] Objective To explore the role and mechanisms of FGF2 in chemo?resistance in breast cancer. Methods The inhibitors for different signal pathway were used to treat two drug?resistant breast cancer cell lines MCF?7/5?Fu and T47D/5?Fu established in our lab. MTS assay was used to determine chemo?sensitivity and Hoechst stain was used to measure apoptosis. Protein activation and FGF2 protein level in cell culture medium were detected by western blot and ELISA respectively. Results Akt inhibitor MK?2206 (20 nM) and mTOR inhibitor AZD8055 (2 nM) significantly reversed the chemo?resistance of MCF?7/5?Fu and T47D/5?Fu cell lines to 5?Fu and paclitaxel, but ERK1/2 inhibitor SCH772984 showed no significant effect. Compared to parent cell lines MCF?7 and T47D, p?Akt and p?S6K (represented as mTORactivity) levels were obviously up?regulated in MCF?7/5?Fu and T47D/5?Fu cell lines, and so do the FGF2 mRNA level and FGF2 protein level from culture medium. Moreover, FGFR inhibitor AZD4547 (4 nM) markedly reversed the chemo?resistance of MCF?7/5?Fu and T47D/5?Fu cell lines to 5?Fu and paclitaxel and down?regulated activation of FGFR?Akt?mTOR signal pathway. In agreement, FGF2 protein (10ng/ml) enhanced the chemo?resistance of MCF?7 and T47D cell lines to 5?Fu and paclitaxel and up?regulated activation of FGFR?Akt?mTOR signal pathway. Conclusion Activation of FGF2?FGFR?Akt?mTOR signal pathway promoted chemo?resistance of breast cancer cells.

Aim To investigate the regulatory effects of baicalin on apoptosis induced by virus H1 N1 in hu-man pulmonary carcinoma cell A549 . Methods The chips were used to screen the RNA samples in virus-in-fected A549 cells. Differentially expressed genes were selected in the pathway of apoptosis. The mRNA ex-pressions of caspase-3 and -8 were verified by Real-Time PCR. Results With the DNA microarray, the functions of differentially expressed genes involved in apoptosis biological pathways were analyzed by Kyoto Encyclopedia of Genes and Genomes ( KEGG ) Path-way databases. caspase-3, -7, -8, -10, TRAIL, MYD88 , IL1 A and IL1 B were up-regulated in virus-in-fected group. Oseltamivir could down-regulate gene ex-pressions of caspase-3 ,-4 and-8 . High-dose of baica-lin could down-regulate gene expressions of caspase-3 ,-4,-6 and -8. Except gene expressions of above, low-dose of baicalin could also down-regulate gene expres-sions of IL1RAP and Cn. Real-Time PCR experiments showed that baicalin could significantly decrease mR-NA expression of caspase-3 , -4 , -6 , -8 , IL1 RAP and Cn ( P < 0. 01 ) , compared with the virus-infected group. The results also figured that the interference ef-ficacy of low-dose baicalin was better than that of high-doses. As expected, real-time PCR data were in good agreement with the microarray assay. Conclusions Baicalin can be detected in their suppression effect of caspase-3,-4,-6, and -8 mRNA expression, so it re-sists against the apoptosis to fight against influenza vi-rus in vitro.

Objective To study the effects of main ingredients from microemulsion extract of Compound Longqincao in vitro on anti-influenza virus H1N1 activity; To analyze effects of main ingredients from microemulsion extract on influenza virus inhibition rate.Methods Uniform design was used to conduct the experiment. MTT method was used to detect the effect rate (ER) of anti-influenza virus H1N1 on A549 cells. Setting ER as the index, Minitab17 software was used to establish mathematical model to come up with regression equations of all factors. The effects of ingredients on ER were analyzed and the efficient composition ratio of the optimum anti-influenza virus H1N1 was chosen.ResultsIn the compound compatibility, baicalin showed the most obvious antivirus activity, and licorice glycosides had certain inhibition effects on pathological changes of cells. Five ingredients had coordinative or controlled relation with ER. When per milliliter liquids containing licorice glycosides, baicalin, leucine, aspartic acid, glutamic acid was 13.94μg, 49.44μg, 0.23 mg, 1.25 mg, and 2.50 mg, ER was the best. ER was 85.34%±4.72% after verification.ConclusionThe optimized combination of main ingredients from microemulsion extract of Compound Longqincaocan better play a role in anti-influenza virus H1N1.

Objective To learn the present hospital management conditions in Shanghai for upgrading quality of care.Methods The stratified sampling method was used for a questionnaire survey of the quality of care at 20 hospitals in Shanghai (10 tertiary hospitals and 10 secondary hospitals).The survey covered such six dimensions as organizational framework,management functions,management tools,professional training,regulations and norms,and supervision over operations.Results Medical quality management system is established at such hospitals and all of them have established medical quality management committees.Rooms of improvement remain in such details as departmental quality management,regulations standardization,IT support,and management tools popularity.Conclusion Management regulations and standards of medical quality management should be improved and implemented from both external and internal aspects,to improve medical quality and patient safety.

Objective To explore the clinical value of portal exposure in laparoscopic treatment of children with type Ⅲ biliary atresia (BA).Methods From June 2013 to October 2017,30 infants with type Ⅲ BA who treated with laparoscopic portoenterostomy in Huai'an Women and Children's Hospital were selected.A percutaneous suture was used to snare the round ligament and retract the liver,other percutaneous stay sutures were then introduced and fundus and neck of gallbladder were sutured to elevate the liver to expose the portal hepatis.The fibro cord and hepatic vessels were mobilized,and then two rubber bands were put around the left and right portal veins and hepatic arteries.The portal hepatis was exposed by laterally stretching the two elastic rubber bands.The fibro cord was removed and then laparoscopic portoenterostomy was accomplished.In 20 cases,the liver was enlarged,part of hepatic lobus quadratus was removed laparoscopiclly for exposure of the portal hepatis.Results There were 30 cases in this group,2 cases were converted to open surgery by a micro transverse incision.There was no surgical death.Time of laparoscopic procedure varied from 210 to 280 min.All cases survived the surgery without any intraoperative complications.Blood loss during operation was minimal,without necessity for blood transfusion.One case died of respiratory failure one week after surgery.Two cases were lost follow-up.Twenty-five cases were followed up for 3～51 months(mean 22.4 months).Three cases died because of repeated cholangitis and liver failure at 10,16,35 months postoperatively.Nineteen patients' total bilirubin had dropped to normal,three others' bilirubin levels dropped significantly after surgery.Conclusion The technique of laparoscopic hepatic porta exposure can help to complete hepatic portoenterostomy successfully,reduce the conversion rate of laparoscopic surgery,and improve the surgical effect.

Objective: To investigate whether it can reduce the incidence of pressure ulcer caused by ICU equipment, when nurses in ICU use the SKIN model framework to carry out preventive and nursing measures. Methods: To construct the teaching group of nursing workshop based on SKIN mode for preventing pressure ulcer caused by ICU equipment and train 36 ICU nurses. Before and after training course, to collect the behaviors of preventing pressure ulcer caused by ICU equipment during clinical work time and the incidence and severity of pressure ulcer. Results: The nurses′ behaviors of controlling skin status of patients who use Bi-level positive airway pressure non-invasive mask and evaluating nutritional status of patients change a lot (χ²=34.420,10.123, P <0.01). The nurses′ behaviors of checking and evaluating skin status of patients who have stomach tube to reduce skin pressure, shear and friction and assessing nutritional status of patients were improved (χ²=7.547-49.451, P <0.05). The nurses′ behaviors mentioned above of nursing patients who have oral air tube were also changed significantly (χ²=5.225, 23.402, 12.444, P<0.05 or 0.01). The incidence of pressure ulcer caused by ICU equipment dropped from 2.86%(100/3 502) to 1.87%(67/3 580) (χ²=7.445, P<0.05). The decrease in incidence of Ⅱand Ⅲ grade pressure ulcer are from 48%(48/100) to 22.39%(15/67) and 34%(34/100) to 7.46%(5/67) respectively and had significant differences as well (χ²=11.202, 15.784, P<0.01). Conclusions This study explains the training approach based on SKIN mode of prevention of pressure ulcer caused by ICU equipment. The results show that the training approach can decrease the incidence and severity of pressure ulcer caused by ICU equipment, improve the nurses′ nursing behaviors and promote the transform of theory related to pressure ulcer from basement to clinical reality.