Recently, stem cell like side population (SP) cells have been found in many normal organizations and malig?nant tumors, which have the proficiency of differentiation and self-renewal. These cells play an important role in cancer stem cell research, though they occupy a low proportion in total cells. Here, we reviewed the foundation of SP cells, and their rela?tionship with stem cells, and the clinical application in the future.

Objective To explore the effects of Shenfu injection combined with low-dose hydrocortisone on plasma lev?els of human leukocyte antigen (HLA)-DR and procalcitonin (PCT) in patients with septic multiple organ dysfunction syn?drome. Methods A total of 118 patients with septic multiple organ dysfunction syndrome were divided into three groups:control group (n=39), experimental group 1 (n=39) and experimental group 2 (n=40). The control group received conventioanl medicine therapy, while the experimental group 1 received Shenfu injection (100 mL, 2/d, for 7 d) combined with conventio?anl medicine therapy, and the experimental group 2 received Shenfu injection combined with low-dose hydrocortisone (200 mg/d, for 14 d) besides conventional medicine therapy. The peripheral blood samples were collected for the detection of HLA-DR, PCT and lipoperoxide (LPO) before treatment, 1 d, 3 d amd 7 d after treatment. The mortality in 14 d was record?ed. Results The mortality rates in 14 d were 61.5%(24/39), 41.0%(16/39) and 25.0%(10/40) for control group, experimen?tal group 1 and experimental group 2 (χ2=8.15, P<0.05). There were no significant differences in PCT, HLA-DR and LPO levels before treatment and 1 d after treatment between the three groups (P>0.05). The plasma levels of PCT and LPO were significantly decreased in control group, experimental group 1 and experimental group 2 after 3-d and 7-d treatment, but the levels of HLA-DR was significantly increased (P < 0.05). Conclusion The combination therapy of Shenfu injection and low-dose hydrocortisone can effectively reduce PCT level and increase HLA-DR level, which promotes the improve?ment of patients with septic multiple organ dysfunction syndrome.

Objective To investigate the expressions of high mobility group box-1(HMGB1) and high sensitivity C-re?active protein (hs-CRP) in patients with acute coronary syndrome (ACS) and the effects of atorvastatin on the two inflamma?tory cytokines. Methods A total of 90 patients with ACS and 90 cases of normal control subjects were selected in this study. The serum concentrations of HMGB1 and hs-CRP were measured before treatment in patients of ACS. Patients were randomly divided into two groups:control group (n=45) and atorvastatin group (n=45). Atorvastatin was given 20 mg/24 h and 40 mg/24 h. Blood samples were obtained from the patients for detection of HMGB1 and hs-CRP one week after treatment with atorvastatin. Results There were significantly higher serum levels of HMGB1 and hs-CRP in patients with ACS than those of control subjects (P<0.01). The level of HMGB1 was positively correlated with the level of hs-CRP in patients of ACS (r=0.389, P<0.01). Before treatment, there were no significant diffferences in level of HMGB1 and hs-CRP in patients with ACS between the two groups. After treatment with atorvastatin, the levels of HMGB1 and hs-CRP were decreased in the two groups of ACS, and those were significantly lower in the intensive group than the standard group (P<0.05). Conclu?sion HMGB1 could stimulate the secretion of hs-CRP and other inflammatory cytokines, playing an important role in the process of occurrence and development of atherosclerosis. High loading dose of atorvastatin may reduce the expression of HMGB1 and decrease the inflammation, and stabilize the plaques in patients with acute coronary syndrome.

Objective To observe the hemostatic efficacy and safety of argon plasma coagulation (APC) through bron?choscope after biopsy. Methods The APC was given to patients suffered from coronary heart disease combined hyperten?sion or paroxysmal auricular fibrillation and accepted bronchoscopy biopsy with much bleeding. The hemostatic effect and changes of heart rate, blood pressure and SPO2 were observed before and after treatment. Results Sixty-two patients were treated with endoscopic hemostasis by APC. The hemostasis was successful in 60 cases. The hemostasis was performed with APC successfully in 2 patients after intubation and mechanical ventilation because of the biopsy hemorrhage. Sixty-two cas?es included 42 cases of airway tumor (26 cases in lobe bronchus and 16 in segmental bronchus), 16 cases of broadening of the trachea ridge and mucosal rough, and 4 cases of granulation tissue of lobe bronchus. There were no significant differenc?es in mean arterial pressure and heart rate before and after treatment in 60 patients (P>0.05). The oxygen saturation was sig?nificantly lower after treatment than that before treatment (0.939±0.027 vs. 0.956±0.017, P<0.05). Conclusion Hemosta?sis treatment by APC through bronchoscope has the characteristics of rapid, thorough and safe, especially for patients com?bined with cardiovascular disease. It can avoid the occurrence of cardiovascular system complications caused by convention?al hemostatic treatment.

Objective To analyze the skeletal structure features of temporomandibular joint (TMJ) by using cone beam computed tomography (CBCT) in patients with sleep bruxism. Methods CBCT scanning was performed in the intercuspal position in 30 patients with sleep bruxism (sleep bruxism group) and 30 health adults (normal group). The reconstruction of TMJ images were analysed by Invivo5 software. Measurements of horizontal section include antero-posterior diameter, medial-lateral diameter and axial angel. Measurements of sagittal section include acetabulum depth, aricular eminence inclination, anterior space, superior space and posterior space. Measurements of coronal section include force angle. Results There were no significant differences in both sides of TMJ between sleep bruxism group and normal group(P>0.05). Compared with control group, there were significant differences in antero-posterior diameter, medial-lateral diameter, acetabulum depth, anterior space and force angle in sleep bruxism group (P<0.05). There were decreased antero posterior diameter, me?dial-lateral diameter and increased acetabulum depth, anterior space and force angle in sleep bruxism group than those of control group. Conclusion The bilateral bone stuctures of TMJ are basically symmetry in patients with sleep bruxism. There is no significant change in condylar position in acetabulum , but there is a trend of absorbtion of anterior space and de?crease of condyle in patients with sleep bruxism.

Objective To analyze the clinical and laboratory characteristics of the ischemic stroke in patients with non-valvular atrial fibrillation (AF), and to provide evidence for the prevention of ischemic stroke. Methods A total of 198 patients with ischemic stroke were chosen and divided into two groups:with AF (71 patients)/and without AF (127 patients) groups. Clinical data and biochemical markers were collected and compared in two groups. CHADS2 and CHA2DS2-VASc score systems were used to determine the risk levels in patients with AF. Finally, related risk factors of ischemic stroke with AF were determined and analyzed. Results The values of age, length of hospital stay, the hypertention history, heart rate and plasma homocysteine (Hcy) were significantly higher in the with-AF group than those in the without-AF group ( P <0.05). The levels of total cholesterol (TC), triglyceride (TG) and very low density lipoprotein cholesterol (VLDL-C) were sig?nificantly lower in the with-AF group than those of the without-AF group (P<0.05). CHA2DS2-VASc scores reached to the moderate-to-high risk level in the with-AF group. Multiple-factor logistic regression analysis showed that age and heart rate were the independent risk factors of the ischemic stroke in patients with non-valvular AF. ROC analysis indicated that age (AUC=0.761, cut-off point=72.50 years old) and heart rate (AUC=0.612, cut-off point=76.50 bit/min) had predictive and di?agnostic value for the ischemic stroke in patients with non-valvular AF. The age of these patients had the best sensitivity (70.4%) and specifity (71.1%), and the cut-off point of which was 72.50 years old. Conclusion The characteristics of isch?emic stroke in patients with non-valvular AF includes older age, faster heart rate, higher CHA2DS2-VASc scores and higher Hcy level.

Objective To study the clinical value of bedside ultrasound in predicting the fluid responsiveness in pa?tients with septic shock in intensive care unit (ICU). Methods Forty-two mechanically ventilated patients with septic shock who admitted to ICU of the Affiliated Hospital of North China University of Science and Technology from January 2015 to April 2015 were included in this study. All patients were treated with volume expansion (VE) text. Hemodynamics in?dexes were obtained by ultrasound before and after each test, including stroke volume (SV), aortic peak blood flow velocity variation rate of breathing (△VpeakAO), inferior vena cava expansion index (△IVC) and brachial artery maximum speed vari?ation rate (△VpeakBA). Clinical data and central venous pressure (CVP) were recorded. Based on the responsiveness of SV, patients were divided into responsive group (R) and non-responsive group (NR), respectively. The differences of the above in?dexes were compared between two groups. The correlation of△IVC,△VpeakAO,△VpeakBA and△SV was determined. The role of the hemodynamic index for predicting volume responsiveness was evaluated by receiver operating characteristic ROC curves. Results A total of 47 VE tests were performed in 42 patients, 25 in R group and 22 in NR group. Before VE test, the hemodynamics indicators of△IVC,△VpeakAO and△VpeakBA were significantly higher in R group compared with those of NR group (P<0.05). The values of△IVC,△VpeakAO and△VpeakBA were positively correlated with△SV in two groups. The areas under the ROC curve of the hemodynamics indicators were 0.825, 0.853 and 0.866 for △IVC, △VpeakAO and△VpeakBA, and they all showed high sensitivity and specificity. Conclusion The hemodynamic index measured by bedside ultrasound can predict the volume responsiveness in mechanically ventilated patients with septic shock fluid therapy, and which can be used to fluid therapy with a high degree of specific and sensitivity in clinical practice.

Objective To analyze the differences of positive detection rate and copy number of human papillomavirus (HPV) DNA and E6/E7 mRNA between different grades of cervical lesions, and evaluate their clinical values in early screen?ing of cervical cancer. Methods The cervical exfoliated cell samples from 154 women undergoing biopsy examination and 32 objects undergoing hysterectomy (control group) were collected in Tianjin Central Hospital of Gynecology Obstetrics in 2014. According to the pathological results of cervical biopsy, 154 samples were divided into low-grade squamous intraepi?thelial lesion group (LSIL, n=51), high-grade squamous intraepithelial lesion group (HSIL, n=71), and squamous cell carci?noma group (SCC, n=32). HPV DNA was tested with hybrid capture technology, and E6/E7 mRNA was detected with fluores?cence quantitative hybridization. Immunohistochemistry was performed by detecting E6/E7 protein in all patients after sur?gery or cervical biopsy. Results Combined results of HPV DNA and E6/E7 mRNA demonstrated that the positive detection rate was significantly lower in control group than that of all levels of lesion groups (P<0.05). The copy number of high risk HPV E6/E7 mRNA was significantly increased with the aggravation of lesions (P<0.05), whereas no difference was found in that of HPV DNA. Compared with the normal control and low-grade squamous intraepithelial lesion group, cervical cancer patients with mRNA copies > 10 000 E6/E7 were significantly increased in high-grade squamous intraepithelial lesion group. Immunohistochemical results showed that the positive detection rate of E6/E7 was significantly lower in control group than that of all levels of lesion groups (P<0.05). The positive rate of E6/E7 was significantly higher in the high-grade squa?mous intraepithelial lesion group than that of low-grade group (P<0.05). Conclusion HPV infection is closely related to cervical abnormalities, which is one of effective measures for early screening of cervical cancer. The negative result of HPV DNA is very helpful to exclude the cervical abnormality, whereas the positive detection of mRNA has great value in predict?ing the disease. Combined results of positive detection and copy number make a comprehensive evaluation for the risk of cer?vical lesions.

Objective To explore the most accurate T staging and optimal surgical method of lung adenocarcinoma of trans-lobe type, and to provide supportive diagnosis as well as therapeutic evidences for this disease. Methods A total of 192 postoperative patients, hospitalized in Tianjin Medical University General Hospital from January 2008 to June 2013, who were diagnosed with lung adenocarcinoma were recruited. Patients were divided into three groups according to the 7th edition of TNM staging criteria issued by the IASLC in 2009. A total of 163 patients with T2 stage were selected as Group T2, and 12 patients with T3 stage were selected as Group T3, both of which were considered as control groups. Other 17 pa?tients who were diagnosed as trans-lobe type of lung adenocarcinoma, were Group trans-lobe. The clinical data and progno?sis were compared between three groups. The trans-lobe type of lung adenocarcinoma was diagnosed based on imaging and pathological examination. Subtypes of trans-lobe lung adenocarcinoma were identified by referring to 2011 international mul?tidisciplinary classification standard of lung adenocarcinoma. Kaplan-Meier method was used to analyze the prognosis of dif?ferent subtypes and surgical modus in patients with lung adenocarcinoma of trans-lobe type. Results By comparison, the postoperative survival rate was significantly lower in patients diagnosed with trans-lobe type of lung adenocarcinoma than that of Group T2 (P<0.05), and no significant difference in survival rate compared with Group T3 (P>0.05). There were no significant differences in survival rates between different surgical modus (P<0.05). Seventeen patients with trans-lobe type of lung adenocarcinoma consisted of four subtypes, including 8 solid predominant, 5 acinar predominant, 3 papillary predomi?nant and 1 invasive mucinous adenocarcinoma. There were no statistical significances in postoperative survival time and sur?vival rates between four subtypes. Conclusion The clinical stage of trans-lobe type of lung adenocarcinoma should be clas?sified as stage T3. Both pulmonary bilobectomy and lobectomy combined with resection of proximal invaded lobe can be used as effective surgical therapies for trans-lobe type of lung adenocarcinoma.

Objective To observe the effects of ischemic postconditioning (I-postC) on lung injury after limb ischemia reperfusion (LIR) in rats, and to investigate the protective effect and the mechanisms. Methods Twenty-four Wistar rats were divided into three groups:control group (group Control), ischemia-reperfusion group (group IR) and ischemic postcondi?tioning group (group I-postC). Referring to routine method in our department, the model rats underwent 4-hour ischemia and 4-hour reperfusion of hind limbs were made. In group Control, the rubber band around the limb was loose,which did not block the blood flow. Rats in group I-postC were given repeated 3 times of 5 min ischemia-5 min reperfusion, and then did perfusion 4 h before reperfusion. The blood and lung samples were collected for detecting arterial gas of partial pressure of oxygen [p(O2)] and partial pressure of carbon dioxide [p(CO2)]. The plasma and lung tissue levels of malondialdehyde (MDA), superoxide dismutase (SOD) and xanthine oxidase (XOD) were detected. The morphological changes of lung tissue were ob?served under light microscope and electron microscope. Results It was found that after suffering from ischemia-reperfu?sion, levels of p(O2) and p(CO2) decreased significantly. The activity of SOD in plasma and lung tissues decreased, but XOD and MDA increased significantly (P<0.05). With microscope, lung interstitial vascular dilation, infiltration of neutrophils, the width of the alveolar space, alveolar septal thickening and alveolar exudate were found. Compared with IR group, it was found that p(O2) and p(CO2) increased significantly in group I-postC. The activity of SOD in plasma and lung tissues in?creased, but XOD and MDA decreased significantly(P<0.05). The mild damage of pathological changes were found. Conclu?sion Ischemic postconditioning can reduce the lung injury after limb ischemia reperfusion in rats, which may be related to the inhibition of lipid peroxidation.