Stem cells are characterized by the ability to renew themselves and differentiate into a di-verse range of specialized cell types.Bmi1 gene has been determined to play critical roles in the self-renewal of stem cells.Many of the tumor originated in stem cells.Enhanced self-renewal capability in stem/progenitor cells changes its biological characteristic and drives tumor initiation

Objective To study the demographics and background of attempted suicide individuals,such as age,gender,mode of suicide,seasonality,etc.so as to improve prevention strategy.Methods By sequential sampling analysis,there were data of 895 survivors from committed suicide taken from 907 attempted suicide individuals recorded in an emergency room of a local hospital between 2002 and 2008 for retrospectively study.Results The sample was composed of 191 males and 704 females with a male to female ratio of 1∶3.69.The adolescents and young adults aged 15-34 years accounted for the vast majority of attempted suicide individuals with the peak at the age of 24 years.The number of committed suicide remarkably reduced after the age of 47 years.The major mode of committed suicide was ingestion of poisons.The incidence of committed suicide declined significantly from 2002 to 2005,and then increased between 2005 and 2008.It was more often occurred in the seasons of Spring and Summer. Conclusions Age,gender,and seasonality are associated with attempted suicide in china,and these risk faetors should be the focuses of suicide prevention in China.Additionally,control of pesticides and psychological intervention should be the parts of the work to prevent suicide in the this cohort of special individuals with propensity of committed suicide.

Objective To discuss the pathogenesis of cerebral hemorrhage in maintenance hemodialysis patients.Methods From Jan.2002 to Dec.2004all the 261 hemodialysis patients in changai Hospital were divided into two groups on the basis of with or without cerebral hemorrhage :(1)the control group,(2)the group of cerebral hemorrhage.Clinical data of 261 hemodialysis patients were retrospectively analyzed.Results In the group of cerebral hemorrhage,the incidence of high blood pressure was 81.1%:the blood pressure after medical therapy not up to standard was 83.8%;the usage of ordinary heparin was 78.4%;the average RRF was(3.8?1.9)and those of the control group were 62.5%,52.7%,52.7% and(7.1?3.3).There were significant differences between the two groups.Conclusion The maintenance hemodialysis patients with cerebral hemorrhage result from multiple factors.Positive control of the blood pressure,selection of appropriate anticoagulant and protection of RRF have important clinical significance.

Objective To study the validity of furosemide test for predicting the hematoma enlargement in pa- tients with hypertensive cerebral hemorrhage.Methods Four hundred fifty-one patients with hypertensive cerebral hemorrhage were diagnosed using CT after oneset of the disease and 24 h reexamined 24 h after.The incidence of enlarged hematoma was evaluated by comparison the baseline and 24 h CT scanning.Furosemide(20 mg iv)was ad- ministered and blood pressure was measured 30 min after furosemide.Results The decreasing level of MAP after furosemide was significantly inversely related with incidence rate of hematoma enlargement{ r=-0.94,t=58.4,P 10 mmHg as the cut-off point,with the rate of hematoma enlargement as being 6.4 %,MAP decreased≤10 mmHg was associated with increases in prevalence of hematome to 33.2 %(?~2=51.82, P

Anterior approach refers to a method of hepatectomy which is first to resect the hepatic parenchyma and then to free the liver; hanging maneuver refers to placing a tape before the inferior vena cava for hanging the liver during hepatectomy.In October 2011,anatomical trisectionectomy was performed on a 54-year-old male patient with large hepatocellular carcinoma in the left medical lobe and right lobe with anterior approach and hanging maneuver.The diameter of the tumor was 16 cm,and was in the ⅢA/T3NOM0 stage.The indocyanine green retention at fifteen minutes was 5.4％,and the ratio of hepatic left lateral lobe volume over the standard total liver volume was 44％.The left bile duct was slightly dilated because of the compress of the tumor.The operation started with the isolation and dissection of the inflow vessels,including the right hepatic artery,the right portal vein,the middle hepatic artery,the portal vein branches of left internal lobe.The hepatic parenchyma transection was performed along the fight side of the falciform ligament.A tape was passed between the anterior surface of inferior vena cava and liver,and the liver was suspended during the transection.The left bile duct was cut at the right side of round ligament,and then the middle hepatic vein and the right hepatic vein were resected.The ligaments around the liver were dissected and the right hepatic lobe was removed.Finally,the end-toend anastomosis between the left hepatic duct and the common hepatic duct was performed.The operation lasted for 4 hours and the intra-operative blood loss was 350 mL.The patient was recovered well.At the end of 4 months after surgery,magnetic resonance cholangiopancreatography showed that the anastomosis of the bile duct was unobstructed,and there was no recurrence of tumor inside the liver.

Background and purpose:Histological grade of DCIS is an important factor in the prognosis, high nuclear grade have higher inifltration trend and recurrence rate. This study aimed to evaluate the dynamic and morphological MRI charactristics of ductal carcinoma in situ (DCIS) of the breast, then analyze its relations with nuclear grade. Methods:Of the 94 patients, 97 lesions were proved DCIS by pathology. The morphology, maximum size, time-intensity curve of lesion were recorded or measured. Statistic was performed to identify MR imaging features that optimally discriminated HNG from non-HNG DCIS. Results:There were 49 non mass-like enhancement lesions, and 48 masses enhancement lesions. Among 49 non mass-like lesions, 29 were segmental enhancement (59.18%). Dynamic enhanced performance:50 exhibited plateau curves and 27 were washout curves. BI-RADS categories:22 BI-RADS 4A, 19 BI-RADS 4B, 29 BI-RADS 4C, and 27 BI-RADS 5. HNG lesions exhibited larger mean maximum lesion size (non-mass-like enhancement: P=0.01; mass: P=0.03), time- intensity curve was variable to approach signiifcance (P=0.01), and BI-RADS can help to discriminate the nuclear grade (P=0.02). There were no differences in lesion morphology (P>0.05). Conclusion:The preliminary ifndings suggest that DCE MR imaging features may aid in identifying patients with high risk DCIS.

University of Manchester who first introduced Problem based learning(PBL)to the UK medical education,and adopted this new curriculum in 1994.Notably,Cambridge and Oxford have always had a high proportion of student-centred and self-directed learning,and have therefore not introduced PBL.Other medical schools have followed the example of Manchester,now PBL has become the mainstream curriculum in British medical edacation.First,this article is going to introduce how PBL curriculum is structured at Manchester medical school,and then reflect and give some thoughts on its current practice.

Objective To study the relationship between angiotensin Ⅱ type 2 receptor (AGTR2) gene single nucleotide polymorphisms and hypertension in patients with essential hypertension and renal hypertension.Methods Direct DNA sequencing was performed to detect the single nucleotide polymorphisms (SNP) in eighty patients with essential hypertension,eighty patients with renal hypertension and forty normal blood pressure controls.Results There was significant difference on A allele frequencies between essential hypertension group and control group ( 56.88％ [ 91/160 ] vs 30.00％ [ 24/80 ],x2 =15.44,P ＜ 0.001 ).A allele frequency had no correlation with renal hypertension (42.50％ [ 68/160 ] vs 30.00％ [ 24/80 ],x2 =3.52,P ＞0.05).There was no significant difference on SNP between essential hypertension group and renal hypertension group ( P ＞ 0.05 ).Conclusion A1675G signal nucleotide polymorphisms of AGTR2 may be associated with the development of essential hypertension,but has nothing to do with renal hypertension.

Cardiomyopathies ; congenital ; Heart Ventricles ; pathology ; Humans ; Infant, Newborn ; Male ; Myocardium ; pathology

Objective To analyse the efficacy of lamivudine(LAM) combined adefovir dipivoxil(ADV) and entecavir(ETV) in the treatment of naive patients with chronic hepatitis B (CHB) .Methods Cochrane Library ,MEDLINE ,Web of Science ,CNKI (China National Knowledge Infrastructure ) ,WANFANG database and VIP database were searched and the references of eligible studies were screened .All relevant literatures published before March 6th ,2012 were reviewed .Comparison of the efficacy of lami-vudine combined adefovir dipivoxil and entecavir in the treatment of naive patients with chronic hepatitis B was included and Rev Man 5 .1 software was used for Meta analysis .Results Four eligible studies (587 patients in all) were included for the analysis .In the entecavir monotherapy group ,the serum ALT normalization rate was a little higher at the 12 weeks and 24 weeks of the treat-ment compared to the combination group[OR=0 .52 ,95% CI(0 .28 ,0 .97) ,Z=2 .04 ,P=0 .04] ,[OR=0 .45 ,95% CI(0 .22 ,0 .95) , Z=2 .11 ,P=0 .04] ,respectively .But after 36 weeks there was no significance between the two groups .For HBV DNA undetect-able rate ,there were no significant differences between the two groups at the 12 weeks ,24 weeks ,36 weeks ,48 weeks ,18 months , 24 months and 30 months of the treatment (P=0 .22 ,P=0 .30 ,P=0 .86 ,P=0 .31 ,P=0 .93 ,P=0 .84 and P=0 .83 respectively) . At the 48 weeks ,HBeAg negative rate has no significant difference between the two groups [OR=0 .93 ,95% CI(0 .29 ,2 .95) ,Z=0 .13 ,P=0 .90] .Conclusion Both LAM+ADV combination therapy and ETV monotherapy are effective in the treatment of naive patients with CHB ,but further studies are still needed to obtain long term results and safety by high quality ,large scale randomized controlled trials .