The treatment of multiple myeloma has become possible in the era of novel agents. Novel agents have dramatically improved the response rates of multiple myeloma (MM) and have extended the survival of patients even if MM remains an incurable disease. De-termining the treatment goals of MM has become a major challenge for clinicians in the era of novel agents. Many results show the correlation between response depth and patients' survival. Complete remission (CR), stringent CR, phenotypic CR, and CRs at the molecular and PET-CT levels are being explored and becoming the goals of MM treatment. Doctors should balance efficacy with adverse effects in daily clinical practice to avoid the blind pursuit of a high and deep response rate.

Diagnostic Imaging ; Humans ; Multiple Myeloma ; diagnosis ; therapy

Objective-To-investigate-the-feasibility-of-total-laparoscopic-hysterectomy-for-complicated-hysteromyoma-,-such-as-broad-ligament-myoma,-lower-uterine-fibroids,-or-cervical-myoma.-Methods-From-December-2009-to-December-2012,-we-performed-laparoscopic-hysterectomy-on-166-patients-with-complicated-hysteromyoma-and-on-170-patients-with-common-hysteromyoma-.-The-operation-time-,-intraoperative-blood-loss-,-recovery-time-of-gastrointestinal-function-,-postoperative-morbidity-,-and-the-rate-of-conversion-to-laparotomy-were-compared-between-the-two-groups-respectively-.-Results-No-significant-differences-were-detected-in-operation-time-[(112.2-±15.3)-min-vs.(110.3-±16.1)-min,-t=1.088,-P=0.277],-intraoperative-blood-loss-[(117.0-±35.3)-ml-vs.(110.8-±37.8)-ml,-t=-1.525,-P=0.128],-recovery-time-of-gastrointestinal-function-[(20.8-±2.7)-h-vs.(21.3-±2.3)-h,-t=1.797,-P=0.073],-postoperative-morbidity-[6.3%(10/159)-vs.7.3%(12/165),χ2-=0.124,-P=0.725],-and-the-rate-of-conversion-to-laparotomy-(4.2%vs.2.9%,χ2-=0.397,-P=0.529)-between-the-two-groups-.Both-the-groups-were-followed-up-at-1,-2,-and-6-months-after-procedure-,-and-none-of-the-patients-showed-severe-postoperative-complications-.-Conclusions-Total-laparoscopic-hysterectomy-for-complicated-hysteromyoma-is-feasible-.To-prevent-complications-,-it-should-be-converted-to-laparotomy-timely-when-the-myoma-has-a-wide-base-or-is-located-at-lower-position-.

Objective To study the expression of hepatocyte growth factor (HGF) in placenta from normal pregnancy and pregnancy induced hypertension (PIH) and the effect of HGF on angiogenesis in placenta. Methods Immunohistochemistry was used to determine the location and intensity of HGF staining in placenta from 20 cases of normal pregnancy and 58 cases of mild,moderate and severe PIH groups. HE staining was used in order to count the number of the vessles. Results HGF mostly were expressed in villous core mesenchymal cells,less in decidual cells . Intensity of HGF immnostaining in villous mesenchymal cells was significantly reduced in the severe PIH group compared with the normal group(H=7.395,P=0.003),while there were no statistical differences between the mild,moderate PIH group and the normal group (H=0.869,P=0.351,H=0.017,P=0.896) .The count of vessels reduced in severe PIH (F=10.676,P=0.008). There was positive correlation between the expression of HGF and the count of vessels in villous(r=0.246,P=0 030). Conclusion These results suggested that HGF is secreted mainly by villous core mesenchymal cells in human placenta and the reduction of HGF in PIH may be responsible for the impaired vascularization in PIH.

Adult ; Chromosome Aberrations ; drug effects ; Ethylene Oxide ; poisoning ; Humans ; Lymphocytes ; drug effects ; pathology ; Male ; Micronuclei, Chromosome-Defective ; drug effects

Objective To investigate the relationship of vascular endothelial growth factor(VEGF)with the invasion and metastasis of non-Hodgkin lymphoma.Methods The levels of serum VEGF was measured by enzyme linked-immunoadsorbent assay(ELISA).Comparing the parameters between NHL group and the control group.Compared the parameters with different groups divided by clinical stage,the effect of the treatment,the level of plasma LDH and effect of treatment.Analyzed the correlation of the levels of serum VEGF and plasma LDH in patients of NHL.Results The levels of serum VEGF are remarkablely higher in patients than that in the control group(P＜0.05).The levels of serum VEGF in the group of Ⅲ,Ⅳ clinical stage are higher than that in the group of Ⅰ,Ⅱ clinical stage,but no significant difference(P＞0.05)were observed.The level of serum VEGF is higher in the group of none CR than the group of CR(P＜0.05).The level of serum VEGF is higher in the group of non-normal level of plasma LDH than group of normal LDH level(P＜0.05).The levels of VEGF and LDH are significantly correlated each other(P＜0.01).Conclusion The angiogenesis are important for tumor metastasis in patients of NHL.The serum VEGF can be used as prognosis parameters in patients with NHL.

Objective To observe the clinical effects of laparoscopic varicocelectomy to ejaculum quality in patients with varicocele.Methods Fifty patients with varicocele were treated by laparoscopic varicocelectomy.The patients were grouped into Group A and Group B according to venous diameter.Semen parameters including semen volume,sperm density,sperm motilities (a + b + c),sperm motilities (a + b),sperm motilities (a),total sperms,normal spermmorphology rate and sperm survival rate were measured and recorded before operation and 1,3,6 months after operation.Results After the follow-up of 6 months above in 50 cases,there is no significant difference about semen volume preoperative and postoperative at different follow-up time(P ＞ 0.05).In some semen parameters(sperm density,sperm motilities,total sperms,normal spermmorphology rate),there is no significant difference between preoperative and postoperative 1 month(P ＞ 0.05),but there is significant difference between postoperative 3 months and postoperative 6 months(P ＜ 0.05).There is no significant difference in preoperative semen parameters between the 2 groups(P ＞ 0.05),but there is significant difference in postoperative 6 month(P ＜0.05).In Group A,there is significant difference in sperm density between preoperative and postoperative 1 month (P ＜0.05).In Group B,there is significant difference in sperm density,sperm motilities and normal spermmorphology rate between preoperative and postoperative 1 month(P ＜ 0.05).Conclusions Laparoscopic varicocelectomy has a positive effect on sperm parameters,it can significantly improve postoperative semen parameters.Semen parameters improve to a relatively stable level by 3 months following operation.

Objective: To assess trends of β-blocker use within 24h of admission in ideal candidates with acute myocardial infarction (AMI) in eastern urban China from 2001 to 2011. Method: A 2-stage random sampling design was performed. In the first stage, a simple random-sampling was used to identify participating hospitals. In the second stage, a systematic sampling was conducted in 2001, 2006 and 2011 to select cases from the participating hospitals. Data was obtained by central medical record abstraction. 10-year trend and predictors of early β-blocker application were assessed with weighted calculation for each year to represent the overall situation of eastern urban China. Results: 35 hospitals were sampled and 32 of them were finally participated. With necessary exclusion, 1399 ideal candidates were included in this analysis. The early weighted β-blocker application rates in 2001, 2006 and 2011 were 64.7%, 69.7%, and 60.9% respectively, P=0.0447 for trend. Patients with chest pain at admission (OR=2.22, 95% CI 1.19-4.13), higher systolic blood pressure (OR=1.40, 95% CI 1.11-1.77) or faster heart rate (OR=2.01, 95% CI 1.58-2.55) were more likely to use β-blocker; in contrast, compared with NSTEMI patients, STEMI patients seemed less likely to receive such treatment (OR=0.55, 95% CI 0.37-0.81). Conclusion: The early β-blocker therapy in eastern urban China is suboptimal for ideal AMI patients who could benefit from it. The application pattern has not been changed from 2001 to 2011 which might be related to physicians' misunderstanding of relevant evidence or guidelines. Our study may help to create an important target to improve the quality of AMI care.

Objective To detect the changes and the clinical significance in plasma protein-complement factor H-related protein 2 (CFHR2) in pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD) children.Methods Various types of 66 CHD patients with or without PAH and 16 healthy children(healthy control group) were studied,including 11 ventricular septal defects (VSD) with PAH (VSD-PAH),11 isolated VSD,11 atrial septal defects with PAH (ASD-PAH),11 isolated ASD,11 mixed type of heart defects [two or more defects of VSD,ASD and patent ductus arteriosus (PDA)] with PAH (Mix-PAH) and 11 cases without PAH (Mix).CFHR2 was validated by enzyme linked immunosorbent assay in the sample plasma.Results Compared with the healthy control group,the CFHR2 concentration in VSD-PAH patients [(189.10 ±24.01) μg/L vs.(42.99 ±4.53) μg/L,t =4.975,P ＜0.01] and VSD patients [(189.10 ±24.01) μg/L vs.(165.00 ±23.17) μg/L,t =2.661,P ＜ 0.05] were lower.The CFHR2 protein was also confirmed to be decreasing significantly in VSD-PAH patients compared with VSD patients (t =4.698,P ＜ 0.01).The plasma CFHR2 level in ASD-PAH patients [(189.10 ± 24.01)μg/L vs.(70.92 ± 8.27) μg/L,t =3.951,P ＜0.01] and ASD patients [(189.10 ±24.01) μg/L vs.(72.48 ± 8.99) μg/L,t =3.880,P ＜ 0.01] were significantly lower than those in the healthy control group,although there was no significant difference between ASD-PAH and ASD patients (t =0.128,P ＞ 0.05).The plasma CFHR2 level in Mix-PAH patients [(189.10 ± 24.01) μg/L vs.(83.23 ± 15.96) μL,t =3.314,P ＜ 0.05] was significantly lower than that in the healthy control group,while Mix patients [(189.10 ±24.01) μg/L vs.(170.40 ±33.15) μg/L,t =0.468,P ＞ 0.05] had no difference compared with the healthy control group,but had statistical significance with M ix PAH group (t =2.370,P ＜ 0.05).Conclusions The decrease of CFHR2 protein may demonstrate the deficiency of the immune system and coagulation mechanism in these patients and can be consi-dered as biomarker of CHD-PAH disease.

BACKGROUND:Palatal rugae assist for consonantal formation;however,effect of palatal rugae on phonetics has been previously reported to be involved in different complete denture base plates of recipients.OBJECTIVE:To qualitatively analyze the effe-cts of different palate base plate morphology on phonetics of edentulous jaw patients using a computerized speech lab.DESIGN,TIME AND SETTING:A contrast study was performed at the Department of Stomatology,Beijing Hospital of Healthy Administration,and at the Department of Otorhinolaryngology,Beijing Friendship Hospital affiliated to Capital Medical University between February 2007 and February 2008.PARTICIPANTS:Ten edentulous jaw patients wore complete denture with smooth surface and palatal rugae complete denture base.METHODS:Spike,voice onset time and transition of 10 edentulous iaw patients were measured by computerized speech lab when/da/,/ta/,/sa/,and/na/were pronounced.MAIN OUTCOME MEASURES:Spike.voice onset time and transition.RESULTS:Spikes were observed in all syllables.When/da/and/ta,were pronounced.voice onset time in the smooth surface group was significantly shorter than palatal rugae group(P<0.05):voice onset time of/d/and/t/in the palatal rugae group was similar to normal value(P>0.05).When/da/and/ta/ were pronounced,transition frequency in the smooth surface group was significantly lower than palatal rugae group(P<0.05),while that in the palatal rugae group was similar to normal value(P>0.05).CONCLUSION:As an anatomical landmark,palatal rugae contribute to phonetic restoration and consonant articulation of edentulous jaw patients.Computerized speech lab can quantitatively analyze phonetic changes after complete denture restoration and may be used as guidance for clinical dental prosthetics.