The tumor stem cell has attracted more and more attentions in recent years,which is involved in a possibili- ty that the knowledge on the tumor stem cell would be a novel base for the developing of research fields in the tumor pre- vent,diagnose and therapy.However,the basic knowledge system on tumor stem cell has not formed as an enough re- search about it has not been done.In this commentary,the author presents his understanding on several biological issues of tumor stem cells,and some controversy in this field as well.The author also wishes his necessary information would in- duce reader's interesting and future considerations.

A computer-based online search of PubMed database and Chinese Journal Full-text Database was undertaken to identify articles about the monitoring of pulmonary arterial pressure (PAP),mixed venous oxygen saturation (SvO2),and breathing mechanics in the patients undergoing lung transplantation from January 1990 to May 2008 to evaluate their clinical values in maintaining cardiorespiratory function of patients during anesthetic stage. PAP,cardiac output and SvO2 are key parameters of monitoring during the diseased lung resection and donor lung transplantation; breathing mechanics and SvO2 are key parameters of monitoring after lung ventilation. The former are reliable indicator to predict lung transplantation reaction and pulmonary edema and the latter can guide regulation of positive end expiratory pressure and when to remove extracorporeal membrane oxygenator. A combination of hemodynamics (PAP,pulmonary capillary wedge pressure,cardiac output,and central venous pressure),breathing mechanics and SvO2 consists an overall monitoring of heart and lung function. By Meta-analysis,these indicators can guide the regulation and protection of heart and lung function in patients undergoing lung transplantation and other severe patients during the anesthesia period.

Taking 175 township public hospitals in Jiangxi as the samples,descriptive statistics and comparative analysis were applied based on their financial yearly report data from 2012 to 2016 to analyze the operation situation of hospitals before and after the public reform,analyze the influences of medical reform policies on township public hospitals and propose relevant policies,so as to promote the soon coming urban public hospital reform in Jiangxi.

Genetically engineered mice is one of the powerful research systems in exploring the gene protein life phenomenon,which is useful in generating the laboratory animal model of human diseases and developing the new drugs. With the development of functional genomics and model organism in life science area, biological medicine research is in need of genetically engineered mice deadly. There are still some problems to be resolved, including death effect, no or low expression and no phenotype. It is essential to improve the basic research related to genetically engineered mice.

Objective: To improve the micro-manipulation of mouse fertilized eggs,promoting its survival rate and productivity in pseudo-pregnant mice. Methods: DNA fragments of definite concentration and size were used for micro-manipulation with conventional and improved methods, then their survival rate of manupulated eggs and productivity of pseudo-pregnant mice were analyzed and compared. Results: With improved methods, the survival rate of eggs increased from 60.3% to 79.5%, the productivity of pseudo-pregnant mice and offspring increased from 35.7% to 56.8% and 10.1% to 14.1% respectively. Conclusion: The improved methods of micro-manipulation can be used in transgenic mouse production.

Aberrant promoter methylation in special genes such as tumor suppressor genes is early eventin carcinogenesis of lung cancer. Aberrant methylation, resulting in corresponding mRNA silence or overexpression , closely relates to carcinogenesis, development, treatment response and prognosis of lung cancer and it may become a potential biomarker. Methylation of special genes may provide evidences for individual treatment of lung cancers.

Objective To compare the clinical effect of remifentanil and dexmedetomidine on controlled hypotension during endoscopic sinus surgery. Methods Forty patients undergoing endoscopic sinus surgery were randomly divided into group R and group D, 20 in each group. All patients received controlled hypotension when the surgeons began to sterilize the nasal cavity for the purpose of maintaining the MAP at 60 ~ 70 mmHg. Group R received remifentanil 1μg/kg over 1 minute, followed by 0.2 to 0.4μg/kg per minute infusion during maintenance, whereas group D received dexmedetomidine 1μg/kg over 10 minutes, followed by 0.2 to 0.7μg/kg per hour during maintenance. At the moment of pre-induction(T0), incision(T1), 30 min(T2) and 60 min(T3) after incision and 10 min(T4) after end of controlled hypotension, MAP and HR were measured. Quality of the surgical field, blood loss and extubation time were recorded. Sedation and postoperative pain were assessed on arrival at the PACU. Results The goals for the MAP level were achieved and the surgical field quality was ideal in both groups. The MAP and HR values at T1~ T3 were significantly lower than those at T0 in both groups (P < 0.05). There were no significant differences in the MAP or HR values between the groups at each time point (P>0.05). No significant difference was founded between the groups in the Fromme operative field score and blood loss (P > 0.05). The extubation time was significantly shorter in group R than in group D(P<0.05). The sedation score in the PACU was significantly lower in group R than in group D(P<0.05), while there were no significant differences in postoperative pain between the groups(P<0.05). Conclusion Both remifentanil and dexmedetomidine are safe agents for controlled hypotension and are effective in providing satisfactory surgical fields during endoscopic sinus surgery. However , remifentanil is advantageous in time for extubation and complete consciousness from anesthesia and therefore it may have the advantage of fast track anesthesia.

Objective To observe the clinical effect of the transdermal acupoint stimulation treatment on intractable hiccups of patient with blood disease. [Methods]The 57 inpatients with intractable hiccups induced by chemotherapy or corticosteroids were randomly divided into two groups, percutaneous acupoint electric stimulation group and control group with Ritalin injecting in zusani, from January 2010 to December 2013. Clincal effect and adverse reaction were compared and analyzed after treatment. [Result]There was no significant difference on the clinical effect between two groups,while the adverse reaction in percutaneous acupoint electric stimulation therapy group was relatively mild.[Conclusion] Percutaneous acupoint electric stimulation is an effective method for the treatment of intractable hiccups, which should be popularized in clinical practice.

Objective To compare the effect between i-gel mask and SHPA mask in the airway management of general anesthesia.Methods Sixty patients of general anesthesia with ASA I or Ⅱ were randomly divided into two groups:i-gel mask group (30 cases) and SLIPA group(30 cases).After intubation and general anesthesia,fiberoptic bronchoscopy was used to detect and evaluate.The peak airway pressure,mean airway pressure,condition of the laryngeal mask intubation,time of intubation,time of extubation,time of recovery and the side effect occurrence of extubation were recorded.Results The time of anesthesia,time of operation,time of extubation,time of recovery,achievement ratio of first time,achievement ratio of second time,time of intubation,peak airway pressure and mean airway pressure had no significant difference between two groups (P ＞ 0.05).The airway seal pressure in i-gel mask group was significantly higher than that in SL1PA group [(29 + 6) cm H2O (1 c m H2O =0.098 kPa) vs.(23 ± 4) cm H2O] (P ＜ 0.05).For the grade of fiberoptic bronchoscopy in i-gel mask group,there was 27 patients in I grade,3 patients in Ⅱ grade.But in SL1PA group,there was 3 patients in I grade,4 patients in Ⅱ grade,13 patients in Ⅲ grade,10 patients in ⅣVgrade.There was significant difference between two groups (P ＜ 0.05).There were none of regurgitation in two groups.Conclusions The i-gel mask and SLIPA mask can provide the same effective ventilation.The i-gel mask has higher airway seal pressure,less side effect during the intubation and extubation,and have better airway management of general anesthesia.

OBJECTIVE To analyze the bacterial distribution and drug-sensitivity in sputum bacterial culture of the hospitalized patients with respiratory tract infection in the department of respiratory medicine to help reasonably choose the antibiotics and reduce the nosocomial infection rate. METHODS The bacterial infection of all the hospitalized patients with lower respiratory tract infection in the department of respiratory medicine from 2004 to 2005 was analyzed retrospectively and compared with all the patients of the hospital. RESULTS The nosocomial infection rate of the department of respiratory medicine in 2005 was 10.18%,which was higher than the rate of nosocomial infection of the whole hospital(3.09%).The Gram-negative bacteria were the main ones infected through respiratory tract.What should be paid attention to was the comparably higher fungal infection rate in 2005.The main Gram-negative bacteria were dominated by Pseudomonas aeruginosa.The most sensitive drug was piperacillin+ tazobactam in 2004 and aminoglycoside antibiotics in 2005.The Gram-positive bacteria were most sensitive to vancomycin. CONCLUSIONS The nosocomial infection is dominated by lower respiratory tract infection in the department of respiratory medicine.The nosocomial infection rate,dominated by Gram-negative bacteria is high.In order to decrease nosocomial infection rate,cross infection should be avoided,sensitive antibiotics be chosen,body resistance be enhanced and hospital stay be reduced.