Objective To evaluate the efficacy and safety of bortezomib combined with dexamethasone and thalidomide in the treatment of autologous stem cell transplantation ( ASCT) in multiple myeloma ( MM) . Methods The randomized con-trolled trials ( RCTs) on combined therapy with bortezomib,dexamethasone and thalidomide for ASCT in MM were retrieved from Pubmed,Medline,the Cochrane Library,CNKI,VIP and Wanfang databases (published until December 2014).The method of the Cochrane systematic review was used to evaluate the quality of the included RCTs and the Review Manager 5.3.5 software was em-ployed for Meta-analysis. Results Five RCTs involving 1 271 patients were included.The meta analysis results showed that the complete remission ( CR) rate,near-CR rate and total effective rate were significantly higher after combined treatment with borte-zomib,dexamethasone and thalidomide when compared with those in other combination therapies [CR+nCR, RR=1.50,95%CI (1.16,1.94),P=0.002;the total effective rate,RR=1.13,95%CI (1.03,1.24),P=0.009].In terms of safety,the grade 3/4 ad-verse events were significantly increased in the group of combined therapy with bortezomib,dexamethasone and thalidomide [ RR=1.29,95%CI (1.05,1.59),P=0.02]. Conclusion Bortezomib combined with thalidomide and dexamethasone for the treat-ment of ASCT in MM can significantly improve the CR+nCR and the total effective rate,but it also increases the incidence of the overall adverse events at the same time.

Objective To investigate oxygen nebulizer usage among inpatients in an upper first‐class hospital so that this de‐vice can be used by medical personnel and patients properly .Methods Totally 409 patients were investigated about the usage of the device from May 12th to 30th 2014 ,whose outcomes were analyzed by Excel2007 software .Results The total liquid volume of in‐halation on prescription was much larger than the favorable one ,ranging from 4 to 6 mL .And the Oxygen flow ,ranging from 2 .5 to 3 .5 L/min ,was much lower than the normal flow (ranging from 6 to 8 L/min) .In addition ,all patients failed to breathe normally with occasional deep breaths and failed to gargle timely after corticosteroid inhalation .Only 3% patients cleaned their faces after corticosteroid inhalation ,43 .5% patients sit in an upright position ,44 .0% patients kept the nebulizer vertical during treatment .The accuracy rates of mouthpiece position ,the right time to stop nebulizer therapy ,rinsing the nebulizer with sterile or distilled water and allowing to air dry were 95 .1% ,99 .2% ,and 99 .3% ,respectively .Conclusion There are many common patient use nebulizer incorrectlly in the upper first‐class hospital ,and education and guidance by medical personnel should be strengthened .

Objective To observe the effects of pressure control ventilation with volume guar-antee (PCV-VG)on the pulmonary function during percutaneous nephrolithotomy procedures in pa-tients with general anesthesia.Methods Forty patients scheduled for percutaneous nephrolithotomy were selected and randomly allocated into PCV-VG group (n =20)and volume controlled ventilation (VCV)group (n =20).For two modes of ventilation,the goal tidal volume was 6-8 ml/kg,and the respiratory rate was contralled to 12-20 bpm.PA-a O 2 ,OI,RI,Ppk,Pmean,Cst,Hct,Lac were re-corded at intubation (T0 ),1 5 min (T1 ),30 min (T2 ),60 min (T3 ),and 120 min (L4 )after intuba-tion.Results PCV-VG resulted in significantly lower PA-a O 2 ,RI,Ppk,Pmean compared with VC ventilation (P < 0.05 or P < 0.01 ),and significantly higher OI,Cst versus VC ventilation (P <0.05 or P < 0.01).Conclusion In general anesthesia patients undergoing percutaneous nephrolithoto-my,PCV-VG is superior to VCV in terms of lower airway pressure and more stable hemodynamics, thus protects pulmonary function.

A growing number of studies have shown that chronic heart failure is a risk factor for stroke.It can influence the prognosis of patients with stroke,increase mortality,morbidity,and recurrence rate of stroke.However,at present the studies about the correlation between heart failure and ischemic stroke are rare.This article reviews the advances in research on chronic heart failure and ischemic stroke.

Objective To investigate the therapeutic effects and the possible mechanism of fecal transplantation on rats with Clostridium difficile-associated pseudomembranous colitis. Methods A total of 40 Sprague-Dawley rats were divided into four groups including the healthy control group, model group, fecal transplant treatment group and vancomycin treatment group. Rats in three experimental groups were subcuta-neously injected with clindamycin phosphate (10 mg), followed by treatment with toxin producing Clostridi-um difficile (ACTT43255) enema 24 hours later. The rats in fecal transplant treatment group and vancomy-cin treatment group were respectively treated with fecal suspension and vancomycin one day after modeling. The rats were fasted for one day after the last administration and then executed. The levels of potassium ion ( K) , sodium ion ( Na) , albumin ( ALB) , white blood cells ( WBC) , C-reaction protein ( CRP) , interleu-kin-1β ( IL-1β) , interleukin-10 ( IL-10 ) , interleukin-12 ( IL-12 ) and interleukin-17 ( IL-17 ) as well as the percentage of neutrophils ( N%) in serum samples were detected. The colon tissue samples were collect-ed for pathology examination. Results The rat model of pseudomembranous colitis was successfully estab-lished by subcutaneous injection of clindamycin in combination with toxin-producing Clostridium difficile (ACTT43255) enema. The signs of intestinal inflammation including serious weight loss, remarkably short-ened colon length and significantly increased colon wet weight index were observed in rats from the model group (P<0. 05). Compared with the rats from model group, the rats received fecal transplant showed sig-nificantly increased levels of K, ALB, IL-10 and IL-10/IL-12 in serum and decreased levels of WBC, N%, CRP, IL-1β and IL-17 (P<0. 05). Conclusion Fecal transplantation was proved to be an effective ap-proach for the treatment of pseudomembranous colitis. The therapeutic mechanism might due to its impacts on serum inflammatory factors.

Objective To establish the phenobarbital addiction rat model by the modified drug‐admixed‐food(DAF) method . Methods Rats were selected as the experimental animal .The modified DAF method was adopted to construct the model .The initial dose of phenobarbital 75 mg/kg was given mixed and the dase was gradually increased day by day ,which continued for 45 d .The es‐tablished model was verified by the precipitated withdrawal method and the natural withdrawal method for judging whether the model construction succeeding .Results The convulsion rate in the DAF precipitated withdrawal group was higher than that in the control group(P< 0 .01) ;the withdrawal symptoms scores in the DAF natural withdrawal group were higher than those in the con‐trol group(P< 0 .05) ;the relieving degree of body mass in the two withdrawal groups was greater than that in the control group (P< 0 .05) .The brain section in the mode group revealed obvious cellular apoptotic change .Conclusion DAF is simple and feasible for establishing the phenobarbital addiction rat model .

Objective To examine the expressions of AQP1 and VEGF in human hepatitis B associated hepatocellular c arcinoma and to investigate its relationship with the occurrence and development of hepatocellularcarcinoma. Methods AQP1 and VEGF expressionsin the cancer tissues and AQP1 and VEGF levels in the serum were detected in 62 cases of hepatocellula carcinomaby immunohistochemistry and ELISA , respectively. Results The expressions of AQP1 and VEGF in the liver cancers were significantly higher than in the normal tissues (P<0.01). The higher expression was related to pathologic type,degrees of differentiation and lymph node metastasis, but not related to sex, age and TNM stages. In the serum of liver cancer, the concentrations of AQP1 and VEGF were significantly higher than those in the control group. Conclusion High expressions of AQP1 and VEGF in the patients with liver cancer may be correlated to the occurrence and development of liver cancer. Plasma levels ofAQP1 and VEGF may be more meaningful for the evaluation of clinical prognosis.

OBJECTIVE:To study the relation between the level of bacterial endotoxin and the severeness of biliary tract infection METHDOS:Chromogenic technique was adopted to detect the content of bacterial endotoxin in human bile RESULTS:The level of bacterial endotoxin in human bile raised along with severeness of biliary tract infection CONCLUSION:Detection of bacterial endotoxin in bile using chromogenic technique is of help to the clinical judgement of the severeness of biliary tract infection

Objective To explore effects of shuanghuanglian combined with levofloxacin on antibiotic resistance of Staphylococcus Aureus ATCC29213 to levofloxacin. Methods Tissue cage infection model with Staphylococcus aureus was established in rabbits, and the infected animals were given with levofloxacin alone ( group A ) or in combination with shuanghuanglian ( group B) for 5 days respectively. Steady-state concentration of levofloxacin in tissue cage, bacteria recovery and bacterial resistance in tissue cage infection model were studied. Results Steady-state concentration of levofloxacin in tissue cage was not significantly different between group A and group B. The recovery rate of bacteria was significantly lower in group B than in group A (20. 0% vs. 100. 0%). The minimum inhibitory concentration (MIC) was lower in group B than in group A. Conclusion Shuanghuanglian combined with levofloxacin is helpful to reduce antibiotic resistance of Staphylococcus aureus to levofloxacin, indicating that some Chinese traditional medicine combined with antibiotics can reduce antibiotic resistance.

Objective To investigate the relationship between vascular endothelial function and insulin resistance(IR) and the incidence of metabolic syndrome(MS).Methods A seven-year follow-up study was conducted in 583 simple obese subjects who were chosen in 2000.Body fat,blood pressure,lipid profile,plasma glucose,insulin resistance index(HOMA-IR) and endothelium- dependent dilatation(EDD) were measured before and after the follow-up.Results A total of 177 new cases with MS were found during this seven years,which was 33.78% of all subjects who were followed up in 2007.Cumulative incidence of MS among seven-year was 38.14% in the impaired EDD group and 48.11% in the impaired EDD with IR group,both rates were higher than that of the IR group(25.00%)(P