Objective To explore the clinical feature and prognosis of multiple myeloma with heart failure as initial manifestations.Methods 12 patients of multiple myeloma with heart failure as initial manifestations were analyzed and followed up.Results Twelve patients,9 men and 3 women,with mean age of 48～69(58.4?5.2)years older were enrolled.The first symptoms of the patients were almost the same,with different degree of dyspnea and tachypnea.Anaemia and proteinuria were 83.3% and 75% respectively in 12 patients.ECG showed that 8 patients had low voltage in the limb leads,with present poor R wave progression in the precordial leads and ST-T changes in 6 patients.UCG showed that 10 patients had enlarged left atrium(41.6?4.2)mm,8 patients had increased thickness of the interventricular septums and left ventricular walls as well as diffuse weakness of the wall motion.Followed up for(4.0?3.7)months,all of the patients(100%)died.Conclusion Multiple myeloma with heart failure as initial manifestations is rare clinically,but has fast aggravation and bad prognosis.Pro-brain natriuretic peptide(Pro-BNP)and cardiac troponin are subtile markers for judging the prognosis of patients with multiple myeloma.

OBJECTIVE: To evaluate the effect of different cumulative energy composite parameters on the outcomes of phacoemulsification cataract surgery in patients with type 2 diabetes mellitus. METHODS: A total of 252 patients with cataract (involving 252 eyes) and type 2 diabetes mellitus received phacoemulsification cataract surgery in our hospital between January, 2017 and June, 2019. The patients were divided into group A (150 cases) and group B (102 cases) for cataract phacoemulsification with cumulative energy composite parameters of 8 and 10, respectively, and 90 nondiabetic patients received cataract phacoemulsification with a cumulative energy composite parameters of 10 served as the control. The macular thickness, best corrected visual acuity, visual acuity, and postoperative leakage in the 3 groups were evaluated at 1 week, 1 month, and 3 months after the surgery. RESULTS: The visual acuity was significantly improved after phacoemulsification better in all the 3 groups. At 3 months after the surgery, the proportions of patients with visual acuity ratio < 0.1 or >1.0, macular thickness, best corrected visual acuity and permeability differed significantly between groups A and B ( < 0.05), but not between group A and the control group ( > 0.05). At 1 month and 3 months after the surgery, the proportion of patients with visual acuity ratio < 0.1 was significantly lower and the rate of visual acuity ratio >1.0 was higher in group A than in group B. At 1 month after the operation, the total leakage rate in group A (31.1%) was higher than that in the control group (21.1%) but comparable with that in group B; at 3 months, the total leakage rates were significantly lower in group A than in group B (10.0% 32.4%, < 0.05), and the leakage resulted mainly from local and diffuse permeation. CONCLUSIONS Phacoemulsification can effectively improve the visual acuity of cataract patients especially in non-diabetic patients. A lower cumulative energy composite parameter achieves better outcomes in type 2 diabetic patients with cataract. The macular thickness, local infiltration and diffuse leakage can be used as indicators for assessing visual recovery and stabilization after phacoemulsification.
Cataract ; Cataract Extraction ; Diabetes Mellitus, Type 2 ; Humans ; Phacoemulsification ; Visual Acuity