Objective To investigate the mRNA,protein expression and tyrosine phosphorylation of insulin receptor substrate.1(IRS-1)in endometrial carcinoma.Methods Sixty-three endometrial carcinoma(EC)patients,21 endometrial atypical hyperplasia(AHE)patients and 22 normal control(NE) entered this smdy.Their clinical information were colleeted Fasting serum C-peptide concentration was measured.Expression of IRS-1 in endometrium was examined by RT-PCR and western blol Immunoprecipitation was used to measure the tyrosine phosphorylation of IRS-1.Results C-peptide 0.007].There were no significant differences in IRS-l mRNA and protein expression among the three grouDs.Tyrosine phosphorylation of IRS-1 in EC group[(62±36)%]was higher than that in AHE and NE groups[(53 4-34)%and(35 4-33)%;P=0.048,0.002].IRS-1 activation in AHE group was also higher than nornlal control(P=0.045).IRs-1 activation in endometrioid carcinoma[(69 4-33)%]was higher than that in other histological types[(34±31)%;t=2.300,P=0.025].IRs-l tyrosine phosphorylation was significantly higher in patients with advanced stage,high grade,deep myometrial invasion and pelvic lymph node metastasis.IRS-l activation in endometrium was positively correlated with fasting sertlm C-peptide concentration(r=0.491,P=0.001).Conclusions There is excessive activation of IRS-1 in endometrial carcinoma and atypical hyperplasia.Activation of IRS-I in endometrial carcinoma is related with poor clinical-pathologic fleatures and may be a prognostic predictor for this tumor.Over-activationof IRS-1 may be an intermediate event linking the hyperinsulinemia and endometrial carcinoma.

Objective To analyze the clinical features of obstructive sleep apnea-hypopnea syndrome(OSAHS)with initial diagnosis of aorta dissection(AD)and therefore to improve its diagnosis.Methods The clinical data of 6 cases of AD with OSAHS were retrospectively analyzed.Results There were six male cases of obesity whose average body mass index(BMI)was 32.72±3.57,with an average age of(43.83±2.14)and the leading symptoms were daytime hypersomnolence,nocturnal wake by suffocation and habitual snoring.ESS was(13.83±2.14),apnea hypopnea index(AHI)was≥62/h[on averaga of(73.35±9.16)/h],the lowest pulse oxygen saturation(LSpO2%)was(58.67±10.95)%,time of oxygen saturation level lower than 90%(min)[T90(min)]was(244.20±144.74)min,the percent of the total time with oxygen saturation level lower than 90%(TS90%)was 54.48±30.18.They had more than two years history of hypertension.Conclusion Severe OSAHS affects the prognosis of AD.Early diagnosis and timely treatment can delay the progress of AD and lower death rate,with an important significance in improving the prognosis of AD.

Objective To explore the effects of family member's behaviors on outcome of patients with acute cerebral infarction. Methods 160 cases with acute cerebral infarction were investigated with 9 kinds of family member's behavior. Results 9 kinds of family member's behavior were all closely related to the outcome of patients with acute cerebral infarction. Conclusion Family member's behavior was closely related to the patients with acute cerebral infarction

Objective To evaluate the effects of doxofyline on intraoperative pulmonary function in patients receiving double lumen endotracheal intubation for one-lung ventilation. Methods Fifty patients who underwent elective pulmonary lo-bectomy under general anesthesia using double lumen endotracheal intubation were randomly divided into two groups ( n=25 each):control group (group C) and doxofyline group (group D).Doxofyline (4 mg?kg-1) was injected intravenously after double lumen endotracheal intubation in group D,while equal volume of 0.9% sodium chloride was intravenously given in group C.Total intravenous anesthesia with target controlled infusion was performed during the operation.Two milliliter blood samples were taken from the radial artery for blood gas analysis immediately before administration ( t0 ) ,at 30 min ( t1 ) ,60 min ( t2 ) after one-lung ventilation and at the moment of two-lung ventilation after chest closing ( t3 ) . The PaCO2 , PaO2 , peak airway pressure (Ppeak),airway plateau pressure (Pplat),airway resistance (Raw) and lung compliance (Compl) were recorded at t0-3. Results The Ppeak,Pplat and Raw were significantly decreased and the Compl and PaO2 significantly increased at t1-t3 in group D when com-pared with those in group C (P<0.05).The Ppeak,Pplat and Raw were significantly increased and Compl and PaO2 significantly de-creased at t3 as compared with those at t0 in group C ( P<0.05) . Conclusion Doxofyline can improve intraoperative pulmonary function in patients who undergo double lumen endotracheal intubation for one-lung ventilation.

Objective To explore the effect of humidification of oxygen delivered by nasal cannula on the respiratory symptoms. Method A total of 540 patients receiving low-to-mid flow oxygen therapy (<4L/min) by nasal cannula for more than 12 hours were assigned to receive humidified (n=235) or dry (n=305)oxygen. While 226 patients receiving a low-to-mid flow oxygen therapy for more than 24 hours received humidified or dry oxygen respectively. The patients' respiratory symptoms were observed and recorded. Results Dryness over naso-pharyngeal region was the only symptom reported by patients in this study. There was no significant difference on the rate of dryness over naso-pharyngeal region between patients receiving humidified oxygen and patients receiving dry oxygen (P>0.05) either in the same patients when receiving dry and humidified oxygen (P>0.05). Conclusion Routine humidification is not necessary in low-to-mid flow oxygen therapy by nasal cannula.

Objective To discuss influence of the humidification or non-humidification on oxygen humidity during low-mid volume oxygen inhalation through nasal cannula.Methods A total of 160 patients with low-mid volume oxygen inhalation through nasal cannula for≥12 hours were randomly assigned to the humidified group and the un-humidified group with 80 patients in each.Recording the chases of oxygen humidity from the humidifying bottles.at the same time the indoor air humidity was also observed.Influence of the humidification or non-humidification on oxygen humidity during low-mid volume oxygen inhalation through nasal cannula was observed.Results There was not significant difference in oxygen humidity between the two groups.Conclusions Routine humidifying is not necessary in low-mid volume oxygen inhalation through nasal cannula.

Background: It is unknown if medication-overuse headache, clinically similar to chronic tension-type headache, has pre-attentive problems which may be related to pain or substance abuse. Methods: Auditory frequency deviance elicited mismatch negativity was recorded from 22 patients with chronic tension-type headache, 26 with medication-overuse headache from underlying chronic tension-type headache and 41 healthy volunteers as controls. Their depression and anxiety scores were noted. Results: There were no signifi cant differences in the N1 latency or amplitude to both standard and deviant stimuli for the different groups. However, the latency and amplitude of mismatch negativity were signifi cantly shortened and reduced at Fz, Cz, and Pz in medication-overuse headache as compared to chronic tension-type headache and normal subjects. Anxiety levels were elevated in chronic tensiontype headache and medication-overuse headache subjects compared to healthy controls but were not correlated with mismatch negativity latency or amplitude in a given group. Conclusions: In medication-overuse headache subjects, the shortened mismatch negativity latency indicates quick involuntary attention switching to auditory change, while its reduced amplitude indicates poor accuracy in discriminating early stimuli, which may be related to medication overuse rather than to the head pain experienced.

[Objective] To refer a geographical distribution rule of alpha-L-fucosidase (AFU) reference values for the health adults in China via exploring its spatial distribution trend and its correlation with geographical factors.[Methods] A total of 6564 samples of AFU reference values from 66 administrative units in the years 2004-2015 were collected,male and female of which were 3701 cases (56.4％) and 2863 cases (46.3％).A research concerning AFU reference values in whole country were calculated using methods of information content and ridge regression.[Results] AFU reference values for Chinese healthy adults were influenced by geographical factors and presented autocorrelation,and it showed eastern and northern areas were highery than western and southern areas.[Conclusions] AFU reference values have a spatial variation and the regional disparities should be considered in practice.

Objective To evaluate the feasibility of using lumbar plexus block for unilateral extremity artificial vascular graft between femoral artery and deep femoral artery in elderly patients.Methods Forty ASA physical status Ⅱ or Ⅲ patients,aged 67-81 yr,weighing 47-65 kg,scheduled for extremity artificial vascular graft between femoral artery and deep femoral artery,were randomly divided into 2 groups (n =20 each) using a random number table:spinal anesthesia group (group S) and lumbar plexus block group (group L).In group S,0.5 ％ hyperbaric ropivacaine 3 ml was injected into the subarachnoid space.In group L,lumbar plexus block was performed with 30 ml of 0.5 ％ ropivacaine under the guidance of a nerve stimulator.The onset time and duration of sensory block,anesthetic efficacy,and requirement for ephedrine and volume of fluid infused during operation,and development of lumbar plexus block-related adverse events were recorded.Results Compared with group S,the onset time and duration of sensory block were significantly prolonged,the requirement for ephedrine and volume of fluid infused during operation were decreased,and no significant change was found in anesthetic efficacy in group L.No lumbar plexus block-related adverse events developed in group L.Conclusion Lumbar plexus block can be used for unilateral extremity artificial vascular graft between femoral artery and deep femoral artery in elderly patients.

Objective: To evaluate the dietary risk of neonicotinoid insecticides in market-sold vegetables in Guangzhou City, so as to provide insights into ensuring food safety for residents. Methods: Forty-five samples of 21 kinds of vegetables were collected from supermarkets and farmer's markets in Guangzhou City from June to September in 2022, and 10 kinds of neonicotinoid insecticides were determined using liquid chromatography-mass spectrometry (LC-MS). The vegetable consumption was obtained through the survey of food consumption and nutrients intake of residents in Guangzhou City. The dietary risk was evaluated by calculating daily exposure and non-carcinogenic risk quotients of neonicotinoid insecticides. Results: A total of 27 samples of vegetables were detected with neonicotinoid insecticides, and the detection rate was 60.00%. Among 10 kinds of neonicotinoid insecticides, 6 kinds were identified, including clothianidin, thiamethoxam, imidacloprid, acetamiprid, dinotefuranand and nitenpyram. The detection rates of clothianidin, thiamethoxam and imidacloprid were relatively high (26.67%, 11.11% and 6.67%), and some samples exceeded the standard, with the rate of 4.44%, 2.22% and 2.22%, respectively. The total exposure of neonicotinoid pesticides (IMIRPF) was 3 053.00 ng/g, and the contents and IMIRPF of imidacloprid were the highest in roots and tubers. The daily exposure of imidacloprid, acetamiprid, dinotefuran, clothianidin, thiamethoxam and nitenpyram was 34.58, 3.85, 1.20, 6.87, 7.19 and 0.86 ng/(kg·d). Non-carcinogenic risk quotients of imidacloprid, acetamiprid, dinotefuran, clothianidin, thiamethoxam and nitenpyram was 5.76×10-4, 0.55×10-4, 0.06×10-4, 0.69×10-4, 0.90×10-4 and 0.02×10-4, respectively, which was lower than 1; and the sum of non-carcinogenic risk quotients was 7.98×10-4, which was lower than 1. Conclusions The dietary risk of neonicotinoid pesticides is low in 21 kinds of market-sold vegetables in Guangzhou City; however, the contents of neonicotinoid insecticides in some vegetable samples exceed the standard. The supervision of vegetable markets should be strengthened.