At present,there are many problems in the cultivation for the young clinicians including lack of subjective initiative,insufficient innovation education.This paper analyzed the current status of the academic and charactersfic training of the young clinicians then put forward new training methods which can be used for reference.Developing prominent features and novelty is the most important way to implement the aforementioned training methods.

Objective To investigate the relationship among CEA, CA199, clinical pathological characteristics and prognosis in patients with rectal cancer. Methods A total of 142 patients diagnosed rectal cancer were collected for the study between January 2006 and December 2010. The clinical data including age, sex, size of tumor, differentiation, depth of tumor (T), lymph node metastasis (N), distant metastasis (M), lymphatic invasion, venous invasion, stage, and preoperative serum levels of CEA and CA199 were obtained. Patients′ follow-up ranged from 42 months to 90 months. Results Preoperative elevated CEA levels were significantly associated with distant metastasis (P < 0.05). Median overall survival time was 150 weeks in the group with normal preoperative CEA and CA199, and 101 weeks in the group with preoperative abnormal preoperative CEA and/or CA199, and Kaplan-Meier analysis showed that the difference was significant between two groups (P = 0.031). Conclusion Elevated preoperative CEA level can predict distant metastasis. The patients with abnormal preoperative CEA and/or CA199 have shorter overall survival time.

Objective To investigate the antitumor mechanism of astragaloside combine with cetuximab on the colon cancer cell line RKO of EGFR over expression through cell proliferation and autophagy. Methods The cell proliferation of colon cancer cell line RKO intervened by astragaloside with or without cetuximab was detected by 4- methyl- teerazolium (MTT). The expressive changes for protein of EGFR 、P62 and LC3 in RKO cells was detected by western bolt. Results MTT showed that 100 ug/mL astragaloside combined with 120 ug/mL cetuximab had significantly inhibiting effect on RKO cells of EGFR expression. Western blot showed that astragaloside can affect the expression of P62 and LC3 to suppress the occurrence ofautophagy. Conclusion In the vitro studies showed that astragalosidecan enhance the antitumor cell proliferation of cetuximab through inhibit autophagy in the treatment of colon cancer.

Objective:To investigate the association between the single nucleotide polymorphisms(SNPs) of transporter associated with interleukin2(IL-2),interleukin4(IL-4)and the susceptibility of hepatitis B in north China.Methods:Genomic DNA was extracted from the peripheral blood leukocytes of hepatitis B patients and healthy controls.Two fragments covering -330 of the IL-2 gene and -590 of the IL-4 gene were amplified by polymerase chain reaction (PCR).The SNPs were revealed by restriction fragment length polymorphism (RELP).Software PHASE 1.0was used to construct the haplotype of every individual.Unconditional Logitic regression model was used to analyze the statistical association of genotype or haplotype in two groups adjusted by gender and age.Results:There was significant difference in the SNPs of IL2 between the healthy controls and the heptitis B patients in north China.Significant difference was also found in the combination of --/GT to the two groups.Conclusion:SNPs of IL2(-330) may have relation to the susceptibility o heptitis B.--/GT was also related to the susceptibility of heptitis B.These findings suggest that SNPs of IL2 is one of the important host factors to the infection of the heptitis B.

Exosomes are cell-derived vesicles and have biological activity.The diameter of exosomes is between 30 and 120 nm.Exosomes participate in the invasion,metastasis and multi-drug resistance of malignant tumors.In the field of radiotherapy,it has been proven that radiation-induced changes in the secretion of exosomes from tumor cells can affect intercellular communication and enhance the radiotherapy resistance of tumor cells.In this article,the research progress on exosomes in the radiotherapy for malignant tumors was reviewed.

Objective To investigate the effect of tripterine combined with fluorouracil on the proliferation,invasion and apoptosis of human hepatocellular carcinoma Hep3B cells,and to identify whether the combining application of the two drugs has synergistic inhibitory effect.Methods The Hep3B cells were divided into blank control group,tripterine (2.5 mol/L) treated group,fluorouracil (25 g/ml) treated group and combined treated group (2.5 mol/L of tripterine and 25 g/ml of fluorouracil) by random number table method.Proliferation,invasion and apoptosis of different drugs treated Hep3B cells were assessed by MTS,Transwell assay,and flow cytometry,respectively.The migration differences of the four groups were detected by the scratch assay.Finally,the levels of the proliferation-related proteins p-AKT,p-ERK and the apoptosis-related proteins cleaved caspase-3 and Bax were detected by Western blotting at 24 and 48 h.Results Compared with the blank control group,the cell proliferation rate (24 h:0.305％ ± 0.016％ vs.0.768％ ± 0.063％;48 h:0.201％ ± 0.008％ vs.1.111％ ± 0.037％),and the cell migration rate (24 h:0.20％ ± 0.03％ vs.0.40％ ± 0.04％,48 h:0.25％ ± 0.02％ vs.0.59％ ± 0.07％) of combined treated group decreased (P＜0.01),while the cell apoptosis rate (24 h:24.33％ ± 3.85％ vs.3.80％ ± 0.40％,48 h:45.10％ ± 4.10％ vs.8.47％ ± 1.65％) significantly increased (P＜0.01).Compared with the blank control group,the cleaved caspase-3 (24 h:1.39 ± 0.11 vs.1.01 ± 0.04,48 h:1.38 ± 0.12 vs.0.99 + 0.03) and Bax (24 h:1.35 ± 0.13 vs.1.00 ± 0.08,48 h:1.39 ± 0.09 vs.0.99 ± 0.05) protein expression of combined treated group significantly increased (P＜0.05).After 24 h of the intervention,the number of cell invasionin (15 ± 6 vs.231 ± 38) the combined group was significantly lower than that in the blank control group (P＜0.05).The protein expression of p-AKT/AKT (0.79 ± 0.04 vs.0.99 ± 0.05) and p-ERK/ERK (0.52 ± 0.04 vs.0.75 ± 0.07) in the combined group was significantly lower than that in the fluorouracil group 48 h after the intervention (P＜0.05).Conclusions The combination application of 5-FU and Tripterine on Hep3B cells significantly inhibited the cells proliferation,migration and invasion ability and promoted the apoptosis of Hep3B cells by down-regulating the expression of p-AKT and p-ERK and up-regulating the expression of cleaved caspase-3 and Bax.

Objective:To investigate the relationship between preoperative plasma fibrin degradation products (FDP) level and clinicopathological features of patients with completely resected non-small cell lung cancer (NSCLC).Methods:A retrospective case series study was performed. The clinical data of 521 patients who were pathologically diagnosed with NSCLC in Beijing Friendship Hospital Affiliated to Capital Medical University from January 2016 to December 2017 were retrospectively analyzed. Among 521 cases, 406 cases were postoperatively pathologically confirmed as non-lymph node and non-distant metastasis (non-metastasis group) and 115 cases were postoperatively pathologically confirmed as lymph node or distant metastasis (metastasis group). The preoperative FDP level and clinicopathological characteristics as well as the clinicopathological characteristics of NSCLC patients with different FDP levels were compared between the two groups. The correlation between preoperative FDP level and TNM staging was analyzed by using Spearman correlation analysis.Results:Among 521 NSCLC patients, 266 cases were female, 255 cases were male; the age [ M( Q1, Q3)] was 59 years (54 years, 65 years); 441 cases were adenocarcinoma and 70 cases were squamous cell carcinoma. The preoperative median FDP level was 2.78 mg/L (2.35 mg/L, 3.13 mg/L) and 2.99 mg/L (2.56 mg/L, 4.16 mg/L), respectively of NSCLC patients in non-metastasis group and metastasis group, and the difference was statistically significant ( Z = 6.13, P < 0.001). The preoperative FDP level was 2.56 mg/L (2.35 mg/L, 3.20 mg/L) and 2.99 mg/L (2.56 mg/L, 3.20 mg/L), respectively in the early-stage NSCLC (stage Ⅰ-Ⅱ) and advanced NSCLC (stage Ⅲ-Ⅳ) patients, and the difference was statistically significant ( Z = 8.42, P < 0.001). Spearman correlation analysis showed that preoperative FDP level was positively correlated with tumor diameter ( r = 0.287, P < 0.001). There was a positive correlation between preoperative FDP level and the number of metastatic lymph nodes in 115 patients with lymph node metastasis ( r = 0.679, P < 0.001). According to the preoperative median FDP (2.78 mg/L), all patients were divided into FDP ≤2.78 mg/L group and FDP >2.78 mg/L, and there were statistically significant differences in age, metastasis, tumor staging, tumor diameter, the metastatic number of lymph node and histological types of NSCLC patients in both groups (all P < 0.05). Conclusions:The increase of preoperative plasma FDP level may be related to the tumor metastasis and clinical stage of NSCLC patients

OBJECTIVETo explore the safety and efficacy of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing chemotherapy-induced neutropenia in patients with breast cancer and non-small cell lung cancer (NSCLC), and to provide the basis for clinical application.

METHODSAccording to the principle of open-label, randomized, parallel-group controlled clinical trial, all patients were randomized by 1∶1∶1 into three groups to receive PEG-rhG-CSF 100 μg/kg, PEG-rhG-CSF 6 mg, or rhG-CSF 5 μg/kg, respectively. The patients with breast cancer received two chemotherapy cycles, and the NSCLC patients received 1-2 cycles of chemotherapy according to their condition. All patients were treated with the combination chemotherapy of TAC (docetaxel+ epirubicin+ cyclophosphamide) or TA (docetaxel+ epirubicin), or the chemotherapy of docetaxel combined with carboplatin, with a 21 day cycle.

RESULTSThe duration of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg and PEG-rhG-CSF 6 mg groups were similar with that in the rhG-CSF 5 μg/kg group (P>0.05 for all). The incidence rate of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group, and G-CSF 5 μg/kg group were 69.7%, 68.4%, and 69.5%, respectively, with a non-significant difference among the three groups (P=0.963). The incidence rate of febrile neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg/kg group were 6.1%, 6.4%, and 5.5%, respectively, showing no significant difference among them (P=0.935). The incidence rate of adverse events in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg / kg group were 6.7%, 4.1%, and 5.5%, respectively, showing a non-significant difference among them (P=0.581).

CONCLUSIONSIn patients with breast cancer and non-small cell lung cancer (NSCLC) undergoing TAC/TA chemotherapy, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF at 48 hours after chemotherapy show definite therapeutic effect with a low incidence of adverse events and mild adverse reactions. Compared with the continuous daily injection of rhG-CSF 5 μg/kg/d, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF has similar effect and is more advantageous in preventing chemotherapy-induced neutropenia.

Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; Breast Neoplasms ; drug therapy ; Carboplatin ; administration & dosage ; adverse effects ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Cyclophosphamide ; administration & dosage ; adverse effects ; Epirubicin ; administration & dosage ; adverse effects ; Female ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Humans ; Incidence ; Induction Chemotherapy ; Lung Neoplasms ; drug therapy ; Neutropenia ; chemically induced ; epidemiology ; prevention & control ; Polyethylene Glycols ; Recombinant Proteins ; administration & dosage ; Taxoids ; administration & dosage ; adverse effects