Runt-related transcription factor 2 (Runx2) is a nuclear transcription factor of PEBP2/CBF superfamilies,and can regulate matrix metalloproteinase (MMP),osteopontin (OPN) and bone sialoprotein (BSP) which are associated with the metastasis of tumors including breast cancer and prostate cancer.In these cancers,the expression of Runx2 is highly up-regulated,which is closely correlated with the cell transformation and tumor progress.Lots of studies have demonstrated that the function of Runx2 is involved in several signal pathways activation,which can promote the early metastasis of malignant tumors.Therefore,the treatment targeting to Runx2 may be a new clinically choice to block the metastasis of tumors in the future.

Objective To investigate the nursing professional values of different nursing groups and probe into the influencing factors.Methods By cluster and stratified sampling,a total of 583 participants including nursing students and registered nurses were investigated by Nursing Professional Values Scale.Results Nursing students and registered nurses hold a higher level of nursing professional values.Nursing professional value scores of nursing students were significantly higher than registered nurses.There was statistical difference between different nursing groups.Working years and monthly income were important influencing factors.Conclusions Nursing educators and administers could choose effective methods according to the condition to improve nursing professional values.

Objective To investigate the clinicopathological characteristics and prognosis of lung metastases from breast cancer.Methods The clinical data of 119 breast cancer patients treated at our institution from January 2000 to January 2007 were retrospectively reviewed.Results Among 119 patients with lung metastasis,35.3％ was hormone receptor (HR) +/human epithelial growth factor receptor (HER2)-,17.6％ was HR +/HER2 +,21.8％ was HR-/HER2 + and 25.2％ was trriple negative breast cancer (TNBC).The rate of grade Ⅲ in triple negative breast cancer was higher than the other subtypes(P =0.016).The median overall survival was 60 months (9-141 months),the median time to lung metastases was 29 months (3-99 months),and the median survival after lung metastasis was 33 months (range,6-98 months).The 1-,2-,3-and 5-year survival rate was 72.9％,54.1％,35.1％ and 14.4％.Conclusions TNBC,number of lung metastases,time to lung metastases less than 24 months,and a history of systemic chemotherapy were important factors for prognosis of patients with lung metastases.

Objective To evaluate the effects of Met inhibitor XL-880 on radiosensitivity of breast cancer cells MDA-MB-231.Methods MDA-MB-231 cell lines were assigned to the following treatment groups:control group,radiation group,XL-880 group and combination group.Cell apoptosis,cell cycle distributions and tumorigenicity were investigated by flow cytometry or clonogenic assay.The expression of apoptosis and cell cycle related proteins (p21,Cyclin B1,Bcl-2,Caspase-3 and PARP),and phosphorylation levels of c-Met were measured by Western blot.Results XL-880 combined with radiation significantly decreased the proliferation activity of MDA-MB-231 cells (P ＜ 0.05).Flow cytometry results showed that the rate of G2/M cell were increased with XL-880 (P ＜ 0.05),and the rate were (17.3 ±1.3) ％,(20.0 ± 4.0) ％,(28.5 ± 3.1) ％,(57.0 ± 3.3) ％,respectively.Annexin V/PI double-staining assay showed that XL-880 obviously induced the apoptosis of MDA-MB-231 cells after radiation (P ＜ 0.05),of which the apoptotic rates were (7.3 ±0.9)％,(14.1 ±0.6)％,(35.5 ±4.4)％,(48.2±5.3)％,respectively.XL-880 downregulated the expressions of Cyclin B1 and anti-apoptosis protein Bcl-2,while promoted the expression of apoptosis related protein cleaved Caspase-3 and PARP.Conclusions XL-880 enhance the radiosensitivity of breast cancer cell MDA-MB-231 by inhibiting Met pathway.

Objective: In order to evaluate the effect of catastrophic disease medical assistance policy in Qingdao and provide suggestions for Qingdao policy reform.Methods: This paper selects NSCLC and liver cancer as the typical deceases to analyze the effects of the policy on patients and medical insurance institutions and finally evaluate the effect of the policy.Results: results shows that after the implementation of special medicines and special medical equipment assistance, the rate of co-paying patients decreased 40.57%, and the pressure on medical insurance institutions' expenditure was significantly reduced;while after the implementation of large cost assistance, but rate of co-paying patients only decreased 7.13%, and the pressure on medical insurance institutions' expenditure was not effectively alleviated.Conclusions: Therefore, the policy not only protects patients with catastrophic disease by greatly reducing their medical burdens, but it also achieves the fine management of medical insurance fund and increases the efficiency of the fund.

Objective:To retrospectively analyze the clinical efficacy and safety of rivaroxaban alone or in combination with folic acid/methylprednisolone in the treatment of livedoid vasculopathy (LV) .Methods:Clinical data were retrospectively collected from LV patients who were treated with rivaroxaban alone or in combination at the Department of Dermatology, Kaifeng People's Hospital from April 2020 to September 2023. Before treatment, all the patients underwent serum folate and homocysteine tests. Folic acid therapy was given to patients with low folate levels; glucocorticoid therapy was given to patients with generalized skin lesions in the extremities in the acute stage or with dense inflammatory cell infiltration around the dermal vessels on histopathological examination. Clinical symptoms (erythema, ulceration and pain) were scored before and after 8 weeks of treatment. Adverse reactions were recorded during the treatment.Results:A total of 11 patients were collected, including 6 males and 5 females; their ages ranged from 15 to 73 (29.00 ± 17.85) years, and the disease duration ranged from 1 month to 4 years (13.36 ± 15.87 months). Among the 11 patients, 3 were treated with rivaroxaban combined with methylprednisolone and folate, 1 with rivaroxaban combined with methylprednisolone, 5 with rivaroxaban combined with folate, and 2 with rivaroxaban alone. The total score of clinical symptoms was 5.00 ± 2.28 points before treatment, and significantly decreased to 1.18 ± 0.75 points after 8 weeks of treatment with rivaroxaban alone or in combination ( t = 6.90, P = 0.001). In addition, the pain scores of 5 patients who reported pain dropped to 0 point after 8 weeks of treatment. One patient experienced coagulation abnormalities after 2 weeks of treatment, and the coagulation parameters returned to normal without special treatment after 4 weeks. Conclusion:Rivaroxaban alone or in combination with folic acid/methylprednisolone was effective for the treatment of LV with a good safety profile.

OBJECTIVE:To improve medication compliance of patients with nonvalvular atrial fibrillation (NVAF) to warfarin and its influential factors,and to provide reference for guaranteeing the safety and effectiveness of therapy.METHODS:A questionnaire survey was conducted among NVAF patients receiving warfarin anticoagulation in our hospital,MMAS-8 and WRKS were adopted to evaluate medication compliance of patients to warfarin and the understanding of patients to the knowledge of anticoagulation treatment.Related influential factors for medication compliance of patients to warfarin were investigated by x2 test,t test and Logistic multiple regression analysis.RESULTS:Totally 129 questionnaires were sent out,and 112 were effectively received with effective recovery of 86.82％.The mean score of MMAS was (6.54 ± 1.61),and 42.86％ patients had good medication compliance.The mean score of WRKS was (7.95 ± 1.65);that of patients with good medication compliance was (9.31 ± 0.83),and that of patients with poor medication compliance was (6.92 ± 1.34).Single factor analysis showed that there was statistical significance in gender,age,occupation,educational level,the number of compliance,WRKS score between patients with good medication compliance and those with poor medication compliance (P＜0.05).Multivariate Logistic regression analysis showed that WRKS score,gender,educational level and the number of compliance were significantly correlated with medication compliance (P＜0.05).CONCLUSIONS:Poor medication compliance of NVAF patients to warfarin is related to multiple influential factors.The knowledge of warfarin anticoagulation is an important factor.

Objective:To construct a core competency indicator system for prehospital emergency nursing staff in stroke.Methods:A preliminary draft of the core competency indicator system for prehospital emergency nursing staff in stroke was formulated through literature research and group discussions. From January to March 2023, 15 experts were selected, and after two rounds of Delphi expert consultations, the indicators at all levels were modified and improved to form the final version of the indicator system. The degree of expert enthusiasm was expressed as the effective response rate of the questionnaire, the degree of expert authority was expressed as the expert authority coefficient ( Cr), and the degree of expert opinion coordination was expressed as the Kendall harmony coefficient and coefficient of variation. Results:In two rounds of Delphi expert consultation, the effective response rates of the questionnaire were 100.00% and 93.33%, respectively, and the expert authority coefficients were 0.853 and 0.861. After the second round of expert consultation, the coefficient of variation for each item was from 0 to 0.23, and the Kendall's harmony coefficient was 0.185 ( P<0.01). The final constructed indicator system included four primary indicators, 14 secondary items, and 31 tertiary items. Conclusions:The constructed core competency indicator system for prehospital emergency nursing staff in stroke is scientific and reliable, and can provide reference for the training and assessment of prehospital emergency nursing staff.

Objective:To investigate the efficacy and adverse reactions of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) combined with chemotherapy in the treatment of superior mediastinal lymph node metastasis after esophageal cancer surgery.Methods:The clinical data of 72 patients with concurrent chemoradiotherapy for superior mediastinal lymph node metastasis after esophageal cancer surgery in Tai'an Cancer Prevention and Treatment Hospital from January 2019 to May 2021 were retrospectively analyzed, and they were divided into intensity-modulated radiotherapy (IMRT) group (36 cases) and SIB-IMRT group (36 cases) according to different radiotherapy methods. The short-term efficacy, long-term survival rate and adverse reactions of the two groups were compared.Results:The response rate in the IMRT group was 66.7% (24/36), the response rate in the SIB-IMRT group was 86.1% (31/36), and the difference between the two groups was statistically significant ( χ2 = 3.77, P = 0.047). The 1-, 2- and 3-year overall survival rates in the IMRT group were 75.0%, 44.4% and 27.8%, and the 1-, 2- and 3-year overall survival rates in the SIB-IMRT group were 83.3%, 52.8% and 33.3%; the difference in the overall survival between the two groups was not statistically significant ( χ2 = 0.70, P = 0.401). There were statistical differences in the incidence of leukopenia, radiation esophagitis and radiation pleural gastritis between the two groups (all P < 0.05). There were no statistical differences in the incidence of radiation pneumonia and gastrointestinal reactions between the two groups (both P > 0.05). Conclusions:SIB-IMRT combined with chemotherapy in patients with superior mediastinal lymph node metastasis after esophageal cancer surgery has good local control rate and mild adverse reactions.

Objective Directly excited the denervated orbicularis oculi muscle (OOM) by electric current on rabbits,to induce efficient eyelid closure,and seek the optimal sites for such excitation that can produce efficient eyelid closure with the minimal excitating current in the least channel.Methods Bilateral peripheral facial paralysis model on 20 healthy NewZealand rabbits (40 sides)were prepared.Exciting current was designed for two-way rectangular pulse,35 Hz frequency and 0.2ms pulse width.The current intensity could be adjusted between 0 and 2.5 mA.Middle of upper-orbit (A),outer orbital rim (B),and middle of lower-orbit (C) sites were located around the OOM.Each site underwent parallel muscle fiber excitation by 2.5 and 5 mm distance dual-electrode respectively,additional dual-electrodes were also placed in A-B and A-C positions.All resulted in a total of 8 different exciting methods,and were labeled A2.5,A5.0,B2.5,B5.0,C2.5,C5.0,AB and AC.Then the current was adjusted to achieve efficient eyelid closure.The minimal current intensity needed was regarded as threshold value.Results All efficient eyelid closure occurrence rates of 8 methods were compared with combined x2 test and showed significant difference.A crossed x2 test showed the rates of C2.5,C5.0,and AC was significant lower than the highest methods.Except 3 methods above,the mean threshold values of remain 5 methods were compared with ANOVA test and showed significant difference.Further Fisher's LSD test showed B2.5 had the lowest mean value,was significant lower than A2.5 and AB,P ＜ 0.001,and had no significant difference with A5.0 and B5.0,P ＞ 0.05.A5.0's mean value was significant lower than A2.5 's,P ＜ 0.05.Methods B2.5,B5.0 and A5.0 were more likely to achieve a perfect closure.Conclusions Middle of supraorbital margin (A) and outer orbital rim (B) are the ideal sites for electric excitation.Exciting the two sites can sufficiently induce the contraction of denervated OOM,leading to high efficient eyelid closure occurrence rates,more perfect closure meanwhile with lower threshold current value,which are priority options.