Chemotherapy is the basic therapy in non small cell lung cancer, but combined chemotherapy has a response rate that still remains in the range of 30%-40%. Resistance of cancer cells to the anti tumor drugs is the main factor that reduces the efficacy of the chemotherapy. The mechanism of the drug resistance of lung cancer cells is very complex involving changes of drug resistance gene MDR1, MRP, LRP,GST, change of quality and quantity of toposomerase Ⅱ, ? tubulin gene mutation and fibroblast growth factor. Prospective measurement of the molecular marker as a guide for clinical chemotherapy is a key factor that can facilitate the individualization of the regime and thus increase the response rate.

Objective To discuss the value of combination of various clinical laboratory methods in the diagnosis of Mycobacteri-um tuberculosis(MTB) .Methods T-SPOT .TB ,sputum smear ,sputum culture ,and MTB-DNA detection were used to detect MTB .The sensitivity ,specificity ,rate of missed diagnosis ,coincidence rate and correct diagnosis index for tuberculosis diagnosis of the four methods and their pairwise combinations were analyzed and compared .Results Comparing with other methods ,T-SPOT . TB combined with MTB-DNA detection had the highest sensitivity ,coincidence rate and correct diagnosis index ,and the lowest rate of missed diagnosis ,with significant difference(P<0 .05) .Conclusion T-SPOT .TB combined with MTB-DNA detection could be used as an adjuvant method for the early diagnosis of tuberculosis .

Objective To explore the clinical characteristics of the elder patients with the invasive fungal infections (IFI) in gerontal hematological malignant. Methods 38 patients with IFI during Jan 2000 to October 2007 were enrolled to analyze retrospectively. Results A total of 38 cases of gerontal hematological malignancies were diagnosed IFI. Occurrence of IFI correlated with agranulocytosis persistence >5 days, broad - spectrum antibiotics using >7 days, complicating diabetes, the hospitalized day longer than 20 days,chemotherapy scheme combined with glucocorticoids. IFI clinical manifestation varied with different infection sites and different fungal species. Lung was the frequently fungal infection site(25 cases, 65.8 %). The most common fungal subtypes were Candida albicans (14 strains, 38.9 %) and aspergillus (7 strains, 19.4 %).Although amphotericin B and itraconozole were adopted to treat IFI, but there were still 10 cases of patients died because of severe respiratory failure. Conclusion Elder patients with gerontal hematological malignant with a marked increasing mortality of IFI, prognosis was poor. Morbidity concerned with many factors, early prophylaxis or empiric antifungal treatment should be adopt.

OBJECTIVETo observe the clinical efficacy and side effects of brentuximab vedotin (BV) plus chlormethine hydrochloride (CH) in patients with relapsed and refractory Hodgkin lymphoma (HL) after failure with BV alone.

METHODSFrom March, 2014 to December, 2014, 6 patients who failed with BV monotherapy were enrolled in this study. The chemotherapy regimen consisted of BV (1.2-1.8 mg/kg, iv. gtt, d1) and CH (6 mg/m2, iv. gtt, d1) was given for 3 weeks as one course, and all patients received about 3-8 courses of chemotherapy, with an median of 4 courses. Clinical efficacy and adverse events were assessed and observed by radiographic examination and serological detection.

RESULTSAmong 6 patients, the overall response rate was 100% with 2 complete remission and 4 partial remission. The main adverse events were grade I (2 patients) and IV (2 patients) bone marrow depression, grade II (2 patients)gastrointestinal reaction, grade I (1 patient) increase of transaminase and myocardial enzyme and grade I (1 patient) mouth ulcers.

CONCLUSIONThe combination of BV and CH in the treatment of relapsed and refractory HL after failure with BV alone was high effective and the toxicities were well tolerable.

Antineoplastic Agents, Alkylating ; therapeutic use ; Hodgkin Disease ; drug therapy ; Humans ; Immunoconjugates ; therapeutic use ; Mechlorethamine ; therapeutic use