Multiple myeloma is a plasma cell disease with the second highest incidence among hematological malignancies. Its risk of concurrent thrombosis is high, which greatly affects the quality of life and even endangers life of multiple myeloma patients. The pathogenesis of thrombosis in patients with multiple myeloma is complex, which is still unclear. However many mechanisms are considered to be related to hypercoagulable state in patients with multiple myeloma. Currently, there is a lack of thrombosis risk assessment model for multiple myeloma. Therefore, this paper reviews the research and the latest progress of venous thrombosis in patients with multiple myeloma, and provides a theoretical basis for the prevention and treatment of thrombosis.

OBJECTIVE: To investigate the antitumor activity of decoction and study its liver and kidney toxicity and its effect on the immune system in a tumor-bearing mouse model. METHODS: Hepatoma H22 tumor-bearing mouse models were randomized into model group, cyclophosphamide (CTX) group, and low-, moderate-, and high-dose decoction groups (JW-L, JW-M, and JW-H groups, respectively). The antitumor activity of decoction was assessed by calculating the tumor inhibition rate and pathological observation of the tumor tissues. Immunohistochemistry was used to detect the expressions of Bax, Bcl-2, Bax/Bcl-2 and caspase-3 in the tumors. The liver and kidney toxicity of decoction was analyzed by evaluating the biochemical indicators of liver and kidney functions. The immune function of the tumor-bearing mice were assessed by calculating the immune organ index, testing peripheral blood routines, and detection of serum IL-2 and TNF-α levels using enzyme-linked immunosorbent assay. RESULTS: Compared with that in the model group, the tumor mass in CTX, JW-M and JW-H groups were all significantly reduced ( < 0.05) with cell rupture and necrosis in the tumors. Immunohistochemistry revealed obviously up-regulated expressions of Bax and caspase-3 and down- regulated expression of Bcl-2 protein with an increased Bax/Bcl-2 ratio in CTX, JW-M and JW-H groups. Treatment with decoction significantly reduced Cr, BUN, AST and ALT levels, improved the immune organ index, increased peripheral blood leukocytes, erythrocytes and hemoglobin levels, and up-regulated the levels of TNF-α and IL-2 in the tumor-bearing mice. These changes were especially significant in JW-H group when compared with the parameters in the model group ( < 0.01). CONCLUSIONS decoction has a strong anti-tumor activity and can improve the liver and kidney functions of tumor-bearing mice. Its anti-tumor effect may be attributed to the up-regulation of Bax, caspase-3, TNF-α and IL-2 levels and the down-regulation of Bcl-2 expression as well as the enhancement of the non-specific immune function.
Animals ; Antineoplastic Agents, Phytogenic ; pharmacology ; Carcinoma, Hepatocellular ; drug therapy ; immunology ; metabolism ; pathology ; Drugs, Chinese Herbal ; pharmacology ; Kidney ; drug effects ; Liver ; drug effects ; pathology ; Liver Neoplasms ; drug therapy ; immunology ; metabolism ; pathology ; Mice ; Necrosis ; Neoplasm Proteins ; metabolism ; Random Allocation ; Up-Regulation

Objective To analysis the change of hip joint in healthy infants by ultrasound,and establish the normal reference value of the developmental dysplasia of the hip(DDH). Methods A total of 8 000 healthy infants from 0 to 24 weeks were collected from the Multi-center study of 10 children′s medical centers. Among them,3 855 infants(2 065 females and 1 790 males) with complete data and follow-up were included in this study. All subjects were divided into 6 groups ( ＜4,4～7,8～11,12～15,16～19 and≥20 weeks group). α angle,femoral head length and width,femoral head coverage ratio by acetabulum ( FHC) were measured in the coronal view on the neutral position;distance from pubis to femoral head ( P-H) and distance from ischium to femoral head ( I-H ) were measured in the transverse view on neutral position;distance from femoral head topubis ( H-P) was measured in the posterolateraltransverse view on the flexion position. The results of each group changes with age were analysised. Results ① The α angle of healthy infants from 0 to 20 weeks were increased with age,the difference among the groups were statistically significant( P ＜0.05),but there was no significant difference between 16～19 and ≥20 weeks group( P ＞0.05). ②The femoral head length and width of all age groups were increased with age,the difference among all the groups was statistically significant( all P ＜0.05). ③ FHC from 0 to 20 weeks were increased with age,the difference among the groups were statistically significant( P ＜0.05) except between 16～19 and ≥20 weeks group( P ＞0.05). ④ The P-H and I-H in all age groups showed no statistically significant ( all P＞0.05). ⑤The H-P of all age groups were increased with age,the difference between the groups were statistically significant(all P ＜0.05).Conclusions The development of hip joints have the certain regular developmental pattern in healthy infants less than 5 months of birth and are relatively constant after birth more than 5 months. The ultrasound normal reference value of the hip joints can be used for the early diagnosis of the DDH.

Objective To investigate the chemical constituents and activities of Linum usitatissimum L.aboveground. Meth-ods The chemical constituents were separated through silica gel,ODS,Sephadex LH-20,and semi-preparative RP-HPLC chroma-tography and identified by optical rotation and spectroscopic analysis. All of the isolates were evaluated for their inhibitory activities by the luciferase assay. Results Eight dibenzylbutyrolactone lignans were separated from L. usitatissimum and identified as(-)-hinoki-nin(1),(-)-bursehernin(2),(-)-dimethylmatairesinol(3),(-)-yatein(4),(-)-thujaplicatin trimethyl ether(5),nemerosin (6),(+)-E-7,8-dehydromatairesinol dimethyl ether(7),and E-7,8-dehydrothujaplicatin trimethyl ether(8),respectively. Conclu-sion Compounds 7 and 8 were isolated from L. usitatissimum for the first time,and NMR spectral data of compound 8 were reported for the first time. Compounds 1 and 3 showed moderate inhibitory activities on IL-6/STAT3 signaling pathway with IC50 values of 42.12 and 43.43μmol/L,respectively.

Objective To summarize the effect of eye socket reconstruction in patients with severe depressed eye socket combined anophthalmos and to assess the methods of eye socket reconstruction.Methods Forty patients of severe depressed eye socket combined anophthahnos,from Oct,2001 to Mar,2014,underwent eye socket reconstruction in Beijing Tongren Hospital.Thirty four eye sockets were reconstructed with free flap,the scapular flap in 2 cases,the forearm flap in 17 cases,the lateral arm flap in 15 cases.The reversed submental island flap was utilized in 2 patients.The other 4 cases were treated by implant-retained orbital prosthesis.Results All the patients were followed up for more than 2 years.The flaps survived.The artificial eye could be fitted satisfactorily and the appearance of the ill eye socket was improved significantly.The implant-bodies in orbital bone and the prosthesis were stable without peri-implantitis.Conclusions The flap transfer is effective for eye socket reconstruction in patient with severe depressed eye socket combined anophthalmos.The implant-retained orbital prosthesis is also alternative.The treatment choice must be based on the patient 's own conditions.

This paper introduced the development of medical specialists alliance in Zhejiang University. With Jinhua Central Hospital as an example,merits and setbacks of the 3-level trusteeship model in practice were discussed,with improvement recommendations raised for progress of the hierarchical medical system.

Objective To evaluate the clinical and radiological results of Phlios plate and Multiloc nail in treatment of proximal humerus fractures.Methods From February 2013 to December 2015,data of 37 cases of proximal humerus fractures who were treated by reduction and fixation using Phlios plate or Multiloc nail were retrospectively analyzed.In group one (Phlios plate),there were 10 males and 8 females,with an average age of 56.3±5.8 years,including 7 cases of Neer 2-part surgical neck fracture,6 cases of Neer 3-part fracture,4 cases of Neer 4-part fracture,and 1 case of fracture-dislocation.In group two (Multiloc nail),there were 8 males and 11 females,with an average age of 57.2±7.4 years,including 8 cases of Neer 2-part surgical neck fracture,9 cases of Neer 3-part fracture,1 case of Neer 4-part fracture,and 1 case of fracture-dislocation.Operation time,range of motion of shoulder joint,visual analogue scale (VAS) pain score,American Shoulder & Elbow Surgeon (ASES) score and ConstantMurley score were collected.Results All 37 patients were followed up for an average period of 15.5 months (range,12-36 months).The average bone healing time were 2.5±0.5 months (range,2-3 months)and 2.2±0.5 months (range,1.5-3 months) in the plate and nail group respectively.At the latest follow-up,average VAS score was 0.4±0.6 (range,0-2),the ASES score aver aged 85.4±6.8 points (range,73-96),Constant-Murley score averaged 83.4±7.3 points (range,71-94),and external rotation averaged 30.8°±10.0° (range,10°-50°) in plate group,while average VAS score was 0.2±0.4 (range,0-1),ASES score averaged 89.7± 5.6 points (range,80-98),Constant-Murley score averaged 88.5±6.8 points (range,76-98),and external rotation averaged 40.3°± 7.9° (range,20°-50°) in the intramedullary nailing group.One case had partial necrosis of humeral head in the plate group,while 1 case suffered absorption of the greater tuberosity in the nail group,with the complication rate of 5.6％ (1/18) and 5.3％ (1/19) respectively,without significant difference.The internal and external rotation degrees,ASES and Constant-Murley scores were better in nail group than those in plate group for 2-part fractures,while the forward elevation and abduction degrees were similar.Conclusion Similar results were achieved for the treatment of proximal humeral fractures by Phlios plate and Multiloc nail.The Multiloc nailing group had achieved superior outcomes in Neer-2-part proximal humeral fractures.

Objective To analyze the immune privilege of lung in acute graft-versus-host disease (aGVHD).Methods The models of aGVHD were established,and C57BL/6J→C57BL/6J model was used as control.The clinical scores and survival were observe& The pathological injuries were compared between the lung and traditional target organs (liver,small intestines and skin).The expression of IFN-γ in different organs after transplantation was detected by ELISA.Results Allogeneic hematopoietic stem cell transplantation (HSCT) mice had high 42-day survival rate (20 ％) post-transplantation,and recipients of allogeneic grafts showed classical symptoms and histological injury,and pathological changes of lung were not as serious as the liver,small intestine,skin at day 28 after transplantation.Syngeneic mice all survived at day 42 after transplantation,without GVHD symptoms and pathological changes.The mice in MHC-disparate mice (2 ∶ 1 and 4 ∶ 1 groups) died significantly faster at a median of 12 days after transplantation,with severe changes of clinical symptoms and pathology of classical organs,and MHC-disparate mice (4∶1 groups) had developed severe interstitial pneumonitis.The mean IFN-γ concentration in the lung of allogeneic HSCT mice was obviously increased in the first and second week after transplantation,the IFN-γ concentrations of target organs (liver,small intestines,skin) were slightly increased in the first and second week after transplantation,and there were statistically significant difference from lung (P＜0.05).Condmion There wasrelativeimmune privilege of lung in a murine model of aGVHD induced by HSCT,which was associated with the expression of MHCin the mice and IFN-gamma of lungs after transplantation.

Objective To compare the clinical efficacies of warm needling versus salt moxibustion in treating knee osteoarthritis. Methods One hundred and twenty patients with knee osteoarthritis were randomly allocated to groupsⅠ andⅡ, and control group, 40 cases each. GroupⅠ received salt moxibustion; groupⅡ, warm needling; the control group, routine medication. After 4 weeks of treatment, the Lysholm Knee Scoring Scale scores, the VAS scores, the quality of life scores and the clinical therapeutic effects were compared between the three groups.Results There were statistically significant pre-/post-treatment differences in the Lysholm Knee Scoring Scale scores, the VAS scores and the quality of life scores in the three groups (P<0.05). There were statistically significant post-treatment differences in the Lysholm Knee Scoring Scale scores and the VAS scores between groupⅠ orⅡ and the control group (P<0.05). The total efficacy rate was 90.0% in groupⅠ, 87.5% in groupⅡ and 70.0% in the control group. There was a statistically significant difference in total efficacy rate between groupⅠ orⅡ and the control group (P<0.05).Conclusions Warm needling and salt moxibustion are both effective way to treat knee osteoarthritis and have equal therapeutic effects.

Objective To investigate the efficacy of combined monitoring of motor evoked potentials with transcranial electrical stimulation (TES-MEP),somatosensory evoked potentials (SEP) and spontaneous electromyo-graphy (s-EMG) in tuberculosis surgery involving the thoracic,lumbar and sacral vertebrae.Methods Twenty-seven patients with tuberculosis of the thoracic vertebrae (T2-L2) received intra-operative SEP and TES-MEP monito-ring.Combined SEP,TES-MEP and spontaneous EMG monitoring were employed in 11 patients with tuberculosis of the lumbar or/and sacral vertebrae (L3-S1).SEP and TES-MEP were used to precisely observe the status of the sen-sory and motor pathways; s-EMG responses were used to more accurately localize nerve root irritation.ResuIts (1) SEP monitoring was successful in all of the operations.TES-MEPs were successfully monitored in 35 of them (92.1％).Combined motor and sensory monitoring was successfully achieved in 35 cases (92.1％).Abnormal SEPs were observed in 3 cases (7.9％),while abnormal MEPs were observed in 11 cases (28.9％).Abnormality in both the SEP and TES-MEP occurred in 2 cases (5.3％).There were 9 cases (23.7％) where the SEPs were nor-mal and the TES-MEPs were abnormal.In only 1 case (2.6％) was the SEP normal and the MEP abnormal.The false negative rate was 0％ with combined SEP and TES-MEP monitoring,while the false positive rate was 5.3％.There were 2 cases complicated by post-operative neurological deficits.(2) Spontaneous EMG monitoring can accu-rately determine the functioning of lumbar nerve roots during lumbar or lumbosacral tuberculosis surgery.Among 5 cases where EMG responses were observed,4 cases occurred during the spinal canal and nerve root decompression,1 case occurred in the orthopedic reset phase.Conclusions (1) During tuberculosis surgery involving thoracic,lumbar or sacral vertebrae,combined monitoring of SEPs and TES-MEPs can reflect the physiological and pathological condition of the spinal cord after ruling out interfering factors.This can improve monitoring and help assure the safety of lumbar surgery.(2) Intra-operative s-EMG monitoring can accurately reveal nerve root function in real time,help-ing to avert nerve root injury in lumbar and lumbosacral tuberculosis surgery.