Ezrin protein plays an important role in morphogenesis,motility,adhesion.Moreover,Ezrin protein participates in multiple steps of the process of tumor invasion and metastasis.In the progress of tumor metastasis,Ezrin protein is related to several signaling pathways such as Rho mediated signaling pathways,hepatocyte growth factor (HGF) pathways,Fas mediated cell apoptosis signaling pathways,phosphatidyl inositol 3-kinase (PI3K)-Akt pathways,and in which it plays different regulatory role.

Objective To evaluate the effect of antimicrobial management guideline on the daily antimicrobial use rate in a general hospital.Methods An one-day point-prevalence survey on antimicrobial use in hospitalized patients was conducted in 2010,2011,and 2012 by means of cross-sectional investigation method.Results The daily utiliza-tion rate of antimicrobial agents in 2010,2011,and 2012 was 65.40% ,42.09% and 26.74% respectively,the rate of the submission of specimens for bacterial culture was 22.53% ,35.74% and 41.74% respectively(χ2 trend= 266.42, 29.02,respectively,bothP<0.01). The utilization rate of single drug was 83.72% ,80.27% and 93.41% respec-tively. the utilization rate of both two-drug and more than three-drug combination kept a downward tendency. The utilization rate of antimicrobial agents in several departments(digestive internal medicine,cardiovascular,hematolog-ical tumor,neurology,general surgery,orthopedics,obstetrics,pediatrics,and ophthalmology)showed a decreasing tendency(all P<0 .0 1 ).Conclusion The implementation of antimicrobial management guideline has remarkably re-duced the daily antimicrobial use rate,and increased etiological detection rate for therapeutic antimicrobial use.

Background and purpose:Previous studies have revealed potential roles for Ezrin in a variety of cancers. Ezrin participates in several functions including cell adhesion, motility and cell survival, and there is increasing evidence that it regulates tumour progression. This study aimed to determine the differential expression of Ezrin between cervical cancer tissues and normal controls and to explore the association of Ezrin expression with clinical pathological characteristics and with the expression of PCNA, MMP-2, MMP-9 and HPV E6 protein. Methods:Retrospective study was performed among 30 cervical cancer tissue samples which were diagnosed in our hospital from Jan. 2002 to Dec. 2006. Ten normal cervixes from uterine myomas were employed as normal controls. Semi-quantitative immunohistochemisty analysis was performed to detect the association of Ezrin expression with clinical pathological characteristics, and with expression of PCNA, MMP-2 and MMP-9, HPV E6 protein in cervical cancer tissue and normal controls. Analyze the association of Ezrin expression with the clinical characteristics. Results:The expression of Ezrin was strong and the distribution was diffuse mainly in the cytoplasm and membrane in cervical cancer tissues, while the normal cervical tissues was weak and mainly in the membrane. However, there was no signiifcant association between the expression of Ezrin and the clinical characteristics including tumor stage, histology and grade. Ezrin expression was positively correlated with the expression of MMP-2, MMP-9 and HPV E6 protein in cervical cancer tissues, except PCNA. Conclusion:Ezrin was over-expressed in cervical cancer tissues and may be involved in the progress of invasion and metastasis in cervical cancer.

Background and purpose:Gestational trophoblastic neoplasm (GTN) is a spectrum of disease arising from trophoblastic cells, and the majority of patients with GTN have favorable outcome because of the sensi-tivity to chemotherapy. While the cure rate for high-risk patients is still 70% to 80% as a result of drug resistance and disease recurrence. This study aimed to evaluate the clinical characteristics and outcome of patients with high-risk GTN.Methods:The clinical records of patients with high-risk GTN treated in Obstetrics and Gynecology Hospital of Fudan University from Jan. 2003 to Jan. 2013 were analyzed and reviewed retrospectively from the aspect of different treatment.Results:Fifty-one patients with high-risk GTN were admitted to this hospital. Among 51 high-risk GTN patients, 46 patients were evaluated retrospectively and 5 patients were excluded for incomplete treatments. Of the 46 patients with high-risk GTN, 27 patients were treated by chemotherapy alone, 19 patients received chemotherapy and adjuvant surgical therapy. Forty-four patients received EMA-CO (VP-16+Act-D+MTX/VCR+CTX) as a ifrst-line chemotherapy, 81.82% (36/44) had complete remission and 8 patients developed resistance to EMA-CO. EMA-EP (VP-16+Act-D+MTX/VP-16+cisplatin) was used as second-line chemotherapy for the 8 patients resistant to EMA-CO, 6 patients (2 underwent adjuvant surgical therapy) achieved remission and 2 patients died as a result of drug-resistance and disease progression. For the remaining 2 patients, one was treated by 5-FU+KSM and pulmonary resection, and the other was treated by MTX for misdiagnosis as ectopic pregnancy and then converted to EMA-CO for the pathological diagnosis of choriocarcinoma after surgery. Both of them achieved complete remission. Ultimately, 95.65% (44/46)patients achieved complete remission. Among the 19 patients who underwent adjuvant surgical therapy, 94.70% (18/19) patients achieved complete remission after chemotherapy and adjuvant surgery, and the remaining one patient died of disease progression.Conclusion:Standard combination chemotherapy is crucial in the treatment of high-risk GTN. The role of adjuvant surgery in the management of high-risk GTN should not be underestimated.

OBJECTIVE:To establish a method for the concentration determination of vitamin A(VitA)in human serum,and apply it in healthy volunteers and hepatocirrhosis patients. METHODS:After liquid-liquid extraction,serum sample was deter-mined by HPLC. Using VitA acetic ester as internal standard,the separation was performed on Kromasil C18 column with mobile phase consisted of methanol-water (98∶2,V/V) at the flow rate of 1 ml/min. The wavelength was set at 325 nm,and the column temperature was room temperature. The sample size was 20 μl. RESULTS:The linear range of VitA were 0.012 4-3.210 μg/ml(r=0.997 2,n=5),and the limit of quantification was 0.012 4 μg/ml. Inter-day and intra-day RSD ranged 1.66%-2.97%;sample re-coveries were 98.18%-99.56%;extraction recoveries were 89.59%-91.38%. Average blood concentration of VitA were(0.71±0.08)μg/ml in 24 healthy volunteers and (0.28 ± 0.06)μg/ml in 24 hepatocirrhosis patients. There was statistical significance in average blood concentration of VitA between healthy volunteers and hepatocirrhosis patients in different age groups (P<0.05). CONCLU-SIONS:The method is simple,rapid,sensitive and accurate,and can be used for the concentration determination of VitA in serum of healthy volunteers and hepatocirrhosis patients.

Objective To investigate effect of carnosine on oxygen glucose deprivation/reperfusion ( OGD/RP) induced injury in rat brain slices. Methods Injury of brain slices was determined by TTC methods.The contents of ATP, ADP and AMP were determined by high performance liquid chromatography.Reactive Oxygen species ( ROS) were determined by fluorescence methods.Results Compared with control group, rat hippocampal slices were significantly damaged by OGD/RP, indicated by light color and decreased A490 nm value of TTC staining.Meanwhile the contents of ATP and ADP were significantly decreased, and the content of AMP and ROS were significantly increased, the difference between two group was significant ( P<0.01).Pre-incubation with Carnosine (1000, 200, 40 μg/mL) significantly inhibited the light color and decreased A490 nm value of TTC staining, increased the contents of ATP, ADP and AMP, and decreased the content of ROS, the difference between two group was significant ( P <0.01 ) . Conclusion Carnosine can protect rat hippocampal slices against injury induced by OGD/RP, which may relate to improve the energy metabolism and strengthen the ability of anti-oxidative stress.

Objective To explore the improvement of cardiopulmonary resuscitation (CPR) efficiency by rescue team through the clinical access to pre-hospital care.Methods Mter establishment of clinical approaches to cardiac arrest,the training program of first line personnel of rescue teams in the Hangzhou Emergency Center was carried out with practice on simulated patients and scenario.A total of 45 eligible teams were randomly enrolled for study by observing the performance of some essential resuscitation techniques before and after training.Result The efficiency of resuscitation performed by rescue team for cardiac arrest was generally not good enough before training evidenced by the shortage of application of ECG monitoring,endotracheal intubations and establishing intravenous line which were only 8 (17.8％),5(11.1％),6 (13.3 ％),respectively,and the interruption time of chest compression during the first three minutes was (102.13 ± 13.68) seconds and the successfully artificial respiration ratios by assistant members was (0.37 ± 0.09),and ratios of ECG forensics and written inform consent were 8 (17.8％) and 6 (13.3％) respectively,CPR and forensics done simultaneously was only 2 (4.4％).The efficiency of rescue for cardiac arrest was obviously improved after training by the clinical approaches proved by the increase in application of ECG monitoring,endotracheal intubations,intravenous line set up reached to 45 (100％),43 (95.6％),43 (95.6％),respectively,and the interruption time of chest compression during the first three minutes was shorten to (69.7 ± 7.7) seconds and the successfully artificial respiration ratios done by assistant members was (0.57 ±0.12) after training.The ratios of on-site ECG forensics and written inform consent were 40 (88.9％) and 43 (95.6％),respectively,and CPR and evidence obtained simultaneously was up to 36 (80.0％).The efficiency of work done by teams was obviously improved and the risk of miserable events was controlled.Conclusions The clinical approaches to cardiac arrest in prehosptial care is the efficient strategy to rescue the patient with cardiac arrest and it is worthy to popularize at present.

Background Measurement of corneal thickness is important for the early diagnosis and treatment of some eye disorders,including corneal diseases and refractive errors.However,the corneal parameters from schoolage population are rarely reported.Objective The aim of this survey was to characterize the central corneal thickness (CCT),minimum corneal thickness (MCT) and paracentral corneal thickness in healthy Chinese schoolage population.Methods A cross-sectional study was designed in this study.Children aged 7 to 15 years with the diopter of-3.00 D to +3.00 D were recruited from two primary schools in Baoshan district in Shanghai based on random cluster sampling under the approval of Shanghai First People's Hospital and informed consent of child custodian.Routine examinations were firstly performed to determine the healthy participants.CCT (within 2 mm range away the corneal vertex),MCT and paracentral corneal thicknesses (2 to 5 mm zone away the cornea vertex in superior,inferior,nasal and temporal quadrants) were then measured by RTVue Fourier optical coherence tomography (OCT) for the comparison between both eyes and different gender.The subjects were grouped into the 7-9,10-12 and 13-15 years groups,and the correlations between age and CCT,MCT and paracental corneal thicknesses were analyzed.The coordinate position of the thinnest cornea was determined.Results A total of 147 children were enrolled in the study.The mean CCT value of the right eyes was (537.77±29.33) μm,and that of the left eyes was (539.22±29.16) μm,showing a significant difference between them (t =-3.21,P =0.00).The paracentral corneal thicknesses of the right and left eyes were (565.52±30.11) μm and (568.42±31.07) pm in the superior quadrant,and those in the temporal quadrant were (549.01 ±30.46) μm and (547.24±30.23) μm,with significant differences between them (t =-2.47,P =0.01 ; t =2.12,P =0.04).No significant difference was found in the CCT,MCT,paracentral corneal thicknesses from various quadrants (all at P＞0.05).In addition,no considerably correlation was seen between age and CCT,MCT and paracentral corneal thickness (all at P＞0.05).The thinnest cornea area was located in the inferotemporal region in 40.82％ right eyes and 57.82％ left eyes.The distance of thinnest cornea area away corneal vertex was (0.62±0.33)mm in the right eyes and (0.91±0.63)mm in the left eyes,with a significant difference between them (t =-5.17,P =0.00).Conclusions The central,superior and temporal corneal thicknesses are significantly different between the right and the left eyes among healthy Chinese school-age children,but corneal thickness change is not associated with age or gender.The thinnest corneal area does not locate at the vertex.

Objective To explore the influence of LPS treatment on related molecules in Smads and ERK1/2 signal pathway in pancreatic stellate cell line LTC-14.Methods LTC-14 cells were cultured in vitro, and were treated with LPS at different dose in different time points.Protein expressions of related molecules in Smads pathway and ERK1/2 pathway and α-SMA in LTC-14 Cells were examined by Western blot.Results On Treated LTC-14 cells by 0, 1, 5, 10, 20 and 50 mg/L LPS,protein expressions of Smad3 were 0.15±0.02, 0.37±0.02, 0.44±0.01, 0.46±0.02, 0.372±0.01 and 0.24±0.03;expressions of Smad7 were 0.79±0.05, 0.84±0.02, 0.55±0.03, 0.45±0.03, 0.34±0.02 and 0.92±0.07;p-ERK1/2 levels were 0.48±0.05, 0.74±0.03, 0.72±0.04, 0.89±0.02, 0.81±0.02 and 0.72±0.03;p-cPLA2 levels were 0.15±0.03, 0.30±0.01, 0.31±0.01, 0.30±0.02, 0.28±0.03 and 0.32±0.02;α-SMA levels were 0.56±0.06, 0.62±0.06, 0.54±0.04, 1.03±0.11, 1.39±0.08 and 1.28±0.10.The changes of protein expressions before and after LPS treatment were obvious (all P<0.01).The protein expressions of ERK1/2 were 0.56±0.03, 0.57±0.02, 0.53±0.02, 0.58±0.02, 0.59±0.05 and 0.55±0.04, which did not change obviously along with increased LPS dosages.LTC-14 cells treated with 10 mg/L LPS for 0, 1, 3, 6 and 9 h,the expressions of Smad3 were 0.69±0.05, 0.68±0.07, 1.02±0.14, 1.82±0.0 and 2.04±0.11,those of Smad7 were 2.77±0.10, 1.37±0.08, 1.45±0.14, 0.78±0.09 and 0.63±0.06,those of p-ERK1/2 were 0.16±0.03, 0.32±0.05, 0.79±0.03, 1.50±0.07 and 1.77±0.04,those of p-cPLA2 were 0.15±0.04, 0.32±0.06, 0.63±0.04, 0.95±0.04 and 1.49±0.10,those of α-SMA were 0.84±0.03, 1.26±0.21, 1.81±0.19, 4.28±0.26 and 4.37±0.15, all of which changed obviously as the treatment time increased (P<0.05 or 0.01).The expressions of ERK1/2 were 0.75±0.03, 0.72±0.02, 0.80±0.04, 0.74±0.03 and 0.85±0.09, which did not change obviously as the treatment time increased.Conclusions LPS could upregulate the expression of α-SMA in a time-and dose-dependent way, and activate intracellular Smads and ERK1/2 inflammatory pathways, which may be the potential molecular mechanism of the development of chronic pancreatitis.

Aim To investigate the effect of astragalo-side IV ( ASIV) on myocardial energy metabolism and mitochondrial biosynthesis in myocardial cells of dia-betic rats induced by streptozotocin ( STZ ) . Methods
50 SD rats at 6 weeks of age were assigned to 5 groups,10 for each group:control group, model group, ASIV 10 mg·kg-1 ·d-1 group, ASIV 20 mg·kg-1 ·d-1 group, ASIV 40 mg·kg-1 ·d-1 group. Except the control group,the remaining 40 were used to estab-lish type 1 diabetes model by the tail vein injection of STZ (35 mg·kg-1 ) . At the end of 16 weeks of treat-ment, left ventricular systolic pressure ( LVSP ) , left ventricular diastolic final pressure ( LVEDP ) and left ventricular maximum rising/falling rate ( ± dp/dtmax ) were tested. Pathological section was observed by HE staining. ATP, ADP, AMP levels were detected by ELISA. The expressions of PGC-1α and NRF-1 protein were assessed by Western blot. The expressions of PGC-1α and NRF-1 mRNA were determined by RT-PCR. Results Compared with control group, model group markedly elevated LVEDP and decreased LVSP, ± dp/dtmax , ATP/AMP and ATP/ADP ratio. Com-pared with model group, low-dose ASIV group did not change significantly,middle-dose ASIV group and high-dose ASIV group obviously decreased LVEDP, and im-proved LVSP, ± dp/dtmax , ATP/ADP and ATP/AMP ratio. Meanwhile, the expressions of PGC-1α and NRF-1 protein and mRNA were increased in a dose-de-pendent manner. Conclusion ASIV could promote mitochondrial biosynthesis, improve energy metabolism in myocardial cells of type 1 diabetic rats by PGC-1αand NRF-1 .