A comparison teaching experiment was carried out in grade 2001 and grade 2002.The students majoring in clinical medicine in these two grades were taught surgery with graphical approach and traditional method respectively.The student number,the test marks and the survey by questionnaire show that graphical teaching approach is more attractive with its visualization and originality it can stimulate students' interests in learning,develop their thinking and improve their clinical analytic ability.It is an important approach to improve clinical teaching quality to lay a good foundation for students before their clinical practice.

Objective To evaluate the efficacy and safety of lentinan injection plus cisplatin (LIC) in the treatment of malignant pleural effusion (MPE).Methods We searched the database of Cochrane Library,PubMed,EMBASE,ISI Web of Knowledge,Chinese Biomedical Literature Database,Chinese Scientific Journals Full-text Database,Chinese Journal Full-text,and Google Scholar,etc.,up to February 28th,2011 to identify randomized controlled trials (RCTs) about lentinan injection (LI) for MPE,evaluate the quality of the included studies,and analyze the data by Cochrane Collaboration's RevMan5.0 software.Results Twenty-nine RCTs involving 1831 patients were included.Meta analysis results suggested that there were some differences when comparing LIC with control groups suffering from MPE,for LIC could improve the near-term curative effect and the quality of life to some extent.Besides,compared with chemotherapy alone,LI plus chemotherapy had an advantage in relieving adverse reactions,such as gastrointestinal reactions,myelosuppression,chest pain,and general malaise.Conclusion The current evidence indicates that LI may have adjuvant therapeutic effects for MPE.

OBJECTIVE To study the antitumor activity and underlying mechanisms of Xiaoaiping injection(Xap)combined with gefitinib(Gef)in nude mice bearing resistant non-small cell lung cancer (NSCLC) cells H460 or H975. METHODS BALB/c nude mice were inoculated with human NSLCL cells H460 or H1975 and the drug treatment did not start until the tumor volume reached 50-100 mm3. The tumor bearing mice were divided into four groups:control group,Xap group(5 g · kg-1,ip),Gef group (50 mg · kg-1,ig),and Xap plus Gef group. All the administration lasted for 21 d continuous. Tumor volumes were measured two or three times per week,and the body weight of animals was re-corded. At the end of the test,tumors were weighed after the sacrifice of mice. Tumor inhibition rate and relative tumor proliferation rate were calculated based on tumor weight and tumor volume. The related biomarkers and proteins in tumor tissues were detected by immunohistochemistry and Western blot assay, respectively. RESULTS Compared with the control group,no significant effect was observed on the growth of H460 and H1975 xenografts in groups of Xap or Gef alone in nude mice. However,the two-drug combination significantly suppressed tumor volume,with (1103 ± 340) versus (3020 ± 450) mm3 for H460 and(487 ± 153)versus(1269 ± 161)mm3 for H1975,respectively(P<0.05). The combined Xap and Gef application also significantly reduced the tumor weight,with(1.20±0.52)versus(2.78± 0.93)g for H460 and(0.52 ± 0.32)versus(0.92 ± 0.42)g for H1975,respectively(P<0.05). The relative tumor proliferation rate and inhibition rate in the combination group was 42.1%and 43.5%for H460(P<0.01),43.0%and 52.5% for H1975(P<0.01). Compared with Xap and Gef drug alone,their combination showed significant difference in reducing tumor weight,suppressing tumor proliferation rate and increasing tumor inhibition rate(P<0.05). Immunohistochemistry results showed that each drug alone had no effect on tumor angiogenesis markers of vascular endothelial growth factor(VEGF)and CD105 expression,or on drug resistance related proteins of p-ERK,p-Akt and p-mTOR,whereas the combination of Xap and Gef obviously reduced the expression of these biomarkers in H460 and H1975 tumor tissues. The decreased drug resistance related proteins of p-PI3K and its downstream molecules p-Akt,p-ERK and p-mTOR by the two-drug combination were also confirmed by Western blot results(P<0.01,compared with control), and showed significant difference compared with each single treatment(P<0.05). CONCLUSION The addition of Xap significantly improves the antitumor activity of Gef in H460 and H1975 xenografts,and this synergistic effect may be ascribed to the inhibition of tumor angiogenesis,the down-regulation of PI3K and its downstream signaling molecules which are associated with drug resistance.

OBJECTIVETo study the efficacy and safety of brucea javanica oil emulsion (BJOE) combining platinum-contained first-line chemotherapy in treating non small cell lung cancer (NSCLC).

METHODCochrane library, PubMed, EMBASE, VIP, CBM and CNKI were searched through computers. The search was finished in February, 2011. Randomized controlled trials (RCTs) of BJOE combining platinum-contained first-line chemotherapy were included. Two researchers extracted data and assess literature quality separately,and made a meta-analyses by RevMan 5.1.2 software.

RESULTTotally 22 RCTs involving 1512 patients were included. The Meta-analysis showed that compared with the pure application of platinum-contained first-line chemotherapy,the combination of BJOE and chemotherapy can enhance the near-term curative effect (RR = 1. 31, 95% CI: 1.18-1.45, P < 0. 000 01), improve the quality of life (RR = 1.78, 95% CI: 1.51-2. 09, P < 0.00001) and reduce the suppression of bone marrow (OR = 0.37, 95% CI: 0. 27-0. 51, P < 0.00001) and the gastrointestinal reactions (OR = 0.59, 95% CI: 0.44-0.80, P = 0.0007) ,with an improvement in organism immunity.

CONCLUSIONThe current evidence indicates that BJOE can enhance the chemotherapeutic effect on NSCLC patients, improve the quality of life and reduce adverse effect of platinum-contained chemotherapeutics and thus it is worth referring in clinic.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Brucea ; chemistry ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; Emulsions ; administration & dosage ; Female ; Humans ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Organoplatinum Compounds ; administration & dosage ; Phytotherapy ; Randomized Controlled Trials as Topic ; Young Adult