Cancer stem cells (CSC) have been defined as an unique subpopulation in tumors that possess the ability to initiate tumor growth and sustain tumor self-renewal. The tumor stem cell model proposes that tumor stem cells are the origin of most tumors. Accompanying with further extension in the investigation of cancer stem cells, the effects of niche that serves as'their microenvironment in tissue on the functions of cancer stem cells attract more and more attention, which plays important roles in maintaining the characteristics of cancer stem cells. It is essential to understand how cancer stem cells interact with their microenvironment. Although the evidence has been provided to support the existence of CSCs in various solid tumors, the identity of gastric CSCs has not been reported. In this review, we will examine gastric cancer stem cell niches and their impact on stem cell biology. The research on gastric cancer stem cell will provide new approaches for improved understanding of gastric cancer biology and gastric cancer treatment.

OBJECTIVE:To observe therapeutic efficacy of citalopram in the treatment of post-stroke depression. METHODS:126 post-stroke depression patient were selected and randomly divided into observation group and control group with 63 cases in each group. Control group was given routine treatment of nervous system drugs;observation group was given citalopram,20 mg, qd,after breakfast,on the basis of control group.They were given relevant medicine for consecutive 2 months. The mental status, the levels of plasma substance P (SP),plasma adrenocorticotropic hormone releasing hormone (CRH) plasma neuropeptide Y (NPY),rehabilitation compliance were observed in 2 groups before and after treatment. RESULTS:After treatment,HAMD and NIHSS score of observation group were decreased obviously,and lower than control group, with statistical significance (P<0.05);MMSE score of observation group increased significantly,and higher than control group,with statistical significance(P<0.05). After treatment,SP and CRH levels of observation group were decreased significantly,and lower than control group;NPY level increased significantly and higher than control group,with statistical significance(P<0.05). After treatment,complete com-pliance of observation group (71.43%) was obviously higher than that of control group (49.21%),with statistical significance (P<0.05). The maximum effect of observation group was significantly better than that of control group,with statistical signifi-cance(P<0.05). CONCLUSIONS:Citalopram in the treatment of post-stroke depression can significantly improve the patients' de-pression,nervous function and rehabilitation compliance of patient,showing significant therapeutic efficacy.

Objective To evaluate the short-term clinical results of total hip arthroplasty(THA) through a direct anterior minimally invasive approach aided by lower extremity tractor for hip diseases.Methods Between August 2013 and August 2015,115 patients (138 hips) were admitted for hip diseases.They were 71 men and 44 women,aged from 28 to 77 years (average,59.4 years).Their body mass indexes ranged from 19.7 kg/m2 to 28.9 kg/m2,averaging 24.7 kg/m2.Their hip diseases included avascular necrosis of the femoral head in 56 cases (with an average disease course of 15.7 months),hip osteoarthritis in 35 cases (with an average disease course of 12.6 months),hip dysplasia in 14 cases (with an average disease course of 2.8 years) and inflammatory arthritis in 10 cases (with an average disease course of 6.8 years).All the patients were treated by primary THA through a direct anterior minimally invasive approach and assistance of lower extremity tractor.Results All the 115 patients (138 hips) were followed up for an average of 31.6 months (from 12 to 40 months).Their average length of incision was 9.4 cm,average operative time 115.9 min,average blood loss 210.2 mL,and average hospital stay 7.5 days.Their postoperative imaging results were as follows:the angles of acetabular abduction averaged 41.6° (from 37° to 56°) and the angles of acetabular anteversion 18.1° (from 11° to 23°).Their average Harris hip score one year postoperatively was 91.4 points (from 80 to 96 points).Split fracture of the proximal femur happened in one patient (one hip) (0.7％) intraoperatively;injury to lateral femoral cutaneous never was observed in 6 patients (7 hips) (5.1％).Complications like deep infection,hip dislocation,deep vein thrombosis or prosthetic loosening were not observed during follow-ups.Conclusions THA with assistance of lower extremity tractor through a direct anterior minimally invasive approach can lead to fine short-term clinical results,including quick recovery of hip function and decreased intraoperative and postoperative complications.

Retinoblastoma (RB) therapy has evolved over decades.In the 1970s, enucleation was important for improving life prognosis.In the 1980s, external beam radiotherapy (EBRT) was popular.In the 1990s, systemic intravenous chemotherapy (IVC) was introduced and currently remains prevalent worldwide for intraocular RB control as well as prevention of systemic metastasis.However, RB seeds in vitreous and subretinal space are still the major obstacles for successful treatments.Advanced ophthalmic imaging technology promotes thorough and detailed description and observation of RB seeds.In the 2000s, interests in periocular chemotherapy (POC), intra-arterial chemotherapy (IAC) and intravitreous chemotherapy (IVitC) have been explored to overcome the low drug concentration around the seeds and to reduce the systemic side effects.This leads us into a new era of target local chemotherapy of RB.How to make the treatment decision based on biological behavior of RB seeds is a major task for us now.

Osteogenic differentiation of mesenchymal stem cells (MSCs) is an important link of bone metabolism and bone repair, the mechanism of which is usually complicated. Recent studies have found that BMP, FGF, Wnt, Hedgehog, NELL1, IGF, Notch and othersignaling molecules are involved in the regulation of osteogenic differentiation of MSCs. These signaling molecules themselves have been shown to have a strong ability to promote osteogenic differentiation. They can activate the corresponding receptors by specific ligands, thus initiating the specific signal transduction pathways in the cell, and finally promote the transcription and translation of the genes related to bone formation. Furthermore, all the signaling pathways form a complex network which regulates and influences the osteogenic differentiation ofMSCs. Further researches on the mechanism of the interaction of these signaling pathways is of great significance in promoting the development of bone tissue engineering and the treatment of bone metabolic diseases.

Objective To observe the effects of Er-YAG and surgical resection in the treatment of oral cav-ity mucous cyst. Methods A total of 63 patients with oral cavity mucous cyst ,selected in our hospital from March 2013 to May 2014,were divided into control group(n=31)and experimental group(n=32)based on dif-ferent therapies. The oral cavity mucous cysts in the experimental group and the control group were treated with Er-YAG and surgical resection ,respectively. The two groups were compared in terms of therapeutic effect. Results The cure rate in the two groups had no significant difference (P>0.05). The operation time in the experiment group was significantly shorter than the control group(P<0.05). In the experiment group,the incidence of intra-operative blood loss,postoperative edema and postoperative scarring were significantly lower than those of the con-trol group(P<0.05),but the two-year recurrence rate in the two groups had no significant difference(P>0.05). The SAS scores had no significant difference between the two groups at 1 week after operation (P > 0.05),but they were significantly higher in the experiment group than in the control group before operation and 3 days after op-eration(P < 0.05). In HAD emotional determination,the numbers of patients who had the manifestation of anxi-ety and depression in the experiment group were smaller than control group before operation and 3 days after opera-tion(P<0.05),but there was no significantly difference between the two groups at 1 week after operation(P >0.05). Conclusions The curative effect of Er-YAG in the treatment of oral mucous cysts is close to that by the conventional surgery,but the former is advantageous for easier operation,less postoperative complications and alle-viation of patientspsychology pressure,worthy of clinical spreading.

Objective To study the change and clinical value of SP‐D ,CCL18 and CC16 in serum and in exhaled breath con‐densate in acute exacerbation of chronic obstructive pulmonary disease .Methods Sixty two cases of COPD patients admitted in our hospital from 2010 January to 2013 December were selected as the research object .All the 62 patients were divided into group A(32 patients with COPD in acute exacerbation) and group B(30 patients with COPD in remission stage) in accordance with the severity of COPD .Thirty six cases of health people were selected as the control group .Statistical subjects SP‐D ,CCL18 ,CC16 content in se‐rum and in exhaled breath condensate ,and the relations between the various indexes and age ,smoking ,pulmonary function and BMI were analyzed .Results The exhaled breath condensate SP‐D ,CCL18 content in group A was significantly higher than that of B group and the control group (P<0 .05) ,and the SP‐D ,CCL18 in group B was higher than that in control group (P<0 .05) .The se‐rum SP‐D ,CCL18 ,CC16 content in group A was significantly higher than that of B group and the control group (P<0 .05) ,and the SP‐D ,CCL18 ,CC16 in group B was higher than that in control group (P< 0 .05) .Serum SP‐D ,CCL18 levels were significantly higher than those in the exhaled breath condensate (P< 0 .01) .Exhaled breath condensate SP‐D was positively associated with smoking age (r=0 .298 ,P<0 .05) ,and FEV1% pred ,FEV1/FVC (% ) showed a negative correlation (r= -0 .318 ,-0 .402 ,P<0 .05);the serum levels of SP‐D was positively associated with tobacco (r=0 .297 ,P<0 .05) ,and FEV1% pred ,FEV1/FVC (% ) were negative correlated (r= -0 .278 ,-0 .298 ,P<0 .05);serum CC16 and FEV1% pred ,FEV1/FVC (% ) were negatively corre‐lated (r= -0 .358 ,-0 .382 ,P<0 .05);Exhale breath condensate SP‐D ,condensate CCL18 ,SP‐D ,CCL18 serum ,serum CC16 were are positively correlated in each two (P<0 .05);and there was no significant correlation between other indexes and age ,smoking , pulmonary function and BMI etc .Conclusion Exhaled breath condensate ,serum SP‐D ,serum CCL18 ,exhaled breath condensate , exhaled breath condensate ,serum CC16 are closely related to acute exacerbation of COPD ,and monitoring the indicators can be judgment of the degree and prognosis of COPD .

Objective To evaluate the application value of multi-slice spiral CT(MSCT)in D2 radical total gastrectomy for gastric carcinoma.Methods CT and clinical data of 353 cases with D2 radical total gastrectomy for gastric carcinoma was analyzed retro-spectively.Results Operative time was 236 (1 91-35 1)mins VS.245 (189-308)mins,no significant difference was observed be-tween the CT scan group and the non-CT scan group(P >0.05).The number of lymph nodes dissected was (27 ±3)VS.(20±2), there was significant difference between the CT group and the non-CT group (P <0.05).The blood loss in the CT group and no CT group was less 168 (110-600)mL and 280 (150-720)mL respectively(P<0.01).Postoperative hospital stay was shorter (11.2±2.1)days in CT group than no CT group (14.5±2.0)days (P <0.01).Postoperative complications developed in 1 7 patients in the CT group and in 29 patients in the non-CT group.The difference didn’t show statistically significant between the two groups (P >0.05).Conclusion Multi-slice computed tomography scanning has a great value in D2 radical total gastrectomy for gastric carcinoma.

The paper briefly summarizes the chief manifestations of moral degradation on the part of medical personnel and then makes a preliminary analysis of the causes. On the basis of this, it discusses at some length some major measures to be adopted in reconstructing medical personnels morality. These include: ① carrying forward traditional Chinese medical ethics and using medical codes of ethics from Western countries for reference; ②strengthening the education and training of medical personnel in ethics; ③perfecting the codes of ethics for medical personnel; ④speeding up reform in the personnel and distribution systems; ⑤reinforcing supervision and setting up corresponding evaluation mechanisms; ⑥selecting personnel combining ability with political integrity to engage in the medical profession; ⑦strengthening the construction of social morals.

Bibliometrical method was used in this article to analyze the publications in a hospital from 2004 to 2013.Results show that the number of publications increased during 8 years,and the quality has been improved consistently.However,the rate of clinician participation in research and the present of core authors were still on the lower side.Besides,the age structure of core authors is steady and lack of growth.Based on this analysis,we summarized the past experience and explored the strategies of research management.