Origin of lymphoma stem cells is very complicated,it is proposed that committed lymphoid progenitor/precursor cells(CLP)with V-D-J recombination are stem cells of follicular lymphoma(FL)and mantle cell lymphoma (MCL).Conversely,B lymphocytes within the germinal center as the diffuse large B-cell lymphoma (DLBCL)and sporadic Burkitt lymphoma (BL)stem cells.An alternative model supports an epigenetic modification of genes as the first occurring hit,which leads to retaining stem-cell features in hematopoietic cells, followed by secondary chromosomal translocations that eventually transformed into lymphoma.Isolation and characterization of the different B-cell non-Hodgkin lymphomas will provide critical insights into the disease pathogenesis and will represent a step towards the development of more effective therapies.

Myeloid leukemias are clonal disorders originating from a primitive multipotential hematopoietic cell and characterized by aberrant proliferation, differentiation and maturation of leukemic progenitors and precursor cells. Studies have identified sub-populations of leukemic cells possessing different functional capabilities. Hypothesis hold that the heterogeneity is mainly due to leukemia stem cells (LSC). Data from the past decade implied that LSC has impact on the care of myeloid leukemias. The history of LSCs and the more recent data of the origin, immunophenotype, frequency and self-renew ability of LSCs are reviewed.

Objective; To elucidate the mechanism of the role of ER-a in fat metabolism by regulating the expression of ER-a in SD rats marrow mesenchymal stem cells during differentiating into adipocytes in vitro. Methods ;SD rats marrow mesenchymal stem cells were separated and cultivated. The ER-a was transfected into the rBMSCs in group one. Tamoxifen Citrate was used to restrain the expression of ER-a in group two, the group without any treatment was used as control. Western blot was used to identify the difference of ER-a expression among different groups and Oil-Red-0 staining was employed to identify the adipocytes in vitro. Results; There was significant difference between the number of lipids and different groups (P <0. 01) ,the number of lipid droplet changed concomitantly with ER-a: Low-expression ER-a group > Control group > High-expression ER-a group. Conclusion; ER-a in SD rats marrow mesenchymal stem cells may restrain the adipocyte differentiation.

Objective To know about the status quo and influencing factors of undergraduate nurses' psychological empowerment at present,and provide a theoretical basis for nursing administrators so as to take measures to raise the level of psychological empowerment of undergraduate nurses.Methods General information questionnaire for nurses,Psychological Empowerment Scale were used to survey 207 undergraduate nurses in 3 first class teaching hospital of Dalian City.Results Undergraduate nurses' psychological empowerment score was (43.890±6.515) points,four dimensions whose scores from high to low were self-efficacy,job significance,autonomy and job impact.There was statistical difference in terms of ages,working length,working positions,professional titles,working purposes and training opportunities.Among them,working position and working purpose were the most important influencing factors of psychological empowerment.Conclusions Psychological empowerment of undergraduate nurses needs to be improved,managers should pay attention to the role of psychological empowerment,and actively cultivate and correctly guide undergraduate nurses in order to stimulate their potential in work,and finally,promote the sustainable development of a solid nursing career.

OBJECTIVE:To analyze the utilization and variation tendency of oral hypoglycemic agents in Wuhan area,and to provide reference for drug selection and enterprise production and sale. METHODS:The utilization of oral hypoglycemic agents in 34 hospitals from Wuhan area during 2011-2013 was analyzed statistically in respects of consumption sum,DDDs and DDC etc. RESULTS:The consumption sum and DDDs of oral hypoglycemic agents increased by 20% and 7% respectively year by year. Acarbose had a market share of over 40%. The drug use frequency of metformin ranked the second place only to acarbose. DPP-4 inhibitor had a promising future,with a consumption sum proportion of more than 10%,while the market share of traditional Chi-nese medicine had fallen below 3%. Except for repaglinide,gliclazide,glimepiride,Xiaoke pills,etc.,the selling of other medica-tions are consistent with the user. CONCLUSIONS:The utilization of oral hypoglycemic drugs is basically rational in 34 hospitals from Wuhan area during 2011-2013.

Pediatric head injury is the leading cause of death and disability,about 40% to 60% of kids of head injury get a CT,and the majority are those with minor head injury,about 10% of these CT scans are positive.Clinical decision rules for pediatric head injury exist to identify children at risk of traumatic brain injury.Those of the highest quality are children's head injury algorithm for the prediction of important clinical events(CHALICE),Pediatric Emergency Care Applied Research Network(PECARN)and the Canadian as-sessment of tomography for childhood head injury(CATCH)clinical decision rules.This review aimed to systematically introduce primary clinical decision rules for children with minor head injury and compare them for diagnostic accuracy in detecting intracranial injury and injury requiring neurosurgery.

Objective:To observe the effectiveness and security of piperacillin sodium/sulbactam sodium in the treatment of bacte-rial infections and perform the pharmacoeconomics evaluation. Methods: Totally 126 patients with hand trauma bacterial infections were divided into the control group and the treatment group. The control group was given piperacillin sodium/tazobactam sodium 2. 5g, ivd, bid, while the treatment group was treated with piperacillin sodium/sulbactam sodium 1. 25g, ivd, bid. After 14-day treatment, the clinical therapeutic effect and adverse reactions of the two groups were observed, and the cost-minimization analysis was carried out. Results:The effective rate of the treatment group was 93. 65%while that of the control group was 92. 06%(P>0. 05). The bac-terial clearance rate of the treatment group was 96. 83%while that of the control group was 95. 24% (P>0. 05). The incidence of ad-verse reactions of the treatment group was 4. 76% (3/63) while that of the control group was 9. 52%(P>0. 05). The cost-effective-ness of piperacillin/sulbactam was significantly lower than that of the control group (P<0. 05). Conclusion: The effectiveness and safety of the two groups show no obvious differences in the treatment of hand trauma bacterial infections, and both have good antibacte-rial effect with low incidence of adverse reactions. For the better economic benefits, piperacillin /sulbactam is worthy of promoted ap-plication.

Objective To investigate the changes of human leukocyte antigen-G (HLA-G) protein expression and Th1/Th2 type cytokines in intrahepatic cholestasis of pregnancy (ICP) and their relativity to the etiology of ICP. Methods Peripheral blood and placental tissues were obtained from 26 ICP patients (the ICP group) and 22 normal pregnant women (the NP group) in the operation room for Cesarean birth. Immunohistochemistry was used to detect the expression of HLA-G protein in the placental tissues. Meanwhile we tested the concentrations of tumor necrosis factor-α (TNF-α) and interleukin-4 (IL-4) by enzyme-linked immunosorbent assay (ELISA) in the peripheral blood and checked the levels of TBA in the serum.Results TBA level in the ICP group was (27.05±6.08) μmol/L, significant higher than that in the NP group (4.35±2.68)μmol/L (P＜0.01). The positive expression of HLA-G protein in extravillous trophoblast in the ICP group was significantly lower than that in the NP group (P＜0.01). The mean optical density (MOD) of positive expression of HLA-G protein in the placenta tissues in the ICP group (52.91±7.19) was significantly lower than that in the NP group (69.26±7.72) (P＜0.01). The concentration of TNF-α was significantly higher in the ICP group (101.31±19.30) pg/mL than that in the NP group (54.51±23.72) pg/mL (P＜0.01). The concentration of IL-4 was lower in the ICP group (22.16±6.55) pg/mL than that in the NP group (31.69±8.25) pg/mL (P＜0.01). The ratio of TNF-α/IL-4 was higher in the ICP group (4.52±1.91) than that in the NP group (1.72±0.61) (P＜0.01). There was a negative correlation between the MOD of HLA-G protein and TNF-α (r=-0.98, P＜0.01) in the ICP group. No correlation with IL-4 and TNF-α/IL-4 was seen (P＞0.05). There was a positive correlation between TBA and TNF-α (r=0.99, P＜0.01), and a negative correlation between TBA and the MOD of HLA-G protein (r=-1.00, P＜0.01) in the ICP group. No correlation with IL-4 and TNF-α/IL-4 was seen (P＞0.05). Conclusion There is an imbalance of Th1/Th2 cytokines to the Th1 type in the peripheral blood of ICP patients. The expression of HLA-G protein in the placenta of ICP patients decreases, leading to an increase of Th1 type cytokines that may be one of the reasons for liver destroy in ICP.

Objective To analyze the effect of persistent nursing intervention on long-term therapeutic compliance of statins in elderly patients with coronary heart disease. Methods A total of 100 cases of elderly patients with coronary heart disease from December 24, 2015 to February 24, 2017 in Hangzhou city of Zhejiang Province, the Red Cross Hospital as the research object. They were divided into two groups by dynamic randomized odd number grouping. Two groups of patients were treated with statins for a long time, while were given general care, continuous care intervention, to explore the two groups of patients with lipid changes, the total effective rate of treatment, the incidence of adverse reactions, treatment compliance differences. Results Large differences are observed in lipid changes group and control group, the total efficiency of treatment and treatment compliance than the control group, the adverse reaction was lower than that of control group, the difference was statistically significant (P<0.05). Conclusion Continuing nursing intervention has a certain effect of intervention in long-term treatment compliance of statins in elderly patients with coronary heart disease.

Next-generation sequencing (NGS) platforms have recently evolved to provide an accurate and comprehensive means for the detection of molecular mutations in acute myeloid leukemia(AML).The 54th ASH annal meeting reported lots of studies on NGS in AML,reflect the important role of the NGS technology in modern diagnosis and treatment of blood diseases and the impact on the future development of the blood disease.