Induced pluripotent stem cells can differentiate into a variety of cell types,which promote the development of human disease model,drug toxicity screening and sources of autologous cells.However,there have been many problems in the induced pluripotent stem cells reprogramming,such as safety and low efficiency.Small molecules are considered as a promising method to improve the reprogramming processes of induced pluripotent stem cell,and more and more small molecules have been identified to maintain stem cell self-renewal,providing a new approach to produce the desired reprogramming cells.

[ABSTRACT]OBJECTIVETo evaluate the effectiveness of low temperature radiofrequency ablation on tongue cancer in early stage (<2 cm T1 stage) .METHODS High differentiated tongue squamous cell carcinoma(<2 cm T1 stage) were removed with radiofrequency ablation in 11 patients and with high-frequency electrotome in 20 patients from 2009 to 2014 in our hospital. All the patients underwent elective neck dissection(I,Ⅱ,Ⅲ regions). Intraoperative blood loss, VAS ratings of post-operative pain, post-operative bleeding rate and the recurrence rate of tongue cancer or lymph node metastasis were compared between the two groups.RESULTSIn the radiofrequency ablation group, the mean intraoperative blood loss was 13.82±7.40ml, the VAS ratings of post-operative pain were 3.8±1.3 (day 1), 2.5±0.7 (day 3) and 1.8±0.6(day 5), post-operation bleeding occurred in one case, and lymph node metastasis occurred in one case at 6 month after operation. In the high-frequency electrotome group, the mean intraoperative blood loss was 40.55±12.03ml, the VAS ratings of post-operative pain were 6.8±1.3(day 1), 4.4±1.1(day 3) and 2.3±0.7(day 5), post-operation bleeding occurred in one case, and lymph node metastasis occurred in 3 cases at 6 month to one year after operation. The intraoperative blood loss and post-operative pain in radiofrequency ablation group were significantly lower and less than that in the high-frequency electrotome group.CONCLUSIONRadiofrequency ablation is a promising method for early stage tongue cancer with less blood loss, invasiveness and complications.

Acupuncture Therapy ; Humans ; Meridians ; Sensation

Objective:To evaluate the nasal safety of gastrodin nasal temperature-sensitive in situ gel through the studies on cilia toxicity in toads and mucosal irritation in rats. Methods:The toads were randomly divided into four groups, saline group, gastrodin in situ gel group, blank gel matrix group and sodium deoxycholate group, and the cilia toxicity was observed in vivo by a toad palate meth-od. The rats were randomly divided into three groups, saline group, gastrodin in situ gel group and blank gel matrix group, and the mucosal irritation was studied in rats through the observation of nasal mucosal pathological changes and behavioral indices. Results:Compared with the saline group, gastrodin in situ and blank gel matrix showed no notable effect on the cilia movement function in toads, and the effect on cilia movement of sodium deoxycholate showed statistically significant difference when compared with that of sa-line, gastrodin in situ gel and blank gel matrix (P<0. 01). During and after the treatment, no sneezing appeared in the rats. Com-pared with that in the saline group, the number of scratching nose in the gastrodin in situ gel group and blank gel matrix group in-creased (P<0. 05) without difference between the groups (P>0. 05), and after the 2-day withdrawal, that in the gastrodin in situ gel group and blank gel matrix group decreased significantly when compared with that at the last administration (P<0. 05) and showed no notable difference when compared with that in the saline group (P>0. 05). The number of inflammatory cells in the nasal mucosa in the gastrodin in situ gel group and blank gel matrix group increased complicated with congestion and cilia falling off, and after the with-drawal, the mucosal morphology in the three groups showed no significant difference. Conclusion:The local application of gastrodin in situ gel has high security, which is valuable to be studied further.

Objective To investigate the effectiveness of target-controlled infusion (TCI) of etomidate and remifentanil for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).Methods Sixtynine ASA Ⅰ or Ⅱ patients of both sexes,aged 35-71 yr,weighing 41-83 kg,scheduled for elective EBUS-TBNA,were randomly divided into 3 groups ( n =23 each).In group Ⅰ,anesthesia was induced with TCI of propofol and iv injection of fentanyl 4 μg/ml,and the target plasma concentration (Cp) of propofol was set at 3-4 μg/ml.In group Ⅱ ,anesthesia was induced with TCI of propofol ( Cp 3-4 μg/ml) and remifentanil ( Cp 5 ng/ml).In group Ⅲ ,anesthesia was induced with TCI of etomidate (Cp 0.3-0.4 μg/ml) and remifentanil (Cp 5 ng/ml).After the patients lost consciousness,laryngeal mask airway was inserted to perform mechanical ventilation.PETCO2 was maintained at 30-40 mm Hg.BIS value was maintained at 40-60.The use of vasoactive agents (perdipine,ephedrine,atropine and esmolol) and occurrence of bucking during operation,emergence time,and the occurrence of nausea and vomiting within 24 h after operation were recorded.Blood samples were collected from the femoral vein at 30 min before induction,at the end of operation and at 24 h after operation for determination of the plasma cortisol concentration.Results The incidence of bucking and nausea and vomiting was significantly lower,the emergence time was significantly shorter,and the number of patients who needed vasoactive agents during operation was significantly smaller in groups Ⅱ and Ⅲ than in group Ⅰ ( P ＜ 0.05).The number of patients who needed vasoactive agents during operation was significantly smaller in group Ⅲ than in group Ⅱ (P ＜0.05).Compared with groups Ⅰ and Ⅱ,the plasma cortisol concentration was significantly decreased at the end of operation in group Ⅲ (P ＜ 0.05).There was no significant difference in the plasma cortisol concentration at each time point between groups Ⅰ and Ⅱ (P＞0.05).Conclusion TCI of etomidate (Cp 0.3-0.4 μg/ml) and remifentanil (Cp 5 ng/ml) can provide satisfactory anesthesia for EBUS-TBNA with few adverse effects.

Objective To compare the effects of honey dressing and silver sulfadiazine dressing for wound healing in burn patients by Meta-analysis.Methods All the randomized controlled trials were collected by searching many kinds of databases in or out of the country to compare honey dressing with silver sulfadiazine dressing for wound healing in burn patients.Review Manager 5.2 was used to analyze the effects.Results Six randomized controlled trials (RCT) were included.Honey dressing was much better than silver sulfadiazine dressing for burn wounds,while there were no significant differences in positive rate of wound swab culture and healing days.Conclusions It can be proved that honey dressing has an advantage over silver sulfadiazine dressing in the wound healing days within 21 and final outcome.Whether honey dressing is superior to silver sulfadiazine dressing in antibacterial effects and healing days remains to be studied with adequate,powerful,high quality randomized controlled trials.

Objective To test whether the prophylactic small dose amitriptyline has any beneficial influence on the rate of poststroke depression (PSD) by clinical experiment. Methods All 123 patients with first stroke were divided into the intervention group and the control group according to the block randomization tables. The patients in the intervention group were treated with 12. 5 mg amitriptyline every night for more than 1 month and the control group was blank Before and at the end of the observation, the rate of PSD and activities of daily living (ADL), degree of neurological deficit (NIHSS) of all the subjects were assessed. Results At the end of the one-month treatment, the intervention group had lower rate of PSD (16. 4% ) than the control (51.6%);and they had lower score in NIHSS (2. 83 ± 1.74 vs 3. 64 ±1.93) and higher score in ADL (93.0 ± 16. 1 vs 87.0 ± 37. 1) than the control. Multivariate Logistic regression analysis showed: the change of ADL score was closely related to the rate of PSD (RR =3.01 ,P =0. 04); the change of NIHSS score was closely related to the rate of PSD ( RR = 2. 42, P = 0. 03 );prophylactic small dose amitriptyline was closely related to PSD ( RR = 3.11, P = 0. 01 ). Conclusions Prophylactic small dose amitriptyline can decrease the rat of PSD, reduce the neurologic impairment and improve the activity of daily living.

Objective To establish a model of pancreatic cancer induced by 7,12-dimethylbenzathracene (DMBA) in SD rats, and to detect the expression levels of RAD51 and Myc-associated factor X (MAX) and their effect on carcinogenesis of rat pancreas. Methods Ninety SD rats were randomly divided into 3 groups: a model group, an intervention group, and a control group. DMBA was directly implanted into the parenchyma of rat pancreas (the model group and the intervention group). Rats in the intervention group were treated with 1 mL trichostatin A (TSA) saline solution (1 μg/mL) via ip weekly. Rats within 3～5 months in the model group and the intervention group were executed and observed by macrograph and under microscope. Meanwhile, the rats in the control group were executed at 5th month. The EnVision~(TM) immunohistochemistry to assay the expression levels of RAD51 and MAX was used in conventional paraffin-embedded sections from the above pancreatic specimens.Results The incidence of pancreatic cancer in the model group within 3-5 months was 48.7% (18/37), including 17 ductal adenocarcinomas and 1 fibrosarcoma. The incidence of pancreatic cancer in the intervention group within 3-5 months was 33.3%(12/36), including 11 ductal adenocarcinomas and 1 fibrosarcoma. The maximal diameter of mass in the model group was significantly higher than that in the intervention group (P＜0.05). No pathological changes were found in pancreas of the control group and other extra-pancreatic main organs of the model group and the intervention group (such as the liver, biliary tract, gastrointestine tract, kidney, and lung). The positive rate of RAD51 was significantly higher in ductal adenocarcinoma in the model group, the intervention group, and the model group +the intervention group than those in corresponding groups of non-cancerous pancreatic tissues (P＜0.01), but the positive rate of MAX expression was opposite to RAD51 expression(P＜0.01). The positive tissues of RAD51 expression and/or negative tissues of MAX expression in non-cancerous tissues showed atypical-hyperplasia of ductal epitheli. Pacncreas of the control group showed the negative expression of RAD51 and positive expression of MAX. Two cases of fibrosarcoma showed the negative expression of RAD51 and MAX.Conclusion DMBA directly implanted into the parenchyma of pancreas can obtain an ideal pancreatic cancer model with high incidence in a short time. The TSA might have an inhibitive effect on carcinogenesis and growth of rat pancreas. The over-expression of RAD51 and/or lose-expression might have important effect on carcinogenesis induced DMBA in rat pancreas.

Objective To investigate the protective effect of pitavastatin on the patients with earlystage diabetic nephropathy and its mechanism.Methods Seventy cases of early-stage type 2 diabetic nephropathy were divided into pitavastatin group and regular treatment group by random digits table method with 35 cases each.Meanwhile,35 healthy adults with physical examination were recruited as control group.Before and after treatment in pitavastatin group and regular treatment group and on the day of physical examination in control group,the blood glucose,blood lipid,renal function,urinary albumin excretion rate (UAER),high-sensitivity C-reactive protein (hs-CRP),tumor necrosis factor (TNF)-α,interleukin (IL)-18 were determined and compared.Results Before treatment,the levels of total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),triglycerides (TG),fasting blood sugar,2 h postprandial blood glucose,glycosylated hemoglobin,UAER,hs-CRP,TNF-α,IL-18,HDL-C were (5.74 ± 1.35) mmol/L,(3.73 ± 0.75) mmol/L,(3.46 ± 1.87) mmol/L,(10.25 ± 2.36) mmol/L,(15.59 ± 3.64) mmol/L,(8.67 ± 2.28)％,(124.2 ± 52.5) μg/min,(3.64 ± 1.48) mg/L,(43.74 ± 8.35) μ g/L,(113.43 ± 32.75) ng/L,(1.15 ± 0.36) mmol/L in regular treatment group and (5.93 ± 1.41) mmol/L,(3.68 ± 0.71) mmol/L,(3.29 ± 1.92) mmol/L,(10.48 ± 2.69) mmol/L,(16.04 ± 3.16) mmol/L,(9.48 ± 2.46)％,(116.2 ± 50.4) μ g/min,(3.48 ± 1.46) mg/L,(45.93 ± 9.41) μg/L,(120.68 ±35.20) ng/L,(1.18 ±0.35) mmol/L in pitavastatin group,and (4.57 ±0.83) mmol/L,(2.87 ± 0.64) mmol/L,(1.37 ± 0.58) mmol/L,(4.57 ± 1.37) mmol/L,(7.38 ± 1.30) mmol/L,(5.84 ± 1.57)％,(14.8 ± 9.4) μ g/min,(0.84 ± 0.52) mg/L,(10.42 ± 2.83) μ g/L,(20.84 ± 8.56) ng/L,(1.54 ± 0.39) mmol/L in control group.Before treatment,the levels of TC,LDL-C,TG,fasting blood sugar,2 h postprandial blood glucose,glycosylated hemoglobin,UAER,hs-CRP,TNF-α,IL-18 in regular treatment group and pitavastatin group were higher than those in control group,HDL-C was lower than that in control group,and there were significant differences(P ＜ 0.01).The levels of TC,LDL-C,TG were (4.42 ± 1.28),(3.20 ± 0.57),(2.02 ± 0.87) mmol/L after treatment in pitavastatin group,which were lower than those before treatment,and there were significant differences (P ＜ 0.01).The levels of UAER,hs-CRP,TNF-α,IL-18 were (88.3 ± 36.7) μ g/min,(2.54 ± 0.76) mg/L,(35.62 ± 5.28) μg/L,(83.23 ± 21.57) ng/L in regular treatment group and (64.8 ± 34.6)μ g/min,(2.19 ± 0.65) mg/L,(27.70 ± 7.58) μ g/L,(63.20 ± 18.67) ng/L in pitavastatin group after treatment,which were lower than those before treatment,but the decreased degree was obvious in pitavastatin group.Conclusions Pitavastatin can significantly reduce not only UAER,but also the levels of hs-CRP,TNF-α,IL-18,while effectively lower the blood lipid,in early diabetic nephropathy,which indicates that pitavastatin can reduce urine protein and protect renal function by inhibiting the inflammatory process.

Objective To identify risk factors of lymph node metastasis in superficial esophageal squamous cell carcinoma (ESCC),and to provide evidence for treatment choice under endoscope.Methods From January 2007 to December 2011,285 patients with pathologically diagnosed ESCC who received surgery and had clear record of lymph nodes resection were enrolled.The clinical pathological data of these patients were analyzed,including age,gender,smoking and drinking history,history of cancer,family history of cancer,location,tumor size,presence of esophageal,depth of infiltration,differentiation,and vascular cancer embolus.Univariate analysis (chi square test or Fisher exact probability method) and multivariate Logistic regression analysis were performed for risk factors of lymph node metastasis assessment.According to the rates of lymph node metastasis,patients were divided into three groups as follows:low risk,high risk and extremely high risk of lymph node metastasis.KaplanMeier method was used to calculate the average survival time and cumulative five years survival rate.Results Among the 285 patients with ESCC,40 (14.0 ％) patients with lymph node metastasis.The results of univariate analysis showed that location (x2 =9.333),tumor length (Fisher exact probability method),depth of infiltration (x2 =9.327),differentiation degree (Fisher exact probability method) vascular cancer embolus (Fisher exact probability method) were significantly associated with lymph node metastasis (all P＜0.05).The results of multivariate analysis indicated that tumor length over 5 cm,invasion to submucosal layer and vascular cancer embolus were independent risk factors of lymph node metastasis,and the odd ratio was 17.408(95％ confidence interval (CI) 1.557 to 194.686),3.471(95％CI 1.440 to 8.365) and 6.256(95％CI 1.787 to 21.910),respectively.The lymph node metastasis rates of patients in low risk,high risk and extremely high risk group were 5.2％(6/115),15.8％ (24/152) and 10/18,respectively;the average survival times were (69.9 ± 2.4),(63.8 ± 2.1) and (51.7 ± 1.7) months,respectively.The cumulative five years survival rates were 59 ％,51 ％ and 31％,respectively,and the difference was statistically significant (x2 6.816,P=0.033).Conclusions The risk of lymph node metastasis is high in ESCC patients with tumor length over 5 cm,invasion to submucosal layer and vascular cancer embolus,and the prognosis is poor.Lymph node metastasis should be considered when endoscopic therapy is chosen.