Multiple myeloma is a plasma cell malignancy.At diagnosis,most patients are older than 65 years,In newly diagnosed myeloma patients younger than 65 years,high-dose of melphalan followed by autologous stem cell transplantation(ASCT)is regarded as the standard treatment.In elderly patients,usually older than 65 years,oral melphalan and prednisone(MP)has been considered as the standard regimen recently.However,the discovery of thalidomide,lenalidomide,and the proteasome inhibitor bortezomib will increase the effect of clinical treatment.This review will summarize literatures and focus on the treatment of newly diagnosed myeloma.

Objective To evaluate the clinical efficacy of integration of traditional Chinese and western medicine (ITWM) or pure western medicine on the patients with immune thrombocytopenia (ITP). Methods Randomized controlled trials (RCTs) on ITWM treatment of ITP were searched in PubMed, EMBASE, Wanfang database, CBMDisc, CNKI and VIP. Quality of the RCTs was evaluated strictly, and statistical analysis was performed with Cochrane Collaboration’s RevMan5.1.7 software. Results Twenty-two trials involving 1527 patients were included. The results of Meta-analysis showed that the ITWM treatment of ITP significantly improved the total effective rate [RR=1.23, 95%CI (1.17, 1.29), P<0.000 01] compared with that of pure western medicine treatment. Funnel plot showed that publication bias was small. Meanwhile, peripheral platelet count and the number of megakaryocyte which can generate platelet in bone marrow increased, obvious advantage was showed in long-term effect, and adverse reactions were reduced with ITWM treatment in ITP patients. Conclusion The existed limited evidences suggest that ITWM treatment of ITP can significantly improve clinical efficacy. The quantity and quality of research literature were limited, and well-designed randomized double-blind controlled trials with large sample and multi-centers are required for a more reliable conclusion.

Objective:To study the clinicopathological and immunohistochemical features of hepatic malignant vascular tumors. Methods:H E and immunohistochemistry were used to study 6 angiosarcoma and 5 epithelioid hemangioendothelioma (EHE) of the liver. Patients were aged 0.5 68 years, 7 were females and 4 were males. Results:Patients presented with nonspecific symptoms. Macroscopically,the tumors were usually multiple (3 13.7 cm in diameter) and were frequently hemorrhagic and multinodular. Histologically,there was a wide morphologic spectrum among cases. Six angiosarcoma included areas similar to cavernous and capillary hemangioma,spindle cell and epithelioid sarcoma. In the hepatic EHE,the tumor were comprised of dendritic and epithelioid cells that often contained vacuoles representing intracellular lumina. The stroma was fibrous with myxohyaline areas. Immunohistochemically,all tumors were positive for at least one endothelial marker(factor Ⅷ related antigen and /or CD 34 ). Conclusion:Hepatic malignant vascular tumor is very rare, the angiosarcoma of the liver is highly malignant with short survival. The prognosis of EHE is usually much better than that of angiosarcoma, surgical resection can obtain prolonged survival. The diagnosis can be made based on histological and immunohistochemical features of the tumor.

Objective To resolve the sharing of the images which are dispersed in multiple mini-PACS in one hospital or in the distributed PACS in the different hospitals.Methods The grid technology and the medical image network were integrated to research some key technologies on a medical image storage grid.Results Basing on the services provided by grid and considering the hospital's situation,two layers architecture of storage grid that was adapted with the sharing character of the medical information were put forward.Using the services provided by the storage grid,the dynamic storage extension was realized.Conclusion The medical image storage grid can integrate multiple storage systems in the image network.It supports the effective usage of the storage system and transparent accessing for users.

To study the immunopathological characteristics and differential diagnosis of hepatic angiomyolipoma(AML).Methods:Thirty-six surgically resected hepatic AML were investigated clinicopathologically and immunohistochemically with 10 antibodies.Results:Hepatic AML occurred in 21 females and 15 males,with the mean age of 41.6 years(26-60 years old).The patients with AML often had no special symptoms even had large space-occupying lesions in the liver.The diameter of AML was 2.5 cm to 14 cm(mean 6.8 cm).Histologically,AML was composed of varying heterogeneous mixture of 3 tissue components:blood vessels,smooth muscle and adipose cells.Extramedullary hemopoiesis sometimes existed.According to tissue components,AML was subcategorized into mixed type(19.4%,n=7),lipomatous type(11.1%,n=4),myomatous type(66.7%,n=24),and angiomatous type(2.8%,n=1).The epithelioid smooth muscle cells were sensitive to HMB-45(100%),SMA(100%),and CD117(66.7%) staining.Conclusion:Hepatic AML often contains smooth muscle elements,which have varied morphological features and should be carefully differentiated from hepatocellular carcinoma,mesenchymal hamartoma，and tumors with rich fat or blood vessels.Immunohistochemical staining with HMB-45 and SMA are the best available markers for the diagnosis of hepatic AML.

DICOM acquisition gateway,the strobe of PACS date flow,is a key element of PACS.But on the process of acquisition,the images sometimes might be lost.This paper will focus on the image recovery scheme of DICOM acquisition gateuay in the notion of image missing.

OBJECTIVE:To explore the mechanism of procyanidins on mitochondrion injury caused by cerebral ischemia reperfusion(IR) in rats.METHODS:Forty-eight Wistar rats were randomly separated into 4 groups including sham operation group,IR model group,procyanidins pretreatment high and low doses groups(400,40 mg?kg-1).After medication for 30 days,the reperfusion model following focal cerebral ischemia in rats was made by thread embolish of MCA,and the rats were put to death 2 h later for sampling of brain tissues.The expression of cytochrome C protein was detected by immunofluorescence method and that of caspase-9 mRNA was detected by RT-PCR technique.RESULTS:There were significantly more cytochrome C and less caspase-9 mRNA in procyanidins pretreatment group than in IR model group(P

Objective To solve the new problems for quality assurance of PACS which imported by the use of PACS.Methods The medical imaging quality control system used between imaging modality and image acquisition gateway was designed.Results The medical imaging quality control system could partially solve the problem for quality assurance of PACS.Conclusion With the use of medical image quality control system,wrong or low quality image can be found and modified earlier.Therefore,the veracity of medical information and medical image of PACS can be improved farther.

Based on the requirements of quality assurance during drug control process,a quality assurance system is developed for drug control in the institute of drug and equipment control.The results show that the method developed in this paper is much suitable tothe process of drug control and can be applied tocontrolling the quality from the drug receiving tothe drug releasing.The quality assurance system guarantees that the detected data are achieved scientifically and efficiently.

10 000 : 1, the scoring might result in misleading conclusions. The concentration of genomic DNA-PCR reaction products in 50 ng/fd was suitable for CEA analysis. Conclusion: The concentration of PCR reaction residues in CEA system is one of the key factors altering genotyping results.