Objective To study the correlation of EMMPRIN and VEGF-C expression with invasion and metastasis of breast carcinoma. Method The expression of EMMPRIN and VEGF-C was detected by immunohistochemical technique in 21 cases hyperplasia of mammary glands, 10 cases of in-tubule carcinoma and 68 cases invasive carcinoma. Results The positive rate of EMMPRIN expression in hyperplasia of mammary glands, in-tubule carcinoma and invasive carcinoma were 4. 76% (1/21), 40. 00% (4/10)73.53% (50/68), respectively;Significant difference was found among three groups ( P < 0.01 ). The positive rate of VEGF-C expression in hyperplasia, in-tubule carcinoma and invasive carcinoma were14. 29% (3/21) ,60. 00 (6/10) ,77.94% (53/68), respectively. The positive rates of VEGF-C expression in situ and invasive ductal carcinoma were remarkably higher than that of hyperplasia of mammary glands ( P <0. 01 ). The expression of EMMPRIN significantly correlated with the expression of VEGF-C in breast tubule carcinoma ( rs =0. 390, P <0. 01 ), Lymph nod metastasis and the number axillary Lymph nod metastasis were related to EMMPRIN and VEGF-C ( P < 0. 01 ). Conclusion The over-expression of EMMPRIN and VEGF-C were important elements to promote the invasiveness and metastasis of breast carcinoma. Synergistic effect between EMMPRIN and VEGF-C may take place in lymph node metastasis of breast carcinoma.

‘Service-learning’is fashionable and advanced teaching concept and mode in many countries currently.Applying‘service-learning’concept and methods in medical ethics curriculum can form a new ethics education mode.Three methods were adopted to evaluate the new model:conducting questionnaires for all students participating in‘service-learning’activities,selecting part of the students to do face to face interview and selecting the core project-medical poverty relief activities.The results showed that the effect of new model was obvious,which was embodied by innovating practical teaching path,improving medical ethics study effect,satisfying human needs and cultivating noble spirits.

Innovative education on business venturing at medical colleges and universities is a need of both the time of knowledge economy and the socialization of medicine.Innovative venturing education is a new model to cultiv ate high-caliber medical talents with wide social perspective,profound knowledge,creativity and entrepreneurship.Approaches to implementing such education in the transition of educational model may include enhancing cultural and sociological education,promulgating venturing practices in medical field,establishing favorable at mosphere for innovative venturing education,fostering English language skills in the whole process,emphasizing clinical practices,setting up effective competency assessment system and establishing a high-caliber faculty team.

Objective:To investigate the role of service-learning model in medical ethics education. Meth-ods:A qualitative and quantitative research was conducted within 831 undergraduates and 302 graduates in Shan-tou University Medical College. Results: Service-learning model was well accepted by most medical students. Higher medical ethics awareness and more positive tendency of behavior choices were found on the group who par-ticipated in serving-learning model activities, which also revealed a positive correlation relationship to participated frequency. Conclusions:Serving-learning model plays an important role in medical ethics education, which is an effective way to deeply practice Opinions on Deepening the Medical and Educational Reform toward Personnel Training in Clinical Medicine.

Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P＜0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.

Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P＜0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.