Through discussing the connotation of medical humanities spirit and the current situation of medical humanities education in our country, the authors put forward that in clinical practice, respiratory medicine interns medical ways for the cultivation of the humanistic spirit, which include: guide the trainee doctors in treating pa-tients alike, on the basis of understanding and respect for life and death;to cultivate the ability of effective commu-nication between patient and physician internship; interns cultivated the spirit of collaboration and leadership skills;the in-depth, on the basis of clinical practice, in practice the doctor to write a detailed records;construc-tion of a high level of teacher love team, set an example for the students.

Objective: To evaluate 3D imaging technology in the preoperative evaluation of breast conserving surgery. Methods: A ret-rospective analysis was conducted using clinical data from 38 patients who underwent breast conserving surgery that was assisted by 3D imaging technology in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from April 2017 to January 2019. All 38 patients underwent 3.0-T breast magnetic resonance imaging (MRI) examination before surgery, and 3D reconstruction of virtu-al images was constructed through 3D modeling of medical digital imaging and communication (DICOM) data. The predicted resected tissue volume was compared with the volume of the actual resected specimen, and the surgical margin and postoperative aesthetics of the breast conserving surgery were evaluated. Results: The reconstructed 3D model clearly displayed the anatomical structures of the breast, tumor, gland, and blood vessels, and their relationship in 3D spaces. The goodness of fit of the 3D model to the practical sit-uation was 97.4% (37/38). In terms of the resection tissue volume, there was no significant difference between the predicted results (PRTV) and actual results (ARTV) [(61.7 ± 20.1) mL vs. (65.1 ± 20.7) mL, P>0.05]. There was a strong positive correlation between ARTV and PRTV (P<0.01). One patient underwent supplementary secondary surgery, resulting in an incidence of 2.6% (1/38). The postopera-tive satisfaction for breast conserving surgery was 100% (38/38). Conclusions: 3D imaging technology clearly displays the anatomical relationship between breast tumor and surrounding tissues, and correctly assesses breast volume, guiding surgical resection.

Objective To explore the impact of clinical treatment decisions on the long-term survival of different molecular subtypes of locally advanced breast cancer(LABC),and to promote the development of more effective and individualized treatment regimens for LABC.Methods The cases of LABC diagnosed by pathology from 2010 to 2015 were searched in the database.Breast cancer-specific survival(BCSS)and overall survival(OS)were estimated by plotting Kaplan-Meier curves.The log rank test(Mantel-Cox)was used to analyze the difference between the groups,and the benefit population of LABC was determined after for age,TNM stage,grade,treatment methods.Results The 5-year OS and BCSS were 77.43％and 84.34％in breast-conserving,and 68.03％and 76.90％in mastectomy,respectively.The 5-year OS and BCSS of Luminal A LABC were 79.91％and 87.23％in breast-conserving,and 71.78％and 81.16％in mastectomy,respectively.The 5-year OS and BCSS of Luminal B LABC were 79.30％and 83.14％in breast-conserving,and were 70.37％and 76.92％in mastectomy,respectively.The 5-year OS and BCSS of triple-negative LABC were 60.77％and 68.13％in breast-conserving,and those of mastectomy were 47.13％and 55.94％,respectively.The 5-year OS and BCSS of HER2 positive were 75.42％,82.05％in breast-conserving,and were 67.05％and 75.01％in mastectomy,respectively;The 5-year OS and BCSS of triple-positive LABC were 86.12％and 91.63％in breast-conserving,and 74.54％and 82.56％in mastectomy,respectively.The 5-year OS and BCSS of well differentiated and N0 triple-positive LABC patients with chemotherapy were 88.24％and 76.91％,and those of patients without chmotherapy were 88.24％and 90.91％,respectively(BCSS:P=0.812;OS:P=0.311).Conclusion In the selective population,OS and BCSS of patients with LABC undergoing breast conserving surgery were significantly better than those of mastectomy.When OS and BCSS were compared for different molecular types and stages of LABC,breast-conserving surgery was still superior to total mastectomy.LABC could be considered for highly differentiated,N0 stage Triple positive without chemotherapy.

Objective To analyze the factors influencing axillary lymph-node metastasis(ALNM)in microinvasive breast cancer(MIBC)patients,as well as to establish the risk-prediction model of ipsilateral ALNM in MIBC patients.Methods A total of 4475 primary female MIBC diagnosed by pathology from 2010 to 2015 were searched and screened from the SEER database.The obtained data were used to establish a prediction model for ALNM of MIBC.A total of 2266 primary female MIBC patients diagnosed by pathology from 2018 to 2020 in the SEER database were screened as the external validation cohort.The clinicopathological data of the enrolled MIBC patients were collected.Univariate analysis was used to screen out the factors affecting ALNM in MIBC patients.Statistically significant variables in univariate analysis were included in multivariate logistic regression analysis.The independent factors influencing ALNM in MIBC patients were screened out,and a nomogram was established.The area under the curve(AUC)was calculated by plotting the ROC curve.After plotting the calibration curve,the model was evaluated by Hosmer-Lemeshow goodness-of-fit test.Results A total of 309 patients were diagnosed with ipsilateral ALNM among the 6741 MIBC patients,accounting for about 4.58%.Univariate analysis of the modeling group showed that age,ethnicity,histological grade,pathological type,molecular subtype,and lateral side were associated with ALNM in MIBC patients(P<0.05).Results of multivariate analysis showed that the risk of ALNM was higher in MIBC patients≤40 years old,black people,histological grade Ⅱand Ⅲ,and primary right side(P<0.05).Subtype is an independent factor influencing ALNM in MIBC patients.However,the difference in ALNM risk was not statistically significant between the subtype of HR+HER2+,HR-HER2+,HR-HER2-and HR+HER2-subtypes.The AUC of the modeling group was 0.716(95%CI:0.682-0.750),the best cut-off value was 0.045,the sensitivity was 0.733,and the specificity was 0.608.The newly established nomogram model was used for the validation cohort,and its AUC was 0.722(95%CI:0.667-0.777).The P values of the Hosmer-Lemeshow goodness-of-fit test of the calibration curves in the modeling and validation groups exceeded 0.05.Conclusion The risk-prediction model of ALNM in MIBC patients established by the SEER database has good predictive ability and can thus be expected to serve as a reference for clinical practice.

Objective: To study the mRNA expressions of various CD97 isoforms in colorectal carcinoma tissues and their clinical significances. Methods: A total of 50 colon cancer patients in the First Affiliated Hospital of Wenzhou Medical University from December 2013 to May 2014 and human colon cancer cell lines SW480 and SW620 were enrolled. The real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the mRNA expressions of CD97 human epidermal growth factor (EGF) (1, 2, 5), CD97EGF (1, 2, 3, 5) and CD97EGF (1, 2, 3, 4, 5) in colon cancer tissues, adjacent tissues, normal colon tissues, SW480 cells and SW620 cells. The relationship between the mRNA expression of CD97EGF (1, 2, 5) and the clinicopathological factors was analyzed. Results: Compared with those low expressions in adjacent tissues and normal tissues, the mRNA expressions of CD97 isoforms CD97EGF (1, 2, 5), CD97EGF (1, 2, 3, 5) and CD97EGF (1, 2, 3, 4, 5) in cancer tissues were highest, and the differences were statistically significant (0.71±0.20 vs. 0.40±0.09 vs. 0.35±0.07, F = 107.642, P < 0.01; 0.45±0.11 vs. 0.26±0.05 vs. 0.27±0.06, F = 94.231, P < 0.01; 0.41±0.10 vs. 0.21±0.05 vs. 0.19±0.03, F = 165.672, P < 0.01). In addition, the mRNA expression of CD97EGF (1, 2, 5) in colon cancer patients was associated with tumor infiltration depth (T₁-T₂ and T₃-T₄), clinical stages (Ⅰ-Ⅱ and Ⅲ-Ⅳ), and the differences were statistically significant (t = -2.582, P = 0.013; t = -5.062, P < 0.01). The mRNA expression of CD97EGF (1, 2, 5) in SW620 cells was higher than that in SW480 cells. Conclusions CD97 isoforms are highly expressed in colon cancer tissues, and CD97EGF (1, 2, 5) may play an important role in the development and invasion of colon cancer. The CD97 isoforms may be new markers in the treatment of colon cancer.