Clinical characteristics and prognostic factors of elderly multiple myeloma / 中国基层医药

Objective To investigate the clinical characteristics of elderly patients with multiple myeloma and their prognostic factors.Methods 100 multiple myeloma patients with age≥ 60 years and 100 multiple myeloma patients with age <60 years who admitted in our hospital from December 2007 to December 2015 were collected as research subjects.100 patients with age ≥60 years were divided into elderly multiple myeloma group,100 cases with aged <60 years were divided into non -elderly multiple myeloma group.The clinical data and laboratory results of two groups were compared,the prognosis factors in elderly patients with multiple myeloma were analyzed.Results The incidence rate of ISS stage Ⅰ -Ⅱ in elderly multiple myeloma group (45.0%)was lower than non -elderly multiple myeloma group (60.0%),the incidence rate of stage Ⅲ was higher than non -elderly multiple myeloma group (χ2 =4.511,P <0.05).The infection incidence of elderly multiple myeloma group(30.0%)was higher than non -elderly multiple myeloma group(15.0%)(χ2 =10.452,P <0.05 ).The hemoglobin,serum albumin contents of elderly multiple myeloma group [(83.7 ±19.8)g/L,(27.89 ±6.87)g/L]were less than non -elderly multiple myeloma group[(92.1 ±22.5)g/L,(33.15 ±7.69)g/L](t =4.297,4.426,all P <0.05).The calcium content,the propor-tion of bone marrow plasma cells,serum creatinine and blood β-microspheres protein levels of elderly multiple mye-loma group [(2.51 ±0.41)mmol/L,(39.43 ±18.64)%,(182.24 ±125.47)μmol/L,(9.02 ±6.24)mg/L]were higher than non -elderly multiple myeloma group [(2.36 ±0.48)mmol/L,(37.45 ±19.86)%,(143.25 ± 116.43)μmol/L,(5.87 ±3.41)mg/L](t =5.945,4.196,4.375,4.264,all P <0.05).The median survival time of elderly multiple myeloma patients were significantly correlated with the patients'age,the proportion of plasma cells in bone marrow,blood β2 -microglobulin,albumin,and ISS staging (χ2 =4.125,3.254,8.542,5.748,9.244,all P <0.05).Conclusion The condition of elderly myeloma patients is more serious,age,proportion of plasma cells in bone marrow,blood β2 -microglobulin,albumin and ISS stage affect myeloma patients prognosis.

Composition of and drug resistance in bacteria isolated from the lesions of patients with squamous cell carcinoma of the face and head / 中华皮肤科杂志

Objective To analyze the composition of and drug resistance in bacteria isolated from the lesions of patients with squamous cell carcinoma of the face and head.Methods Lesional tissue or discharges were obtained from 246 patients with squamous cell carcinoma of the face and head,and subjected to conventional bacterial culture.The isolated bacteria were identified by VITEK TWO automated microbiology system.Antimicrobial susceptibility testing was carried out by Kirby-bauer method.WHONET 5.3 software was utilized for statistical analysis.Results Totally,294 bacterial strains were isolated,including 168 Gram-negative bacteria (57.1％)and 126 Gram-positive bacteria(42.9％).The bacterial isolates were predominated by Staphylococcus aureus(21.4％),followed by Escherichia coli(20.4％),Staphylococcus epidermidis(18.4％),Klebsiellapneumoniae(15.4％)and Pseudomonas aeruginosa(9.5％).The prevalence was 40％,26.7％,42.9％ and 55.6％ respectively for extended spectrum β lactamases-producing E.coli and K.pneumoniae,methicillinresistant staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative S.epidermidis(MRCNS)respectively.P.aeruginosa,E.coli and K.pneumoniae were highly susceptible to imipenem and meropenem,and favorably sensitive to β-lactam and β-1actamase inhibitor combination.No resistance was observed for vancomycin,teicoplanin or linezolid in staphylococci.Conclusions The bacterial isolates from squamous cell carcinoma tissue on the head and neck are predominated by conditional pathogenic bacteria,and the proportion of Gram-negative bacteria is higher than that of Gram-positive bacteria.These isolates seem to be highly resistant to common antibiotics.

Application of local flaps in repair of nasal defects after excision of small cutaneous malignant tumors / 中华皮肤科杂志

Objective To investigate the methods for repairing skin defects after excision of small cutaneous malignant tumors at the lower one third part of nose and their clinical effects.Methods Lesions of small cutaneous malignant tumors at lower one third part of the nose were removed in 54 patients.Intraoperative pathology was performed to confirm the absence of survival carcinoma tissues after resection.According to the site,size,shape and neighborous skin status of defects,bilobed flaps,two-side rotation flaps and nasolabial flaps were selected to repair nasal skin tissue defects.Results There were 39(72.22%) cases of basal cell carcinoma, 9(16.67%) squamous cell carcinoma, 6(11.11%) keratoacanthoma.Skin defects after tumor removal were situated at the lower one third part of nose in all cases with less than 2.0 cm in diameter.Bilobed flaps were used to repair skin defects in 20 cases.rotation flaps in 2 cases,and nasolabial flap in 32 cases.As a result,all flaps survived and no obvious deformation of nose was observed in these cases.No recurrence occurred in a 5-year follow-up.Conclusion A satisfactory repair of skin defects at the lower one third part of nose with a diameter of less than 2.0 cm is achieved with bilobed flaps,two-side rotation flaps and nasolabial flaps.