Basic research and clinical research on multiple myeloma (MM) have extensively progressed, as proven by the change in the definition of complete response (CR). With improvements in laboratory technology and introduction of novel agents, CR particu-larly emphasized both micro-and macro-models. The development of CR yielded therapeutic advances in MM and vice versa. The defi-nitions of response and treatment strategies were closely connected and improved. A need exists for further detailed studies on long-term disease control, such as optimal combination of agents. Given the shortage of new drugs and the distinctiveness of health in-surance, Chinese doctors should select the best treatment projects based on real-life situation in China.

Objective To study the difference in immunomodulatory effects among non-Hodgkin lymphoma (NHL)-, Hodgkin lymphoma (HL)- and normal adult bone marrow-derived mesenthymal stem cells (MSCs). Methods MSCs were obtained from HL, NHL and normal adult bone marrow and cultured in expanded medium. Immunophenotype was investigated by FACS. The levels of cytokines were evaluated by enzyme linked immunosorbent assay (ELISA). T-cell suppression ability was evaluated by Transwell. Moreover, the immunoregulatory ability of HL-, NHL- and normal adult bone marrow-derived MSCs was detected by mixed lymphocyte culture assay. Results HL-, NHLand normal adult bone marrow-derived MSCs were similar in morphology and immunophenotype, and they did not express HLA-DR and co-stirnulatory molecules (CD40, CD80 and CD86). All HL-,NHL- and normal adult bone marrow-derived MSCs could significantly suppress T lymphocytes'proliferation in a dose-dependent manner and such an effect could be reversed by anti-TGF-β1 antibody.MSCs differentiated into various mesenchymal lineages did not alter their immunosuppressive effects on T-cell proliferation. Conclusion The similar immunomodulatory effects were found among HL-,NHL- and normal adult bone marrow-derived MSCs, which was not changed by differentiation.

Objective To observe the effect of the operation and application value of encircling constriction of superficial femoral vein with electrocoagulation in the varicose veins of lower extremity.Methods 271 cases were divided into the research group(n=166)with encircling constriction of superficial femoral vein with electro-coagulation and the control group(n=105)with traditional encircling constriction of superficial femoral vein with electrocoagulation.The degrees of the venous reflux,velocities of blood flow,CEAP classification and clinical scoring of the two groups were compared.Results The research group was better than the control group on decrease in de- grees of the venous reflux.increase in velocities of blood flow and decrease in clinical scores(P<0.01).Conclu- sions The encircling constriction of superficial femoral vein with electrocoagulation is the desirable method in the treatment of varicose veins of the lower extremity.

Objective:To study the role of FDCs-miR-548m-CDK6 axis on clonogenicity in mantle cell lymphoma. Methods:RT-qPCR and Western blot were used respectively to test the expression of miR-548m and CDK6. Bioinformatics assay was applied to predict the targets of miR-548m, and Western Blot was used to test the expression level of CDK6 after miR-548m overexpression or in-hibition. Luciferase report assay was performed to test whether CDK6 was a direct target of miR-548m. Colony forming assay was used to test the colony forming activity in MCL after overexpression of miR-548m or knockdown of CDK6. Results:Cell adhesion to FDCs induced downregulation of miR-548m and CDK6 expression in MCL. Bioinformatics assay revealed that miR-548m could target the 3'-UTR of CDK6 and that a negative correlation exists between the level of miR-548m and the CDK6 expression. Luciferase report as-say confirmed that miR-548m directly targeted 3'-UTR of CDK6. Colony forming assay showed that overexpression of miR-548m or knockdown of CDK6 significantly suppressed MCL colony formation. Conclusion:This study reveals that FDC-enhanced mantle cell lymphoma clonogenicity is mediated by the miR-548m/CDK6 axis.

Objective:To explore the clinical treatment of retinoblastoma (RB) after being treated with vitrectomy (PPV) due to misdiagnosis.Methods:A retrospective case study. From July 2015 to July 2018, 5 cases and 5 eyes of RB children diagnosed by pathological examination at the Eye Center of Beijing Tongren Hospital were included in the study. Among them, there were 3 males with 3 eyes and 2 females with 2 eyes; all of them had monocular disease. The average age was 4.8±1.7 years old. At the first visit, the diagnosis was endophthalmitis in 2 eyes (40%, 2/5); vitreous hemorrhage in 3 eyes (60%, 3/5). All were treated with PPV. All children underwent slit lamp microscopy, orbital MRI and CT, and eye color Doppler ultrasound blood flow imaging. If there was no clear extraocular spread, the eyeball removal combined with artificial orbital implantation was performed; if there was clear extraocular spread, the modified orbital content enucleation operation was performed with part of the eyelid preserved. The average follow-up time after surgery was 34.6±7.9 months.Results:Among the 5 eyes, 2 eyes (40%, 2/5) underwent eyeball enucleation combined with stage I artificial orbital implantation, and 3 eyes (60%, 3/5) with modified orbital content enucleation. There were 2 eyes of endogenous type (40%, 2/5), 1 eye of diffuse infiltration type (20%, 1/5), and 2 eyes of mixed type (40%, 2/5). The orbit spread in 3 eyes, the tumor invaded the optic nerve in 1 eye, and regional lymph node metastasis in 2 eyes. All children received systemic chemical therapy (chemotherapy). During the follow-up period, there were no new metastatic diseases and no deaths.Conclusions:After RB misdiagnosis and PPV, surgical treatment should be performed as soon as possible. If there is no clear extraocular spread, eyeball removal or combined stage I orbital implantation should be performed. If there is clear extraocular spread, the orbital contents should be enucleated; Chemotherapy should be combined after surgery.

ObjectiveTo improve the understanding of chronic myelomonocytic leukemia associated with Sweet' s syndrome.MethodsRetrospective analysis of a case of chronic myelomonocytic leukemia associated with skin herpes was reported. Skin biopsy was performed. DA and CAG regiment were administrated.ResultsSweet's syndrome was diagnosed by skin biopsy.Corticosteroids therapy alone was not effective. Complete remission was achieved by CAG regiment and skin rash has been effectively controlled.Three months later Sweet' s syndrome relapsed and chronic myelomonocytic leukemia developed into acute myelomonocytic leukemia. ConclusionChronic myelomonocytic leukemia associated with Sweet's syndrome is rare but implies a quick progression to acute myelomonocytic leukemia.

Objective To explore the clinical significance of PET-CT in evaluating distant metastasis and M staging of nasopharyngeal carcinoma(NPC). Methods 257 NPC patients with no prior treatment were investigated with PET-CT and conventional imaging (chest X-ray, abdominal ultrasound, and bone scan). The findings of PET-CT in diagnosing distant metastasis and M staging were compared with those of conventional imaging according to the results of biopsy and follow-up. Results PET-CT disclosed 34 of 39 patients with distant malignancy compared with 22 patients disclosed by conventional imaging. The false positive rate of PET-CT was 12.8 %. On region-based analyses, PET-CT was more effective than bone scan and chest X-ray for detecting mediastinum metastasis (x2=4.063, P =0.041) and bone metastasis (x2=5.939, P=0.015), respectively. Compared with conventional imaging, PET-CT had an impact on the M staging of 19 patients (7.4 %), of which 15 patients were truly staged and 4 patients incorrectly staged. Conclusion PET-CT is superior to MRI in evaluating distant metastasis and M staging of NPC.

To investigate physicians' knowledge about chronic obstructive pulmonary disease (COPD) in tertiary hospitals in northeast China.Physicians from 77 tertiary hospitals in northeast China were surveyed with a questionnaire,which included questions such as risk factors,symptoms,exacerbations,comorbidities and diagnostic criteria of COPD.Besides cigarette smoking,air pollution and pulmonary infections,only 22.5％ (40/178) physicians recognized that the biomass fuels may induce COPD.Totally 59.0％ (105/178) physicians recognized the importance of spirometry to the diagnosis of COPD.Besides dyspnea,cough,sputum production,wheezing and chest tightness,only 23.7％ (42/177)of physicians considered that limitation of activity was an important symptom of COPD.65.5％ (116/177)physicians believed that recurrent lung infections was one of the most important comorbidities of COPD.However,less than 30％ [20.9％ (37/177)-28.8％ (51/177)] physicians were aware of the other important comorbidities.The physicians of tertiary hospitals in northeast China need to be systematically educated on COPD to meet the new guideline.

Objective To study the effects and mechanisms of mesenthymal stem cells (MSCs)derived bone marrow of patients with chronic myelogenous leukemia (CML) on function of monocytederived dendritic cells in vitro. Methods Bone marrow mononuclear cells from CML patients were obtained and cultured. Peripheral blood mononuclear cells (PBMCs) derived from normal volunteers were isolated and cultured in DC differentiational condition. Moreover, PBMCs were co-cultured with CML bone marrow-derived MSCs (CML-MSC) or normal volunteers' bone marrow-derived MSC (normal-MSC) in DC differentiational condition. Immunophenotype and the endocytosis of monocytederived DCs were investigated by FACS. The level of IL-12 was evaluated by enzyme linked immunosorbant assay (ELISA). The immunoregulatory ability was detected by mixed lymphocyte culture assay. Results CML-MSCs or normal-MSC inhibited the up-regulation of CD1a,CD40,CD80,CD86,and HLA-DR during DC differentiation and reduced CD40,CD86,and CD83 expression during DC maturation. CML-MSCs inhibited the endocytosis of DCs and decreased their capacity to secret IL-12. CML-MSC could significantly suppress the function of DCs stimulating proliferation of T lymphocytes. Conclusion CML-derived MSCs harbored effect on the differentiation and maturation of DCs in vitro ; CML-MSC could inhibit the immunregulation of DCs.

Objective To apply robotic surgery of early ovarian malignancy tumors clinically and evaluate its feasibility in management for early ovarian cancer. Methods Using the da Vinci robotic surgical system, seven patients with early ovarian malignancy tumors (stage Ⅰ) underwent robotic surgery from April 2012 to September 2013. The average age was 45.7 years. Robotic surgeries approaches contained salpingo-oophorectomy,para-aortic lymphadenectomy, pelvic lymphadenectomy, omentectomy and appendectomy. Perioperative and follow-up clinical data were recorded. Results All robotic surgeries were successfully completed without the conversion to laparotomy. The mean operative time was 225 minutes (100-330 minutes). The average estimated blood loss was 171 ml (20-600 ml). No patients received blood transfusions. No intraoperative and postoperative complications were observed. The average number of pelvic lymph node dissected were 18.3 (11-34). The average number of para-aortic lymph node dissected were 3.7 (3-4). The mean follow-up time was 26.0 months after surgery (20-36 months). Currently, all patients had no tumor recurrence and survived. Conclusion Robotic surgery is feasible as a novel alternative approach in the treatment of early ovarian malignancy tumors.