In recent years,considerable progress has been made in the treatment of multiple myeloma(MM).However,despite the current improved prognosis of this malignancy,it always ends in relapse and therefore new therapeutic approaches are urgently needed to overcome it.The chimeric antigen receptor(CAR)-T cells targeting B cell maturation antigen(BCMA),cluster of differentiation 19(CD19),cluster of differentiation 38(CD38) and kappa light chains have been evaluated,and have achieved remarkable results in clinical trials.However,even when MM is treated with CAR-T cell therapy,most patients eventually relapse,which is the greatest limitation of this therapy.This paperreviewedthe research progress,limitations and optimization of CAR-T cell immunotherapy in the treatment of MM.

Gefitinib and erlotinib are the first generation of targeted therapeutic agents approved for the treatment of advanced non-small cell lung cancer. Despite a dramatic initial response, most patients subsequently and ultimately become resistant to the drugs. Recent studies have proposed various mechanisms of such resistance, some of which related to a second mutation in epidermal growth factor receptor, aberrant activation of other tyrosine kinase receptors, bypassing signal pathways and constitutive activation of downstream signal molecules. Other researches also associated the drug resistance to internalization of epidermal growth factor receptor and changes in tumor microenvironment. Furture studies need to focus on overcoming or reversing resistance to the drugs and developing new targeted therapeutic agents.

Objective To interview the work feelings of the Middle youth patients with peritoneal dialysis. Methods Using the purposive sampling method, 11 patients were interviewed, and analyzed the content of the interview. After the interview, data were transcribed and extracted the keywords. Results Eight keywords were extracted, the patients had four positive feelings:self-perceived burden relived;more social support; more glad, negative feelings relived; peritoneal dialysis could be sure. 4 negative themes were extracted:tedious;had economic pressure;lack of self-realization;could not take the family burden. Conclusions Work can improve the living conditions of middle youth patients with peritoneal dialysis. More patients should be encouraged to return to work.

Objective To establish a HPLC method to determine the antiseptics in compound dexamethasone acetate cream and evaluate the usage rationality of antimicrobial preservatives. Methods The content of ethyl hydroxybenzoate was calculated by external standard with HPLC.The effectiveness of antimicrobial preservatives was measured according to the preservative effectiveness test in ChP(2015edition) by inoculating 5 kinds of test microorganisms including Pseudomonas aeruginosa,Escherichia coli,Staphylococcusaureus,Candida albicans and Aspergillusniger.Results The linear ranges of ethyl hydroxybenzoate was 6.63-132.6 μg/mL ( r =0.999 7 ) .The average recoveries was 99.2%.The samples from different batche had different antimicrobial effectiveness due to the content of ethyl hydroxybenzoate.Conclusion The described method can be used in the determination of the preservatives of ethyl hydroxybenzoate in compound dexamethasone acetate cream.At present the use of antibacterial agent is arbitrary, it is necessary to strengthen research and supervision.

A systematic comparative study ou the morphology and histology of the rhizomes of polygonatum including "Huangjing" and "Yuzhu" currently available on the Chinese market werepresented. The differences between this two types of herbal medicines were given.

Objective To observe the clinical effect of emergency operative treatment on thoracolumbar compression or burst fractures using pedicle screw instrument through posterior approach and indirect reduction.Methods53 acute thoracolumbar compression or burst fractures cases injured within 4 days were accepted the emergency operation of indirect reduction, decompression and fixation using pedicle screw instrument through posterior approach. The mean percentage of traumatic vertebral body height, sagittal diameter of spinal canal, degrees of kyphosis and Frankel scoring of nerve function were evaluated before and after operation.ResultsAll cases received two weeks following-up, 47 cases had more than one-year following-up. The mean percentage of traumatic vertebral height restored from 42.28% (pre-operation) to 93.46% (post-operation); the mean degrees of kyphosis recovered from 26.44° (pre-operation) to 17.73° (post-operation); the mean percentage of sagittal diameter of spinal canal changed from 63.14% (pre-operation) to 78.55% (post-operation). All but cases with completely spinal cord injury got more than one grade nerve functional restoration. Neither later spinal cord injury nor back pain existed among the patients. Three cases emerged partial internal fixation device failure, but neither symptoms nor abnormality correction missed.ConclusionEmergency operation using pedicle screw instrument through posterior approach is a feasible and confirmatory choice in treatment of the acute thoracolumbar compression or burst fractures if the cases are selected properly.

Objective:To explore the effects of levocarnitine adjunctive therapy on serum nutritional index and inflammatory factor level in maintenance hemodialysis patients. Methods:Totally 62 patients with hemodialysis were randomly divided into the observation group and the control group with 31 cases in each. The observation group was treated with 1g levocarnitine injection with intravenous in-jection after the dialysis, and the control group was treated with 0. 9% physiological saline injection with the same volume after the di-alysis. After 3-month treatment, the nutritional indices including Hb, Alb, TC, TG, LDL-C and HDL-C and the change in inflamma-tory factors including C-reactive protein (CRP), IL-6, IL-8 and TNF-α of the patients in the two groups were studied and compared. Results:After the treatment, the level of Hb and Alb was improved in the observation group (P<0. 05), while the level of TC, TG, HDL-C and LDL-C had no significant change (P>0. 05). All of the indices showed no significant change in the control group (P>0. 05). After the treatment, the level of Hb and Alb in the observation group was higher than that in the control group (P<0. 05). After the treatment, the level of CRP, IL-6, IL-8 and TNF-α was reduced in the observation group (P<0.05), while the control group had no significant changes in the indices (P>0. 05). All of the indices in the observation group was better than those in the control group (P<0. 05). Conclusion:Levocarnitine used in the treatment of patients with hemodialysis can effectively improve the nutritional status and inflammatory factors level without obvious effects on lipid metabolism, which is very important for the reduction of complication and the improvement of life quality, and worthy of clinical promotion.

Objective To analyze the risk factors of metastasis and biological characteristics of patients with gastroenteropancreatic neuroendocrine tumor (GEP-NET).Methods One hundred and forty patients with neuroendocrine (NET) confirmed pathologically were collected between Jan.1993 and Mav 2009,and were divided into relative benign tumors or malignant tumors according to WHO prognostic criteria about GEP-NET.The clinicopathological parameters that related with metastasis of NETs were analyzed by univariate and Logistics regression methods,and the biological behavior characteristics was assessed further.Results GEP-NET showed a maximum incidence at age of 45-54 years for man and of 35-44 years for women.The onset of NET varied in age according to location of primary tumors(P<0.01).The onset age of patients with pancreas NET was lowest(42.92 years).The location that demonstrated the greatest incidence of GEP-NET was pancreas.The univariate analysis showed that gender,age,differentiation,location of primary tumors and maximum diameter of NETs were significantly associated with metastasis of GEP-NET(all P values<0.01).Logistic regression analysis revealed that the site,diameter and differentiation of tumor were the most important predictors for metastasis.The mean age of patients with malignant NET (54.78 years)was older than that of patients with relative benign NET (44.12 years,P<0.01).Conclusions The NET are more commonly found in pancrease.The location of primary tumor,diameter and differentiation of NET are important predictors for tumor metastasis.Poorly differetiated NET are common in patients with gastrointestinal NET or elderly NET patients.

OBJECTIVE： To prepare pefloxacin mesylate eye drops.METHODS： The content of pefloxacin was determined with UV－ spectrophotometry.The therapeutic effect of the eye drops was observed in 170 out－ patients.RESULTS： The linearity range was 2～ 14μ g/ml with a regression equation of A=0.1 018C and r=0.9 999(n=7).The average recovery was 99.64％ with a RSD of 0.43％ .After treatment,150 out－ patients recovered,16 out－ patients improved and 4 out－ patients had no efficiency with a total effective rate of 97.6％ .CONCLUSION： The eye drops has definite therapeutic effect.The UV－ spectrophotometry method is simple,rapid and accurate in determination of the content and no special reagent is needed.

BACKGROUND:Induced pluripotent stem cel s can bypass the ethical issues of embryonic stem cel s, and become the hotspot of stem cel research. OBJECTIVE:To explore the research progress and problems of induced pluripotent stem cel s. METHODS:A retrospective analysis on the findings, research progress and problems of induced pluripotent stem cel s in recent years was performed. The Thomson Reuters Web of Science was searched for the articles related to the induced pluripotent stem cel s and p53 gene. RESULTS AND CONCLUSION:In recent years, domestic and foreign scholars have conducted a lot of researches on induced pluripotent stem cel s. For example, a Japanese group is establishing the stem cel bank to provide a basis for the treatment of retinal diseases. However, the safety issues of induced pluripotent stem cel s need to be solved before routine cel treatment application, in which the functional research of related p53 gene is one of the essential concerns. The other member of p53 gene, p73 gene, also participates in the generation and differentiation of induced pluripotent stem cel s, and the in-depth studies are needed. The finding of p53 gene function wil promote the in-depth development of regenerative medicine and translational medicine.