Objective To investigate the role of STK4-AS1 in regulating the proliferation,invasion,and migration of esophageal squamous cell carcinoma(ESCC)cells through the MYG1/Notch signaling pathway.Methods Quantitative real-time PCR(qRT-PCR)was used to detect the expression of STK4-AS1 in ESCC cells.MTS assay,wound healing and Transwell assay were conducted to explore the proliferation,migration,and invasion abilities in each group in Eca109 and Kyse150 cells.mRNA sequencing(mRNA-seq)was used to detect the down-stream target genes of STK4-AS1.KEGG functional enrichment analyses were used to predict the possible biological processes and signaling pathways.qRT-PCR and western blot were performed to identify mRNA expression of MYG1 and the key downstream transcription factors HES1,HES5,and HEY1 of the Notch signaling pathway,as well as the protein expression of NICD1.Co-transfection plasmids(for over-expressing STK4-AS1 and MYG1)were used to detect the mRNA expression of HES1,HES5,and HEY1 and the protein expression of NICD1 which acted as the key downstream transcription factors in the Notch signaling pathway,as well as the effects on the proliferation,migration,and invasion abilities of ESCC cells.Results The expression of STK4-AS1 was decreased in ESCC cell lines(P<0.01).Over-expression of STK4-AS1 inhibited the proliferation,migration and invasion abilities in Eca109 and Kyse150 cells(P<0.05).STK4-AS1 negatively regulated the expression of MYG1(P<0.01),and the expression of MYG1 was increased in ESCC cell lines(P<0.01).Over-expression of MYG1 could partially reverse the effect of STK4-AS1 on the malignant biological behavior of Eca109 and Kyse150 cells(P<0.05),as well as the mRNA expressions of HES1,HES5,and HEY1 and the protein expression of NICD1(P<0.05).Conclusion STK4-AS1 affects the malignant biological behaviors of ESCC through the MYG1/Notch signaling pathway.

Objective The purpose of this study is to investigate the expression of histone lysine-specific demethylase 1 (KDM1A) and ubiquitin carboxyl-terminal hydrolase L3 (UCHL3) in thyroid cancer (TC) tissue and its relationship with clinical features and prognosis. Methods 94 TC patients diagnosed and treated at the Third Hospital of Heilongjiang Province from January 2017 to January 2019 were retrospectively selected as the study subjects. Immunohistochemistry was used to detect the expression of KDM1A and UCHL3 in tissues. Spearman correlation analysis was used to investigate the correlation between KDM1A and UCHL3. Kaplan-Meier survival curve was used to analyze the relationship between the levels of KDM1A and UCHL3 and the 5-year progression-free survival rate of TC patients. Multivariate COX regression model was used to analyze the prognostic factors of TC patients. Results The positive rates of KDM1A (68.09％) and UCHL3 (65.96％) in cancer tissues were higher than those in adjacent tissues(10.64％,8.51％),and the differences were statistically significant(x2=64.984,66.369,all P<0.001). The protein expression of KDM1A and UCHL3 was significant protein correlation (r=0.714,P<0.001). The positive rates of KDM1A (87.50％,90.91％) and UCHL3 (85.00％,87.88％) in TNM stage Ⅲ～Ⅳ and lymph node metastatic TC cancer tissues were higher than those in stage Ⅰ～Ⅱ(53.70％,53.85％)and non-lymph node metastatic(55.74％,54.10％) cancer tissues,and the differences were statistically significant(x2=9.985～12.191,all P<0.001). The 5-year progression-free survival rates of TC patients in the KDM1A positive and negative groups were 62.50％ (40/64) and 86.67％ (26/30),with significant differences,the 5-year progression-free survival rates of UCHL3 positive and negative patients were 58.06％ (36/62) and 90.63％ (29/32),with significant differences (Log-Rankx2=5.670,9.724,P=0.017,0.002). KDM1A positive,UCHL3 positive,TNM stage Ⅲ～Ⅳ,lymph node metastasis were risk factors affecting the prognosis of TC patients (Waldx2=1.315～1.697,all P<0.001). Conclusion KDM1A and UCHL3 are upregulated in TC,and played a pro-cancer role. They are new tumor markers for evaluating the prognosis of TC patients.

Objective To investigate the role of STK4-AS1 in regulating the proliferation,invasion,and migration of esophageal squamous cell carcinoma(ESCC)cells through the MYG1/Notch signaling pathway.Methods Quantitative real-time PCR(qRT-PCR)was used to detect the expression of STK4-AS1 in ESCC cells.MTS assay,wound healing and Transwell assay were conducted to explore the proliferation,migration,and invasion abilities in each group in Eca109 and Kyse150 cells.mRNA sequencing(mRNA-seq)was used to detect the down-stream target genes of STK4-AS1.KEGG functional enrichment analyses were used to predict the possible biological processes and signaling pathways.qRT-PCR and western blot were performed to identify mRNA expression of MYG1 and the key downstream transcription factors HES1,HES5,and HEY1 of the Notch signaling pathway,as well as the protein expression of NICD1.Co-transfection plasmids(for over-expressing STK4-AS1 and MYG1)were used to detect the mRNA expression of HES1,HES5,and HEY1 and the protein expression of NICD1 which acted as the key downstream transcription factors in the Notch signaling pathway,as well as the effects on the proliferation,migration,and invasion abilities of ESCC cells.Results The expression of STK4-AS1 was decreased in ESCC cell lines(P<0.01).Over-expression of STK4-AS1 inhibited the proliferation,migration and invasion abilities in Eca109 and Kyse150 cells(P<0.05).STK4-AS1 negatively regulated the expression of MYG1(P<0.01),and the expression of MYG1 was increased in ESCC cell lines(P<0.01).Over-expression of MYG1 could partially reverse the effect of STK4-AS1 on the malignant biological behavior of Eca109 and Kyse150 cells(P<0.05),as well as the mRNA expressions of HES1,HES5,and HEY1 and the protein expression of NICD1(P<0.05).Conclusion STK4-AS1 affects the malignant biological behaviors of ESCC through the MYG1/Notch signaling pathway.

Objective The purpose of this study is to investigate the expression of histone lysine-specific demethylase 1 (KDM1A) and ubiquitin carboxyl-terminal hydrolase L3 (UCHL3) in thyroid cancer (TC) tissue and its relationship with clinical features and prognosis. Methods 94 TC patients diagnosed and treated at the Third Hospital of Heilongjiang Province from January 2017 to January 2019 were retrospectively selected as the study subjects. Immunohistochemistry was used to detect the expression of KDM1A and UCHL3 in tissues. Spearman correlation analysis was used to investigate the correlation between KDM1A and UCHL3. Kaplan-Meier survival curve was used to analyze the relationship between the levels of KDM1A and UCHL3 and the 5-year progression-free survival rate of TC patients. Multivariate COX regression model was used to analyze the prognostic factors of TC patients. Results The positive rates of KDM1A (68.09％) and UCHL3 (65.96％) in cancer tissues were higher than those in adjacent tissues(10.64％,8.51％),and the differences were statistically significant(x2=64.984,66.369,all P<0.001). The protein expression of KDM1A and UCHL3 was significant protein correlation (r=0.714,P<0.001). The positive rates of KDM1A (87.50％,90.91％) and UCHL3 (85.00％,87.88％) in TNM stage Ⅲ～Ⅳ and lymph node metastatic TC cancer tissues were higher than those in stage Ⅰ～Ⅱ(53.70％,53.85％)and non-lymph node metastatic(55.74％,54.10％) cancer tissues,and the differences were statistically significant(x2=9.985～12.191,all P<0.001). The 5-year progression-free survival rates of TC patients in the KDM1A positive and negative groups were 62.50％ (40/64) and 86.67％ (26/30),with significant differences,the 5-year progression-free survival rates of UCHL3 positive and negative patients were 58.06％ (36/62) and 90.63％ (29/32),with significant differences (Log-Rankx2=5.670,9.724,P=0.017,0.002). KDM1A positive,UCHL3 positive,TNM stage Ⅲ～Ⅳ,lymph node metastasis were risk factors affecting the prognosis of TC patients (Waldx2=1.315～1.697,all P<0.001). Conclusion KDM1A and UCHL3 are upregulated in TC,and played a pro-cancer role. They are new tumor markers for evaluating the prognosis of TC patients.

Objective : To investigate the effect and mechanism of celecoxib on retinal vascular endothelial growth factor(VEGF) in rats with diabetic retinopathy. Methods : Forty - five SD rats were divided into normal control group (NC) , diabetic retinopathy group (DR) , celecoxib intervention diabetic retinopathy group ( DR + C) . The diabetic model was established by intraperitoneal injection of 1% STZ. After one month , celecoxib (50 mg/kg) was given intragastric administration (1/day) in the DR + C group. Two months later, serum total cholesterol (TC) and insulin were detected. The histopathological changes of the retina were observed. The expression of junctional adhesion molecule⁃like protein (JAML) , VEGF and their signal pathway proteins and the distributions of interleukin⁃10 (IL⁃10) , vascular cell adhesion molecules⁃1(VCAM⁃1) were detected by Western blot. HUVEC cells were divided into normal glucose group (NG) , high glucose group (HG) and high glucose plus celecoxib group (HG + C) to detect the expression of the above proteins. Results : Compared with DR , retina in DR + C group was thinner. The retina in the DR + C group was thicker than that in the NC group. The levels of retinal JAML ,phosphatidylinositol kinase3(PI3K), phosphorylphosphatidylinositol kinase3(P⁃PI3K) , hypoxia⁃inducible factor1 ⁃α (HIF1 ⁃α ) , and VEGF in DR + C group were lower than those in DR group ,while higher than those in NC group. The expression of retinal IL⁃10 and VCAM⁃1 decreased . The content of TC in DR + C and DR group was higher than those in NC group (P < 0. 01) , while the content of insulin in DR + C and DR group was lower than thlse in NC group (P < 0. 001) . Compared with HG group , the expressions of JAML , PI3K , P ⁃PI3K , HIF1 ⁃α , VEGF in HG + C group decreased , but was higher than those in NG group. There was no significant difference in PI3K among the three groups. Conclusion Celecoxib can decrease the expression of VEGF , IL⁃10 , VCAM⁃1 in retina of DR rats , which may be related to the PI3K/HIF1 ⁃α signaling pathway mediated by JAML.

Objective:To investigate the impact of achievement goals on the academic achievement of medical students.Methods:In May to June of 2019, an online questionnaire survey was performed for data collection, and the stratified sampling method was used for sampling. Demographic factors, Achievement Goal Scale, and Academic Achievement Scale were used in this study, and descriptive statistics, the Pearson correlation analysis, and the multivariate linear hierarchical regression analysis were performed to analyze the impact of achievement goals on the academic achievement of medical students.Results:For these medical students, the mean value of achievement-near to the goal orientation was (3.45±0.77), the mean value of achievement-dodge the goal orientation was (3.43±0.80), and the mean value of mastery goal orientation was (3.85±0.66). Achievement-near to the goal orientation had a significant positive impact on academic achievement ( β=0.336, P<0.01), and mastery goal orientation also had a significant positive impact on academic achievement ( β=0.540, P<0.01). Conclusion:The achievement goals dominated by mastery goal orientation is the most beneficial dimension for the development of medical students.

Objective:To compare the effect of the 2% chlorhexidinegluconate disinfectant and 0.5% iodophor disinfectant on the maintenance of central venous catheter (CVC) in patients with immunodeficiency.Methods:The patients were randomly divided into two groups. 2% chlorhexidinegluconate disinfectant was used in the experimental group, and 0.5% iodophor disinfectant was used in the control group. The CVC was sterilized once a week and continuously maintained for 3 weeks. According to the condition of catheter, the dressing was changed in time in case of any problem,and the reason and time for the catheter nursing care were recorded. The duration of changing the catheter dressing in different disinfectant, incidence rate of dressings looseness and incidence of catheter-related infections in two groups were analyzed.Results:The duration of skin drying and duration of caring in the experimental group were (0.62±0.10)min, (11.67±0.33) min, significantly shorter than the control group [(1.97±0.18) min, (14.48±0.33) min]( t values were 63.044, 57.296, P<0.01).In term of the adverse effects on CVC,there were no statistical differences between two groups ( P> 0.05). Conclusions:Both 2% chlorhexidinegluconate and 0.5% iodophor disinfectant have similar disinfection effect on CVC caring, but 2% chlorhexidinegluconate disinfection is more efficient and worthy of application in clinical settings.

Objective:To investigate the current situation of general practitioners' occupational pressure in Heilongjiang Province, and explore its relationship with professional identity and perceived organizational support. It aims to provide references for the construction of general practitioners and the development of general medical education.Methods:The general situation questionnaire, perceived organizational support scale, occupational pressure scale, and professional identity scale were applied through network and site surveys for collecting data. A total of 288 questionnaires were collected with 263 valid questionnaires (91.3%). Pearson correction analysis and bootstrap analysis were performed for data analysis.Results:The average score of occupational pressure among general practitioners was (115.95±22.40), and the results of Pearson correction analysis showed that perceived organizational support was negatively correlated with occupational pressure ( r=-0.413, P<0.01) and positive correlation with professional identity ( r=0.587, P<0.01). There were also significant negative correlations between professional identity and occupational pressure ( r=-0.442, P<0.01). Moreover, the mediating effect showed that professional identity had a certain mediating effect on the relationship between perceived organizational support and occupational pressure (LLCI=-0.2039, ULCI=-0.0760, P<0.05). Conclusion:General practitioners' occupational pressure was at a high level, which can be reduced through improving the perceived organizational support and professional identity.

This paper systematically reviews the relevant literature on early clinical exposure (ECE) in China in recent years. It analyzes the main contents of literature, summarizes the various forms of ECE that the colleges and universities provide, and analyzes its positive effect on the students' learning interest and ability, their humanistic care for patients, as well as the teacher's self-improvement. Finally, according to the actual practical situation of ECE in medical universities in China and relevant experience from foreign studies, it is proposed that China should increase the emphasis on ECE in colleges and universities, strengthen the construction of teaching staff, and establish a scientific and systematic evaluation system.

The nursing experience of one hemaphagocytic syndrome patient with skin damage complication who underwent haploidentical hematopoietic stem cell transplantation were summarized. The patients gradually appeared ulceration of elbow joint skin, perianal mucosa, and bilateral axillary skin during the phase of agranulocytopenia and immune inhibition after transplantation. The overall skin ulceration area was accounted for 13% of total body surface area. We chose different dressings, combination anti-infection with promoting wound healing for nursing and achieved great effect. The skin lesions gradually healed and the patient went to the general ward successfully.