Cancer stem cell niche provides a relatively stable microenvironment for cancer stem cell (CSC)existence,proliferation and differentiation.This microenvironment consists of kinds of cells,stroma and cytokines, etc. Within it , CSC can resist chemoradiotherapy. It has been shown that destruction of the microen vironment can significantly enhance the effect of chemoradiotherapy and improve prognosis of cancer patients.

Objective To study the characteristics of military occupational stress and its impaction on mental health of survicemen, and the strategies to cope with the situation. Methods By random cluster sampling, the mental status of 1902 army officers and soldiers were investigated according to the contents and parameters of "Chinese Military Mental Health Scale (CMMHS)", "Military Occupational Stress Scale" and "Military Personnel Scene-trait Coping Style Scale". Results 1) The total score of occupational stress and passive coping, and the score of each factor were significantly higher in the mentally unhealthy group than that in the healthy group (P

0.05).Conclusion Certain changes have been found in mental health of Chinese standby peacekeepers,such as expectancy anxiety,depression,neurasthenia,interpersonal sensitivity etc.

Objective To observe the therapeutic effects of balloon dilatation with ice water and room temperature water on cricopharyngeal achalasia after brainstem stroke.Methods Forty dysphagic patients with cricopharyngeal achalasia after brainstem stroke were recruited.Twenty patients assigned to experimental group were treated by balloon dilatation with ice water and low frequency elecrtrical stimulation.Twenty patients assigned to control group were treated by balloon dilatation with room temperature water and low frequency electrical stimulation.Results After treatment,36 out of the 40 patients of the two groups could eat pasty food independently without choking.Videofluoroscopic swallowing study (VFSS) showed that the cricopharyngeal sphincter relaxed and the foods passed successfully when swallowing bolus,and no aspiration happened.In comparison,the level of cricopharyngeal opening,the number of patients with nasogastric tube remained and eating normally,and the scores of functional oral intake scale (FOIS) between the two groups showed no significant difference (P ＞ 0.05).The average treatment sessions,average hospitalization days and average treatment cost in treatment group were significantly less than those in the control group(P ＜0.05).Conclusion Cricopharyngeal achalasia can be treated effectively by balloon dilatation with ice water or with room temperature water combined with low frequency electrical stimulation,but treatment course of balloon dilatation with ice water were significantly shorter than that of balloon dilatation with room temperature water.

Objective To investigate the changes and clinical significance of the coagulation function after mitral valve replace‐ment (MVR) .Methods 163 cases of MVR admitted in our hospital from January 2012 to January 2014 were included in the obser‐vation group and contemporaneous 163 individuals of healthy physical examination were selected as the control group .The pro‐thrombin time (PT) ,activated partial thromboplastin time (APTT ) ,fibrinogen concentration (FIB) ,thrombin time (TT ) and pro‐thrombin time international normalized ratio (INR) in the two groups were detected and the detected results were performed the statistically comparative analysis .Results PT ,APTT and INR in the majority of the observation group were significantly higher than those in the control group ,the differences had statistical significance (P < 0 .05) .Conclusion The regular determination of blood coagulation function after MVR can effectively reflect the disorder status of anticoagulant and coagulation mechanism ,and can improve the efficiency of diagnosis and treatment and clinical predictive value .

Objective To study the constituents in Melicope pteleifolia. Methods Plant material was isolated with 80% EtOH. Compounds were separated with chromatographic methods and their structures were elucidated on the basis of spectral analysis (EI-MS, 1H-NMR, and 13C-NMR) and chemical evidence. Results Five compounds were isolated from petrol ether or ethyl acetate soluble fraction. Their structures were identified as 3,5,3'-trihydroxy-4'-methoxy-7-(3-methylbut-2-enyloxy) flavone (pteleifolosin C, 1), 3,7-dimethoxyl kaempferol (kamatakenin, 2), vanillic acid (3), tricosanoic acid tetradecyl ester (4), and p-sitosterol (5), respectively. Conclusion Compound 1 is a new structure named pteleifolosin C. Compounds 2-4 are isolated from this plant for the first time.

Objective To study the chemical constituents of Evodia lepta.Methods The chemical constituents were isolated by chromatographic methods and their structures were elucidated by physicochemical characteristics and spectral data.Results Two compounds were isolated and their structures were identified as erythro-3-(1',2',3'-trihydroxy) isopentyl-7-hydroxycoumarin(Ⅰ) and?-daucosterol (Ⅱ).Conclusion CompoundⅠis a new one named evodosin A while compoundⅡis isolated from E. lepta for the first time.

Objective To explore the role of Color Doppler Flowing Imaging(CDFI) in assessing metastatic lymph node for nasopharyngeal carcinoma (NPC). Methods Neck lymph node were detected by CDFI in 206 patients who received the initial course radiotherapy in our hospital. The characteristic of neck node, such as position, figure, number, size, its relation to surrounding soft tissue, the ratio of longitudinal diameter over trnsverses′(L/T) and blood flow resistance index (RI), were recorded detailedly. Fine needle aspiration biopsy was performed on some of patients under the guide of ultrasound. Results The clinical N-stage was changed markedly after CDFI plus biopsy, with up-staging in 25 from N0 to N1 , 6 N0 to N2, 20 N1 to N2, 3 N1 to N3, 4 N2 to N3; and down-staging in 14 from N2 to N1, 7 from N3 to N2. The misdiagnosis rate of node involvement by palpation was 38.3% (79/206). The sizes of lymph node detected by palpation were larger than those by CDFI (P0.6, and the value would reached to 92.9%(182/196) and 95.5%(107/112)when such criteria combined with the diameter and growth behavior of lymph node. Conclusion Color Doppler Flowing Imaging is useful in N-staging for nasopharyngeal carcinoma by providing more reliable evidence.

Objective To study the value of focused abdominal sonography for trauma (FAST) used by emergency doctor in emergency department. Method It's a prospective,double-blinded and controlled study from June 2008 to October 2009. A total of 97 casualties with severe multiple trauma, 72 male and 25 female aged from 14 to 88 years old with average age of (41 ± 16) ,admitted to emergency department were enrolled, and the bedside focused abdominal sonography for trauma was performed by emergency doctor. It was diagnosed as positive if free fluid was detected in abdomen or pericardium. The severe injury scores (ISS) were from 14 to 38 with average score of (23.2±9.3). The criteria of inclusion were age over 14 years old, injury happened within 12 hours and casualties admitted directly into emergency room. The criteria of exclusion were death of patients within 2 days without CT scanning of abdomen and exploration of abdomen with laporotomy, and operations directly determined by using FAST without conventinal sonographic examination. The FAST was compared with CT and conventional sonography judged by the findings observed during operation. Results The examination with FAST was completed in (3.18±0.79) min, whereas that with conventional sonography was (16.63t4.62) min(t = 28.61,P ＜0.001). The FAST was positive in 11 cases and negative in 86 cases, whereas the conventional sonography was positive in 13 cases and negative in 84 cases ( P = 0.5). There were 4 false negative findings in FAST resulting in 73% sensitivity, 100% specificity, 95.3% negative predictive value, 4.6% false negative rate, 100% positive predictive value, 0% false positive rate and 95.9% accuracy. Conclusions The emergency doctors are able to operate the FAST well for casualties with multiple trauma in emergency department after proper training.

Objective To approach the changes of serum insulin and peptide C and determine their relationship with inflammatory reaction in patients with severe multiple trauma. Methods The serum insulin, peptide C, tumor necrosis factor (TNF)-α, interleukin (IL)-10, C reactive protein (CRP) were detected in 30 patients with severe multiple trauma at days 1,3 and 7 after trauma to analyze the dynamic changes of serum insulin and peptide C and their correlations with Acute Physiology and Chronic Health Evaluation Ⅲ ( APACHE Ⅲ), cytokines and CRP. The changes of cytokines and CRP were also compared with those of serum insulin and peptide C in patients with different outcomes. The changes of serum insulin and peptide C of 35 healthy subjects were detected and used as control. Re-sults The serum insulin and peptide C levels of patients were higher than those in control group at each time point after trauma, with remarkably positive correlation with APACHE Ⅲ. Whether the serum glu-cose and age were controlled or not,serum insulin and peptide C were positively correlated with IL-10 at each time point and with TNF-α and CRP at days 3 and 7. The levels of serum insulin, peptide C and IL-10 were decreased with time in both groups with different outcomes. Meanwhile, the levels of TNF-α and CRP were decreased in the survival groups but increased in the death groups. The levels of above indices in death group were significantly higher than survival groups at the same time point. Conclusions The increasing of serum insulin and peptide C is correlated with inflammatory reaction after severe multiple trauma. The dynamic changes of both indices can either reflect injury severity or be used as an effective index in dynamically monitoring anti-inflammatory degree of the organism.