Cancer stem cells (CSC) play a crucial role in the tumor angiogenesis.Angiogenic factors and hypoxia mediate the process.CSC car differentiate into vascular endothelial cells and participate in the formation of vasculogenic mimicry,which may be one of the key factors in the initiation and progression of tumors.lndepth studies of the roles of CSC in tumor angiogenesis might help provide the basis for developing more effective therapeutic drug target.

Objective To explore the efficacy and safety of different doses of budesonide mixed suspension atomization inhalation in children with post infectious cough,and provide reference for the rational use of budesonide.Methods One hundred and twenty children with post infectious cough aged 2-14 years old were selected and divided into three groups by random digits table method (40 cases in each group).Control group was treated with 4 mg once montelukast sodium chewable tablets for 2-5 years old children,or 5 mg once for 6-14 years old children.Low-dose group was treated 2 times/d with a dose of 0.5 mg budesonide mixed suspension diluted in normal saline to 4 ml based on control group and high-dose group was treated 2 times/d with a dose of 1.0 mg budesonide mixed suspension diluted in normal saline to 4 ml based on control group.The outcome of curative effects were recorded and analyzed after 7 days of treatment.Results The total efficacy rate was 70.0％(28/40),52.5％(21/40),35.0％(14/40) in high-dose group,low-dose group and control group after 3 days of treatment,and there was significant difference between high-dose group and control group (P＜ 0.01).The total efficacy rate was 92.5％(37/40),90.0％(36/40),72.5％ (29/40) in high-dose group,low-dose group and control group after 7 days of treatment,and there was no significant difference(P ＞ 0.025).Few adverse events associated with inhaled corticosteroids,such as thrush,sore throat,hoarseness were observed in three groups.Conclusions Budesonide mixed suspension atomization inhalation alleviates symptom of post infectious cough significantly with no obvious side effects,even in high-dose group which has a more outstanding efficacy.Therefore,this therapy is valuable in clinical application.

Objective To compare the therapeutic effect in two kinds of inhalation in infant asthmatic bronchitis.Methods Two hundred and twelve asthmatic bronchitis children were randomly divided into group A (103 cases) and group B (109 cases).The children in two groups were treated with conventional therapy,including antibiotics,fluids and other treatment.The children in group A were given budesonide 1 mg,terbutaline 5 mg plus 0.9％ sodium chlorine in 2 ml,with oxygen driven inhalation therapy,2-4 times/d.The children in group B were given albuterol sulfate inhalation aerosol 1-4 spray/times,4-6 times/d,inhaled fluticasone quantitative aerosol spray 1-2 spray/times,2 times/d,15 s/times.The course of two groups was 5-7 d.The therapeutic effect was compared.Results The total effective rate in group A and group B were 92.2 ％ (95/103) and 97.2 ％ (106/109),there was no significant difference (x2 =2.73,P ＞ 0.05).The relieve time of cough,gasping and wheezing,hospital stay in group B were shorter than those in group A [(12.00 ± 2.75) h vs.(29.00 ± 1.25) h,(10.00 ± 1.45) h vs.(31.00 ± 2.75) h,(13.00 ± 1.55) h vs.(33.00 ± 2.33) h,(7.20 ± 0.65) d vs.(8.70 ± 1.35) d],the cost of hospitalization in group B was lower than that in group A [(2.00 ± 0.30) thousand Yuan vs.(2.50 ± 0.55) thousand Yuan],there were significant differences(P ＜ 0.05).Conclusions The albuterol inhalation solution combined with fluticasone has the advantages of rapid efficacy,short course,low cost,easy to accept and adjust.It is worth to spread in primary hospital.

Objective To explore CT angiography(CTA) method for the influence of the cerebral angiography ,looking for dif-ferent situations using which kind of scan mode can achieve the best results .Methods 350 CTA patients were selected and tested by 4 kinds of scanning methods which were subtraction scan (236) ,experience value scan (13) ,smart tracking scan (68) ,smart tracking and subtraction combined(33) .To compare and analyze that four kinds of scanning methods ,to explore which kind of method under what circumstances can get the best examination results .Results Smart tracking and subtraction combined with scan method and subtraction scan method for excellent rate of image quality were 93 .93% and 93 .64% respectively ,there were no sig-nificant statistical differences between them .Experience value method and smart tracking method for excellent rate of image quality were only 76 .92% and 66 .18% ,there was significant difference in statistics .Conclusion Subtraction scan can be used as a conventional scan method .In low dose test bolus of time-density curve detection failure cases ,smart tracking and subtraction combined with scan method was used to get the image quality with subtraction scan method ,it is an effective complement of subtraction scan method ,is worth generalization .

[ABSTRACT]AIM:ToobservetheeffectofthesignalingpathwayofproteinkinaseC(PKC)-nuclearfactor-ery-throid 2-related factor 2 (Nrf2) on the expression of heme oxygenase-1 (HO-1) induced by cigarette smoke extract (CSE) in the rat airway epithelial cells .METHODS:After exposed to CSE , the airway epithelial cells of male SD rats were di-vided into control group , CSE3 group, RO318220 group, Nrf2 siRNA group and RO318220+Nrf2 siRNA group.The pro-tein levels of HO-1, Nrf2 and PKC were semi-quantified by Western blotting .The protein expression of HO-1 was assessed by immunocytochemistry .The mRNA expression of HO-1 was detected by reverse transcription-polymerase chain reaction ( RT-PCR) .Nrf2 protein location was observed by immunofluorescence staining .HO-1 activity was also determined .RE-SULTS:After exposure to CSE for 3 h, the Nrf2 protein was mainly located in the nucleus , and the expression level of Nrf2 protein in the nucleus was stronger than that in the control cells .CSE also significantly enhanced the levels of p-PKC protein, and HO-1 mRNA, protein and activity .Pretreatment with RO318220 significantly decreased the levels of PKC pro-tein, Nrf2 protein, and HO-1 mRNA, protein and activity.Meanwhile, Nrf2 protein significantly decreased , and the activ-ity, mRNA and protein levels of HO-1 were also significantly attenuated by pretreatment with siRNA to knock down Nrf2. Pretreatment with RO318220 and Nrf2 siRNA significantly decreased the PKC protein , Nrf2 protein, and HO-1 mRNA, protein and activity .CONCLUSION:CSE up-regulates the HO-1 expression through PKC-induced nuclear translocation of Nrf2 in the rat airway epithelial cells .

Objective To investigate the analgesic effect and safety of intravenous flurbiprofen axetil combind with fentanyl and propofol on coloscopy.Methods Ninety patients undergone coloscopy were randomly assigned into three groups according to different analgesics received(30 in each,groupⅠ: fentanyl 1?g/kg;groupⅡ flurbiprofen axetil combined with fentany 0.5?g/kg;group Ⅲ: fentany 0.5?g/kg).Patients in group Ⅱ received intravenous flurbiprofen axetil 1mg/kg 10min before examination.All patients were given intravenous midazolam 0.02mg/kg 2mins before examination,however patients in group Ⅰ received intravenous fentanyl 1?g/kg followed by intravenous propofol 0.5-1mg/kg,whereas patients in group Ⅱ and Ⅲ received intravenous fentanyl 0.5?g/kg followed by equal dosage of propofol.Propofol was administrated according to patients' reaction during examination.After the examination all patients were transferred to recovery room.BP,HR and SpO2 were measured before and after drug administration,when the coloscope reached the splenic flexure of the colon and after the examination.Dosage of propofol and fentanyl,duration of coloscopy,side effects and patients' memory of pain during examination were recorded.Results Propofol dosages of the three groups were 82.0?23.8mg,73.0?25.0mg and 108.2?36.5mg,respectively.Propofol dosage of group Ⅲ was much larger than that of groups Ⅰand Ⅱ(P0.05).Dizziness and nausea occurred in 17 patients in group Ⅰ when they left the recovery room,whereas the same side effects only appeared in one patient in group Ⅱ and 3 patients in group Ⅲ,respectively.It was shown by follow-up that all patients of the three groups had no memory of pain.Conclusion Intravenous flurbiprofen axetil may strengthen intraoperative analgesia during coloscopy,reduce the dosage of fentanyl and propofol,and decrease the side effects of anesthesia.

Objective To study the effects of total intravenous anesthesia and combined inhalation and intravenous anesthesia on arousing time and recovery quality in rectifying surgery of scoliosis. Methods Forty patients (ASAⅠ-Ⅱ) were divided randomly into total-intravenous anesthesia group and combined inhalation and intravenous anesthesia group (n=20 each). Target controlled infusion (TCI) with propofol (2-4?g/ml) was used for maintenance in total intravenous anesthesia group, while isoflurane (0.8%-1.5%) and nitrous oxide (50%) were used in combined inhalation and intravenous anesthesia group. TCI remifentanyl (2-6ng/ml) was used for maintenance in both groups. Results Arousing time were 19.7?5.1min in total intravenous anesthesia group, but 11.9?3.3 min in combined inhalation and intravenous anesthesia group (P

Objective To compare the influences of sulfentanyl or fentanyl combined with midazolam on respiratory function in slow induction of anesthesia.Methods Forty ASA Ⅰ-Ⅱ patients were divided into two groups.Anesthesia was induced with midazolam 0.03mg/kg in both groups,and fentanyl 2?g/kg(i.v.)was given in fentanyl group or sulfentanyl 0.2?g/kg(i.v.)in sulfentanyl group.Five minutes later,2ml of 1% decicaine was administered by cricothyroid membrane puncture to facilitate the intubation.Respiratory indexes(respiratory frequency,VT,MVV,PETCO2,SPO2),circulatory indexes(MAP,HR)and sedation level were measured before and 1,2,3,4,5 minute(s)after injection of drugs,at cricothyroid membrane puncture,and pre-and post-intubation.Results Patients showed respiratory depression(respiratory frequency was reduced)in both groups 2 minutes after injection of drugs.However,respiratory frequency was decreased more markedly in fentanyl group than that in sulfentanyl group.Ten out of 20 patients were obliged to receive breathing intervention in fentanyl group,but two in sulfentanyl group.Conclusion In combination with midazolam,sedative effect of sulfentanyl is stronger than that of fentanyl in equivalent analgesic dose,but with less respiratory depression.Sulfentanyl may be more suitable for slow induction of anesthesia.

Objective To study the relationship between serum soluble interleukin-2 receptor (SIL-2R) titer and severity of involved muscles and transient aggravation due to large dose corticosteroid therapy in patients with myasthenia gravis.Methods 30 severe patients with MG were classified according to improved Osserman method. The involved voluntary muscles were divided into seven groups. The severity of MG was recorded with five grades and four parts formulation. The absolute integral was taken as the index of MG degree. ELISA was used to measure the titer of serum SIL-2R.Results Remarkable difference was found between patient group and control group both in the SIL-2R titer and the severity of MG(all P0.05) when the cases aggravated transiently during large-dose corticosteroid therapy.Conclusion Cell immunity is abnormal in patients with MG. SIL-2R may reflect the severity of involved muscles.

Hypoxia-inducible factor (HIF) is an important transcriptional factor,which plays crucial role in response to hypoxia.HIF is highly expressed in many human cancers,and it is closely related to tumor angiogenesis.HIF promotes tumor growth,invasion and metastasis via up-regulating vascular endothelial growth factor gene and starting associated angiogenesis.With the in-depth study of HIF regulation of tumor angiogenesis mechanism,HIF is expected to become an important target for anti-angiogenesis therapy.