Stem cell (SC) is a class of initial cells with potential self renewal and differentiation ability.Under certain conditions,it can proliferate and differentiate into various functional ceils.Nucleoprotein Oct-4,Nanog and Sox2 are three major transcription factors,which play central roles in maintaining the pluripotent characteristics and inhibiting SC differentiation.Cancer stem cell(CSC) theory supposed that there is also existing SC-CSC possessing potential self renewal and differentiation abilities in tumor tissues.It is the SC properties of CSC that result in tumor's invasive growth,metastasis and resistance to treatment.Therefore,looking for CSC and determining their markers become an important direction for cancer research.And the introduction of Oct-4,Nanog and Sox2 into CSC research field is undoubtedly the most exciting forefront.

Objective To investigate the key technical points of microvascular decompression (MVD)for the treatment of primary glossopharyngeal neuralgia (GPN)and its efficacy. Methods From July 2011 to October 2016,18 consecutive patients with primary GPN treated with MVD at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were enrolled retrospectively. All patients received magnetic resonance angiography (MRA)examination before procedure. The anatomical relationship between glossopharyngeal nerve / vagus nerve and peripheral blood vessels were identified. Seventeen of them were treated via suboccipital retrosigmoid approach,one were treated via far lateral approach. None of the patients were treated with nerve root rhizotomy. Results Eighteen patients had paroxysmal severe pain in tongue,pharynx,tonsil or deep ear canal and other parts before procedure. Preoperative MRA indicated and confirmed in the surgery that the offending vessels were the trunks or their branches of the posterior inferior cerebellar artery in this group of patients. During the operation,the offending vessels were removed from the out brainstem areas of the glossopharyngeal nerves and vagus nerves under the direct vision in order to ensure that the blood vessels and nerves no longer contacted with each other. There were no complications, such as disability and death,cerebrospinal fluid leakage,and intracranial infection. All the patients were followed up after procedure;the mean follow-up period was 1-62 months. The symptom of pain disappeared completely in 17 of them. The Numberical Rating Scale (NRS)score for pain were 0. The pain in one patient was not relieved. The NRS score was 8 at discharge;it was the same as before procedure. Three patients had mild hoarseness,throat discomfort after procedure. They were relieved gradually in the follow-up period. Conclusion MVD is a safe and effective method for the treatment of GPN. Posterior inferior cerebellar artery is the most common offending artery. Preoperative imaging examination and clear decompression during the procedure are very important. The cutting off of glossopharyngeal nerves and vagus nerves needs to be handled with care.

Objective To preliminarily discuss the safety and efficacy of microvascular decompression for patients with trigeminal neuralgia caused by vertebrobasilar dolichoectasia (VBD).Methods From January 2013 to August 2016,16 patients with trigeminal neuralgia caused by vertebrobasilar dolichoectasia admitted to the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were analyzed retrospectively.All patients received preoperative magnetic resonance angiography examination.The anatomical relationship between the trigeminal nerves and the peripheral vessels was identified.Microvascular decompression was conducted via suboccipital retrosigmoid approach.They were followed up for 12-52 months after procedure.The trigeminal neuralgia score standard of Barrow Neurological Institute was used to evaluate the degree of pain of the patients before procedure,after procedure,and during the follow-up period.Results Of the 16 patients,the pain disappeared immediately in 15 after procedure,and the pain was not obviously relieved in 1 case after procedure,and the pain disappeared gradually at 6 months after procedure.One patient had hearing loss after operation compared with pre-operation.The follow-up time ranged from 12 months to 52 months.Three patients had recurrent pain at 6,12,and 36 months,respectively after procedure.Conclusion Microvascular decompression treatment of trigeminal neuralgia caused by VBD has better safety and surgical efficacy,but there was a certain pain recurrence rate,which needed further research.

Objective: To detect the expression of nuclear transcription factor OCT-4 in laryngeal squamous cell carcinoma (LSCC) and its relationship with CD44, and to explore the relationship between OCT-4 and the cancer stem cells and its significance in tumors. Methods: Sixty-nine specimens of laryngeal surgical resection were selected from LSCC patients from January 2008 to December 2012 in Lanzhou General Hospital of Lanzhou Military Region. Another 18 cases of normal laryngeal mucosa tissues were selected as control. OCT-4, CD44 and OCT-4⁺ CD44⁺ cells were observed by using tissue microarray, immunohistochemistry staining and immunohistochemical double staining techniques, and the relationship between their pathological features, such as expression intensity, distribution, cell morphology and clinical parameters were analyzed to explore the clinicopathological significance of CD44⁺ OCT-4⁺ cells. Results: The percentage of CD44-positive cells in LSCC was significantly higher than that in normal laryngeal mucosa tissues [(63.62±8.76)% vs. (13.61±5.81)%, P < 0.001]. The percentage of OCT-4-positive cells in LSCC was (50.44±10.84)%, while it was not expressed in normal laryngeal mucosa tissues (P < 0.001). In LSCC, the expression of OCT-4 was significantly lower than that of CD44 (P < 0.001); the coexpression rate of these two molecules was (5.07±2.90)%. The percentage of CD44-positive cells in poorly differentiated LSCC was significantly higher than that in the well-differentiated group [62.78% (8.22%) vs. 28.62% (30.45%), P < 0.05]. The percentage of OCT-4-positive cells in poorly differentiated LSCC was significantly higher than that in the well-differentiated group [49.89% (13.12%) vs. 33.00% (20.00%), P < 0.05]. In the cancer stem cells, the percentage of OCT-4⁺ CD44⁺ cells in poorly differentiated carcinoma group was also significantly higher than that in the well-differentiated carcinoma group (P < 0.01), the lower the degree of differentiation, the higher the expression level of OCT-4. In LSCC poorly differentiated group, the expressions of OCT-4 and CD44 showed no significant difference between different T stages, but the percentage of OCT-4⁺ CD44⁺ cells elevated with T stage increasing (P < 0.05). The expression of OCT-4 in patients with lymph node metastasis was significantly higher than that in patients without lymph node metastasis (P < 0.01). Conclusions The expressions of OCT-4 and CD44 are associated with the malignant biological behaviors of LSCC closely. OCT-4 may be a valuable marker of tumor stem cells of LSCC.