Tumor stem cells (TSCs) are a group of cells which have self-renewal and differentiation potential in tumor tissues.TSCs not only play an important role in the occurrence and development in tumors , but also are closely related to tumors′invasion,metastasis,heterogeneity and chemo-resistance.Further research of TSCs has become a hot spot .This review intends to explain the formation of TSCs ,the relationship between TSCs and the microenvironment , as well as the model of the TSC microenvironment .Signalling pathways and regulatory factors of TSCs are also discussed .

Almost all multicellular organisms have a symbiotic relationship with prokaryotes in nature.In humans,the interaction between host and microbial flora is particularly important in the gastrointestinal tract.Technical and conceptual advances have enabled us to establish its role in human health and disease.Studies have shown that disorder of gut microbiota may participate in the development of metabolic diseases,such as obesity and type 2 diabetes.This review opens up new ideas to find strategies for modifying gut microbiota to impact on the occurrence of metabolic diseases.

Objective To establish a HPLC method for the determination of preservative in iron maltose syrup.Methods A Kromasil 100-5 C18 column was used with acetonitrile-sodium acetate buffer solution(40 ︰60) as the mobile phase at the flow rate of 1.0 mL/min and 254 nm as the detection wavelength.The column temperature was set at 30 ℃.Results The calibration curve was linear within the range of 0.62 ~3.72 μg/mL for methyl parahydroxybenzoate, 0.18~1.07μg/mL for propyl parahydroxybenzoate, and the linear equation was Y=228494X-2512.5,Y=203351X-3471.4, respectively.The average recovery of methyl parahydroxybenzoate, propyl parahydroxybenzoate was 100.9%(RSD=1.5%),99.6%(RSD=0.5%), respectively.Conclusion The established method is simple, rapid and accurate, which could be used in the determination of preservative in iron maltose syrup.

Objective To evaluate the feasibility and advantages of transvaginal hysterectomy (TVH) for enlarged uterus without prolapse. Methods Six hundred and ninety-six patients underwent TVH for gynecological disorders from Sept, 1998 to Dec, 2002. Meanwhile, the method of operation, complications of surgery, operation time, estimated operative blood loss, postoperative recovery and hospital stay days were retrospectively analyzed. Results The operation was successful in 693 out of 696 cases (99.6%). The mean operative time was 49.3 minutes (11-125 minutes). The estimated blood loss was 69.7ml (15-450ml). Operative injuries were found in 3 patients (0.4%). Complications attributable to surgery were found in 6 cases (1%). The mean time of subsidence of fever was 1.2 days (0-5 days) and the time of passing flatus was 22.6 hours (8-32 hours). The average hospital stay was 5.3 days (4-15 days). Conclusion TVH can be performed safely for most of non-prolapsed large uterus. Because it has the advantages of less bleeding, short operating time, rapid recovery and less cost compared to TAH and LAVH, it is our opinion it should be the first option for enlarged uterus.

Objective To investigate the incubation period, degree of injury, distribition of pathological changes, and therapeutic effect of eye injury in “8?4” mustard gas poisoning accident. Methods The relationships among contact pattern, contact time and incubation period and degree of injury were analyzed, and the distribition of pathological changes and therapeutic effect were assessed. Results An incubation period was found in eye injury after the exposure to mustard gas. It varied with the mode of contact and the time of exposure to the gas. The conjunctiva was the main site of injury, follwed by the eyelid, and then the cornea and the iris. Conclusions The length of the incubation period varied with the degree of injury and contact time and mode. Thorough washout and medicinal intervention should be instituted as early as possible.

Objective To evaluate the advantages and feasibility of transvaginal excision of ovarian tumor. Methods A series of 62 patients with ovarian benign tumors had the tumors excised transvaginally from Dec 2001 to Oct 2003. The indications of transvaginal surgery, the method of operation, the complications following the operation, the overall operation time, the estimated blood loss during operation, the postoperative complications, and hospital stay days were analyzed retrospectively. Results Transvaginal ovarian tumor excision was successfully completed with neither the aid of laparoscopy or shift to laparotomy. No intra-abdominal spillage of cystic contents occurred. The mean operation time was 39.4 minutes. The estimated blood loss was 37.5ml. No postoperative complications occurred. The mean length of a low fever was 1.3 days, and the time of recovery of bowel movement was 20.1 hours. The average hospital stay was 4.2 days. Conclusion For free benign ovarian tumors, the transvaginal route should be considered to minimize trauma. There would be no skin incision, and it could be carried out in patients who had relatively large ovarian tumors with no intra-abdominal spillage. There would be less blood loss, shorter operation time, shorter hospital stay and lower cost.

Objective To evaluate the feasibility and advantages of the excision of uterine fibroids by vaginal myomectomy. Methods A series of 58 patients with uterine fibroids were managed with myomectomy from May 2001 to Dec 2003. Meanwhile, the indications of vaginal surgery, the methods of operation, the complications of surgery, the overall operating time, the estimated operative blood loss, the postoperative recovery and hospital stay were explored. Results Myomectomy were successfully completed vaginally without shifting laparotomy in 57 patients. The successful rate was 98 3%. The mean operative time was 48 16 minutes. The estimated blood loss was 70 58ml. The postoperative complication was occurred in one patient with uterine infection. The mean length of lower fever was 1 8 days and the bower movement was 1 3 days. The average hospital stay was 4 9 days. Conclusions For uterine fibroids, the vaginal myomectomy is a good choice when the indication of operation are managed properly. It can be used in patients who have numerous, relatively large, and intramural fibroids with micro invasive surgery, little interfering with abdominal organs, less blood loss, less operating time, less cost and less hospital stay in comparison with abdominal myomectomy or laparoscopic myomectomy

Objective To evaluate the feasibility and efficacy of treatment of leukoplakia vulvae with high-intensity focused ultrasound. Methods 65 patients with leukoplakia of the vulva were treated with high-intensity focused ultrasound. The patients were followed up after the treatment, and the symptoms including itch of the vulva, color change, the elasticity of the vulva lesions, and release of adhesions were observed and evaluated at the different times after treatment. Result All of the patients experienced relief in different degree (the ratio of effectiveness was 100%). Of them 28 patients were complete cured, 29 were distinctly improved, 8 were improved. In 5 patients there was a recrudescence with mild itch 2-3 months after treatment, but there was still a positive response to the second course of treatment. Conclusions High-intensity focused ultrasound is a highly effective instrument in the treatment of leukoplakia of the vulva. The treatment not only stops itch, but enables the color and elasticity of the vulva to recover as well.

Objective To evaluate the influence of aging on left ventricular systolic and diastolic function by quantitative tissue velocity image(QTVI) and B-type natriuretic peptide (BNP). Methods Sixty healthy participants aged from 36 to 82 years old were divided into age <60 years group (32 cases) and age≥60 years old group (28 cases). Compared traditional echocardiography,QTVI and BNP between the two groups, and analysised the correlation between age and the abovementioned measurements. Results Compared age ≥60 years group with age <60 years group, the ratio of early to late mitral annulus flow velocity(E/A) (0. 92 ±0. 18 vs. 1. 28 ± 0. 18), mean of systolic mitral annulus velocity (Sm) ([6. 04 ± 0.77] cm/s vs.[6. 89 ± 1. 03] cm/s) ,mean of early diastolic mitral annulus velocity (Em) ([5. 67 ±0.99]cm/s vs. [7.29 ± 1. 11]cm/s),the ratio of Em to Am(Em/Am) (0. 79 ± 0. 13 vs. 1.18 ± 0. 33) were significantly decreased (t =5. 396,2.478,4.075,3. 535, respectively, Ps < 0. 05), whereas mean of late diastolic mitral annulus velocity (Am) ([7. 67 ±0. 80]cm/s vs. [6. 80 ± 1. 16] cm/s),the ratio of E to Em(E/Em) (14. 83 ±4.43 vs. 10. 68 ±2. 85), BNP ([51. 25 ± 12. 21] ng/L vs. [14. 15 ± 6. 68] ng/L) were significantly increased (t =-2. 268,-2.995 and-3. 523, Ps < 0.05) . Age was negatively correlated with Sm, Em, Em/Am, E/A (r =-0.411,-0. 631,-0.622,-0. 614,Ps<0.05),and age was positively correlated with Am,E/Em and BNP (r = 0.481,0.614 and 0. 684,Ps <0. 05). Conclusion Left ventricular systolic and diastolic function decreased with aging. QTVI and BNP could evaluate left ventricular function sensitively and easily.

ObjectiveTo observe the effect of Qishen Tongluo Zengzhi decoction on cognitive impairment in patients with acute phase of ischemic stroke.Methods A prospective randomized controlled trial was conducted, and 130 patients with acute phase of ischemic stroke and cognitive impairment accompanied by Qi deficiency and blood stasis and stagnationof phlegm-dampness syndrome admitted into the Neurology and Rehabilitation Departments of Rizhao Hospital of Traditional Chinese Medicine(TCM) Affiliated to Shandong University of TCM were randomly divided into treatment group and control group, 65 cases in each group. In the two groups, conventional internal treatment was given to all patients, and in the treatment group, additionally the Qishen Tongluo Zengzhi decoction was administered orally(composition: astragalus membranaceus 30 g, radix pseudostellariae 30 g, notoginseng 10 g,spatholobus stem 25 g, hirudo 3 g, pberetima 10 g, radix paeoniae rubra 12 g, Chinese angelica 12 g, peach kernel 10 g, carthamus tinctorious 10 g, achyranthes 12 g, radix rhapontici 10 g, rhizoma alismatis 6 g, Acorus gramineus Soland 9 g, polygala root 9 g, rhizoma cyperi 10 g, herba siegesbeckiae 15 g),one dose a day. While in the control group, oxiracetam 4.0 g intravenous drip was given, once a day. The whole course was 21 days in both groups. Before and after treatment, the cognitive function of all the patients in two groups was assessed by Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA) scores, and incubation period and amplitude of P300 wave were recorded.Results Finally 62 cases were in treatment group and 63 cases in control group. Before treatment, the comparisons of the MMSE score, MoCA score and P300 latent period and amplitude between the two groups had no statistically significant differences(allP>0.05). After treatment in the two groups, the MMSE score, MoCA score and P300 wave amplitude were elevated, P300 latency period was shortened compared with those before treatment, and the changes were more prominent in treatment group〔score of MMSE: 25.33±2.32 vs. 21.68±2.29, score of MoCA(score): 26.61±3.06 vs. 22.40±2.93, P300 wave incubation period(ms): 349.62±20.01 vs. 371.87±19.63, P300 wave amplitude(μV): 8.70±2.92 vs. 5.72±2.33,allP<0.01〕.ConclusionQishen Tongluo Zengzhi decoctioncan effectively intervene cognitive impairment in patients with acute phase of ischemic stroke, and improve their cognitive function.