Objective To investigate the current distribution of radiotherapy resources in Gansu Province, evaluate the equity of resource allocation, and provide a scientific basis for optimizing regional resource allocation. Methods A questionnaire survey was carried out to assess radiotherapy resources in medical institutions across Gansu Province, China. The equity of radiotherapy resource distribution and associated disparities were assessed using the Gini coefficient, Lorenz curve, and Theil index. Results A total of 23 medical institutions in Gansu Province provided radiotherapy services, comprising 39 radiotherapy devices and 438 professionals, of whom medical physicists accounted for 16.9%. The radiotherapy frequency was 0.47 cases per thousand population. The Gini coefficients for radiotherapy resource distribution ranged from 0.38 to 0.56 by population and from 0.52 to 0.70 by geography. The Theil index for radiotherapy resources ranged from 1.36 to 3.67. Conclusion Radiotherapy resources in Gansu Province were insufficient, and the capacity of radiotherapy service was suboptimal. The equity of radiotherapy resource allocation by geography was worse than that by population. Therefore, it is imperative to address the shortage of radiotherapy resources, strengthen the professional workforce, enhance the capacity radiotherapy service and resource utilization, optimize resource allocation, and promote regional equity in radiotherapy provision in Gansu Province.

Objective:To investigate the cognitive status of professionalism among medical college students and ways to cultivate physician professionalism.Methods:According to the literature and interview, we made the questionnaire on the cognition of physician professionalism among medical students. A total of 512 valid questionnaires (including e-questionnaires) were collected from medical students of Shantou University Medical College and Qingdao University Medical College of Shandong Province from May to September, 2017. SPSS 20.0 software was used to perform the normality and single-sample t-test on physician professionalism, professional cognition, professional emotion and professional willingness. Quantitative data was analyzed by cross-table chi-square test and mean-standard deviation. Results:The professional cognition scored lowest (3.62±0.50) in the three dimensions, the professional willingness scored the highest (4.35±0.58), and the professional emotional scored in the middle (4.05±0.48). There was significant difference in physician professionalism among medical students with different family background ( P<0.05), but no statistical difference in gender and school system. Conclusion:The results demonstrate a low-to-medium level of physician professionalism in medical students. We suggest to cultivate and promote physician professionalism from the aspects of emphasis on objectivity, and cultivation of humanism and service consciousness.

Objective To compare the consistency of thrombelastography (TEG) and light transmittance aggregometry (LTA) in monitoring the antiplatelet therapy of the patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI),and observe the changes of mean platelet volume (MPV) of the patients treated with aspirin and clopidogrel after PCI.Methods A total of 177 patients undergoing PCI and the treatment of aspirin and clopidogrel in Peking University First Hospital during March 2014 and May 2015 were enrolled in the study.Their adenosine diphosphate (ADP) or arachidonic acid (AA) induced platelet inhibition rates determined by TEG,MPV before and after antiplatelet therapy,and the maximum platelet aggregation rates measured by LTA from 99 patients were retrospectively analyzed.Results There was no any correlation between the maximum aggregation rates measured by LTA and the platelet inhibition rates determined by TEG regardless of using ADP or AA as agonist (all P ＞ 0.05).The detection rates of clopidogrel hyporesponsiveness determined by LTA and TEG were 30.3％ and 45.5％,respectively,while those of aspirin hyporesponsiveness were 19.2％ and 31.3％,respectively.The detection rate of hyporesponsiveness determined by LTA was significant lower than that by TEG (P ＜ 0.05).The MPVs after antiplatelet therapy were significant lower than that before treatment (all P ＜ 0.01) regardless of clopidogrel hyporesponsive or sensitive and aspirin hyporesponsive or sensitive.The MPVs in clopidogrel hyporesponsive group before and after treatment were significantly lower than that in clopidogrel sensitive group (all P ＜ 0.05).The PLT counts in clopidogrel or aspirin hyporesponsive groups after treatment were significantly higher than that before treatment (all P ＜ 0.05).Conclusion There is poor correlation between LTA and TEG.It should be noted that the incidence rate of antiplatelet drug hyporesponsiveness is high in clinical practice.The MPVs of the patients significantly decrease after antiplatelet therapy.The patients with a significant increase of PLT after antiplatelet therapy are more likely to become drug hyporesponsiveness,while the patients with lower MPV are more likely to have clopidogrel hyporesponsiveness.

Objective:To investigate the role and mechanism of miR-143 in the proliferation and migration of gastric cancer (GC) cells. Methods:Western blot was performed to detect the expression level of avian erythroblastosis oncogene B-3 (ERBB3) in GC tissues, paired non-cancerous tissues, and SGC7901 GC cells. RT-qPCR was conducted to determine the mRNA and miR-143 of ERBB3 quantita-tively. Bioinformatics tools were used to predict the target gene of miR-143. Luciferase reporter assay was carried out to confirm the predicted target gene. Transwell and EdU assays were applied to observe the migration and proliferation of SGC7901 GC cells transfect-ed with miR-143 mimics/inhibitor/NC mimics/inhibitor. Results:Compared with the expression levels of ERBB3 and miR-143 in the paired non-cancerous tissues, the expression level of ERBB3 was upregulated and the expression level of miR-143 was downregulated in GC tissues. In the prediction of the potential target gene, miR-143 could bind to a specific sequence of the 3′-untranslated regions (UTR) of the mRNA of ERBB3. This finding was supported by luciferase reporter assay results. In vitro, ERBB3 protein expression and cell migration and proliferation were suppressed significantly in the SGC7901 cells transfected with miR-143 mimics. By contrast, these processes were remarkably enhanced when the cells were transfected with miR-143 inhibitor. Conclusion:miR-143 can suppress the migration and proliferation of GC cells by downregulating the expression of ERBB3.

Gastric cancer is one of the most common malignancies worldwide; however, the molecular mechanism in tumorigenesis still needs exploration. BCL2L11 belongs to the BCL-2 family, and acts as a central regulator of the intrinsic apoptotic cascade and mediates cell apoptosis. Although miRNAs have been reported to be involved in each stage of cancer development, the role of miR-24 in GC has not been reported yet. In the present study, miR-24 was found to be up-regulated while the expression of BCL2L11 was inhibited in tumor tissues of GC. Studies from both in vitro and in vivo shown that miR-24 regulates BCL2L11 expression by directly binding with 3'UTR of mRNA, thus promoting cell growth, migration while inhibiting cell apoptosis. Therefore, miR-24 is a novel onco-miRNA that can be potential drug targets for future clinical use.
Animals ; Apoptosis ; genetics ; Apoptosis Regulatory Proteins ; deficiency ; genetics ; Base Sequence ; Bcl-2-Like Protein 11 ; Cell Line, Tumor ; Cell Movement ; genetics ; Cell Proliferation ; genetics ; Down-Regulation ; genetics ; Gene Silencing ; Male ; Membrane Proteins ; deficiency ; genetics ; Mice ; MicroRNAs ; genetics ; Proto-Oncogene Proteins ; deficiency ; genetics ; Rats ; Stomach Neoplasms ; genetics ; pathology

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cell Culture Techniques ; methods ; Child ; Female ; Humans ; Induced Pluripotent Stem Cells ; cytology ; metabolism ; Male ; Middle Aged

Objective To evaluate extended criteria donor liver in adult cadaveric liver transplant.Methods 126 liver transplantations were performed from January 2003 to June 2009,of them,74 patients received standard criteria donor livers,52 patients received extended criteria donor livers.These 52 donor livers could be divided into two groups:E1 group (a graft with 1 to 2 risk factors) and E2 group(a graft with 3 to 4 risk factors).Results There was no significant difference in half a year and 1 year survival rates between patients received E1 group extended criteria donor livers and those received standard criteria donor livers(respectively x2 =2.55,3.64,all P ＞0.05).But 2 year survival rate of patients received E1 group extended criteria donor livers was lower than those receiving standard criteria donor livers (x2 =4.9,P ＜0.05).Half a year,1 year and 2 year survival rates in patients receiving E2 group extended criteria donor livers were less than those receiving standard criteria donor livers (respectively x2 =3.91,8.67,11.34,all P ＜ 0.05).The half a year,1 year,and 2 year survival rates of patients received extended criteria donor livers with MELD score more than 20 was less than those with MELD score ＜ 20 (respectively x2 =0.16,0.16,0.07,all P ＜ 0.05).Conclusions Extended criteria donor livers can be used safely if the risk factor of donor liver was less than 3,or when recipient's MELD score was ＜20.

ObjectiveTo explore the surgical approach and therapeutic efficacy of injury of liver and vascular approaching to liver.MethodsThe clinical data from January 1997 to May 2010 of 35 patients with injury of liver and vascular approaching to liver were retrospectively analyzed.Results Among 35 cases,32cases were cured by surgery ( cure rate 91.43％ ) and 3 cases died ( mortality rate 8.57％ ).Postoperative complications occurred in 5 patients ( complication rate 14.29％ ).There were 2 cases of pulmonary infection,1case of biliary fistula,1 case of multiple organ failure and 1 case of incision infection.Conclusion Urgent surgery need to be performed for injury of liver and vascular approaching to liver and effective recovery was important.In the operation,careful handling,complete dissociation and sufficient exposure were the key to successful repair.

Objective To approach the efficacy of urgent liver transplantation for acute liver failure.Methods The clinical data of 22 patients with acute liver failure undergoing urgent liver transplantation in our hospital from January 2003 to January 2009 were retrospectively analyzed.The prognosis,survival rate and complication were summarized.Results Among 22 patients,there were 14 cases of hepatitis B-induced acute liver failure,and 8 cases of drug-induced acute liver failure.The mean waiting time was 2.3 days.Three patients died perioperatively.Retransplantation was done in 1 patient.Complications after urgent liver transplantation included:abdominal cavity hemorrhage (2 cases),biliary complications (2 cases).There were no vascular complications.Renal dysfunction of different degrees occurred in all patients.Psychiatric symptom occurred in 17 cases,epilepsy in 1 patient,pulmonary infection in 11 patients,and acute cell rejection in 3 patients.The 1-,2-and 3-year recipient survival rate was 81.8 ％,81.8 ％,81.8 ％,respectively,and the 1-,2- and 3-year graft survival rate was 81.8 ％, 77.3 ％, 77.3 ％, respectively.ConclusionUrgent liver transplantation has a good efficacy for acute liver failure.Reasonable preoperative evaluation,length of waiting for graft,and effective treatment of various kinds of complications are the key point to improve the prognosis of patients with acute liver failure undergoing urgent liver transplantation.

Objective To investigate the efficacy of preoperative transcatheter artery chemoembolization (TACE) correlates with outcome after orthotopic liver transplantation (OLT) in patients with hepatocellular carcinoma (HCC). Methods Sixty-seven patients with HCC underwent TACE before OLT. In all the patients, there were 52 males and 15 females with age ranging from 34 to 67 years old (average 48). Sixty-one patients met the Milan' standard, and 6 patients exceeded Milan' standard. Classic OLT was done in 62 patients and pigyback liver transplantation was done in 5 patients. Immunosuppression regimen after operation included Tacrolimus (or Ciclosporin,Sirolimus), mycophynolate, steroid hormone. The efficacy of TACE was assessed according to histological findings after OLT. Tumor recurrence rate of 1-and 2-year tumor recurrence rate, and 1-and 2-year survival rate in different groups with different responses to preoperative TACE were compared. Results Tumor necrosis rate was greater than 50% in 50 patients and new tumor nodi occurred in 2 patients. Tumor necrosis rate after TACE was 73. 77%. Tumor necrosis rate was less than 50% in 17 patients and new tumor nodi occurred in 7 patients. Forty-eight patients had satisfactory efficacy after TACE and no new tumor nodi occurred, 1-and 2-year tumor recurrence rate was 2. 08/ (1/48) and 6. 25% (3/48) respectively, and 1- and 2-year survival rate was 97. 92% (47/48) and 95. 83% (46/48) respectively. Nineteen patients had worse efficacy after TACE and new nodi occurred, 1- and 2-year tumor recurrence rate was 36. 84% (7/19) and 57. 89% (11/19), and 1-and 2-year survival rate was 73.68% (14/19) and 47. 37% (9/19) respectively. There were statistically significant difference between the two groups (P＜0.05). Conclusion TACE provides good local control in preoperatively diagnosed HCC, but its impact is limited in lesions not detected preoperatively. Patients with satisfactory efficacy after TACE before OLT had a good prognosis. The response to preoperative TACE may predict long-term outcome after LT.