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Objective: To analyze the influence of Revised International Staging System (RISS) on the prognosis and treatment of multiple myeloma (MM). Methods: The clinical information of two hundred and fifty-nine newly diagnosed patients with MM was retrospectively analyzed. The survival and prognosis of these MM patients was compared by using Durie-Salmon (DS) staging, International Staging System (ISS) and RISS, respectively. The influence of use of bortezomib and autologous stem cell transplantation (ASCT) on the prognosis of patients with MM according to RISS was evaluated. Results: The median age of 259 patients with MM was 58 years (range: 34-87 years). The ratio of male to female was 1.3: 1. The median follow-up time was 32 months (range: 1-188 months), and the median progression-free survival (PFS) and median survival time were 45 and 67 months, respectively. In 239 patients with MM according to DS staging, the patients with DS stage I, II and III MM were accounted for 4.2%, 16.7% and 79.1%, respectively; the median PFS were 68, 41 and 44 months, respectively (P = 0.496), and the median survival time were 99, 64 and 67 months (P = 0.478); the 5-year PFS rates were 60.0%, 38.1% and 31.3% (P = 0.208), and the 5-year overall survival (OS) rates were 60.0%, 60.9% and 53% (P = 0.533). In 236 patients with MM according to ISS, the patients with ISS stage I, II and III MM were accounted for 17.4%, 41.1% and 41.5%, respectively; the median PFS were 53, 48 and 38 months, respectively (P = 0.033), and the median survival time were 68, 92 and 57 months, respectively (P = 0.028); the 5-year PFS rates were 36.8%, 40.0% and 25.6% (P = 0.291), and the OS rates were 60.0%, 63.9% and 42.1%, respectively (P = 0.119). In 173 patients with MM according to RISS, the patients with RISS stage I, II and III MM were accounted for 9.2%, 81.6% and 9.2%, respectively; the median PFS were 68, 47 and 16 months (P = 0.022), and the median survival time were statistics not shown and 72 and 25 months, respectively (P = 0.001). The 5-year PFS rates were 55.6%, 34.7% and 11.1% (P = 0.049), and the OS rates were 80.0%, 59.2% and 22.2% (P = 0.012). The patients with RISS stage III MM had better prognosis in bortezomib-based combination chemotherapy group, and the median survival time was 30 months, which was longer than that of the routine chemotherapy group (14 months, P = 0.014). ASCT had significant difference neither in PFS nor in OS according to RISS (P > 0.05). Conclusion: The RISS is superior to DS staging and ISS in the prognostic significance. Patients with RISS stage III MM have poor prognosis, and the bortezomib can improve the prognosis.
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Objective To compare the abnormal influence of Ureaplasma urealyticum(UU) and human papillomavirus(HPV) infection on early pregnant women,and to investigate the correlation between reproductive tract infection with spontaneous abortion in early pregnant women.Methods A total of 460 pregnant women were included in the observation subjects,including 230 cases of spontaneous abortion (observation group) and other 230 normal pregnant women of delivery as the control group.The cervical swab samples were collected from the research subjects of the two groups and performed the UU and different types of HPV detections by using corresponding PCR reaction reagents.Results The UU total infection rate among 460 pregnant women was 17.83%(82/460),which of the observation group was 24.8%(57/230) and which the control group was only 10.9%(25/230),the difference between the two groups was statistically significant(P<0.01).The HPV total infection rate was 20.2%(93/460),which of the observation group was 29.1%(67/230) and which of the control group was only 11.3%(26/230),the difference was statistically significant.Among them,the single subtype HPV infection proportion was 14.1%(65/460),the multiple subtype HPV mixed infection proportion was 6.1%(28/460),while the high risk type HPV infection rate was 18.3%(84/460) and the low risk type HPV infection rate was 8.91%(41/460).The infection rate of UU combined HPV was 2.6%(12/460),in which the observation had 11 case and control group had 1 case,the difference was statistically significant (P<0.01).Conclusion Infection of UU and HPV in early pregnant women may lead to spontaneous abortion.But its concrete mechanism and the role of different types of HPV need to be further studied.
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Objective To investigate the availability and safety of pulmonary rehabilitation for hospitalized patients with acute exacerba-tion of chronic obstructive pulmonary disease (COPD). Methods Seventy-two hospitalized patients with acute exacerbation of COPD were randomly included into test group (n=36) and control group (n=36) from June, 2015 to June, 2016. All the patients accepted management of anti-infection, phlegm elimination, antiasthma, etc., as well as the guidance of expectoration and health education; while the test group ac-cepted pulmonary rehabilitation from the third day of admission to discharge. Their strength of hand grip, 1-minute sit-to-stand test (STST), the days of hospitalization, lung function parameters, modified Medical Research Council (mMRC) scores and COPD Assessment Test (CAT) scores were measured before and after treatment. Results Compared with the control group, the strength of hand grip (t=2.985, P0.05). There was no significant difference in lung function after treatment in both groups (Z0.05). Conclu-sion Pulmonary rehabilitation is effective on hospitalized patients with acute exacerbation of COPD in muscle strength, capability of activi-ties, and relieve the symptoms.
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Objective To analyze antimicrobial resistance of clinically isolated Burkholderia cepacia (B.cepacia),and provide evidence for clinical rational antimicrobial use.Methods B.cepacia isolated from clinical specimens between January 2013 and December 2014 were analyzed retrospectively,antimicrobial susceptibility results were statistically analyzed.Results A total of 98 isolates of B.cepacia between January 2013 and December 2014 were isolated,the main specimen was sputum(n =86,87.76 ％),the main department distribution was intensive care unit(n =46,46.94％),resistance rate of B.cepacia to ticarcillin / clavulanic acid was highest(73.47％),resistance rates to piperacillin / tazobactam and cefoperazone / sulbactam were both 16.33％,resistance rate to minocycline was the lowest(5.10％).Conclusion Infection caused by B.cepacia is high,prevention and control of healthcare-associated infection should be strengthened,early etiological examination should be performed,antimicrobial treatment should be combined with antimicrobial susceptibility results.
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Objective To compare the lipoprotein(a) (Lp-a) and lipid metabolism level in rheumatoid arthritis(RA) patients and control group (healthy subjects),and evaluate the correlation between Lp-a levels and systemic inflammation in patients with RA.Methods Blood samples from 30 RA patients with positive rheumatoid factor and 30 healthy controls were collected,with same distribution of gender and age in both groups.Lipid metabolism level such as Lp-a,triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),very low-density lipoprotein cholesterol (VLDL-C) and inflammation markers such as tumor necrosis factor α (TNF-α),interleukin 6 (IL-6) and C reactive protein (CRP) were detected and analyzed statistically.Results LP-a levels were higher in RA patients than that of control group(P＜0.001),HDL-C levels were lower in RA group (P＜0.05),while TC,TG,LDL-C and VLDL-C levels showed no difference (P＞0.05).The TNF-α、IL-6 and CRP levels of RA patients were higher than that of control group(P＜0.05),and the association between higher Lp-a level and TNF-α were confirmed (r=0.753,P＜0.001).Conclusions High levels of Lp-a are often observed in RA patients,and a rising Lp-a level are associated with systematic inflammation reaction.Lp-a may be a risk factor for RA progress.