Objective To observe the clinical effect of hyperbaric oxygen and electrocoagulation in the treatment of venous ulcers on legs.Methods 36 patients with venous ulcer on legs were divided into group A of 12 cases,group B of 12 cases and group C of 12 cases.Group A was treated by hyperbaric oxygen and electrocoagulation;group B was treated by hyperbaric oxygen;group C was treated by electrocoagulation.The operation method:every one had been performed electrocoagulation,and performed improved Linton operation if traffic vein valve had functional disorder,and performed wearing ring operation if vein reflux exceed Ⅲ °.Results The time of healing:group A was ( 18.00 ± 4.66) days,group B was (28.20 ± 6.42 ) days and group C was (31.32 ± 4.88 ) days.The time was significantly different between the two groups( A and B,P ＜0.01 ;A and C,P ＜0.01 ; B and C,P ＜ 0.05).29 cases had been investigated by 6 to 40 months,the venous ulcers on legs had no recurrence.Conclusion The treatment for venous ulcer on legs by hyperbaric oxygen and electrocoagulation was a new therapy which had advantage of healing quickly and less recurrence,It ought to be popularized.

Objective To discuss the etiology and treatment of extrahepatic biliary stenosis due to iatrogenic bile duct injuries. Methods A total of 12 cases of extrahepatic biliary stenosis after iatrogenic bile duct injuries(including 5 cases of open cholecystectomy and 7 cases of laparoscopic cholecystectomy) from January 1998 to January 2005 in this hospital was reviewed.After the establishment of a percutaneous transhepatic access,choledochoscopic stone removal,balloon dilatation,and drainage stent placement were performed for treating biliary stenosis.Results A F_(20) Gruntzig balloon catheter was employed for bile duct dilatation.The plastic drainage stent at 6~8 mm in diameter was successfully placed after 2 times of dilatation in 8 cases and after 3 times of dilatation in 4 cases,for 6~12 months of indwelling.Follow-up observations in the 12 cases for 2~3 years (mean,2.6 years) found no abdominal pain,fever,or jaundice.B-ultrasonography and MRCP findings showed no biliary stenosis and recurrent stones.Conclusions Choledochoscopic stone removal,balloon dilatation,and drainage stent placement are minimally invasive,safe,and effective in the treatment of extrahepatic biliary stenosis.

Objective To investigate methods and effects of percutaneous choledochoscopy via cholangio-jejunal anastomotic stoma in the treatment of recurrent intrahepatic biliary duct stones. Methods Eight cases of recurrent intrahepatic biliary duct stones after a Roux-en-Y cholangiojejunostomy from January 2000 to February 2005 were treated with percutaneous choledochoscopy. An enterostomy was made at the afferent jejunal loop. Then a choledochoscope was introduced into the intrahepatic biliary ducts by way of the cholangio-jejunal anastomotic stoma for stone removal and intrahepatic duct or anastomotic stoma dilatation. Results The intrahepatic stones were thoroughly removed in all the 8 cases. The biliary duct stenosis in 4 cases and the anastomotic stoma stenosis in 2 cases were relieved. Follow-up checkups in the 8 cases for 1~3 years revealed no recurrence of intrahepatic stones or stenosis. Conclusions Percutaneous choledochoscopy via cholangio-jejunal anastomotic stoma is minimally-invasive, safe, feasible, and effective in the treatment of recurrent intrahepatic biliary duct stones.

Objective To assess the dagnostic value of computed tomography(CT) for recurrent carcinoma of larynx after operation. Methods 45 CT cases of recurrent carcinoma of larynx were analysed retrospective and were compared with pathology results.Results CT was capable of demonstrating the existence,border and range of the recurred tumor and showing the information about inetastasis in lymph node of neck,the involved throat space and the invaded blood vcsscls in cervical.Conclusion CT is an cxact,rcliable and convenient method to evaluate the recurrence of larynx carcinoma,and is helpful to make therapy planning.

This paper discussed on current medical education situation in UK through introducing the concept,method and system.Medical education in UK takes students as the center of education,emphasizes humanistic education and cultivates medical students' eloquence,clinical skills and scientific research.Medical education in UK sheds light on how to mobilize students' subjective initiative,improve communication skills and clinical skills,which medical education in china can draw lessons from.

Objective To evaluate the efficacy and adverse effects of gefitinib as the first line treatment in elderly patients with lung adenocarcinoma.Methods 81 elderly patients of previously untreated advanced lung adenocarcinoma,who were non-smokers and unsuitable for chemotherapy,received gefitinib treatment until disease progression or intolerable toxicities occurred.The curative effect performance status of improvement and adverse effects were observed.Results All of the patients were evaluable.Partial response rate and stable disease rate of gefifinib were 25.9 ％ (21/81) and 48.1％ (39/81),respectively.55.5 ％ (45/81)of patients had performance status improved after treatment.Conclusion Gefitinib has curative effect and is well tolerated in the treatment of elderly patients with previously untreated advanced lung adenocarcinoma.

Objective To investigate the changes and clinical significance of T-lymphocyte subsets in the treatment of advanced lung adenocarcinoma. Methods Ninety six patients with advanced lung adenocarcinoma who underwent treatment in Xuanwu Hospital Capital Medical University from October 2015 to May 2016 were selected as the subjects. There were 63 cases in the transferred group and 23 cases in the un-transferred group. The peripheral blood was taken, then flow cytometry was used to detect CD3+, CD3+CD4+, CD3+CD8+, CD4+/CD8+, CD3-CD16+CD56+(NK), CD8+CD28+, CD8+CD28-, Treg cells, CD3+γδ, and the results were analyzed statistically. Results The levels of CD3+γδand Treg cells in the transferred group were significantly higher than those in the un-transferred group (6.56±3.11 vs. 3.05±2.23; 25.83±6.22 vs. 20.81±9.03) (t=1.590, P=0.026; t=2.027, P=0.044). The level of CD45RA+in the effective group (52.15 ±7.99) was significantly lower than that in the untreated group (70.26 ±17.33) (t= 1.660, P= 0.024). Conclusion The detection of peripheral blood T-lymphocyte subsets in treatment of patients with advanced lung adenocarcinoma has a certain value in predicting the therapeutic effect and prognosis.

Objective To investigate the clinical significance of intraperitoneal perfusion of IL-2 combined with Addi injection for ascites re-growth control after decompression of abdominal compartment syndrome induced by malignant ascites.Methods 69 patients with abdominal compartment syndrome induced by malignant ascites,after tube decompression and paracentesis,were given intraperitoneal perfusion therapy,and they were randomly divided into two groups.42 cases in the observation group were given with 0.9％ sodium chloride injection 50mL + IL-23 millions u and Addie injection 50-60mL,once a week,a total of 2-3 times;27 cases in the control group were given with 0.9％ sodium chloride injection 50mL and cisplatin 40mg,once a week,a total of 1-3 times.Results In the observation group,CR 25 cases (59.5％),PR 11 cases (26.2％),NC 6 cases (14.3％),the total effective achieved in 36 cases (85.7％).In the control group,CR 11 cases (40.7％),PR 6 cases (22.2％),NC 10 cases (37.0％),the total effective achieved in 17 cases (62.96％).The effective rate of the observation group was significantly better than that of the control group,there was statistically significant difference(x2 =4.78,P ＜ 0.05).The qualities of life of the observation group were improved,8 cases were stable,lower in 2 cases,the effective rate was 76.2％,which of the control group were improved,10 cases were stable,lower in 4 cases,the effective rate was 48.1％.The effective rate of the observation group was significantly better than that of the control group,there was statistically significant difference (x2 =5.70,P ＜ 0.05).Conclusion Intraperitoneal perfusion of IL-2 combined with Addi injection for ascites control after decompression of abdominal compartment syndrome induced by malignant ascites is a new method,which is worthy of clinical application.

Objective To investigate the expression of hypoxia inducible factor 1α (HIF-1α) and glucose transporter 1 (GLUT1) in lung adenocarcinoma and its correlation with tumor metastasis. Methods SP immunohistochemistry was used to detect GLUT1 and HIF-1α protein expression in 125 lung adenocarcinoma, including 41 cases without metastasis, 38 cases with lymphatic metastasis and 46 cases with brain metastasis. The correlation of GLUT1 and HIF-1α in lung adenocarcinoma metastasis was analyzed by using x 2 test and Pearson correlation analysis. Results Most lung adenocarcinoma were histologically heterogeneous, which contained more than one adenocarcinoma type. 73.2 % (30/41) cases were acinar predominant adenocarcinoma in lung adenocarcinoma without metastasis; 53.6 % (15/38) cases were acinar predominant adenocarcinoma and 26.3 % (10/38) cases were solid predominant adenocarcinoma in lung adenocarcinoma with lymphatic metastasis; 47.8 % (22/46) cases were papillary predominant adenocarcinoma and 34.8 % (16/46) cases were solid predominant adenocarcinoma in lung adenocarcinoma with brain metastases. The expression level of GLUT1 and HIF-1α in lung adenocarcinoma with lymphatic metastasis group was higher than that of the group without tumor metastasis (P< 0.05); the expression of GLUT1 and HIF-1α were positively correlated (r=0.407, P=0.000). Conclusions Papillary adenocarcinoma is the most histological type in lung adenocarcinoma with brain metastasis, suggesting that papillary adenocarcinoma is more prone to brain metastasis. The expression of GLUT1 and HIF-1α play an important role in lymph node metastasis and brain metastasis of lung adenocarcinoma.

Objective To evaluate the antitumor effects of interferon (IFN)γ-endostatin based gene radiotherapy in a metastatic breast tumor model of mice, and to elucidate the possible mechanisms involved. Methods Murine mammary adenocarcinoma 4T1 cells transfected with pEgr-IFN-γ and pEgrendostatin plasmids were irradiated with 2-20 Gy of X-rays. IFN-γ and endostatin levels in the culture supernatants were measured. Female BALB/c mice were inoculated with 1 × 105 of 4T1 cells by mammary fat pad injection, and divided randomly into control, empty vector, gene therapy (pEgr-IFN-γ and pEgrendostatin), radiotherapy, and combined gene-radiotherapy groups. Tumor/body weight ratio, lung metastases, and survival of the tumor-bearing mice were observed. Splenic cytotoxic T-lymphocyte (CTL)and natural killer (NK) cell activity and intratumor microvessel density were also assessed. Results Irradiation significantly enhanced the section of IFN-γ and endostatin from the transfected 4T1 cells.Compared with gene therapy or radiotherapy alone, combined gene-radiotherapy resulted in the maximal attenuation in tumor growth rate, lung metastases and increased survival. The activities of CTL and NK cells were significantly enhanced and intratumor microvessel density reduced ( t = 2. 120-22.140, P ＜ 0.05 ).Conclusions IFN-γ-endostatin-based gene-radiotherapy could provide a potential antitumor effect in a murine metastatic breast tumor model, which may be related to IFN-γ-stimulated CTL and NK cell activation, and endostatin-induced antiangiogenic activity. Gene-radiotherapy could serve as a neoadjuvant therapy for the locally advanced breast cancer.