Cerebral artery atherosclerosis is the main reason leading to cerebral infarction. CD40/CD40L overexpression will stimulate the immune and inflammatory responses,leading to local inflammatory cell infiltration within the atherosclerotic plaque, triggering plaque rupture, and thus causing cerebral infarction. Studies have suggested that that CD40L is associated with the severity of cerebral infarction, Therefore, clinical detection of CD40L can be used as an indicator for identifying the severity of cerebral infarction to guide clinical treatment.

Egr-1 is an important transcription factor, which regulates at least 30 kinds of gene expression. Egr-1 couples extracellular signals to long-term responses by altering expression of Egr-1 target genes. So egr-1 can directly or indirectly affect cell differentiation,apoptosis,immune response,injury and repair. This article reviewed the progress in Egr-1 and the lung disease.

Background and purpose:Breast cancer can be divided into several molecular subtypes according to its biomarkers. The pattern of distant metastasis has a great clinic significance but was rarely investigated. This study investigated the impact of molecular subtype of breast cancer on initial sites of metastasis..Methods:All the patients with operable invasive breast cancer diagnosed in Zhongshan People’s Hospital between 1998 and 2004 were recruited. Subtypes were defined as Luminal A, Luminal B, human epidermal growth factor receptor 2 (HER-2) enriched, and triple negative (TN) according to the expression of estrogen receptor (ER), progestogen receptor (PR) and HER-2 status. The first distant metastatic sites and the time of their appearances were recorded. Survival curves were constructed using the Ka-plan-Meier technique.Results:Among 390 eligible patients, there were 215(55.1%) with Luminal A, 43 (11.0%) with Lu-minal B, 52 (13.3%) with HER-2 enriched, and 80 (20.5%) with TN. The median follow-up time was 118 months (11-163 months). Seventy-two (18.5%) distant metastases occurred during follow-up: 37 metastases in Luminal A, 8 in Luminal B, 10 in HER-2, 17 in TN. Bone was the most common site of the first distant metastasis (39/72, 54.2%) followed by lung (25/72, 34.7%), liver (22/72, 30.6%), and brain (7/72, 9.7%). Among all the metastases, tumors of Luminal type (Luminal A 70.2%, Luminal B 50.0%) had a higher chance of bone involvement than that of HER-2 enriched (30.0%) and TN (35.3%,P=0.03). Both Luminal B (37.5%) and TN (17.6%) subtypes had a higher percentage of brain involvement than Luminal A and HER-2 enriched (P=0.01). The survival analysis showed no significant difference among the four subtypes in 9-year distant metastasis-free survival. However, distant metastasis appeared earlier in HER-2 enriched and TN breast cancer than in Luminal type.Conclusion:Organ-specific metastasis may depend on the molecular subtype of breast cancer. Bone metastasis occurs more in luminal type than in other types. Luminal B and TN types of tumors had more chance of brain metastasis than Luminal A and HER-2 enriched type of tumors.

Objective To investigate the associations of IL-6(rs6949149,rs1800796 and rs10499563) and IL-6R(rs2228145) single nucleotide polymorphisms(SNP) with the risk of gastric cancer in Chinese Han population of Xuyi,Huai'an.Methods A total of 400 patients with gastric cancer and 400 healthy controls were enrolled in this case-control study.The genotypes of the four SNPs were detected by the Mass-Array technology.The associations between the IL-5/IL-6R SNPs and the risk of gastric cancer were analyzed by Logistic regression model.Results There was a significant difference in the distribution of the IL-6 rs1800796 genotypes between the patients with gastric cancer and healthy controls(x2 =6.213,P =0.045).The IL-6 rs1800796 GG genotype was associated with a increased risk of gastric cancer(adjusted OR =1.27,95 ％ CI:1.15-3.20,x2 =6.326,P =0.012).Subgroup analysis showed that the associations between the IL-6 rs1800796 GG genotype and the risk of gastric cancer were obvious in the female(adjusted OR =3.99,95％ CI:1.36-11.71,x2 =6.358,P =0.012) and the patients with H.pylori infection(adjusted OR =2.20,95％ CI:1.08-4.45,x2 =4.770,P =0.029).Conclusion The IL-6 rs1800796 GG geuotype is associated with the risk of gastric cancer,especially in the female and the patients with H.pylori infection.

Objective To investigate the effect of pregnancy-induced hypertension (PIH) syndrome on the blood lipid level of neonate. Methods Eighty neonates, whose mother had PIH, were enrolled and divided into three groups according to the 6th version of diagnostic standard from published Obstetrics and Gynecology:gestational hypertension group (PIH group 1 ,n = 30) ,mild pre-eclampsia group (PIH group 2,n =30),serious pre-eclampsia group (PIH group 3,n =20) ,and 40 infants with healthy mother were enrolled as normal control group. The blood lipid was measured by automatic biochemical analyzer. Results (1) The TG levels of the cord blood were (0.28±0. 10)mmol/L in PIH group 1,(0.33 ±0.09)mmol/L in PIH group 2,(0.39 ±0.06) mmol/L in PIH group 3,and (0. 23 ±0. 07)mmol/L in normal control respectively. TG levels were significantly higher in PIH groups compared to normal control,and the TG concentration increased gradually with the mothers' gestational hypertension (F = 2. 765, Ps <0. 05). (2)The HDL-C levels of the cord blood were (0. 61 ±0. 23) mmol/L in PIH group 1, (0. 54 ± 0. 25) mmol/L in PIH group 2, (0.47 ± 0. 15) mmol/L in PIH group 3, (0. 65 ±0. 14) mmol/L in the normal contral respectively;and the ApoA levels of the cord blood were (0. 63 ±0.24)g/L in PIH group 1 ,(0. 59 ±0. 16)g/L in PIH group 2, (0.53 ±0.21)g/L in PIH group 3,(0.69 ±0. 12)g/L in the normal contral respectively. Both index were significantly higher in PIH groups compared to normal control, and the concentrations decreased gradually with the mothers' gestational hypertension (F=2.783,P<0.05;F=2.831,P<0.05). (3)The TC levels of the cord blood were (1.41 ± 0. 37) mmol/L in PIH group 1, (1. 51 ±0.45) mmol/L in PIH group 2, (1. 56 ±0. 56) mmol/L in PIH group3, (1. 36 ±0.41) mmol/L in the normal contral respectively;and the LDL-C levels of the cord blood were (0. 79 ±0. 26)mmol/L in PIH group 1,(0. 80 ±0. 18)mmol/L in PIH group 2,(0. 82 ±0. 30)mmol/L in PIH group 3,(0.74 ±0. 18) mmol/L in the normal contral respectively. The data showed that the cord blood TC and LDL-C levels of PIH were higher than normal control and increased gradually with the mothers'gestational hypertension, but they didn' treach the significant level (F = 0. 695,P>0. 05;F = 0. 483,P>0. 05). (4)The LPA levels of the cord blood were (24. 50 ± 12. 01) g/L in PIH group 2, (22. 68 ± 9. 50) g/L PIH group 3,which were lower than normal control (25.70 ±11.90) g/L, and the LPA levels of the cord blood were higher in PIH group 1(33.46 ± 20. 10)g/L,while the differences didn't reach significant level compared among four groups (F = 1.480,P> 0.05). Conclusion The unhealthy intrauterus condition of PIH lead abmoral fat metabolism in fetus, and itmight get worse along with the severity of the mother's gestational hypertension. We presumed that the neonates of PIH mothers would be more prone to have coronary heart disease,atherosclerosis and abnormal fat metabolism related disease compared with newboms from normal control group.

Because of ignoring the basic knowledge training, the medicine graduates lack ba-sic knowledge of clinical pathology, which has seriously affected their improvement of medical skills. The paper analyzes the status of pathology teaching in clinical medicine graduates and the necessity to strengthen clinical pathology general education. Then it proposes measures about enhancing clinical pathology general education, so as to increase the basic clinical pathology knowledge of medical grad-uates.

Objective To investigate the clinical effect of Ultrasound-guided minimal invasion technique used in the diagnosis and treatment of benign breast tumor .Methods 60 cases of benign breast tumors , including single or multiple breast lumps ,were treated using minimally invasive technology under the guidance of ultrasound . The average operation time was 25min.Through 3-6months after operations ,any residue and recurrence at local lesion were not found by clinical and ultrasonic examination , and incision scar formation was not clear .Minimally invasive operation can completely amputate breast tumors .Results Under real time ultrasound monitoring ,all the 60 cases of operation had 100%of display rate.The tumor pathologic classification is as follows:25cases of fibroadenomas ,2 ca-ses of cyst ,3 cases breast cystic hyperplasia ,12 cases of adenosis of mammary glands ,3 cases of lipoma of the breast and one case of phyllodes tumor .The other 14 cases have both two kinds of pathological types .Conclusion The system of ultrasound-guided minimally invasive technology can accurately puncture benign breast tumor with high re -section rate,small trauma and is operated safely .It is a therapeutic method and consistent with the opinion of cosme-tology.

The construction and management working of clinical practice teaching base is an important component of the western medical colleges and universities.The colleges and universities highlights the status of clinical practice teaching base construction,such as improving construction management system of clinical practice teaching base,strengthening the basic teaching facilities construction,the teachers troop construction and the system construction of clinical practice teaching base,strengthening the organization,teaching and funds management of the clinical practice teaching base and improving the quality and level of graduation practice.

Abstract: Objective　To explore the value of real-time shear wave elastography in evaluating the severity of liver fibrosis in hepatitis B, and to analyze the factors that affecting its accuracy. Methods　A total of 196 chronic hepatitis B patients, who admitted to the Third Affiliated Hospital of Chengdu Medical College from February 2018 to October 2020, were selected for retrospective analysis. Demographic indicators such as gender, age, body mass index(BMI), and laboratory indicators such as fasting blood glucose, liver function, and blood lipid composition were collected. The patients were detected by real-time shear wave elastography. Taking the pathological test results as the gold standard, the diagnostic value of real-time shear wave elastography in the severity of liver fibrosis in chronic hepatitis B was analyzed, and the comprehensive effect of various factors on the diagnostic accuracy of real-time shear wave elastography was evaluated by Logistic regression analysis. Results　The differences in real-time shear wave elastography of patients with different severity of liver fibrosis in hepatitis B were statistically significant, and F0 grade

Objective To investigate and analyze the job satisfaction of medical staff in Chongqing military hospitals.Methods Minnesota Satisfaction Questionnaire was used to investigate 868 medical staff in three military hospitals in Chongqing of their job satisfaction.Results Totals of 896 questionnaires were handed out and 868 were recovered,with the efficiency rate of 96.88％.The score of overall satisfaction of 868 medical staff was (68.46 ± 11.73).The three highest score for individual item was (4.09 ± 0.80) for doing things without going against conscience,(3.99 ± 0.69) for style of colleague communication and (3.90 ± 0.83) for leaders' ability of making decisions,and the three lowest score for individual item was (2.60 ± 1.12) for income and workload,(2.86 ± 1.10) for busy status and (3.00 ± 0.89) for promotion opportunity.Among job satisfaction,the score for autonomy satisfaction was the highest,which was (14.43 ± 2.39),while the score for development satisfaction was the lowest,which was (13.05 ± 2.61).Conclusions The overall job satisfaction of military medical staff was relatively low and managerial staff should take some measures accordingly.