Clinical oncology is becoming more and more important as the tumor incidence increases year by year. According to the need of clinical teaching, some important contents in teaching should be emphasized. And some ideas should be pard attention to such as chronic disease needing long-period and long period of treatment of chronic tumor diseases, necessary pathlolgical diagnosis, in despensible evidence-based medicine, multidisciplinary treatment combined with individualized treatment, caring psychological problems and pain in cancer patients, recognizing tumor research progresses by way of molecular targeted therapy. Finally, some teaching methods to raise study interest in a flexible way were put forward.

OBJECTIVE:To investigate the effects and safety of Compound xuelian burning wound ointment in the treatment ofⅡdegree deep burn. METHODS:Using consubstantial control method,2 burn wounds(Ⅱdegree deep burn,about 10 cm×10 cm) selected from symmetric or adjacent part of extremities in 80 patients withⅡdegree deep burn were divided into treatment area and control area. Treatment area was given Compound xuelian burning wound ointment,and control area was given Sulfadiazine silver cream. Healing time,degree of pain due to dressing change,the amount of infiltration liquid,wound infection rate,the incidence of scar formation and the incidence of ADR were observed. RESULTS:The healing time of wound in treatment area was signifi-cantly shorter than in control group [(18.7±3.6)d vs.(23.8±3.1)d],with statistical significance(P<0.05). During treatment,the proportion of patients suffering from acute pain and severe pain due to dressing change in treatment area,the amount of infiltration liquid and the incidence of scar formation were significantly lower or less than in control area;the proportion of patients suffering from mild pain due to dressing change in treatment area was significantly higher than in control area,with statistical significance (P<0.05). There was no statistical significance in the proportion of patients suffering from moderate pain and indolence due to dressing change,the incidence of wound infection between treatment area and control area(P>0.05). No obvious ADR was found in 80 patients. CONCLUSIONS:Compound xuelian burning wound ointment in the treatment of Ⅱdegree deep burn can relieve the degree of pain due to dressing change,control the amount of infiltration liquid,promote wound healing and reduce the occurrence of scar with good safety.

Objective To investigate clinical value of endoscopic ultrasonography (EUS) on diagnosis and treatment of esophageal leiomyoma.Methods The clinical feature of patients diagnosed as esophageal leiomyoma by EUS was analyzed.All patients underwent conventional gastroscopy and EUS examination as well as blood test.The EUS findings were compared with histopatholoical diagnosis for endoscopically or surgically resected specimens.All patients were followed-up with EUS for 14.3 months (range 2-36 months) for leiomyoma recurrence.Results A total of 191 patients were diagnosed with esophageal leiomyomas by EUS.Clinical manifestation,serum examination,conventional gastroscopy and spiral CT were not helpful for diagnosing esophageal leiomyoma,One hundred and sixteen patients with esophageal leiomyomas were treated by either endoscopic resection (111 cases) or surgical excision (5 cases).of which,101 resected specimens were pathologically confirmed as leiomyomas.The diagnostic accuracy of EUS was 87%.The follow-up study showed that there was no change of leiomyomas in 75 untreated patients and no recurrence was found in 116 surgically treated patients.Conclusion Esophageal leiomyoma is a benign tumor,EUS plays a very important role in diagnosis and treatment of this disease.

Objective To evaluate the value of interventional therapy in treatment of iliac compression syndrome (ICS) and subsequent venous thrombosis. Methods Examined by DSA, 125 cases were diagnosed of iliac vein compression and subsequent thrombosis. In 39 cases of ICS ( group 1 ), left: right = 4.6: 1. In 86 cases of ICS complicated with subsequent thrombosis (group 2), left: right = 4.7: 1. The patients of iliac vein compression and compression-related iliac vein stenosis or occlusion without fresh thrombus were treated by percutaneous transluminal angioplasty (PTA) and self-expandable stenting. In those cases with fresh thrombosis the inferior vena cava filter were inserted before thrombosis suction, mechanical thrombus ablation, PTA, stenting and transcatheter thrombolysis. The Chi-square test for comparison of proportions was used to test statistical significance. Results In 39 cases of ICS, 38 cases were treated by PTA and stenting. In 86 cases of deep vein thrombosis complicated with ICS, 83 cases were treated by various interventional therapy. There was no significant difference in the efficiency of intraluminal treatment between the two groups at discharge (97.4% and 96.5%, X2 =0.000,P >0.05) and at 6 months follow-up(96.3% and 90.2%, X2 = 0.266, P > 0.05 ), the difference in excellent-good rate of the two groups was significant at discharge (94.9% and 79.1%, X2=3.879, P <0.05) and at 6 months follow-up (92.6% and 68.6% ,X2 =4.441,P <0.05). Conclusions Interventioual treatment for ICS and secondary thrombosis is safe and effective.

Objective To compare the effects of higher dosage of atorvastatin alone and combination of lower dosage of atorvastatin with ezetimibe on levels of lipid and metalloproteinases in patients with coronary artery disease. Methods Forty-two patients with coronary artery stenosis (50% to 70% stenosis) without stent replacement were selected, and were randomly divided into atorvastatin group (treated with 20 mg or 40 mg atorvastatin alone, n = 19) and combined-therapy group(treated with 5 mg, 10 mg atorvastatin and 10 mg ezetimibe, n =23). The levels of serum lipid, hepatic and renal functions, creatine kinase, metalloproteinase (MMP)-2, MMP-9 and tissue inhibitor of MMP-1 (TIMP-1) were detected 12 weeks after treatment. Results Twelve weeks after treatment, the level of LDL-C in atorvastain group was (1.94 ± 0.49) mmol/L (37.82% decrease from baseline), and that in combined-therapy group was (1.92 ±0.54) mmol/L(38. 26% decrease from baseline), and there was no significant difference between these two groups (P >0.05). Twelve weeks after treatment, the levels of MMP-2 and MMP-9 were significantly decreased and that of TIMP-1 was significantly increased compared with baseline levels in atorvastatin, while no such changes were detected in combined-therapy group. Conclusion In patients with coronary artery stenosis, combined therapy with lower dosage of atorvastatin and ezetimibe may lead to the same lipid-lowing effects compared with therapy with higher dosage of atorvastatin, but it may not result in a significant reduction in serum levels of MMP-2, MMP-9 and increase of TIMP-1.

Thirty seven patients with congestive heart failure (CHF) were divided into cilazapril group (n=19) and general treatment group (n=18). Serum levels of interleukin-6 (IL-6) ,interleukin-8 (IL-8) , interleukin-10(IL-10) and tumor necrosis factor-α(TNF-α) , left ventricular ejection fraction (LVEF) ,left ventricular end-diastolic diameter (LVEDD), cardiac output (CO) and fractional shortening (FS) were measured before and after treatment. Serum levels of cytokines were also measured in 40 healthy individuals (control group). Results: The serum levels of IL-6, IL-8, IL-10 and TNF-α in CHF patients were significantly higher than those in the control group ( all P<0.01 ) ; After treatment, the serum IL-6, IL-8 and TNF-α were significantly decreased (P<0.01 ,P<0.05 ) in the cilazapril group. The LVEF, FS, CO were significantly increased in the Cilazapril group ( P<0.01 ) ; And the serum levels of IL-6 were significantly decreased in the cilazapril group as compared with the general treatment group ( P<0.05 ), however, after treatment, the EF, LVEF, FS and CO had no statistical differences in the cilazapril group as compared with the general treatment group. In the control group only LVEF and FS improved(P<0.01) ; Cytokine levels showed no changes. It suggests that cilazapril can reduce the serum levels of pro-inflammatory cytokines, increased the serum levels of anti-inflammatory cytokine, protect and improved cardiac function in the patients with congestive heart failure.

Objective To explore the prognostic value of APACHE Ⅱscore in patients with Severe acute organophosphorus poi-soning .Methods 42 patients with Severe acute organophosphorus poisoning ,in which 34 cases survived ,8 cases dead ,were select-ed .The APACHE Ⅱscores of patients in first 24 h of admission were collected ,and receiver operating characteristic curves (ROC curve) were drawn .Results APACHE Ⅱ score of the 42 patients with Severe acute organophosphorus poisoning was 18 ~30 (20 .11 ± 6 .32) ,in which the survival group was(16 .10 ± 3 .12) ,the dead group was(28 .01 ± 4 .46) (P<0 .01) .With the increase of APACHE Ⅱ score ,the fatality rate gradually increased .The total area under the ROC curves of APACHE Ⅱ score for death judgment was 0 .922 ,APACHE Ⅱ score of 21 .2 was the best diagnostic point ,the sensitivity was 95% ,and specificity was 89% . Conclusion The APACHE Ⅱscore could predict severity of patients with Severe acute organophosphorus poisoning ,and APACHEⅡscore ≥21 .2 could be used as the prognosis for death of the patients .

ObjectiveTo investigate prospectively the feasibility and clinical value of catheterization via the ipsilateral great saphenous vein in catheter-directed thrombolysis (CDT) for acute iliofemoral deep vein thrombosis (IFVT) by a comparative study.MethodsThe prospective study included 93 cases of IFVT proved by venography.All patients were divided into three groups randomly.In group A,31 patients received CDT via the ipsilateral great saphenous vein.In group B,27 patients received CDT via the ipsilateral popliteal vein.In group C,35 patients received anterograde thrombolysis via an ipsilateral dorsalis pedis vein.Urokinase was adopted as the thrombolytic agent in all cases.The assessment of the curative effect include therapeutic effective rate,rate of edema reduction and venous patency which were observed according to the clinical symptoms and the follow-up venograms obtained 5 days after thrombolysis.The time and comfort scores of procedures was recorded and compared between group A and B using two independent samples t test.The rate of edema reduction and venous patency were assessed using analysis of variance (LSD method).Therapeutic effective rate and complication rate were assessed using Chi-square test.Results The total effective rate of the three groups were 90.3％ (28/31),92.6％ (25/27) and 68.6％ (24/35) respectively.The limbs edema reduction rate were (83.5 ±21.1)％,(82.4 ±20.1)％,and(67.0±23.3)％ respectively(F=6.059,P = 0.003 ).The venous patency rate after thrombolysis were (61.2 ± 20.2) ％,(55.7 ± 20.5 ) ％,and (44.2 ±23.6)％ respectively.There was no significant difference between group A and B in therapeutic effective rate( x2 =0.09,P =0.759),rate of edema reduction( P =0.822 ) and venous patency ( P =0.343 ).There was a significant difference statistically in therapeutic effective rate(x2 =4.65,P =0.031 ),rate of edema reduction (P = 0.002) and venous patency (P = 0.002) between group A and C.Compared with group A and B,the procedure time [group A (8.3 ±3.1) min,group B (16.3 ±3.5) min,t =9.379,P ＜0.05],comfort scores during treatment [ group A (2.2 ± 1.2),group B (5.0 ± 1.4 ),t = 8.129,P ＜ 0.05 ] had statistical significant difference.The CDT-asscciated complications in group A were less than group B significantly(3 cases in group A,11 cases in group B,x2 =7.60 P ＜0.05).ConclusionsCatheterizationvia the great saphenous vein in CDT therapy for acute IFVT is feasible and effective.It is easily operable with less complications.

Objective To investigate the safety and clinical efficacy of catheter-directed thrombolysis(CDT) with prolonged infusion of low dose urokinasefor treatment of acute iliac-femoral vein thrombosis.Methods From January 2005 to March 2011,63 patients of unilateral acute iliac-femoral vein thrombosis were treated by CDT and followed up for more than 12 months.The complications during CDT,thrombus clearance ratio,time for CDT,dose of urokinase,degree of limb swelling and clinical follow-up data were retrospectively reviewed.The Fisher exact test was used for enumeration of data.The measurements of data were tested with the one-way analysis of variance and two-two comparison LSD test.Thrombus clearance ratio in different time frame was tested by repeated measurement of data and analysis of variance.Results During the CDT,no symptomatic pulmonary embolism (PE) and significant bleeding happened.Ten (15.9％) patients had complications of minor bleeding,including 3 patients with blood oozing along the edge of vascular sheath,3 patients with subcutaneous ecchymosis or hematoma around the puncture site,3 patients with hematuria and 1 patient with gums bleeding.In four (6.3％) patients,complications were caused by catheter placement,including 3 patients with soft tissue inflammation around puncture site and 1 patient with secondary thrombosis surrounding the vascular sheath.Fifty three patients (84.1％) achieved thrombolytic degree Ⅲ and Ⅱ at 4th to 8th day during CDT.Thrombus clearance ratio was higher in CDT with urokinase 500 000 U/d and 750 000 U/d than 250 000 U/d[(91.2 ± 10.1)％ vs (75.9±20.1)％,(91.3 ± 12.2)％ vs (75.9±20.1)％,all P ＜0.05].Thrombus clearance ratio showed no significant difference between CDT with urokinase 500 000 U/d and 750 000 U/d [(91.2 ±10.1) ％ vs (91.3 ± 12.2) ％,P ＞0.05].There was no significant difference between CDT with urokinase 500 000 U/d and 750 000 U/d in perfusion thrombolytic time to reach thrombolytic degree Ⅲ [(7.1 ± 1.0)vs (6.2±1.3)d,P＞0.05]and Ⅱ[(6.4±1.0) vs (6.0±0.8)d,P＞0.05].Thrombus clearance ratio increased along with an increase in thrombolytic time for CDT (P ＜ 0.05).After 24 hours of CDT,58 (92.1％) patients showed reduction of soft tissues tension.After 48 hours of CDT,affected limb circumference decreased significantly compared with the preoperative measurement [thigh (54.25 ±5.79) cm vs (56.46±5.91) cm; leg(44.05 ±5.18) cm vs (45.68 ±5.16) cm,all P＜0.05].At the time of discharge,there was no significant difference between affected limb circumference and normal side [thigh (49.00±4.67) cmvs (48.38 ±4.68) cm; leg(38.41 ±4.15) cm vs (37.73 ±3.92)cm,all P ＜ 0.05].The patency rate of iliac venous stent was 91.1％ (41/45) after 6 months.Doppler ultrasound showed regurgitation of femoral venous valve in 11 patients after 12 months.Conclusions CDT with prolonged infusion of low dose urokinase is a safe,highly effective method for the treatment of acute iliacfemoral venous thrombosis.