0.05).The optimal combination was PCR-CTPP for MDR1 C3435T and PCR-SSP for G2677T/A.Conclusions PCR-CTPP and PCR-SSP are simple,accurate,rapid and economical methods for detection of SNP of MDR1 C3435T and G2677T/A,and can be applied in clinical research.

Objective To investigate the association of genetic polymorphisms in glutathione S-transferases T1 (GSTrl), M1 (GSTM1) and P1 (GSTP1) with aristolochic acid nephropathy (AAN) of Chinese people in Wenzhou of China. Methods Fifty-nine patientswith AAN (AAN group) including 29 male and 30 female as well as 157 healthy ethnically matched controls (control group) including 93 male and 64 female were enrolled in this study. The genotypes of GSTT1, GSTMI and GSTP1 were determined by multiple PCR and confronting two-pair primers PCR (CTPP-PCR). Results The genotype frequencies of GSTP1 were in Hardy-Weinberg equilibrium. Compared with the healthy controls, the frequency of GSTT1 null genotype was significantly higher in the patients with AAN (66.1% vs 48.4%,P＜0.05). Risk of A.AN for individuals with GSTT1 null genotype was 1.747 fold of those without GSTIl null genotype (95% CI=0.818-3.731). The frequency of GSTM1 null genotype, GSTP1 variant genotypes and GSTP1 G allele in the patients and in the controls were 40.7%, 28.8%, 16.1% and 47.8%, 31.8%, 17.5%, respectively, which were not significantly different. No significant differences were found in prevalence of GSTM1 and GSTP1 gene distribution between patients and controls. Conclusion GSTrl gene polymorphism appears to be associated with susceptibility to AAN in Southern China.

Objective:To investigate the application of three-dimensional image reconstruction combined with problem-based learning (PBL) in the teaching of physicians receiving continuing education in thoracic surgery.Methods:A total of 68 physicians who received continuing education in Department of Thoracic Surgery in our hospital were selected as research subjects, and they were divided into control group and observation group using a random number table, with 34 physicians in each group. The physicians in the control group received traditional teaching, while those in the observation group received three-dimensional image reconstruction combined with PBL teaching. A questionnaire survey, theoretical assessment, and assessment of practical skills were performed to evaluate the effect of teaching. SPSS 22.0 was used to perform the t-test. Results:Compared with the control group, the observation group had significantly higher degrees of satisfaction with each item of the questionnaire survey ( P<0.05). Compared with the control group, the observation group had significantly higher scores of theoretical assessment [(94.07±6.03) vs. (86.34±5.46), P<0.001] and the assessment of practical skills [(95.20±5.48) vs. (84.71±6.14), P<0.001]. Conclusion:The application of three-dimensional image reconstruction combined with PBL teaching can help to improve the comprehensive ability of physicians receiving continuing education.

Objective:To discuss the practice and application of "artificial intelligence + big data" in the construction of thoracic surgery golden course.Methods:The intern students of the Department of Thoracic Surgery in Harbin Medical University Cancer Hospital were selected as the research objects, and they were randomly divided into 2 groups with 36 cases in each group. The control group was taught with regular courses, and the observation group was taught by the golden course system under "artificial intelligence + big data". After the course, self-made assessment forms were used to assess the academic performance (theoretical knowledge assessment results and skill operation assessment results) of the two groups of medical students. The excellent and good rate of knowledge mastery and the mastery of clinical operation techniques were scored by the teachers, and the evaluation was made from the aspects of learning attitude, the mastery degree of theoretical knowledge and clinical operational techniques, etc. In addition, self-made innovative thinking ability scale was used to assess the medical students. SPSS 22.0 was used for independent samples t test and chi-square test. Results:There was no statistically significant difference between the two groups of theoretical knowledge assessment scores and skill operation assessment scores before the teaching; after the course, the theoretical knowledge assessment scores and skill operation assessment scores of the control group were higher than those before the teaching, with statistically significant differences ( t=5.37, 4.17, P<0.05). After the course, the theoretical knowledge assessment scores and skill operation assessment scores of the observation group were higher than those before the teaching, with significant differences ( t=10.93, 8.24, P<0.05). The results of theoretical knowledge assessment and skill operation assessment in the observation group were significantly higher than those in the control group after the course ( t=7.10, 5.77, P<0.05). In the control group, 17 cases were excellent in knowledge mastery, accounting for 47.22%, and the rate of knowledge mastery was 83.33% (30/36); in the observation group, 26 cases were excellent in knowledge mastery, accounting for 72.22%, and the excellent and good rate of knowledge mastery was 100% (36/36), and the difference was statistically significant ( χ2=4.55, P=0.033). After the course, the innovative thinking ability of the control group was higher than that before the teaching, the innovative thinking ability of the observation group was higher than that before the teaching, and the innovative thinking ability of the observation group was higher than that of the control group, and the difference was statistically significant ( t=7.07, P<0.001). Conclusion:The use of the "artificial intelligence + big data" golden course to build a teaching system can improve the academic performance, knowledge mastery and innovative thinking ability of medical students.

Immunotherapy, represented by immune checkpoint inhibitors, may lead to immune-related adverse events (irAEs) while demonstrating favorable efficacy in patients with malignant tumors. Many domestic and international guidelines or consensus have been established to assist clinicians in effectively managing the majority of irAEs. However, further exploration about irAEs is required regarding the definition and determination, temporal patterns, individual variances, utilization of hormones and immunosuppressants, correlation between irAEs and therapeutic outcomes, immune reactivation, and special populations. The identification and management of severe, refractory, and multiple irAEs necessitate additional solutions. This paper aims to clarify 10 prominent issues concerning irAEs individually and provide assistance for clinicians.