The signal transduction system induced by epidermal growth factor receptor(EGFR) regulates cell cycle ,modulates cell growth and differentiation and improves damage repair.The overexpression of EGFR in several epithelial tumors including non small cell lung cancer(NSCLC) forecasts low survival rate, poor prognosis and metastasis. Thereby EGFR can be a potential target for gene therapy. Tyrosine kinase inhibitors(TKIs) selectively inhibit tyrosine kinase activity,supress tumor growth ,and increase the sensitivity of radio chemotherapy. [

Objective To explore the diagnosis for early stage lung cancer with "normal" plain CT scan in order to draw the concern of physician to these patients. Methods We reviewed and analyzed 3 cases of central bronchogenic carcinoma with normal plain CT scan at first visit who were confirmed through fiber bronchoscope examination and PET/CT scan later. Then we compared the values of some diagnostic methods for early-stage central bronchogenic carcinoma. Results Three patients were all males with long smoking history. They came to hospital for cough and bloody sputum. All their plain CT scan showed "no abnormal findings", but their symptom continued. Later, the fiber bronchoscope examination and PET/CT scan strongly suggested that they were suffered from central bronchogenic carcinoma, and then the pathological findings and sputum cytology confirmed the diagnosis. Two patients received lobectomy, and the other one was suggested to accept radiotherapy because of his poor lung function. Conclusions The positive rate of plain CT scan for early-stage central bronchogenic carcinoma is relatively low. Thus, some of these patients lost the chance of surgery and combined therapy. So physicians should pay more attention to these patients with symptoms of persistent bloody sputum or obstructive pneumonia, even if the plain CT scan is negative at first visit. Using PET/CT and fiber bronchoscope examination, physicians can confirm the diagnosis of central bronchogenic carcinoma. So these two methods are important in the diagnosis for early-stage central bronchogenic carcinoma without any abnormal plain CT scan findings.

Leukoaraiosis (LA) is a group of clinical syndrome caused by multiple etiologies.It belongs to one of the types of cerebral small vessel diseases.Studies have shown that LA usually can lead to different degrees of cognitive impairment.In recent years,with the development of imaging techniques,the studies about correlation between maging findings and cognitive impairment in LA patients and cognitive impairment are increasing gradually and have drawn some new conclusions.And thus,the understanding of the clinical significance of LA has been further deepened.This article mainly reviews the advances in research on the correlation between imaging findings and cognitive impairment in LA patients.

ObjectiveTo evaluate the effect of psychological and behavioral intervention combined with varenicline smoking cessation clinics and to analyze predictors of successful quitting.Methods Subjects were collected from quitters who went to receive consultation and intervention in “smoking and related diseases” clinic at Zhongshan Hospital,Fudan University from March 2009 to September 2010.Eligible subjects were screened and divided into strengthen follow-up group and control group.The 4 weeks continuous abstinence rate from week 9 through week 12 were observed logistic regression model and used to analyze the predictors of successful quitting.Results Subjects who are addicted to nicotine received strengthening psychological and behavioral intervention combined with varenicline in smoking cessation clinics.The total continuous cessation rate during the 9th-12th week was 52.3％,with 60.9％ (28/46) and 46.2％ (30/65) of strengthen follow-up group and control group respectively.The most frequent adverse effects were nausea 39.6％ (44/111),insomnia and abnormal dreams 17.1％ ( 19/111 ).Adverse effects were tolerable and withdraw symptoms were few.Preparation and medication time can be used as predictors of successful quitting.Conclusion The quit rate of varenicline therapy combining with strengthen intervention is high and strengthening psychological and behavioral intervention could increase the success rate more obviously,which is a good choice for cessation therapy in smoking cessation clinics.Better preparation and regular adequate treatment can improve quit rate.

Objective To explore the relationship between lesion sites of stroke and swallowing function. Methods Ischemic stroke patients consecutively admitted into the stroke unit were screened in this study. The new and previous lesion sites of stroke, dysphagia and aspiration under videofluoroscopy (VF) were recorded and their relation was analyzed. Results 211 patients were included and 169 patients had completed the MRI and VF examination. 159 patients had dysphagia and 94 had aspiration under VF. 72 patients (9 missing) were found disorder in oral phase and 150 in pharyngeal phase. There was no significantly difference in dysphagia under VF and in aspiration among different lesion sites (P>0.05). Patients with stroke in medulla tended to happen aspiration (P=0.056). Stroke sites above the tentorium of cerebellum (P=0.028) or above medulla (P=0.005) may cause disorder in oral phase. Conclusion The stroke injury in brain cortex, white matter, brainstem and cerebellum or hemisphere could lead to dysphagia and aspiration. The injury of medulla may cause aspiration. Lesion of brain hemisphere or above the medulla could result disorder in oral phase of swallowing.

Objective To study the relationship between stress rise of blood glucose and the PEEL prognostic index of the patients with acute myocardial infarction, and provide the basis for a quick judgement and evaluation of prognosis to nurses. Methods Taking the 6.8,7.8 and 8.8 mmol/L as demarcation point to study the PEEL prognostic index in 59 patients with acute myocardial infarction, and compare the PEEL score value on two sides of each demarcation point. Results No significant difference in PEEL evaluation score when taking 6.8 mmol/L as the demarcation point, there was significant difference when taking 7.8 mmol/L as the demarcation point, PEEL score in blood glucose > 7.8 mmol/L group was higher than that of ≤7.8mmol/L group, so was when taking 8.8 mmol/L as the demarcation point. Conclusions There was instructive signifi-cance for nurses to observe a stress rise of blood glucose timely in evaluating the prognosis of patients with a-cute myocardial infarction. Nurses should strengthen disease observation and preventive nursing of admission patients whose fasting blood glucose are above 7.8 mmol/L as well their blood glucose monitoring.

The population of the very elderly is growing steeply with prolonged life expectancy.Age is an independent risk factor for stroke.Naturally,the very elderly become the high risky population.Hypertension is the most common and modifiable risk factor of stoke in the very elderly.Results of studies conducted during these 20 years have been reported to explore and investigate the relationship between stroke primary prevention and antihypertensive treatment,some of which are regarded as landmarks trials,providing essential evidences for blood pressure management in the very elderly.

Background and purpose:The epidermal growth factor receptor (EGFR) is commonly overexpressed in a variety of solid tumors, and has important roles in cancer pathogenesis and progression. EGFR thus provides a rational target for cancer therapy. We studied siRNA-mediated inhibition of epidermal growth factor receptor expression and its biologic effects in different human cancer cell lines (A431, HeLa and SPC-A-1). Methods:Cells were transfected with chemically synthesized siRNA-EGFR. EGFR mRNA was quantified by real-time PCR and was detected by immunofluorescence staining and flow cytometry. The biologic effects on cell growth were assessed by colony-formation assay.Results:siRNA-EGFR significantly decreased mRNA level of EGFR by 73.9 %, 44.6 % and 57.7 %, protein expression of EGFR by 77.0 %, 61.3 % and 65.2 %, and reduced colony number by 27.2 %, 53.9 % and 59.1 % in A431, HeLa and SPC-A-1, respectively.Conclusions:Our data suggested that RNA interference could downregulate EGFR and inhibit colony forming ability and EGFR expression at mRNA/protein levels in human cancer cell lines with different pathological types. siRNA could be one of the promising strategies in future targeted cancer therapy.

Objective:To investigate the distribution of γδT17,Th17 and Tc17 cells in the lung of mice severely infected by influenza A(H1N1)pdm09 virus and the relationship between these cells with lung immunopathalogical injury.Methods:Intranasal infection was used to establish mouse model of severe H1N1 infection.Flow cytometry assay was used to detect the proportion and number of γδT17 cells,Th17 cells and Tc17 cells in the lung.The concentrations of interleukin-17A(IL-17A),interleukin-1β(IL-1β)and interleukin-23(IL-23) in the bronchoalveolar lavage fluid and serum were assayed by enzyme-linked immunosorbent assay and Lu-minex assay.Results:①The model of mice severely infected by influenza A(H1N1)pdm09 virus was established successfully.②The ratio of γδT cells,but not CD4+T and CD8+T cells in total lymphocytes of the lung of infected mice significantly increased compared with uninfected control mice at the third day post infection(DPI)(P<0.01).③The proportion and number of γδT17 cells,Th17 cells and Tc17 cells in total γδT cells,Th cells and Tc cells in the lung of infected mice were significant higher than that in uninfected control mice at the first DPI,respectively.However,the absolute number of γδT17 cells was far more than Th17 and Tc17 cells(P<0.05);④The concentration of IL-17A in BALF increased significantly after infection(P<0.05),and the concentration of IL-17A in serum increased significantly at the third DPI(P<0.05).The concentrations of both IL-1β and IL-23 in BALF probably participating in the activation of γδT17 cells increased significantly after infection compared with uninfected control mice.Conclusion:The γδT17 cells could be activated and secreted IL-17A via γδTCR non-depended pathway and involved in inflammatory pathological injury of lung at the early stage of severe H1N1 infection.

The rising prevalence of preschool childhood obesity is a global health problem.Statistic data show that the incidence of childhood obesity in China has increased seven times,which threatens health of children and adults.Firstly,childhood obesity may lead to the development of adult obesity.Secondly,it can lead to metabolic disorders and other diseases.There are many factors affecting childhood obesity.It is the result of interaction of genetic and environmental factors,and environmental factors are more important influencing factors of childhood obesity including predisposing genes,obesity of parents,maternal dyslipidemia,maternal gestational diabetes and smoking during pregnancy,intestinal flora,child's diet and physical activity.This review summarizes the influencing factors of childhood obesity in order to provide effective basis for future treatment.