Objective To investigate the diagnosis,differential diagnosis,treatment and prognosis of solitary plasmacytoma (SP) and summarize its clinical features for pathological and clinical application.Methods Reviewed the data of 18 patients diagnosed with SP from January 2005 to August 2013.The clinical features,diagnosis,treatment and prognosis were analyzed retrospectively.Results All 18 cases were pathologically confirmed with SP and met the diagnostic criteria of SP.In 18 patients,12 patients were male and 6 patients were female.Four cases of lesion were located at lumbar,each 2 cases of lesion were located at mandible and ribs,each 1 case of lesion was located at sacrum and occipital bone,3 cases of lesion were located at nasal cavity and maxillary sinus,2 cases of lesion was located at pars nasalis pharyngis,each 1 case of lesion was located at parotid,parasternal and peritoneal cavity.All patients were followed up for 54 months,2 patients were died,3 patients were local recurrence,2 patients were transformed to multiple myeloma,others were survival with no tumor.Conclusions As early as possible to diagnose is the key to treat SP.The final diagnosis of SP is based on the histopathological findings and the optimal treatment for patients with SP is surgery combined with moderate dose radiotherapy.

AIM: To investigate the clinical effect of small incision lenticule extraction (SMILE) for super high myopia.METHODS: Totally 64 cases (128 eyes) patients with super high myopia, were randomly divided into observation group and control group, 32 cases (64 eyes) in each group.The two groups were separately treated with SMILE or femtosecond laser LASIK (FS-LASIK).We calculated the effectiveness index and safety index by contrastive observation of clinical effects in all patients included uncorrected visual acuity, best corrected visual acuity and postoperative spherical equivalent at preoperative and postoperative 1d, 1wk, 1, 3 and 6mo.RESULTS: The safety index: the observation group and the control group at 6mo after operation were respectively 1.10±0.10 and 1.08±0.12, the difference between the two groups was not statistically significant (P>0.05).The validity index: the observation group and the control group at 6mo after operation were respectively 1.08±0.12 and 1.06±0.14 and there was no significant difference between the two groups (P>0.05).Postoperative spherical equivalent at 6mo in the observation group was 0.09±0.36D, that in the control group was 0.36±0.46D.After 6mo, the count of spherical equivalent refraction within ±0.50D were 58 eyes (90.1%) in observation group and 49 eyes (76.6%) in the control group, within±1.0D were 64 eyes (100%) and 60 eyes(93.8%).CONCLUSION: SMILE is safe and effective in the treatment for super high myopia.The postoperative visual acuity and diopter can be stabilized earlier by comparing with FS-LASIK.

ObjectiveTo investigate the common pathogenic bacteria and antimicrobial resistance status in neonatal ward to provide guidance for rational clinical medication. MethodsData of 2306 cases in neonatal ward from July 2008 to June 2010 whose body fluid were cultured with positive results of common bacteria were collected. The change of the bacteria and drug resistance was analyzed. Results Among 10 017 body fluid samples, 80 species consisted of 2306 strains of bacteria were found. Enterobacteria accounted for about 53.8％ (1241/2306), Klebsiella pneumoniae subsp. pneumoniae (430/1241, 34.6％) and Escherichia coli (341/1241, 27.5％) were the most common ones,and among which 68.1％(293/430)strains of Klebsiella pneumoniaesubsp.pneumoniae and 59.5 ％ (203/341 ) strains of Escherichia coli were extended-spectrum β-lactamases (ESBLs) producing strains, which were significantly lower than those[78.1％ (118/151) and 82.6％(76/92) respectively]during 2003 to 2005 (U=-2.32 and -4.11, P＜0.05 respectively).Methicillin-resistant Staphylococcus aureus(MRSA)detectionrate was 8. 5％(23/272)in Staphylococcus, which was lower than that (17.7％, 15/85) in year 2004 to 2006 (U= -2.4, P＜0. 05). Methicillin-resistant coagulase-negative Staphulococcus (MRCNS) detection rate was 63.5％(157/247), which was higher than that (32.6％, 97/298) in year 2004 to 2006(U=7.54,P＜0.05).The common pathogens of nosocomial infection were Klebsiella pneumoniae subsp.pneumoniae,Escherichia coli , Acinetobacter baumannii and Pseudomonas aeruginosa ; while common pathogens of community infection were Staphylococcus aureus, Klebsiella pneumoniae subsp.pneumoniae and Escherichia coli. Multiple drug-resistant infections in hospital were significantly higher than those in community. Drug susceptibility results showed that the resistance of Staphylococcus haemolyticus,Acinetobacter baumannii and Klebsiella pneumoniae subsp.pneumoniae were especially severe.ConclusionsOpportunistic infections and drug resistant strains increased. The increasing of MRCNS and drug-resistant of Acinetobacter baumanniishouldbepaidmore attention.Comprehensive measures might reduce the production of ESBLs bacteria. The choice of antibiotics should be based on drug susceptibility test.

To study the apoptotic regularity of peripheral lymphocytes in radiation compound wound healing and explore their relationship to radiation delayed wound healing, apoptosis and Bax and Bcl 2 proteins were estimated by in situ terminal labeling (TUNEL) and immunohistochemical method of alkaline phosphatase, respectively. White blood cells in radiation compound wound(RW) group decreased and reached the lowest 3 days after wound, it was still lower in RW group than in simple wound(SW) group 5 days after wound; apoptosis of peripheral lymphocytes of both groups increased, however, the lymphocyte apoptosis in RW group was higher than that in SW from beginning to end in the whole process of wound healing; the expression of Bax protein of lymphocyte increased at different times after wound, and the expression in RW group was obviously higher than that in SW group, while Bcl 2 showed an opposite tendency. It is suggested that reduction of white blood cells and increment of lymphocyte apoptosis are the major causes of radiation delayed wound healing; Bax and Bcl 2 proteins take part in the regulation of lymphocyte apoptosis in wound healing.

Objective To study the expression of protein kinase B (Akt/PKB) isoforms in the gastrocnemius muscle of rats at different ages. Methods The expression levels of mRNA and protein of three Akt isoforms in the gastrocnemius muscle of 30-month-old and 6-month-old rats were detected respectively by RT-PCR and Western blotting. Data were analyzed statistically. Results (1) The levels of Akt1 and Akt2 mRNA in the 30-month-old rats was significantly higher than those in the 6-month-old rats (t=7.124, P=0.000; t=2.598, P=0.021), however, no significant difference was found in the level of Akt3 mRNA between the two groups (t=0.460, P=0.653) . (2) The level of Akt-Thr308 phosphorylation in the 30-month-old rats was significantly lower than that in the 6-month-old rats (t=-9.861, P=0.000), while the level of Akt2 protein in the 30-month group was significantly higher than that in the younger rats (t=7.522, P=0.000). No significant differences were detected in the levels of Akt1 and Akt3 proteins between the two groups (t=0.469, P=0.646; t=0.058, P=0.955). Conclusion The expression levels of three Akt isoforms in the gastrocnemius muscle of rats change with age, suggesting that the three isoforms of Akt have different functions in the gastrocnemius muscle metabolism of rats at different ages.

Objective To observe the difference between the bone marrow and peripheral blood engraftment evidence after allogeneic haemopoietic stem cell transplantation(Allo-HSCT) using PCR-STR. Methods DNA from peripheral blood or bone marrow of donors and recipients in different phases were extracted,and 16 STR loci with high polymorphism were amplified by PCR.Separation of the PCR products and fluorescence detection were performed by ABIprism 3100 Genetic Analyzer with capillary electrophoresis.Results The 16 patients included in the study had different levels of engraftment.Twelve patients displayed complete chimerism,while 5 patients showed mixed chimerism.One patient was keeping continuance of remission.The decrease of donor DNA amounts in mixed chimerism was earlier in bone marrow than that in peripheral blood(P

Objective To study the diagnosis and treatment of multiple-ligament injury to the knee and report the clinical outcomes of the disease.Methods A total of 51 patients with multiple-ligament tear in the knee were enrolled in this study.The lesion involved the ACL and MCL in 21 cases,ACL and PLC in 1,PCL and MCL in 4,PCL and PLC in 6,ACL,PCL,and MCL in 6,ACL,PCL,and PLC in 3,ACL and PCL in 8,and PCL and patella tendon in 2.Among the patients,14 patients had acute Ⅲ grade MCL tear and 3 had acute Ⅲ grade PLC injury;open suture repair were performed on these cases,and then arthroscopic surgery was carried out for other injured ligaments after 3-week immobilization.For 2 patients who had chronic Ⅲ grade MCL injury and 3 cases that were suffering from chronic Ⅲ grade PLC tear,open surgery for ligament reconstruction was employed,arthroscopy were used afterwards to remodel the ACL and PCL.In the 51 patients,totally 39 ACLs were injured,20 of these ligaments were reconstructed under a arthroscope using Hamstring tendon,17 were repaired with BPB by arthroscopy,and 2 were remodelled by implanting allogeneic tendons.In addition,29 PCLs tear were diagnosed,among which arthroscopic PCL reconstruction with autologous Hamstring tendon was performed on 19,allogeneic ligaments were used in 2,and the other 8 injured PCL were not repaied surgically because the lesion was relieved after immobilization(improved from grade Ⅲ to

Objective To evaluate the impact of different anatomical landmarks on registration in imaging-guided radiation (IGRT) for lung cancer. Methods For 20 patients with non-small cell lung cancer receiving stereotactic body radiotherapy (SBRT) in Fudan University Cancer Hospital, 100 frames of kilo-voltage cone-beam computed tomography scanning were evaluated in this study. The spine, carina and tumor were selected as landmarks for registration, respectively. Results of registration using different landmarks were documented and compared. Results The average set-up errors in the left-right, superiorinferior and anterior-posterior directions were -0. 08 cm ±0. 32 cm, -0. 16 cm ±0. 45 cm and 0. 06 cm ±0. 23 cm with the spine for registration;0. 06 cm ±0. 34 cm, -0. 13 cm ±0. 45 cm and -0. 02 cm±0.23 cm with the carina;and -0. 17 cm ±0.25 cm, 0.03 cm ±0.47 cm and 0. 15 cm ±0.38 cm with tumor. The registration results between using the carina and tumor as landmarks were statistically significant different (q=4.61, P=0. 002 ;q = 2. 23 , P=0. 118;q=3.44, P=0. 017). The registration results were equal when using the spine and tumor as landmarks ( q = 1.85, P = 0. 195; q = 2. 54, P = 0. 075; q = 1.89,P=0. 185), as well as using the carina and tumor as landmarks (q=2.76, P=0. 054;q=0.31, P=0. 826 ;q = 1.55, P = 0. 276). Conclusions For early stage lung cancer, the spine and tumor can be used equally as registration landmarks in imaging-guided SBRT. The carina is not suggested for its poor reproducible position.

Objective: To investigate the relationship between attachment to pets and psychosecial develop-ment of children. Methods: Totally 147 children pet owners from grade 3 to grade 5 were selected from 11 primary schools in Beijing. They were asked to complete the Lexington Attachment to Pets Scale, Self Description Question-naire, Children's Loneliness Scale, and 2 dimensions of Children Social-life Adjustment Scale. Results: Attach-ment to pets was positively correlated with self-concept, pro-social orientation and living ability of daily life (r=0.47, 0.42, 0.34, Ps < 0.001), and negatively correlated with loneliness (r=-0.28, P <0.01) . Even the variables including study performance, interrelationship and socioeconomic status of family were taken as covari-ares, the higher attach group was better than lower attach group in self-concept, pro-social orientation, living abili-ty of daily life [(163.81±17.81)vs.(138.36±27.71), (46.19±4.25)vs.(40.64±6.93), (39.05±4.17)vs.(33.77±6.51); Ps<0.001] and loneliness [(28.53±11.08)vs.(34.79±10.96); P <0.01].Conclusion: There is apparent relationship between pet attachment and psychosocial development in children.