting BCMA have achieved remarkable efficacy and safety in many clinical studies. This article introduces the latest immunotherapy for MM at the 62nd American Society of Hematology (ASH) Annual Meeting.

Objective To prove into the effect of parental involvement in nursing to discharged children with metabolic syndrome.Methods Forty-six children with metabolic syndrome were equally divided into the observation group and the control group according to the order of admittance.Both groups accepted health education,guide to lifestyle and so on.After leaving hospital,the observation group accepted parental involvement in nursing,while the control group accepted physical examination regularly.Then the lifestyles,physical indicators,blood pressure and biochemical indicators of both groups were compared.Results The lifestyle of the observation group was significantly greater than that of the control group(All P<0.01).The observation group had greater declines in waist,blood pressure,TC,TG and LDL-C and a greater increase in HDL-C than those of the control group.Conclusions Parental involvement in nursing can improve the lifestyle of children patients,which is good for the declines of their weigh and blood lipid.This treatment can achieve the goal of control and treatment of children metabolic syndrome.

Objective To improve the recognition of sarcoidosis in elderly patients.Methods Clinical data of 13 elderly patients with sarcoidosis were retrospectively analyzed.Results There were three cases without symptom and five cases with intra-pulmonary and extra-pulmonary manifestations respectively.Eight cases had atypical radiological appearances and five cases showed inflammatory changes through bronchofibercopy.There were three cases with increased percentage of lymphocytes and high ratio of CD4/CD8 in bronchoalveolar lavage fluid (BALF) respectively.Seven cases were diagnosed through biopsy.And the symptoms of all thirteen patients diminished after treatmeit.Conclusions The clinical symptom and radiologieal manifestation of sarcoidosis in elderly patients are varied and usually atypical.The diagnosis should be based on comprehensive analysis including clinical manifestation and examination.The elderly patients with indication of treatment can be given corticosteroid therapy with close clinical monitoring.

[Objective]To investigate the ability of repairing bone defect with the combination of recombinant human insulin-like growth factor-1(rhIGF-1),coralline hydrolyapatite(CHA) and autogeneous red bone marrow(ARBM) by way of imaginology.[Method]Bilateral middle radius periosteum-bone defects (11mm in length) were created in 54 Chinese rabbits,and were ramdonly devided into 6 groups(each group containning 18 radial defects of one forearm): group A, defects transplanted with rhIGF-1/CHA/ARBM,group B,with CHA/ARBM,group C,with rhIGF-1/CHA,group D,with CHA,group E,with autograft,group F,no implant.At 2,4,8,and 12 weeks postoperation,the repair effects of defects were evaluated by observation of gross appearance,roengenodiagnosis and radionuclide bone image assay.[Result]In group A,radiological and bone density image analysis showed that the defects were bridged well at 12 weeks postoperatively and was significantly superior to those of any other groups(P0.05).[Conclusion]The recombinant compound rhIGF-1/CHA/ARBM,which possesses the potential ability of osteogenesis,osteocondution and osteoinduction for bone defect repairing,can enhance bone healing and serve as a new type of bone substitute.

Objective To reconstruct caudate nucleus,lentiform nucleus and thalamus three-dimensionally,fuse these neural structures with (patient's) radiological images and provide anatomical data for diagnosis and treatment of neurosurgical diseases. Methods Chinese Virtual Human dataset was segmented using image-transparency method at first and each image was smoothed by eroding and dilating, then fused neural structures with MRI,the neural structures and brain in MRI were reconstructed and displayed using surface rendering and volume rendering lastly. Results The reconstructed neural structures were smooth,natural and realistic.Their shapes and positions was clearly displayed and could be rotated, observed in any direction.On the fused images,the neural structures and tumor could be seen at the same time.Conclusion The reconstructed structures and fused images have great reference value to teaching and learning and diagnosis and treatment of neurosurgical diseases.

Adult ; Calcinosis ; metabolism ; pathology ; Diagnosis, Differential ; Fibroma ; metabolism ; pathology ; Gastrointestinal Stromal Tumors ; pathology ; Humans ; Male ; Stomach Neoplasms ; metabolism ; pathology ; Vimentin ; metabolism

Slow coronary flow phenomenon(SCFP) is an angiographic observation characterized by delayed distal vessel opacification in the absence of significant epicardial coronary disease. Only limited studies have been focused on the etiologies, clinical manifestations and treatment of this unique angiographic phenomenon. In our case report, we described an 85-year-old man who came with significant ST segment elevation in leads V1-V4 and V3R-V5R without increase in myocardial enzyme. The patient also developed respiratory failure requiring intubation and mechanical ventilation. Coronary angiography revealed only mild atherosclerosis without spasm or thromboembolic occlusion. Slow flow was seen in all coronary arteries, especially in the left anterior descending and right coronary arteries. This case speculated that transmural myocardial ischemia with ST segment elevation might be resulted from slow coronary flow. Transmural myocardial ischemia can occur owing to abnormalities of the coronary microcirculation.

Background Perineural invasion is an important biological character for adenoid cystic carcinoma (ACC) of lacrimal gland,which is different from those of other lacrimal gland tumors.As the important part of neurotrophic factors,glial-derived neurotrophic factor (GDNF) plays an important role in perineural invasion for ACC of salivary gland.GDNF regulation in the ACC cell biology function needs to be further explored.Objective This study was to investigate the effect of GDNF on proliferation and migration of ACC cells,and to explore the mechanism of neural invasion in ACC of lacrimal gland.Methods ACC-2 cell line was cultured and passaged in RPMI 1640 medium with 10％ fetal bovine serum,100 U/ml penicillin and 0.1 g/L streptomycin.Single-cell suspension was prepared with the density of 2×104/ml using logarithmic phase of cells and then incubated to 96-well plate.GDNF with the final concentration of 20,60,80,100 and 120 μg/L was added into the medium respectively in the experimental groups,and the cells were cultured in the medium without GDNF as the control group.The expression of GDNF in ACC-2 cells was detected by immunohistochemistry.MTT assay was employed to assay the absorbance value at the wavelength of 570 nm (A570) for the evaluation of proliferation of ACC-2 cells after cultured by different concentrations of GDNF for different time points.Meanwhile,transwell chamber was used to examine the cell migrated number.Results Immunochemistry assay exhibited that ACC-2 cells showed the positive response for GDNF with the brown staining in the cytoplasm.In 48 hours after culture,the A570 value was elevated with the increase of GDNF concentration,showing a significant difference among various groups (F =3.336,P =0.026),and the A570 value in various concentrations of GDNF groups was higher than that of 0 μg/L GDNF group (all P＜0.05).After action of 80 μg/L GDNF,the A570 value of the cells was gradually increased with the prolong of culture time (Ftime =39.979,P=0.000).In 30 minutes after GDNF cultured,the number of migrated cells increased with the increase of GDNF concentration (F=144.886,P=0.000).ACC-2 cells were cultured by 100 μg/L GDNF for 24,30 and 40 hours,the number of migrated cells were more as the time lapse,and more migrated cells were seen in GDNF group at various time points (Ftime =46.747,P =0.000 ; Fgroup =63.786,P =0.000).Conclusions GDNF can stimulate the proliferation and migration of ACC-2 cells in a dose-and time-dependent manner.

Objective To investigate the effect of lower limb rehabilitation training robot combined with task-oriented training on walking ability after stroke. Methods From February 2014 to August 2015,74 consecutive patients with post-stroke who received rehabilitation therapy and met the inclusion criteria admitted to the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University were collected prospectively. They were all the patients with the first-ever stroke for 1 to 12 months. They were divided into either an observation group (n = 39)or a control group (n = 35)according to whether they were treated with the lower-limb rehabilitation robot. The patients of both groups received task-oriented training,2 times a day,once for 20 min,5 days a week for 12 weeks. The observation group was also treated with the lower-limb rehabilitation training robot,1 time a day,once for 30 min,5 days a week. Berg balance scale,Fugl-Meyer assessment (FMA),timed up-and-go test (TUG)and knee flexion active range of motion (KFAROM)were used to assess the efficacy. Results (1)After treatment,the Berg scale and FMA scale scores were increased in the observation group and the control group compared with before treatment. There was significant difference (Berg scale:28 ±9 vs. 22 ±9,29 ±9 vs. 24 ±9;FMA scores:47 ± 8 vs. 36 ± 8,40 ± 6 vs. 36 ± 7;all P < 0. 01),however,there was no significant difference between the two groups (P <0. 05),and there was significant difference in FMA scores between the 2 groups (P < 0. 01 ). The differences of Berg scale scores in the observation group and the control group were 10. 75 + 0. 30 and 4. 71 + 0. 14 respectively before and after treatment. There was no significant difference between the 2 groups (t = 0. 95,P = 0. 345). The differences of FMA scores in the observation group and the control group were 5. 8 ±0. 6 and 4. 9 ±0. 8 before and after treatment (t =5. 16,P <0. 01). (2)After treatment,the tug test and KFAROM of the observation group and the control group were better than those before treatment. There were significant differences (TUG test:35 ± 13 s vs. 56 ± 18 s,53 ± 17 s vs. 58 ± 18 s;KFAROM:82 ± 24° vs. 60 ± 23°,63 ± 23° vs. 57 ± 26°;all P < 0. 01),and there were significant differences between the 2 groups (all P < 0. 01). The differences of the TUG test in the observation group and the control group before and after treatment were 21. 5 ± 5. 0 and 4. 6 ± 0. 6 s respectively. There was significant difference between the 2 groups (t = 9. 55,P < 0. 01);the differences of KFAROM in the observation group and control group before and after treatment were 5.8 ±0.6° vs. 4.9 ±0.8° respectively. There was significant differences between the 2groups (t =4.17,P <0. .01). Conclusion Lower limb rehabilitation training robot combined with task-oriented training may improve the lower extremity motor function,walking ability,knee flexion joint activity of the patients after stroke,but the improvement effect of the lower limb balance is not obvious.

Objective Not much information is available on the comparative analysis of G test on diagnosis of deep fungal in -fection by colormetric and turbidimetric measurements .The purpose of this paper was to explore the clinical value of fungal (1-3)-β-D-glucan detection kit ( colormetric measurement ) . Methods 89 clinical samples collected from Hainan Branch of PLA General Hos-pital were detected by fungal (1-3)-β-D-glucan detection kit (turbidimetric measurement) and fungal (1-3)-β-D-glucan detection kit ( colormetric measurement ) respectively , among which 32 cases were from disease group ( deep fungal infection in patients ) and 57 ca-ses were from control group ( healthy person ) .The comparison was made on the sensitivity , specificity and accuracy of these two meth-ods. Results The sensitivity, specificity and accuracy of colormetric measurement kit on the diagnosis of deep fungal infection were obviously higher than those of turbidimetry method kit (81.2%vs 53.1%, 91.2%vs 75.4%, 87.6%vs 67.4%, P<0.05), which was of significant difference .Detection result of colormetric method had a positive coincidence rate with other systems '( except respira-tory system) deep fungal infection, which was obviously higher than turbidimetry method (92.8%vs 57.1%, P<0.05).Positive co-incidence rate and total coincidence rate between colormetric method kit and clinical diagnosis result on differentiate samples were obviously higher than those of turbidimetric method kit (P=0.01). Conclusion Colormetric measurement kit has higher accuracy and higher coincidence rate with clinical diagnosis than turbidimetry meas-urement kit , which is better for clinical service .