Tumor cell invasion and metastasis are associated with the proteolytic activity of various types of proteinases.Among them,cathepsin D,which is a lysosomal proteinase,has received more attention recently.Various studies have shown that the lysosomal aspartic protease cathepsin D is over-expressed and hyper-secreted by numerous cancer cell lines.Indeed it plays an essential role in the multiple steps of tumor progression,in stimulating cancer cell proliferation,tumor invasion and metastasis,fibroblast outgrowth and angiogenesis,as well as in inhibiting tumor apoptosis.In addition,CD is also a key mediator of induced- apoptosis.The aim of this article is to review the current knowledge on Cathepsin D action in cancer progression and metastasis,as well as its dual function in apoptosis.

3D printing is to complete replication or creation process for the object items through digital modeling for the prototype under the control of a computer. 3D printing can complete the individual replication and achieve accurate simulation for the object shape and structure. Using a variety of medical imaging results to implement data modeling, 3D printing technology has the outstanding advantages in the biomedical field. In recent years, 3D printing technology has been applied in the prevention, treatment, and rehabilitation of cerebrovascular diseases. This article briefly review s the application of 3D printing technology in intracranial aneurysms and arteriovenous malformation, and the prospect of future application is prospected.

OBJECTIVE:To provide reference for systematic reform in national state-owned hospital.METHODS:System reforms of township hospitals in Zhangjiagang were analyzed.Then three kinds of reform modes were summarized including privatization,town-owned-town-management and sino-foreign joint venture.Reform effects were also discussed.RESULTS & CONCLUSIONS:The achievement that the reformed township hospitals have made in Zhangjiagang in improving the medical insurance and pharmaceutical management system,reforming hospital management system and operation mechanism and creating a harmonious relationship between doctor and patient can provide a reference for domestic state-owned hospital reform.

OBJECTIVEThis study aims to determine the awareness oral medical interns about occupation safety protection of knowledge and to present a scientific basis for perfecting the occupation safety education system and standard protection behavior.

METHODSA self-designed questionnaire that used a retrospective questionnaire survey on 425 stomatological interns, scoring, and statistical analysis of the survey were performed. The questionnaire included occupation safety prevention knowledge, behavior cognitive, and protective behavior, among others.

RESULTSThe questionnaire recovery rate was 100%, and the average scores of the prevention knowledge and behavior cognitive were 4.55 ± 0.91 and 4.40 ± 1.05, respectively. More than 90% interns can conduct the conventional protection, and less than 40% can perform special protection. For the item "occupation safety protection knowledge", the scores of three grade III hospitals were higher than that of stomatological hospitals and second level of first-class hospitals; the difference was statistically significant (P < 0.001). For the items "behavior cognition" and "protective behavior", the scores of the second level of first-class hospitals were lower than those of grade III hospitals and stomatolgical hospitals (P < 0.001). The second level of first-class hospitals was relatively poor in safety protection knowledge, behavioral cognitive, and protection behavior. The average score was higher for than for boys in the three contents, and the average score of interns accepting pre-job training was higher than those rejected; the difference was statistically significant (P < 0.001).

CONCLUSIONThe occupation safety knowledge of oral medical interns is not sufficient, and the protective behavior is poor. Schools and hospitals should strengthen the intern occupation safety and protection education and improve the status of occupation safety behavior.

Clinical Competence ; Humans ; Internship and Residency ; Occupational Health ; Occupations ; Oral Medicine ; education ; Retrospective Studies ; Surveys and Questionnaires ; Universities

Objective To investigate the accuracy of functional magnetic resonance imaging(fMRI) and contrast-enhanced ultrasound on evaluation of the breast cancer patients after neoadjuvant chemotherapy.Methods Forty-eight patients with breast cancer who were confirmed by biopsy,undergoing 4 cycles weekly dose-concentrated programs (wPC) neoadjuvant chemotherapy,evaluated the efficacy by fMRI and contrastenhanced ultrasound.Results In pathology,complete remission was 12 cases (25.0％,12/48),non remission was 13 cases (27.1％,13/48).In contrast-enhanced ultrasound,complete remission was 20 cases (41.7％,20/48),non remission was 10 cases (20.8％,10/48).In fMRI,complete remission was 17 cases (35.4％,17/48),non remission was 11 cases (22.9％,11/48).The P values more than 0.05 showed no statistically significant among three methods,the Kappa test showed that fMRI were superior to contrastenhanced ultrasound on evaluating the efficacy of neoadjuvant chemotherapy.Conclusions fMRI and contrast-enhanced ultrasound can be used in evaluating the efficacy of neoadjuvant chemotherapy,however,the data shows fMRI is superior to contrast-enhanced ultrasound.Contrast-enhanced ultrasound must be as the supplementary method.

Objective To investigate the drug resistance and distribution of Staphylococcus aureus isolated from infected pa‐tients in our hospital from 2009 to 2013 ,and provide basis for clinical treatment .Methods Retrospective review was adopted to an‐alyze the antibiotic resistance and the specimen source of 562 SA strains .ATB Expression and ID 32 STAPH were used to identify SA .Antibiotic susceptibility testing was performed by K‐B method .Results 562 SA strains ,including 218 MRSA ,are mainly from secretions ,sputum and pus .Resistance was most frequently observed on penicillin ,followed by erythromycinand clindamycin .None of the isolates was resistant to vancomycin ,amikacin ,nitrofurantoin and linezolid .The resistance rates of MRSA to penicillin ,eryth‐romycin ,cotrimoxazole ,clindamycin ,gentamicin ,cefoxitin ,tetracycline and rifampicin were obviously higher than that of MSSA ,and there are very significant differences between them (P<0 .05) .Conclusion There is a declining trend in the isolation rates of SA and MRSA in our hospital ,but the drug resistance situation remains serious .Vancomycin is still the first option for the cure of MR‐SA infections .Therefore ,strengthening SA resistance monitoring and avoiding misuse of antimicrobial drugs is an effective way to prevent SA infection .

Objective To investigate the chemical constituents of Wedelia trilobata.Methods The chemical constituents were separated by chromatography and their structures were determined by physico-chemical constants and spectral analyses.Results Eleven compounds were isolated and identified as grandiflorenic acid(1),1?-acetoxy-6?,9?-dihydroxy-4,10?-dimethyl-5?H,7?H,8?H-endesm-3-en-8,12-olide(2),1?-acetoxy-4?-hydroxy-6?-isobutyryloxy-9?-isovaleryloxyprostatolide(3),16?-hydroxy-ent-kauran-19-oic acid(4),(3R,4R,6R)-3,4-dihydroxy-1-menthene(5),trilobolide-6-O-isobutyrate(6),1?-acetoxy-4?,9?-dihydroxy-6?-isobutyroxyprostatolide(7),16?,17-dihydroxy-ent-kauran-19-oic acid(8),daucosterol(9),protocatechualdehyde(10),and caffeic acid(11).Conclusion All the compounds are isolated from W.trilobata for the first time except compounds 6 and 7.Compounds 2 and 3 are new sesquiterpene lactones,named as trilobolide A and 1?-acetoxy-4?-hydroxy-6?-isobutyryloxy-9?-isovaleryloxyprostatolide,respectively.

Objective To investigate the value of Color Doppler ultrasound in hemodynamic changes of non-alcoholic fatty liver disease.Methods 120 cases with non -alcoholic fatty liver disease were selected and divided into the mild group,moderate group and severe group.According to the degree of fatty infiltration of the liver taxono-my,40 cases in each group,hemodynamic changes of each group were detected in Color Doppler ultrasound equip-ment.Results Hepatic venous pulse waveform analysis and comparison constituted of the three groups and control group,the difference was statistically significant (χ2 =25.343,P <0.05).PPVV,MPVV,HARI of the three groups and control group were compared,the difference was statistically significant(F =34.67,51.03,31.06,all P <0.05).Conclusion Color Doppler ultrasound which is used to detect hemodynamic changes in non -alcoholic fatty liver disease had good clinical value,can assess disease progression in patients,can provide the basis for clinical treat-ment.

Objective To investigate the clinical efficacy of intravitreal injection of Lucentis combined with pan retinal photocoagulation and trabeculectomy for neovascular glaucoma(NVG). Methods Seventeen eyes of 15 patients with NVG were treated by 0.5 mg Lucentis intravitreal injection first. Trabeculectomy was performed 7 days later and Pan retinal photocoagulation 2 weeks later. Iris,anterior chamber angle neovascularization,intraocu?lar pressure ,and visual acuity were observed in the following 6 months. Results Iris and anterior chamber angle neovascularization were completely regressed 7 days after the injection in 17 eyes. Six months after photocoagulation, 6 eyes had different degrees of improvement in visual acuity,10 eyes no change in visual acuity and 1 eye decreased from anterior index to immediate manual. There was significant difference in pre?treatment IOP and postoperative IOP( t = 12.75 ,10.26 ,9.73 ,10.77 ,P < 0.01 ). No serious complications were observed after intravitreal injec?tion and trabeculectomy. Conclusions Intravitreal injection of Lucentis could significantly accelerate the regres?sion of iris and anterior chamber angle neovascularization ,which could improve the successful rate of trabeculecto?my and pan retinal photocoagulation. Intravitreal injection of Lucentis combined with trabeculectomy and panretinal photocoagulation is safe and effective for NVG.