Objective:To verify the predictive value of the Second Revision of the International Staging System (R2-ISS) in newly diagnosed patients with multiple myeloma (MM) who underwent first-line autologous hematopoietic stem cell transplantation (ASCT) in a new drug era in China.Methods:This multicenter retrospective cohort study enrolled patients with newly diagnosed MM from three centers in China (Beijing Chao-Yang Hospital, Capital Medical University; the First Affiliated Hospital, Sun Yat-Sen University, and the Second Affiliated Hospital of Naval Medical University) from June 2008 to June 2018. A total of 401 newly diagnosed patients with MM who were candidates for ASCT were enrolled in this cohort, all received proteasome inhibitor and/or immunomodulator-based induction chemotherapy followed by ASCT. Baseline and follow-up data were collected. The patients were regrouped using R2-ISS. Progression-free survival (PFS) and overall survival (OS) were analyzed. The Kaplan-Meier method was used to analyze the survival curve and two survival curves were compared using the log-rank test. Cox regression analysis were performed to analyze the relationship between risk factors and survival.Results:The median age of the patients was 53 years (range 25-69 years) and 59.5% (240 cases) were men. Newly diagnosed patients with renal impairment accounted for 11.5% (46 cases). According to Revised-International Staging System (R-ISS), 74 patients (18.5 %) were diagnosed with stage Ⅰ, 259 patients (64.6%) with stage Ⅱ, and 68 patients (17.0%) with stage Ⅲ. According to the R2-ISS, the distribution of patients in each group was as follows: 50 patients (12.5%) in stage Ⅰ, 95 patients (23.7%) in stage Ⅱ, 206 patients (51.4%) in stage Ⅲ, and 50 patients (12.5%) in stage Ⅳ. The median follow-up time was 35.9 months (range, 6-119 months). According to the R2-ISS stage, the median PFS in each group was: 75.3 months for stage Ⅰ; 62.0 months for stage Ⅱ, 39.2 months for stage Ⅲ, and 30.3 months for stage Ⅳ; and the median OS was not reached, 86.6 months, 71.6 months, and 38.5 months, respectively. There were statistically significant differences in PFS and OS between different groups (both P<0.001). Multivariate Cox regression analysis showed that stages Ⅲ and Ⅳ of the R2-ISS were independent prognostic factors for PFS ( HR=2.37, 95% CI 1.30-4.30; HR=4.50, 95% CI 2.35-9.01) and OS ( HR=4.20, 95% CI 1.50-11.80; HR=9.53, 95% CI 3.21-28.29). Conclusions:The R2-ISS has significant predictive value for PFS and OS for transplant-eligible patients with MM in the new drug era. However, the universality of the R2-ISS still needs to be further verified in different populations.

Objective:To present the surgical details of manual double-layer suturing in patients with obesity combined type 2 diabetes mellitus by three-incision laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy .Methods:Clinical data and follow-up information of 52 obesity combined type 2 diabetes mellitus patients (BMI 27.59-43.71 kg/m2) who underwent three-incision laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy from Jan 2019 to Jul 2022 at Beijing Shijitan hospital were retrospectively analyzed.Results:The procedure was successful in all patients. The median operative time was 120 (90, 120) min, and the median intraoperative bleeding was 20.0 (10.0, 27.5) ml. No fistula or serious surgical complications were observed in the patients at 1 month postoperatively. Compared with the preoperative period, the patient's weight decreased [(93.22±15.21) kg vs. (69.97±11.06) kg, t=21.707, P<0.01], BMI decreased [(33.11±4.09) kg/m 2vs. (24.86±2.95) kg/m 2, t=23.224, P<0.01], and the patient's fasting glucose level decreased [9.52 (7.57, 12.96) mmol/L vs. 5.47 (4.66, 6.39) mmol/L, Z=6.11, P<0.01]. The remission rate of various obesity comorbidities was greatly improved. Conclusion:Under the condition of three-incision laparoscopy, the pure manual duodenal and jejunal double-layer suture method is safe, feasible, and effective for patients with obesity combined with type 2 diabetes mellitus.

Objective:To evaluate the application of Moorehead-Ardelt Ⅱ questionnaire (MA Ⅱ) in assessment of the quality of life (QOL) among obese patients after bariatric surgery.Methods:One hundred and five patients with obesity were enrolled, the weight, body mass index (BMI), comorbidities and MA Ⅱ scores before and after operation were counted. The difference between the QOL of pre- and post-operation was analyzed.Results:All the patients completed the questionnaire. The Cronbach α coefficient of the questionnaire was higher than 0.7. The post-operational scores of 6 items were significantly higher than that of pre-operation. ( P<0.001). The proportion of "poor" and "very poor" QOL in the pre-operational patients was 43.8%, compared with 0 in the post-operative patients;the proportion of "good" and "very good" QOL in the pre-operatve patients was 4.7%, compared to 86.7% in the post-operative patients ( χ2=146.863, P<0.001). Conclusions:MA Ⅱ questionnaire is a professional, easy oprated tool for assessment of QOL associated with obesity.

OBJECTIVETo summarize the 2491 acupuncture inpatient consultations in Qilu Hospital of Shandong University during 2014, and analyze the application of acupuncture in comprehensive hospital, hoping to provide direction and methods for clinical practice and scientific research of acupuncture.

METHODSThe consultation record and hospitalization information during 2014 in Department of Acupuncture-Moxibustion and Tuina, Qilu Hospital of Shandong University, were collected and summarized through Inpatient Information Management System. The distribution of consultation discipline and disease were analyzed.

RESULTSAmong all the consultations, 15 second-class disciplines were involved, and the number of neurology and surgery was 1399, accounting for 59.00% of all consultation. 111 types of diseases were found in consultation, mainly postoperative complications, cerebrovascular disease and arthropathy. The primary disease of consultations involved all the systems, mainly nervous system disease, musculoskeletal system disease, connective tissue diseases and genitourinary system diseases, accounting for 73.89% of all consultations. .

CONCLUSIONAcupuncture is closely related with clinical disciplines of neurology and surgery. The cooperation between acupuncture and pediatrics and oncology should be strengthened. Acupuncture has an advantage over treating postoperative complications and neuromuscular diseases.

Objective To explore the morbidity of surgery in connection with laparoscopic sleeve gastrectomy (LSG) and its effect on obese T2DM.Methods 106 obese T2DM patientes undergoing LSG were divided into 2 groups in group 125 patients did not have oversewing the staple line and group 281 patients had the staple line oversewn in order to reduce bleeding.Results The differences in intraoperative blood loss (35 ± 15) ml vs.(28 ± 18) ml,postoperative recovery time (2.4 ± 0.9) d vs.(2.3 ± 0.9) d,time to taking liquid food (4.7 ± 1.0) d vs.(4.6 ± 1.0) d between two groups were not significant.There were no significant difference of complication between 2 groups (x2 =3.271,P =0.071).Comparing before surgery to 6 month after surgery,the BMI in group 1,was from (39 ± 5) to (29 ±4) kg/m2;in group 2,from (40 ±6) to (31 ±5) kg/m2,FPG in group 1,from (8.4 ± 1.4) to (6.4 ±1.2) mmol/L;in group 2,from (8.2 ± 2.0) to (6.8 ± 1.5) mmol/L,2 hour post-meal blood sugar [group 1,(13.2±4.1) to (9.6±3.2) mmol/L;group 2,(12.2±3.2) to (10.6±2.8) mmol/L] and HbAlc (group 1,7.2％ ±1.2％ to5.5％ ±1.1％;group 2,7.1％ ±1.1％ to 5.9％ ±1.2％) decreased significantly in both groups (P ＜ 0.01).There was 72 (68％) remission cases of T2DM in 106 patients,there were no significant differences of T2DM remission and BMI between 2 groups at 6 months after surgery (P =0.617).Conclusions LSG leads to significant weight loss and T2DM control.

Objective To study the treatment principles and surgical skills in laparoscopic subtotal cholecystectomy (LSC) for acute cholecystitis.Methods We retrospectively analyzed the clinical data of patients who underwent LSC for acute cholecystitis from Jan.2006 to Dec.2015 at the Beijing Shijitan Hospital,Capital Medical University.We dissected any serious pericholecystic adhesions according to the principle that "It is better that the gallbladder rather than other tissue is injured",and the technique that "After the gallbladder anterior wall is excised,the gallbladder ampulla and duct are split along the longitudinal direction of the cholecystic duct,then the opened cholecystic duct is sutured inside the gallbladder".Results LSC was completed successfully in 96 patients.There were no conversion to open surgery,and no bile duct injury.The mean surgery time was (108.0 ± 37.0) min,the mean blood loss was (121.0 ± 62.0) ml,the mean peritoneal drainage was (105.0 ± 32.0) ml.The drainage tube was removed at a mean of (3.4 ±1.2) d after surgery.The mean hospitalization time after surgery was (6.1 ± 2.2) d.Surgical complications occurred in 2 patients with bleeding after surgery.One patient underwent laparoscopic exploration to stop bleeding.Another patient underwent conservative treatment and the bleeding stopped spontaneously.There were 3 patients who had mild bile leakage.All these patients recovered well after drainage.No patient developed bile duct stenosis or obstructive jaundice on follow-up.Conclusions LSC for acute cholecystitis was safe.Bile duct injuries could be avoided if we follow the principle of "It is better that the gallbladder rather than other tissue is injured" and the technique of "After the gallbladder anterior wall is excised,the gallbladder ampulla and duct are split along the longitudinal direction of the gallbladder,then the opened cholecystic duct is sutured inside the gallbladder".

Objective To investigate the effect of FTO gene on laparoscopic Roux-en-Y gastric bypass for type 2 diabetes.Methods From Jan 2014 to 2015 Jun,32 T2DM patients received LRYGB in Beijing Shijitan Hospital.According to single nucleotide polymorphism of FTO rs9939609 gene,patients were divided into TF genotype (20 cases),and AT/AA genotype (12 cases).Results Following the degression of BMI from (36.4 ±3.3) kg/m2 to (28.1 ±2.8) kg/m2,fasting blood glucose and HbA1c in group A significantly improved [(8.9 ± 1.6) mmol/L vs.(5.6 ± 1.2) mmol/L,t =8.274,P =0.000;(8.5％ ± 1.9％) vs.(6.2％ ± 0.8％),t =5.032,P =0.000].Following the degression of BMI from (39.5 ±5.6) kg/m2 to (29.7 ± 5.1) kg/m2,fasting blood glucose and HbA1c in group B significantly improved [(10.8 ± 2.8) mmol/L vs.(4.9 ± 0.6) mmol/L,t =7.589,P =0.000;(9.0％ ± 1.8％) vs.(6.1％ ±0.9％),t =5.324,P =0.000].Insulin resistance index in both groups significantly improved [(12.6±10.7) vs.(4.9±5.6),t=5.402,P=0.000;(16.0±5.6) vs.(1.7±1.3),t=9.025,P=0.000].Fasting blood glucose and the insulin resistance index in group B patients was significantly lower than that in group A patients (P ＜ 0.05).Conclusion T2DM patients with FTO rs9939609 gene phenotype AT/AA have better prognosis than those with TT in postoperative diabetes improvement.

Mr ZHENG Yugui, a distinguished acupuncturist in Qilu area, is one of the successors of Chengjiang acupuncture school in Shandong province. Through collecting the papers and works concerning Mr ZHENG, the academic thoughts are summarized, including careful and clear differentiation of syndrome, specific and precise selection of acupoints, reinforcing and reducing methods based on qi, and gentle and soft manipulation of needles. He has discovered new acupoints such as Fengyan point, etc. He also focuses on moxibustion and creates Taiyang moxibustion method. In addition, to develop acupuncture education, Mr ZHENG has played a deep and important role in spreading Chengjiang acupuncture school in Shandong province.
Acupuncture ; education ; history ; Acupuncture Therapy ; history ; China ; History, 20th Century ; Humans ; Schools

Objective To observe the clinical efficacy of comprehensive muscle-region therapy based on Chuang Medicine in treating cervical spondylosis of neck type.Method A hundred patients with cervical spondylosis of neck type were randomized into a treatment group and a control group, 50 cases in each group. The treatment group was intervened by the comprehensive muscle-region therapy based on Chuang medicine (muscle-region tuina, fire-needle acupuncture of Chuang medicine, and cupping), while the control group was by regular acupuncture treatment. The Visual Analogue Scale (VAS) score and symptoms and signs scores were observed before and after intervention, and the clinical efficacies were compared.Result The VAS scores respectively after 1 and 2 treatment courses were significantly different from that before intervention in the treatment group (P<0.05,P<0.01). The VAS score after 2 treatment courses was significantly different from that before intervention in the control group (P<0.05). After 2 treatment courses, the VAS score in the treatment group was significantly different from that in the control group (P<0.05). After treatment, the symptoms and signs scores (pain intensity, pain-affected area, number of tender points, limited motion, and general score) were significantly different from that before intervention in the treatment group (P<0.01, P<0.05). In the control group, the pain intensity, limited motion and general score after treatment were significantly different from that before intervention (P<0.05,P<0.01). After treatment, the symptoms and signs scores in the treatment group were significantly different from that in the control group (P<0.05,P<0.01). The total effective rate was 100.0% in the treatment group versus 84.0% in the control group, and the difference was statistically significant (P<0.05).Conclusion Comprehensive muscle- region therapy in Chuang medicine is an effective approach in treating cervical spondylosis of neck type.

The characteristics and academic thoughts of Chinese Acup-Mox Medicine written by YAO Tianmin during the Republic of China was studied and analyzed in this paper. The academic thoughts of this book were confluence of Chinese and western knowledge, respecting for classics culture but not stubborn, using western science and medicine without worshiping it. The main characteristics were the scientific meridian-acupoint theory, extensive acupoint selection, "qie" method of acupuncture, high recommendation on medicated thread and ironing moxibustion, reinforcing and reducing based on the meridian direction in infantile massage, using acupuncture and cream formula for surgical treatment, and creating his own acupuncture codes.
Acupuncture Points ; Acupuncture Therapy ; history ; Books ; history ; China ; History, 20th Century ; Humans ; Moxibustion ; history