The theory of cancer stem cells (CSCs) provides a new perspective for the study of cancer. CSCs doctrine presumes that tumor cells are heterogeneity, and there are cancer stem-like cells in tumors, whose proliferation is uncon-trolled. The cancer stem-like cells could form tumors from only few cells, who only account for a very small part of all the tu-mor cells. These cells with stem cells characteristics could form different extend of differentiation of tumor cells and work as source of tumor growth, recurrence and metastasis. miRNAs are widely-existed non-coding small RNAs, which regulate 1/3 of all human genes and participate in a series of essential processes of life. More and more evidences indicate that miRNAs contribute significantly to cancer generation and development. They may exhibit oncogenic activity and act as tumor suppres-sors. As one of the post-transcriptional controlling factors, they regulate biological processes of tumor related genes exten-sively and specific miRNAs expression profiles were shown in different cancers. The research of miRNA about CSCs has be-come very hot. Some studies have confirmed that miRNAs play a very important role in a variety of CSCs, which act as a new target for tumor therapy. Researchers have found that some specific miRNAs express in plasma of cancer patients, which can be used as tumor markers to assist diagnosis and prognosis. This review focused on current progress of research in function of miRNAs in CSCs and its role as tumor markers.

Objective To observe the clinical efficacy of triple needling and centro-square needling in treating hemifacial spasm. Method Sixty-eight patients with facial spasm were randomized into a treatment group and a control group, 34 in each group. The treatment group was intervened by centro-square needling at topical Ashi points and triple needling at Yifeng (TE 17) on the affected side; the control group was intervened by regular acupuncture. The two groups were treated once a day, 10 times as a treatment course, for 3 courses in total. Cohen Albert grading scale was adopted to evaluate the spasm intensity before and after the intervention, and the clinical efficacies were then compared.Result After intervention, there was a significant difference in comparing the spasm intensity between the two groups (P<0.05). The significant improvement rate was 88.2% in the treatment group versus 50.0% in the control group, and the difference was statistically significant (P<0.05).Conclusion Triple needling plus centro-square needling is an effective method in treating hemifacial spasm. This method uses less points, but it produces a high efficacy, strong pertinence, and is easy-to-operate.

Objective To observe the clinical efficacy of acupoint application and moving cupping plus photo ionization treatment apparatus in treating hyperplasia of mammary glands. Method Sixty patients with hyperplasia of mammary glands were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by acupoint application and moving cupping plus photo ionization treatment apparatus, while the control group was by oral administration of Tamoxifen and Ru Pi San Jie tablets. The breast pain and lump score was observed before and after 2-month treatment, and the clinical efficacy was compared. Result The breast pain and lump scores were significantly changed in both groups after intervention (P<0.05). After intervention, there was no significant difference in comparing the breast pain and lump score between the two groups (P>0.05). The total effective rate was 96.7% in the treatment group versus 86.7% in the control group, and the difference was statistically significant (P<0.05). Conclusion Acupoint application plus moving cupping plus photo ionization treatment is an effective method in treating hyperplasia of mammary glands, and it can ease or reduce breast pain, and improve or reduce the lump.

Objective To investigate the genetic homology in clinical isolates of extensively drug-resistant Acinetobacter baumannii (XDRAB),so as to provide evidence for better controlling hospital infections.Methods The genotypes of 28 clinical XDRAB isolates were determined by Enterobacterial Repetitive Intergenic Consensus PCR (ERIC-PCR).PCR was conducted to analyze 9 types of β-lactamase genes (blaKPC,blaIMP,blaVIM,blaNDM-1,blaOXA-23,blaOXA-24,blaOXA-48, blaOXA-51 and blaOXA-58),the outer membrane porin gene (CarO)and insertion sequence (IS)ISAba1.We also carried out linkage analysis for ISAba1-OXA23 and ISAba1-OXA58.Results Most of the above 28 XDRAB strains were isolated from respiratory tract specimens from intensive care patients.The result of ERIC-PCR showed that there was high homology between all the strains,suggesting that they might derive from the same clone.The genes blaOXA-23,blaOXA-51,CarO and the IS ISAba1 except Class Bβ-lactamase genes,blaOXA-24,blaOXA-48,blaOXA-58,ISAba1-OXA23 and ISAba1-OXA58 were detected in all the clinical strains by PCR.Conclusions All the XDRAB isolates belong to the same clone and carry the same drug-resistant genes,indicating that there was clone spread among XDRAB isolates.

The growth of brain metastasis needs appropriate microenvironment, and the change of normal brain microenvironment is the basis for exploring metastasis with MRI. Through the local magnetic field changes and the application of contrast agents for improving the discrepancy of the cerebral tissue, MR can accurately detect brain metastasis in position, number, size, and shape. MR with contrast-enhanced technique is the first choice for screening brain metastasis. The application of all kinds of new MR techniques, sequences and intracellular contrast agents can not only further improve the specificity of detection, but also improve the sensitivity of MRI, which is favorable to formulating reasonable treatment and prolonging the lifetime of the patients. The microenvironment of brain metastasis and advances in the new MR techniques were reviewed in this article.

Objective To evaluate the effect of embelin combined with paclitaxel on the inhibition of A 549 lung cancer cell proliferation and tumor growing in tumor bearing nude mice. Methods The anti-proliferation efficiency of embelin combined with paclitaxel were evaluated by MTT assay, and A 549 cell apoptosis were evaluated by lfow cytometry. A 549 cells were xenografted in mice to establish the animal model, which were used to evaluate the effect of anti-tumor. Results compared to saline group、embelin group and paclitaxel group, the (paclitaxel+embelin) group could inhibit the growth of A 549 cells effectively(P<0.05). The embelin combined with paclitaxel induced the apoptosis of A 549 cells more effective than paclitaxel alone. The (paclitaxel+embelin) group significantly inhibited the growth of tumor tissue. Conclusion the paclitaxel can inhibit the growth of A 549 cells, the embelin can induce the apoptosis of A 549 cells, and the combination of paclitaxel and embelin may be a potentially effective treatment for lung cancer.

Objective To explore the application and effectiveness of simulated patient role play in the inquiry and the medical record writing teaching.Methods Carrying out the teaching model of simulated patient role play in the Second Clinical Medical College of Southern Medical University to the undergraduate students of grade 2009 snd 2010 in diagnose inquiry and medical record writing training class.A self-designed student questionnaire mainly about atmosphere of class,study enthusiasm,Self-evaluation of learning efficiency,the effect of the medical record writing in-class training and so on was used to do the survey.On the other hand,questionnaire for teachers included students' performance,students' writing ability,etc.100 students and 50 teachers were investigated with the survey.The percentage of the options of each question on the questionnaire was calculated in order to analyze the new teaching mode.Results The random questionnaire survey showed that 85％ (85/100) of the students believe that the new teaching mode can activate classroom atmosphere and improve learning motivation.About 62％(62/100) of the students said medical record writing errors can be obtained and corrected timely in-class training.Most students in grade 2009 have better capacity in medical record writing than those students who did not contact with new teaching mode.Conclusion The teaching model of simulated patient role play in the analogue inquiry and medical record writing is efficient and feasible in medical education,which can improve students' practical ability and is expected to be applied in undergraduate medical education.

Objective To evaluate the efficacy and safety of acarbose tablets combined with protamine zinc recombinant lai pulp mixing insulin injection in the treatment of elderly patients with type 2 diabetes.Methods 170 elderly patients with type 2 diabetes were randomly divided into the observation group and the control group.85 cases in the observation group were given acarbose tablets combined with protamine zinc recombinant lai pulp mixing insulin injection,85 cases in the control group received aspart 30.The patients were followed up for 12 weeks,the blood glu cose levels,blood glucose fluctuation,glycosylated hemoglobin (HbAlc),the incidence of hypoglycemia and insulin dosage were observed.Results' The level of fasting plasma glucose (FPG) (t =9.92,P ＜ 0.05),2h postprandial blood glucose(2hPG) (t =18.18,P ＜0.05),the mean blood glucose within 4h(t =13.62,P ＜0.05),days of average blood glucose fluctuations (t =14.56,P ＜ 0.05) of observation group dropped significantly compared with that before treatment;HbAlc achieved rate(6.5％)of the observation group and control group were 35.29％,28.23％,re spectively,HbAlc achieved rate (7.0％) of observation group and control group were 57.64％,52.94％,the differences were not statistically significant(all P ＞ 0.05).The dose of insulin was significantly lower in the observation group(20.11 ±3.36) u/d than(35.78 ±4.68) u/d in the control group(t =25.08,P ＜0.01).There were 2 cases of hypoglycemic events and 3 cases in the control group.Conclusion Protamine zinc recombinant insulin lispro injection combined with acarbose has reliable clinical efficacy and safety.

Objective To establish a HPLC method for determining the serum methotrexate(MTX)concentration in children patients for monitoring the blood drug concentration in clinic.Methods The chromatographic analytical column was the Shimaduz C-18 colum(250 mm×4.6 mm,5 μm),the mobile phase was 0.025 mol/L NaH2 PO4 (pH 5.41)-methanol(76∶24,V/V).The flow rate was 1 .0 mL/min.The detection wavelength was 313 nm.The column temperature was set at 35 ℃.The plasma samples were deposited down the protein with 10% HClO4 ,the supernatant liquid 130 μL added with 1 mol/L NaOH 10 μL was directly injected for determination.Results The mass concentration of MTX in the range of 0.00-4.84 μmol/L and 4.84-10.00 μmol/L showed the good linear relation with the peak area,r 1 =1 ,r2 =1 .The mean recovery rates were 61.67%and 71.83%.Intra-day and inter-day precision were <10% and 12%,respectively(n =3).Conclusion The used method is simple,accurate and reliable with high sensitivity,good reproducibility and wide linearity range,which is suitable for the monitoring blood MTX concentration.

Generalized epilepsy with febrile seizures plus(GEFS+)is a familial in herited epileptic syndrome characterized by phenotypic heterogeneity from the mi lder febrile seizures to the severest epileptic encephalopathy such as severe my oclonic epilepsy in infancy(SMEI).GEFS+ is a disorder with a genetic heterogen eity.Molecular genetics have revealed that four genes are associated with the p athogenesis of GEFS+.These include mutations in genes encoding subunits of neur onal voltage-gated sodium channels(SCN1A,SCN1B,SCN2A)and ?2 subunit of the gamma amino-butyric acid(GABA)A receptor(GABRG2).These genes have be en confir med as having a role in autosomal dominant GEFS+ families.In addition,the phen otypes of the affected members may depend on the types and locations of these ge ne mutations.This review states the molecular genetic progress of GEFS+ in brie f.