Recent advances in carbohydrate metabolism in cancer stem cells were obtained by analyzing the key words in relation with carbohydrate metabolism in cancer stem cells, which are covered in cluster-derived databases ( GoPubMed, XplorMed, AnneO'Tate, MEDSUM, PubReMiner) , with the basic strategies and use characteristics of these 5 databases compared, in order to provide the effective retrieval tools for embedded subject service in li-brary.

Objective:To observe the postoperative complications of percutaneous coronary intervention (PCI)in pa-tients With coronary heart disease (CHD)and analyze its nursing methed.Methods:A total of 200 CHD patients un-dergoing PCI in our hospital from Sep 2011 to Aug 2012 Were enrolled.The postoperative complications and thera-peutic effect Were observed and analyzeits nursing methods.Results:There Were 42 cases of PCI postoperative com-plications,included 26 cases (13%)of forearm hematoma,five cases (2.5%)of errhysis and edema at puncture site,four cases (2%)of extubation syndrome,tWo cases (1%)of arrhythmia and tWo cases (1%)of pseudoaneu-rysm etc.,in Which the incidence of forearm hematoma Was the highest,compared With any other complication (P<0.05 );after direction nursing,all complications significantly improved and recovered to normal.Conclusion:Comprehensive and directive nursing can effectively prevent postoperative complications and promote rehabilitation as soon as possible in patients With coronary heart disease after percutaneous coronary intervention.

Objective:To observe the effects of Periploca forrestil Schltr Compound extract in serum interleukin-4(IL-4),interferon-γ(IFN-γ),tumor necrosis factor-α (TNF-α) and transforming growth factor-β1 (TGF-β1) in joint synovial tissue of rats,and further to investigate it′s therapeutic effects and related mechanism.Methods: To built the complete adjuvant arthritis (AA) model in rats,and then to detect the contents of IL-4,IFN-γ,TNF-α in serum by ELISA,TGF-β1 in synovial tissues of rats knee was detected by immunohistochemistry.Results: The contents of IFN-γ,TNF-α were higher and IL-4 and TGF-β1 were lower in adjuvant arthritis rats (model group) than those in blank control (P<0.01).By comparing with the model group the contents of IFN-γ and TNF-α were significantly lower in Periploca forrestil Schltr Compound treated rat group,whereas the expressions of IL-4 and TGF-β1 were increased(P<0.05).Conclusion: The Periploca forrestil Schltr Compound can significantly inhibit the expression of IFN-γ and TNF-α,and enhance the expression of IL-4 and TGF-β1,adjusted the Th1/Th2 cell and cytokines imbalance,to alleviate arthritis and cartilage destruction,therefore the Periploca forrestil Schltr Compound can significantly inhibit the proliferation of T lymphocyte and infiltration in synovial tissues of experimental rheumatoid arthritis.

BACKGROUND: The nucleus pulposus tissue engineering is regarded as an ideal method in repairing intervertebral disc degeneration. However, the resource of nucleus pulposus cells is limited, so seed cell plays a vital role in nucleus pulposus (NP) tissue engineering. OBJECTIVE: To verify whether adipose-derived stem cells (ADSCs) can differentiate into NP-like cells induced by three-dimensional scaffold. DESIGN, TIME AND SETTING: An in vitro observation based on cell-materials level was performed at the Orthopaedic Research Institute, General Hospital of Beijing Military Area Command of Chinese PLA from July to December 2008. MATERIALS: Three Japanese big-eared rabbits with 3-months old were provided by Vital River Laboratory Animal Technology Co., Ltd., and the medical chitosan was purchased from Golden-shell Biochemical Co., Ltd. METHODS: The ADSCs were isolated from the rabbit adipose and then subcultured with collagenase digestion. The second ADSCs were prepared 50 uL cell suspension (5×10~6 cells), and mixed with 150 uL chitosan-alginate (C/A) and cultured in a12-well plate for 20 minutes in room temperature to obtain C/A gel. The experiment divided into 3 groups, in the control group, 2 mL DMEM containing 10% fetal bovine serum was added; DMEM containing bovine serum albumin, transforming growth factor-1 (TGF), hexadecadrol, vitamin C, bone morphogenetic protein-7,1% ITS was added, and then cultured with 2% O_2 or 20% O_2. All the samples were placed in incubator at a humidified atmosphere of 5% O_2 at 37 V for 21 days. MAIN OUTCOME MEASURES: Histomorphological observation; levels of proteoglycan, as well as type II collagen. RESULTS: The scanning electron microscopy showed that ADSCs grew well on the chitosan-alginate scaffolds, which was positive to oil-O staining and Alcian blue staining. More proteoglycan was produced. With time increasing, there was no significant change in the proteoglycan content and type II collagen in the control group. The content of proteoglycan and collagen type II was higher in the induced group, which had difference to the control group (P < 0.001, P < 0.05). Meantime, the expression of collagen type II and proteoglycan was greater in hypoxia-induced group than that of normoxia-induced group (P<0.05, P<0.01). CONCLUSION: Rabbit ADSCs growing on the scaffolds of chitosan-alginate gel may differentiate towards NP-like cells under certain conditions, especially better under hypoxia state.

Exudative erythoma multiforme is a related to the immune function of children with skin and mucosa,damage to its diversity of characteristics of acute non suppurative inflammation,one of the aller-gic diseases.The disease and its pathogenesis is complex,the body can cause multi system and multi organ damage,the cause has not yet entirely clear.In recent years,due to our understanding of the exudative erytho-ma multiforme gradually thorough,both domestic and abroad on the level of diagnosis and treatment of the disease have greatly improved,the prognosis of patients with exudative erythoma multiforme has improved significantly.The progress of the pathology,clinical manifestation,diagnosis and treatment of exudative ery-thoma multiforme were summarized.

Objective To test the utility of a new type of inflatable rehabilitation boot in the treatment of Danis-Weber type-A stable external malleolus fractures. Methods Fifty-four patients with stable external malleolus fractures were randomized into two groups. After closed reduction, the observation group was treated by immobilisation with the inflatable rehabilitation boot and the control group with a plaster slab. All were instructed to avoid weight-bearing on the affected side. The swelling volume of the injured limb was measured by drainage measurement before treatment and at the 1st, 3rd and 7th days after treatment. Pain was evaluated using a visual analogue scale (VAS) score before treatment and after 12, 24 and 72 hours. All of the ankles were x-rayed to recheck for displacement after 2weeks. Results The average volume of the injured limbs in the observation group was significantly less than in the control group at every time point. The average VAS score in the observation group was significantly lower than that in the control group. Fracture displacement in the observation group was also significantly better. Conclusions The inflatable rehabilitation boot has better curative efficacy than the typical plaster slab for patients with stable external malleolus fractures in terms of improving edema in the injured limb, relieving pain and preventing fracture displacement.

Objective To investigate the changes in cerebral cAMP and PKA levels during development of acute opioid tolerance induced by remifentanil and to determine whether post-receptor cAMP/PKA signaling pathway is involved in the process. Methods Fifty-six male Kunming mice weighing 25-35 g were randomly divided into 5 groups: group Ⅰ control (C) (n=8); group Ⅱ received morphine infused intraperitoneally (IP) at 0.6 μg'kg-1·min-1 for 120min(M) (n=8); group Ⅲ,Ⅳ,Ⅴ received remifentnil infused IP at 0.4, 0.8 and 1.6 μg·kg-1·min-1 for 120 min(R1=8, R2n=8; R3 n=24).Control group received IP infusion of normal saline. Tail-flick test was performed td measure the response of animals to a thermal nociceptive stimulus before IP infusion, at 30, 60, 90 and 120 min after beginning of IP infusion and at 15, 30, 45 and 60 min after termination of IP infusion. Eight animals were decapitated at 60 min after termination of IP infusion in all 5 groups and the other 16 animals in group R3 were decapitated at 30 and 45 min after termination of IP infusion (n=8 each) for determination of intracellular contents of cAMP and activities of PKA in cerebral cortex and inferior colliculus-striatum by ELISA or radioactive isotope [32p,] ATP-catalyzing assay. Results The tail-flick latency was significantly prolonged during IP infusion as compared with the baseline before infusion in group M, R1 , R2 and R3 but became significantly shorter at 30 and 45 min after infusion than the baseline values in group R1, R2 and R3indicating hyperalgesia after remifentauil infusion. The cerebral contents of cAMP and PKA activities at 60 min after termination of infusion were comparable or decreased in group M, R1, R2 and R3 as compared with group C. There was no significant difference in cerebral cAMP contents and PKA activities at 30, 60 and 45 min after IP remifentanil infusion in group R3. Conclusion Remifentanil can induce acute hyperalgesic effect on mice, and there is no up-regulation of post-receptor cAMP/PKA signaling pathway in the acute opioid tolerance, which is not similar to that chronic opioid tolerance.

Objective To analyze the effect of prognosis of psychological counseling combined with early double anti antiplatelet on the treatment of acute cerebral infarction.Methods 76 patients with acute cerebral infarction who were admitted to our hospital from February 2014 to March 2016 were numbered according to their admission order.The patients with even numbers were in the observation group and with the odds number in the control group, 38 cases in each group.The control group were given aspirin and clopidogrel in the early stage, and the observation group were given psychological guidance on the basis of the control group.The prognosis in the two groups was recorded and analyzed.Results The neurological deficit score (NIHSS) and simple mental state score (MMSE) in the observation group (9.16±0.73)points, (25.42±2.00)points were significantly higher in the observation group than those in the control group (12.59±1.05)points, (20.73±2.16)points.And the differences were significant (P<0.05).The level of dailyliving activity index (Barthel) and Hamilton depression (HAMD) in the observation groupwere (80.86±3.29)points, (13.70±1.53)points, respectively, which were better than those in the control group (71.53±3.75)points, (18.53±1.99)points, and the differences were significant (P<0.05).The total adverse reaction rate in the treatment group was 18.42%, slightly higher than 14.29% in the control group, but the difference was not statistically significant.Conclusion Psychological counseling combined with early double antiplatelet intervention has positive effect on the prognosis in the patients with acute cerebral infarction.

Objective To discuss the prevention and management of complications of transurethral electrovaporization of the prostate(TUVP).Methods A total of 820 patients underwent TUVP from June 1998 to August 2005.A Wolf electrovaporization system and a F_(24) 12? resectoscope were used.After the seminal colliculus was identified for making a reference plane,the prostatic tissues were removed untill the surgical envelope,and the bladder neck and the apex of prostate were surgically shaped.Results Complications occurred in 124 patients(15.1%,124/820).There were 17 cases of intraoperative complications(2.0%),including massive haemorrhage in 6 patients(0.7%),presymptoms of transurethral resection syndrome in 6 patients(0.7%),and perforation on the juncture of the bladder and the prostate in 5 patients(0.6%).There were 107 cases of postoperative complications(13.0%), including urethral stricture in 18 patients(2.2%),spasm of the bladder in 32 patients(3.9%),secondary hemorrhage in 3 patients(0.4%),retrograde ejaculation in 11 patients(1.3%),temporary incontinence in 13 patients(1.6%),infection of the urinary tract in 24 patients(2.9%),and acute pulmonary thromboembolism in 6 patients(0.7%). Conclusions Preoperative precautions and clear intraoperative exposure are essential to prevent the incidence of complications of TUVP.

In order to accelerate the comprehensive reform of clinical education,the Ministry of Education and the Ministry of Health decided to implement the program of excellent doctor education training plan in 2012.On the basis of the plan,taking a certain medical college as an example,on the problems such as lack of teachers,unreasonable age structure,the lack of advanced experimental technology and comprehensive talents and the lack of innovation and enterprising spirit and so on,the author puts forward some proposals from the development of experimental teaching,the teachers' personal and professional growth and the institutional and policy level,such as strengthening the foreign exchange,making learning training plan and personal development planning,establishing the evaluation system of the experiment teaching quality and opening up a variety of learning methods to improve the teachers' comprehensive ability.