With the deepening of the lung cancer molecular biology research,small molecular targets antitumor drugs make breakthrough progress,the epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) is one of the most attention drug.A series studies show that EGFR-TKI can enhance the antitumor activity of ionizing radiation.Therefore,EGFR-TKI combined with radiotherapy alone for poor-risk patients appears survival benefit,but can't ignore the lung toxicity.However,there is a big contro-versy that EGFR-TKI combined with chemoradiotherapy for locally advanced NSCLC.

Breast cancer and thyroid diseases are common diseases in women.It is reported that breast cancer and thyroid diseases have some relevance.Breast cancer patients have relatively high incidence of thyroid dysfunction,thyroid node and thyroid cancer,which are easily misdiagnosed for lacking of obvious clinical manifestations and will affect the treatment and prognosis of breast cancer.In breast cancer patients,screening and diagnosis of thyroid function and disease through thyroid function detection and ultrasound examination should be strengthened.

Postoperative adjuvant therapy for primary invasive breast cancer patients with synchronous ax-illary metastases is mainly based on the characteristics of biomarker of the primary tumor. Recently, some studies have showed the discordance and clinical significance of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status between primary breast cancer and synchronous axillary lymph node metastases. As local metastasis, the synchronous axillary metastases may represent the potentially metastatic breast cancer cells much better than the primary tumor. Hence, determination of biomarkers status should be performed in synchronous axillary metastasis, together with primary tumor, to guide therapy management and evaluate the prognosis of primary invasive breast cancer patients with synchronous axillary metastases.

Objective To investigate the relationship between the anti-phospholipid antibodies (APLs)and activated protein C resistance (APCR). Methods The response to activated protein C (APC) was studied by an APTT-based (clotting) assay with a Stago autoanalyzer and expressed as the ratio between the APTT obtained in the presence and absence of exogenous APC. APC sensitive ratio higher than 2 was regarded as APCR. Anti-?2-glycoprotein Ⅰ (?2GP-Ⅰ) antibody and anti-cardiolipin antibodies (ACL) were measured by an enzyme-linked immunosorbent assay (ELISA). Lupus anticoagulant (LA) was tested by activated partial thromboplastin time (APTT). Results The existence of LA and acquired APCR showed significant correlation (?2=16.332, P=0.008). Acquired APCR was significantly associated with the presence of anti-?2GP-Ⅰ antibody (?2=6.179, P=0.012), but not ACL. The presence of APCR was associated with an increased frequency of history of thromboembolic events and/or recurrent abortions (?2=7.347, P=0.01). Conclusion This study suggests that APCR is linked to the presence of LA and anti-?2GP-Ⅰ antibody. APLs may interfere with the activation of protein C. APCR phenotype may be a major risk factor for thrombophilia in patients with APLs. Combined detection of APLs has the potential value for predicting thrombosis.

Breast cancer and dyslipidemia are common diseases in women.It is reported that breast cancer and dyslipidemia have some relevance.Breast cancer patients have a relatively high incidence of dyslipidemia,which is easily undiagnosed for lacking of obvious clinical manifestations and will affect the treatment and prognosis of breast cancer.In breast cancer patients,screening and diagnosis of dyslipidemia through blood lipid detection should be strengthened.

Objective To observe the clinical efficacy of infrared thermal therapy against pseudomonas ae-ruginosa infection on deep partial-thickness burn wound. Methods Forty-three patients in our hospital with main-ly deep partial-thickness burn wound from January 2015 to October 2016 were randomly enrolled to the treatment group(TG,treated with sulfadiazine silver + infrared thermal therapy)and the control group(CG,treated with sulfadiazine silver only). Scores of wound exudation,positive rate of pseudomonas aeruginosa on wound,wound healing rate,wound healing time and overall evaluation of wound healing on the day of 0,3,7,14,21,28 after treatment were conventionally recorded. Adverse effects in TG and CG were also observed. Results (1)Age,sex and burn surface area of patients were found no statistically significant difference between the two groups(P>0.05). (2)On the day of 3,7 and 14,wound exudation score of TG was significantly lower than that of CG(P<0.05);On the day of0,21 and 28,wound exudation score of the two groups were almost same.(3)Positive rate of pseudomonas aeruginosa between the two groups on the day of 7,14 and 21,TG was significantly lower than CG(P < 0.05). (4)Wound healing rate of TG on the day of 7,14 and 21 was higher than CG,which was statistically significant difference in the 2 groups(P<0.05);Wound healing time of TG patients[(21.1 ± 6.5)day]was significantly shorter than that of CG patients[(26.2 ± 6.5)day](P<0.05).(5)Overall evaluation of wound healing of TG was better than that of CG on the day 14 and 21(P<0.05). Conclusions Infrared thermal therapy could reduce the secretion of deep partial-thickness burn wound and effectively control pseudomonas aeruginosa infection. Furthermore,infrared thermal therapy finally improved wound healing rate and shortenedwound healing time of burn wound.

Objective To evaluate the efficacy and safety of percutaneous radiofrequency ablation combined with immunotherapy in the treatment of hepatocellular carcinoma .Methods A total of 124 patients with liver cancer were randomly divided into the two groups .60 cases in the control group were given immunity treatment alone ,while 64 cases in the observation group were treated by percutaneous radiofrequency ablation combined with immune therapy . The middle and long term curative effect of two groups was observed .Results After treatment,the tumor diameter, serum alpha fetoprotein (AFP) and carcino-embryonic antigen (CEA) levels in the two groups were significantly decreased(t=4.867,P=0.005;t=5.175,P=0.004;t=3.155,P=0.025;t=4.845,P=0.005;t=4.031,P=0.010;t=2.668,P=0.044),but the declining degree of the observation group was better than the control group (t=4.119,P=0.009;t=3.621,P=0.015;t=3.492,P=0.017).The total effective rates and disease control rates of the observation group were 53.1%,78.1%,which were significantly higher than 28.3%,46.7%in the control group (χ2 =11.290,P=0.010;χ2 =21.290,P=0.000).The 1-year,3-year,5-year survival rates of the observation group were 60.9%,31.3%,12.5%,those of the control group were 21.7%,5.0%,0.0%,the middle and long term sur-vival rates of the observation group were significantly higher than the control group (χ2 =21.935,P=0.000;χ2 =56.452,P=0.000;χ2 =40.516,P=0.000).No statistically significant differences in the CD 4+,CD8+,CD4+/CD8+, IL-12 and other indicators between the two groups before treatment ,but these indicators in the observation group were significantly improved after treatment (t =4.515,P =0.006;t =10.014,P =0.000;t =5.217,P =0.003). Conclusion Combination of percutaneous radiofrequency ablation and immunotherapy in the treatment of hepatocell-lular carcinoma has exact effect and with advantages of less adverse reaction , good safety , which can significantly improve the quality of life and survival rate of patients ,it has good clinical application value .

With the development and the expansion of higher medical education,lack of course resource became a “bottleneck” which restricted the development of medical schools.Teaching hospitals played some roles in medical education,but there was a huge gap in teaching ability between these hospitals and the hospitals affiliated with universities.The Clinical College analyzed the current situation of teaching ability in teaching hospitals and did the preliminary research for the solutions of this situation.

Objective To evaluate the efficacy and toxicity of induction chemotherapy with nedaplatin and docetaxel plus concurrent intensity?modulated radiotherapy ( IMRT) with nedaplatin or cisplatin in the treatment of locally advanced nasopharyngeal carcinoma (NPC). Methods A total of 223 patients with pathologically diagnosed locally advanced NPC in five treatment centers from 2011 to 2012 were randomly divided into two groups. In the test group, one hundred and thirteen patients received two cycles of induction chemotherapy with docetaxel (65 mg/ m2 on day 1) and nedaplatin (80 mg/ m2 on day 1) plus concurrent IMRT with nedaplatin (40 mg/ m2 on day 1). In the control group, 110 patients received two cycles of induction chemotherapy with the same regimens plus concurrent IMRT with cisplatin (40 mg/ m2 on day 1). The survival rates were calculated with the Kaplan?Meier method and the differences in the survival rates between the two groups were analyzed using the log?rank test. Comparison of the incidence rates of adverse reactions between the two groups was made by the chi?square test. Results The follow?up rate was 99?? 1%.The response rates at 3 months after treatment in the two groups were both 100%. The 2?year local recurrence?free, regional recurrence?free, distant metastasis?free, and overall survival rates were 94?? 0%, 94?? 2%, 88?? 2%, and 90?? 3%, respectively, in the test group, versus 93?? 4%, 94?? 1%, 86?? 7%, and 87?? 3% in the control group ( P= 0?? 757、 0?? 478、 0?? 509、 0?? 413). The incidence rates and severity of leucopenia, neutropenia, and thrombocytopenia were significantly higher in the test group than in the control group ( P= 0?? 027 , 0?? 028 , 0?? 035 ) . The incidence rates and severity of hemoglobin reduction and nausea /vomiting were significantly lower in the test group than in the control group (P= 0?? 000,0?? 023). There were no significant differences in the incidence rates of mucositis and xerostomia between the two groups ( P=0?? 483,0?? 781). Conclusions The short?term efficacy of induction chemotherapy with nedaplatin and docetaxel plus concurrent IMRT with nedaplatin is similar to that with cisplatin in the treatment of locally advanced NPC. The mild gastrointestinal reactions can be tolerated by patients. However, the severe myelosuppression should be closely monitored during the treatment.

[ ABSTRACT ] AIM: To characterize the phenotypic and genetic features of a patient with Lowe syndrome. METHODS:The clinical data and the MRI of a ten-month-old patient were analyzed.At the same time, all exons of the OCRL gene of the patient and his parents were amplified and Sanger-sequenced.RESULTS:Clinical analysis revealed that the patient has abnormal vision, nystagmus, congenital cataract, hypotonia, proteinuria, hematuria and psychomotor retar-dation.MRI showed white matter myelination delay, bilateral frontal and temporal dysplasia, and subarachnoid cavity en-largement.The results of PCR and Sanger sequencing detected a de novo mutation, NM_000276.3: c.1280-1281delTT (p.Cys428Hisfs*2), a deletion causing a frame shift.To our knowledge, this mutation in OCRL gene has not been repor-ted previously.CONCLUSION:The clinical manifestations suggested a phenotype of Lowe syndrome, and molecular ge-netic testing confirmed the diagnosis.The novel de novo mutation enriches the OCRL mutation spectrum.