Colorectal stem cells have many bio-markers, including Lgr5 which expression is associated with THE stage of disease , also regulating the cell cycle , anothers is +4 stem cell , which is associated with tumor heteroge-neity, also expressed Bmi1, arresting cell cycle.Besides there is Msi1.Many studies show that those markers are highly expressed in colorectal cancer , which activate Notch and Wnt signaling pathway , and can promote the pro-gress of tumor .

Objective Diabetes is a common chronic disease in the elderly and needs long-term treatment. This study aims to determine the effect of extended nursing service in rehabilitation of army retired officers with diabetes. Methods We selected 78 ca-ses of military retired officers with diabetes from September 2010 to September 2012 in Nanjing General Hospital of Nanjing Military Region. According to the different intervention methods, patients were divided into experimental group and control group( n=39 cases) . The control group used conventional nursing service, and the experimental group added extended nursing service on the basis of the control group . After one year follow-up, the fasting blood glucose level, glycosylated hemoglobin ( HbAlc) , self-rating depression scale (SDS) evaluation and self-rating anxiety scale (SAS) and the changes of patients′ satisfaction of the two groups were observed. Results The fasting blood glucose levels and HbAlc of experimental group were significantly better than control group, with statisticalsignificance (P<0.05);The SAS scores (34.9±5.9)and SDS scores (36.9±4.5) of experimental group were significantly lower than the control group(52.3±4.2 and 55.9±3.9), with statistical significance ( t=5.489, t=5.226, P<0.05);The satisfaction degree of the exper-imental group was significantly higher than the control group (99.8%vs 79.9%, χ2=4.898, P<0.05). Conclusion the extension ofnursing service in health rehabilitation in the retired veteran cadres in the army with diabetes can effectively improve the patient′s fast-ing blood glucose levels, reduce depression, as well as improving the nursing service satisfaction.

Musashi1 (Msi1) is an evolutionary conservative RNA-binding protein (RBP),and it is a stem marker in a variety of organizations,including intestinal,neural system.Msi1 maintains the balance between self-renewal and differentiation.Recently,many researchers report that Msi1 is overexpressed in many types of tumors,especially in colorectal neoplasms,participating in the regulation of cell cycle,proliferation,apoptosis and so on.Msi1 becomes a key regulator of many cancers,which is expected to turn into a new target for cancer therapy.

Objective To study the ways of obstetrics and gynecology noviciate on how to increase medical students' practical ability in eight-year program. Methods The three aspect studies ,such as experimental technology teaching on gynecology, clinical observation and thought of emergency and ward practice,and simulation teaching of clinical skill,has been accomplished in 50 students of eight-year program in the grade of 2004. Results Teaching achievements has been made in three aspects,such as the settlement of the difficulties in obstetrics and gynecology teaching, the increase of clinical skill and enhancement of practical chance in obstetrics and gynecology. Conclusions The studies of obstetrics and gynecology noviciate provide referenced teaching modes for increase medical students' practical ability in eight-year program.

Acupuncture Therapy ; Animals ; Animals, Newborn ; Brain ; metabolism ; Hypoxia-Ischemia, Brain ; metabolism ; therapy ; Malondialdehyde ; metabolism ; Nitric Oxide ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the role of AMP-activated protein kinase (AMPK)-dependent autophagic signaling pathway in ketamine-induced reduction of diabetic neuropathic pain (DNP) in rats.Methods Sixty male Wistar rats,aged 3 months,weighing 200-250 g,were equally randomized into 5 groups using a random number table:control group (C group),normal saline group (NS group),ketamine group (K group),ketamine + Compound C group (KC group),and ketamine + 3-methyladenine (3-MA) group (KM group).DNP model was established by intraperitoneal injection of streptozocin (STZ)65 mg/kg in anesthetized rats.Four weeks later,the equal volume of normal saline,ketamine 10 mg/kg,ketamine 10 mg/kg + Compound C1 mg/kg,and ketamine + 3-MA 2 μl were injected intraperitoneally once a day for 7 consecutive days in NS,K,KC and KM groups,respectively.The mechanical paw withdrawal threshold (MWT) was measured on 8th day.The rats were then sacrificed,and the lunbar segment (L1-5) of the spinal cord was removed for determination of the expression of AMPKαt,Beclin-1,microtubule-associated protein 1 light chain (LC) 3B (by Western blot) and dendritic spine density in the dorsal root ganglia.Results Compared with group C,the MWT,expression of AMPKα,Beclin-1,and LC3B,and dendritic spine density were significantly decreased in group NS (P＜0.05).Compared with group NS,the MWT,expression of AMPKαt,Beclin-1,and LC3B,and dendritic spine density were significantly increased in group K (P＜0.05).Compared with group K,the MWT,expression of AMPKα,Beclin-1,and LC3B,and dendritic spine density were significantly decreased in KC and KM groups (P＜0.05).Conclusion Activation of AMPK-dependent autophagic pathway is involved in ketamine-induced reduction of DNP in rats.

Objective To evaluate the relationship between carotid artery plagues and the clinical risk factors in patients with diabetes mellitus type 2 by observing the ultrasonic characteristics of carotid atherosclerosis plagues.Methods The ultrasound results of carotid arteries in 665 patients with diabetes mellitus type 2 from January 2009 to December 2011 in Beijing Amery General Hospital were retrospectively analyzed.The location and quantity of carotid atherosclerotic plaques were observed .The relationship between the occurrence and risk factors of diabetes such as hypertension ,family history of diabetes and age were analyzed.Single factor and multi-factor analysis were applied for the related risk factors .Results The ultrasonography showed 405 cases of carotid artery plaques.Most carotid artery plaques were located in the posterior wall of carotid sinus and were hyperechoic ,hypoechoic or isoechoic.The single factor analysis showed hypertension,family history of diabetes and age are risk factors of carotid atherosclerosis (χ2 =42.322,9.682 and 140.658,all P<0.01).Multi-factor logistic regression analysis showed age was an independent risk factor of carotid atherosclerosis in patients with diabetes mellitus type 2.The risk factors scores of patients who were less than 45 years,45-65 years and over 65 years of age were (3.50 ±1.16)scores,(3.46 ±0. 92)scores and (3.21 ±0.88)scores,and the difference was statistically significant (F=5.781,P<0.001). There were significant differences between risk factors scores of different age groups ( t =2.084,2.002, 3.786,3.474,2.877 and 2.504,all P<0.05).In patients more than 65 years of age,the risk of atherosclerosis plaques is 28.732 times higher than that of patients less than 45 years of age.After controlling the age factor,the possibility of atherosclerosis plaque increased 1.201 times for each additional one point of score. Conclusions Most carotid artery plaques in patients with diabetes mellitus type 2 are located in the posterior wall of carotid sinus and are hyperechoic ,hypoechoic or isoechoic.Age is an independent risk factor for the formation of carotid plaque.Patients more than 45 years of age should undergo early intervention to avoid the occurrence of major vascular complications .

Objective To explore the effects of two methods for deep endotracheal suction.Methods Forty patients who had ineffective airway clearance or lung infections or refused suction were randomly divided into observation group (n=21) and control group (n=19).Temporay airway was established by using oropharyngeal airway.Then,the control group received subglottic suction after pading the shoulder with ordinary pillow (≤10cm),while the observation group received subglottic suction after pading the shoulder with homemade pillow (=15cm).The two groups were compared in terms of sputum suction effect and mucosal injury.Results There was no incidence of mucosal injury in the observation group but three in the control group.The times of suctioning in the observation group were fewer than those of the control group and the volume for suctioning was larger as well (allP<0.05).Conclusion Deep endotracheal suction through oropharyngeal airway,shoulder elevation for 15cm,temporary indwelling of suction tubes can achieve better suction effect without corresponding complications.

Objective To explore the effect of the unilateral lumbar anesthesia by hypobaric bupivacaine and general anesthe‐sia in elderly hip replacement and their influence on the stress response .Methods Forty elderly patients undergoing hip replace‐ment in our hospital from December 2013 to November 2014 were selected and randomly divided into the unilateral lumbar anesthe‐sia group and general anesthesia group according to the random number table ,20 cases in each group .Venous blood was collected to determine the levels of blood sugar ,serum catecholamine(CA) and cortisol(CORT ) at 10 min before anesthesia(T0 ) ,end of surgery (T1 ) and at postoperative 24 h(T2 ) .MAP ,HR ,SpO2 ,intraoperative adverse reactions and postoperative related complications were recorded at each time point ,and the comparative analysis was performed .Results All patients successfully completed surgery and the anesthetic effect was satisfied .The occurrence rates of intraoperative hypotension ,hypertension and bradycardia in the unilateral lumbar anesthesia group were lower than those in the general anesthesia group ,the differences had statistical significances (P>0 .05) .HR and MAP at T1 in the two groups were reduced ,but the differences between the two groups were no statistical signifi‐cance(P>0 .05);the levels of GLU ,CORT and CA were increased ,moreover the differences between the two groups were statisti‐cally significant(P<0 .05) .SpO2 at T2 in the general anesthesia group was obviously lower than that in the unilateral lumbar anes‐thesia group ,while CORT was higher than that in the unilateral lumbar anesthesia group ,the differences were statistically signifi‐cant(P<0 .05) .The occurrence rates of postoperative nausea and vomiting ,sore throat ,dizziness ,drowsiness and pulmonary infec‐tion in the unilateral lumbar anesthesia group were lower than those in the general anesthesia group ,the differences were statistical‐ly significant(P<0 .05) .Conclusion The unilateral lumbar anesthesia by using hypobaric bupivacaine and general anesthesia all could offer better anesthetic effect .The unilateral lumbar anesthesia by using hypobaric bupivacaine can effectively regulate the stress response in elderly patients with hip replacement .

Objective To explore the importance of gene diagnosis and prenatal diagnosis of spinal muscular atrophy(SMA),and improve the clinical diagnosis of SMA by analyzing the electrophysiological and gene characteristics of SMA.Methods Fifteen cases with SMA including 9 male and 6 female were enrolled in this study.The age was 5 months to 12 years.The 15 cases were subdivided into 3 clinical types,5 cases of type Ⅰ including 3 male and 2 female aging 5-18 months;7 cases of type Ⅱ including 4 males and 3 females aging 5 months-3 years;3 cases of type Ⅲ including 2 male and 1 female aging 3-12 years.They were all characterized by symmetric muscle weakness(more proximal than distal)associated with atrophy,absence or marked decrease of deep tendon reflexes,loss of voluntary movement and inability to sit or stand.The clinical characteristics and changes of electromyography(EMG)and nerve conduction velocity were assessed in all cases by using Danish Medoc Keypoint myoelectricity and evoked potentials inducer.The survival of motor neuron(SMN)gene was detected by PCR and restriction endonuclease spectrum analysis in 10 cases.Results EMG analysis found 94% patients had spontaneous potential,90% patients had increased duration of motor unit,and amplitude increased in 89% patients.Motor nerve conduction velocity was determined in 78 nerves.Motor nerve compound action potential wave amplitude decreased in 52 nerves,among them,distal latent period prolonged and motor conduction velocity reduced slightly in 36 nerves.Sensory nerve conduction velocity was determined in 45 nerves and remained normal.The SMN gene detection revealed deletion of exon 7 and 8 in 9 cases,deletion exon 7 in 1 case.The SMN gene detection in 10 patients and their parents didn't find any deletion of exon 7 and 8.Conclusions The definite diagnosis of SMA will rely on the typical clinical characteristics,changes of EMG and gene deletion analysis.Gene diagnosis of SMA lays a basis for prenatal diagnosis.