A small fraction of tumor stem cells exist in glioma and play a key role in the tumorigenesis and propagation of glioma.They have a close relationship with their niche that offers structural and functional support.In glioma niche,vascular endothelial cells can provide Notch ligands for cancer stem cells to activate Notch signaling pathway and contact with other signaling pathways,maintaining the tumor stem cell self-renewal and increasing resistance of brain tumor stem cells to radiotherapy.Therefore,Notch signaling pathway is considered to be a new therapeutic target of glioma.

Objective:To explore the improvement effect of tirofiban on the myocardial reperfusion of non-ST segmant elevated myocardial infarction (NSTEMI) patients underwent percutaneous coronary intervention (PCI) treatment.Methods:78 NSTEMI patients underwent PCI in our hospital from April 2012 to April 2015 were selected and divided into the observation group (n=38) and the control group (n=40) according to different drugs.Patients in the control group were given asprin,clopidogrel and heparin,while patients in the observation group were additionally given tirofiban.Then the myocardial contrast echocardiography (MCE) was taken to evluate the myocardial reperfusion.Results:No statistical difference was found in the levels of A,β,A β,CK-MB and cTnⅠ before PCI between 2 groups.The levels of β,A β of observation group were obviously higher,CK-MB and cTnⅠ were obviously lower than those of the control group(P＜0.05).The MACE rate of observation group was 2.63％,which was 5.00％ in the control group,no significant difference was between two groups (P＞0.05).Conclusion:Tirofiban could obviously improve the myocardial reperfusion of NSTEMI patients underwent PCI with high safety.

Objective The purpose of this study was to assess the imaging features of newly diagnosed high-grade glioma and the effect of relevant factors such as postoperative radiotherapy and chemotherapy on progression-free sur-vival (PFS) time. Methods A total of 54 patients with recurrent high-grade glioma confirmed by pathology or progressive malignant glioma proved by clinical follow-up were included in this retrospective study from 4 clinical centers. The prog-nostic factors selected included MR image features at initial diagnosis (including the maximum diameter of tumor, peritu-moral edema, degree of enhancement, degree of necrosis and presence of cystic or satellite), postoperative radiotherapy and chemotherapy. Kaplan-Meier method and Cox’s proportion-hazards model were used to analyse the factors influenc-ing the progression free survival (PFS) time. Results The univariate Kaplan-Meier analysis revealed that the degree of peritumoral edema (PTE, P=0.001), degree of necrosis (P<0.001) , degree of enhancement (P<0.001), postoperative radio-therapy (P=0.008) and chemotherapy(P=0.035) were significant factors for PFS. Cox multivariate analysis also showed that the degree of PTE(P=0.019),degree of necrosis (P<0.001) were all significantly correlated with PFS. The less edema or necrosis was associated with the longer PFS. In addition, postoperative radiotherapy (P=0.035) and chemotherapy (P=0.049) were also significantly correlated with PFS. The normative chemotherapy and radiotherapy were associated with longer PFS. Conclusions The PTE and necrosis on preoperative MR images can be used to predict the PFS of glioma af-ter total resection. Adjuvant normative chemotherapy and radiotherapy should be recommend for supratentorial high-grade glioma including those even with MRI confirmed total resection.

Objective:To study the mRNA expressions of bone morphogenetic protein 2 ( BMP2) in different types of gliomas and the relation between BMP2 mRNA expression and survival time, and to explore the role of BMP2 mRNA expression in prognosis evaluation in gliomas. Methods:The clinical data of 692 patients with gliomas in China Glioma Genome Atlas (CGGA) database were collected. Differences of BMP2 mRNA expression were compared among glioma patients with different histophiologic types, and patients with different gender and different ages, patients at primary or recurrent status, and those with different WHO grading, isocitrate dehydrogenase 1 (IDH1) mutation, 1P19q heterozygous deletion status, and molecular typing. The difference in survival time between patients with high and low BMP2 mRNA expression levels were compared in different categories of gliomas. Results:(1) The BMP2 mRNA expressions were different in different histopathological types of gliomas ( F=9.392, P=0.000); BMP2 expression in the oligodendroglioma subtype was the highest, followed by astrocytoma subtype and glioblastoma. The BMP2 relative mRNA expressions in male and female patients were 9.78±0.65 and 11.26±0.86, respectively, without statistical difference ( P>0.05). The BMP2 relative mRNA expressions in patients <43 years old and patients≥43 years old were 12.51±0.81 and 8.37±0.65, respectively, with significant difference ( P<0.05). The BMP2 relative mRNA expressions were 10.09±0.62 and 10.90±0.93, respectively, without significant difference ( P>0.05). The BMP2 relative mRNA expressions were 13.98±1.12, 12.88±0.88 and 5.18±0.64 in WHO grading II, III, and IV gliomas patients, respectively, with significant differences ( F=30.912, P=0.000). The BMP2 relative mRNA expressions in patients with IDH1 wild-type and IDH1 mutant were 2.73±0.16 and 17.47±0.85, respectively, with significant difference ( P<0.05). The BMP2 relative mRNA expressions in patients with 1P/19Q non-absence and 1P/19Q absence were 7.02±0.36 and 25.28±1.66, respectively, with significant difference ( P<0.05). In patients with lower graded glioma and glioblastoma, the BMP2 mRNA expressions in these patients with IDH mutation were significantly higher than those in patients with IDH wild-type ( P<0.05). (2) In patients with primary glioma and patients with recurrent glioma, the survival time of these patients with high BMP2 mRNA expression (≥4.68) was significantly longer than that of patients with low expression (<4.68, χ2=62.975, P=0.000; χ2=12.810, P=0.000). Conclusion:The BMP2 mRNA expression can be used as an index to predict the malignant degrees of gliomas; patients with high expression have longer survival time than those with low expression.

Objective:To explore the progress of microcirculation research in shock and sepsis from 2000 to 2019 based on knowledge visualization analysis.Methods:The literatures related to microcirculation of shock and sepsis published in Web of Science and Wanfang databases were collected from 2000 to 2019. Then, data collected was sorted out and used to make bar charts and curves reflecting the growth trend of the literatures using Excel software. The information about country, institution and author were extracted by CiteSpace 5.0 R1 for generating co-occurring network, to find the main research power and each cooperative relation. This software was also used to analyze the related-keywords and cited reference, so that the map of co-citation reference was drawn subsequently to explore the frontiers and hot spots in this field.Results:There were a total of 2 000 Chinese "papers" or "dissertations", 1 823 English "articles" or "reviews", collected preliminarily. The Chinese literatures were only statistically described for the amounts, institutions and authors, however, all retrieved English literatures were enrolled in the visualization analysis eventually. From 2009 to 2019, the number of English literatures rose steadily; however, the number of Chinese literatures had been sliding since 2011. On terms of quality, the impact factors of most literatures were under 6, lacking high quality ones, and the number remained stable every year. According to the analysis of English literatures, the top three countries that published related papers around the world were Germany ( n = 430), the United States ( n = 401) and Netherlands ( n = 223). In the aspect of research institutions, the University of Amsterdam (Netherlands) ranked first in the Web of Science ( n = 113), while the institution in China with the most publications was the Southern Medical University ( n = 71). According to the analysis of co-occurring author network, there were three major globe scientific groups in which Can Ince, Daniel De Backer and Jean-Louis Vincent contributed most to this research field. The top three authors who published most Chinese papers were Niu Chunyu ( n = 20), Zhao Zigang ( n = 18) and Duan Meili ( n = 13). By generating the co-occurring keyword mapping, the research hot spots mainly focused on "blood flow", "nitric oxide", "hemorrhagic shock" and "perfusion". However, these burst keywords, including "cardiogenic shock", "acute kidney injury", "fluid resuscitation", "sublingual microcirculation", "mortality", "oxidative stress", and "critically ill patient", represented the frontiers in microcirculation research of shock and sepsis field. Finally, the results of co-citation reference analysis showed that "sublingual microcirculation" and "mottling score" were most active, indicating that the research of microcirculation monitoring technology could be considered as a hot spot and also the frontier in this field, which was consistent with the results of co-occurring keywords network. Conclusions:Knowledge visualization analysis can visually exhibit the hot spot and trend of microcirculation research in shock and sepsis. The power was mainly focused on a few developed countries in Europe, and the trend was more inclined to the related microcirculation monitoring technology.