Objective:To investigate the current situation of junior medical students'cognition on the relationship between doctors and patients,and to provide reference for medical students'medical education and medical education reform,Methods:Self-made questionnaire was adopted to investigate the cognitive status of doctor-patient relationship among junior medical students from three medical universities in Guangzhou.Results:Totally 41.04％ of junior medical students had a basic understanding of doctor-patient relationship,and the degree of understanding of doctor-patient relationship is not different between junior and senior medical students (P ＞ 0.05);76.62％ of medical students got acquainted with the status of doctor-patient relationship mainly through the media;86.57％ of junior medical students thought that the doctor-patient relationship was tense.The cognition of doctor-patient relationship between male and female students was similar (P ＞ 0.05),and so wasit between freshmen and sophomores (P ＞ 0.05).Male and female students had the same opinion on the future trend of doctor-patient relationship (P ＞ 0.05).Many junior medical students were optimistic about the future doctor-patient relationship.Compared with freshmen,sophomore medical students were less optimistic about the future doctor-patient relationship (P ＜ 0.05).Medical students mostly agreed on the causes of medical disputes (P ＞ 0.05),believing that the main reason was the medical system.Conclusions:The cognition of the doctor-patient relationship profoundly affects the junior medical students as well as their choices of future employment and communication styles between patients and them,which may have important significance for avoiding medical disputes.Society,schools and the media should actively create a good atmosphere for the doctor-patient relationship.

OBJECTIVETo investigate the association between MDR1 gene expression in breast cancer stem cells and the molecular subtypes of breast cancer tissue.

METHODSAccording to ER, PR, Her-2 and CK5/14 expression profiles, 153 breast cancer specimens were divided into 5 molecular molecular subtypes, in which the expression of MDR1 was detected to analyze the relationship between MDR1 gene expression and the subtypes of breast cancer stem cells.

RESULTSThe expression of MDR1 in Luminal A subtype breast cancer was 0.26∓0.04, which showed no significant difference from that of Luminal B subtype (0.31∓0.03, P>0.05). Compared with these two subtypes, HER-2 (+) subtype breast cancer tissues showed a significantly higher MDR1 expression(0.56∓0.05, P<0.05). MDR1 expression in Basal-like subtype and Normal-like subtype breast cancers was comparable (0.98∓0.01 vs 0.90∓0.15, P<0.05), but both significantly higher than that in Luminal A and B subtypes and HER-2 (+) subtype (P<0.05).

CONCLUSIONThe expression of MDR1 gene in cancer stem cells is related with the molecular subtypes of breast cancer tissue.

ATP Binding Cassette Transporter, Sub-Family B ; ATP-Binding Cassette, Sub-Family B, Member 1 ; genetics ; metabolism ; Adult ; Breast Neoplasms ; genetics ; metabolism ; Female ; Humans ; Middle Aged ; Neoplastic Stem Cells ; metabolism

OBJECTIVETo investigate the expression of methionine sulfoxide reductase (MsrA) in colorectal cancer stem cells and its association with the tumorigenesis and progression of colorectal cancer.

METHODSThe CD133⁺/CD44⁺/ESA⁺ subpopulation of colorectal cancer cell line SW480 was obtained by magnetic activated cell sorting (MACS). The expression of MsrA, VEGF, MMP-13 and CXCR4 in the cancer cells, cancer stem cells and normal colon mucosa cells were detected using RT-PCR. The proliferation of colorectal cancer stem cells was evaluated with MTT assay.

RESULTSThe expression of MsrA was significantly higher in cancer stem cells than in the cancer cells and normal mucosa cells. Overexpression of MsrA inhibited the proliferation of colorectal cancer stem cells and down-regulated the expression of VEGF, MMP-13 and CXCR4.

CONCLUSIONSMsrA suppresses the tumorigenesis and progression of colorectal cancer cells possibly by inhibiting cell proliferation and down-regulating VEGF, MMP-13 and CXCR4.

Cell Line, Tumor ; Cell Proliferation ; Colorectal Neoplasms ; enzymology ; Down-Regulation ; Humans ; Matrix Metalloproteinase 13 ; metabolism ; Methionine Sulfoxide Reductases ; metabolism ; Neoplastic Stem Cells ; enzymology ; Receptors, CXCR4 ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism

Objective To investigate the expression of methionine sulfoxide reductase (MsrA) in colorectal cancer stem cells and its association with the tumorigenesis and progression of colorectal cancer. Methods The CD133+/CD44+/ESA+subpopulation of colorectal cancer cell line SW480 was obtained by magnetic activated cell sorting (MACS). The expression of MsrA, VEGF, MMP-13 and CXCR4 in the cancer cells, cancer stem cells and normal colon mucosa cells were detected using RT-PCR. The proliferation of colorectal cancer stem cells was evaluated with MTT assay. Results The expression of MsrA was significantly higher in cancer stem cells than in the cancer cells and normal mucosa cells. Overexpression of MsrA inhibited the proliferation of colorectal cancer stem cells and down-regulated the expression of VEGF, MMP-13 and CXCR4. Conclusions MsrA suppresses the tumorigenesis and progression of colorectal cancer cells possibly by inhibiting cell proliferation and down-regulating VEGF, MMP-13 and CXCR4.

Objective To investigate the expression of methionine sulfoxide reductase (MsrA) in colorectal cancer stem cells and its association with the tumorigenesis and progression of colorectal cancer. Methods The CD133+/CD44+/ESA+subpopulation of colorectal cancer cell line SW480 was obtained by magnetic activated cell sorting (MACS). The expression of MsrA, VEGF, MMP-13 and CXCR4 in the cancer cells, cancer stem cells and normal colon mucosa cells were detected using RT-PCR. The proliferation of colorectal cancer stem cells was evaluated with MTT assay. Results The expression of MsrA was significantly higher in cancer stem cells than in the cancer cells and normal mucosa cells. Overexpression of MsrA inhibited the proliferation of colorectal cancer stem cells and down-regulated the expression of VEGF, MMP-13 and CXCR4. Conclusions MsrA suppresses the tumorigenesis and progression of colorectal cancer cells possibly by inhibiting cell proliferation and down-regulating VEGF, MMP-13 and CXCR4.

OBJECTIVETo explore the feasibility of subserosal injection of carbon nanoparticle via venous infusion needle to label lymph node and its application value in laparoscopic radical gastrectomy.

METHODSForty patients with gastric cancer were randomly divided into two groups (carbon nanoparticle group and control group). Subserosal injection of carbon nanoparticle around the tumor was performed via venous infusion needle laparoscopically at the beginning of surgery in carbon nanoparticles group, while the patients routinely underwent laparoscopic radical gastrectomy in control group. Results of harvested lymph nodes were compared between the two groups. The perioperative complications and the side effect of carbon nanoparticle were also evaluated.

RESULTSThe average number of harvested lymph node in carbon nanoparticle group (31.7±7.6) was significantly higher than that in control group (19.8±6.1, P<0.05). The proportion of harvested small node (< 5 mm) in carbon nanoparticles group(61.0%) was higher than that in control group(43.3%, P<0.01). The mean harvest time in carbon nanoparticle group [(23.5±4.8) min] was shorter than that in control group [(32.6±5.5) min, P<0.05]. The rate of black-dyed harvested lymph node was 61.9% and the metastasis rate of black-dyed lymph node was 23.0% in carbon nanoparticle group, which were significantly higher than those without black-dyed(6.2%, P<0.05) and those in control group (15.7%, P<0.05). The operative time and perioperative complications were not significantly different between the two groups, and no serious side effect caused by carbon nanoparticle was observed.

CONCLUSIONSubserosal injection of carbon nanoparticle via venous infusion needle to label lymph nodes during laparoscopic radical gastrectomy is safe and feasible. It can increase the number of harvested lymph node, especially the small node.

Adult ; Aged ; Carbon ; administration & dosage ; Female ; Gastrectomy ; methods ; Humans ; Injections, Intravenous ; Laparoscopy ; Lymph Node Excision ; methods ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Nanoparticles ; administration & dosage ; Prospective Studies ; Staining and Labeling ; Stomach Neoplasms ; surgery

Objective: To analyze the effect of body mass index (BMI) on the number of lymph nodes (LNs) harvested in patients who underwent colorectal cancer resection. Methods: A retrospective analysis of 328 patients with colorectal cancer who were treated at Fujian Provincial Hospital between December 2014 and January 2017 was conducted. All patients underwent colorectal cancer resec-tion and were assigned into 2 groups:<12-LN group and≥12-LN group. Potential clinicopathological variables that might influence the number of LNs harvested were statistically analyzed. Results: Univariate analyses demonstrated that BMI (χ2=7.697, P=0.006), tumor location (χ2=7.900, P=0.048), and TNM stage (χ2=34.795, P<0.01) affected the number of LNs harvested. Logistic regression analysis re-vealed that BMI of≥25 kg/m2 and rectosigmoid location were associated with 2.557-and 1.731-fold increases in the number of LNs harvested, compared with BMI<25 kg/m2 group and other tumor locations, respectively. Conclusions: Higher BMI may decrease the number of LNs harvested in patients who underwent colorectal cancer resection and could affect the postoperative pathological stage. K

Objective To explore the feasibility of subserosal injection of carbon nanoparticle via venous infusion needle to label lymph node and its application value in laparoscopic radical gastrectomy. Methods Forty patients with gastric cancer were randomly divided into two groups (carbon nanoparticle group and control group). Subserosal injection of carbon nanoparticle around the tumor was performed via venous infusion needle laparoscopically at the beginning of surgery in carbon nanoparticles group, while the patients routinely underwent laparoscopic radical gastrectomy in control group. Results of harvested lymph nodes were compared between the two groups. The perioperative complications and the side effect of carbon nanoparticle were also evaluated. Results The average number of harvested lymph node in carbon nanoparticle group (31.7±7.6) was significantly higher than that in control group (19.8±6.1, P<0.05). The proportion of harvested small node (< 5 mm) in carbon nanoparticles group (61.0%) was higher than that in control group (43.3%, P<0.01). The mean harvest time in carbon nanoparticle group [(23.5±4.8) min] was shorter than that in control group [(32.6±5.5) min, P<0.05]. The rate of black-dyed harvested lymph node was 61.9% and the metastasis rate of black-dyed lymph node was 23.0% in carbon nanoparticle group, which were significantly higher than those without black-dyed (6.2%, P<0.05) and those in control group (15.7%, P<0.05). The operative time and perioperational complications were not significantly different between the two groups, and no serious side effect caused by carbon nanoparticle was observed. Conclusion Subserosal injection of carbon nanoparticle via venous infusion needle to label lymph nodes during laparoscopic radical gastrectomy is safe and feasible. It can increase the number of harvested lymph node , especially the small node.

Objective:To evaluate the value of implementing a modified reverse puncture procedure for esophagojejunostomy during totally laparoscopic total gastrectomy.Methods:This was a descriptive case series. Relevant clinical data, including the operative procedure, recovery, and pathological findings of 35 patients with gastric cancer who had undergone esophagojejunostomy with a modified reverse puncture technique during totally laparoscopic total gastrectomy in the Department of Gastrointestinal Surgery, Fujian Provincial Hospital, from June 2022 to January 2023, were prospectively collected and retrospectively analyzed. The age of all patients in the group was (64.9±8.0) years old, with 22 males (62.9%) and a body mass index of (23.2±2.4) kg/m 2. The tumors were located in the upper and middle parts of the stomach in 24 cases (68.6%) and in the junction of the esophagus and stomach in 11 cases (31.4%). Important technical aspects of the modified reverse puncture procedure are as follows. (1) Site of the esophageal incision: a transverse incision is made across the right lateral wall of the esophagus at the expected site of esophageal disjunction. (2) Technique for inserting an anvil: after threading a silk thread through the tip of anvil, the end of the thread is knotted and fixed as the traction thread, after which an anvil is inserted into the esophagus through the esophageal incision, leaving the end of the traction line exposed. Next, a 60-mm linear cutter is placed through the right midclavicular trocar to straighten the opened esophagus vertically, after which the rod of the anvil is pulled out of a small incision that has been made in the esophagus by pulling the traction thread, thus completing anvil placement. (3) Jejunal binding: the jejunum on the central bar of the stapler is fastened with silk thread to the stump of the jejunum, and then tied to the output loop of the jejunum with a gauze strip. Results:All 35 surgeries were successful, with no mortality or conversion to laparotomy. The operation time, anvil insertion time, and digestive tract reconstruction time were (232.7±34.4), (8.5±1.4), and (40.5±4.8) minutes, respectively. The intraoperative blood loss was 100 (20–250) mL and the incision was (5.3±0.9) cm long. The upper surgical margin was negative in all patients and the mean distance between the upper and tumor margins was (3.5±1.2) cm. The mean number of lymph nodes dissected per patient was 33.9±7.1. The times to initial ambulation, initial passage of flatus , postoperative fluid intake, and length of postoperative hospital stay were (3.2±1.1), (3.7±1.5), (4.6±2.3), and (9.8±3.2) days, respectively. Postoperative complications occurred in five patients: one case of anastomotic leak, two of anastomotic stenosis, one of pulmonary infection, and one of incomplete intestinal obstruction, all of which were successfully managed conservatively.Conclusion:Esophagojejunostomy using a modified reverse puncture technique during totally laparoscopic total gastrectomy is safe and feasible for gastric cancer, requiring only a small incision and achieving higher upper esophageal resection margins and good postoperative recovery, and therefore warrants further implementation.