Chemotherapy with traditional standard dose or autologous stem cell transplantation (ASCT) after chemotherapy with high dose have some remission effect for multiple myeloma, but relapse still exists. The maintenance treatment would prolonged the remission stage. These treatments included the use of alkylating agent, interferon, corticosteroids, thalidomide and so on. Every maintenance treatment has some advantages and some side effects. The truly effective maintenance treatment would not only minimize the harm of the disease, but also would prolong the overall survival, progression-free survival and the event-free survival. This article summarizes the current progress in the maintenance treatments for multiple myeloma.
Alkylating Agents ; administration & dosage ; therapeutic use ; Glucocorticoids ; administration & dosage ; therapeutic use ; Humans ; Interferons ; administration & dosage ; therapeutic use ; Multiple Myeloma ; drug therapy

Objective To investigate the changes in the expression of GABAAα1, receptors in medial prefrontal cortex (mPFC) in a rat model of neuropathic pain. Methods Nine male Wistar rats weighing 200-210 g were randomly divided into 3 groups ( n = 3 each): control group (group C) , sham operation group (group S) and neuropathic pain group (group P). Neuropathic pain was induced by chronic constrictive injury. The right sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 3-0 chromic catgut. In group S, the right sciatic nerve was exposed but not ligated. The thermal and mechanical pain threshold was measured at 1 d before and 1,4,7, 10 and 14 d after operation. The animals were then sacrificed and the mPFC was removed. The expression of GABAAα1, receptors in mPFC was determined by Western blot. Results Compared with C and S groups, thermal and mechanical pain threshold were significantly decreased and the expression of GABAAα1, receptors was up-regulated in group P ( P ＜ 0.01) . There was no significant difference was in the thermal and mechanical pain threshold and expression of GABAAα1 receptors between C and S groups (P ＞ 0.05). Conclusion Up-regulation of GABAAα1 receptor expression in mPFC may be involved in the development and maintenance of neuropathic pain in rats.

Aim To study the effects of cycle arrest and molecular mechanism in human leukemia HL-60 cells induced by diallyl disulfide ( DADS ) . Methods Cell count, colony formation in soft agar experiments and flow cytometry analysis were employed to observe the DADS-induced cell growth inhibition and the effect of cycle arrest in HL-60 cells. The expressions of Chk1/2 and its downstream element in HL-60 cells were detected by Western blot. Results Cell count revealed that population doubling time increased to 35. 03 h and 71. 82 h, respectively, from 19. 14 h in HL-60 cells treated with 60 and 120 μmol·L-1 DADS ( P<0. 05 ) . Colony formation in soft agar experiments showed that colony formation inhibition rate of HL-60 cells exposed to 30, 60, 90 and 120μmol·L-1 DADS increased to 35. 06%, 62. 10%, 93. 79% and 99. 35%, respectively ( P<0. 05 ) . Flow cytometry a-nalysis exhibited that HL-60 cells treated with 60 and 120 μmol · L-1 DADS for 24 h and 48 h arrested in G2/M phase in a concentration-and time-dependent manner ( P <0. 05 ) . Western blot disclosed that the expression of p-Chk1 increased in a time-dependent manner ( P <0. 05 ); however, Chk1, Chk2 and p-Chk2 were not changed in HL-60 cells treated with 60μmol·L-1 DADS (P >0. 05). The expression of Cdc25C, CyclinB1 and CDK1 decreased after treated with 60 μmol·L-1 DADS in a time-dependent manner ( P<0. 05 ) , but the expression of 14-3-3 protein did not change ( P>0. 05 ) . Conclusion DADS can in-hibit the proliferation of HL-60 cells, and induce G2/M arrest through Chk1/Cdc25 C/CyclinB1/CDK1 path-way.

Objective To discuss the effect and application value of applying the master teacher responsibility system in neurology teaching. Methods 100 five-year medical students were randomly di-vided into the experimental group and the control group with computer. Master teacher and teaching team were set in the experimental group to use a variety of teaching methods for course-teaching. At the same time, the traditional teaching method was used in the control group. After the course, theory test was arranged for the two groups blindly. Statistic tool SPSS 13.0 of t test was used to evaluate the teaching effect of these two groups. And capability-oriented questionnaire survey for experimental group was conducted to survey students' subjective assessment of their own learning. Results The experimental group students' average score of the theory examination was (73.87±7.12), while control group students' average score was (73.18± 9.94), and the difference was not statistically significant (t=0.265, P=0.792). Besides, there was no signifi- cant difference in the scores of male and female students in the experimental group either (t=0.068, P=0.947). Teaching satisfaction survey results showed that 100% (16/16) of the experimental group students believed that their ability of autonomous learning, problem analysis and team cooperation was improved significantly. Conclusion Setting up master teacher responsibility system is beneficial to strengthening teacher team and cultivating students' autonomous learning ability, and it also ensures the fairness of the exam. But it still need to be improved in the quality of teachers, quantity of students, process supervision and so on to ensure the teaching effect.

Objectives To search for the pathogenesis of vaseular endothelial injury and its clinical significance.Methods 36 patients with acute lower respiratory trect infection(ALRI)and 30 healthy controls were envolved. Circulating endothelial cells (CEC)and nitric oxide (NO) levels were tested.Results Circulating nitrite/nitra levels,the stable metabolic products of NO,were found to be significantly higher in the patients with ALRI (44.6?22.6umol/L) than that in the controls (24.5?14.1umoI /L, P

Objective To explore the effects of application of self-made pipe protective belt for catheter of thrombolysis on treatment of patients with lower limb ischaemia via femoral artery puncture. Methods From March 2016 to December 2016,116 patients with lower limb ischaemia treated with femoral artery puncture in a tertiary hospital in Hebei Province were recruited using convenience sampling method. We divided all patients into the ex-perimental group (58 cases) and the control group (58 cases) according to random number table method. For the experimental group,we used sterile transparent dressings to fix the catheter of thrombolysis,then applied self-made pipe protective belt to fix it.In the control group,we used traditional sterile transparent dressings to fix the catheter of thrombolysis,then used self-adhesive elastic bandage for external fixation by cross overlapping. Incidence rate of accidental extubation,pressure ulcer related to medical equipment (tee joint) and medical adhesive-related skin in-jury from two groups were observed. Results The incidence rate of accidental extubation in the experimental group was lower than that in the control group (P<0.01);there were statistically significant differences in the pressure ul-cer related to medical equipment (tee joint)and medical adhesive-related skin injury between two groups (P<0.05). Conclusion During catheter-directed thrombolysis for patients with lower limb ischaemia via femoral artery punc-ture,the self-made pipe protective belt can reduce the incidence of accidental extubation,avoid adverse events such as related to medical equipment (tee joint)and medical adhesive-related skin injury effectively,and ensure safety of the patients.

ObjectiveTo investigate clinical risk factors and coronary angiographic features in young men with acute myocardial infarction (AMI).MethodsWe retrospectively studied 200 young men with AMI and compared with 104 non-CHD men,89 old men with AMI.All patients were admitted to hospital from January 2009 to December 2010 and undergone coronary angiography,and the clinic and coronary angiographic features were assessed.The relation between body mass index (BMI),smoking history,familial history of early coronary artery disease,essential hypertension,type 2 diabetes mellitus,hyperlipidemia,serum uric acid ( UA),lipids,hemoglobin (Hb),fasting blood glucose (FBG) with coronary artery disease and its severity was observed.The severity of CAD was diagnosed by the number of diseased vessel.Results In young men with AMI group,the factors such as smoking history,obesity,essential hypertension,type 2 diabetes mellitus,familial history of early coronary artery disease were remarkably different ( P ＜ 0.05 ) ; body mass index,fasting blood glucose,total cholesterol,triglyceride,low density lipoprotein cholesterol were higher than the control group ( P ＜ 0.05 ),hemoglobin was lower than the control group ( P ＜ 0.05 ).Applying Logistic regression analysis,obesity ( OR =11.020),type 2 diabetes mellitus ( OR =5.805 ),essential hypertension ( OR =4.428 ),familial history of early coronary artery disease ( OR =2.883 ),smoking history ( OR =2.153 ) and lower concentration hemoglobin ( OR =1.034) are independent risk factors (P ＜ 0.05) for young men with AMI. According to coronary angiography in young men with AMI,there were 14 cases with zero-vessel disease,109 cases with singlevessel disease (54.50％,69 cases involved with left anterior descending artery) and 42 cases with twovessel disease,35 cases with three-vessel disease.The ratio of single vessel disease involved left anterior desending artery in young men was higher than that of old men with AMI ( P ＜ 0.05 ).Conclusions Obesity,type 2 diabetes mellitus,essential hypertension,familial history of early coronary artery disease,smoking history and lower concentration of hemoglobin are risk factors of young men with AMI ; Single vessel coronary disease is seen more frequently in young men with AMI.

OBJECTIVETo observe MET-associated alteration during the trans-differentiation from MSCs to neuron-like cells, and to explore the possible molecular mechanism.

METHODSBone marrow MSCs were isolated from rat femur and purified in continuous cell culture. After induced differentiation to neuron-like cells by the combination of butylated hydroxyanisole (BHA) and dimethyl sulfoxide (DMSO), cells were tested by comparative polymerase chain reaction (PCR) for the relative expression of MET biomarkers and transcription factors, and for cell cycle by flow cytometry. Meanwhile, target genes of Wnt/β-catenin pathway were also analyzed by comparative PCR to determine the possible involvement.

RESULTSIn MSC-induced neuron-like cells, MET-associated transcription factors such as Snail, Slug, ZEB1, ZEB2, and Twist were significantly attenuated in expression level. The Mesenchymal marker Vimentin expression level was increased. Membrane protein E-cad was slightly down-regulated, while N-cad level was marginally elevated. Percentage of proliferating cells (S phase in cell cycle) markedly shrank from 40.42% for MSCs to 6.76% for MSC-derived neuron. Additionally, Wnt/β-catenin target genes β-catenin and c-myc were decreasingly expressed.

CONCLUSIONChemically induced trans-differentiation from MSC to neuron caused similar MET-featured alteration in gene expression and proliferation to known MET, which might be underlied by deactivation of Wnt/β-catenin pathway.

Animals ; Epithelial-Mesenchymal Transition ; Mesenchymal Stromal Cells ; cytology ; Neurons ; cytology ; metabolism ; Proto-Oncogene Proteins c-myc ; metabolism ; Rats ; Wnt Signaling Pathway ; beta Catenin ; metabolism

Objective:To evaluate the immunogenicity of recombinant factor H binding protein(fHBP) by detecting serum antibody titer and serum bactericidal antibody test (SBA).Methods:fHBP sequence was selected and synthesized, connected to plasmid pET43.1a, transformed to Escherichia coli BL21(DE3), and expressed two recombinant fHBP proteins, included two subfamilies, fHBPA and fHBPB. After purification, the recombinant fHBP proteins were immunized to rabbits and mice. The immune antiserum titer and the bactericidal titer to epidemic strains of meningococcal bacteria group B were measured by ELISA and SBA respectively. Results:The antiserum titer of fHBP immunized rabbits was greater than 2.0×10 6, and that of immunized mice was not less than 1.0×10 6. fHBP immunized rabbit serum had bactericidal titer more than 1∶128 to 41 strains A subfamily and 20 strains B subfamily in the SBA against 69 endemic strains, and there was no cross-protection between the subfamily bacteria. The bactericidal titers of mouse serum immunized fHBPA to strains A subfamily such as Nm210902 Nm211009、Nm450522 were 1∶1 024, 1∶608、1∶861, to Nm510703、Nm311304、Nm431002 were 1∶234、1∶861、1∶430 respectively, and mouse serum immunized fHBP B to strains B subfamily Nm311302、Nm311304、Nm431002 were 1∶876、1∶274、1∶1858, all of three strains were positive in bactericidal titers. Conclusions:the titer of fHBP antiserum was higher than 1.0×10 6, the bactericidal titer was no less than 1∶128 to 61 epidemic strains, and it has a 94.2% protective effect on 69 meningococcal epidemic strains group B.

OBJECTIVETo explore the effect of septoplasty or in combination with out fracture of the inferior turbinate in patients with nasal septum deviation on the airflow field and the nasal airway structure.

METHODSSix patients with nasal septum deviation underwent spiral CT imaging scans before surgery and during the follow-up. The 3D finite element meshes of the nasal airway were developed from the above CT scans. Given three preconditions, the nasal airflow fields were described by the Navier-Stokes and continuity equations at the inspiratory flow rate of 12 L/min. The whole airflow patterns were obtained and then compared with the airflow filed and airway structure changes before and after surgery. SPSS 12.0 software was used to analyze the data.

RESULTSBefore surgery, area of the common airway and the middle and ventral medial regions in the concave side were (1.61 ± 0.18), (0.40 ± 0.10), (0.40 ± 0.14) cm(2) respectively, and those of convex side were (1.30 ± 0.18), (0.33 ± 0.05), (0.36 ± 0.10) cm(2) respectively. The differences between both sides were of no statistical significance (Z value was 1.782, 1.363, 0.526 respectively, all P > 0.05). Airflow of the above airways were (361 ± 68), (131 ± 25), (100 ± 28) ml respectively in concave side and (178 ± 33), (59 ± 26), (59 ± 18) ml respectively in convex side, which differences were significant statistically (Z value were 2.207, 2.201, 2.201 respectively, all P < 0.05). The inferior turbinate in concave side [(0.93 ± 0.10) cm] was statistically (Z = 2.214, P < 0.05) bigger than that in convex side [(0.58 ± 0.12) cm] before surgery. The airflow fields were in disorder in both ill-airways. After surgery, area of the common airway was (2.55 ± 0.44) cm(2) in concave side and (2.20 ± 0.72) cm(2) in convex side respectively, and area of the middle and ventral medial regions in the convex side were (0.58 ± 0.13), (0.81 ± 0.26) cm(2) respectively, which differences were of significance statistically when comparing to areas before surgery (Z value were 2.201, 2.201, 2.201, 2.201, P < 0.05). The airflow passed through nasal airway orderly in both sides. But the thickness of inferior turbinate was (0.73 ± 0.08) cm in concave side after surgery, which difference was significant statistically in comparison to that before surgery (Z = 2.264, P < 0.05). Consequently, nasal resistance decreased from (0.41 ± 0.03) kPa×L(-1)×s(-1) to (0.16 ± 0.01) kPa×L(-1)×s(-1) after surgery, the difference was significantly (Z = -2.207, P = 0.027).

CONCLUSIONSeptoplasty or in combination with out fracture of the inferior turbinate, followed by the self-adaptation consecutively, could improve the airway and breathing capacity of the nose.

Adult ; Air Movements ; Female ; Humans ; Male ; Nasal Cavity ; physiology ; Nasal Obstruction ; surgery ; Nasal Septum ; surgery ; Respiration ; Treatment Outcome ; Turbinates ; surgery ; Young Adult