Clinical manifestations and analysis of diagnosis and treatment of POEMS syndrome / 临床神经病学杂志

Objective To observe the clinical manifestations of POEMS syndrome, and to improve the early diagnosis and prognosis.Methods The clinical data of 61 POEMS syndrome patients were analyzed retrospectively. Results Among the 61 patients,there were 27 males and 34 females with an average age of 47.2 years.The average time from the primary admission to the confirmed diagnosis was 22.5 months.All the patients(100%)had peripheral neuropathy by various degrees,the majority showing the sensory dysfunction of lower limbs.Fifty-two cases (85.2%)were identified with organomegaly by imaging techniques,most presented with the enlargement of spleen and lymph nodes.Fourty-five cases(73.8%)were accompanied with endocrinopathy, reflected by diabetics along with the hypofunction of the pituitary, gonad, thyroid and the adrenal glands.Fifty cases(82.0%)were with positive serum M protein.Twenty-seven cases(44.3%)manifested evident skin changes including hair growth along the limbs and trunk, skin pigmentation and skin keratinization of the feet.In this group of patients, 59 patients mainly use dexamethasone treatment,some patients with horses flange or cyclophosphamide,lenalidomide treatment. The other 2 patients were treated by autologous stem cell transplantation therapy.The clinical outcome of patients with diagnosis time ≤10 months was significantly better than that of patients with diagnosis time 10 to 20 months and≥20 months(all P<0.05).Patients with diagnosis time ≥20 months had the worst clinical outcomes, with the highest death rate(all P<0.05).Conclusions The clinical manifestations of POEMS syndrome are complex, especially the peripheral nerve damage symptoms and merging other organs or systems.M protein detection is needed in order to make clear diagnosis.Early diagnosis and effective treatment for patients can get better prognosis.

Clinical investigation on intravesical instillation of high-dose pirarubicin during perioperative period to prevent bladder carcinoma recurrence / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of intravesical instillation of high-dose pirarubicin during perioperative period to prevent bladder carcinoma recurrence.</p><p><b>METHODS</b>A prospective randomized controlled clinical trial was carried out. A total of 120 patients with bladder transitional cell carcinoma (TNM I-II) underwent partial cystectomy or transurethral resection of bladder tumour were randomly divided into 2 groups, which were chosen from the patients were hospitalized during June 2003 to May 2009. There were 62 patients were in group A and 58 patients were in group B. In group A, intravesical instillation of high-dose pirarubicin during perioperative period was conducted. In group B, intravesical perfusion of pirarubicin was performed regularly after operation. All the patients were followed up in order to record the relapse rates and adverse reaction.</p><p><b>RESULTS</b>No significant difference was found between group A and group B from gender, age, pathological stage and operation methods (P > 0.05). The recurrence rates were 8.1% in group A, and 20.7% in group B. The adverse effect rates of urethrostenosis in group A and group B were 3.2% and 18.9%. The adverse effect rates of cystic stimulation including irritation signs of bladder and hematuria in group A and group B were 4.8% and 27.6%. There were significant differences in recurrence rates and adverse effect rates between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>Intravesical instillation of high-dose pirarubicin during perioperative period is an effective procedure for the prevention of bladder cancer recurrence.</p>

To verify the determination of iodine in foodstuff by dry ashing As3-Ce4+ catalytic spectrophotometry / 中国地方病学杂志

Objective To verify the determination of iodine in foodstuff by dry ashing As3+-Ce4+catalytic speetrophotometry.Methods The mixture of foodstuff powder and the solution of K2CO3,ZnSO4,KClO3 and NaCl was heated and dried at 105℃ for 3 hours,then heated by a adjustable electric heater for around 0.5 hour,transferred into muffle fumace to eremated at 600℃ for 4 hours.The dissolved ash was measured by As3+-Ce4+catalytic speetrophotometry.The linear range of the calibration and sensitivity were tested;The precision and accuracy for three kinds of iodine in samples of difierent pumpkins were tested:The iodine contents of standard urine samples and the American standard materials were tested as well.Results This testing covers iodine ranged from 4.4 ng to 250 ng.The relevance coefficient of standard curve was from-0.9997 to-0.9993.The pumpkin iodine contents detected were 45.8,145.0,195.6 μg/kg,with constant variables of 4.3%,3.0%and 3.9%respectively.The recovery was 96.8%,97.8%and 97.6%for three kinds of iodine in samples[(47.2±2.6),(71.9 4-3.3),(95.9±2.4)μg/kg].The relative error was-6.5%when the American standard materials were assessed.The relative error were 11.0%.10.7%and 10.7%when the standard urine samples of three kinds were tested.Conclusion This method,easy to be pefformed with better precision and accuracy,is suitable to measure food iodine as well as total iodine in urine.