Objective: To investigate the correlation between CD47 and cervical lesions. Methods: The expression and overall survival of CD47 in cervical cancer was analyzed using TCGA and TCGA Target GTEx databases. Based on GEO databases , the expression of CD47 was analyzed between cervical sample infected by HPV 16/18 and nonHPV. The differences of CD47 expression in the degrees of cervical lesions infected by HPV 16/18 were compared.The patholgical sections of colposcopy biopsy came from 320 patients who were admitted cervical cancer screening ,including HPV typing and E6/E7 mRNA detection. Immunohistochemistry were used to determine CD47 expression , and histochemistry score(H⁃score) was used to quantify the levels of CD47. The correlation among HPV 16/18 , pathological grades and CD47 was analyzed. Results: Bioinformatics tool analysis and immunohistochemistry showed that CD47 was up⁃regulated in HSIL and CC , associated with the prognosis of CC. The expression levels of CD47 in cervical tissues increased significantly after HPV 16/18 infection ( t = 2. 494 , P < 0. 05 ) , and in HPV 16/18 infected tissues , with the increase of pathological grades. The expression levels of CD47 significantly increased(F = 4. 351 , P < 0. 05 ; rs = 0. 278 , P < 0. 001) . The expression of CD47 in the E6/E7 mRNA( + ) was higher than that in the E6/E7 mRNA( - ) ( t = 5. 710 , P < 0. 000 1) , and the copies of E6/E7 were related to the degree of cervical lesions , and were positively correlated with the expression level of CD47 ( F = 15. 557 , P <0. 000 1 ; rs = 0. 649 , P < 0. 000 1) ( rs = 0. 73 , P < 0. 000 1) . Conclusion CD47 is overexpressed in HSIL and CC after HPV 16/18 infection. The expression levels of CD47 increases with the degree of cervical lesions , and is correlated with E6/E7 mRNA. CD47 may be a potential target for cervical disease progression and therapy.

Objective:To explore the obstacles of the promotion of nursing quality homogenization management under the mode of multiple hospital areas, and to make the best response strategies and management ideas according to the obstacles, so as to achieve the goal of nursing quality management with the same quality and high efficiency.Methods:Based on the theory framework of 5M1E analysis, this study made an interview outline. Through focus group interview and personal interview, 44 nurses of different positions and levels were interviewed. The interview materials were sorted out and analyzed by Colaizzi seven step analysis method, and the themes were extracted to obtain the obstacles to the promotion of nursing quality homogeneity management.Results:The factors that hinder the management of nursing quality homogeneity included: the lack of understanding and thinking on the management of nursing quality homogeneity, the incomplete integration of quality control organization system in different hospital areas, the lack of comprehensiveness of nursing quality management system and standard unification, the differences in the implementation of quality control system, standard and plan, the difference in information system, the disunity of quality control index extraction, the physics of treatment room, etc. There were six aspects of environmental layout differences.Conclusion:The homogenization of nursing quality management under the mode of "one hospital, multiple districts" is of great significance. Hospitals need to formulate feasible countermeasures and development ideas according to the obstacles of homogenization management, so as to promote the development of nursing quality management and provide patients with the same quality of nursing services.