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China Clinical Cases Library of Traditional Chinese Medicine is built to promote the establishment of a scientific and technological talent evaluation system oriented on innovative value， ability and contribution in the backgroud of breaking the four only and setting new standards required by the document jointly issued by several national administrations and commissions. In the process of the construction， in order to further consolidate the foundation and ensure the quality and authority of case reports， we need to fully understand the origin and development of Chinese medical cases. Therefore， we clarified the development situation of Chinese medical cases by combing the characteristics of ancient and modern case reports， comparing the differences between Chinese and western medical case reports in terms of content and writing requirements， finally formed the main points of systematic case report norms and quality evaluation system， aiming to fully explore the unique advantages of Chinese medical cases in the fields of discipline development， scientific research innovation， clinical practice and guidance， talent evaluation and training， so as to promote its innovative development in a broader direction.
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Objective: To investigate the safety and efficacy of 125I radioactive seed implantation in the treatment of mediastinal lymph node metastasis. Methods: Records of 53 patients enrolled in Shaanxi Provincial Tumor Hospital from June 2014 to June 2018 with me-diastinal lymph node metastasis treated by computed tomography (CT)-guided 125I seed implantation were analyzed retrospectively. The preoperative treatment planning system was validated after the surgery. Intraoperative and post-operative complications were re-corded. The improvement in quality of life was observed. Chest CT follow-up was conducted 1 month, 3 months, 6 months, 1 year, and 2 years after treatment. The local focus control was evaluated. The median survival and total survival were recorded, and the survival prognosis and causes of death were analyzed. Results: The median survival time was 254 days (8.5 months), one-year survival rate was 48.67%, and complete and partial response rate was 83.02% (44/53). Multivariate Cox model analysis showed that the survival progno-sis was related to the Eastern Cooperative Oncology Group (ECOG) score, distant metastasis at the time of implantation, concurrent chemotherapy after implantation, and secondary seed implantation (P<0.05). The rates of developing pneumothorax and hemoptysis during and after the surgery were 20.75% (11/55) and 13.20% (7/55), respectively. No patients died. After implantation, the remission rate of cough, shortness of breath, pain, hoarseness, and superior vena cava syndrome was 60.00%-82.61%. Conclusions: CT-guid-ed 125I seed implantation in the treatment of mediastinal lymph node metastasis has the advantages of minimal trauma, remarkable cu-rative effect, safety, and feasibility. It has important application value and is worthy of further clinical application.
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Objective To explore the clinical value of serum κ/λ ratio in the differential diagnosis of multiple myeloma (MM) and primary nephritic,and to explore its relationship with MM other laboratory markers.Methods We obtained 88 cases of MM patients with serotyping by immunofixation and 109 cases of primary nephritic patients.In accordance with the composition of protein M in immunofixation electrophoersis (IFE),88 patients were divided into 4 groups:IgGκ,IgGλ,IgAκ and IgAλ.In addition,45 serum samples of health examination were collected as control samples.The levels of serum IgG,IgA,IgM,light chain κ and λ in each group were tested by immune turbidimetry,and κ/λ ratio was calculated.The levels of serum β2-microglobin (β2-MG),albumin (ALB),serum urea (BUN),creatinine (CRE),and M protein percentage were also detected.Results (1) In MM group,there was no significant difference of sex and International Staging System (ISS) stages between each type(P ＞ 0.05),while there was significant difference in age distribution between each type (P ＜ 0.05).(2) Compared to control,the levels of se-rum light chain κ,κ/λ ratio,and matched Ig were significantly higher and the level of light chain λ and other Ig were significantly lower in κ typed MM patients,while the levels of serum light chain λ were significantly higher and the levels of serum light chain κ,and κ/λ ratio were significantly lower in λ typed MM patients(P ＜0.01).The levels of light chain κ,λ,and IgG in primary nephritic patients were significantly lower than control(P ＜0.01),while there was no significant difference in κ/λ ratio between two group (P ＞ 0.05).There were also significant difference of light chain,Ig,BUN and CRE levels between MM patients and primary nephritic patients (P ＜ 0.05).(3) The κ/λ ratio correlated with serum ALB (r =-0.264,P =0.013) and β2-MG (r =0.235,P =0.040) levels in MM.Conclusions Serum levels of light chain κ,λ,and κ/λ ratio have great significance in the differential diagnosis of multiple myeloma and primary nephritic.The κ/λ ratio correlated with several tumor markers in MM progresses,rendering it as a promising method for diagnosis and prognosis monitoring of MM.