To investigate the immunophenotypings of malignant epithelial mesothelioma (MEM), and to seek the valuable markers in distinguishing peritoneal MEM from peritoneal metastatic ovarian adenocarcinoma (OA) and colorectal adenocarcinoma (CA), immunohistochemical SP method was used to detect expressions of HBME-1, E-cadherin, CA19-9, MOC-31 and CK7 in paraffin-embedded tissues of 18 cases of MEM, 20 OA and 20 CA. The results showed that there was a significant difference in the expressions of E-cadherin, CA19-9 and MOC-31 between MEM and OA group (P<0.05). Similarly, the difference in the expression of HBME-1, E-cadherin, CA19-9, MOC-31 and CK7 between MEM and CA groups is significant (P<0.05). These results indicate that HBME-1 could be used as a positive marker in distinguishing MEM from CA. E-cadherin, CA19-9 and MOC-31 are considered to be useful negative markers in diagnostic distinction between MEM and metastatic adenocarcinomas, including OA and CA. CK7 is the best positive marker in distinguishing MEM from CA, but this marker appears to be valueless in discriminating MEM from OA.

Objective To analyze the clinical features of pulmonary embolism(PE) after urologic surgery in order to provide the theory base for preventing pulmonary embolism Methods CNKI database was used to look for our subjects who were with PE after urologic surgery from January 2005 to December 2011.Ten cases were selected.Three related patients simultaneously in Xuancheng Central Hospital were also recruited as our subjects.The information of diagnosis and treatment information and clinical features were collected.Results Among the 13 patients,3 were women and 10 were men with confirmed PE.Their age ranged from 48 to 79 years old and the average was 61.Among the 13 patients,2 conducted routine surgery,and the other 11 conducted mini-invasion operation.The 13 patients underwent PE from 2 to 18 days after urologic surgery and 7 patients (53.85％) died of PE.Conclusion No specificity of clinical feature for PE was found to contribute to cure rate.Early diagnosis and prevention of PE are important,and anticoagulant treatment and immediate thrombolytic are critical.

Objective:To explore the effect of case teaching in clinical nursing teaching and medical ethics ed-ucation in the department of cardiology. Methods: A sample of 75 nurse interns came to practice in November 2014 to April 2015 were allocated to the control group, while 96 nurse interns came in July 2015 to December 2015 were allocated to the experimental group. The interns in control group were taught according to the traditional teach-ing method, and the case teaching method was used in the experimental group. The scores of critical thinking abili-ty and the times of praise were compared between the two groups. Results:Both critical thinking ability and praise of the interns in the experimental group were better than those in the control group ( P<0 . 01 ) . Conclusion:In-troducing the case teaching method to clinical nursing teaching and moral education can improve nurse interns′clin-ical critical thinking ability and stimulate the enthusiasm for learning. Meanwhile, it is beneficial to cultivate nurse interns′medical humanistic spirit and improve the medical humanistic quality.

Objective To investigate the application of leukoreduction filter in removal of leukocytes in platelet concentrate . Methods Platelet concentrate was prepared by using platelet‐rich plasma method .35 bags of the same type of prepared platelet concentrate were filtered by using leukoreduction filter .The changes of conventional indicators of platelet before and after filter were measured and recorded .The activating platelets indicators PAC‐1 and CD62p were detected by using flow cytometry .The platelet hypotonic shock was measured by biochemical analyzer .The platelet aggregation was measured by using platelet aggrega‐tion instrument .Results After platelet concentrate was filtered by using leukoreduction filter ,leukocyte removal rate was(98 .28 ± 0 .97)% ,platelet recovery rate was(86 .37 ± 2 .84)% .After filtration ,white blood cell count ,platelets ,red blood cells were reduced than before filtration(P<0 .05) .The differences of capacity of platelets ,mean platelet volume and pH before and after filtration were not statistically significant(P> 0 .05) .Before and after filtration ,the expression of platelet activation markers PAC‐1 and CD62p ,platelet aggregation and platelet hypotonic shock were not statistically different(P>0 .05) .Conclusion Platelet leukore‐duction filter could effectively filter leukocytes in platelet concentrate .It would not change the conventional indicators ,and not affect platelet activation ,aggregation and anti‐hypotonic shock capacity significantly .

Objective To screen and identify the predominant T-and B-cell ( T-B) combined an-tigenic epitopes on the outer membrane protein Loa22 of pathogenic Leptospira interrogans ( L.interrogans) stains and to further analyze their immunogenicity.Methods PCR analysis was used to detect loa22 gene in L.interrogans strains belonging to eight different serogroups or serovars prevalent in China.The PCR prod-ucts were sequenced after T-A cloning.A prokaryotic expression system for loa22 gene of L.interrogans sero-group Icterohaemorrhagiae serovar Lai strain Lai was constructed.The expressed recombinant protein rLoa22 was extracted by Ni-NTA affinity chromatography.The rabbit anti-rLoa22 serum samples and IgG were pre-pared.The T-B combined antigenic epitopes on Loa22 protein were predicted by using professional bioinfor-matic softwares.Phage display in combination with Western blot assay and ELISA were performed to identify the immunogenicity of the recombinant phage PⅢ protein-displayed and artificially-synthesized T-B com-bined antigenic epitopes, respectively.MTS assay and ELISA were performed to detect the activation of T cells and the expression of IL-2, IL-4 and IFN-γinduced by T-B combined antigenic epitopes, respectively. Results All of the tested pathogenic Leptospira strains were positive for loa22 gene, sharing 85.5%-99.8%homologies in nucleotide sequences and 93.9%-99.5%homologies in amino acid sequences.The construc-ted prokaryotic expression system for loa22 gene efficiently expressed the rLoa22 protein.Among four T-B combined antigenic epitopes (Loa22-77, Loa22-90, Loa22-125 and Loa22-157), only Loa22-90 epitope presented a strong positive band in Western blot analysis.The proliferation of CD4+T cells and the expres-sion of IL-2 ( Th1 ) and IL-4 ( Th2 ) were significantly enhanced by the stimulation with Loa22-90 epitope peptide (P<0.05).Conclusion Loa22 protein is a sequence-conserved genus-specific outer membrane protein of L.interrogans.The Loa22-90 epitope is the predominant T-B combined antigenic epitope of Loa22 protein, which might be used as a candidate antigenic epitope in the development of multiple antigenic pep-tide ( MAP) vaccines against Leptospira infection.

Objective To investigate the posttraumatic stress disorder(PTSD) and ethical decision-making in nurses suffered workplace violence, and analyze the relmionship between them. Methods Totally 340 nurses suffered workplace violence were questionnaired by the PTSD Scale and the Ethical Decision- making Scale. Results The incidence rate of PTSD was 17.06%(58/340), the total score of PTSD was (38.77± 13.57).The scores of ideal ethical practice, actual ethical practice and ethical decision- making in the PTSD group were 121.36±8.33, 105.56±7.76, 226.92±15.52, and were significantly lower than that in the non-PTSD group (140.60±9.01, 117.65±8.41, 258.27±16.73) (t=-14.996, -10.015, -13.153, P < 0.01). The score of PTSD was negtively correlated with the scores of ideal ethical practice, actual ethical practice and ethical decision- making (r=-0.415, -0.431,-0.420, P < 0.05). Conclusions The PTSD probably occurred after workplace violence, nursing administrators should pay close attention to the PTSD and therefore improve nurses′ethical decision-making.

Objective To investigate the chemical preventive effect of matrine on ethyl nitrate nitroguanidine nitrate induced gastric cancer in rats. Methods 100 male Wistar rats were selected and randomly divided into four groups,each had 25 rats ,treated with different drugs respectively.Rats in the negative control group (group A)freely drunk water;each rat in gastric carcer model group (group B)drunk ethyl nitrate nitroguanidine nitrate (ENNG)1.5 mg/d by themselves;gastric cancer model rats of experimental group (group C)drunk matrine 150 mg/(kg · d)ethyl nitrate nitroguanidine nitrate (ENNG)150mg/(kg·d)by themselves;negative control group (group D)rats drunk matrine for injection 150 mg/(kg·d)by themselves.Rats were killed after 24 weeks,rats were observed on gastric mucosa change by naked eye and microscope ,and detected proliferating cell nucleus antigen (PCNA)of stomach tissue ,levels of serum transforming growth factorβ1 (TGF-β1 )and B cell lymphoma/leukemia-2 (Bcl-2).Results Canceration rate [64.00% (16/25)]of the rat gastric mucosa in Group B was significantly higher than that in group C [12.00% (3/25)],and the difference was statistically significant (P<0.05 );PCNA,TGF-β1 and the Bcl-2 level of rats in group C was lower than those in group B,and the difference was statistically significant (P<0.05 );after raising 24 weeks,change rate of gastric mucosa atrophy and hyperplasia in group B were significantly higher than those of group C,and the difference was statistically significant (P<0.05 );after raising 24 weeks,there was no cancerous changes on gastric mucosa in group A and D ,and the change of gastric mucosa atrophy and hyperplasia had no obvious difference,there was no statistically significant difference.Conclusion Matrine could inhibit rat gastric cancer induced by ENNG by lowering PCNA,TGF-β1 and the Bcl-2 levels,which provides evidence for the potential chemical preventive effect on human gastric cancer.

Objective To evaluate the efficacy of proximal percutaneous pedicle screw fixation combined with distal open osteotomy for sagittal plane imbalance of adult spinal deformity.Methods From January 2011 to June 2015,23 patients with diagnosis of adult spinal deformity were treated with proximal percutaneous pedicle screw fixation combined with distal open osteotomy,there were 8 males and 15 females,aged from 52 to 67 years old (average,62.1 years old).The operation time,blood loss,drainage and perioperative complications were recorded;standing anteroposterior and lateral radiographs of the whole spine were taken and the following parameters were measured:sagittal vertical axis (SVA),lumbar lordosis(LL),pelvic tilt (PT),sacral slope (SS),pelvic incidence/lumbar lordosis mismatch (PI-LL),the above parameters were compared between preoperation and postoperation.Oswestry disability index (ODI) was used to evaluate the clinical efficacy.Results The mean operation time was 253.9±52.1 min,the mean blood loss and drainage was 1 258.5±272.2 ml and 725.1 ± 135.2 ml.No patient got infected,died or had deep vein thrombosis.All patients were followed up for an average of 21.2 months (range,13-52 m).The SVA was restored from 12.6±1.4 cm to 3.5±0.7 cm.In addition,LL,SS,PT,and PL-LL were improved from 13.5°±2.3°,13.9°±2.3°,29.7°±9.6°,29.5°±13.7° to 38.8°±9.6°,25.5°±5.8°,18.9°±8.2°,7.1°±3.6°.The ODI score decreased from 40.3％±12.5％ to 13.6％±2.57％ at the time of the last follow-up compared with preoperation.Conclusion Proximal percutaneous pedicle screw fixation combined with distal open osteotomy for sagittal plane imbalance of adult spinal deformity could restore the sagittal balance and improve the quality of life.

Objective To study the expression of cyclin E and epidermal growth factor receptor (EGFR) in breast carcinoma and their correlation with metastasis,relapse and survival time. [WT5”HZ]Methods Cyclin E and EGFR expressions at protein level were determined by immunohistochemistry technique in 110 patients with breast carcinoma. Results Of the 110 patients,cyclin E and EGFR positive expression were both in 60 (54.55%),and there was a positive relationship between cyclin E and EGFR expression (r s=0.823,P =0.001);Cyclin E and EGFR expression level were correlated with clinical stage (? 2=12.86,P =0.005;? 2=14.21,P =0.004),tumor histological grading (? 2=8.86,P =0.005;? 2=4.90,P =0.04),lymph node metastasis (? 2=10.22,P =0.001;? 2=9.62,P =0.002),ER expression (? 2=29.8,P =0.001;? 2=32.08,P =0.001) and PR expression (? 2=19.56,P =0.001;? 2=26.92,P =0.001). The rate of local relapse and distant metastasis in cases with positive cyclin E and EGFR expression were significantly higher than that in cases with negative expression (? 2=7.33,P =0.01;? 2=7.88,P =0.005);The mean survival time and 5-year survival rate in cases with positive cyclin E and EGFR was significantly shorter than that in cases with negative expression. [WT5”HZ]ConclusionCyclin E and EGFR expression can predict the relapse and metastasis of breast carcinoma. They can be used as markers of prognosis of breast carcinoma in clinical practice.

AIM: To obtain a McAb that can inhibit the function of matrix metalloproteinase-2 (MMP-2), we expressed the fibronectin-like domain of MMP-2 (MFD) in vitro and prepared a McAb against MMP-2. METHODS: The purified MFD protein was used to immunize BALB/C mouse three times. Then the spleen of mouse was taken out and hybridized with hybridoma cells SP2/0. The positive cell clones were screened with ELISA method. The subtype and tissue specificity of the McAb were identified and its effect on endothelial cell migration and tube-formation was analyzed. RESULTS: After the spleen cells of the mouse and hybridoma cells SP2/0 were hybridized, a piece of cells that continuously secreted McAb against MMP-2 was obtained and named SZ-117. The titers of this McAb in culture supernatants and ascites were 2?10~-3 and 2?10~-5 , respectively. The heavy chain of the McAb belongs to IgG1 subclass. The McAb identified native MMP-2. MMP-2 existed in the stromal tissue of stomach, cholecystis, spleen, ovarian, prostate, salping and lymph node. It inhibited the invasion behavior of endothelial cells Eahy926 and pancreatic carcinoma cells 1990 and inhibited the tube-formation of Eahy926 cells. CONCLUSION: A useful tool for testing MMP-2 is obtained and it will be helpful to look for a kind of new anti-tumor material.