Relapsed/refractory multiple myeloma (MM) is always a challenge in the field of MM treatment.In the 19th European Hematology Association (EHA) annual congress,there was a detailed and full-length description on the definition,prognosis,therapeutic strategies and new drugs of the relapsed/refractory MM.New agents with activity and good tolerability are promising in the future.

Objective The purpose of this study was to investigate the effects of cardiopulmonary bypass(CPB) on monocyte HLA DR expression and immune function Methods Sixteen ASA Ⅱ Ⅳ patients [mean age (38 5?5 1)yr,mean body weight (42 9?10 2kg)] of both sexes (male 7,female 9) with rheumatic value disease undergoing mitral value replacement (11 patients) and mitral value and aortic value replacement (5 patients) with moderate hypothermic CPB were enrolled in this study Another ten patients undergoing lung lobectomy were used as control group Patients suffering from infection, immuno deficiency or receiving corticosteroid or immunoregulatory drugs were excluded Premedication included intramusallar midazolam 0 1mg?kg -1 and morphine 0 1mg?kg -1 Anesthesia was induced with intravenous midazolam 0 15mg?kg -1 , fentanyl 8?g/kg and vecuronium 0 1mg?kg -1 and maintained with isoflurane inhalation (0 8%～1 2%) and intermittent boluses of fentanyl and vecuronium The total dose of fentanyl was (18 3?3 2)?g/kg in CPB group and (9 6?1 3)?g/kg in control group CPB time was (74 2?22 5) min and aortic clamping time (57 5?19 2) min Blood samples were taken from CVP line before and 5 min after induction of anesthesia, before and after CPB and on the 1st, 3rd and 5th postoperative day for determination monocyte count and percentage of HLA DR + monocytes Results The number of monocytes decreased at the end of surgery but greatly increased on the postoperative days The percentage of HLA DR + monocytes also decreased at the end of surgery and decreased further on the 1st postoperative day but started increasing on the 3rd postoperative day In two patients who developed infection the percentage of HLA DR + monoeytes was lower than the average percentage of HLA DR + monocytes of the other 14 CPB patients In control group the percentage of HLA DR + monocytes also decreased significantly after operation but there was no significant change in the number of monocytes However there was a significant difference in monoeyte HLA DR expression between the two groups Conclusions The changes in monocyte HLA DR expression and monocyte count may be induced by impaired immune response after CPB and dynamic monitoring of monocyte HLA DR expression may help to predict complication of infection after CPB

Accumulating studies have proved that systemic inflammation is one of the important pathophysiologic mechanisms of heart failure. This article focuses on the sources of inflammation mediators and the causes of inflammation activation in heart failure including hemodynamic changes and oxidative stress, Toll-like receptors, microbial antigens and microorganisms, endotoxin hypothesis and neurohormonal activation. Furthermore, the effects of inflammation mediators such as cytokines and chemokines on heart failure are introduced. All lead to the conclusion that heart failure is a process with complex inflammation.

Objective: To investigate the characteristics of mortality of injury among residents in Gusu District, Suzhou City, Jiangsu Province from 2013 to 2023, so as to provide the evidence for developing targeted measures of injury prevention and control. Methods: Gender, age and underlying cause of deaths due to injury in Gusu District were collected through Death Reporting Information System of Chinese Disease Prevention and Control Information System and Jiangsu Death Reporting Information System from January 1, 2013 to December 31, 2023. The crude mortality, Chinese-standardized mortality and world-standardized mortality of injury were analyzed, and the trend in mortality was analyzed using annual percent change (APC). Results: Totally 4 217 deaths due to injury were reported in Gusu District from 2013 to 2023. The crude, Chinese-standardized and world-standardized mortality rates were 51.58/105, 23.24/105 and 21.98/105, respectively, all showing a tendency towards a rise (APC=6.802%, 2.688% and 2.823%, all P<0.05). The crude mortality rate of injury was higher in women than in men (54.61/105 vs. 48.41/105, P<0.05). The five most common causes of injury included fall (32.99/105), traffic accidents (6.03/105), suicide (4.23/105), drowning (3.00/105) and asphyxia (2.16/105), accounting for 93.86% of the total number of deaths. The crude mortality rates of fall, suicide and asphyxia appeared a tendency towards a rise (APC=9.724%, 6.333% and 5.638%, all P<0.05). The crude mortality rates of injury among men, women and overall residents appeared a tendency towards a rise with age (all P<0.05). Fall was the primary cause of injury death among residents aged 65 years and above, and suicide was the primary cause of injury death among residents aged 15 to 44 years. Conclusions The crude mortality of injury appeared a tendency towards a rise in Gusu District from 2013 to 2023. The main causes of death were fall, traffic accidents, suicide, drowning and asphyxia, with the crude mortality of fall, suicide and asphyxia showing an upward trend.

Based on the strain breeding theory and metabolic engineering theory, A high-yield mutant of Lactobacillus Thermophilus ATCC8317 was obtained through the compound inducements by the original Acetic acid-Sodium acetate plate and the productivity increased 210%.The best media components included saccharifying corn,malt powder 30g/L,peptone 5g/L.Based on the variety of specific cell growth rate and specific L-lactic acid production rate at different temperatures, the strategy of temperature control was obtained. The total product of L-lactic acid reached 135g/L besides the rate of glucose consumed and the average L-lactic acid productivity were up to 95% and 2.25g/(L?h) respectively.

Objective To explore the relationship between quality of life and sub-health state of Guangdong urban dwellers.Methods A total of 2 200 urban dwellers were investigated using SF-36 and Sub-Heahh Measurement Scale Version 1.0(SHMS V1.0).Results As for the scores in PCS,MCS,psychosocial symptom,cognitive function,social adaptability,those of man urban dwellers (respectively (78.89± 15.25),(73.15 ± 15.26),(63.73± 18.82),(62.13± 19.34),(68.04± 17.90)) were higher than those of woman dwellers (respectively(76.98± 14.20),(71.76± 14.72),(60.53± 18.28),(57.00± 17.89),(65.73± 17.07)).The difference was statistically significant (P＜0.05).Bivariate correlation analysis showed that the PCS and MCS of quality of life were positively related with all dimensions of sub-health (P＜0.001).Canonical correlation analysis indicated that vitality,social adaptability,psychosocial symptom and positive emotion were the main factors of sub-health status,and MCS was of quality of life.Conclusion Sub-health state of Guangdong urban dwellers is positively related with quality of life,and the more serious sub-health state is,the worse quality of life is.Therefore,intervention of subhealth and quality of life should be targeted to be strengthened according to the investigation.

OBJECTIVETo analyze the changes of patients with type 2 diabetes in different stages in glucagon (GC) and free fatty acid (FFA) in fasting, OGT and L-Arg experiments, and discusses the role of pancreatic alphabeta cells in diabetes pathogenesis by studying the relations among indexes such as glucagon (GC), free fatty acid (FFA) and blood glucose (BG), insulin, insulin homeostasis model (HOMA) and glucose metabolism hormone secretion curve, in order to provide theoretical basis for the treatment of diabetes.

METHODStudy objects were divided into the T2DM group (45 cases), the IGT group (28 cases) and the NGT group (30 cases) for an OGTT experiment and then an L-Arg experiment on the next day. Under the fasting state, their blood glucose (FBG), insulin (F), glucagon (FGC), free fatty acid (FFA) were detected to calculate HOMA-beta, insulin sensitivity index (ISI) and HOMA-IR of different groups. Meanwhile, efforts were made to calculate different time quantum detected in OGTT and L-Arg experiments and area under the curve AUC(BG), AUC(INS) and AUC(GC).

RESULTObvious overall differences were observed in FFA and FGC of the three groups. FGC of each group was negatively correlated with HOMA-beta and ISI. Among all of the 103 study objects, FGC was positively correlated with FBG and HOMA-IR and negatively correlated with HOMA-beta and ISI, with no correlation with FINS; FFA was positively correlated with FBG, HOMA-IR and negatively correlated with FINS, HOMA-beta, ISI. FGC and FFA were positively correlated in the T2DM group and the IGT group, but with no statistical correlation in the NGT group. The sequence of the three study objects was T2DM > IGR > NGT in AUC(GC) in the OGTT experiment and T2DM > IGR > NGT in in AUC(GC) in the L-Arg experiment, with the significant positive correlation between AUC(GC) and AUC(BG) and significant negative correlation with AUC(INS).

CONCLUSIONGlucagon and free fatty acid of T2DM and IGT patients increased, which was positively correlated with blood glucose and HOMA-IR and negatively correlated with INS, HOMA-beta and ISI. The increase in glucagons of T2DM and IGT patients indicated inappropriate secretion of pancreatic alphabeta cells among patients with type 2 diabetes.

Adult ; Blood Glucose ; metabolism ; Diabetes Mellitus, Type 2 ; metabolism ; Fatty Acids, Nonesterified ; metabolism ; Female ; Glucagon ; blood ; Humans ; Insulin ; secretion ; Islets of Langerhans ; secretion ; Male ; Middle Aged

OBJECTIVE To study the possibility of applying Anerdian skin disinfectant for blood donor skin disinfection. METHODS Put Anerdian at 21℃,35℃ and 42℃ to exposure in air for 24h,48h and 72 h,detect the volatilization volume,effective iodine and appearance of disinfectant,and evaluate its effect on blood donor elbow by culture method. RESULTS At 21℃ exposure for 24 h the volatilization rate for Anerdian was 5%,effective iodine was 0.215%.At 35℃ and 42℃ exposure for 24 h its volatilization rate was more than 5%,and effective iodine was within the range of 0.18-0.22%.The average killing logarithm value of elbow skin natural bacteria in 30 donors was over 1. CONCLUSIONS Anerdian disinfectant is suitable for blood donor predonation skin treatment.

Objective To investigate the diagnosis and treatment of sequential diffuse large B-cell lymphoma (DLBCL) after peripheral T-cell lymphoma (PTCL).Methods A case with sequential DLBCL after PTCL was reported,and the characteristics and responses of this case were analyzed.The previous literature was reviewed in order to explain the mechanism and prognosis of such type of disease.Results This patient was diagnosed as PTCL not otherwise specified (PTCL-NOS) definitely,but after a period of treatment,DLBCL was developed as a second tumor.The characteristics and onset interval were just similar to those described in the literature,in which the mechanisms were mentioned as common effects of tumor cell,microenviroment and therapies.This patient got effects through the initial treatment,but considering the poor outcome by former researchers,the prognosis needed to be closely followed up.Conclusion Sequential development of EBV-unrelated DLBCL after PTCL-NOS is very rare,and the mechanism,therapy and prognosis need further investigation.

Objective To search for the methods preventing nephrotoxic injury of amikacin,Methods Case-control research was used in this study. There were 50 normal children in control group The urine routine, the ?2-microglobulin (?2 -M), mosmol and THP in urine and blood, the AIb, rGT and NAG in urine, the renal function and serum concentration of amikacin were determined respectively.The 43 patients with serious illness childten in study group, were divided into 2 groups (Group 1 and group 2 ). Group 1 (23 cases) was treated only with amikacin for 7 days, and group 2 (20 cases) was treated with vitaminC, vitamin E and amikacin for 7 days. Before treatment, the 3rd and 7th day during the treatment, all the items mentioncd above were examined in gtoup 1 and 2.Results The incidences of nephrotoxic injury of amikacin are 87 per cent (20/23)and 55 per cent (11/20) respectively in group 1 and 2. There is significant difference (P