Six patients with POEMS syndrome who received autologous peripheral blood stem cell transplantation (auto-PBSCT) were retrospectively analyzed.Conditioning regimen was high dose melphalan.Peripheral blood stem cells were collected after mobilization with cyclophosphamide (CTX) and growth factors.One patient presenting hydrothorax and ascites was treated with 3 cycles of lenalidomide and dexamethasone before mobilization.Auto-PBSCT was fairly tolerable.Hematopoietic reconstitution was successful in all patients without transplantation-related mortality.A decrease or normalization of serum vascular epithelial growth factor (VEGF) was observed in all patients at 3 months after transplantation.The neurological remission was seen in 5/6 patients.

We report two rare cases of multiple myeloma (MM) with dural intracranial disease and TP53 deletion. The two patients presented with skull lytic lesion and dural involvement of myeloma. The association between intracranial involvement in MM and TP53 deletion has not been determined. The two patients received bortezomib-based intensive induction and got good response, just as that reported in literature. MM presenting with dural intracranial disease and TP53 deletion at diagnosis is associated with poor outcome. Multi-drug regime containing bortezomib followed by autologous or allogeneic stem cell transportation would improve the prognosis.
Antineoplastic Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; Bortezomib ; therapeutic use ; Brain Neoplasms ; drug therapy ; genetics ; pathology ; Gene Deletion ; Humans ; Multiple Myeloma ; drug therapy ; genetics ; pathology ; Prognosis ; Treatment Outcome ; Tumor Suppressor Protein p53 ; genetics

Objective To investigate the clinical features of primary gastric lymphoma(PGL)combined with acute upper gastrointestinal hemorrhage,and to improve the diagnosis and treatment level.Methods The clinical manifestations and treatment of 2 PGL cases combined with acute upper gastrointestinal hemorrhage were analyzed retrospectively,and the related literature was reviewed.Results Two patients suffered from venosity,abdominal pain and weight loss,which were diagnosed by gastroscopy mucosa biopsy with upper gastrointestinal hemorrhage and uncontrolled hemorrhagic shock.Vascular embolization was used to stop bleeding and systemic chemotherapy was followed to achieve further curative effect.Conclusion Embolization treatment is safe and effective for PGL combined with acute upper gastrointestinal hemorrhage without any influences on chemotherapy.

Objective Based on the diagnostic technique of electric meridian detection, to observe the clinical efficacy of acupuncture in treating angioneurotic headache.Method Totally 106 patients with angioneurotic headache were randomized into a treatment group and a control group, 53 cases in each group. The treatment group received acupuncture based on the electric meridian detection, while the control group received medication treatment. The hemorheology indexes [plasma viscosity (PV), erythrocyte sedimentation rate (ESR)] and McGill Pain Questionnaire (MPQ) [Pain Rating Index (PRI), Visual Analogue Scale (VAS), and Present Pain Intensity (PPI)] were observed before and after intervention, and the clinical efficacies were compared. Result The total effective rate was 88.7% in the treatment group versus 71.7% in the control group, and the between-group difference was statistically significant (P<0.05). After intervention, the hemorheology indexes and MPQ scores were significantly changed in both groups (P<0.01,P<0.05).Conclusion Acupuncture based on electric meridian detection is an effective method in treating angioneurotic headache.

BACKGROUND:Warm acup-moxibustion is an effective treatment in Chinese traditional medicine, which combines acupuncture with moxibustion. With an immediate analgesia or/and long-term effect, warm acup-moxibustion has been used clinicaly for acute and chronic pain. OBJECTIVE:To analyze the progress in the studies about clinical application of warm acup-moxibustion as analgesic therapy for acute and chronic pain and to discuss the influential factors. METHODS: CNKI, VIP and Wanfang databases were searched for relevant articles published between January 1995 and July 2015 using the keywords of “warm needling; warm acup-moxibustion; pain; analgesic” in Chinese. According to the exclusion and inclusion criteria, 51 articles were included in result analysis. RESULTS AND CONCLUSION: Compared with ordinary acupuncture, medicine and other treatment methods, warm acup-moxibustion can play an analgesic role in multiple systems, which is better than ordinary acupuncture and Western medicine. Warm acup-moxibustion combined with drugs and acupuncture techniques can increase the analgesic effect and improve joint function activity. Warm acup-moxibustion with the overal regulatory role plays an effective analgesic pain role in the multiple systems and shortens the duration of treatment, which is an effective method for treating pain and worthy of further promotion and application.

Objective To evaluate effects and possible mechanisms of ileal transposition on spontaneous non-obese type 2 diabetic GK rats.Methods 20 GK rats were randomly divided into two groups:ileal transposition group and sham operation group (n =10).We observed and determined the weight change,daily average food consumption and FBG (fasting blood-glucose) level of rats before the operation (0 weeks) and 1,4,8,16 and 24 weeks after the surgery.Glucose tolerance test (GTT) was carried out and GLP-1 (glucagon-like peptide-1) concentration measured before the operation (0 weeks) and 4,8,16 and 24 weeks after the surgery and the fasting insulin concentration before the surgery (0 weeks)and 4,24 weeks after the surgery measured,and the indicator of HOMA-IR calculated.Results There was no significant difference in the operating time between the two groups [(87 ± 8) min vs.(84 ± 7)min],P ＞ 0.05.Compared with those before surgery,body weight and food consumption of the two groups of rats decreased significantly a week after surgery (P ＜ 0.05),and then the body weight and food consumption of the two groups of rats all gradually increased,but the difference of the two groups of rats has no statistical significance 1-24 weeks after surgery (P ＞ 0.05).The FBG of the two groups of rats a week after surgery [ileal transposition group (6.1 ± 0.6) mmol/L,sham operation group (6.2 ± 0.8) mmol/L]decreased significantly compared with that before surgery [(7.0 ± 0.5) mmol/L and (6.9 ± 0.5) mmol/L](P ＜ 0.05),and then FBG of the two groups of rats all rose again.The FBG of the rats in surgery group decreased slowly from 8 to 24 weeks after surgery,while the FBG of the rats in the sham surgery group maintained the preoperative level,and the differences of the FBG of the two groups all have statistical significance 8-24 weeks after surgery (P ＜ 0.05).Four weeks after surgery,OGTT of the ileal transposition group significantly improved (P ＜ 0.01).24 weeks after surgery,fasting insulin levels of the ileal transposition group were lower [(0.26 ± 0.08) ng/mL vs.(0.42 ± 0.09) ng/ml],P ＜ 0.05.Compared with the sham surgery group,and HOMA-IR was lower (1.1 ± 0.4) vs.(2.6 ± 0.4),P ＜ 0.05.Four weeks after surgery,oral glucose-stimulated peak (30 min) levels of blood GLP-1 increased markedly in operation groups after surgery (P ＜ 0.01).Conclusions Ileal transposition is effective for the treatment of non-obese T2DM rats,and the control of blood glucose does not depend on the reduction of body weight and food comsumption,and the high secretion of GLP-1 after ileal interposition seem to be helpful in diabetes control.

Objective To study the diagnosis and surgical treatment of Mirizzi syndrome (MS).Method The clinical data of patients with Mirizzi syndrome treated in our center from July 2001 to July 2011 were retrospectively studied and the diagnostic methods,operative strategies and outcomes of surgical treatment were analyzed.Results Mirizzi syndrome (MS) was identified in 56 out of 13800patients who received cholecystectomy (0.4％). MS was diagnosed preoperatively in 30 patients (53.6％).There were 29 patients with Mirizzi syndrome type Ⅰ,17 patients with type Ⅱ,9 patients with type Ⅲ,and 1 patient with type Ⅳ using the Csendes's classification.In two patients (3.6％) coincidental gallbladder carcinoma was detected.An initial laparoscopic approach was attempted in 33patients,and 16 were converted to open surgery.The remaining 23 patients underwent open operation.Surgical procedures included cholecystectomy,choledochotomy and T-tube insertion,simple closure and drainage (via T tube) of the biliary fistula,Roux-en-Y hepaticojejunostomy,radical resection of gallbladder and hepaticojejunostomy.Inadvertent bile duct injury occurred in 2 patients who had an initial laparoscopic approach for a preoperative undiagnosed MS. Postoperative morbidities included biliary leak (n =4) and residual common bile duct stone (n=2).All patients recovered completely and there was no hospital mortality.Conclusions Preoperative diagnosis of Mirizzi syndrome is still challenging despite the availability of multiple imaging modalities.Open surgery remains the standard of care,although laparoscopic treatment may be used in selected patients,especially for type Ⅰ Mirizzi syndrome.Patients with Mirizzi syndrome should be managed differently,basing on intraoperative findings and the type of Mirizzi syndrome.

ObjectiveTo demonstrate the efficacy and safety of Hangzhou tacrolimus capsule (Saishi Tac capsule,Hangzhou Zbongmei Huadong Pharmaceutical Co.Ltd,China) in Chinese liver transplant recipients.MethodsMulticenter,randomized open-labeled,prospective controlled clinical trial was performed in de novo Chinese liver transplant recipients.According to inclusive and exclusive criterion,83 liver recipients from 11transplant centers were enrolled.The recipients accepted Saishi Tac capsule,mycopheolate and steroid 48 h post-operation.The initial dose of Tac was 0.1-0.15 mg kg-1day-1and C0 was 8-12 ng/ml in the first 60 days,followed by 5-10 ng/ml until the terminal observation time poiut (12 weeks after transplantation).The efficacy and safety were estimated during the period.The primary efficacy endpoint of the study was the incidence of biopsy-confirmed acute rejection.Graft survival was the secondary endpoint.Safety was assessed by monitoring laboratory parameters and adverse events reported over the course of the study,such as infection,renal damage,hypertension,hyperlipema and diabetes mellitus and other adverse affairs.ResultsThe dose of Tac at 1st,2nd,4th and 8th week post-operation was (4.1±1.9),(4.5±2.1),(4.5±2.1),(4.4±1.8) and (4.1±2.1) mg,and correspondjng values to the C0 were (8.1±4.5),(8.9±4.5),(8.8±4.3),(8.8±4.1) and (8.0±2.8) ng/ml.During 12 weeks of follow-up,the incidence of biopsy-confirmed acute rejection was 4.8％ (4/83),and all of cases were reversed by implosive therapy.The survival rate of graft hver was 100％.The incidence of lung infection and diabetes mellitus was both 6.02％.ConclusionSaishi Tac capsule was safe and effective to Chinese liver transplant recipients.

Objective To investigate the effect of oncolytic adenovirus vector SG600-IL24expressing human melanoma differentiation associated gene-7 (mda-7/IL-24) on hepatocellular carcinoma cell lines with different metastatic potential of HepG2, SMMC7721, MHCC97L and normal liver cell line LO2. Methods The oncolytic adenovirus SG600-IL24 which carrying mda-7/IL-24 gene was transfected into hepatocellular carcinoma cell lines and normal liver cell line. The mRNA and protein expression of mda7/IL-24 in HepG2, SMMC7721, MHCC97L and LO2 cell lines was confirmed by RT-PCR,ELISA assay and Western blot respectively. MTT assay and flow cytometry were used to study tumor cell proliferation and cell cycle in vitro. Hoechst33258 and flow cytometry were studied to indicate the apoptosis effects. Results It was confirmed by RT-PCR, ELISA assay and Western-blot that the exogenous mda-7/IL-24 gene was highly expressed in HepG2, SMMC7721, MHCC97L and LO2 cell lines. MTT and apoptosis detection indicated that MDA-7/IL-24 can induce the growth suppression (the inhibition rate was 75% ±2. 5% ,86% ±3. 5% ,and promotes apoptosis ( the apoptosis rate was 56. 5% ± 4. 0% , 34. 4% ± 2. 0% , 43. 3% ± 2. 5%cell lines at G2/M phase ( the blocking rate was 35. 4% ± 4. 2% , 40. 5% ± 5. 0% , 42. 0% ± 5. 0%metastatic potential hepatocellular carcinoma cell lines but not in normal liver cell line.Conclusions Oncolytic adenovirus vector SG600-IL24 can selectively induce growth suppression, promote apoptosis in hepatocellular carcinoma lines in vitro but not in normal liver cell LO2.

Objective To investigate the safety and feasibility of reoperatively laparoscopic technique in treatment for locally recurrent rectal cancer.Methods The study enrolled 17 patients with locally recurrent rectal cancer between February 2004 and September 2009 from Shanghai Minimally Invasive Surgery Center.The patients were divided into two groups according to their pelvic recurrence types:central recurrence group (n =14) and anterior recurrence group (n =3).Demographic,surgical data and survival outcomes between two groups were compared.Results The outcomes of demographic data between two groups were not different(P＞ 0.05 ).Compared with central recurrence group,anterior recurrence group had longer operating time (P =0.028).However,the differences of operative blood loss,complications,postoperative rehabilitative outcomes and ratio of R0 resction between groups were not significant ( P ＞ 0.05 ).The overall 5- year survival rate of all the patients was 36％.And the median survival time was 42 months without significant difference between two groups (x2 =1.641,P =0.200).Conclusions Reoperatively laparoscopic technique in treatment for locally recurrent rectal cancer is safe and feasible.Selected patients,specialist operation and higer ratio of R0 resection are the key factors conducive to better short-and long-term outcomes.