The prognosis for patients multiple myeloma(MM)has improved substantially over the past decade with the development of new,more effective chemotherapeutic agents and regimens that possess a high level of anti-tumor activity.In spite of this important progress,however,nearly all MM patients ultimately relapse,even those who experience a complete response to initial therapy.This summarize provided detailed recommendations on management of relapsed disease,with sections dedicated to diagnostic evaluation,determinants of therapy,and general approach to patients with specific disease characteristics.In addition,the article provided a summary of evidence from clinical trials that have significantly impacted the field,including those evaluating conventional therapies,as well as both autologous and allogeneic stem cell transplantation.Finally,perspective is provided regarding new agents and promising directions in management of relapsed MM.

Objective:To evaluate the cytotoxicity of propolis and calcium hydroxide for human gingival fibroblast.Methods:Human gingival fibroblast(HGF)was incubated in culture solution containing propolis or calcium hydroxide at different concentrations.The relative growth rates(RGR)were examined by method of MTT assay and cytotoxicity was classified by the five-class method.Then the results were statistically analysed.Results:The cytotoxicities of both 0.1% to 0.6% propolis and calcium hydroxide solutions at different concentration were all graded as first or second class.There was no statistical difference between them.Conclusion:Propolis and calcium hydroxide have weak cytotoxicity for HGF and they are all safe as local application for oral diseases.

Objective:To evaluate bacteriostasis effect of domestic-made water-soluble propolis on prevotella intermedia(Pi),fu-sobacterium nucleatum(Fn)and mixture bacteria of Pi and Fn in vitro.Methods:With agar dilution,minimal bactericidal con-centrations(MBC)of propolis for Fn,Pi and mixture bacteria were determined.Results:MBC of propolis for Fn,Pi or mixture bacteria were 0.025%,0.025%,0.05% respectively.Conclusion:Propolis shows the favourable antibacterial activity against the main anaerobic bacterium in infectious root canal which it has a value of application for disinfecting root canal.

OBJECTIVE: To observe the clinical efficacy and toxic effects of irinotecan (CPT-11) combined with 5-fluorouracil/leucovorin (5-Fu/LV) in the treatment of advanced colorectal cancer. METHODS: Among 31 cases of advanced colorectal cancer, 30 cases were evaluable. All patients received 2 weeks of therapy regimen: CPT-11 180 mg?m-2 i.v. gtt d1, LV 200 mg?m-2 i.v. gtt d1～2, 5-Fu 400 mg?m-2 i.v. and 5-Fu 600 mg?m-2 i.v. gtt for 22 h, d1～2. A treatment course last for 14 days. 6 weeks later, clinical efficacy was evaluated. RESULTS: Complete remission was observed in 1 case and partial remission 11 cases. The remission rate (RR) was 40%. Stable disease was reported in 14 cases and disease progression 4 cases. Medium time to progress (TTP) was 6.5 months and medium survival time(MST) was 13.9 months. Major toxic reactions were delayed diarrhea (Ⅲ/Ⅳ grade of 30%) and neutropenia (Ⅲ/Ⅳ grade of 26.6%). CONCLUSION: The regimens of CPT-11 combined with 5-Fu / LV have high response rate and tolerable toxicity in treatment of advanced colorectal cancer. It can be use as first or second line chemotherapy for advanced colorectal cancer.

Objective:To establish the identification method of Jianpigao Tablets.Methods: The microscopic identification and TLC were used. Results: 8 herbs in Jianpigao Tablets can be identified by microscopic identified. Radix Codonopsis, Rhizoma atractylodis macrocephalea and Radix glycyrrhizae can be identified respectively by TLC.Conclusions: The method is accurate and simple, and can be used for quality control of Jianpigao Tablets.

Objective To detect the serum level of interleukin (IL)-1 1, lymphocyte subsets and NK cells in patients with idiopathic thrombocytopenic purpura (ITP), and explore the related factors in the pathogenesis of ITP. Methods The serum level of IL-11, lymphocyte subsets and NK cells were detected by double antibody sandwich enzyme linked immunosorbent assay (ELISA) and flow cytometry in 50 ITP patients (ITP group) and 30 controls (control group). Results The platelet in ITP group [ (30.21 ± 19.40) ×109/L] was lower than that in control group [ (207.21 ± 31.55 ) × 109/L] obviously (P ＜ 0.05 ); the serum level of IL-11 in ITP group [(255.72 ± 163.43) ng/L] was significantly higher than that in control group [ (40.60 ± 5.57 ) ng/L ] (P ＜ 0.05 ). The correlation analysis indicated that the blood serum levels of IL- 11 had negative relationship with the platelet (r = -0.557 ,P ＜ 0.05). The percentage of CD3+ and CD4+ T lymphocyte percentage, CD4+/CD8+ in ITP group were lower and the percentage of CD8+ T lymphocyte was higher than those in control group obviously (P ＜ 0.05 ). The percentage of CD3- CD(16+56) +NK cell in ITP group was lower than that in control group (P ＜ 0.05). Conclusion IL-11, lymphocyte subgroup and NK cell change correlate with ITP morbidity closely, and the IL-11 level and the platelet possibly have the negative feedback control action.

Objective To investigate the relationship between rs7903146-T/C polymorphism of transcription factor7-like 2 gene (TCF7L2) gene and gestational diabetes mellitus in Han population of Liaoning province.Methods The rs7903146-T/C polymorphism was detected in 115 healthy Han controls and 113 patients with gestational diabetes mellitus by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.Results There were three genotypes:CC,CT,and TT; and their frequencies in control group and patients were 95.65％/84.96％,4.35％/15.04％,and 0/0,respectively.The allele frequency T of rs7903146 in control group and the patients was 2.17％ and 7.52％,respectively.There was statistical difference between two groups.Conclusions The rs7903146-T/C polymorphism of TCF7L2 might be associated with gestational diabetes mellitus in Liaoning Han population.

Middle East Respiratory Syndrome-Coronavirus (MERS-CoV) is a novel coronavirus which can cause severe acute respiratory illness with a high mortality rate .There is no proven medication or vaccine for MERS-CoV .Currently MERS-CoV has spread from the main epidemic area ,the Middle East area ,to many other countries including United States of America and has the potential of global endemic .It has raised global public health concerns regarding the current situation and its future evolution .This review will mainly focus on the research progress of MERS-CoV about the animal reservoir and transmission , infection mechanisms and development of anti-viral drugs or vaccine .The goal is to provide with useful references to the devel-opment of specific drug and vaccine and an effective control and prevention of M ERS-CoV infection .

Diet therapy is considered as the basic treatment of chronic kidney disease (CKD),and its primary goals are improving metabolic disorder,relieving symptoms and prevent complications,hence to retard renal function lost of CKD patients.However,there have been controversies about the results of clinical studies on nutritional treatment for CKD.This article reviews the effectiveness,safety and compliance of low-protein diet (LPD) for CKD patients,and related clinical management strategies.The article also recommends the feasible diet scheme to provide a reference of clinical LPD therapy for patients with CKD.