BACKGROUND:Lung cancers are highly heterogeneous and resistant to available therapeutic agents, with a five year survival rate of less than 15%. It has been difficult to determine the basis of lung cancer heterogeneity and drug resistance. Cancer stem cellmodel has attracted a significant amount of attention in recent years as a viable explanation for the heterogeneity, drug resistance, dormancy and recurrence and metastasis of various tumors. OBJECTIVE:To summarize the current understanding of lung cancer stem cells, including their histological types and tumor growth areas, and to discusses the prognosis of lung cancer and its relationship with lung cancer stem cells, in an effort to eradicate these cells to combat lung cancer. METHODS:In order to search relevant articles about the lung cancer stem celland its relationship with lung cancer from PubMed and Sciencedirect databases (from 1990 to 2014), a computer-based search was performed, using the key words of“lung cancer, cancer stem cell, lung cancer stem cell, lung cancer occur, tumor heterogeneity, drug resistance, gene mutation, signal pathways”in English. After eliminating literatures which were irrelevant to research purpose or containing a similar content, 48 articles were chosen for further analysis. RESULTS AND CONCLUSION:The cancer stem cellmodel has gained considerable support recently in context of lung cancers and stem-like cells that are associated with aggressive cancer behavior, metastatic progression, resistance to therapy and relapse. Since lung cancer stem cells are thought to consist of a heterogeneous population depending on the histology and site of tumors, and multiple signaling pathways might have to be targeted to effectively eliminate lung cancer stem cells for therapeutic benefit. It can be imagined that the multidisciplinary efforts currently under way to characterize and target stem-like cells in lung cancer wil reap significant therapeutic benefits in the future.

BACKGROUND:Studies have shown that lung cancer stem cel s can be isolated from lung cancer cel lines. But there are few reports about in vitro isolation, culture and identification of lung cancer stem cel s in patients with lung squamous carcinoma.
OBJECTIVE:To explore the feasible methods of harvesting lung cancer stem cel s from fresh lung cancer tissue in patients with lung squamous carcinoma.
METHODS:Side population cel s were isolated by col agenase digestion, Ficol density gradient centrifugation and Hoechst 33342 solution. The isolated cel s were suspended in conditioned medium for isolated culture. Flow cytometry method was used to detect lung cancer stem cel s based on the cel surface markers CD133 and CD44, and the positive rates of CD133+, CD44+and CD133+/CD44+cel s were recorded.
RESULTS AND CONCLUSION:Cel s adhered at 0.5 hour after incubation;typical cel colony was formed at 4 days of culture;cel s showed paving stone-shape at 7 days in a total number of 10 8. The positive rates of CD133+, CD44+and CD133+/CD44+cel s at passage 4 were increased significantly. These findings indicate that stem cel-like lung cancer cel s were obtained from fresh lung cancer tissue in patients with lung squamous carcinoma, which were stably and rapidly amplified in vitro, laying the foundation for the further study on the heterogeneity and resistance of lung cancer stem cel s in the future.

BACKGROUND:Studies have shown that lung cancer stem cels can be isolated from the lung cancer cel lines, But there are few reports on in vitro isolation, culture and identification of lung cancer stem cels in patients with lung squamous carcinoma.
OBJECTIVE:To establish the feasible methods of harvesting lung cancer stem cels from fresh lung cancer tissues in patients with lung squamous carcinoma, and to investigate the alterations in cel number and function during primary culture.
METHODS: Side population cels were isolated by colagenase digestion, Ficol density gradient centrifugation and Hoechst 33342 efflux properties. The isolated cels were isolated and cultured in conditioned medium. Flow cytometry method was used to detect lung cancer stem cels based on the cel surface markers CD133 and CD44, and the positive rates of CD133+, CD44+ and CD133+/CD44+ were recorded. The single cel clones assay, flat colony formation assay and the cel sphere formation assay were used to identify the stem-like characteristics of lung cancer stem cels between the first and fourth generations.
RESULTS AND CONCLUSION:The positive rates of CD133+, CD44+ and CD133+/CD44+ cels at the fourth generation were increased significantly, and the positive rates of CD133+ and CD133+/CD44+ cels at passage 4 were significantly higher than those at the first generation. The abilities of single cel clone formation, the flat colony formation and the cel sphere formation in the fourth-generation cels were greatly enhanced compared with the first-generation cels. Experimental findings showed that stem cel-like lung cancer cels were obtained from fresh lung cancer tissue in patients with lung squamous carcinoma, which stably and rapidly amplified in vitro, laying the foundation for the further study of the heterogeneity and drug resistance of lung cancer stem cels.

Objective To investigate the association between Metabolic syndrome and colon cancer.Methods A literature search was performed through PubMed,Ovidsp,CNKI and Wangfang Data within the time limit of January 1 990 to May 2014.Ac-cording to the inclusion and exclusion criteria,the studies were screened and the data were extracted.Then Meta-analysis was per-formed using Stata Statistical Software version 12.0.Results A total of 8 studies(6 cohort studies and 2 case-control studies)met the inclusion criteria.Meta analysis showed that patients with Metabolic syndrome had a higher risk of colon cancer incidence com-pared with the control group without Metabolic syndrome(OR =1.43,95%CI :1.23 - 1.66,P <0.05 ).Stratified analysis showed Metabolic syndrome had a higher risk of colon cancer incidence in male(OR=1.50,95%CI :1.22-1.84,P <0.05),but in female, this association was not found(OR=1.39,95%CI :0.98- 1.96,P =0.07).In addition,Meta analysis showed that Metabolic syn-drome was not associated with an increased risk of colon cancer mortality(OR=1.22,95%CI :0.92-1.63,P =0.1 7).Conclusion This Meta analysis indicated a positive association between Metabolic syndrome and colon cancer incidence in male,but not in fe-male.Metabolic syndrome might not be associated with an increased risk of colon cancer mortality,yet it needs more prospective co-hort studies to confirm the conclusion.

Objective: To understand knowledge, attitude and behavior toward Coronavirus disease 2019 (COVID 19) among middle school students in Wuhan, in the phase of normalized control and prevention of COVID 19, so as to provide evidence for further health education. Methods: In January 2021, cluster random sampling method was used to select one middle school from Hongshan and Dongxihu District, as well as Donghu high tech zone, respectively. By using the "questionnaire star" platform, questionnaire QR code were sent to students through QQ or wechat by schools. A total of 4 531 middle school students were investigated. Results: Preventive knowledge and behavior rate was 71.5% (3 238) and 56.0% (2 537), respectively. Preventive behaviors towards COVD 19 was reported in 56.0% (2 537) of participants. Students with parents as health care workers reported higher preventive behaviors(P<0.05).Girls had a higher rate of possession of health knowledge for prevention and control than boys. Compared with "essentially no concern about the epidemic","students with less concern about the epidemic" and "those with similar concern as 2020" were more likely to have higher awareness of health knowledge for prevention and control. Compared with the first-year junior middle school students, high school students were less likely to have the rates of knowledge for prevention and control health [OR(95%CI）=1.24（1.09-1.43）,2.56(1.54-4.25),3.30(1.99-5.48),0.49(0.39-0.62),0.45(0.36-0.57),0.63(0.46-0.88)].In terms of health behavior rate, middle school students whose mothers are undergraduates, whose incomes were more than 8 001-15 000 and 15 000 yuan, "whose attention to epidemic situation has declined" , "whose attention is the same as that in 2020" , "who did not plan to study medicine before" , "who are determined to study medicine, and who plan to study medicine more firmly after epidemic situation " were more likely to have health behavior,[OR(95%CI)=1.29(1.04-1.60),1.39（1.07-1.82）,1.74(1.32-2.29),1.77(1.06-2.96),3.47(2.08-5.81)] ,The grade-2 high middle school students had lower probability of preventing and controlling health behaviors [OR(95%CI)=0.74(0.60-0.90)](P<0.05). Preventive knowledge and behaviors towards COVID 19 are mainly from school education, communication with parents and mobile learning. Conclusion Preventive knowledge and behaviors towards COVID 19 among Wuhan middle school students are needed to be improved and targeted health education should be implemented accordingly.

OBJECTIVE：To study the effects of paeonol combined with cisplatin on the proliferation and apoptosis of human osteosarcoma cell MG- 63 and its possible mechanism. METHODS ：MG-63 cells in logarithmic growth phase were divided into blank control group ，cisplatin group （4 µmol/L），paeonol group （50 mg/L），and low ，medium，high concentration combined groups （50，100，200 mg/L paeonol+ 4 µmol/L cisplatin ）. CCK- 8 method was used to detect the cell proliferation rate at 24，48，and 72 hours of treatment. Annexin Ⅴ-FITC/PI double staining method was used to detect the cell apoptosis rate at 24 hours of treatment. The relative expression of PI 3KCA，Akt，mTOR，P-gp and PTEN mRNA in cells were detected by qRT-PCR. RESULTS ：Compared with blank control group ，the cell proliferation rate at each time point ，and the relative expression of PI 3KCA，Akt and mTOR mRNA in cells were significantly reduced and the apoptosis rate and the relative expression of P-gp and PTEN mRNA in the cells were increased significantly （P＜0.05 or P＜0.01）. Compared with cisplatin group and paeonol group ，cell proliferation rate at each time point and the relative expression of PI 3KCA，Akt and mTOR mRNA in cells were decreased significantly in the high concentration combination group ，while the relative expression of P-gp and PTEN mRNA in the cells were significantly increased （P＜0.01）；there were statistical significance in some of the above indicators in the medium and low concentration combination groups（P＜0.05 or P＜0.01）. CONCLUSIONS ：The combination of paeonol and cisplatin could inhibit the proliferation of MG- 63 cells and promote their apoptosis ，which may be related to the down-regulation of PI 3KCA，Akt and mTOR mRNA expression ，and the up-regulation of P-gp and PTEN mRNA expression.

OBJECTIVE: To explore the predictive significance of exhaled breath temperature (EBT) for airway inflammation changes in children with asthma. METHODS: A total of 60 children with asthma who met the inclusion criteria at the first visit were chosen as the asthma group, and 60 healthy children were selected as the control group. The EBT level was measured by the latest third-generation product (X-halo). The Childhood Asthma Control Test (C-ACT) score was recorded. EBT level and C-ACT score were compared between the asthma and control groups. At the subsequent visit one month later, the children were divided into well-controlled, partially-controlled, and uncontrolled groups according to their C-ACT scores. The EBT level and the FeNO level of the three groups were measured. EBT level and C-ACT score were compared among the three groups. The correlation between EBT and FeNO was analyzed. The data of initial diagnosis were reviewed, the EBT level and C-ACT score at the first visit were compared among the three groups, and the differences in EBT level and C-ACT score among the three groups at the second and first visits were evaluated. RESULTS: At the first visit, the asthma group had a significantly higher EBT and a significantly lower C-ACT score compared with the control group (P<0.05). At the time of the subsequent visit, there was a significant difference in EBT level between the three groups, i.e., uncontrolled group > partially-controlled group > well-controlled group (P<0.05), and there was also a significant difference in C-ACT score between the three groups, i.e., well-controlled group > partially-controlled group > uncontrolled group (P<0.05). There were no significant differences in EBT level and C-ACT score at the first visit between the three groups. From the first visit to the subsequent visit, EBT level was significantly decreased in the well-controlled group (P<0.05), but significantly increased in both partially-controlled group uncontrolled groups (P<0.05); C-ACT score was significantly increased in the well-controlled and partially-controlled groups (P<0.05), but significantly decreased in the uncontrolled group (P<0.05). EBT and FeNO levels at the subsequent visit were positively correlated with each other in the uncontrolled group (P<0.05). CONCLUSIONS EBT has predictive significance for the changes in airway inflammation in children with asthma.
Asthma ; Breath Tests ; Child ; Humans ; Inflammation ; Nitric Oxide ; Temperature

Breast Neoplasms/genetics* ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; Humans ; Lymphatic Metastasis ; MicroRNAs/genetics*

Objective:To investigate the epidemiological characteristics and current status of surgical management for esophageal cancer in China.Methods:A national database was setup through a network platform. The clinical data of esophageal cancer treated by surgery was collected from 70 major hospitals in China between January 2009 and December 2014.Results:Complete data of 8 181 cases of esophageal cancer patients who underwent surgery were recorded in the database and recruited in the analysis. Among them, 6 052 cases were male and 2 129 were female, the average age was 60.5 years.The epidemiological investigation results showed that 148 cases (1.8%) had history of psychological trauma, 7 527 cases (92.0%) were lower social economic status, 5 072 cases (62.0%) were short of fresh vegetables and fruits, 6 544 cases (80.0%) ate rough food frequently, 3 722 cases (45.5%) drank untreated water directly from lake or river or shallow well, 3 436 cases (42.0%) had a unhealthy eating habit, including habits of eating food fast (507 cases, 6.2%), eating hot food or drinking hot tea/soup (998 cases, 12.2%), eating fried food (1 939 cases, 23.7%), 4 410 cases (53.9%) had the habits of smoking cigarettes and 2 822 cases (34.5%) drank white wine frequently.The pathological results showed that 7 813 cases (95.5%) were squamous cell carcinoma, 267 cases were adenocarcinoma (3.3%), 25 cases were adenosquamous cell carcinoma (0.3%) and 50 cases were small cell carcinoma (0.6%). A total of 1 800 cases (22.0%) received preoperative neoadjuvant therapy due to locally advanced disease or difficulty of resection. The esophagectomies were performed through left thoracotomy approach in 5 870 cases (71.8%), through right chest approach in 2 215 cases (27.1%), and the remain 96 cases (1.2%) received surgery though other approaches.A total of 8 001 cases (97.8%) underwent radical resection, the other 180 cases (2.2%) received palliative resection. The 30-day postoperative mortality rate was 0.5%, the overall ≥ grade Ⅱ postoperative complication rate was 11.6% (951 cases). The 1-yr, 3-yr, and 5-yr overall actual survival rates were 82.6%, 61.6%, and 52.9%, respectively.Conclusions:The data analysis of the national database for esophageal cancer shows that bad eating habits or eating rough food without enough nutrients, lower social and economic status, drinking white wine and smoking cigarettes frequently may be correlated with tumorigenesis of esophageal cancer. However, strong evidences produced by prospective observation studies are needed. Overall, the long-term survival of esophageal cancer patients has been improved gradually due to the application of advanced surgical techniques and reasonable multimodality treatment.

Objective:To investigate the epidemiological characteristics and current status of surgical management for esophageal cancer in China.Methods:A national database was setup through a network platform. The clinical data of esophageal cancer treated by surgery was collected from 70 major hospitals in China between January 2009 and December 2014.Results:Complete data of 8 181 cases of esophageal cancer patients who underwent surgery were recorded in the database and recruited in the analysis. Among them, 6 052 cases were male and 2 129 were female, the average age was 60.5 years.The epidemiological investigation results showed that 148 cases (1.8%) had history of psychological trauma, 7 527 cases (92.0%) were lower social economic status, 5 072 cases (62.0%) were short of fresh vegetables and fruits, 6 544 cases (80.0%) ate rough food frequently, 3 722 cases (45.5%) drank untreated water directly from lake or river or shallow well, 3 436 cases (42.0%) had a unhealthy eating habit, including habits of eating food fast (507 cases, 6.2%), eating hot food or drinking hot tea/soup (998 cases, 12.2%), eating fried food (1 939 cases, 23.7%), 4 410 cases (53.9%) had the habits of smoking cigarettes and 2 822 cases (34.5%) drank white wine frequently.The pathological results showed that 7 813 cases (95.5%) were squamous cell carcinoma, 267 cases were adenocarcinoma (3.3%), 25 cases were adenosquamous cell carcinoma (0.3%) and 50 cases were small cell carcinoma (0.6%). A total of 1 800 cases (22.0%) received preoperative neoadjuvant therapy due to locally advanced disease or difficulty of resection. The esophagectomies were performed through left thoracotomy approach in 5 870 cases (71.8%), through right chest approach in 2 215 cases (27.1%), and the remain 96 cases (1.2%) received surgery though other approaches.A total of 8 001 cases (97.8%) underwent radical resection, the other 180 cases (2.2%) received palliative resection. The 30-day postoperative mortality rate was 0.5%, the overall ≥ grade Ⅱ postoperative complication rate was 11.6% (951 cases). The 1-yr, 3-yr, and 5-yr overall actual survival rates were 82.6%, 61.6%, and 52.9%, respectively.Conclusions:The data analysis of the national database for esophageal cancer shows that bad eating habits or eating rough food without enough nutrients, lower social and economic status, drinking white wine and smoking cigarettes frequently may be correlated with tumorigenesis of esophageal cancer. However, strong evidences produced by prospective observation studies are needed. Overall, the long-term survival of esophageal cancer patients has been improved gradually due to the application of advanced surgical techniques and reasonable multimodality treatment.