Objective:To investigate the mutations of TP53 and KRAS genes in the patients with six common types of digestive system tumors,including colorectal cancer(COAD),cholangiocarcinoma(CHOL),gallbladder cancer(GBC),liver hepatocellular carcinoma(LIHC),stomach adenocarcinoma(STAD),and pancreatic adenocarcinoma(PAAD),and to analyze the relationships between TP53 and KRAS gene mutations and clinical pathological characteristics,tumor mutation burden(TMB),and microsatellite instability(MSI)of the patients.Methods:The pathological paraffin or biopsy samples of 112 patients from January 2022 to December 2023 diagnosed with six types of tumors based on imaging and pathology were collected.Hybrid capture-based gene sequencing technology was used to detect TP53 and KRAS gene mutations in the patients with different types of tumors;mutation landscapes of common digestive system tumor samples were constructed.The patients were divided into high and low TMB groups according to the TMB levels.The mutation statuses of TP53 and KRAS genes in the patients with different types of digestive system tumors were compared,and the TP53 and KRAS gene mutations in the patients with different clinicopathological characteristics were examined.Results:A total of 276 mutations were detected in the 112 samples,with the highest mutation rate in TP53 gene(67％),followed by KARS gene(34％).TP53 gene mutation was most prominent in COAD,followed by LIHC,while KRAS gene mutation was most significant in PAAD.TP53 gene mutation mainly occurred in exons 5-8,while the KRAS gene mutation primarily occurred in exon 2.There was no statistically significant difference in TP53 gene mutation rate among the six types of digestive system tumors(P＞0.05),while the KRAS gene mutation rate showed statistically significant difference(P＜0.05).The mutation rates of TP53 and KRAS gene co-mutation also showed statistically significant difference among the six types of tumors(P＜0.05).There were statistically significant differences in TP53 and KRAS gene mutation rates between the patients with high TMB and low TMB(P＜0.05),while there were no statistically significant differences in TP53 and KRAS mutation rates between the patients with different sex,age,tumor size,differentiation degree,TNM stage,lymph node and/or distant metastasis and MSI(P＞0.05).Conclusion:The mutation rates of TP53 and KRAS genes are higher in common digestive system tumors,which are related to tumor types and TMB.

Objective To design and conduct objective structured clinical examination (OSCE) in professional postgraduates in obstetrics and gynecology, and to investigate the improvement measures for the teaching of professional postgraduates in obstetrics and gynecology by analyzing the performance of postgraduates in OSCE. Methods In October 2017, OSCE was performed for postgraduates in obstetrics and gynecology in the classes of 2016 and 2017 to evaluate their clinical ability. This OSCE consisted of the following four aspects: inquiry of standardized patients, basic practical skills in obstetrics and gynecology, utilization and interpretation of auxiliary examinations, and case analysis. The postgraduates were scored according to the following six items: doctor-patient communication skills, completeness of inquiry, basic practical skills in obstetrics and gynecology, utilization of auxiliary examinations, competence of clinical thinking, and mastery of medical knowledge. SPSS 18.0 was used for statistical analysis, and the t-test was used for comparison between groups . Results A total of 27 postgraduates participated in this OSCE . Among the six scoring items, completeness of inquiry had the lowest score (78 ±6), and utilization of auxiliary examinations had the highest score (85±3). Among the 27 postgraduates, 7 (25.9％) lacked doctor-patient communication skills, 6 (22.2％) showed serious problems in basic practical skills in obstetrics and gynecology, and 6 (22.2％) lacked the scientific thinking of clinical diagnosis. Conclusion In the training of professional postgraduate students in obstetrics and gynecology, doctor-patient communication skills and clinical thinking should be emphasized, and basic clinical skill training should be strengthened.

Objective To evaluate the association of vaginal dysbiosis and infertility.Methods Cohort studies, case-control studies and cross-sectional studies were searched in electronic databases, including MEDLINE,EMBASE and SinoMed(from inception to October 2017);in addition, the reference lists of included studies and similar reviews were handsearched.These studies investigating the correlation between vaginal dysbiosis and infertility were included.The Meta-Analysis was performed by RevMan 5.3 software.Results 1 724 records were retrieved by the search; from those,9 cross-sectional studies were included,comprising 3 367 participants(1 702 in infertility group and 1 665 in control group).The likelihood of vaginal dysbiosis in infertility group is higher than that of control group[OR=3.15,95% CI (1.57,6.32), P=0.001].Conclusions The available evidence suggests that vaginal dysbiosis was associated with the incidence of infertility.However, further case-control studies or cohort studies are required to confirm or refute these findings.(Chin J Lab Med,2018,41:281-286)

Objective To explore relationship of CD44 and transforming growth factor-? 1 (TGF-? 1) in endometriosis (EM) patients. Methods The histopathological changes and the expressions of CD44 and TGF-? 1 were observed and determined by immunohistochemistry in 17 cases of ectopic endometrium of EM patients and 17 cases of ovarian ectopic endometrium of EM patients. The other 20 cases of non-endometriosis and non-tumorous endometrial tissues were used as the control group. Results No difference in the expressions of CD44 and TGF-? 1 was found in the ectopic endometrium of EM patients and the control group, but the expressions in the ovarian ectopic endometrium of EM patients were significantly higher than those in the control group. Conclusion The abnormal expressions of CD44 and TGF-? 1 in ectopic endometrium of EM patients may be associated with the genesis and progression of EM.