Multiple myeloma is a monoclonal plasma cell malignant proliferative disease,accounting for about 10％ of malignaut tumors of blood system.In recent years,due to the application of hematopoietic stem cell transplantation and the application of MDT by combining new drug such as thalidomide,lenalidomide and bortezomib,the average survival of MM patients was significantly longer than before.The treatment strategy should be individualized before treatment according to the patient's age,physical condition and complications.In this paper,the treatment strategy of multiple myeloma patients were reviewed.

To investigate the curative effect of retaining the peripheral anterior lens capsule combined lensectomy with vitrectomy for ocular trauma.
●METHODS: Totally 33 patients ( 33 eyes ) with eye trauma underwent combined lensectomy with vitrectomy, retaining the peripheral anterior lens capsule and phase Ⅱposterior chamber lOL implantation. After follow - up of 6mo, visual acuity, intraocular pressure ( lOP ), lOL position, and intraoperative and postoperative complications were observed.
●RESULTS: Visions of all the patients were improved at varying degrees. After follow-up of 6mo, no obvious lens deflected and serious complications ( glaucoma, retinal detachment) appeared.
●CONCLUSlON: Combined lensectomy with vitrectomy, retaining the peripheral anterior lens capsule for ocular trauma has good curative effects of lessening complications during operation and postoperation and good visual acuity recovery.

Actins ; metabolism ; Adult ; Brain Neoplasms ; metabolism ; pathology ; surgery ; Desmin ; metabolism ; Diagnosis, Differential ; Dura Mater ; chemistry ; pathology ; Female ; Granuloma, Plasma Cell ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Meningeal Neoplasms ; pathology ; Meningioma ; pathology ; Neoplasms, Muscle Tissue ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Objective To explore the effect of failure mode and effect analysis (FMEA) on reducing the unplanned extubation rates for patients with severe craniocerebral injury. Methods FMEA model was used to analyze the main reasons of unplanned extubation patients with severe craniocerebral injury, 7 failure modes with higher RPN scores was selected. The nursing intervention for the fixation of the catheter were improved. The control group with 181 cases of patients without FMEA application were given routine care. FMEA group owning 196 cases were given the optimization process. The incidence rate of unplanned extubation of two groups was compared. Results After improvement of the nursing process of patients with severe craniocerebral injury for fixing the catheter, the RPN of 7 failure modes was lowered. Compared with the control group, the total rate of unplanned extubation in FMEA group decreased to 1.1% (9/832), less than 5.1% (40/779) of the control group. The statistical difference was significant (χ2=22.410, P < 0.01) . The rate of UEX in gastric tube, urinary catheter and central venous catheter were 3.1%(6/196), 1.0%(2/196), 0, lower than 8.8%(16/181), 4.9%(9/181), 3.9%(7/181) in the control group. The statistical difference was significant(χ2=5.718, 5.224, 7.724, P < 0.05). No statistical difference in tracheal cannula and drainage tube of head between the two groups was found(P>0.05). Conclusions The FMEA model can be effective in reducing the rate of unplanned extubation .

?Acute retinal necrosis syndrome ( ARN) is a serious eye disease, which caused by Herpes virus mostly, with unknown pathogenesis. Because of the aggressive progression, treatment of ARN is difficult, and the blindness rate is extremely high. Current treatment strategies are the combination of the drug therapy and the operative treatment. Drugs commonly used are antiviral drugs, glucocorticoids, and antiplatelet drugs, and the operative treatment includes laser photocoagulation and vitrectomy.

After the background, main contents and paper writers of the medical journal Yi Chao founded in Nanjing during the late period of Republic of China were analyzed with stress laid on its characteristics of nursing experiences and surgical treatment procedures for diseases, its historical values in studying the debate on traditional Chinese and Western medicine and the history of public health and medical cause during the period of Republic of China were elaborated.

Objective:To detect the levels of TGF-β1 in hypertensive renal function impairment patients and its clinical value. Methods: Primary hypertension patients with no target organs damage were enrolled in control group, primary hypertension patients with renal function stageⅠand stageⅡwere enrolled in renal function stageⅠgroup and stageⅡgroup. Serum TGF-β1 levels and renal function indices of three groups were compared. Results:There were no significant difference of serum creatinine and blood urea nitrogen of three groups(F=23.523, P<0.05);endogenous creatinine clearance rate of renal functionⅠandⅡgroups were lower than that of control group, TGF-β1 levels of renal functionⅠandⅡ groups were higher than of control group; TGF-β1 levels were negatively correlated with creatinine clearance rate. Conclusion:TGF-β1 level is an ideal index to reflect renal function for its level significantly changes in renal damage stageⅠ,Ⅱand has good correlation with Cin.

Objective To find the frequencies of FcγRIIIA polymorphisms in Chinese people and the potential role of these polymorphisms(SNPs) in systemic lupus erythermatosus(SLE) and lupus nephritis(LN).Methods The investigation covers 324 unrelated Chinese SLE patients and 319 controls.FcγRIIIA F158V polymorphism was genotyped by specific primer-polymerase chain reaction(PCR).Results The frequency of F allele of FcγRIIIA polymorphism is 60.8% in Chinese people.FcγRIIIA polymorphism revealed a significant difference of both genotype and allele distribution in SLE patients and controls.LN patients have a significant increase in carrier frequency of the FF genotype, while the VV genotype reveals a significant decreased risk of early onset of LN.ConclusionsFcγRIIIA polymorphisms is potentially related with SLE in Chinese people.The homozygous FF genotype of FcγRIIIA might be the risk factor for LN, while the homozygous VV genotype might be the protective factor for late onset lupus nephritis.

Objective To study the serum procalcitonin (PCT)in patients with sepsis clinical application value,for the hospi-tal,infection control,to provide a scientific basis for reasonable Shaanxi General of antibiotics.Methods Retrospective anal-ysis of Shaanxi General hospital of CARF in 2011 May~2013 May 201 cases of patients with ICU,According to the severi-ty of infection were divided into 4 groups(SIRS)63 cases,(Sepsis)40 cases,(Severe sepsis)70 cases,(Septic shock)19 ca-ses,Dynamic analysis of ICU monitoring in 1,3,5,7,10,14,17 days each in the blood in patients with PCT,hs-CRP and WBC levels and blood culture,and PCT on the sensitivity,sepsis diagnostic specificity,positive predictive value,and negative predictive value,diagnostic accordance rate.Results PCT levels of SIRS and Sepsis (1.92 ng/ml)(10.8 ng/ml)group,the Severe Sepsis (24.0 ng/ml),and Septic shock compared (34.0 ng/ml)group,the difference was statistically significant (q1=13.8,q2=15.6,q3=17.9,P<0.05).Four groups of hs-CRP and WBC count,and there was no statistically significant difference (F=5.10,P>0.05),PCT levels and the severity of sepsis in positive correlation (r=0.781).The positive rate of blood culture in 26.6%,and PCT the on diagnosis of sepsis sensitivity,specificity,positive predictive value (PP),negative predictive value (NPV)were 87.2%,85.4%,78.9% and 89.3%,respectively,for sepsis diagnosis coincidence rate 85%, the increase of PCT level(≥ 1 ng/ml)was anindependent index 28 natural deposit rate.Conclusion Compared with PCT hs-CRP and WBC could better evaluate the severity of sepsis,and dynamic j udgment of sepsis disease prognosis was more sensitive.Joint detection with blood culture could improve the of accuracy differential diagnosis of sepsis,and to guide clinical rational application of antibiotics.The change of concentration of PCT daily can help predict mortality risk in patients with sepsis in ICU of the hospital,reduce complications and reduce mortality.

Objective To examine the inhibitory effect of Chinese herbal Compound Dongju on 4-nitroquinoline 1-oxide(4NQO)-induced tongue carcinogenesis in rats. Methods A total of 85 Wistar rats were divided into four groups: model group(n=35),administration group(n=35),normal control group(n=5) and herb control group(n=10).4NQO dissolved in drinking water was administered orally to induce tongue carcinogenesis in rats.The herb compound was injected into the stomach of the rats during oral carcinogenesis.Rats were sacrificed at 9,13,20,24 and 32 weeks from the beginning of the experiment.The tongues of the rats were dissected for gross and histological assessment,and SP immunohistochemical method was also employed to detect the expression of cyclin D1 in the specimens. Results Compared with the model group,the incidence of dysplasia and the positive rate of cyclin D1 were suppressed by Compound Dongju(P