BACKGROUND: Cancer stem cells have bean a hot topic in life science research. EpCAMhigh/CD44+ colorectal cancer stem cells are beneficial to observe morphological characteristics and distribution of cancer stem cells.OBJECTIVE: To investigate the quantity, location, distribution and hematoxylin-easin staining morphologic features of colorectal cancer stem cells (Co-CSCs).DESIGN, "rIME AND SETrlNG: The observational study was performed at the Department of Pathology, Lanzhou General Hospital of Lanzhou Military Area Command of Chinese PLA from March to August 2008.MATERIALS: A total of 67 colorectal cancer paraffin embedding samples were collected from 200512007 archive at the Department of Pathology, Lanzhou General Hospital of Lanzhou Military Area Command of Chinese PLA, comprising 27 males and 40 females, aged 29 90 years.METHODS: EpCAM and CD44 was used to label cancer stem cells in paraffin embedding colorectal cancer samples. The locations of EpCAM and CD44 double positive cells were detected by SP(streptavidin HRP) immunohistochemical staining and double immunohistochemical staining. The morphologic features of them were investigated on hematoxylin-easin staining at the same position.MAIN OUTCOME MEASURES: Number, location, distribution of EpCAM and CD44-posltive cells, and morphology following hematoxylin-eosin staining.RESULTS: The number of double-positive cells accounted for 0.1% to 30.0% of all tumor cells, and the cells were scattered or distributed focally along the basement of glandular-like structure. The cells with scarcely cytoplasm were cube or oval, and its nucleus was oval or high cylindrical, deep stained and homogeneous; The quantity of double-positive cells were negatively correlated with the differentiation of colorectal cancer.CONCLUSION: Cancer stem cells are the causes of tumor development, metastasis and recurrence and drug resistance. To observe the number, location, distribution and morphology of Co-CSCs and to analyze the relationship between Co-CSCs and pathological parameters will provide guidance for the diagnosis, staging, prognostic evaluation and clinical prognosis of cotorectal carcinoma.

In practice of forensic medicine, potential disease can be associated with fatal asphyxia in restraint position. Research has demonstrated that nitric oxide (NO) and nitric oxide synthase (NOS) are plentifully distributed in skeletal muscle, contributing to the regulation of contractile and relaxation. In the current study, respiratory functions, indices of diaphragmatic biomechanical functions ex vivo, as well as NO levels in serum, the expressions of diaphragmatic inducible NOS (iNOS) mRNA, and the effects of L-NNA on contractility of the diaphragm were observed in sepsis induced by cecal ligation and puncture (CLP) under the condition of restraint position. The results showed that in the CLP12-18h rats, respiratory dysfunctions; indices of diaphragmatic biomechanical functions (Pt, +dT/dt(max), -dT/dt(max), CT, Po, force over the full range of the force-frequency relationship and fatigue resistance) declined progressively; the NO level in serum, and iNOS mRNA expression in the diaphragm increased progressively; force increased significantly at all stimulation frequencies after L-NNA pre-incubation. Restraint position 1 h in CLP12 h rats resulted in severe respiratory dysfunctions after relative stable respiratory functions, almost all the indices of diaphragmatic biomechanical functions declined further, whereas little change took place in NO level in serum and diaphragmatic iNOS mRNA expression; and the effects of L-NNA were lack of statistical significance compared with those of CLP12 h, but differed from CLP18 h group. These results suggest that restraint position and sepsis act together in a synergistic manner to aggravate the great reduction of diaphragmatic contractility via, at least in part, the negative modulation of NO, which may contribute to the pathogenesis of positional asphyxia.
Animals ; Asphyxia ; Diaphragm/physiology* ; Muscle Contraction ; Muscle, Skeletal ; Nitric Oxide/metabolism* ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Rats ; Respiration Disorders ; Restraint, Physical ; Sepsis

BACKGROUND:Tumor recurrence results from the incomplete removal of cancer stem cel s with self-renewal characteristics, and then how to label and eliminate cancer stem cel s becomes the key to cancer treatment. OBJECTIVE:To observe the morphology,distribution and number of CD44+/C-myc+METHODS:Pathological tissues from 150 patients with colorectal cancer were taken to prepare tissue microarray, in order to observe and count CD44 cel s in colorectal cancer, and to explore the relationship between the expression and postoperative metastasis.+/C-myc+cel s by using immunohistochemical double staining. Patients were fol owed up through mobile phones , letters , and so on, and the relationship between the expression of CD44+/C-myc+cel s and postoperative metastasis were statistical y recorded.RESULTS AND CONCLUSION:There was no CD44+/C-myc+cel s in normal tissue and little in adenoma. A smal number of CD44+/C-myc+cel s distributed as dots or focal lesions in adenocarcinoma. The number of CD44+/C-myc+cel s was related to the degree of adenocarcinoma differentiation, depth of invasion, and lymph node metastasis (P<0.05). The univariate analysis showed that the overal survival rate and progression-free survival rate were associated with the number of CD44+/C-myc+cel s, lymph node metastasis and Ducks staging in adenocarcinoma (P<0.05). The multivariate analysis showed that the overal survival rate was related to CD44+/C-myc+cel amount and the progression-free survival rate was related to CD44+/C-myc+cel amount and the Ducks staging. Therefore, CD44+/C-myc+cel s are probably cancer stem cel s, and Ducks staging and CD44+/C-myc+cel amount are important prognostic factors for colorectal cancer.

Objectives To study the level and development of serum specific antibody against severe acute respiratory syndrome coronavirus(SARS-CoV)of different populations in SARS pestilence district after SARS outbreak in a general hospital.Discuss SARS sub-clinical infection and protective action of the IgG antibody.Methods Seroepidemiology method,enzyme-linked immunosorbent assay (ELISA)and indirect immunfluorescence assay(IFA)were employed to investigate the changing level of serum antibody to SARS-associated coronavirus in non-SARS population in SARS pestilence district during and after SARS outbreak.The development of IgM and IgG antibody in patients with SARS in 6 weeks after the onset of SARS was studied qualitatively.The level changing of IgG antibody in con- valescent patients with SARS in 82 weeks after the onset was observed dynamically.Results The ELISA test outcome of IgG antibody was negative in 200 non-SARS people who were random samples of normal mass in SARS pestilence district and common community.The positive rate was 0.41% in 487 SARS high risk population tested by ELISA,but showed negative when retested by IFA.The A value level of IgG antibody existed significant difference in non SARS mass during and after SARS outbreak and the later's was higher them the former's(P

Objective To explore the detection methods for cognitive dysfunction of the major depression in Elderly and analyze their clinical significance.Methods Using matched-pairs study,42 patients with seniie de- pressive disorders(experimental group)and 42 normal aged people(control group)were examined with auditory e- voked potential P300(event related potential,ERP-P300)and SECF,respectively.Results It was found that the scores with registration,span,recall,classification and total score of the subjects in the experimental group were sig- nificantly lower than those in the control group(P

BACKGROUND: Reducing perioperative blood loss in total hip arthroplasty is a hot topic for joint surgeons. Both intravenous infusion and intra-articular injection of tranexamic acid significantly reduce perioperative blood loss, blood transfusion volume, and need for blood transfusion in patients undergoing total hip arthroplasty. However, differences between the intravenous and intra-articular methods are not clear.OBJECTIVE: To evaluate the effects of these two tranexamic acid administration methods on perioperative blood loss in patients undergoing total hip arthroplasty.METHODS: We are conducting a prospective, single-center, open-label, randomized, controlled clinical trial at the Tengzhou Central People's Hospital, China. Ninety patients undergoing unilateral total hip arthroplasty have been randomized into three groups. In the intravenous infusion group (n=30), 15 mg/kg tranexamic acid diluted in 100 mL physiological saline was infused intravenously at the beginning of surgery and 20 mL of physiological saline was injected intra-articularly after deep fascia suturing. In the intra-articular injection group (n=30), 100 mL of physiological saline was infused intravenously at the beginning of surgery and a mixture of 1.5 g tranexamic acid and 20 mL physiological saline was injected intra-articularly after deep fascia suturing. In the control group (n=30), 100 mL of physiological saline was infused intravenously at the beginning of surgery and 20 mL of physiological saline was injected intra-articularly after deep fascia suturing. The primary outcome is hidden blood loss at 1 and 3 days postoperatively. The secondary outcomes are visible blood loss, need for blood transfusion, and mean blood transfusion volume intraoperatively and on days 1 and 3 postoperatively. Other outcomes are the incidence of adverse reactions and complications within 3 months of surgery. The study protocol has been approved by the Ethics Committee of Tengzhou Central People's Hospital of China, approval number 2015-026. All protocols will be performed in accordance with the Ethical Principles for Medical Research Involving Human Subjects in the Declaration of Helsinki. Written informed consent was provided by each patient and their family members after they indicated that they fully understood the treatment plan.DISCUSSION: This trial was designed in April 2015. Cases were collected in July 2015. Data analysis will be finished in December 2017. This study is designed to investigate the effects of intravenous infusion versus intra-articular injection of tranexamic acid on perioperative blood loss in patients undergoing total hip arthroplasty to determine the more effective mode of administration.

Objective To compare the value of conventional ultrasound,hydrosonography and double-contrast enhanced ultrasound in the display capacity of periampullary carcinoma and its relationship with the surrounding tissue.Methods A total of 18 patients with the periampullary carcinoma were diagnosed pathologically or by endoscopic biopsy.Each patient had three imaging modalities by conventional ultrasound,hydrosonography and double-contrast enhanced ultrasound.The display capacity and the relationship between the mass and surrounding tissue were compared with three modalities.Results The display rates of limpid visibilities of carcinoma on conventional ultrasound,hydrosonography and double-contrast enhanced ultrasound were 16.7%(3/18),22.2%(4/18) and 94.4%(17/18),respectively;The display rates of duodenum protrusion on three modalities were 0(0/18),38.9% (7/18) and 72.2% (13/18),respectively,with significant differences among conventional ultrasound,hydrosonography and double-contrast enhanced ultrasound.The double-contrast enhanced ultrasound showed two cases of peripheral vascular invasion and one case of intrahepatic metastasis.Conclusion The double-contrast enhanced ultrasound can increase the display capacity of periampullary carcinoma as a new diagnostic modality for periampullary carcinoma.

BACKGROUND:Increasing reports have focused on the application of tranexamic acid to reduce bleeding during total knee arthroplasty, but its usage method remains controversial.
OBJECTIVE:To explore the impact of topical articular application of tranexamic acid and intravenous application of tranexamic acid on blood loss during primary unilateral total knee arthroplasty.
METHODS:According to randomized control ed principle, 90 patients who received unilateral total knee arthroplasty in the Tengzhou Central People’s Hospital from October 2013 to December 2014 were enrol ed in this study, and randomly assigned to intravenous injection group and topical injection group (n=45). Patients in the intravenous injection group were given tranexamic acid by intravenous injection (10 mg/kg, maximum 1.2 g) during the induction of anaesthesia. Patients in the topical injection group were given intraarticularly tranexamic acid (2 g dissolved in 50 mL physiological saline) before articular capsule suture and after prosthesis fixation. Drainage amount after replacement, hemoglobin and hematocrit on the next day after replacement, and the number of blood transfusion population were compared between the two groups. Simultaneously, clinical symptoms of pulmonary embolism and deep vein thrombosis in the lower limb were observed. If necessary, lower extremity vascular Doppler ultrasound was conducted.
RESULTS AND CONCLUSION:No significant differences in drainage amount after replacement, hemoglobin and hematocrit on the next day after replacement, the number of blood transfusion population, and the proportion of blood transfusion were detected between the two groups (P>0.05). No deep vein thrombosis was found in the lower limbs at 14 days after replacement in both groups. These findings confirm that compared with intravenous systemic application, periarticular topical application of tranexamic acid during total knee replacement could obtain identical effects on reducing blood loss and blood transfusion after surgery, and could avoid relevant complications of intravenous application of tranexamic acid.

Objective To explore the reason and remedy on tumor patients' PICC misplacement.Methods The reason of 32 tumor patients' PICC misplacement were analyzed. The patients whose PICC misplaced were observed by X-ray,and then regulated to precava before remove the wire.Results PICC misplacement was much more observed in patients who was sixty years old or above than that of their younger counterpart (x2 =4.733,P ＜0.05).87.5％ of PICC misplacement were observed in the ipsilateral vein and less observed in right upper extremity ( x2 =7.552,P =0.006).The rate of PICC misplacement of cephalic vein,median cubital vein and basilic vein respectively were 15.7％,8.89％ and 8.12％.And there was no significant difference was detected in the gender,method and the location of cancer ( P ＞ 0.05 ).Finally,all the misplacement PICC were regulated to the right place.Conclusions Adept technology makes success,and more attention should pay to elderly patients.It is better to insert PICC in patient' s right upper extremity,especially basilic vein,and then median cubital vein.Utilize the X-ray to adjust patients position,and matching inspiration to adjust PICC' s location in order to avoid misplacement.

Objective To explore the expression of P -glycoprotein ( P-gp) in rat liver during acute inflammation ( AI ) and the possible mechanism involved.Methods Twenty rats were randomly divided into two groups:model group (n=10) and control group (n=10).The rats in model group were treated by a single 5 mg? kg -1 intraperitoneal injec-tion of lipopolysaccharide ( LPS).Control rats received equivalent injec-tion of sterile normal saline.The levels of P-gp, ubiquitinated P-gp and 26 S proteasome activity in both groups were analyzed by Western blot, immunoprecipitation and fluorescence detection, respectively. Results Compared to the control groups, ubiquitination levels of liver P-gp and 26S proteasome activity in model groups were significantly in-creased ( P<0.01 ) , accompanied by an decrease of liver P-gp protein expression level. Conclusion The participation of the ubiquitin -proteasome system in down-regulation of liver P-gp expression levels under AI conditions.