Breast cancer is the most common cancer in women, and radiotherapy is an important method of its treatment. The outcome of radiotherapy greatly depends on radiosensitivity of cancer cells. The key pathways of microRNAs (miRNAs) involved in breast cancer radiotherapy response include DNA damage repair, apoptosis, cell cycle arrest, autophagy and related signaling pathways. This article reviews the role of miRNAs in regulating the response of breast cancer to radiotherapy and related signaling pathways. To explore the role of miRNAs in regulating the treatment response of breast cancer to radiotherapy and related signaling pathways, it can provide reference for miRNAs to be used as an indicator to evaluate the diagnosis, prognosis and radiotherapy efficacy of breast cancer.

Objective:To investigate the methylation status of SDC2, PPP2R5C and ADHFE1 genes in stool and their values in the screening of colorectal cancer and precancerous lesions.Methods:From August 2020 to March 2021, 64 patients with colorectal cancer, 72 patients with adenoma, 33 patients with hyperplastic polyps and 59 healthy people were recruited from Qingdao Central Hospital Affiliated to Qingdao University, and the morning stool samples were collected from the research subjects. The genomic DNA was extracted and modified with sulfite. The methylation status of SDC2, PPP2R5C and ADHFE1 genes were detected by methylation specific polymerase chain reaction (MSP), and the fecal occult blood test (FOBT) was performed. Taking the pathological results as the gold standard, receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to compare the effect of combined detection of methylation of three genes and FOBT in predicting colorectal cancer and precancerous lesions. R-Studio software was used to construct a nomogram for the prediction of colorectal cancer with combined detection of gene methylation in stool and other clinical features, and the calibration and validation were performed.Results:The positive rates of combined detection of methylation of SDC2, PPP2R5C and ADHFE1 genes in stool were higher than those of FOBT in colorectal cancer+adenoma [74.3% (101/136) vs. 47.1% (64/136), χ2 = 23.20, P = 0.001], colorectal cancer [90.6% (58/64) vs. 70.3% (45/64), χ2 = 8.91, P = 0.003] and adenoma [59.7% (43/72) vs. 26.4% (19/72), χ2 = 14.43, P = 0.002]. There was no significant difference in the positive rates in hyperplastic polyps [21.2% (7/33) vs. 6.1% (2/33), χ2 = 0.12, P = 0.125] and healthy controls [10.2% (6/59) vs. 8.5% (5/59), χ2 = 4.01, P = 1.000]. The combined detection of gene methylation was better than FOBT in the prediction of colorectal cancer + adenoma [AUC: 0.85 (95% CI 0.80-0.91) vs. 0.71 (95% CI 0.64-0.78), P < 0.05], especially in the prediction of adenoma [AUC: 0.82 (95% CI 0.74-0.89) vs 0.64 (95% CI 0.57-0.69), P < 0.001]. The sensitivity and specificity of ADHFE1 gene methylation status in predicting colorectal cancer were high (90.6% and 96.6%). In colorectal cancer patients over 50 years old, the positive rate of combined detection of gene methylation was higher than that of FOBT [90.2% (55/61) vs. 68.9% (42/61), P < 0.05]. The nomogram calibration curve for predicting colorectal cancer constructed based on the combined detection of gene methylation and each clinical feature showed a high degree of concordance between the predicted and observed diagnostic performance of colorectal cancer. Conclusions:The methylation levels of SDC2, PPP2R5C AND ADHFE1 genes in stool are increased in patients with colorectal cancer or adenoma. The combined detection of gene methylation is expected to be a non-invasive method for the screening of colorectal cancer and precancerous lesions.

Objective:To explore the effect of problem-based learning (PBL) combined with case teaching method in the three-year probationary teaching of clinical urology in three-year higher vocational colleges.Methods:A total of 45 students from Class 1, Grade 2015, and 37 students from Class 2, Grade 2016 of Ningxia Medical University were selected as study subjects. They were divided into experimental group and control group. Forty-two students in experimental group were taught with PBL combined with case teaching method. 40 students in control group were taught with traditional clinical probation teaching method. Besides, a questionnaire survey was conducted among two groups of students in the Department of urology.Results:There was no significant difference in the scores of theoretical examination between the experimental group and the control group ( P>0.05). The scores of medical history collection, physical examination, practical skills and total scores were much higher in the experimental group than in the control group. The results of the questionnaire survey showed that the teaching of the experimental group could significantly motivate students' enthusiasm and participation, as well as enhance ability of self-study, information acquisition, innovation, analysis and problem-solving and team consciousness ( P<0.05). Conclusion:The new model of PBL combined with case teaching is helpful in improving students' academic performance, probation effect and comprehensive practical ability in urology internship teaching, which is worth being popularized in clinical teaching.

Autophagy is a crucial physiological process for cellular self-renewing and homeostasis,which plays a dual role in both tumorigenesis and anti-tumor treatment.It plays an antineoplastic role by maintaining genomic stability,as well as a protective role in tumorgenesis and progression.Autophagy improves the effectiveness of anti-tumor therapy,meanwhile,it involves in resistance of tumor cells to chemotherapy and irradiation.Using relevant autophagy regulators in different backgrounds is expected to become a new strategy for improving sensitivity of tumor cells to anti-tumor treatment.

Objective To analyze the expressions of thymidine kinase 1 (TK1) and nuclear-associated antigen Ki-67 in triple negative breast cancer (TNBC) and their clinical significances.Methods One hundred and twenty tumor tissue sections of patients with breast cancer who were performed breast conservation treatment or modified mastectomy in the Second Affiliated Hospital of Qingdao University Medical College from June 2009 to December 2010 were collected,and there were 60 cases with TNBC and 60 cases with non-TNBC.The expressions of TK1 and Ki-67 in different breast tissues were detected by immunohistochemistry.The relationships between the expression status and clinicopathologic features were analyzed.Results The positive expression rates of TK1 in TNBC and non-TNBC were 83.33％ and 51.67％ respectively,with a significant difference (x2 =13.713,P =0.000).The positive expression rates of Ki-67 expression in TNBC and nonTNBC were 68.33％ and 31.67％ respectively,with a significant difference (x2=16.133,P =0.000).In TNBC,the expression of TK1 was related to histological staging (x2 =6.125,P =0.013),but it was not related to onset age (x2 =0.809,P =0.369),menopausal stutas (x2 =1.615,P =0.204),tumor size (x2 =0.054,P =0.816) and lymphatic metastasis (x2 =0.672,P =0.412).In TNBC,the expression of Ki-67 was related to histological staging (x2 =13.145,P =0.000) and lymphatic metastasis (x2 =6.182,P =0.013),but it was not related to menopausal stutas (x2 =1.018,P =0.313),onset age (x2 =2.377,P =0.123) and tumor size (x2 =2.401,P =0.121).The expression of TK1 was positively correlated with that of Ki-67 (r =0.369,P =0.023).The results of survival analysis showed that the disease-free survival rates of 5-year were 28.20％ and 66.70％ in the TK1 positive group and TK1 negative group,and the disease-free survival rates of 5-year were 24.30％ and 64.30％ in the Ki-67 positive group and Ki-67 negative group,with significant differences (x2 =4.194,P=0.041;x2 =4.540,P =0.033).Conclusion TK1 and Ki-67 are highly expressed in TNBC,and their expressions are correlated with histological staging and survival,which are expected to become prognostic indicators.

Objective To evaluate combined effect on different population through 2 459 data of SAA,hs-CRP and PCT from 8 three-level hospitals in Guangdong region.Methods Subjects were divided into five groups by ages,and every group had bacterial and virus type.In order to confirm diagnostic effect on infection,methods were performed including in tendency of SAA and hs-CRP,Paired t test between bacterial and virus group,efficiency of 3 indexes in judging infection depending on ROC and parameters,multiple logistic regression,consistency between positive bacterial infection and bacterial culture.Re-sults There were statistically significant differences in SAA and hs-CRP between bacterial and virus in infants and children (P <0.001).SAA had the biggest AUC area 0.824 with sensibility 71.8% and specificity 82.6% in younger group.Corre-sponding,hs-CRP had the biggest area 0.806 with sensibility 84%.There was the accuracy of 78.8% for differential diagno-sis in younger group,while 65.1% in elder group.AUC of SAA was 0.883 for positive bacterial culture with sensibility 71.2% and specificity 90.7%,accuracy of 95.2% for differential diagnosis.Conclusion There was obvious trend of age in SAA and hs-CRP,3 indexes could be used for differential diagnosis alone or combined,especially in younger group.SAA is the best index as a separated index.There is less value at ratio of SAA and hs-CRP.

Background and purpose:Chemotherapy is an alternative treatment option, which could still get a therapeutic effect, when the EGFR-TKI treatment of non-small cell lung cancer failed. Studies have shown that RR, TYMS, ERCC1 and TUBB3 have respectively relationship with chemosensitivity of gemcitabine, pemetrexed, platinum-based drugs and microtubule-based chemotherapy drugs.The expression levels of these molecular markers can predict the sensitivity of these chemotherapy drugs. The patients with RRMI, TS, ERCC1 and TUBB3 higher expression have reduced chemosensitivity, and lower expression have increased sensitivity. The purpose of this study was to explore the sensitivity of tumor cell lines with acquired resistance to geiftinib caused byEGFR-T790M mutation to cisplatin, gemcitabine, pemetrexed, vinorelbine, paclitaxel and docetaxel.Methods:MTT assay was used to detect the IC50 values of cisplatin, gemcitabine, vinorelbine, paclitaxel and docetaxel, pemetrexed to PC9 and PC9/GR cells, and to explore the chemosensitivity of lung adenocarcinoma cells to these chemotherapy drugs; Luminex method was used respectively to detect the expression levels of ERCC1 mRNA, TUBB3 mRNA, TS mRNA, and RRM1 mRNA in PC9 and PC9/GR cells. Western blot was used to detect the protein expression levels of ERCC1, TUBB3, TS and RRM1 in PC9 and PC9/GR cells.Results: The IC50 values of cisplatin, gemcitabine and pemetrexed to PC9/GR cells were signiifcantly higher than those to PC9 cells (P<0.05), while the IC50 values of vinorelbine, paclitaxe and docetaxel to PC9/GR cells were signiifcantly decreased (P<0.05). Luminex method showed the expressions of ERCC1 mRNA, TS mRNA and RRM1 mRNA in PC9/GR cells were signiifcantly increased than those in PC9 cells (P<0.05), while the expression of TUBB3 mRNA was signiifcantly decreased (P<0.05). Western blot method showed the expressions of TUBB3, TS and RRM1 protein in PC9/GR cells were signiifcantly increased than those in PC9 cells (P<0.05), while TUBB3 protein expression in PC9/GR cells was signiifcantly decreased (P<0.05). Western blot method analysis result showed that the expressions of TUBB3, TS and RRM1 protein in PC9/GR cells were significantly increased than those in PC9 cells (P<0.05), while TUBB3 protein expression in PC9/GR cells was signiifcantly decreased (P<0.05). Conclusion:The chemosensitivity of lung adenocarcinoma with EGFR-T790M mutation is changed. It has decreased sensitivity to cisplatin, gemcitabine, pemetrexed and increased sensitivity to vinorelbine, paclitaxel and docetaxel. The reason of the change of chemosensitivity of geiftinib-resistant lung adenocarcinoma cell maybe related to the changes of ERCC1 mRNA, RRM1 mRNA and TS mRNA and their protein expressions.

Triple-negative breast cancer (TNBC) is a subtype of breast cancers which have exclusive pathological and molecular biological characteristics.TNBC's chief feature is early recurrence,rapidly progressive and poor prognosis.Operation,chemotherapy and radiotherapy are the major therapies for TNBC.In recent years,with the developing of the research,new chemotherapeutic drugs and targeted therapies are applied to clinical therapy gradually.

Objective To identify the factors related to radiation pneumonia (PR) in lung cancer treated with intensity modulated radiotherapy (IMRT).Methods Data from 163 lung cancer patients treated with IMRT were analyzed with clinical factors and physical parameters related to the dose-volume histogram.The patients were followed for 6 months after radiotherapy.The relationship between survival status and PR was analyzed.Results The incidence rate of over grade 2 patients was 28.22 ％ (46/163).Univariate analysis revealed a significant relationship between many parameters associated with such as the site of lobe (P =0.033),COPD (P =0.020),chemotherapy (P =0.020) and prophylactic using of glucocorticoid and antibiotic (P =0.025).Multilogistic regression analysis showed that V20 in the contralateral site,the V5 of the all lungs and PTVV were independent factors.Conclusion The RP is associated with multiple factors.Individualized treatment plans should be made according to the specific circumstances of patients.

This article introduced the reform of the teaching mode for Rehabilitation Therapy in higher vocational education, including the course of theory and practice, system of personnel training and assessment.