555 medical vocational students were surveyed with questionnaire to data regarding their employment intentions. The study showed that the employment rate in basic-level medical organizations and the degree of job satisfaction of college students were low. The main factors were economic benefits, living environment, hospital equipment status, self-awareness. Therefore, in order to encourage medical vocational students to choose basic-level medical organizations, it is important to train health talents which is suitable for the grass-roots level, develop basic-level medical organization service qualities and pays more attention to the employment guidance in higher vocational schools, which can help medical vocational students cultivate proper views of employment.

Objective To understand the molecular mechanism underlying the epidermal growth factor receptors(EGFR)signal transduction and its feed-back regulation.Methods Two human keratinocyte cell lines,HaCaT and CHOwt,were cultured and treated with a certain concentration of different ligands,including epidermal growth factor(EGF),heparin-bounding(HB)-EGF,transforming growth factor α (TGFα)and heregulin(HER),for various durations(2,4,8,16,20 hours).After the treatment,cells were collected and protein was extracted.The amount of total and active EGFR was measured by immunoprecipitation and immunoblot assay.The internalization and down-regulation of EGFR were visualized with immunofluorescence and laser seanning confocal microscopy.Results As shown by immunoblot technique,EGF and HB-EGF continuously down-regulated the total amount of EGFRs,whereas TGFα and HER had no significant effect on the degradation of EGFRs.The activation of EGFRs was also attenuated to different extent after long-time treatment with EGF,HB-EGF and TGFα.As indirect immunofluorescenee revealed,in untreated HaCaT and CHOwt cells,EGFRs were essentially located at the plasma membrane,with a little cytosolic distribution;after ten-minute treatment with EGF,EGFRs clustered into patch-like structures which were particularly obvious in HaCaT cells,and translocated into cytoplasmic vesicles resembling endosomes (relatively apparent in CHOwt cells),while the total amount of EGFRs remained constant in these cells.The fluorescence signal from the total EGFRs decreased evidently after four-hour treatment with EGF,indicating a strong reduction in the receptors.Conclusions EGF and HB-EGF,but not TGFα or Heregulin,could down-regulate the amount of total and active EGFRs.There might be different mechanisms for the signal transduction related to EGFRs intemalization and down-regulation between HaCaT and CHOwt cells.

Objective To investigate the performance of surgical management in facial skin malignancies.Methods From January 2000 to December 2006,65 patients with facial skin malignancies,including47 cases of basal cell carcinoma.10 cases of squamous cell carcinoma,3 cases of dermatofibrosarocoma protuberans,2 cases of malignant melanomas,and one case of malignant acanthoma,hemangioendotheliosar-coma and sebaceous carcinoma,respectively,were collected and managed with wide resection followed by reconstruction.In order to achieve a thorough resection,frozen sections were prepared and subjected to pathological examination during the operation process to ensure the margins of resection were free of malignancy.Reconstruction was carried out by direct closure,or with local random flaps,extended flaps,free skin grafts.Resuits All defects were managed by one-stage reconstruction.The survival rate of skin flaps/grafts was 100%,and a satisfactory appearance and function was achieved.During the follow-up from 6 months to 5 years,local relapse was observed in one patient with basal cell carcinoma and one with squamous eell carcinoma,lymphatic metastasis in one with squamous cell carcinoma.Distant metastasis occurred in a patient with malignant melanoma.who died consequently.Conclusions Thorough resection is the key to prevent relapse of facial skin malignancies after surgery.Appropriate reconstruction may favor the restoration of facial appearance,and local random flaps appear to be the best reconstruction strategy.

Objective To investigate the associations of a single-nucleotide polymorphisms (SNPs) in the interleukin (IL)-6 gene with the migraine of a Han Chinese northeastern population.Methods We collected 252 patients of the migraine attack,who were diagnosed at People' s Hospital of Liaoning Province from March 2012 to June 2013,all being Han nationality in the northeast of China.At the same time,we collected 270 healthy people over the same period who had health examination or were healthy workers of People' s Hospital of Liaoning Province.We used polymerase chain reaction and gene sequencing to analyze the genotype and allele frequencies of the-572G/C (rs1800796) IL-6 polymorphisms between migraine cases (n =252;including migraine without aura (MO) group (n =168) and migraine with aura group (n =84);the male group (n =109) and the female group (n =143)) and control group (n =270;the male group (n =116) and the female group (n =152)),as well as analyzed the genotype and allele frequencies distribution between the subgroups.Results We found higher frequencies of the distribution of the C/C genotype and the C allele of the-572G/C polymorphism in migraine cases than in control group (32.54％ (82/252) vs 19.63％ (53/270),x2 =12.061,P =0.002;55.56％ (280/504) vs 45.37％ (245/540),x2 =10.818,P =0.001),higher distribution frequencies of the C/C genotype and the C allele in female group (21.83％ (55/252) vs 12.59％ (34/270),x2 =10.187,P =0.006;33.73％ (170/504) vs 26.48％ (143/540),x2 =10.073,P =0.002).Between MO group and controls,these distribution frequencies had statistically significant difference (24.60％ (62/252) vs 19.63％ (53/270),x2 =18.172,P=0.000;39.88％ (201/504) vs 45.37％ (245/540),x2 =17.307,P=0.000).After correction by conditional Logistic regression,the frequency distribution difference of the C/C genotype between the migraine cases and controls remained statistically significant (OR =22.861,95％ CI 5.218-27.098,P =0.023).Conclusion Our data indicate that the SNPs of the IL-6 are associated with migaine and the C/C genotype increases the migraine susceptibility in a Han Chinese northeastern population.

AIM:To detect the expression of basic fibroblast growth factor (bFGF) and matrix metalloprotei-nase 9 (MMP9) in nasopharyngeal carcinoma (NPC) and its correlation with clinicopathological features and prognosis of the patients.METHODS:The expression of bFGF and MMP9 was detected by the method of SP immunohistochemical staining in biopsy tissues of NPC patients.The relationship between the expression and the clinical significance was analyzed as well.RESULTS:In 289 cases of NPC patients, the positive rates of bFGF and MMP9 were 71.3% and 61.6%, respectively.Correlation analysis demonstrated that the expression rates of bFGF and MMP9 were both positively associated with N stage and clinical stage in NPC patients.The high expression rates of both bFGF and MMP9 were associated with poor overall survival and progression-free survival of NPC patients.Furthermore, the positive rate of bFGF was positively correlated with that of MMP9, and over-expression of both bFGF and MMP9 was correlated with the poorest survival outcomes in NPC patients.CONCLUSION:bFGF and MMP9 are over-expressed in NPC tissues and significantly associated with NPC recurrence and poor outcome.The combined interpretation of bFGF and MMP9 expression levels leads to refinement of the risks for the NPC patients and could be chosen as the prognostic biomarkers.

[ ABSTRACT] AIM: To detect basic fibroblast growth factor ( bFGF ) expression in clinical common malignant tumor ( non-small-cell lung cancer,breast cancer, colon cancer and melanoma) , and to identify relationship between the expression and tumor clinicopathological characteristics.METHODS:Immunohistochemical SP method was used to detect the expression of bFGF at protein level in 208 cases of paraffin-embedded tissue of primary malignant tumor patients ( 68 cases of lung cancer, 80 cases of breast carcinoma, 41 cases of colon cancer and 19 cases of melanoma) .RESULTS:The bFGF protein expression levels were significantly higher in low differentiated non-small-cell lung cancer with lymph node metastasis, and were positively correlated with TNM.In addition, no significant influence of the bFGF protein expression on the patients with median survival period was observed.The protein expression of bFGF was higher in advanced breast cancer with lymph node metastasis and was commonly found in the middle/higher differentiated colon cancer with regional lymph node metastasis.Meanwhile, bFGF protein was highly expressed in advanced melanoma patients with lymph node metastasis.CONCLUSION:bFGF may participate in the process of occurrence and progression of malignant tumor.Ex-pression of bFGF protein may be an effective parameter for evaluating metastasis and prognosis of malignant tumor.

Objective:To explore the effect of combining motor imagery therapy (MIT) with kinesio taping in rehabilitating the upper limb motor function of stroke survivors.Methods:Ninety-two stroke survivors were randomized into a control group ( n=31), an MIT group ( n=31), and a combination group ( n=30). All were given 40 minutes of basic rehabilitation therapy daily, while the MIT group received additional MIT therapy, and the combination group received kinesio taping with the MIT therapy. The taping was applied according to a patient′s condition and changed every other day. The MIT was conducted twice a day. The experiment lasted 8 weeks, six days a week. Before and after the 8 weeks, the upper limb functioning, ability in the activities of daily living and muscle tension of each subject were assessed using the Fugl-Meyer assessment for the upper extremities (FMA-UE), the Hong Kong version of the functional test for a hemiplegic upper extremity (FTHUE-HK), the modified Barthel index (MBI) and the modified Ashworth scale (MAS). Results:The average post-treatment FMA-UE and MBI scores of the combination group were significantly higher than those of the MIT group, and both were significantly higher than the control group′s averages. The average FTHUE-HK grading of the combination group and MIT group after the treatment was significantly higher than in the control group, with that of the combination group significantly superior to the MIT group′s average. After the intervention the average MAS rating of the combination group was significantly lower than that of the control group.Conclusion:MIT combined with Kinesio taping can significantly improve the upper limb motor functioning of stroke survivors, and significantly reduce their abnormal muscle tone compared to traditional treatments.

OBJECTIVETo compare the efficacy and safety of 5 mg perindopril arginine salt and 4 mg perindopril tert-butylamine salt for patients with mild to moderate essential hypertension.

METHODSThe study was designed as multicenter, randomized, double-blind, active controlled trial with two parallel groups enrolling 524 participants with mild to moderate essential hypertension. After 2-week run-in period, 186 patients were enrolled and randomly treated with 5 mg perindopril arginine salt and 183 patients were enrolled and randomly treated with 4 mg perindopril tert-butylamine salt. The random sequence was generated by the I.R.I.S., and a balance was made in each center. After double-blind treatment for 8 weeks, the dose could be doubled for patients with uncontrolled BP ((SBP) ≥ 140 mmHg (1 mmHg = 0.133 kPa) or diastolic blood pressure (DBP) ≥ 90 mmHg) and patients were treated for another 4 weeks.

RESULTSThe sitting SBP was similarly decreased by (19.9 ± 17.2) mmHg in perindopril arginine group and (18.5 ± 14.7) mmHg (P = 0.000 5) in perindopril tert-butylamine group post 8 weeks treatment. Dose was doubled in 109 patients (59.9%) in perindopril arginine group and 116 patients (63.7%) in perindopril tert-butylamine group. At 12 weeks post therapy, the sitting SBP decreased by (19.8 ± 16.2) and (19.6 ± 16.3) mmHg respectively in the 2 groups. The decrease of sitting DBP was also similar in both groups (-12.0 ± 10.0) mmHg and (-11.0 ± 8.9) mmHg (P < 0.000 1), respectively. The control rate or response rate was also similar between the two groups (control rate over 8 weeks was 38.5% vs. 31.3%, 95% CI (-2.6-16.9), control rate over 12 weeks was 36.3% vs. 35.7%, 95% CI (-9.3-10.4), response rate over 8 weeks was 64.3% vs. 63.2%, 95% CI (-8.8-11.0), response rate over 12 weeks was 65.9% vs. 64.8%, 95% CI (-8.7-10.9)). Incidence of adverse events was low and similar in both therapy groups.

CONCLUSIONSThe results show that perindopril arginine salt 5 mg is as efficient as perindopril tert-butylamine 4 mg on lowering BP for patients with mild to moderate essential hypertension. Both drugs have good safety profile and are well tolerated by patients in this cohort.

Antihypertensive Agents ; Arginine ; Blood Pressure ; Butylamines ; Double-Blind Method ; Essential Hypertension ; Humans ; Hypertension ; Perindopril ; Sodium Chloride

Objective:The real-world clinical data of patients with newly diagnosed ovarian cancer (including fallopian tube cancer and primary peritoneal cancer) who received first-line maintenance therapy with poly adenosine diphosphate ribose polymerase inhibitor (PARPi) were retrospectively analyzed, and the prognostic factors were preliminarily explored.Methods:(1) The clinicopathological data and follow-up data of ovarian cancer patients treated with PARPi first-line maintenance therapy from August 2018 (PARPi was launched in China) to December 31, 2021 in Sichuan Cancer Hospital were collected (real-world clinical data). (2) According to the different types of PARPi, real-world clinical data were divided into olaparib group and niraparib group, which were respectively compared with the inclusion and exclusion criteria of representative domestic and foreign phase Ⅲ randomized controlled trials (RCT), including olaparib as first-line maintenance therapy for advanced ovarian cancer patients with BRCA1/2 gene mutation (SOLO-1 study), niraparib as first-line maintenance therapy (PRIMA study), and niraparib as first-line maintenance therapy for Chinese advanced ovarian cancer patients (PRIME study). (3) The prognosis of the two groups and the prognostic factors were analyzed.Results:(1) A total of 83 patients were included in this study, with a median age of 51 years (47-57 years), including 75 cases of ovarian cancer, 5 cases of fallopian tube cancer, and 3 cases of primary peritoneal cancer; 5 cases of stage Ⅰ, 9 cases of stage Ⅱ, 55 cases of stage Ⅲ, 12 cases of stage Ⅳ, and 2 cases of unknown stage; neoadjuvant chemotherapy (NACT) was performed in 40 cases and non-NACT in 43 cases; 62 cases had no visible residual lesion after surgery (R0), 9 cases had residual disease lesions <1 cm (R1), 8 cases had residual disease lesions ≥1 cm (R2), and 4 cases with unknown postoperative residual disease. Thirty-two cases had PARPi treatment interruption, 40 cases had PARPi reduction, and 1 case terminated treatment due to acute leukemia. Of the 83 patients, 35 were in the olaparib group and 48 were in the niraparib group. The proportion of patients with high-grade serous carcinoma (100% and 75%, respectively) and the proportion of BRCA mutant patients (91% and 10%, respectively) in the olaparib group were higher than those in the niraparib group (all P<0.01). (2) Compared with the inclusion and exclusion criteria of the SOLO-1 study, the olaparib group had only 60% (21/35) coincidence rate; compared with the inclusion and exclusion criteria of PRIMA and PRIME studies, the coincidence rates of niraparib group were only 31% (15/48) and 69% (33/48). The most common reasons for non-compliance were number of chemotherapy courses, histopathological type, and surgical pathological stage. (3) Of the 83 cases received first-line maintenance therapy with PARPi, the median follow-up was 15.9 months (11.3-22.9 months), the median progression-free survival (PFS) was 29.7 months (95% CI: 25.9-33.6 months), and the median overall survival was 49.8 months (95% CI: 47.4-52.2 months). Univariate analysis showed that unilateral or bilateral ovarian cancer, efficacy after platinum-containing chemotherapy, presence or absence of measurable lesions at the end of chemotherapy, and total number of chemotherapy courses were significantly associated with PFS (all P<0.05). Multivariate analysis showed that unilateral or bilateral ovarian cancer, total number of chemotherapy courses, and efficacy after platinum-containing chemotherapy were independent factors affecting PFS in stage Ⅱ-Ⅳ patients with PARPi first-line maintenance therapy (all P<0.05). Conclusions:Unilateral ovarian cancer, the total number of chemotherapy courses no more than 9, and achieving complete response after platinum-containing chemotherapy before maintenance therapy are independent influencing factors of PFS benefit in patients with PARPi first-line maintenance therapy. Due to the large differences between the patients in real clinical practice and the research subjects of phase Ⅲ RCT, the results of representative retrospective studies still have important clinical reference significance.

Objective:To introduce the technical essentials of cytoreduction surgery (CRS) with extensive peritonectomy （“rolling carpet” surgery） in stage Ⅲc epithelial ovarian cancer (EOC) and evaluate the feasibility and safety of the operation by analyzing the incidence of surgical complications and perioperative mortality.Methods:From December 2017 to December 2019, 30 patients with stage IIIc EOC who underwent “rolled carpet” CRS and 30 patients who underwent traditional CRS at the same period in Sichuan Cancer Hospital were collected. To summarize the key points of “rolled carpet” CRS operation technology, i.e. the extraperitoneal space was the cut path of ovarian cancer operation, and the tumor in the pelvic cavity was dissociated from the extraperitoneal space of the pelvic cavity. The tumor in the pelvic cavity and all the implants or potential metastases on the parietal peritoneum were removed completely. The clinical and pathological characteristics between the two groups were analyzed retrospectively, and the feasibility and safety of “rolling carpet” CRS were evaluated by comparing the operation related indexes and the occurrence of surgical complications between the two groups.Results:(1) Clinicopathological features: the age of patients in “rolling carpet” CRS group and traditional CRS group were respectively (55.4±9.6) and (54.6±9.5) years, and the median peritoneal cancer index (PCI) was 12 (range, 4-24) and 10 (range, 5-18), respectively. There were no statistical significance between the two groups (all P>0.05). (2) Operation related indexes: in the “rolled carpet” CRS group, all patients （100%, 30/30） were performed optimal CRS, reaching completeness of cytoreduction score （CC score）, named CC-0 score, and there was no visible residual lesion after operation. While, in the traditional CRS group, 23 patients （77%, 23/30） reached CC-0 score, 5 cases （17%, 6/30） reached CC-1 score, 2 cases （7%, 2/30） reached CC-2 score, and there were statistical significance between the two groups ( P=0.011). The median surgical time was 315 minutes (range, 252-446 minutes) vs 268 minutes (range, 215-372 minutes), the median intraoperative blood loss was 589 ml (range, 300-900 ml) vs 450 ml (range, 250-800 ml), the median ICU hospital stay time was 2 days (range, 1-7 days) vs 1 day (range, 0-5 days), the median total hospital stay time was 14 days (range, 9-17 days) vs 12 days (range, 7-15 days). There were no statistical significance between the two groups (all P>0.05). (3) Surgical complications: there were respectively 5 cases (17%, 5/30) and 3 cases (10%, 3/30) complications with Clavien-Dindo grading Ⅰ-Ⅱ, which was significant no difference between the “rolled carpet” CRS group and the traditional CRS groups ( P>0.05). No re-operations were needed and the operative mortality was 0. Conclusion:It is safe and feasible to perform “rolled carpet” CRS in patients with advanced stage Ⅲc EOC with peritoneum implantation and metastasis, which could achieve optimal CRS, and has an acceptable incidence of perioperative complications, no perioperative death.