Cancer stem cells(CSCs) are a group of tumor cells with stem cell-like properties such as infinite self-renewal and multi-differentiation potential. Accumulating evidence strongly indicates the presence of cancer stem cells in a variety of solid tumors. Although rare, CSCs play important roles in tumor initiation, progression, recurrence and metastasis. Research of gastric cancer stem cells is still in its infancy. Specific surface markers of gastric CSC are yet to be identified. Active researches are currently underway to investigate the existence and source of CSC in gastric cancer.

Objective To study curative efficacy of dezocine in treatment of receiving laparoscopic appendectomy and its effects on white blood cell count and c reactive protein.Methods 90 patients of laparoscopic appendectomy who received therapy from January 2015 to October 2016 in our hospital were selected as research objects,according to random number table,those patients were divided into the observation group and the control group,45 cases in each group.The control group was treated with sufentanil, while the observation group was treated with dezocine.Then operation index, T0 (preoperative),T1(extubation),T2(after extubation) mean arterial pressure(MAP),heart rate(HR), respiration rate(RR),isual analogue scale/score ( VAS) , ramsay score ( RSS) , white blood cell count and c reactive protein of two groups after treatment were compared .Results After treatment, MAP,HR in the observation group were significantly lower than control group [(78.30 ±6.20)mmHg vs.(86.08 ±6.09)mmHg,(76.45 ±5.90)mmHg vs.(80.48 ±5.80)mmHg,(90.82 ±9.50)time/min vs.(96.73 ±9.83)time /min,(87.21 ±8.15)time /min vs.(93.59 ±9.90)time /min](P<0.05); VAS, RSS score were significantly lower than the control group[(2.60 ±0.70)score vs.(5.29 ±0.83)score,(3.53 ±0.92)score vs.(6.38 ± 1.21)score](P<0.05); White blood cell count, c reactive protein were significantly lower than the control group[(7.92 ±2.01) ×109/L vs.(14.98 ±2.11) ×109/L,(7.90 ±2.30)mg/L vs(12.46 ±3.10)mg/L](P<0.05).Conclusion Dezocine is well for receiving laparoscopic appendectomy, obvious analgesic effect, can significantly reduce the white blood cell count and c reactive protein.

Objective To study the feasibility of high performance liquid chromatography-evaporative light scattering detector ( HPLC-ELSD) in quantitative analysis of multi-components ( QAMS) by single marker. Methods Four saponins in Astragali Radix were simultaneously determined by HPLC-ELSD using external standard method, and malonylastragaloside I served as internal standard. The relative correction factors between internal standard and astragaloside Ⅰ, astragaloside Ⅱ and astragaloside Ⅳ were calculated, and the stability was investigated. Results Astragaloside Ⅳ in Astragali Radix was little, while malonylastragalosideⅠand AstragalosideⅠwere abundant.The relative correction factors lacked stability, so ELSD could not be used in QAMS. Conclusion HPLC-ELSD can precisely determine contents of four saponins in Astragali Radix. The detector needs to be further studied when the components have poor ultraviolet absorption such as saponins by QAMS.

Objective To investigate the efficacy of dexmedetomidine-assisted topical anesthesia in patients undergoing bronchoalveolar lavage ( BAL). Methods Twenty-four ASA Ⅱ or Ⅲ patients in ICU, aged 24-64 yr, weighing 50-80 kg, scheduled for BAL, were randomly divided into 2 groups ( n = 12 each) : topical anesthesia group (group A) , topical anesthesia + dexmedetomidine group (group B) . In group A, 0.9% normal saline 5 ml was injected intravenously 30 min before operation, 2% lidocaine 5-10 ml was given via a tracheal tube or cannula 5 min before operation and then an increment of 2% lidocaine 5 ml was given using fibreoptic bronchoscope every 15-30 min as required (the total amount was within 20 ml) . In group B, dexmedetomidine 0.5-1.0 μg/kg was injected (time of injection≥ 10 min) followed by infusion at 0.1-0.5 μg·kg-1 ·h-1 and the topical anesthesia was performed as the method described in group A. The time of lavage, adverse reactions and adverse cardiovascular events were recorded. Blood samples were taken 20 min before lavage, 20 min after the start of lavage and 20 min after the end of lavage (T1-3 ) for determination of the concentrations of plasma catecholamine and serum cortisol. Results The incidences of adverse reactions and adverse cardiovascular events were significantly lower and the operation time was significantly shorter in group B than in group A ( P < 0.05). The concentrations of plasma catecholamine and serum cortisol were significantly higher at T2，3 in group A, while lower at T2，3 in group B than at T1 ( P < 0.05) . The concentrations of plasma catecholamine and serum cortisol were significantly lower in group B than in group A ( P < 0.05). Conclusion Dexmedetomidine-assisted topical anesthesia can be used safely and effectively in BAL.

Objective:To evaluate the changes of neurocognitive function in early stage in patients with first-episode schizophrenia.Methods:In this study,73 cases of patients with first-episode schizophrenia (research group) and 75 cases of health person (control group) were selected from January 2015 to January 2016 in our hospital.The neurocognitive function was evaluated by neuro-psychological testing tool and the data between two group were compared.Results:Scores of delayed recall,total recall,3 trial,2 trial and 1 trial of research group were lower than those of control group in BVMT-R test,and the difference was statistically significant (P＜0.05).In HVLT-R test,the scores of total delay,3 trial and 2 trial of research group were significantly lower than those of control group (P＜0.05).The consuming time of dominant hands and subdominant hands in pegboard tasks were significantly higher in research group than in control group (P＜0.05).Conpletion time of connection test A,color connection 1 and 2 in connection test of research group were significantly higher than those of control group (P＜0.05).Attempt number and correct number in research group in PASAT test were significantly lower than in control group (P＜0.05).Number of search errors in research group was higher than in control group,while number of search correct,search total score and digital sign score were significantly lower than in control group (P＜0.05).Total number of words,color and color / word count in research group were lower than in control group in Stroop color word test,and the difference was statistically significant (P＜0.05).WMS-Ⅲ test results between two group had no significant difference (P＞0.05).Conclusion:The neurocognitive function in early stage in patients with first-episode schizophrenia has been extensively damaged.

Objective To observe the therapeutic effect ofYiqi-Fumai injection andShenshao capsule in the treatment of angina pectoris and the influence on vascular endothelial cell function and serum MPO. Methods 90 cases of angina pectoris of coronary heart disease were randomly divided into a treatment group and a control group. 50 cases in the treatment group were treated withYiqi-Fumai injection and Shenshao capsule; 40 cases in the control group were treated with Plavix and metoprolol; clinical symptoms were observed before and after treatment, the indexes of endothelial cell function and electrocardiogram blood serum nitric oxide (NO), endothelin (ET), NOS and serum MPO, SOD, GSH changes were compared.Results The content of nitric oxide (NO), 6-keto-PGFLa and NOS of the treatment group were increased than the control group, while ET was reduced. In the treatment group, NO was (78.09 ± 88.71)μmol/L 6-keto-PGFL was 32.04 ± 25.82 pg/ml and NOS was 27.88 ± 9.08 U/MI before the treatment,; after the treatment, the NO was 127.11 ± 103.60μmol/L, 6-keto-PGFLa was 50.03 ± 60.87 pg/ml and NOS was 35.12 ± 22.18 U/MI. In the control group, NO was 96.98 ± 82.45μmol/L, 6-keto-PGFLa was 40.31 ± 51.92 pg/ml and NOS was 28.12 ± 5.11 U/MI before the treatment; After the treatment, NO was 95.62 ± 6.31μmol/L, 6-keto-PGFLa was 29.09 ± 42.01 pg/ml and NOS was 30.11 ± 7.51 U/MI. In the treatment group, ET was 58.81 ± 33.18 pg/ml before the treatment and 42.47 ± 40.5 pg/ml. after the treatment. In the control group, ET was 56.81 ± 32.76 pg/ml before the treatment and 60.67 ± 12.81 pg/ml after the treatment. In terms of resistance to oxidative stress and MPO, the SOD ,GSH and MPO improvement rate of the treatment group was significantly better than the control group (P<0.05). In the treatment group, SOD was 48.36 ± 17.38 U/MI, GSH was 126.68 ± 19.93 g/L and MPO was 57.33 ± 8.34 mmol/L before the treatment, after the treatment, SOD was 62.45 ± 15.76 U/MI, GSH was 135.98 ± 28.99 g/L and MPO was 17.11 ± 3.60 mmol/L. In the control group, SOD was 48.44 ± 19.37 U/MI, GSH was 29.44 ± 21.66 g/L and MPO was 56.35 ± 14.44 mmol/L before the treatment, after the treatment, SOD was 57.35 ± 14.44 U/MI, GSH was 28.56 ± 24.06 g/L and MPO was 48.62 ± 6.31 mmol/L.ConclusionYiqi-Fumai injection combined with Shenshao capsule has curative effect on angina pectoris of coronary heart disease, being worth of clinical use.

Objective To investigate the application effects of Waveone Gold,Protaper,MTwo and Reciproc on curved root canals of molar teeth.Methods Collect 100 curved in vitro molars and randomly divide them into 5 groups,Root canal preparation was performed using Waveone Gold,Proteper,Reciproc,MTwo,and stainless steel K-files,respectively.Compare the root canal preparation effects and related complications,root canal offset,and root canal filling effects among five groups.Results After analysis,the five groups of root canal preparation time,the difference was statistically significant,Waveone Gold group the shortest preparation time(P<0.05).There were statistically significant differences in the incidence of step formation among the five groups(P<0.05),but there were no statistically significant differences in the incidence of lateral root canal puncture and instrument fracture among the five groups(P>0.05).The root canal offset of 2mm,4mm and 6mm vertical plane in the five groups was small,the difference was statistically significant,and the root canal offset of Waveone Gold group was the smallest(P<0.05).There was no statistically significant difference in overcharging rates among the five groups(P>0.05).However,there was a statistically significant difference in overcharging and underfilling rates among the five groups(P<0.05),with Waveone Gold and Reciproc groups having higher overcharging rates than the control group and lower underfilling rates than the control group(P<0.05).Conclusion The application of Ni-Ti instruments in curved molar root canals can shorten the preparation time of root canals,reduce the related complications,reduce the deviation of root canals,better root canal filling effect,especially Waveone Gold have obvious advantages.

Objective:To investigate the current situation of nurses′ death attitudes, death competency and death education need in tertiary care hospitals, and analyze their relationship and to provide suggestions and guidance for clinical death education.Methods:This was a cross-sectional survey. From January to March 2022, a random sample of 1 902 nurses from five tertiary hospitals in Hunan Province Changsha City was selected as the study population. The general information questionnaire the Death Attitude Profile-Revised (DAP-R), Coping with Death Scale (CDS) and Death Education Needs Scale were used to investigate the current situation of nurses′ death attitudes, death competency and death education needs in tertiary hospitals, and the correlations among them were analyzed.Results:The 1 837 valid questionnaires were finally collected. The total score of death attitude was (91.37 ± 11.26) points, the total score of death competency was (109.25 ± 21.67) points and the total score of death education needs was (214.13 ± 28.64) points. Natural acceptance was positively correlated with death education needs ( r=0.458, P<0.05), escape acceptance was positively correlated with death education needs ( r=0.312, P<0.05), convergent acceptance was positively correlated with death education needs ( r=0.347, P<0.05), death avoidance was negatively correlated with death education needs ( r=-0.291, P<0.05), and death competency was positively correlated with death education needs ( r=0.356, P<0.05). Conclusions:Nurses had some degree of positive death attitudes, moderate level of death competency and higher need for death education. The death education need was positively correlated with positive death attitudes and death competency. The death education should be strengthened to cultivate positive death attitudes and improve death competency to improve the quality of end-of-life care and the quality of patient death.

Background::Exercise, as the cornerstone of pulmonary rehabilitation, is recommended to chronic obstructive pulmonary disease (COPD) patients. The underlying molecular basis and metabolic process were not fully elucidated.Methods::Sprague-Dawley rats were classified into five groups: non-COPD/rest ( n = 8), non-COPD/exercise ( n = 7), COPD/rest ( n = 7), COPD/medium exercise ( n = 10), and COPD/intensive exercise ( n = 10). COPD animals were exposed to cigarette smoke and lipopolysaccharide instillation for 90 days, while the non-COPD control animals were exposed to room air. Non-COPD/exercise and COPD/medium exercise animals were trained on a treadmill at a decline of 5° and a speed of 15 m/min while animals in the COPD/intensive exercise group were trained at a decline of 5° and a speed of 18 m/min. After eight weeks of exercise/rest, we used ultrasonography, immunohistochemistry, transmission electron microscopy, oxidative capacity of mitochondria, airflow-assisted desorption electrospray ionization-mass spectrometry imaging (AFADESI-MSI), and transcriptomics analyses to assess rectal femoris (RF). Results::At the end of 90 days, COPD rats’ weight gain was smaller than control by 59.48 ± 15.33 g ( P = 0.0005). The oxidative muscle fibers proportion was lower ( P < 0.0001). At the end of additional eight weeks of exercise/rest, compared to COPD/rest, COPD/medium exercise group showed advantages in weight gain, femoral artery peak flow velocity (Δ58.22 mm/s, 95% CI: 13.85-102.60 mm/s, P = 0.0104), RF diameters (Δ0.16 mm, 95% CI: 0.04-0.28 mm, P = 0.0093), myofibrils diameter (Δ0.06 μm, 95% CI: 0.02-0.10 μm, P = 0.006), oxidative muscle fiber percentage (Δ4.84%, 95% CI: 0.15-9.53%, P = 0.0434), mitochondria oxidative phosphorylate capacity ( P < 0.0001). Biomolecules spatial distribution in situ and bioinformatic analyses of transcriptomics suggested COPD-related alteration in metabolites and gene expression, which can be impacted by exercise. Conclusion::COPD rat model had multi-level structure and function impairment, which can be mitigated by exercise.