The relapse and refractoriness of multiple myeloma is still the most tough problems in clinical practise.With the increasing cognition of pathogenesis on multiple myeloma, lots of new drugs are constantly emerging with its clinical efficacy and side-effect are gradually acknowledged. There are a serial of new agents and therapies targeted relapsed and refractory multiple myeloma have spring up. This paper will summarize the advancement of treatment for relapsed and refractory multiple myeloma.

Objective To retrospectively analyze of blood culture positive for adult patients with serum calcium concentration ,to understand the relationship between bloodstream infections in patients and serum calcium .Methods From January 2013 to July 2015 ,serum calcium (Ca) ,phosphorus (P) ,alkaline phosphatase (ALP) in 78 cases with the blood culture positive adult patients and 103 healthy subjects were detected and analyzed .Results The value of CA in adult patients was(1 .89 ± 0 .18) mmol/L ,healthy subjects while of that was (2 .23 ± 0 .23)mmol/L in healthy subjects ,There was statistically significant (P<0 .01) in two groups ;The P of patients was (1 .23 ± 0 .24)mmol/L ,which in healthy subjects was (1 .25 ± 0 .28)mmol/L ,There was no statistical differ‐ence (P>0 .05);ALP of patients was (78 ± 42)U/L ,which was (76 ± 40)U/L in healthy subjects .There was no statistical differ‐ence (P>0 .05) ,the r of Ca and P ,Ca and ALP were 0 .023 ,0 .023 respectively (P>0 .05) in patients ,while there were 0 .125 and 0 .132 (P<0 .05) in healthy subjects .Conclusion Calcium in serum of adult patients with blood culture positive might be reduced .

Objective To investigate the effect of liquid temperature, pressure, concentration, pH parameters on the membrane process and rejection in the process of using reverse osmosis membrane to concentrate oil-bearing water bodies ultrafiltrate of Compound Chuanxiong Capsules, and optimize the process. Methods With oil-bearing water bodies ultrafiltrate of Compound Chuanxiong Capsules volatile oil as the research object, the changes in flux under different operating parameters was measured. Results For this system, suitable operation parameters was as follows: pressure was 1.6 MPa, temperature was 35～ 40 ℃, pH was 9～10. Conclusion Using reverse osmosis membrane to concentrate oil-bearing water bodies ultrafiltrate of Compound Chuanxiong Capsules volatile oil, better flux and rejection can be obtained at the appropriate operating conditions.

Objective To evaluate advantages and disadvantages of three procedures-percutaneous ethanol injection,small incision unroofing,and laparoscopic unroofing-in the treatment of renal cysts.Methods Clinical data of 106 cases of renal cysts from January 2001 to November 2004,treated either by percutaneous ethanol injection(Percutaneous Group),or small incision unroofing(Small Incision Group),or laparoscopic unroofing (Laparoscopic Group),were reviewed.The operation time,intraoperative blood loss,hospitalization costs,and cure rate were compared among the three procedures.Results The Percutaneous Group presented the least hospitalization costs(3 261.8?779.2 yuan),the lowest cure rate(78.6%,22/28),and the highest recurrence rate(21.4%,6/28).The Small Incision Group had the shortest operation time(44.1?5.7 min),and the Laparoscopic Group had the highest hospitalization costs(9 050.9?1 116.2 yuan).There were significant differences in these parameters among the three groups(P0.05).Conclusions The three procedures,with each having its own advantages,should be selected depending on individual conditions.For patients with a simple renal cyst

Objective To investigate the effect of FTY720 and gemcitabine on the proliferation and apoptosis of H520 and A549 cells in non-small cell lung cancer(NSCLC) cell line.Methods The interventional influence on the in vitro cultured NSCLC A549 and H520 cells was performed by selecting 0,2,4,6,8,10 μmol/L concentrations of FTY720,then the absorbance value was detected at 24,48,72 h after culture and the proliferation inhibiting effects of FTY720 on A549 and H520 were observed under the condition of different concentration of FTY720;adding single 7 μmol/L of FTY720,single 0.2 μmol/L gemcitabine and 37 μmol / L FTY720 combined with 0.2 mol/L gemcitabine into A549 and H520 cells lines,then the differences of inhibition and apoptosis after 48 h in the cells of each group were observed.Results The inhibitory effect of different concentrations of FTY270 on NSCLC A549 and H520 cell lines was statistically significant difference (P＜0.05).The proliferation inhibiting effect of FTY720 on NSCLC H520 and A549 cell lines had the correlation with the concentration and time.The apoptosis rate of FTY720 combined with gemcitabine on A549 and H520 cells was significantly higher than that of single use in these two drugs (P＜0.05).Conclusion FTY720 combined with gemcitabine can significantly inhibit the proliferation of A549 and H520 in human NSCLC,and can effectively promote the apoptosis of cancer cells,and has the higher clinical value.

Objective To investigate the effects of HRT on endometrium of postmenopausal women.Methods 53 cases of postmenopausal vaginal bleeding(PMB),from Jan,1995 to Dec.1999 treated by HRT were selected to make a comparison with the other 60 cases of PMB without HRT during the corresponding period.Both groups had integrated ultrasonic and pathological data and getting information from succedent inspection.Results The rates of the endometrial carcinorma incidences that happen in the HRT group were non-HRT group were 5 66% and 8 33% respectively,which had little significant.While the occurring rates of inflammation were 1 89% and 16 67% respectively,a significant difference between the both existed here.Conclusions With HRT,the various symptoms of post menopause women can be efficiently improved.It is safe and effective in short term.But a close monitoring is absolutely necessary for its long term effect(5 years or more).

Objective To investigate the effect of GABAB receptor in spinal cord by detecting semi-quantitatively the mRNA for isoforms of GABAB receptor in a chronic neuropathic pain model. Methods Twenty-four male SD rats weighing 200-250g were anesthetized with intraperitoneal pentobarbital. Lamina of L5 vertebra and superior articular process of L6 were removed and posterior root of left L5 spinal nerve was exposed and tightly ligated with 7/0 atraumatic suture. The animals were randomly divided into 4 groups of 6 animals in each group: group A in which animals were observed for 7 days after sham operation; group B in which animals were observed for 7 days after ligation of posterior root of L5 spinal nerve; in group C animals were observed for 14 days after sham operation and in group D animals were observed for 14 days after ligation. Pain threshold was measured by heat stimulation of bilateral hindlimbs before and on the 1st , 3rd , 7th , 10th and 14th day after operation. Lumbar spinal cord was removed on the 7th or 14th day after operation and mRNA for isoforms of GABAB receptor in the spinal cord was detected semi-quantitatively by digoxin hybridization in situ.Results Pain threshold of left hindlimb (ligated side) was significantly lower than that of right hindlimb on the 7th, 10th and 14th day after operation as measured by heat stimulation. There were less mRNA for three isoforms of GABAB receptor in group B and D as compared with group A and C respectively. Conclusion The gene expression of three isoforms of GABAB receptor in the spinal cord has plasticity and is reduced during chronic neuropathic pain.

Objective To explore the intervention effects of trichostatin A ( TSA ) on specialization of rat bone marrow mesenchymal stem cells ( MSCs ) .Methods The rat MSCs were isolated, cultured and purified by the whole bone marrow adherent method in vitro, with morphological observation.The third generation of MSCs were selected, directional induced to osteoblasts, and divided into the TSA low dose group (0.1μmol/L), middle dose group (1μmol/L) , the high dose group (10μmol/L) according to different drug concentrations, seting up blank control group at the same time.MSCs proliferation and cell growth curve of each group were drawn by MMT, the activity of alkaliphosphatase ( ALP) was detected, and the levels of corebinding factor α1 (Cbfα1), basic fibroblast growth factor (bFGF) and insulin-like growth factors-1 (IGF-1) mRNA were detected by RT-PCR. Results The trend of MSCs growth curves in each groups were similar, compared with control group, the growth curve of TSA low dose group had no significant change, the TSA middle dose and high dose significantly promoted the proliferation of MSCs (P<0.05).Compared with control group, ALP activity of TSA low-, middle-and high-dose group were significantly higher at 4th,5th,6th(P<0.05).The expression levels of Cbfα1, bFGF and IGF-1mRNA were significantly higher than those of control group, respectively (P<0.05).Conclusion TSA can significantly promote the rat bone marrow mesenchymal stem cells to differentiate into osteoblast, which is possibly associated with up-regulation of Cbfα1, bFGF and IGF-1mRNA level.

Objective To observe the analgesic effect of ultrasound-guided and nerve stimulator after artificial total knee athroplasty(TKA).Methods Forty elective cases receiving TKA under gen-eral anesthesia were randomly allocated into the ultrasound group (group C)and stimulator group (group S).The time for nerve block,onset time and complications were recorded in both groups. Results Compared to group S,the time for nerve block and onset time was significantly shortened in group C (P <0.05).There was no statistical difference in times of pressing analgesic pump and VAS score in postoperative 48 h.One patient suffered from nerve injury and two underwent vascular dam-age and hematoma in group S,while no complication was found in group C.Conclusion Compared to nerve stimulator,ultrasound-guided continuous femoral nerve block(CFNB)may reduce nerve block time and onset time and decrease complications,so that to increase safety of CFNB.