Objective To investigate the clinical characteristics and treatment efficacy in newly diagnosed multiple myeloma (MM). Methods The clinical data and treatment methods of 176 patients with newly diagnosed MM were retrospectively analyzed. Results The most common chief complaint in the patients with MM was bone pain. 26.1 % (46/176) patients once experienced misdiagnosis. The overall response rate (ORR) was 65.9 % (116/176), the ORR of bortezomib group (81.0 %, 34/42) was significantly higher than that of M2 regimen group (61.8 %, 34/55) and VAD regimen group (60.8 %, 48/79) (P<0.05). Between normal renal function subgroup and renal insufficiency subgroup in bortezomib group, the efficacy was no significant difference (P>0.05). The most common adverse reactions included hematologic toxicity, infection and peripheral neurotoxicity. Multiple organ failure was the main cause of death (47.1 %, 16/34). Conclusions The clinical manifestations of MM are complex and diverse, which is easy to be misdiagnosed. Molecular genetic abnormalities are closely related to prognosis. Proteasome inhibitor bortezomib can improve the curative effect and not be affected by renal function. To prolong the survival time of the patients needs to prevent and control the infection and renal insufficiency actively.

Objective:In order to achieve a dynamic supervision system throughout the logistics process of high-value consumables of oral and maxillofacial surgery and solve the problem of inaccurate traceability. Methods: It is based on the theory of supply chain management and summarizes the logistics process on high-value consumables of oral and maxillofacial surgery. It is a combination of bar code and information management system. Results: The dynamic supervision system throughout the logistics process of high-value consumables of oral and maxillofacial surgery will replace the original static and extensive mode management. It will achieve the refine management of high-value consumables of oral and maxillofacial surgery. Conclusion:It promotes the integration of material flow, information flow, capital flow. It achieves the dynamic supervision system in every procedure including purchasing, warehousing, consuming, destroying, Checking inventory and ensures the accurate traceability.

OBJECTIVE To discuss the management method of hospital medical waste in nursing activity,prevent from the pollutant proliferation,and avoid the second exposure.METHODS Reinforced the management of the medical waste,established the management network of medical waste,and made the training of all staffs,we drew up a series of effective measures according to the law and regulation.RESULTS Various plan and measure were done, nursing personnel were fully aware of the importance of the environmental protection.(medical) waste(management) was much better than before.The infection which related to the medical waste was not occurred.(CONCLUSIONS) Doing well management of the medical waste is depending on some conditions,which are as(follows:)(1)the leaders pay more attention to;(2)strengthen the training of all staffs;and(3)the management system is sound.

Objective To investigate the prevalence and risk factors of Toxoplasma gondii infection among key populations in Wuxi City,Jiangsu Province,so as to provide evidences for developing preventive and control interventions for T. gondii in-fection. Methods A questionnaire was designed to conduct face-to-face interviews to HIV/AIDS carriers/patients,tumor pa-tients,pregnant women and pet breeders. The blood samples were collected to test anti-Toxoplasma IgM and IgG antibodies by using ELISA method. Results Totally 404 participants were investigated,and 38 were positive in testing T. gondii antibodies (9.4%),and among these,37(97.4%)were IgG positive and 1(2.6%)was IgM positive. The multivariate logistic regression indicated that age,regularly contacting cats/dogs and being HIV positive were associated with the infection of T. gondii(OR=2.1,2.6 and 2.3,all P < 0.05). Breeding pets,being HIV positive and being tumor patients were more likely to infect T. gondii than being pregnant(OR = 1.5,8.1 and 2.8,all P < 0.05). Conclusion The high infection rate of T. gondii is observed among key populations in Wuxi City,so that the effective measurements should be taken to enhance the intervention among key popula-tions including immunocompromised people,pet breeders or people having bad dietary habits of eating raw food.

Objective To explore the effects of early active mobilization on hand function after zone 5 flexor tendon and ulnar nerve repair.Methods Fifty-five patients who had received primary repair in zone 5 of a flexor tendon and the ulnar nerve were randomly divided into an observation group (26 cases, 88 digits) and a control group (27 cases, 91 digits).Both groups were given routine treatment after the operation, and started to do active and passive exercise 4 weeks later.The observation group was additionally forced to do active range of motion exercise training starting 8 days after the operation.Twelve weeks after the operation, the hand function of both groups was assessed using the total active motion (TAM) scoring system of the American Society for Surgery of the Hand, peripheral nerve function evaluation and the disabilities of arm-shoulder-hand (DASH) scale.Results At the end of the treatment, the average TAM score of the observation group was significantly better than that of the control group.The average active movement range of the wrist in palm flexion, dorsal extension, ulnar deviation and in radial deviation were all significantly better than in the control group.Grip strength, overall hand function and DASH score were also significantly better on average.Conclusion Early active mobilization following flexor tendon and ulnar nerve repair can effectively promote the recovery of hand function.

Objective:To establish an HPLC method for the determination of thymol in thymol alcoholic solutions. Methods: An Agilent Eclipse XDB-C18(250 mm ×4.6 mm,5μm) column was used with the mobile phase of methanol-water (65∶35), the flow rate was 1. 0 ml·min-1 . the detection wavelength was 275nm, the injection volume was 10μl, and the column tenperature was 25℃. Re-sults:A good linear correlation of thymol was observed within the range of 60-160 μg·ml-1(r=0. 999 5). The average recovery was 101. 59% with RSD of 1. 39%(n=9). Conclusion:The method is quick, simple and accurate, which can be used in the determina-tion of thymol alcoholic solutions with good selectivity and sensitivity.

Objective To observe the pregnancy by transvaginal double slit cervical pregnancy outcome after ligation,and evaluate its clinical application value.Methods The clinical data of 80 cases with cervical incompe-tence were analyzed.All patients had pregnant metaphase inevitable abortion history,the average abortion pregnant was 21.7 week.According to different treatment methods,80 cases were divided into two groups,treatment group (40 cases)in non pregnant women with silk thread woven tape by double vagina and cervix cerclage,another group of 40 cases in 15 -20 weeks of pregnancy by using polypropylene McDonald method with cerclage.The operation,preg-nancy cervical tube length and pregnancy outcome were observed.Results The average operation time and bleeding volume between the two groups had no statistically significant differences.The pregnancy cervical average length of the treatment group was 4.6(4.8 ±0.5)cm,which was significantly longer than 3.9(3.1 ±0.8)cm of the control group (t =2.732,P <0.05).In the treatment group,the full -term delivery rate,preterm delivery rate,mean gestational age at delivery were 55.0%(22 /40),40.0%(16 /40),35.8 weeks,the average abortion was extended 14.1 weeks com-pared with preoperation,fetal survival rate was 90.0%(36 /40),neonatal birth weight was (3 100.0 ±200.0)g;28 gestational weeks following the inevitable abortion rate was 2.5%(1 /40).In the control group,the term delivery rate was 35.0%(14 /40),the rate of premature birth was 50.0%(20 /40),and the rate of abortion was 15.0%(6 /40)in 28 weeks.Mean gestational age at delivery was 33.2 weeks,which was extended 11.5 weeks compared with preoperative average abortion,fetal survival rate was 85.0% (34 /40),neonatal body mass was (2 900.0 ±300.0)g. The term delivery rate,fetal survival rate and neonatal weight in the treatment group were higher than those in the con-trol group.Conclusion Pregnant by double vagina and cervix cerclage treatment cervical function can maintain preg-nancy,cervical length,prolong the time of pregnancy and improve the perinatal survival rate,simple operation,take out stitches convenient,it is worthy of clinical application.

Objective To investigate the distribution of T follicular helper(Tfh)cell subsets in hepa-titis B patients at different immune stages and to clarify the relationships between the level of CXCL13 and the distribution of Tfh cell subsets. Methods Flow cytometry analysis was performed to detect the distribution of Tfh cells. Enzyme-linked immunosorbent assay(ELISA)was performed to measure the levels of CXCL13 in ser-um samples collected from hepatitis B patients. RT-PCR and Western blot assay were used to analyze the expres-sion of CXCL13 in HepG2 and HepG2. 2. 1. 5 cells. Results The percentages of Tfh1 cells were significantly up-regulated at the immune activation(IA)stage,while those of Tfh2 cells were significantly raised at the im-mune tolerance(IT)stage. The percentages of Tfh17 cells in patients at the stage of IT were similar to those in patients at the stage of IA,but were higher than those in responders with HBsAg seroconversion(RP)or healthy controls(HC). The expression of CXCL13 was positively correlated with the percentage of Tfh2 cells. More over,hepatitis B virus(HBV)enhanced the expression of CXCL13 at both transcriptional and translational lev-els. Conclusion HBV might up-regulate the percentage of Tfh2 cells through promoting the expression of CXCL13,which resulted in the induction of immune tolerance. Elucidating the functions of Tfh1,Tfh2 and Tfh17 cells and understanding the type conversion mechanism among the three subsets are important for further researches on HBV-induced immunosuppression.

Objective To observe the effect of pregnancy double loop cerclage for cervical incompetence. Methods 80 cases of cervical function incompetence according to the type of surgery were divided into two groups, 40 cases in each group,15 -20 weeks of surgery in pregnancy,the treatment group underwent double loop cerclage, the control group underwent McDonald single cerclage.The operation,postoperative cervical length and pregnancy outcome of the two groups were observed.Results There was no difference in operation time and blood loss between the two groups.The length of cervix in the treatment group was (4.63 ±0.52)cm,which was longer than (3.71 ± 0.82)cm of the control group(t =2.106,P <0.05).Pregnancy outcome:20 cases of the treatment group in term birth (50%),preterm birth in 18 cases (45%)(34 -37 weeks in 12 cases,28 -34 weeks in 6 cases),fetal survival in 36 cases (90%),less than 28 weeks pregnant inevitable abortion in 2 cases (5%),abortion did not survive.Average delivery gestational age was 35.2 weeks,and preoperative average abortion pregnant weeks contrast,treatment group delivery gestational weeks extended 13.5 weeks,the average weight of newborns was (3 200 ±200)g.The control group of full -term delivery was 14 cases (35%),premature in 20 cases (50%)(34 -37 weeks in 7 cases and 13 cases of 28 -34 weeks),fetal survival in 33 cases (82.5%),less than 28 weeks pregnant inevitable abortion in 4 cases (10%),abortion did not survive.Average delivery gestational age was 33.2 weeks,compared with the average abortion weeks before operation,the gestational age of the control group was extended by 11.5 weeks.The weight of newborn was (2 900 ±300)g.In the treatment group,the term labor rate,fetal survival rate,neonatal weight were higher than those of the control group,the difference was statistically significant (χ2 =7.83,P <0.05).Conclusion The second trimester cervical double cerclage can maintain effective cervical length,prolong gestational age,improve perinatal survival rate.

Objective To analyze and identify the mutations of ATP6V0A4 and ATP6V1B1 gene in autosomal recessive distal renal tubular acidosis (rdRTA) children,and study the association of genotype and phenotype. Methods Genome DNA was amplified by PCR.Mutations of ATP6V0A4 and ATP6V1B1 gene in 3 children from 3 families were examined by direct sequencing.One hundred unrelated healthy subjects were selected to evaluate all mutations found in this study. Results A novel homozygous nonsense mutation was identified in ATP6VOA4 gene in one child, and a novel heterozygous nonsense variant and a frame-shift alteration were found in another child.No mutation of both genes was found in the third child.Conclusions Study of mutant genes of rdRTA in Chinese patients is helpful to understand the association in genotype and phenotype and increase the level of cognition and treatment to this disease.