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.

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.

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.

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 investigate the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of pulmonary cryptococcosis.Methods 15 patients who were diagnosed as pulmonary cryptococcosis were retrospectively studied,all of them were examined by sputum smear,X ray,CT and EBUS-TBNA.Results 15 patients who received EBUS-TBNA were diagnosed pulmonary cryptococcosis by pathological methods and germiculture,during the process no complication was detected.Conclusion EBUS-TBNA is a safe and effective means in the diagnosis of pulmonary cryptococcosis for pulmonary cryptococcosis patients hard to be diagnosed clinically.

Objective To observe the clinical effect of three antisyphilic drugs in the treatment of early syphilis.Methods From January 2007 to March 2013, 90 cases early syphilis in department of dermatology of our hospital were selected and randomly devided into three groups: benzathine penicillin group, clarithromycin group and azithromycin group.The efficacy including the onset time of improvement, recovery time of skin lesions and TRUST negative conversion rate were compared in three groups.Results The onset time of skin lesions improvement in patients with primary syphilis result showed that there was significant difference between benzathine penicillin and clarithromycin (t =14.603, P<0.05), clarithromycin and azithromycin (t=12.682, P<0.05).While in the treatment of primary syphilis and secondary syphilis, there were no significant differences among recovery time of skin lesions.And there were no significant differences the onset time of skin lesions improvement in treatment of secondary syphilis among three groups.The TRUST negative conversion rates of benzathine penicillin and clarithromycin both were 100%, and azithromycin was 96.7%, with no significant difference.Conclusion The antisyphilic efficacy of three drugs are similar.The patients allergic to penicillin may be treated with clarithromycin or azithromycin, who would aquaire a satisfied result.

Objective:To evaluate the effects of HIF-1αprotein in the pathogenesis of oral submucous fibrosis(OSF)tissue.Meth-ods:HIF-1αprotein expression in 30 cases of OSF,5 cases of normale control oral mucosa tissue was studied by SP immunohisto-chemistry with HIF-1αrabbit anti-human polyclonal antibody.Results:The negative expression of HIF-1αwas found in normal oral mucoa tissue and possitive in early,intermediate and advanced stage of OSF(P<0.05 ).Conclusion:HIF-1αprotein may play an importent role in the pathogenesis of OSF.

Objective To explore the value of subglottic secretion drainage in the prevention of the late -onset ventilator associated pneumonia.Methods Clinical data of 273 patients which were treated for long -term mechanical ventilation and tracheotomy were retrospectively analyzed.Based on continued subglottic suction,the patients were divided into the subglottic suction group(132 cases)and control group(141 cases),the late -onset ventilator -associated pneumonia incidence of two groups were compared.Results The ventilator -associated pneu-monia rate of the subglottic suction group was 25.8%(34 /132),and the ventilator -associated pneumonia rate of the control group was 22.7%(32 /141 ),the difference between the two groups was not significant(χ2 =0.345,P >0.05).Conclusion In the prevention of late -onset ventilator -associated pneumonia,the effect of continuous sub-glottic suction is unclear.

18F-fluorodeoxyglucos (18F-FDG) PET/CT can provide metabolic information for three dimensional conformal radiation therapy planning. The biological target volume may be influenced by many factors. Studies of target delineation using 18F-FDG PET/CT and methods to improve the misalignment of PET and CT images due to breathing were reviewed in this article.