The growth factor receptor -bound protein-2 (Grb2) is an adapter protein in cells. Over expression of Grb2 is found in many kinds of tumor and plays an important role in tumor proliferation and progression. So it may be a molecular target for anti-tumor therapy.

Objective To investigate the relationship between prolonged pregnancy,mode of delivery and pregnancy outcomes.Methods A retrospective analysis of the January 2009 to November 2012,406 cases of prolonged pregnancy cases.Results Select meconium staining of the vaginal trial production of transit emergency caesarean section and vaginal delivery group,the incidence of neonatal asphyxia significantly higher than the cesarean group (P＜0.05).Conclusion The prolonged pregnancy conditional vaginal delivery should be closely monitoring fetal heart rate,timing line CST monitoring patients,cervical score the first basin ratings,observation of amniotic fluid nature and progress of labor,and timely cesarean important treatment prolonged pregnancy safety measures.

Objective:To explore the expression of pressure-sensitive transient receptor potential channel (TRPC1)in bronchial epithelium cells of the patients with chronic obstructive pulmonary disease (COPD),and to explain the molecular mechanism about the participation of TRPC1 in airway remodeling.Methods:Sixty-four patients who needed fiberoptic bronchoscope for diagnosis were selected. All the patients were used as non-operation group and divided into COPD group (40 cases of mild to moderate grade)and control group (24 cases without chronic airway inflammatory disease)according to Respiratory Disease Guideline. The level of the forced expiatory volume/forced vital capacity (FEV1/FVC)in the first second and forced expiatory volume in the first second of the expected value (FEV1%pred)were detected by lung function test.The expression levels of TRPC1, matrix metalloproteinase (MMP-9)and transforming growth factor-β1 (TGF-β1 )in bronchoalveolar liquid (BALF) were measured by ELISA. The relevance among expression level of TRPC1 and levels of FEV1/FVC, FEV1%pred,MMP-9,TGF-β1 was analyzed.Seventeen lung samples from the patients underwent pulmonary lobectomy were selected.All the patients were used as operation group and divided into COPD group (8 cases of mild to moderate grade ) and control group (9 cases without chronic airway inflammatory disease ). Then indictator relevance to airway remodeling,such as thickness-diameter ratio (TDR%),percentage of wall thickness (WA%) were measured.The immunohistochemistry experiment was used to detect the distribution characteristics of TRPC1 protein in human bronchial epithelial cells. The Imagepro-plus 6.0 software was used to analyze the expression difference of TRPC1 protein between COPD and control groups. Western blotting method was used to detect the expression level of TRPC1 . The correlation between the expression level of TRPC1 and TDR%, WA% was analyzed.Results:The lung function detection results showed that in non-operation group,the levels of FEV1%pred and FEV1/FVC in COPD group were decreased compared with control group (P<0.05).The expression levels of TRPC1,MMP-9 and TGF-β1 in COPD group were increased compared with control group (P<0.05). The expression level of TRPC1 was negatively correlated with FEV1%pred (r= -0.34,P=0.002)and FEV1/FVC (r= -0.38,P=0.004).The expression level of TRPC1 was positively correlated with MMP-9 (r=0.36, P=0.004)and TGF-β1 (r=0.61,P=0.002).The immunohistochemistry results in operation group displayed that the TRPC1 protein was mainly distributed in the epithelial columnar cell nucleus and the cell membrane near lumen within the bronchial epithelium.The ratio of integrated optical density (IOD)to area within the bronchial epithelium in COPD group was significantly higher than that in control group (P<0.05).The expression level of TRPC1 protein detected by Western blotting method in COPD group was higher than that in control group (P<0.05).The expression level of TRPC1 was positively correlated with TDR% (r=0.59,P=0.002)and WA%(r=0.60,P=0.002).Conclusion:The TRPC1 channel in human bronchial epithelial cells of COPD patients is actived and up-regulated.The expression level of TRPC1 channel is positively correlated with impared extent of lung function and the expression levels of cytokines relevant to airway remodeling. All above imply that pressure-sensitive TRPC1 channel could promote the development of airway remodeling.

Post-stroke aphasia refers to acquired language disorder caused by cerebrovascular disease.As part of cognitive function,language is closely related with other non-linguistic cognitive function.In recent years,many scholars have begun to pay attention to the relationship between language disorder and non-verbal cognitive function in patients with post-stroke aphasia.This paper describes the epidemiology of cognitive impairment in patients with post-stroke aphasia,and summarizes the relationship between language obstruction and the non-language-based cognitive function in patients with aphasia after stroke (such as working memory,attention,execution,etc.) to provide a direction for further research.

Objective To compare the clinical effects of different doses of methylprednisolone therapy for children with severe hand,foot and mouth disease (HFMD).Methods According to different dosage methods, 240 children with severe HFMD were divided into large dose group,medium dose group and small dose group,80 cases in each group.The three groups were given different doses of methylprednisolone infusion on the basis of conventional treatment:large dose group(5 ~10mg·kg· -1 d -1 ),medium dose group(3 ~5 mg·kg· -1 d -1 ),small dose group (1 ~2mg · kg · -1 d -1 ).Results The time of fever sustaining,panic ease,mechanical ventilation,duration of hypertension and heart rate recovery of the medium -dose group were (47.93 ±4.72)h,(45.54 ±2.42)h,(51.43 ± 6.85)h,(53.66 ±7.62)h,(52.45 ±7.84)h,which were significantly shorter than those of the small -dose and large -dose group(all P <0.05).The incidence of turning to critically ill and the rate of ventilator use of the medium-dose group were significantly lower than those of the small -dose and large -dose group (all P <0.05 ).The incidence of pulmonary edema and pulmonary hemorrhage of the medium -dose group were significantly lower than those of the small -dose and large -dose group(all P <0.05).The differences among three groups were not statistically significant in the complications such as hypokalemia,hypocalcemia and gastrointestinal bleeding (all P >0.05 ). Conclusion Medium dose of methylprednisolone in the treatment of children with severe HFMD has significant effect and less adverse reactions,which is worthy of promotion.

Objective To investigate the prevalence of sexual dysfunction in aged men and associated risk factors in Beijing. Methods A cross-sectional study was performed in communities of Beijing involved 1656 men aged over 50 years.The International Index of Erectile Function-5 (IIEF-5),Brief Male Sexual Function Inventory for Urology ( O'Leary 1995 ) and the International Prostate Symptom Score (IPSS)questionnaires was recorded.The body mass index (BMI),prostate size was measured.The survey was conducted to make sure if the patients had diabetes,high blood pressure,hyperlipidemia,cerebrovascular history,and smoking and drinking situation.Pearson's X2 test and unconditional logistic regression were used to investigate the factors associated with sexual dysfunction. Results 1644 subjects were enrolled.The incidence of ED,reduction of sexual desire and defective ejaculation was 90.45％,60.04％ and 38.81％ respectively,and significantly different according to age ( P ＜ O.05 ). Age was positively correlated with ED (3 =0.12,P＜0.05),reduction of sexual desire (β =0.10,P＜0.05) and defective ejaculation (β =0.10,P ＜ 0.05 ) ; ED was significantly associated with BMI (β =0.07,P ＜ 0.05 ).Hypertension and prostate size were risk factors for reduction of sexual desire and defective ejaculation; There was correlation between drinking and defective ejaculation ( β =- O.31,P ＜ 0.05 ). Conelusions Compared with high prevalence of ED and lower sexual desire,the incidence of defective ejaculation were lower; this may reflect the sexual activities of aged male were more active compared with the less success of really erection.The prevalence of ED,reduction of sexual desire or defective ejaculation increased with age.BMI was the risk factor for ED.Enlarged prostate and hypertension was associated with reduction of sexual desire,and drinking was the risk factor for defective ejaculation.

Objective To investigate the characteristics of upper airway collapse in patients with obstructive slcep apnea hypopnea syndrome (OSAHS) when muscle is fully relaxed.Methods Thirty male ASA Ⅱ or Ⅲ patients with OSAHS aged 20-59 yr with body mass index 21-36 kg/m2 and apnea-hypopnea index (AHI) of 28-102times/h were studied.The patients were sedated with iv midazolam 1 mg and sufentanil 5 μg.Nasotracheal intubation was then performed under topical anesthesia with 1％ dicaine.After confirmation of correct position of nasotracheal tube,anesthesia was induced with propofol 0.5 mg/kg and vecuronium 0.08 mg/kg and maintained with target-controlled infusion of propofol and remifentanil.BIS was maintained at 40-60.Fiberopticnasopharyngoscope and pressure transducer were inserted via contralateral nasal cavity and connected with imaging workstation.The site and length of the obstruction were measured and calibrated.Positive pressure was applied to the pharyngeal cavity and gradually increased in increments of 1 cm H2O until 20 cm H2O.The change in cross-section area and critical opening pressure at different planes in pharyngeal cavity were recorded.Results Complete obstruction occurred at the plane of hard palate in one patient (3％).The soft palate and uvula completely collapsed in all 30 patients (100 ％).The collapse occurred at tongue level in 23 patients (77 ％).Every 1 cm H2O increase in pressure produced increase in cross-section area by (10 ± 4)mm2 at the level of hard palate and by(28 ± 18) mm2 at the level of soft palate and uvula.The critical opening pressure ranged from 3 to 18 cm H2O and was≤ 15 cm H2O in 90％ patients.Conclusion Soft palate and uvula collapse in all patients with OSAHS when muscle is fully relaxed.The critical opening pressure is ≤ 15 cm H2O in 90％ patients.

Objective To discuss the diet balance by the enteral nutritional support for patients after hematopoietic stem cell transplantation. Methods We divided 47 patients after hematopoietic stem cell transplantation into the balanced-diet group and the ordinary-diet group. The balanced-diet group received diet according to "diet exchange share" method and took food by the proportional share of 5 kinds of food. The ordinary-diet group took food according to the habits of patients.The effect of nutritional support was compared between the two groups. Results The body weight,white blood cell,hemoglobulin,platelet,total protein and proprotein in the balanced-diet group at the 90th day were different from those at the 30th day after transplantation(t value were -8.5,-4.7,-4.2,-10.2,-3.9,-14.1 and -80.9),P ＜ 0.01.In the ordinary-diet group only body weight,platelet and proprotein at the 90th were statistically different from those at the 30th day after transplantation (t value were -4.5,-4.6 and -14.9), P ＜ 0.01. Conclusion Balanced diet contributed to the rehabilitation and nutritional support after hematopoietic stem cell transplantation.

Objective To evaluate the efficacy of lidocaine solid lipid nanoparticles (L-SLNs) for sciatic nerve blockade in rats.Methods Lidocaine-loaded SLNs were prepared using high pressure homogenization.Ninety SPF male Wistar rats,weighing 220-280 g,were randomized into 6 groups (n =15 each) using a random number table:control group (group C),1％ L-SLN group (group L1-SLN),1％ lidocaine group (group L1),2％ L-SLN group (group L2-SLN),2％ lidocaine group (group L2),and blank SLN group (group SLN).In C,L1-SLN,L1,L2-SLN,L2 and SLN groups,normal saline,1％ lidocaine SLN,1％ lidocaine,2％ lidocaine SLN,2％ lidocaine and blank SLN (200 μl) were injected,respectively,around the sciatic nerve.Before sciatic nerve blockade (baseline) and at 10,20,30,60,120,180,240,300,360,420,480,540 and 600 min after blockade,the paw withdraw latency to a thermal stimulus was measured,and maximum possible effect (MPE) was calculated to reflect the degree of sensory block.Before sciatic nerve blockade and at 10,20,30,60,120 and 150 min after blockade,extensor postural thrust (EPT) of the hind limbs was detected to reflect the degree of motor block.The sciatic nerve at the injection site and the tissues around the site were obtained for observation of the pathological changes at 2 days and 1 and 4 weeks after blockade.Results Compared with the baseline value before blockade and group C,the MPE was significantly increased in at 10-30 min after blockade group L1,at 10-60 min after blockade in group L2,at 10-360 min after blockade in group L1-SLN,and at 10-540 min after blockade in group L2-SLN,and the EPT was decreased at 10-30 min after blockade in group L1,at 10-60 min after blockade in group L2 and group L1-SLN,and at 10-90 min after blockade in group L2-SLN.Compared with group L1,the MPE was significantly decreased at 10 min after blockade,no significant change was found at 20-30 min after blockade,and the MPE was increased at 60-360 min after blockade,and the EPT was increased at 10-30 min after blockade,and no significant change was found at the other time points in group L1-SLN.Compared with group L2,no significant change was found in the MPE at 10-30 min after blockade,the MPE was significantly increased at 60-540 minafter blockade,and the EPT was increased at 10-60 min after blockade,and no significant change was found at the other time points in L2-SLN group.In SLN,L1-SLN and L2-SLN groups,no pathological changes were found in the sciatic nerve at the injection site and the tissues around the site,and only mild inflammatory responses were observed.Conclusion L-SLNs can prolong the duration of block when applied for sciatic nerve blockade in rats and biocompatibility is good.

Objective To evaluate the clinical application value of real-time three-dimensional transesophageal echocardiography (RT-3D-TEE) in diagnosis of mitral valve prolapse(MVP).Methods Twenty patients with MVP with more than moderate mitral regurgitation referred for mitral valve repair (MVR) were studied.All patients underwent RT-3D-TEE and mitral valve quantification(MVQ) before MVR.The location of scallop lesions and ruptured mitral chordae tendineae for mitral valve were evaluated,and compared with surgical findings.Carpentier's nomenclature was applied to the mitral valve anatomic localization either RT-3D-TEE or surgery.There were three anterior leaflet scallops defined as A1,A2 and A3,and three posterior leaflet scallops defined as P1,P2 and P3.Results ① The shape and spatial structure of the scallop lesions and ruptured mitral chordae tendineae of mitral valve were clearly displayed by RT-3D-TEE,also could be observed through left atrium view and left ventricular view.② Compaired with surgical findings,RT-3D-TEE was of high sensitivity (100 ％),higher specificity (95.46 ％) and crude agreement (95.83％) in the location of P2,the positive likelihood ratio of location of P2 (22.03) was the biggest,the negative likelihood ratio (0) was the smallest.③ RT-3D-TEE had lower sensitivity (66.67％),specificity (83.76 ％) and crude agreement (83.33 ％) in the diagnosis of location of P1 than other locations,the positive likelihood ratio(4.11) was the smallest,the negative likelihood ratio (0.40) was the biggest.④ The sensitivity,specificity,crude agreement,positive likelihood ratio and negative likelihood ratio of RT-3D-TEE in diagnosis of ruptured mitral chordae tendineae accompanied by MVP were 100％,91.67％,95.00％,12.00,0 respectively.Conclusions RT-3D-TEE could clearly display the three-dimensional structure of the lesions of mitral valve.It was of better accuracy in diagnosis of the location of scallop lesions of mitral valve and the rupture of chordae tendineae,and was of important clinical application value in MVR.