Objective To compare the efficacy and toxicity of melphalan + prednisone + thalidomide regimen (MPT) and melphalan + prednisone regimen (MP) in the treatment of multiple myeloma (MM).was given 100-200 mg/d everyday. 21 cases in MP group, the dose of melphalan and prednisone were the same as that in MPT group. The efficacy was evaluated after 6 cycles of treatment. Results The overall response rate (ORR) of MPT group and MP group were 65.4 % and 42.9 %, respectively (P＞O.05). The median response time in MPT group versus MP group was 2 months versus 3 months. Compared with the MP group. the increase of hemoglobin and albumin concentration in the MPT group is significantly higher (P＜ 0.05).The incidence of adverse effects of MPT group was higher than that of MP group (P ＜0.05), but the percentage of grade 3 and grade 4 toxicity was no different. The median PFS in MPT group was 11 months, 2-year PFS was 66.18 %. Conclusion Compared with MP, MPT could achieve higher response rate, improve the life quality and prolong the survival time of MM patients with better tolerance.

Objective:To apply the strategy of proteomics with two dimensional gel electrophoresis(2DE) in esophageal cancer.Methods:the protein of esophageal cancer tissues and its adjacent normal tissue were separated by 2DE, the gels were analyzed with software ImageMaster4.01 to find out the spots different between cancer and control, and the proteins in the spots were identified by matrix associated laser desorption/ionization time of flight(MALDI TOF) mass spectrometry.Results:a new reasonable strategy of study for proteomics on esophageal cancer was raised and candidate cancer marker of two pyruvate kinase isozyme were found under such strategy.Conclusion:Under reasonable strategy, the analysis of proteomics with 2DE on human tissue is a useful method for discovering valuable cancer marker candidates. Pyruvate kinase isozyme M2/M1 which were found in cancer tussues will be very important in diagnosis and treatment of esophageal cancer.

Objective To investigate the prognostic factors in acute myeloid leukemia subtype M2 (AML-M2) patients with chromosome translocation of 8 and 21. Methods By using G-banding analyses karyotype and combining the clinical data, prognostic factors in 94 cases of de novo adult AML-M2 in our hospital from 2001 to 2007 were retrospectively analyzed. Results Chromosome 8 and 21 translocation were identified in 53.2 % (50/94) of AML-M2 cases. In the patients with other aberrations in addition to t(8;21), their complete remission (CR) rates, overall survival (OS) was lower than the patients with sole t (8;21) and normal karyotype(P <0.05). And the patients with sole t (8;21) whose CR rates and OS had no difference with patients with normal karyotype (P>0.05). The patients were divided into 3 subgroups (low index, less than 2.5;intermediate index, 2.5-20;high index, 20 or more) according to WBC index. The CR had no difference among the 3 subgroups, but the OS of the 3 subgroups was different (P<0.05). The OS in the lowest index group was longer than that in the others. Conclusion Cytogenetically, 53.2% cases had chromosome 8 and 21 translocation, 46 % cases had t(8;21) with additional chromosomal abnormalities, and the main additional abnormalities were loss of a sex chromosome (LOS). t(8;21) AML-M2 patients with additional chromosome abnormalities had low complete remission rate and shorter survival time, and its prognosis was poorer. WBC index have no influence on complete remission rate but effected the survival time.

PurposeTo probe into the feasibility of small field of view intravoxel incoherent motion (IVIM) MRI in the grading of cervical cancer before surgery.Materials and Methods Twenty-three patients with cervical cancer confirmed pathologically underwent preoperative conventional MRI and IVIM sequence scan [IVIM sequence included 10 b value (0-1500 s/mm2)]. Based on postoperative pathological cell morphology the patients were divided into well differentiated group (10 cases) and moderately or poorly differentiated group (13 cases). Then the parameters such as the ADC standard, D value, D* value and f value were calculated in each group according to double exponential function analysis. The data in the two groups were compared and nonparametric test to see whether they had normal distribution.Results Compared with the well differentiated group, the moderately or poorly differentiated group had statistically lower ADC standard value and D value (t=140.5 and 129.5,P<0.05); the area under the D value curve was 0.965 and 0.854, respectively. The sensitivity and specificity of well differentiated group and moderately or poorly differentiated group were 88.9%, 100.0% and 77.8%, 81.8%, respectively. There was no difference in either D* value or f value between the two groups (t=-0.184 and 1.072,P>0.05).Conclusion Small field of view IVIM MRI is feasible in predicting the differentiation of tumor in the preoperative grading of cervical cancer.

Objective To explore the clinical characteristics and prognosis of acute myeloid leukemia (AML) patients with CCAAT/enhancer binding protein α (CEBPA) mutations.Methods 208 patients with de novo AML were retrospectively analyzed with regard to frequency of CEBPA mutations,clinical characteristics,therapeutic response and long-term outcome.Results CEBPA mutations were detected in 37 patients (17.8 ％),with 29 cases of double mutations and 8 cases of single mutation.In 117 cases of patients with normal karyotype,28 cases (23.9 ％) were detected with CEBPA mutations.As compared with no CEBPA mutation,the following characteristics were observed in patients with CEBPA double mutations.Presented with younger age at diagnosis,82.8 ％ (24/29) of the patients were M1 and M2.Presented with higher peripheral white blood cell count,higher hemoglob in and low platelet count.And increases of CD7,CD34 and HLA-DR expression.Compared with those without mutation,patients with biCEBPA mutations had better overall survival (OS) (2-years OS:100 ％ vs 75.1％,P =0.045).Conclusion BiCEBPA mutation is one of the favorable prognosis indicators.

Objective To evalute and compare the efficacy and safety of epinephrine-saline submu-cosal injection of different concentrations on endoscopic submucosal dissection (ESD),and to discuss the best concentration of submucosal injection.Methods A total of 128 patients who underwent ESD were ran-domly assigned to submucosal normal saline injection group (group A,n =32),0.001% epinephrine-saline injection group (group B,n =32),0.002% epinephrine-saline injection group (group C,n =32),and 0.004% epinephrine-saline injection group (group D,n =32).The incidence of bleeding during and after ESD were counted,the blood preasure and heart rate of preoperative and intraoperative,the amount of sub-mucosal injection,the time of operation were observed.Results ESD was successfully performed on all pa-tients.There were no difference in highest blood preasure and fastest heart rate between preoperative and in-traoperative results of each group.No perforation or intraoperative acute massive bleeding occurred.Intraop-erative acute minimal bleeding during ESD occurred in 9 patients in group A and 3 in group B,2 in group C and 2 in group D (P <0.05),but there were no differences among group B,C and D.The amount of submu-cosal injection of group A was(39.5 ±10.8)ml,which was more than that of group B(29.4 ±9.4)ml,group C(27.3 ±8.2)ml and group D(20.4 ±11.8)ml with significant difference.There were no differences a-mong group B,C and D,but there was less in group D than group B.The operation time of group A was(82.3 ±24.78 minutes),which was longer than that of group B (60.7 ±25.35minutes),group C (54.7 ± 31.72minutes)and group D(59.2 ±28.49 minutes),but there was no difference among B,C and D group. Conclusion Epinephrine-saline submucosal injection assiting ESD is safe and effective and reduces the op-eration time and bleeding than normal saline.The increase of the epinephrine-saline concentrations has not been found to be more beneficial.

Objective:To investigate the expression and prognostic significance of CD19 in patients with Acute myelogenous leukemia with AML1-ETO positive. Methods: Clinical data of 66 patients AML with AML1-ETO positive who were newly diagnosed from Jan 2010 to Dec 2015 were collected. To retrospectively analyze the relationship between clinical characteristics and expression of CD19,so dose the prognosis. Results:The positive rate of CD19 expressing in AML with AML1-ETO positive was 50. 0%. There were no statistically significant differences in terms of age,gender,hemoglobin,platelet,percentage of bone marrow blasts,accompanied with chromosome ,gene mutations between patients with and without CD19 expression(P>0. 05). The white blood cell count(WBC) of the CD19 negative group was higher than CD19 positive group,while showed significant difference(P=0. 027). Although the relapse-free survival (RFS) of patients with CD19 expression was higher than those without,no significant difference was calculated (P=0. 105). Patients with CD19 expression had superior overall survival ( OS ) compared to those without CD19 expression ( P = 0. 030 ) . Multivariable analysis for OS identified CD19 positivity as an independent predictor associated with better prognosis. Conclusion: The expression of CD19 in AML with AML1-ETO positive may be an indicator associated with better prognosis.

Objective To investigate the efficacy and safety of cladribine in the treatment of patients with refractory/relapsed acute myeloid leukemia (AML). Methods The data of 8 patients with refractory/relapsed AML treated with regimens containing cladribine at a dose of 5 mg/m2 per day for 5 consecutive days were retrospectively analyzed. The efficacy and adverse reactions were observed during treatment. Results Among the 8 patients, 5 patients achieved complete remission (CR), 1 patient achieved partial response (PR), and 2 patients obtained non remission (NR). The adverse reactions could be tolerated. Conclusion Regimen containing cladribine is an effective treatment procedure for the patients with refractory/relapsed AML, and its adverse reactions can be tolerated, which requires further clinical study.

Objective To investigate the diagnostic significance of basophil activation test (B A T) in ana-phylaxis to non-ionic contrast media through testing the content of CD 63, m ast cell-carboxypeptidase A 3 (M C-CPA 3), and term inal com plem ent com plex SC5b-9 of the individuals by testing their levels in the norm al im m une group and the anaphylaxis groups to β-lactam drugs and non-ionic contrast media. Methods The CD 63 expression of basophilic granulocyte in blood w as detected by flow cytom etry. The levels of M C-CPA 3 in blood serum and SC5b-9 in blood plasm a w ere detected by ELISA . Results The CD 63 expression of basophilic granulocyte in blood, the levels of M C-CPA 3 and SC5b-9 of anaphylaxis to non-ionic contrast media and β-lactam drugs w ere significantly higher than that in norm al im m une group (P<0.05). Conclusion There is activation of basophilic granulocytes, m ast cells and com plem ent system in anaphylaxis to non-ionic contrast media. B A Tcan be used to diagnose the anaphylaxis to non-ionic contrast media.

of NB4 cells at S phase was lower than those in control group (P <0.05),and the number of NB4 cells at G1 phase was increased (P <0.05).The expression levels of Bcl-2 in ICA groups were significantly lower than that in control group (P < 0.05 ), while the expression levels of Bax were higher than that in control group (P < 0.05 ). Conclusion ICA can induce the apoptosis of NB4 cells via inhibiting the expression level of Bcl-2 and up-regulating the expression level of Bax.