There is no difference between breast conserving surgery (BCS) combined with radiotherapy and radical surgery in outcomes.However, comparing with the radical surgery, BCS has little trauma, less bleeding and lower infection rate, which makes patients′ quality of life improved.In the practice of BCS, due to the disease, patients, physicians, socio-economic, clinical, security and many other factors, there are still many controversial issuesin the doctor-patient communication, socio-economic, aesthetic, margins width, precision operation procedures of BCS.At the same time, new surgical techniques such as plastic breast conserving surgery, and new intraoperative assessment equipment such as MarginProbe system and other new technology development has brought us new ideas to solve these problems.

Aiming to solve the problems in traditional classroom mode PBL teaching during clinical practice of oral and maxillofacial surgery,this paper investigated multi-pattern PBL teaching basing on Weblog,daily ward round and classroom discussion in the clinical practice,and focused on the practice methods,advantages and feature of this multi-pattern PBL teaching.

The culture of modern medical talents is the requirements of the times on cultivating talents of Medical Laboratory of Medical College. In order to establish a high level teaching team and im-prove the quality of teaching and personnel training, through the reform of the traditional teacher training way, we created the teacher training mode of multi echelon teachers including department, university, domestic and international training ways. New curriculum teaching system framework was established which was based on theoretical teaching, practical teaching and scientific research. Besides, innovative and pro-gressive practice teaching platform was set up which included basic experiment, clinical skills, professional training, and practice in company. Course of Clinical Examination Skills was opened. The teaching team achieved some results in the above teaching reform.

Objective To evaluate the prognostic value of three different staging system based on positive lymph nodes,lymph node ratio and log odds of positive lymph nodes in breast carcinoma.Methods In 472 breast carcinoma patients,survival analysis was performed with Kaplan-Merier and COX regression model,the hazard ratio (HR) of the three staging system were compared.Results When more than 10 lymph nodes were dissected in the operation,there was statistical differences in survival among the staging systems based on lymph node ratio and log odds of positive lymph nodes (P ＜ 0.05),while the prognosis was highly homologous between the staging systems based on positive lymph nodes in stage N0 and N1.Univariate analysis showed age,tumor size,Her2 status,estrogen receptor status and the total lymph nodes dissected were related to overall survival (all P ＜ 0.05).COX multivariate analysis showed that the staging system based on lymph node ratio (5.495) and log odds of positive lymph nodes (4.662) had the higher HR than the N staging system (2.722).Conclusions Compared with the number of involved lymph nodes,the staging system based on lymph node ratio and log odds of positive lymph nodes were superior to the staging system based on positive lymph nodes for prognostic assessment of breast carcinoma.

Objective To investigate the effects and mechanism of IL-6 on the epithelial to mesenchymal transition of human pancreatic cancer cells.Methods IL-6 was added into the culture media of human pancreatic cancer cells Capan-2,SW1990,and STAT3-siRNA-SW1990.Cell growth was measured by MTT assays.STAT3,p-STAT3,Snail,Twist,and E-cadherin mRNA and protein expression were examined using real-time fluorescence quantitative polymerase chain reaction (RT-PCR)and Western blot,respectively.The invasion abilities of SW1990 and Capan-2 cells were determined by a cell invasion assay in vitro.Results Our results showed that 100 μg/L of IL-6 significantly promoted the growth and invasion abilities of Capan-2 and SW1990 cells (P＜0.05).The use of IL-6 not only markedly increased the protein expression of P-STAT3 and Snail,but also greatly decreased the mRNA and protein expression of E-cadherin.The use of IL-6 can not change the mRNA and protein expression of Snail and E-cadherin.Conclusion Activation of the STAT3 signal transducer pathway with IL-6 can promote the epithelial to mesenchymal transition of pancreatic cancer cells in vitro through up-regulation of Snail and down-regulation of E-cadherin expression.Therefore the STAT3 signal transducer may provide a novel therapeutic target for the treatment of pancreatic cancer.

Objective To systematically evaluate the effects of psychiatric nurse-led adherence therapy on clinical outcomes and medication adherence in schizophrenia patients.Methods Searched databases to collect randomized controlled trials about psychiatric nurse-led adherence therapy for patients with schizophrenia.Two reviewers independently screened literature,extracted data,and assessed the risk of bias of included studies.Then,meta-analysis was performed using Rev Man 5.2 software.Results Fifteen studies were recruited,including 683 cases of AT and 681 cases of TAU.The results showed that adherence therapy could improve attitude towards adherence,adherence behaviors,psychotic symptoms,function,insight and reduce hospital stay.But regarding stigma,quality of life and side effects,adherence therapy did not show benefits (P＞0.05).Conclusion Psychiatric nurse-led adherence therapy is effective to improve schizophrenia patients' adherence,psychotic symptoms,function,insight and reduce hospital stay.

To study the mechanism of CAIMA (Computer assisted instant monitoring drug administration), atracurium, a new non - depolarizing muscle relaxant was used in isolated rat diaphragm. The doses and administration rate were precisely controlled by using an improved flowing-bath system. The results showed that with increasing drug concentration, onset time shortened,over-shoot time prolonged, initial recovery rate reduced and onset rate, over-shoot extent and recovery index increased. The over-shoot existed at any pharmacologically effective concentrations and it was positively correlated to drug concentration. As a result of need-dependent and intermittent (pulsatil) drug administration, one maximally profited effect from over-shoot, that is, the effect could be maintained with over-shoot at the administration interval. Hence, the total dose could be dramatically reduced. Furthermore, for a given effect, it needs lower drug concentration with CAIMA than with classical methods and so the effect was nuch more stable.

Objective; To clone, sequence and analyze the coding sequences of the Mr 15000 and Mr 9000 active segments of natural granulysin derived from human CTLs activated by allogenic antigen ,in order to establish the basis for further purifying and investigating the immune - impairing mechanism of granulysin. Methods; The coding sequences of the Mr 15000 and Mr 9000 granulysin gene were amplified from the total RNA of activated CTLs of healthy person after reverse transcription by Nested - PCR, inserted into pET32a ( + ) vectors and then transformed into E. Coli TOP10, respectively. The recons were identified by PCR, endonuclease digestion and sequencing. Results: The whole coding sequences of the Mr 15000 and Mr 9000 active segments were successfully cloned as expected. The accurate pET32a - Mr 15000 and pET32a - Mr 9000 recons were obtained through Colony - PCR, endonuclease digestion and sequencing. There lied polymorphism on the 119 th amino acid of the product encoded by GLS gene. Conclusion; The coding sequences of the Mr 15000 and Mr 9000 active segments of human granulysin can be obtained and cloned by the methods mentioned above and can be used for subsequent research.

In order to adapt to the requirements of modem medical knowledge and skills for higher medical workers,and to cultivate medical students' molecular medicine quality and comprehensive ability,Weifang Medical University broke the boundaries of disciplines and constructed experimental course group in molecular medicine based on the ideas of curriculum group construction.Molecular medical knowledge was integrated into the teaching process of experimental course group,experimental teaching content system was reasonably integrated and optimized,high quality teaching team was set up,multi-level experimental teaching platform was built and student-centered teaching mode was implemented to explore the experimental teaching approach which helped medical students to form systematic molecular medicine knowledge structure and ability structure.