High-dose melphalan (Mel) is considered as a current standard preparative regimen in autologous stem cell transplantation (ASCT) for multiple myeloma (MM). Irradiation in total body (TBI) combined with Mel is not superior to Mel alone, and the adverse reactions are increased at the same time. The efficacy of 200 mg/m2 Mel is much better than that of 100-140 mg/m2 Mel in young patients. Several regimens including MelBU, TBC, BCV, MET, MTC, MelBCNU, VMel, MTC as well as bendamustine have similar treatment outcomes compared with 200 mg/m2 Mel. Other strategies need to be evaluated in different trials.

Objective To observe the effect of levocamitine on cardiac function of patients with dilated cardiomyopathy (DCM).Methods 40 patients with DCM were randomly divided into control group (n =20) and the experimental group(20 cases).Control group was given conventional drug such as digitalis,furosemide,benazepril hydrochloride,antisterone for treatment,the experimental group was given levocarnitine on the basis of control group.The treatment efficacy and the situation of cardiac function were compared between the two groups.Results The total effective rate was 95.0％ and 80.0％ in the experimental group and the control group,respectively,the difference was statistically significant(x2 =10.286,P ＜ 0.01).Compared with the control group,the parameters of stroke volume,cardiac output,ejection fraction,and left ventricular fractional shortening rate were significantly increased in the experimental group after treatment(all P ＜ 0.05).Conclusion Levocarnitine can improve cardiac function based on the conventional treatment.

BACKGROUND: Adolescent Intemet addition disorder(IAD) gradually appears with the rapid popularization of Internet in China. National researches are rare at present.OBJECTIVE: To analyze the status quo of Internet use and on-line behavior characters of college students and to provide scientific data for the prevention of adolescent IAD.DESIGN: A status quo survey by employing college students as subjects SETTING: Department of psychiatrics of a medical university-affiliated hospitalPARTICIPANTS: Totally 510 college students were selected from three different type universities of Shanxi province including Shanxi Medical University, Taiyuan University of Technology, Shanxi University of Finance and Economics between November 2003 and February 2004.METHODS: Totally 510 college students from three universities of Shanxi Province were assessed by IAD test and self-compiled questionnaire for on-line college students.and non-IAD students.RESULTS: The detectable rate of IAD in college students of Shanxi province was 6.2%. More male students( n =29) had IAD than female students ( n = 3 ). Weekly on-line time of IAD students was (18.59 ± 16. 12)hours, which was significantly longer than (5.61 ± 5.64) hours of non-IAD student( P ＜ 0. 001 ) . There were significant differences of monthly on-line expenses, usual on-line place, opinions of whether intemet had negative impacts, understanding of their parents on internet functions they used, and the objective of on-line between IAD students and non-IAD students(P＜0.05 -0. 001 ), while there were no significant differences of on-line history and the utilization of internet function between two groups of students ( P ＞ 0. 05).CONCLUSION: The detectable rate of IAD in college students is relatively high and there is significant difference of on-line behavior characters between IAD students and non-IAD students, which should arouse attentions from the related department to prevent the occurrence of IAD.

ObjectiveTo report a series of female patients with bladder cancer who underwent gynecologic-tract sparing radical cystectomy with long term follow-up.MethodsFifty-five female patients between the ages of 25 and 82 years who underwent gynecologic-tract sparing radical cystectomy between 1990 and 2010 were reviewed retrospectively.Pathologic characteristics and survival ( overall and cancerspecific) were reported.Survival was estimated using Kaplan-Meier methods,and Cox proportional hazards regression analyses were performed to determine factors associated with mortality.ResultsFive patients were lost in follow up.Fifty-five women with a mean follow-up of 55.2 months were analyzed.The 3,5 and 10-year cancer specific survival (CSS) was 65％,61％ and 61％,respectively,and the corresponding overall survival (OS) was 61％,54％ and 42％,respectively.For patients with organ confined disease ( ≤ pT2N0M0) the 5-year CSS and OS was 84％ and 72％,while for those with non organ confined disease ( ≥pT3N0M0) the 5-year CSS and OS reduced to 29％ and 29％.Pathologic lymph node status (HR =3.877,P =0.019) and pathologic staging ( HR =3.992,P =0.011 ) were the only clinical or pathologic characteristics significantly associated with survival.ConclusionsFor patients with pathologically organ-confined bladder cancer ( ≤ pT2 N0 M0 ),gynecologic-tract sparing radical cystectomy is an oncologically safe treatment modality,while for those with ≥ pT3N0M0 or positive pelvic lymph nodes,gynecologic-traet sparing radical cystectomy may need large scale randomized control trials to justify its validity,pathological stage and lymph node status are the most important key points when choosing appropriate patients.

Objective To discuss the promoting effect of clinical pathway in the standard and reasonable medication by the application of clinical pathway in the anticoagulation treatment of warfarin and health education for patients with atrial fibrilation.Methods Sixty eight patients with atrial fibrilation and receiving anticoagulation treatment of warfarin were divided randomly into the intervention group(36 cases)and the control group(32 cases).The control group received routine nursing while the intervention group underwent nursing intervention with clinical pathway based upon routine nursing intervention.The time cost to achieve the aims,compliance,incidence rate of complications and satisfaction degree were compared between the two groups.Results All the items in the intervention group were superior to those of the control group except for the items of satisfaction degree and health knowledge score(P<0.05).Conclusion Application of clinical pathway in the anticoagulation treatment of warfarin for patients with atrial fibrilation could ensure standard and reasonable medication in order to decrease medical cost,lower the incidence rate of complications,improve patients compliance and increase nursing quality.

Objective To evaluate the Cys-C、β~2-MG、RBP as marker三of early diagnosis in patients with diabetic nephropathy Ⅱ(DN).Methods ninety patients with DN were divided into three groups according to urinary albumin excretion rate (UAER),that is normal,micro and mass group.Serum Cys-C、β~2-MG、RBP、BUN,Crea were detected and parallelly contrasted in the three groups and control group with thirty healthy people.Results compared with the control group,the serum Cys-C、β~2-MG、RBP of micro and mass group both significantly increased and the normal group had no significant difference.The positive rate of Cys-C、β~2-MG,RBP in mass group was respectively 100%、100%、96.1%;the positive rate in micro group as follows:Cys C (92.3%)＞B2-MG(84.6%)＞RBP(66.6%)＞Crea(46.1%)＞BUN(28.2%).Conclusion serum Cys-C、β~2-MG、RBP have high positive rates in patients with diabetic nephropathy Ⅱ(DN).They can be used as early diagnostic marker of diabetic nephropathy Ⅱespecially Cys-C.

Objective To investigate and compare the diagnostic value of fine needle aspiration biopsy(FNAB) and core needle biopsy(CNB) in the treatment of patients with invasive breast cancer.Methods Given 100 cases of patients with newly diagnosed breast cancer biopsy in our hospital from November 2015 to November 2016,50 cases of patients with FNAB into the observation group,50 cases of patients with CNB into the control group.Taken the pathologic results as a diagnostic gold standard and compared the diagnostic value of two diagnostic methods in invasive breast cancer.Detected the human epidermal growth factor receptor 2(Her-2),estrogen receptor(ER) and progesterone receptor(PR) preoperatively and compared the adverse reactions of puncture of patients in two groups.Results 30 cases of patients in the observation group showed axillary lymph node metastasis and 20 cases of patients had no axillary lymph node metastasis,21 cases of patients were positive cases of axillary lymph node metastasis accepted FNAB examination,the sensibility was 70.00％.29 cases of patients in the control group showed axillary lymph node metastasis while 21 cases of patients didn′t have axillary lymph node metastasis,23 cases of patients were positive cases of axillary lymph node metastasis accepted FNAB examination,the sensibility was 74.19％.Compared the ER、PR、Her-2 antibody with the testing result of primary tumor after operation.The diagnostic accordance rates in the observation group were 93.55％,91.67％,92.86％ respectively.The diagnostic accordance rates in the control group were 94.12％,92.31％,86.67％,the differences in two groups were not statistical significance(P>0.05).The adverse reaction rate was 4.00％ in the observation group and 0.00％ in the control group after puncture.Conclusion The diagnostic sensibility of FNAB is poorer than CNB in the diagnostic procedure of invasive breast cancer.ER,PR,Her-2 in two diagnostic methods keep a high consistency with the testing result of primary tumor after operation.

To improve flexibility and reliability of iris recognition algorithm while keeping iris recognition success rate, an iris recognition approach for combining SVM with ICA feature extraction model is presented. SVM is a kind of classifier which has demonstrated high generalization capabilities in the object recognition problem. And ICA is a feature extraction technique which can be considered a generalization of principal component analysis. In this paper, ICA is used to generate a set of subsequences of feature vectors for iris feature extraction. Then each subsequence is classified using support vector machine sequence kernels. Experiments are made on CASIA iris database, the result indicates combination of SVM and ICA can improve iris recognition flexibility and reliability while keeping recognition success rate.

Non-small cell lung cancer has a poor prognosis. Many patients who were proved to have none lymph node metastasis still relapse after operation. It may be caused by micrometastases which can′t be detected by conventional pathologic technique. Recently immunocytochemistry and moleculer methods are used to detect micrometastases in the peripheral blood, bone marrow or lymph node near the tumor. But the standard and reliable methods need to be developed and the clinical significance of micrometastases need to be discussed.

As a sort of human capital, health is a concrete manifestation of human productivity.At home and abroad, there are many empirical studies focusing on the economic effects of health that have been conducted, but the research methods have not paid enough attention to the endogeneity of health in those studies.This paper evaluates the effects of health on the income of rural residents in China with the micro panel data from China Health and Nutrition Survey.To get reliable results, the paper controls the endogenity of health by using simultaneous equation model and solves the parameters by using the three-stage least squares method.The study found that health has significantly positive effects on the income of rural residents in China, a conclusion which is in conformity with the economic effects of health.To improve the health of rural residents and fully implement the economic effects of health, the study recommends the government to put more efforts on promoting healthcare services, health-related education, and improving the living standards of rural residents in China.