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.

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 investigate the effect of cerebral ischemia on functional parameters of affected arteries and probe into the possible pathogenesis of ischemia-reperfusion injury.Methods Intraluminal suture ischemic model was used by occlusion of left middle cerebral artery in rats.Two hours later,the middle cerebral artery segments were isolated from both ischemia and control groups for measurement of changes in vessel diameter induced by increasing pressure and vasoactive compounds.And then,distensibility,myogenic tone,reactivity to 5-HT and ACh were calculated and compared between groups.Results In lower pressure range,ischemic vessels showed an increased myogenic tone(at 40 mm Hg,1 mm Hg=0.133 kPa,19.3%±0.4% vs 10.0%±0.2%,t=20.568,P=0.000)and decreased diameter.In higher pressure range,ischemic vessels showed an increased diameter.distensibility and decreased myogenic tone(at 120 mm Hg,12.0%±0.2% vs 21.8%±0.4%,t=-23.575,P=0.000).In normal pressure range,myogenic tone was not altered after ischemia. Both groups constricted to 5-HT and dilated to ACh,however,the response was significantly diminished after ischemla.Conclusion These findings demonstrate that contractile and diastolic function of affected artery was impaired after ischemia,a result that may contribute to ischemia-reperfusion injury by losing upstream cerebrovascular resistance and increasing perfusion on the microcirculation.

Objective:To investigate the epidemiological data of maternal sepsis in intensive care unit (ICU), analyze the common causes, outcomes of maternal sepsis, and the risk factors of multi-drug resistant (MDR) bacteria.Methods:A retrospective cohort study. Maternal sepsis cases admitted to ICUs of Peking University Third Hospital, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, and Beijing Friendship Hospital Affiliated to Capital Medical University from January 2008 to September 2022 were enrolled. The following data were recorded: demographic characteristics, sequential organ failure assessment (SOFA) during infection, infection time, infection sites, invasive intervention measures before infection, microbial culture results, blood routine test during infection, body temperature, and clinical outcomes caused by infection. According to the time of sepsis occurrence, the patients were divided into pre-ICU sepsis group and ICU sepsis group, and the causes of sepsis in the two groups were analyzed. According to whether MDR occurred, the patients were divided into MDR group and non-MDR group, and clinical outcomes were analyzed. Multivariate Logistic regression was used to analyze the risk factors of MDR bacteria infection in obstetrics with sepsis.Results:160 patients were enrolled, among which 104 cases of sepsis happened before ICU and 56 cases of sepsis happened during ICU, 53 cases were with MDR bacteria and 107 cases were without MDR bacteria. The median age of the patients was 30.5 (28.0, 34.0) years old, the median temperature was 38.8 (38.2, 39.5) ℃, and the median white blood cell count (WBC) was 17.2 (13.2, 21.3)×10 9/L, the median SOFA score was 5.0 (3.0, 8.0), and 130 cases (81.2%) were referred from other hospitals. The main infection sites were uterine cavity in 64 cases (40.0%), lung in 48 cases (30.0%), abdominal and pelvic cavity in 30 cases (18.8%), urinary system in 27 cases (16.9%). Sepsis led to hysterectomy in 6 cases (3.8%), stillbirth in 8 cases (5.0%), and neonatal death in 2 cases (1.3%). The main surgical intervention measures were cesarean section (44 cases, accounting for 27.5%), followed by exploratory laparotomy (19 cases, 11.9%). The median length of ICU stay was 5.0 (3.0, 10.0) days, and the median hospital length was 14.0 (10.0, 20.8) days. Intrauterine infection was the primary cause of sepsis happened during ICU, accounting for 50.0% (28/56), of which postpartum hemorrhage accounted for 85.7% (24/28). The proportion of diabetes [28.3% (15/53) vs. 14.0% (15/107)], intrauterine operation [41.5% (22/53) vs. 23.4% (25/107)], intrauterine infection [50.9% (27/53) vs. 34.6% (37/107)] and bacteremia [18.9% (10/53) vs. 2.8% (3/107)] in the MDR group were significantly higher than those in the non-MDR group (all P < 0.05). Multivariate Logistic regression analysis showed that diabetes [odds ratio ( OR) = 2.348, 95% confidence interval (95% CI) was 1.006-5.480, P = 0.048] and intrauterine operation ( OR = 2.541, 95% CI was 1.137-5.678, P = 0.023) were independent risk factors for MDR bacterial infection in obstetrics with sepsis. Conclusions:Intrauterine infection is the common cause of maternal sepsis in ICU, and postpartum hemorrhage is the common cause of secondary intrauterine infection in ICU. MDR bacteria can lead to serious clinical outcomes. Diabetes and intrauterine operation are independent risk factors for MDR bacteria' infection.

Objective:To establish a quantitative detection method for the main components of dust mite allergens Der p 1, Der p 2 specific immunoglobulin E (sIgE) by using the nano-magnetic particle chemiluminescence immunoassay.Methods:The performance indexes of the established method were evaluated after setting up and optimizing the chemiluminescence detection system and immune reaction conditions of sIgE for dust mite allergen. Serum sIgE levels of 50 suspected allergic patients with dust mite were determined by this chemiluminescence method. At the same time, this method was compared with the Phadia kit and the consistency was analyzed by Kappa test. Results:The optimal amount of magnetic beads was 25 μg, the optimal reaction buffer (pH=7.4) contained 0.1 mol/L Tris-HCl and 0.25%( W/ W) casein, the optimal coating solution contatined 20 mmol/L phosphate buffer (PB) and 1%( W/ W) bovine serum albumin (BSA), and the luminescence enhancement solution contained 0.05%( V/ V) Triton X-100. The two-step immunoreaction was adopted, and the detection could be completed with 20 μl sample at the optimal reaction temperature of 37℃. The limit of detection (LOD) of the established nano-magnetic particle chemiluminescence system in detecting Der p 1 and Der p 2 sIgE antibodies were both less than 0.01 kU/L, with the linear range of 0.2-100.0 kU/L, the precision of less than 7%, and the cross contamination rate of 0.19% and 0.21%. Compared with the Phadia system, the positive and negative coincidence rate of Der p 1 were 78.0%(32/41) and 9/9 with good consistency ( Kappa=0.65, P=0.008), and the positive and negative coincidence rate of Der P 2 were 93.3%(28/30) and 85.0%(17/20) with good consistency ( Kappa=0.79, P=0.003). Conclusion:The nano-magnetic particle chemiluminescence immunoassay is successfully established for detecting dust mite allergen sIgE, which has good detection performance and good consistency with Phadia system.

Objective: To explore the feasibility of applying Omaha system theory to patients with coronary heart disease (CHD) through comparative analysis of nursing description. Methods: Using content extraction analysis method, the nursing records, nursing plans and nursing measures of discharged patients with CHD were retrieved from the medical records, and then the conceptual consistency of the extracted records and the problem classification system and intervention measures in the Omaha system were evaluated by cross mapping method. Results: A total of 2 609 nursing problems and intervention measures were extracted from the medical records of 68 patients with CHD. Among them, 1 844 (70.68%) records were labeled as "perfect fit", 608 records (23.30%) as "partial fit", and 157 (6.02%) recordsas "not fit at all". The total fit rate was 93.98% (perfect fit and partial fit). The most frequently reported problems were in physiological domain, followed by health-related behaviors domain, psychosocial domain and environmental domain. The nursing interventions extracted accounted for 26.67% (1 968 sentences) of directions and l00.00% (4 kinds) of categories in the intervention scheme of Omaha system. Conclusions The conceptual congruence between the medical records of patients with CHD and the Omaha System is quite high. It can help to improve nursing problems of patients of CHD in health-related behavioral domain, psychosocial domain and environmental domain, and can be applied to such patients after appropriate adjustment, so as to help clinical nursing staff to provide specialized and all-round guidance for patients with CHD.

Objective: To construct a nursing intervention program for patients with coronary heart disease based on the theory of Omaha intervention system, and to provide evidence for the specialist nursing of patients with coronary heart disease. Methods: Based on the Omaha intervention system, the specialist nursing intervention plan for patients with coronary heart disease was preliminarily established on the basis of reviewing the medical records, and was modified by the Delphi method. Results: Reviewing the medical records combined with the Omaha intervention system, preliminary development of nursing intervention programs for patients with coronary heart disease. The expert inquiry letter of the intervention program was 2 rounds, and the expert positive coefficients of the 2 rounds of inquiry letters were 91.67% and 93.94%, the authoritative coefficient was 0.92, and the Kendall Harmony Coefficient was 0.34 and 0.47 respectively. The specialist nursing intervention for patients with coronary heart disease was finally determined. Conclusion The nursing intervention plan for patients with coronary heart disease based on Omaha theory has a good theoretical basis and has been unanimously recognized by experts.

Objective : To investigate the effect of calcium ions on the expression of kallikrein-4 (KLK4) and cell growth of ameloblast, and to provide an experimental basis for calcium ion promoting normal mineralization of enamel. Methods : ALC cells were treated with 0, 2.0, 2.5, 3.0, and 3.5 mmol/L CaCl2 for 24 and 48 h. KLK4 expression was analyzed by qRT-PCR and Western blot analysis. The viability of ALC cells was determined by using CCK-8. AnnexinV-FITC/PI dual staining combined with flow cytometry and Hoechst 33342 staining were used to detect the ALC cell cycle and cell apoptosis. The protein expression level of glucose-regulated protein 78 (GRP78) was measured by Western blot analysis. Results: After 24 h of treatment with 2.5, 3.0, and 3.5 mmol/L CaCl2, the expression of KLK4 mRNA was increased (P<0.05), and after 24 h of treatment with 2.0, 2.5, 3.0, and 3.5 mmol/L CaCl2, the expression of KLK4 protein was increased (P<0.05). After 48 h of treatment with 3.0 mmol/L and 3.5 mmol/L CaCl2, the expression of KLK4 mRNA and protein was increased (P<0.05). Compared with the control group, the viability of ALC cells was increased after 24 and 48 h of treatment with 2.0, 2.5, and 3.0 mmol/L CaCl2 (P<0.05), and the highest cell viability was observed with 2.5 mmol/L CaCl2. Hoechst 33342 staining results showed that 3.0 mmol/L and 3.5 mmol/L CaCl2 may promote apoptosis in ALC cells. Flow cytometry showed that the proportion of G2/M phase cells and the apoptosis rate increased after 3.5 mmol /L CaCl2 treatment for 24 h (P<0.05), compared with the 0, 2.0, 2.5, and 3.0 mmol/L CaCl2 groups. After 24 h of treatment with 3.0 mmol/L and 3.5 mmol/L CaCl2, the expression of GRP78 protein was reduced (P<0.05), and after 48 h of treatment with 2.5 mmol/L CaCl2, the expression of GRP78 protein was reduced (P<0.05). Conclusion Calcium ions can promote the increase of KLK4 expression and cell viability in ALC cells, but a higher concentration of calcium ions can block the G2/M phase of ALC cells, thus inducing apoptosis of ALC cells and reducing the expression of apoptosation-related protein GRP78.