As understanding the biology of multiple myeloma (MM) and application of new drugs, regimens containing new drugs deepened therapeutic response and prolonged the survival of MM patients. This article updates the therapeutic response of regimens reported in the 57th American Society of Hematology annual meeting, containing immunomodulatory agents, proteasome inhibitors, histone deacetylase inhibitors and other new drugs including monoclonal antibodies and the others. In the same time, minimal residual disease (MRD) is also used to evaluate the remission depth of MM. In order to achieve durable long-term remission and higher quality of life, new drug combination regimens have been recommended, especially for the relapsed or the high risk MM patients.

Multiple myeloma (MM) is a unique cancer paradigm for investigating the mechanisms involved in the transformation from a premalignant condition (unknown monoclonal gamma globulin,MGUS) into a malignant disease (MM).In its pathogenesis,genotype characteristics of tumor clones which are highly complex and heterogeneous,as well as the dialogue between plasma cells and their microenvironment are equally important and both play a key role in the outcome of the disease.MM will soon no longer be considered as a single disease.A large number of new drug emergence and applications will increase the need for monitoring minimal residual disease (MRD) in prognosis and treatment of MM.New drugs and high-dose chemotherapy with autologous stem cell transplantation applications have been significantly improving the prognosis of MM in the past 20 years.Re-examining the early MM diagnostic criteria and the possibility of early intervention will open up a new therapeutic approach.It is important to find a balance of efficacy,toxicity and cost in order to achieve a cure for this disease.

Objective:To prepare bryostatins freeze-dried liposomes and to establish a quality standard for the liposomes.Methods: Film dispersion technique was used to encapsulate bryostatins with liposomes.Chloroform was taken as the solvent and was volatilized by revolving.Emulsification was performed with the probe after hydration,then the supporting agent was added for freeze drying.An RP-HPLC method was developed to determine the freeze-dried liposome content.The separation was performed with a Agilent C_(18) Column and the mobile phase was methanol-water in gradient elution 7525(0-38 min),(73.726.3)(38-45 min),7921(45-48 min) by a flow rate of 1.5 ml/min,with the UV detector set at 228 nm.Zetasizer was used to determine the size of liposomes and the entrapment efficiency was determined with centrifugal ultrafilter.Results: The freeze-dried liposomes were homogeneous and the mean diameter was 0.423 ?m.The standard curve was linear over the range of 44-220 ?g/ml,r=0.999 8.The intra-day and inter-day RSDs were less than 2.0%.The recoveries of the high,middle and low concentrations(88,110,and 132 ?g/ml) were 100.8%,98.4%,and 100.9%,respectively.The detection limit was 4.4 ng,the quantitation limit was 17.6 ng,and the entrapment efficiency was 98.68%.Conclusion: The film dispersion technique is(suitable) for preparation of bryostatins liposomes.The method in this study is easy-to-use,accurate,and with good(repeatability.)

Objective To study the validity,reliability and sensitivity of the simplified Chinese version of modified Barthel index (MBI) in evaluation of activities of daily living(ADL) of Chinese stroke patients. Methods Forty Chinese stroke patients (26 males and 14 females,aged 59.65±11.68 years) participated in the study.The duration of the disease averaged 21.20±19.44 days.All the patients were evaluated for three times with MBI.Barthel Index (BI) and the motor component of Functional Independence Measure (M-FIM)independently by twophysiatrists.Spearman correlation coefficients between MBI and Barthel index (BI),between MBI and M-FIM were used to test the validity of MBI.Intraclass correlation coefficients (ICC) were used to test both interrater and intra rater reliability of MBI.Sensitivity of MBl was analyzed with the Wilcoxon signed rank test and paired t-test.Results MBI was highly correlated with BI in each item and total score(r=0.816～1.000,P<0.01),and with M-FIM in total score(r=0.935～0.981,P<0.01).There were high reliability with MBI in the results collected by same assessor and different assessors(ICC=0.866～0.997).Furthermore,MBI was more sensitive than BI in majorities of its items and its total scores as well.Conclusions MBI has good validity and reliability as well as sensitivity in assessment of ADL of Chinese stroke patients.

Objective To investigate plasma pharmacokinetics profiles of compound betameth in guinea pig after postaurieal and systemic administrations,and to explore the possible pathway for postaurical injection. Methods 1 ml compound-betameth was injected postaurieally and intramuscularly into the guinea pig. Blood were samples obtained 0. 5,1,1.5,2,3,5,7 h and 1,2,4 w after the administration of contralateral sigmoid sinus blood and circulatory blood respectively. High performance liquid chromatography was used to dectet compound betameth in the samlowing postaurieal administration. The Cmax(peak concentration) in sigmoid sinus of postaurieal group was 2.56 and 3.03 higher than those in the contralateral and the systemic group. The AUC((area under the ct curve) was 2.41 postaurieal administration. The Cmax and AUC in postaurieal group were 0. 13 and 0. 32 higher than systemic group. Conclusion The postaurieal injection reached a higher concentration of drugs in the sigmoid sinus blood, and remained a lower concentration in circulatory blood.

Objective To study the therapeutic effects and its possible mechanism ofBushen Paidu Mixture on renal interstitial fibrosis. Methods A total of 60 mice were randomly divided into a normal group,UUO group, Bushen Paidu Mixture group and Lotensin group. Mice models were induced by unilateral ureteral occlusion (UUO). Execute the mice at 7, 14, 21, and 28 days after UUO. The involved kidney were separated and had HE staining. Determine integrinβ1 in kidney tissue through immunohistochemical methods. Results Integrinβ1 tissues had a weak expression in normal kidney. Integrinβ1 expressed higher in UUO group than normal group. The expression of integrinβ1 in Bushen Paidu Mixture group and Lotensin group was lower than the UUO group at every timing point. There is no significant difference between the Bushen Mixture group and Lotensin group in terms of integrinβ1 expression. Conclusion Bushen Paidu Mixture can slow down the process of renal interstitial fibrosis through regulating integrinβ1 expression.

Objective To evaluate the accuracy of continuous noninvasive partial pressure of carbon dioxide monitoring in the old diabetic patients undergoing general anesthesia.Methods Sixty-six old diabetic patients of both sexes,aged 65-76 yr,weighing 49-95 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective surgery under general anesthesia,were included in this study.Transcutaneous partial pressure of carbon dioxide (TcPCO2) was monitored by a noninvasive transcutaneous carbon dioxide monitor.Arterial blood samples were collected at 30 and 60 min after endotracheal intubation,partial pressure of arterial carbon dioxide (PaCO2) was monitored,and TcPCO2 and end-tidal pressure of carbon dioxide (PET CO2) were recorded.Bland-Altman analysis was used to measure the agreement.Results At 30 min after intubation,the results of Bland-Altman analysis showed that the mean difference between PaCO2 and TcPCO2 was 1.3,95％ confidence interval (CI) was 1.0-1.6,and the limit of agreement was-1.1-3.7;the mean difference between PaCO2 and PETCO2 was -3.2,95％CI:-3.6--2.8,and the limit of agreement was-6.6-0.2.At 60 min after intubation,the results of Bland-Altman analysis showed that the mean difference between PaCO2 and TcPCO2 was 1.4,95％ CI was 1.1-1.7,and the limit of agreement was-1.0-3.4;the mean difference between PaCO2 and PETCO2 was-3.1,95％CI was-3.5--2.7,and the limit of agreement was-6.7-0.5.The repeatability coefficients of PaCO2,TcPCO2 and PETCO2 were 2.1,2.3 and 2.3,respectively,at 30 and 60 min after intubation.Conclusion Continuous noninvasive partial pressure of carbon dioxide monitoring provides good accuracy and can be used as an alternative to PaCO2 monitoring,and the accuracy is higher than that of PETCO2 for the old diabetic patients undergoing general anesthesia.

Objective To investigate the current status analysis the risk factors of medical adhesive related skin injury(MARSI) in neonates in NICU, in order to provide guidance in prevention and nursing of the skin injury. Methods Convenience sampling five NICU in Shenyang, prospective investigate the incidence of MARSI of neonates during the NICU stay, and analysis the incidence , injury type distribution and risk factors. Results The incidence of MARSI in neonates in NICU was 12.8%(53/413);the major injury type of MARSI was epidermal stripping(47.2%,25/53)and skin tear(35.8%,19/53) in mechanical injury;Logistic analysis showed that the independent risk factors of MARSI were the use of stomach tube, dehydrate skin and blue light therapy (χ2=5.953, 9.806 and 7.568, P<0.05). Conclusions MARSI is frequency interrupted in neonates during the NICU stay, correct selection of medical adhesive products, application of suitable paste and remove skills are helpful to reduce the incidence of MARSI in neonates during the NICU stay.

85%of IRAB were resistant to the rest 12 antibacterials except polymyxin B,cefoperazone/sulbactam and minocycline.CONCLUSIONS It should be exactly detect and control IRAB due to extremely severity about hospital infections and multidrug resistantce.

Objective: To study validity and reliability of Wolf motor function test (WMFT) on assessing the upper extremities motor function of acute stroke patients so as to guide clinical application. Method: Twenty-three stroke patients in acute stage participated in the study. Patients were assessed twice with WMFT and the upper extremities motor function test of Fugl-Meyer movement assessment (U-FMA) within one week. The correlation between the assessment results of WMFT and U-FMA were analyzed to study the validity and reliability of WMFT. Result: WMFT was highly correlated with U-FMA in total scores (r =0.922, 0.929, P＜0.001). There were high correlation in all items of WMFT between two assessment sessions. The intraclass correlation coefficients (ICC) were 0.989, 0.997 for intrarater and 0.980, 0.991 for interrater. Conclusion: The WMFT is valid and reliable on assessing upper extremities motor function of stroke patients in acute stage.