Objective To observe the effect of recurrent thyroid cancer patients treatment with radiotherapy,chemotherapy particle implantation after targeted therapy.Methods 16 thyroid cancer patients after radiotherapy and operation relapsed were seldcted.The patients were randomly divided into the treatment group and the control group,the patients in the treatment group treated with radiotherapy,chemotherapy combined with implantation of targeted for their treatment,through the treatment plan effective vaginal B ultrasound guided,in the 5-FU Sustained-release chemotherapy particle and a 125(I)particle in alternating fashion to the implant,the patients of control group treated with chemoradiation therapy.Results 16 patients were all successfully operated.On postoperative patients during the followup for half a year,the treatment group adopted CT reexamined patients tumor can be narrowed,which completely in 2 cases,partial remission in 5 patients,1 patient had no significant changes compared with the control group,the difference was statistically significant;follow-up of 1 year,prior treatment groups of all patients are in the survival condition,the control group had 1 patient died.Conclusion For recurrent thyroid cancer patients given radiotherapy and chemotherapy,combination with particle implantation targeted treatment,have good effect,which belongs to an effective means of treatment,can be widely used in clinical.

Objective To investigate the expression of R-spondin3(RSPO3)in breast cancer and its prognostic value.Methods TIMER,The Cancer Genome Atlas(TCGA),Gene ExpressionProfilling In-teractive Analysis 2(GEPIA2),Human Protein Atlas(HPA)and other databases were used to analyze the differential expression of RSPO3 in breast cancer tissues and normal tissues around cancer,and analyze the correlation between its expression level and pathological parameters of breast cancer;then the expression and structural characteristics of RSPO3 transcripts in breast cancer were investigated by GEPIA2database;Kaplan-Meier Plotter was used to plot the prognosis survival curve between RSPO3 and breast cancer patients;gene ontology(GO)and kyoto encyclopedia of genes and ge-nomes(KEGG)were used for gene function enrichment analysis and metabolic pathway analysis;TIMER database was used to analyzed the relationship between RSPO3 expression level and immune cell infiltration in tumor microenvironment.Results RSPO3 was low ex-pressed in breast cancer,and its expression level was related to the age,tumor diameter and molecular type of breast cancer patients.The low expression of RSPO3 in breast cancer was related to poor prognosis of patients;the results of GO function enrichment analysis showed that RSPO3 interacting genes were mainly enriched in biological processes involving immune cells and their receptors;the results of im-mune cell infiltration analysis showed that the expression level of RSPO3 in breast cancer tissue was positively correlated with the infiltra-tion level of CD8+T cells,CD4+T cells,CD4+T cell memory,macrophages,B cells,etc.It was negatively correlated with the infiltra-tion level of Treg;the results of KEGG metabolic pathway analysis showed that RSPO3may be involved in Wnt/β-catenin pathway.Conclusion Low expression of RSPO3 in breast cancer is related to the poor prognosis of patients,which may be involved in the progres-sion of breast cancer through inhibition of immune cell infiltration and activation of Wnt/β-catenin pathway.

Objective To investigate whether the colonoscopy skills could be retained after the endoscopy simulator training,and to find evidence for curriculum design.Methods A total of 14 trainees received virtual reality simulator colonoscopy training and took a standardized VR colonoscopy test at the end of training and at 6 months later without practice during the time period.Results Scores drastically decreased at 6 months after training when compared to those right after the training.Although there was no difference in safety or accuracy,there was significant difference in the residual air volume,intestinal loop and procedure time.Conclusion Some skills acquired by using the Endoscopy Simulator can be retained,but other skills may be lost,which requires more practice.

[摘 要] 目的：探讨circ_0072088对甲状腺癌IHH4细胞恶性生物学行为的影响及其可能的机制。方法：选取2015年4月至2019年3月于青海大学附属医院就诊的确诊为甲状腺癌后接受切除手术且术前未进行任何治疗的48例甲状腺癌患者的甲状腺癌组织及其对应癌旁组织。根据GEO数据集（GSE93522）分析鉴定甲状腺乳头状癌中差异表达的circRNA。用qPCR法检测circ_0072088在甲状腺癌组织和细胞中的表达水平。采用CCK-8法和Transwell法检测circ_0072088和miR-532-3p过表达对甲状腺癌IHH4细胞增殖、迁移和侵袭的影响。采用生物信息学和双荧光素酶报告基因实验验证甲状腺癌细胞中circ_0072088与miR-532-3p、miR-532-3p和WEE1基因之间的关系。结果：circ_0072088在甲状腺癌组织和细胞中呈高表达（P<0.05或P<0.01）。circ_0072088过表达促进了甲状腺癌细胞的增殖、迁移和侵袭（P<0.05或P<0.01），而转染 miR-532-3p模拟物能够减弱这种作用（P<0.05或P<0.01）。此外，机制研究表明，circ_0072088可以与miR-532-3p靶向结合，且WEE1是miR-532-3p的下游靶基因。结论：circ_0072088通过调控miR-532-3p/WEE1轴促进IHH4细胞的增殖、迁移和侵袭。