Liver cancer stem cell plays an important role in hepatocarcinoma occurrence and metastasis.Presently, the two theories about the source of liver cancer stem cells are mature hepatocytes' dedifferentiation and hepatic stem cells' blocked differentiation.Side population cell sorting and different surface antigen labeling are general sorting methods of hepatocarcinoma stem cells.Targeting the liver cancer stem cells population provides an effective way to the treatments of liver neoplasms.

Objective To summarize and analyze regularities in clinical use of acupoint application for headache. Method Fifth version Chinese Medical Classics database was searched. Thirty-three library-stored ancient books were searched manually. The ancient literature included for the study was sorted out. Descriptive statistical analysis was made of classification, point selection, used medicine, excipients and dosage forms for acupoint application for headache. Result A total of 51 pieces of literature was included. Statistical analysis showed that there were nine kinds of disease names, three types of classification-based treatment, eight acupoints, fifty kinds of medicines, eight hinds of excipients and five kinds of dosage forms. Conclusion Headache is the most basic nomenclature for pains in the head. Classification-based treatment fully embodies the idea of treatment based on disease differentiation mainly in combination with syndrome differentiation. Point Taiyang is the main point for local selection of point. The most frequently selected medicines are those of going through meridians, opening the orifices, unblocking collaterals and having thick smells. Blistering medicines are used cautiously. Scallion juice is most frequently used as excipients. Medicinal cakes are dosage forms most suitable for acupoint application for headache.

Objective To study the changes of the apparent diffusion coefficient (ADC) values and the association with serum prostate specific antigen (PSA) in prostate cancer patients. Methods Diffusion-weighted echo-planar imaging (EPI) sequences were performed in 47 patients with biopsy proved locally confined prostate cancer,age ranged from 56 to 86 years.t-PSA range,f-PSA range and F/T range in serum of all patients were 1.41-603.16 ng/ml,0.10-12.29 ng/ml and 0.01-0.36,respectively.The patients'clinical staging were 2 cases of stage A,18 cases of stage B and 27 cases of stage C,among which 1 cases were well differentiated (Gleason 2-4), 23 were moderately differentiated (Gleason 5-7) and 23 were poorly differentiated(Gleason 8-10),respectively.Images were obtained with a diffusion factor of 800 s/mm2.According to the pathological results obtained by ultrasound guided systemic biopsy,the locations of the prostate cancerous region were marked as one or more of the sextants.The ADC values of every region and whole gland were measured and analyzed with ROC curve.Correlations between the ADC and t-PSA,f-PSA,F/T ratios were analyzed.Results Acceptable images for ADC measurement were obtained in all cases.The mean ADC values of cancerous and noncancerous regions in 47 prostate patients were(1.29±0.28)×10-3mm2/s and (1.78+0.32)×10-3mm2/s and significant difference was noted in ADC values between cancerous and noncancerous regions(t=13.58,P＜0.01).Negative correlation was found between the ADC values and t-PSA,f-PSA,(γ=-0.353,P＜0.01;γ=-O.401.P＜0.01).There were no significant associations between the ADC values and F/T(γ=-0.123,P＞0.05). Conclusions The ADC values in cancerous regions were negatively correlated with t-PSA,f-PSA. Measurement of ADCs,combined with serum PSA,might be useful to accurate location and preoperative assessment of tumor.

ObjectiveTo evaluate the consistency of HER2 gene status before and after neoadjuvant chemotherapy in breast cancer by FISH (fluorescence in situ hybridization) and IHC (immunohistochemistry) techniques,and analyze the factor of the difference in the result and the feasibility of HER2 gene tested by FISH in the neoadjuvant chemotherapy breast cancer patients.Methods FISH and IHC for HER2 gene expression status was performed on the archival paraffin-embedded sections of breast cancer tissues before and after neoadjuvant chemotherapy from 135 Chinese female patients,x2 test of paired comparison of enumeration data and Kappa analysis were used to compare the difference and consistency of this two techniques.ResultsThe detection rate of HER2 status in punctured cancer tissues before neoadjuvant chemotherapy by FISH and HER2 did not show statistical difference in our research while the opposite result were showed in cancer tissues after neoadjuvant chemotherapy.Moreover,the two techniques of HER2 test were less concordant in patients accepted taxanes neoadjuvant chemotherapy than CAF treatment.ConclusionsThe consistency of FISH and IHC techniques of cancer tissues before neoadjuvant chemotherapy gained advantage compared to the ones after neoadjuvant chemotherapy.Patients received neoadjuvant chemotherapy especially taxanes should take the test of HER2 gene status by FISH technique.

Objective To study the effect and safety of endoscopic retrograde appendicitis therapy (ERAT) in treating patients with uncomplicated acute appendicitis. Methods Patients with uncomplicated acute appendicitis were enrolled and divided into ERAT group and LA group received laparoscopic appendectomy. Then compare treat-ment condition, complications and follow-up of the two groups. Results ERAT were completed successfully in all the patients in ERAT group, while one patient underwent a reversion to open appendectomy for technical difficulties in LA group. Mean operative time was (49.7 ± 18.2) min for ERAT group and (68.9 ± 25.9) min for LA group (P <0.05). Fever relief time (1.3 ± 0.5) d, WBC normalization time (2.0 ± 0.9) d, mean bed time (0.1 ± 0.2) d and mean hospital stay (3.3 ± 1.6) d for ERAT group were significantly lower than LA group (P <0.05). 14 patients with intra-luminal appendicoliths (7 of massive appendicoliths, 4 of broken appendicoliths and 3 of broken appendicoliths with luminal stenosis) underwent endoscopic lithotomy successfully in ERAT group, resulting in a success rate of 100.00%. One patient presented perforation after ERAT was cured with conservative treatment. During the follow-up of at least 1/2 year, the rate of recurrence was 10.00% in ERAT group. 1 patient (5.00%) underwent LA at the 5th month after ERAT during the follow-up. Conclusion ERAT is an effective and safe therapy in treating patients with uncomplicated acute appendicitis with advantages of minimal invasiveness and quick recovery. Uncomplicated acute appendicitis with appendicoliths and/or luminal stenosis are the most suitable indications for ERAT.

Objective To study the skills and effects of endoscopic retrograde appendicitis therapy (ERAT) in treating patients with uncomplicated acute appendicitis .Methods We enrolled 21 patients with suspected acute appendicitis who then underwent emergent ERAT between October 2014 and January 2015 .The data of treatment were collected and the operative skills and effects of ERAT were analyzed . Results ERAT was completed successfully in all the patients ,resulting in a success rate of 100% .Mean operation time of ERAT was (49 .7 ± 18 .2) min and mean hospital stay was (3 .3 ± 1 .6)d .Cannulation of the appendix lumen was the most critical step of ERAT ,and cannulation time [(5 .7 ± 4 .9)min , P< 0 .05] was shortened significantly by the use of LoopTip guidewire . Fourteen patients with intraluminal appendicoliths (7 of massive appendicoliths , 4 of sand‐like appendicoliths and 3 of sand‐like appendicoliths with luminal stenosis ) underwent endoscopic lithotomy successfully with balloon or basket ,with the success rate of 100% .One patient who presented perforation after appendicolith removal by basket was cured with conservative treatment .Appendix stent was inserted ,then pulled out after 1 week in 9 patients ,while no complaint or complication of the stent was observed .Operation time of ERAT shortened with the increase of case number .Conclusion ERAT is an effective and safe therapy for treating patients with uncomplicated acute appendicitis .The high success rate and safety of ERAT will be achieved by selecting suitable instruments for cannulation and appendicolith removal ,deciding suitable indications for stenting ,and accumulating of operative cases .

Objective To observe the effects of betulinic acid (BA) on proliferation of human hepatoma stem cell;To discuss its anti-cancer mechanism from the aspects of cell cycle and cell apoptosis. Methods HepG2 stem cells were cultivated in vitro and testified the self-renewal capacity. The effects of BA in concentration of 40, 20, 10, 5, 2.5, 1.25μmol/L on the cell vitality of cultured human liver cancer stem cells for 24 and 48 hours were measured with CCK-8 method. The human hepatoma stem cell line HepG2 was administrated by BA at concentrations of 40, 20, 10, 5μmol/L for 48 hours, and cell cycle and apoptosis rate were measured by flow cytometry. Results BA could inhibit HepG2 stem cell proliferation obviously with dose-effect relationship. BA influenced cell cycle, and induced tumor stem cell apoptosis. 40μmol/L BA blocked cell cycle in S phase, and cell apoptosis rate reached 10.86%. Conclusion BA has obvious inhibitory effects on proliferation of HepG2 liver cancer stem cell, which probably plays a part in anti-cancer by influencing cell cycle and inducing cell apoptosis.

Objective To retrospectively analyze the treatment results and side effects of postoperative chemoradiotherapy and postoperative radiotherapy of thoracic esophageal squamous cell carcinoma (EPC) with positive lymph nodes.Methods Three hundred and four patients of thoracic EPC were initially treated with three-field lymphadenectomy, with pathological positive lymph nodes and without distant metastases;and randomly divided into two groups:140 patients of the simple postoperative radiotherapy (RT) and 164 patients of postoperative chemoradiotherapy (CRT).The median total dose was 50 Gy.The regimen of concurrent chemotherapy included cisplatin and taxol, and the intermission was 21 days;the median cycles were 2.35.Results The 3-year overall survival rates were 65.7% of CRT and 52.8% of RT (χ2=6.90,P=0.009), and The 3-year disease-free survival rates were 62.5% of CRT and 52.8% of RT (χ2=4.75,P=0.029).The incidences of the supraclavicular lymph-node metastases were 1.8% and 7.1%(χ2=5.21,P=0.022), respectively;and the incidences of distant metastases were 18.3% and 27.9%(χ2=3.94,P=0.047), respectively;and the incidences of overall metastases and recurrences were 27.4% and 39.3%(χ2=4.80,P=0.028), respectively.Early side effects included granulopenia (96.3% and 32.1%,χ2=140.31,P=0.000), radiation-induced esophagitis (37.2% and 26.4%,χ2=4.01,P=0.045),and gastrointestinal toxicity (23.2% and 5.0%,χ2=19.77,P=0.000).Late side effects were 6.1% and 5.0%(χ2=0.17,P=0.678), respectively.Conclusions Postoperative chemoradiotherapy of thoracic EPC with positive lymph nodes can improve the overall survival and disease-free survival, decrease the incidence of the supraclavicular metastases, the distant metastases, the total metastases and recurrences.More severe early side effects were observed in chemoradiotherapy than in the radiotherapy group,but well tolerated.

Objective To explore the feasibility and effectiveness of interventional transcatheter destruction of the aortic valve to establish an animal model with acute aortic valve regurgitation. Methods Eight healthy goats were used for this study. A limited sternotomy approach was used to access the apex of the heart. Puncturing of the apex of the heart was performed to establish a wire track, then, under fluoroscopic guidance a 10 F sheath was inserted along this track of hard wire until to the ascending aorta above the aortic valve. The internal sheath was removed. Via the 10 F sheath a 10 mm occluder of ventricular septal defect (VSD) was introduced into the ascending aorta above the aortic valve. The sheath was pulled back to the left ventricle, while the occluder remained in the ascending aorta above the aortic valve. Then the occluder was quickly pulled back into the left ventricle in order to make some certain damage to the aortic valve. And an acute aortic valve regurgitation model was thus established. Angiography of ascending aorta above the aortic Among the 8 animals, two died of acute left ventricular failure on the spot due to excessive regurgitation blood flow after the operation. Macroscopically, damage of the aortic valve was seen. In the six survivors, angiography of ascending aorta above the aortic valve and Doppler echocardiography showed that moderate degree of regurgitation was detected in 5 and small amount of regurgitation in one. Two experimental goats with moderate degree of regurgitation died of heart failure separately at seven days and fifteen days after the operation. The remaining four experimental goats survived for more than three months. Follow- up checkups with echocardiography suggested the presence of mild- moderate degree of regurgitation. Conclusion Acute aortic valve regurgitation model in experimental goats can be established through transapical transcatheter damage of aortic valve by quickly pulling back a VSD occluder which has been placed in the ascending aorta above the aortic valve. This method is clinically feasible, technically simple and repeatable, the result is reliable, and the degree of regurgitation is controllable.

Objective To discuss the feasibility and effectiveness of transcatheter implantation of double-ring aortic valve stent through puncturing the tip of the heart under thoracotomy.Methods A novel double-ring aortic valve stent was independently designed by the authors.Three healthy goats were selected for this study.A small incision on the left anterolateral thoracic wall was made to expose the cardiac apex,than the puncturing of the left ventricular apex was performed to establish the working pathway.Guided by fluoroscopy,along a hard guide wire a double-ring aortic valve stent was inserted through a 22-French sheath to the site above the aortic valve.By utilizing the opened outer ring of the stent,the double-ring aortic valve stent was accurately placed at the bottom of the aortic valve sinus.Then,the balloon was inflated and the stent was released to substitute the original aortic valve of the experimental goat.The experiment results were evaluated immediately after the procedure.Results Transcatheter aortic valve implantation (TAVI) was successfully accomplished in all the three experimental goats.DSA was performed immediately after the procedure and anatomy evaluation indicated that the position of the implanted artificial aortic valve was satisfactory,which could replace the work of original valve.Conclusion It is technically feasible and clinically effective to use this novel double-ring aortic valve stent to perform TAVI through transapical route by puncturing the left ventricular apex.