SOX17,a member of the SOX family of transcription factors,is conserved in many species and plays an important role in the formation of embryo endoderm.A number of studies have found that SOX17 gene expression is silenced or decreased might be due to promoter bypermethylation,which plays a vital role in tumorigenesis and tumor progression,and may contribute to aberrant activation of canonical Wnt signaling pathway in several human malignant tumors.

The degree of satisfaction of the curriculum is related not only to the degree of the curriculum but also to the degree of the students' development. With the concept of teaching reform micro system engineering, using the SIMPP analysis of the degree of satisfaction of the curriculum, the relevant factors of the students are studied. The results show that, the learning state, learning objec-tives, and the education level of mother affect the students more easily on the curriculum satisfaction. Research shows, in the present curriculum condition, educators should guide the students to study hard, establish a clear and reasonable learning goal, give the students the introduction and analysis of the curriculum, can effectively improve the students on the curriculum satisfaction, enhance the enthusiasm of the study.

Academic diligence level can not only directly affect the academic performance of students, but also affect the individual's emotional and physical health. In this study, through a question-naire survey of university students, with the method of SIMPP and the concept of the micro system engi-neering in higher education teaching reform, the related factors of diligence and the college students' behavior mode with respect to diligence are systematically analyzed. Analysis shows that, students' diligence level is affected not only by inherent factors such as clear learning objectives, learning state and after-school learning time, but also by the school ethos, the influence factors of the curriculum and parents' re-quirements.

Objective To explore the relationship between parental authority,parental psychological control, parental attachment and medical students' social anxiety, and to provide theoretical guidance for medical students' mental health.Methods 2105 medical students were assessed with the social phobia inventory (SPIN), Parental authority questionnaire (PAQ), Parental psychological control questionnaire, Inventory of parent attachment (IPA).Results The mean SPIN score of social anxiety was 17.75 ± 10.47.Girls scored higher than boys,but there were no statistically significant differences between them( 17.97±10.44 vs 17.29 ± 10.52, t =1.305, P=0.192).Rural medical students scored higher than urban students,and the difference had statistical significance (19.47 ± 10.60 vs 15.85 ± 10.01, t = 7.478, P ＜ 0.01 ).Stepwise regression revealed that, for urban students' anxiety, father communication and mother authoritative/flexible were protective factors, father unconscionable emotional response, mother alienation, father unconscionable viewpoint and mother communication were risk factors; and for rural students' anxiety father communication was protective factor, mother alienation and mother authoritarian were risk factors.Conclusion Factors such as parental authority, parental psychological control and parental attachment will affect medical students' social anxiety.But the factors are not same between urban and rural.So these factors are considered when carrying out health education for parents.

Disasters are traumatic events that are always incongruent with our existing cognitive structures. Immediate negative psychological impact and traumatic related psychiatric disorders are popular among survivals involving the disasters. Super-half of survivals involving the "5" 12" Wenchuan earthquake experienced the symptoms of anxiety or increased arousal. 12.59% of survivals were met with the ASD diagnosis. 21.29% of adults and 10.21% of adolescents were met with the PTSD diagnosis 5 months after the major earthquake. Immediately negative psychological impact and high prevalence of traumatic related psychiatric disorders among survivals were confirmed.More effort should be paid on the disaster related patients in emergency department with psychiatric issues. Also, the long-term psychological service is necessary for Sichuan Pest-Disaster Reconstruction Projects.

The aim of the experimental teaching educational reform is to improve teaching quality of pathology and increase the ability of linking theory with practice.The educational reform wag carried out by analyzing clinical pathological cases and integrating basic preclinical medicine mode.Through the educational reform,the students were guided to shape a whole medical knowledge system with the center of organ pathological change,and know well the learning method of connecting each subject,and the teaching quality of pathology Was thus successfully improved.

Objective To evaluate the clinical effect of endoscopic sphineterotomy (EST) and endoscopic sphincterotomy associated with traditional Chinese medicine in the treatment of intrahepafic duct stones.Methods Eighty patients with common bile duet stones and intrahepatic duct stone were randomly divided into a treatment group and a control group.EST associated with traditional Chinese medicine was performed in the treatment group,and EST only was used in the control group.Clinical effects were observed.Results Common bile Duet stone clearance was achieved in 94% patients in the treatment group,contrasting 88% in the control group.There was no significant difference between them (P＞0.05).While intrahepatic duct stone clearance was 74% and 28% respectively in the treatment group and the control group,showing significant difference (P＜0.05).Conclusion It is a good way that endoscopic sphincterotomy associated with traditional Chinese medicine treating intrahepatic duct stones.

Purpose To discuss the clinical pathological features, diagnosis and differential diagnosis, treatment and prognosis of pri-mary breast diffuse large B-cell lymphoma ( DLBCL) . Methods 7 cases of primary breast DLBCL were collected, their clinical path-ological characteristics and immunophenotypes were also observed, and the treatment and prognostic factors were discussed. Results All of the 7 patients were women, aged 28~75 years, with the median 51 years. 5 cases involved left breast, 2 cases were located in the right breast. Painless mammary mass and ipsilateral axillary lymphadenopathy were the commonest clinical manifestations. On mi-croscopic observation, tumor cells were large to medium-sized which characterized as diffuse infiltration between the lobules of mamma-ry gland, around the duct, interstitial and fat tissue, some were single file cord pattern. 1 case was ALK-1 positive DLBCL, 6 cases were DLBCL of the non special type. The immunophenotype showed 5 cases were of non-GCB, 2 cases were of GCB type. Ki-67 index were from 60% to 95%. According to Ann Arbor staging, 2 cases were stage I EA, 5 cases were stage II EA. IPI score:4 cases with 0 score, 3 cases with 1 score. Of 7 patients, one case was modified radical mastectomy, 4 cases were lumpectomy, 2 cases were diag-nosed by core needle biopsy. 2 patients died without chemotherapy, 5 patients were chemotherapy or radiotherapy for 4 to 6 cycles ( CHOP/R-CHOP) , 4 patients received complete response, one died. Patients were followed up from 1 to 114 months, the median fol-low-up time was 18 months. The 1 year OS rate was 57. 1%, 5 years OS rate was 14. 3%. Conclusion The diagnosis of primary breast DLBCL is confirmed by pathological biopsy and immunohistochemical markers. The immunophenotype was mainly non-GCB type. Comprehensive treatment including chemotherapy and radiotherapy is appropriate. The prognosis should be comprehensively eval-uated by multiple factors.

Objective:To evaluate the efficacy of chemotherapy for advanced biliary tract carcinoma and the factors that influence sur-vival. Methods:A total of 91 cases of advanced biliary tract carcinoma from January 2010 to April 2015 were enrolled in our study. The patients' characteristics, chemotherapy regimens, and effects were analyzed. Results:We enrolled 56 males and 35 females with a me-dian age of 57 years. A total of 90 patients were assessable for their responses to first-line chemotherapy. A total of 69 patients re-ceived the GP regimen, whereas 21 patients received some other regimens. The disease control rate (DCR), median progression free survival (mPFS), and median overall survival (mOS) were 68.1%versus 52.4%, 5.10 months versus 2.50 months (P=0.025), and 13.00 months versus 7.20 months, respectively. Only 31 patients received S-1 based regimens, and 12 patients received some other regi-mens as second-line chemotherapy. The DCR, median PFS, and median OS showed no statistical differences. Only four patients re-ceived S-1 based regimen plus bevacizumab as second-line chemotherapy (median PFS 5.3 months;median OS 7 months). Hematologi-call toxicity was the most common side effect in the first-line GP regimen. The side effects of the S-1 based chemotherapy regimen was relatively less. Conclusion:The GP regimen is an effective first-line chemotherapy for advanced biliary tract carcinoma, whereas S-1 ap-pears as an effective second-line chemotherapy drug. Bevacizumab-based regimens may be effective and require further validation.

Objective To investigate effect of trepibutone tablet combined with ursodeoxycholic acid in treatment of patients with gallstone. Methods 200 cases with gallstone were diagnosed and randomly divided into observation group and control group from February 2013 to February 2014.100 cases in control group were given ursodeoxycholic acid treatment 50 mg/(kg? d),two times per day for six month.On the basis of control group observation group were treated with trepibutone one tablet per day,three times per day,4 weeks for 1 course, 2 weeks of treatment interval between 4 courses, totally for four courses.After treatment, patients were followed up and recorded gallbladder wall thickness, gallbladder functional status. Results After 6 months of treatment in patients with gallbladder wall thickness of observation group ( 2.77 ±0.38 ) mm was superior to control group (3.24 ±0.36)mm(P<0.05).After 6 months of treatment in patients with gallbladder function score of observation group (58.75 ±4.79) was better than control group (53.11 ±5.02) ( P<0.05).Recurrence rate of observation group was 9% better than that of control group 18%(χ2 =3.468,P<0.05)after treatment for 6 months.Conclusion Effect of trepibutone tablet combined with ursodeoxycholic acid in treatment of patients with gallstone is well.There is no obvious side effects during the treatment.