BACKGROUND:With the in-depth study of cancer stem cels, increasing evidence has shown that cancer stem cels are the reason for cancer metastasis and recurrence, and therefore it is of great significance to isolate and identify cancer stem cels that can elucidate the pathogenesis of cancer and development of anticancer drugs.
OBJECTIVE: To isolate and culture gastric cancer stem cels and then to detect its biological characteristics.
METHODS: Cancer tissues from 16 patients with gastric cancer were cultured using adherent method and enzymic digestion methods to isolate gastric cancer stem cels. The cel morphology was observed under inverted microscope to drawn out growth curves. Osteogenic and adipogenic ability of cels were also detected.
RESULTS AND CONCLUSION: Gastric cancer stem cels were isolated successfuly by both two methods. Under the microscope, the cels were fusiform- or polygon-shaped. At confluence, the cels grew in a vortex or radial manner. The cel growth curve showed that 1-3 days were latent period, 4-9 days were logarithmic growth phase, and over 10 days were growth plateau phase. Flow cytometry results showed that passage 3 gastric cancer stem cels highly expressed CD90, CD29, CD44, but lowly expressed CD34, CD45 and HLA-DR. After osteogenic induction, calcified nodules were clearly visible in the gastric cancer stem cels at passage 3; after adipogenic induction, bright and tiny fat droplets were seen in the cytoplasm. These findings indicate that cancer stem cels exist in the gastric cancer tissues, and have similar morphology, biological property and multipotent differentiation ability to normal cels, which are probably involved in gastric cancer occurrence and development.

Objective To explore the relationship between angiotensin Ⅱ type 1 receptor (AT1R) gene polymorphisms and cerebrovascular disease (CVD).Methods The 104 patients with CVD and 98 healthy individuals were detected the AT1R genotypes polymorphisms by restriction fragment length polymorphism in order to analysis.Results CC genotype was not found both in CVD and control group. In CVD group, genotypic frequency of AA was 40.4% and AC was 59.6%. The allele frequency of A was 70.1% and C was 29.9%. In control group, genotypic frequency of AA was 91.8% and AC was 8.1%. The allele frequency of A was 95.9% and C was 4.1%. AT1R polymorphism revealed there was significant difference between the genotype and allelic distribution in CVD patients and those of in controls (all P

[Objective]To design an intramedullary nail for mid-shaft clavicular fractures based on the anatomic study of human clavicles.[Method]Sixty adult clavicles and 5 fresh cadaveric clavicles were used to survey data about full length,angle between lateral and middle segments,angle between middle and medial segments and the narrowest outer and inner diameter of clavicle.The designed interlocked intramedullary nail was used to fix mid-shaft clavicular fractures.[Result]The full length of clavicle was about(14.82?1.15) cm.The included angle between lateral and middle segment and included angle between middle and medial segment were all about 30?,the narrowest outer diameter of clavicle was about(1.00~0.16) cm,the narrowest inner diameter of clavicle was about(0.50~0.18) cm.After conversely placing guide pin from fracture end,expanding medullary cavity and adjusting the nail,the designed nail was inserted into the medullary cavity from the distal or proximal ends of clavicle,and the proximal and distal ends of the nail were locked by interlocked screws at last.[Conclusion]Treatment of mid-shaft clavicular fractures with the self-made nail has such advantages as less surgical invasion,visible fracture reduction and stable fracture fixation.The biomechanical properties of the nail will be further investigated.

As a new service model,clinical pathway has been applied in many areas.But there is no study on it from prospective of medical ethics.The author holds that the clinical pathway can enhance help achieving the objective of serving people's health,implementing the principle of informed consent,embody the human-center thinking,and eventually realize the goal of justice.

Objective To investigate the expression of proinsulin, insulin, C-peptide in insulinoma and normal pancreas and their roles. Methods Thirty-eight cases of insulinoma and 20 cases of normal pancreas from Sep. 2006 to Dec. 2009 in our hospital were selected. Immunohistochemistry was used to determine the expression of proinsulin, insulin, C-peptide. Results Proinsulin, insulin, C-peptide was expressed in insulinoma and normal pancreas. Proinsulin, C-peptide were strongly expressed in 100%insulinoma, while they were weekly expressed in 55% ～60% normal pancreas; insulin was expressed as + + +in 79% insulinoma, while it was expressed as + + + + in 85% normal pancreas. Proinsulin, C-peptide positive cell accounted for 80% ～ 100% of 38 insulinoma, and insulin positive cell accounted for 50% ～ 70%,the proinsulin/insulin ratio ＞ 1 accounted for 78.9%; while the corresponding values were 20% ～ 80%, 60% ～90%, 10.0% in normal pancreas, and the difference was statistically significant ( P ＜ 0.05 ). Conclusions The proinsulin/insulin ratio ＞ 1 is 78.9% in insulinoma, and detection of proinsulin may help to diagnose insulinoma.

Objective To investigate the clinical significance of pre-operative ancl intra-operative insulinomas localization, and improve the diagnostic accuracy. Methods 75 patients with suspected insulinomas who were treated surgically were enrolled; all the patients had pathological evidence of insulinomas. The data of pre-operative ultrasound, CT, MRI and intra-operative ultrasound and surgical palpation were collected and analyzed. Results The sensitivity of localization procedures was as follows: ultrasonography 30.7% ( 23/75 ), CT 40.0% (24/60) , MRI 45.4% ( 22/48 ) , while surgical palpation was 80.4% , intra-operative ultrasound 96.4%. The accuracy of intra-operative procedures was higher than that of pre-operative procedures. Conclusions It was difficult to accurately localize insulinomas before operation, but intra-operative palpation and iutra-operative US was easy to perform and highly accurate. Therefore, too much emphasis should not be placed on pre-operative imaging tests.

Objective To investigate the difference of two models of respiratory failure in preterm infants with nasal continuous positive airway pressure(nCPAP)and nasal biphasic positive airway pressure (nBiPAP).Methods Comparative analysis of 81cases of premature infants with respiratory failure requi-ring respiratory support was needed.They were applied nCPAP and nBiPAP ventilation mode treatment.The use of breathing machine and total oxygen inhalation time,the number of treatment failures,the PEEP param-eters of the ventilator,the total number of recent complications and secondary infections were compared.Re-sults In the nBiPAP treatment group,the average time of noninvasive ventilation was(96.34±31.5)h,the total time of oxygen inhalation was(10.11 ±9.39)d,3cases of treatment failure,the incidence of severe complications was 5.56%(2/36),PEEP (4.08±0.73)cmH2O (1cmH2O =0.098kPa ).In the nCPAP group,the average time of noninvasive ventilation was(114.14±41.69)h,the total time of oxygen inhalation was(17.53±15.96)d,15cases were failed,the incidence of severe complications was 15.56%(7/45), PEEP(5.11±1.01)cmH2O.There were significant differences between the two groups(P﹤0.05).But there were no significant differences in infection control and patent ductus arteriosus (P ﹥0.05).Conclusion nBiPAP as one of the first choice treatment for premature infants with respiratory failure significantly better than nCPAP,as soon as the proper use can avoid invasive ventilation.

BACKGROUND:Through a ful investigation of biodegradable scaffolds, we propose a new self-expanding degradable poly-L-lactide coated endotracheal stent based on the design, production, experimental and clinical applications of nickel titanium memory alloy stent. OBJECTIVE:To design a kind of biodegradable endotracheal stent with poly-L-lactide and hydroxyapatite, and to test its mechanical properties, biocompatibility and biodegradation capacity. METHODS:With the technology of computer aided design, the stents were prepared with poly-L-lactide (Mr RESULTS AND CONCLUSION:The average radial supporting force of the tracheal stent was 7.8 kPa, the percentage of stent surface coverage was less than 20%, the stent expansion rate was≥4%, and the stent longitudinal shortening rate was≤9%, which reached the mechanical requirements for degradable endotracheal stents. After 4-16 weeks, there was no significant inflammatory response. The decline in molecular weight changes and weight loss ratio was higher for in vivo degradation than in vitro degradation at different time (P<0.05). These findings indicate that poly-L-lactide/hydroxyapatite composite stents have good mechanical properties, biocompatibility and biodegradability. 150 000) and hydroxyapatite materials, 20 mm to 26 mm in diameter. The mechanical properties were tested using a universal testing machine. These poly-L-lactide/hydroxyapatite stents were implanted into dog models of tracheal stenosis at an appropriate size. The histopathological changes of the tracheas were observed, and biodegradation property was studied via molecular weight changes and weight loss ratio after 4, 8, 12, 16 weeks.

Case teaching has evident characteristics compared with traditional theory teaching. This article expound the purpose,significance,teaching process and the noticeable problems of case teaching in medicaI ethics teaching.

Objective To analyze the clinical characteristics in elderly onset rheumatoid arthritis(RA) patients combined with interstitial lung disease(ILD).Methods Four hundred and four cases of elderly onset RA patients were summarized.They were divided into two groups according to whether combined with ILD.Its clinical manifestations,laboratory examinations and combined diseases were analyzed.Results (1)Male elderly patients with onset of RA were more likely to occur ILD than female(χ2=6.251,P=0.012).There was no significant difference in duration analysis of two groups(t=1.750,P=0.081).(2)The elderly onset patients in RA with knee pain were more likely to happen ILD(χ2=7.048,P=0.008),the difference was significant.And there was no significantly statistical difference in the shoulder joint pain(χ2=0.028,P=0.866),elbow pain(χ2=0.022,P=0.882),hand joint pain(χ2=2.041,P=0.153),hip pain(χ2=0.129,P=0.720),joint deformities(χ2=0.013,P=0.908),morning stiffness(χ2=0.000,P=0.984) and joints rheumatoid nodules(χ2=0.349,P=0.555) of two groups.(3)The elderly onset RA patients with a high level of serum RF were more likely to happen ILD(t=3.325,P=0.001),the difference was significant.And there was no significantly statistical difference in serum ANA antibodies(χ2=0.004,P=0.948),anti SSA(χ2=0.718,P=0.397),SSB antibody(χ2=0.638,P=0.424),AKA antibody(χ2=0.949,P=0.330),CCP antibody(χ2=0.500,P=0.479) and the level of ESR(t=0.582,P=0.561),CRP(t=0.381,P=0.703) and PLT(t=-1.246,P=0.213).(4)The elderly onset RA patients with ILD were more likely to appear osteoporosis(χ2=7.467,P=0.006),the difference was significant.And there was no significantly statistical difference in the occurrence of high blood pressure(χ2=0.403,P=0.526) and diabetes(χ2=0.180,P=0.671) in the two groups.Conclusion Male patients,the elderly onset RA patients with knee pain and associated with high level of serum RF more often occur with ILD.And the elderly onset RA patients with ILD are more likely to appear osteoporosis.