Ezrin is an important membrane-cytoskeleton linker protein.It is highly related with tumor invasion and metastasis and indicates poor prognosis.It is reported that aberrant Ezrin expressed in many carcinomas,such as osteosarcoma and breast carcinoma.However,the complex mechanisms of Ezrin in tumor invasion and metastasis remain unclear.It is involved in several different tumor associated signal pathway based on different tumor types,including adhesion molecule signal transduction,Rho and Akt signal transduction.Therefore,research on the signal transduction of Ezrin has great significance for the understanding of cancer progression and Ezrin is probable to be a new treatment target.

BACKGROUND: Siberian solomonseal rhizome is a sort of Chinese traditional medicine for anti-senilism. The effective component, poly gonati polysaccharide, has the effects of reducing blood glucose and glycosylhemoglobin.OBJECTIVE: To assay regulative effect of polygonati polysaccharide on expression of the key substance of non-enzymic glycosylation of proteinsglycosylated end-product receptor mRNA by reverse transcriptase polymerase chain reaction, so as to develop effective inhibitor for non-enzymic glycosylation of proteins and provide experimental evidences for preventing diabetes and its complications.DESIGN: Randomized control animal trial SETTING: Department of Geriatrics, the Second Xiangya Hospital, Central South University; Department of Cardiology, Haikou Hospital Affiliated to Xiangya Medical College, Central South University.MATERIALS: The experiment was completed in Animal Room of Second Xiangya Hospital of Central South University form March to June 2004. A total of 30 BALB/C mice of clean grade were selected and randomly divided into normal control group, model control group and polygonati polysaccharide group, with 10 in each group.METHODS: Diabetic models were established by intraperitoneal injection with streptozotocin to mice in model control group and polygonati polysaccharide group. Model establishment would be regard as successful if blood glucose of mouse was 8.0 mmoL/L or above. Mice in polygonati polysaccharide group were treated with polygonati polysaccharide (2 mL/kg per day), while mice in normal control group and model control group were treated with injection of 0.5 mL water once a day for 12 consecutive weeks.After medicine had been given to the mice, they were put to death by decapitation. Reverse transcriptase polymerase chain reaction was used to assay expression of glycosylated end-product receptor mRNA in cardiac and renal tissues of experimental animals.MAIN OUTCOME MEASURES: ① Observation of general situation of mice in each group 12 weeks later after model establishment. ② Change of blood glucose of mice in each group before and after model establishment.③ Gel electrophoretic maps of glycosylated end-product receptor mRNA in cardiac and renal tissue of mice in each group. ④ Semi-quantitative assay of glycosylated end-product receptor in cardiac and renal tissue of mice in each groupRESULTS: All the 30 mice entered the results analysis. ① Observation of general situation of mice in each group 12 weeks later after model establishment: mice in normal control group gained weight and moved freely; mice in model control group manifested the symptoms of losing weight, polyuria, listlessness, lags in response etc.; mice in polygonati polysaccharide group manifested milder symptom of polyuria and more sensitive in responses as compared with model control group.② Changes of blood glucose of mice in each group before and after model establishment: blood glucose levels were similar between normal control group and model control group before and after model establishment (P ＞ 0.05), while blood glucose in polygonati polysaccharide group significantly decreased 12 weeks later after model establishment [(10.05±1.16), (7.18±0.84) mmoL/L, P ＜ 0.05]. ③ Gel electrophoretic maps of glycosylated end-product receptor mRNA in cardiac and renal tissue of mice in each group: Compared with normal control group, the expression of glycosylated end-product receptor mRNA increased in cardiac and renal tissue of mice in model control group, while the expression in polygonati polysaccharide group significantly decreased as compared with model control group. ④ Semi-quantitative assay of glycosylated end-product receptor in cardiac and renal tissue of mice in each group: the relative value of glycosylated end-product receptor to β-actin in cardiac and renal tissue of mice in model control group was significantly higher than normal control group (P ＜ 0.01); however, the relative value of polygunati polysaccharide group significantly decreased as compared with model control group (0.760±0.121,0.998±0.202;0.609±0.146;0.765±0.113; P ＜ 0.05).CONCLUSION: Besides reducing blood glucose, polygonati polysaccharide can significantly down regulate high expression of glycosylated endproduct receptor mRNA in cardiac and renal tissue of mice with diabetes, so as to inhibit the combining sites for glycosylated end-products and a series of cytobiological reactions after combined with their receptors, and protect the target organs and tissues from injuring by hyperglycemia.

Objective To investigate the effects of schistosomiasis on malignant bio-behaviors including histological types,differentiation grade,inasie depth,lymphnode metastasis and prognosis of colorectal carcinoma among elderly people in the district of petrochemical industry,Shanghai.Methods A total of 184 cases (aged 60 years and over) with specimens of colorectal cancer were collected from January 2004 to December 2010.These specimens were divided into colorectal carcinoma with schistosomiasis (CRCS) group (102 cases) and simple colorectal carcinoma (CRC) as control group (82 cases).The prognostic data of 40 elderly cases with colorectal carcinoma from January 2004 to December 2006 were simultaneously selected and analysed Results Totally 55.4％ (102/184) cases exhibited coexistent schistosomiasis with colorectal carcinoma.lesion site(x2=16.53),growth pattern(x2 =10.81 ),differentiation degree(x2 =10.46),infiltration degree(x2 =6.71),lymph node metastasis(x2 =3.90),and TNM staging(x2=5.73) in CRCS group were closely related to schistosomiasis compared with CRC group (P＜0.05).Survival curve analysis showed that there was no significant effect of schistosomiasis on the survival time of elderly patients with colorectal carcinoma (x2 =0.14,P＞0.05).Conclusions The coexistent schistosomiasis may be associated with the malignant bio-behaviors of colorectal carcinoma among the elderly,but have no significant influence on the survival time after operation.

Objective To investigate the effect of polygona-polysaccharose on experimental Alzheimer Disease(AD)mice and its possible mechanism. Methods Twenty-six amyloid precursor protein(APP)transgenic mice were randomly divided into high dosage group(HDG),low dosage group(LDG)and model group(MG)which consisted of 9,9 and 8 mice respectively.1 ml of 16%,4% polygona-polysaccharose solution and 1 ml of drinkable tap water were infused into the mouse stomach in HDG,LDG and MG respectively once a day for 45 days.Morris water maze was used to test the mice's proactive learning and memorizing ability.The morphology of cerebral hippocampus was observed by microscope.The content of amyloid-β-protein(Aβ)and the activity of choline acetyltransferase(ChAT)in the cerebral hippocampus were examined by immunochemical staining method. Results Comparisons among treatment groups(including HDG and LDG)and MG showed:(1)Escape delitescence was shortened[at seventh day:(26.0±9.4)s,(31.2±8.7)s and (39.3±10.9)s,P＜0.05];(2)The frequency of finding the hidden platform within 120 seconds was inereased(5.28±0.76)times,(3.00±0.77)times and(1.00±0.63)times,(P＜0.01);(3)The duration of swimming in objective quadrant(the forth quadrant)within 120 seconds was prolonged [(75.50±8.39)s,(51.39±11.9)s and(36.87±1.25)s,(P＜0.05)].HDG provided better results than those in LDG(all P＜0.05);(4)The activity of ChAT was enhanced and Aβ concentration was decreased for which results mice in HDG showed better than in LDG(all P＜0.05);(5)Morphological study in MG showed the sign of neuron apoptosis such as the reduced number of neuron.the shrinking neuron nuclei,the nucleic membrane being irregular and slightly thickened.However.the neuron in treatment groups were more in number,less transformed and more regularly distrIbuted. Conclusions Polygona-polysaccharose can reduce the accumulation of Aβ in the cerebral hippocampus of AD mice and enhance the activity of ChAT.It can significantly improve the learning and memorizing ability of AD mice and thus proves to be an effective experimental drug for treating AD.

OBJECTIVE: To investigate the usefulness of anterolateral thigh flap for reconstruction of the defect after maxillectomy. METHOD: Seventy-two cases with defect after maxillectomy were constructed with anterolateral thigh flap in our department during 10 years. All cases were undertaken total maxillectomy. RESULT: All flaps except one were transferred successfully. Patients were satisfied with their appearances. No serious complications had happened. CONCLUSION Anterolateral thigh flap could be an donor flap for the reconstruction of the defect after maxillectomy.
Face ; surgery ; Free Tissue Flaps ; Humans ; Maxilla ; surgery ; Reconstructive Surgical Procedures ; Thigh

OBJECTIVE:To select the optimum conditions for germination test of Astragalus membranaceus seed and provide reference for the formulation of testing rules of A. membranaceus seed. METHODS:First,the dormancy of A. membranaceus seeds were broken by soaking seed with 98% H2SO4 for 30 min and 35 ℃ warm water for 9 h,then treated with different temperatures of germination,different germinating beds and light conditions. Different treatment methods were evaluated by germination rate, germination potential and germination index. RESULTS:With the increase of temperature,germination rate,germination potential and germination index decreased. At 30 ℃,germination rate,germination index,and germination potential were significantly low-er than those of seed with other treatments,in which the germination rate was the highest at 15℃;but there wasn’t significant dif-ference in germination rate of 15 ℃ and 20 ℃. There were no significant differences in germination rate of different germination beds,but sand bed could restrain bacterial growth well. Under both light and dark conditions,seed could normally germinate. The appropriate condition of A. membranacus seed germination was at 15 ℃,sand bed and dark. The germination rate,germination po-tential and germination index were(98.5±0.65)%,(85.5±0.87)%and 175.8±2.31,respectively. Meanwhile,the germination pe-riod was only 4 days. CONCLUSIONS:Suggested quality control method of A. membranaceus seed is that at 15 ℃,sand bed and dark. The second day of germination as initial counting time and forth day as the last counting time are used to calculate germina-tion index. This method is easy and controllable. It also has short germination period and high germination rate.

OBJECTIVE:To select the optimum conditions for germination test of Sophora alopecuroides seed,and to provide reference for formulating seed test rule and standardization of S. alopecuroides. METHODS:S. alopecuroides seeds were soaked in 98% H2SO4 for 30 min and 35 ℃ warm water for 29 h,and then treated under different temperature conditions (15 ℃,20 ℃, 25℃and 30℃),different germination beds(on paper,between paper,on sand,in sand)and different light conditions(2 000 lx lighting 16 h,dark). Optimal germination condition was screened by using germination rate,germinative potential and germinative index as indicators. S. alopecuroides seeds were cultured under this condition for 7 days,and then germination rate was determined. RESULTS:Different temperatures had no significant effect on germination rate,but influenced germinative potential and germina-tive index;those indicators reached maximal value at 20 ℃. Different germination beds affected each indicator,and under condi-tion of on sand,those indicators were the highest. Light treatment had no significant effect on germination indicators. Under suit-able condition,the seed sprouted since first day of germination bed treatment;germination rate was more than 90% on second day,and reached maximal value on fifth day and didn’t increase any longer. CONCLUSIONS:The suitable condition of seed ger-mination was soaking in 98% H2SO4 30 min+35 ℃ warm water for 29 h,on sand under light at 20 ℃. Initial count on second day of germination bed treatment and final count on forth day were analyzed statistically as well as germination rate. This method can be used as standard quality test of the seed of S. alopecuroides.

Objective To investigate the current status of screening and management of thyroid diseases during pregnancy,and to provide evidence for further improvement of clinical management.Methods Clinical data of 5 981 pregnant women who delivered at Peking University First Hospital between September 1,2013 and September 30,2014 were analyzed retrospectively.Their average age was (30±4) years (18-47 years) and average gestational week was (39.2± 1.6) weeks (25.5-42.0 weeks).The reference range of thyroid stimulating hormone (TSH) was 0.1-2.5 mU/L recommended by the American Thyroid Association (ATA).The reference range of free thyroxine (FT4) was 11.48-22.70 pmol/L and the cut-off value of thyroid peroxidase antibody (TPOAb) was 34 U/ml both recommended by the kit.The specific reference range of TSH was obtained from normal pregnant women in this study (0.23-4.08 mU/L in the first trimester).Pregnant women with hypothyroidism were divided into two groups according to their TSH level at the first trimester:TSH ≥ 2.5-＜4.08 mU/L group and TSH ≥ 4.08 mU/L group.T test,Chi-square or Fisher's exact test were applied for statistical analysis.Results (1) Screening status:Of the 5 981 pregnant women,there were 13 cases (0.2％) of hyperthyroidism and 146 cases (2.4％) of hypothyroidism diagnosed before conception (133 cases of Hashimoto thyroiditis,eight cases after operation for thyroid cancer,and five cases after 131I therapy because of hyperthyroidism).Among the 5 822 cases requiring screening,4 044 cases (69.5％) received screening tests of TSH,FT4 and TPOAb during early pregnancy according to Chinese Guidelines,and 1 778 cases received neither standard screening nor screening test.(2) Treatment of hypothyroidism:Hypothyroidism treatment rate was only 61.5％ (107/174) according to the reference range recommended by the ATA,lower than that of 88.1％ (52/59) according to the reference range of this study (x2=14.430,P＜0.05).There were 60 cases receiving no treatment in TSH ≥ 2.5-＜4.08 mU/L group.Forty-three of these cases were reexamined,and one of them was abnormal,with a rate of 2.3％ (1/43).There were seven cases without treatment in TSH ≥ 4.08 mU/L group;six of them were reexamined among which one was abnormal,with a rate of 1/6.(3) Thyrotoxicosis:Among the 4 044 pregnant women,99 cases had TSH ＜0.1 mU/L,including 11 cases with FT4 ≥ 22.70 pmol/L (22.82-60.96 pmol/L).Only three cases were positive for thyrotrophin receptor antibody,and then diagnosed as hyperthyroidism and treated with propylthiouracil.(4) Thyroid cancer:Among the 5 981 pregnant women,six cases were diagnosed as thyroid cancer during pregnancy and lactation,with an incidence of 100.3/100 000.Of the six cases,five were diagnosed during pregnancy,and one at one month postpartum.All of the six cases underwent operation and were confirmed to be papillocarcinoma by pathology.Conclusions The screening rate of thyroid diseases during pregnancy is high,but the clinical management is not fully standardized.We suggested that each center should established its own normal reference range for thyroid function test.The incidence of thyroid cancer during pregnancy is increasing,thus attention should be paid to its diagnosis.

Objective To introduce the application and assess the outcome of ProPlan CMF software in virtual surgery of mandibular resection and reconstruction with vascularized fibular graft.Methods Nineteen patients were performed mandibular resection,and immediate reconstruction with free fibular graft by application of ProPlan CMF software between March 1,2013 and January 31,2014,including 7 cases of osteoradionecrosis,6 cases of adamantoblastoma,4 cases of carcinoma of gingiva,2 cases of intra-osseous carcinoma of mandible.There were 12 males and 7 females,with an age range of 21-73 years (median,54 years).In each case,three-dimensional spiral CT scan of mandible and fibula was obtained before operation.The CT data were imported into the ProPlan CMF software and the virtual surgical planning was performed.After that,the mandibular rapid prototyping and surgical guide plates were made according to customized design.The segmental resection of mandible,titanium plate bending,fibular molding,insetting and fixing were then carried out by using these surgical guide plates.Results Operations were undertaken successfully according to preoperative design in all nineteen patients and negative margin was detected by intraoperative frozen section.The fibula was cut,shaped and fixed accurately.The operations took 4.5-7.0 hours (mean,5.5 hours).Primary healing of incision was obtained without complications except fistula in 2 cases of osteoradionecrosis,which were resolved with local wound care after 4 weeks.19 patients were followed up between 3 months to 1 year and all patients were alive with disease free.All patients were satisfactory with their maxillofacial appearance,occlusion and function.The ranges of mouth opening was 2.0-4.0 cm.The postoperative panoramic radiographs or CT scan showed perfect situation and contour of fibular graft.Healing of the donor site occurred without significant complications.All patients started early postoperative ambulation,and walked normally after 2 or 3 months.Conclusion The application of ProPlan CMF software in virtual surgical design and guide plates creation can simplify the operation,and improve the accuracy of mandibular resection and reconstruction,especially the spatial relationship of the mandible and the fibula graft.It is worth promotion widely in clinical practice.

Objective To investigate the appropriate screening method for thyroid diseases during early pregnancy.Methods We collected information of 4 044 pregnant women who attended to the Department of Obstetrics and Gynecology of Peking University First Hospital from September 1,2013 to September 30,2014 for antenatal care and underwent one step screening for thyroid diseases in first trimester,which meant blood test for thyroid stimulating hormone(TSH),free thyroxine(FT4) and thyroid peroxidase antibody(TPOAb) at the same time.Simulation analysis was performed on these 4 044 women with twostep screening (TSH first and then FT4 and TPOAb if TSH was abnormal).The incidence,missed diagnosis rate,costs of screening,and outcomes of the missed diagnosed cases of women with thyroid diseases were compared between one-step and two-step screening based on the cutoff value determined by American Thyroid Association (ATA) or our hospital (0.23-4.08 mU/L).The positivel rate of TPOAb was compared among the three groups classified according to TSH value (≥ 0.1-＜ 2.5 mU/L,≥ 2.5-＜ 4.08 mU/L and ≥ 4.08 mU/L).T-test,Chi-square test or Fisher's exact test were applied for statistical analysis.Results When the cutoff value of TSH was set at ≥ 0.1-＜ 2.5 mU/L (ATA recommendation),7.9％ (320/4 044) of the women required medical treatment.It was significantly higher than 3.2％ (129/4 044),which was obtained when the normal reference value of TSH was set based on data from our hospital.The positive rates of TPOAb were 7.2％(214/2 976),13.9％(103/777) and 28.6％(55/192) for TSH ≥ 0.1-＜ 2.5,≥ 2.5-＜ 4.08 mU/L and ≥ 4.08 mU/L group,respectively.When we set the OR value for TOPAb as one in the TSH ≥ 0.1-＜ 2.5 mU/L group,the OR(95％C1)s of the other two groups were 1.972(1.537-2.532) and 5.181(3.679-7.297).If two-step screening protocol and ATA recommendations were applied,0.7％ (27/4 044) of women who needed treatment would be missed.However,312 480 yuan (RMB) would be saved compared with one-step screening (77.27 yuan per person).When the hospitalized reference value was applied,1.1％(45/4 044) of women would not be treated and 384 720 yuan would be saved (95.13 yuan per person) compared to one-step screening.For those missed diagnosed cases,no more adverse pregnant outcomes (all P＞0.05),including fetal distress,gestational diabetes mellitus,preterm birth,fetal growth restriction,oligohydroamnios,polyhydroanmios,fetal death,gestational hypertension with pre-eclampsia,placental abruptio and neonatal asphyxia were reported although no standard treatment had been provided,no matter ATA recommendation or unique reference in our hospital was adopted.Conclusions We recommend the two-step method for thyroid function screening during early pregnancy.For the purpose of cost-saving,reduction of missed diagnosis rate and avoidance of overtreatment,the management protocol should be individualized for those women with TSH value between 2.5 mU/L and the normal reference value of our hospital during pregnancy.