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 investigate the inhibitory effects of RNA silencing via adenovirusmediated angiotensin Ⅱ receptor subtypes shRNA(Ad-ATlaR-shRNA and Ad-ATlbR-shRNA)in mice brainstem nucleus tractus solitarius(NTS)in vivo. Methods C57BL mice were used as animal model.The microinjection into the nucleus of NTS was adopted.Two groups of male C57BL mice(n =7,n=8)were selected.After 10 days of microinjection,mice were killed and their brain tissue were fixed and sectioned.The levels of ATlaR mRNA and ATlbR mRNA at both sides of NTS were examined by in situ hybridization. Results The expression of ATlaR mRNA was significantly inhibited from 1.81/μCi/mg to 0.71μCi/mg[(61.6±6.8)%,P<0.01]by Ad-ATlaR-shRNA.Meanwhile,ATlbR mRNA expression was consistent at both sides,with no significant difference(P>0.05)after Ad-ATlaR-shRNA microinjection.ATlbR mRNA expression at the side with AdATlbR-shRNA injection was significantly inhibited from 10.28/μCi/mg to 4.97μCi/mg[(51.6±5.2)%,P<0.01]by Ad-ATlbR-shRNA.Meanwhile,ATlaR mRNA probe were consistent at both sides,with no significant difference(P>0.05). Conclusions The results show that both AdATlaR-shRNA and Ad-ATlbR-shRNA inhibit the corresponding receptor mRNA expression,and there is no cross-action for each other.

Objective Research and analysis on the clinical effect of rehabilitation of linguistic disturbance of child cerebral palsy patients,mainly through the treatment of acupuncture.Methods Effect comparison between the treatments of acupuncture and the only common way of 121 cerebral palsy children.Results The treatment mainly by acupuncture was obvious better than the common one.Conclusions The treatment mainly by acupuncture is one of the effective ways of linguistic disturbance of infantile cerebral palsy,and there are good prospects and special advantages for the treatment of Traditional Chinese Medical Science

Objective To analyse the cognitive dysfunction early after non-cardiac surgery in elderly. MethodsEighteen elderly patients undergoing selective non-cardiac surgery were investigated. General anesthesia was used in 11 patients and combined epidural-spinal anesthesia in 7 cases. The operations involved orthopedic, thoracic, abdominal and urologic surgeries. The patients were premedicated with phynoharbital 0. 1g and scopolamine 0. 3mg. Results All patients suffered from typical POCD that occurred during 1 to 3 days after operation. The symptoms were more severe at night. The patients with POCD were treated effectively with intravenous injection of midozolam and muscle injection of haloperidol in 15 cases. The symptoms of POCD were attenuated by injection of pethidine in 2 cases. One case had to be given intravenous infusion of propofol continually for 16 hours. All patients were cured without psychological complications before discharge Conclusion POCD is a common complication in the elderly and should be treated actively.

Objective In order to provide a large quantity of retinal pigment epithelial cells (RPE cells) in vitro, we want to estab-lish method for culturing pig RPE cells. Methods RPE cells were separated with trypsin and cultured in vitro. The cells were identified by immunohistochemical staining with anti-human keratin and transmission electron microscope (TEM). Results Cultured RPE cells gradually presented transparent and fusiform shape. Immunohistochemical staining demonstrated that the cells were stained by anti-human keratin, and the cultured cells showed typical ultrastructure of RPE cells. Conclusion The cultured cells may be the foundation of pig RPE cells.

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.