Objective To investigate the relationships between circulating tumor cells (CTCs), circulating tumor endothelial cells (CTECs) and treatment methods in patients with nasopharyngeal carcinoma (NPC) at different stages of treatment. Methods The data of NPC patients at different treatment periods in West China Hospital of Sichuan University from March 2016 to November 2019 were retrospectively collected. The patients received CTCs test and part of those patients received CTECs test, by subtraction enrichment-immunostaining-fluorescence in situ hybridization. The relationships of CTCs and CTECs with radiotherapy and chemotherapy, and the correlations between CTCs and CTECs in NPC patients were analyzed. Results A total of 191 patients were included. Among them, there were 66 cases before initial treatment, 38 cases after induction chemotherapy, and 87 cases after concurrent chemoradiotherapy. A total of 127 patients received CTECs test, including 41 cases before initial treatment, 29 cases after induction chemotherapy, and 57 cases after concurrent chemoradiotherapy. The positive rates of CTCs were 89.4%, 81.6% and 69.0% respectively in the three stages of treatment, and the difference was statistically significant only between the pre-treatment group and the post-concurrent chemoradiotherapy group (P=0.003). The number of CTCs in the post-concurrent chemoradiotherapy group was lower than that in the pre-treatment group and the post-induction chemotherapy group (P<0.001, P=0.002). The number of triploid CTCs in the post-concurrent chemoradiotherapy group was significantly different from that in the pre-treatment group and the post-induction chemotherapy group (P=0.009, P=0.013). The number of tetraploid CTCs in the post-concurrent chemoradiotherapy group was significantly different from that in the post-induction chemotherapy group (P=0.007). The number of polyploidy (pentaploid or > 5 copies of chromosome 8) CTCs in the post-concurrent chemoradiotherapy group was significantly different from that in the pre-treatment group (P<0.001). The positive rates of CTECs were 70.7%, 82.8% and 64.9% respectively in the three stages of treatment, and the difference was not statistically significant (P>0.05). The number of CTECs in the post-concurrent chemoradiotherapy group was only lower than that in the post-induction chemotherapy group (P=0.009). There was no significant difference in the number of triploid or tetraploid CTECs among the three groups (P=0.265, P=0.088). The number of polyploid CTECs was statistically different only between the post-concurrent chemoradiotherapy group and the post-induction chemotherapy group (P=0.007). Spearman correlation analysis showed that there was a significant positive correlation between CTCs and CTECs (rs=0.437, P<0.001). Conclusions Concurrent chemoradiotherapy plays a decisive role in reducing the number of CTCs in the blood of NPC patients, while induction chemotherapy does not appear to directly cause changes in the number of CTCs. In NPC patients, different types of CTCs have different responses to different treatments. There is a significant positive correlation between CTECs level and CTCs level in NPC.
Objective To investigate the students’ satisfaction on teaching content, teaching staff, organizations etc. of the evidence-based medical postgraduate summer school, so as to provide references for further effective training. Methods A self-made questionnaire with cluster sampling was used to investigate the regular students who had participated in the whole course of the evidence-based medical postgraduate summer school, and the feedbacks were analyzed. Results The total number of the questionnaires was 112 and the number of the effective questionnaires was 101; the effective recovery rate was 90.2%. The students were from 32 universities and medical institutions involving 36 disciplines in 26 provinces. A total of 93.1% of the students were satisfied with the general training organization and management, but the satisfaction rates of the class environment and the time arrangement were only 51.5% and 58.4%, respectively. The satisfaction rates of the whole course setting and the teaching materials were 84.2% and 90.1%, respectively. The satisfaction rate of the teaching content of “the progress of the evidence-based medicine” was up to 93.0%. Over 93.1% of the students believed that the teachers were great in teaching skills, but only 73.3% of the students thought that the interaction between teachers and students was plenty. Conclusion This summer school has active students, a great effect and a high overall satisfaction rate. The summer school is beneficial to the cultivation of innovative postgraduates, construction of excellent teaching teams, development of evidence-based medicine discipline and building of The Network Center for Evidence-Based Medicine Education. The satisfaction rate of the summer school training can get promoted by increasing schooling investments, appropriately prolonging training time, setting different subjects in different semesters and enhancing the teaching interaction.