This paper discusses the qualifications that doctors of pre-hospital care should possess,including emergency consciousness,comprehensive knowledge and experienced operating techniques,fine psychological quality,satisfactory physical condition,certain organizing and commanding ability, and the spirit of braveness and commitment.

Our emergency centre concludes a series of treating measures aiming at emergent patients who are in unconscious state,and unknown of name,age address and penniless,who are also known as patients of questionable sources as follows.Firstly,a principle for the treatment for patients of questionable sources is formulated,according to which pre-hospital medical staff could perform.Secondly,an express treating channel for those patients is built thus to provide immediate and convenient medical service for those special patients.Thirdly,after essential first-aid,those patients will be transferred to a higher hospital reasonably.Fourthly,the patients' personal belongings will be taken good care of and their family members or guardians will be looked for by specific staff of the emergency centre.Fifthly,the patients' medical records will be kept and managed properly.By the above means,emergent patients of questionable sources will be treated with satisfactory result in the shortest time,avoiding medical disputes.

Objective To study the expressions of HER2 and p16 in human endomctrial carcino-ms,and the relation with FIGO stage,cell differentiated degree.Methods Endometrial cancer was 46 cas-es,atypical hyperplasia was 10 cases,endometrial hyperplasia was 10 cases,normal endometrium was 20cases.The immunohistochemical S-P methods were used to detect the expression of HER2 and p16.Results The expression ofHER2in endometrial cancerwasmuch higherthan others(P＜0.01),moreover,the expression was increased with the increase of clinical stages(P ＜ 0.05) and the decrease of differentiated degree(P ＜ 0.05). The expression of p 16 in endometrial cancer was lower than others (P ＜ 0.05 ), and the expres-sion was reduced with the increase of clinical stages(P ＜ 0.01 ) and the decrease of differentiated degree(P ＜0.05).There was negative correlation between expression of HER2 and p16 in uterine endometrial cancer(r ＝ -0.4213, P＜ 0.01 ). Conclusions The expression of HER2 and p16 in endometrial cancer is associat-ed with the biological behavior of endometrial cancer. HER2 and p16 may be used as objective predictable indicators of endometrial cancer to guide the postoperative treatment.

In pathological course teaching,multi-media teaching application has promoted pathology teaching tremendously,enriched pathology teaching connotation and widened the students'visual field.It also brings about some negative effect.By discussing the advantages and disadvantages of applying multi-media teaching to pathological mechanism teaching,we can serve the pathological mechanism teaching better.

Objective To analyze CYP17A1 gene mutation in a patient with 46,XY disordered sex development and to explore the possible influence on the phenotype of the patient.Methods Eight exons of CYP17AI gene in the patient and her parents were amplified and directly sequenced.In order to construct Mini-gene system,PCR fragments containing wildtype and mutant splicing sites were inserted in expression vector,and then transfected into cells.RT-PCR was used to observe the influence of splicing site mutation.Wildtype and aberrant splicing CYP17A1 cDNA expression plasmids were constructed and transfected into cells respectively,and CYP17A1 enzyme activity was tested in vitro.Results Mutation analysis revealed compound heterozygous CYP17A1 mutations,with Y329fs in one allele and a synonymous substitution( c.1263G＞A:GCG＞GCA) in another allele.In vitro analysis showed that the synonymous substitution induced a novel splicing site,which resulted in aberrant splicing of CYP17A1 mRNA and lacked six or seven amino acids after 415 in splicing product.In vitro transfection and enzyme activity experiment showed that the aberrant splicing product abolished the enzyme activity completely.However,this mutation did not completely influence splicing.The patient also had a part of normal splicing product,which was a coincidence to the phenotype of the patient.Conclusion This is the first description of an exonic splicing mutation in CYP17A1 relevant to the 17ot-hydroxylase deficiency phenotype.The functional study of the aberrant splicing variant has been initiated.

OBJECTIVE：To explore th e applicatio n of team situatio nal simulation education and teaching mode in clinical pharmacy teaching. METHODS ：A total of 60 clinical pharmacy interns were selected as the research objects ，and course disease was type 2 diabetes mellitus. Thirty interns were randomly selected as control group ，using traditional teaching mode ；other 30 interns were selected as trial group ，which carried out team situational simulation education and teaching mode. The teaching effects were evaluated by using the satisfaction of interns to the two modes ，the comprehensive score of graduation examination and the self-evaluation of learning effect. RESULTS ：Compared with traditional teaching mode ，team situational simulation education and teaching mode was conducive to stimulate the learning interest of interns ，improve their interpersonal communication ability ， cultivate teamwork spirit ，improve the awareness of humanistic care ，and cultivate the professional attitude of clinical pharmacists （P＜0.05）. Compared with control group ，the comprehensive score of trial group was dominantly increased （P＜0.001），and the scores of professional quality ，humanistic care and communication skills in the trial group were significantly higher than control group（P＜0.01）. In terms of self-evaluation of learning effect ，except for the pathogenesis of type 2 diabetes and the commonly used treatment regimens ，the self-evaluation scores of the other items in trial group were significantly higher than control group （P＜0.05 or P＜0.01）. CONCLUSIONS ：Team situational simulation education and teaching mode is superior to traditional teaching mode for clinical pharmacy teaching.

The p21 activated kinase 4 (PAK4) is serine/threonine protein kinase that is critical for cancer progression. Guided by X-ray crystallography and structure-based optimization, we report a novel subseries of C-3-substituted 6-ethynyl-1H-indole derivatives that display high potential and specificity towards group II PAKs. Among these inhibitors, compound 55 exhibited excellent inhibitory activity and kinase selectivity, displayed superior anti-migratory and anti-invasive properties against the lung cancer cell line A549 and the melanoma cell line B16. Compound 55 exhibited potent in vivo antitumor metastatic efficacy, with over 80% and 90% inhibition of lung metastasis in A549 or B16-BL6 lung metastasis models, respectively. Further mechanistic studies demonstrated that compound 55 mitigated TGF-β1-induced epithelial-mesenchymal transition (EMT).