Origin of lymphoma stem cells is very complicated,it is proposed that committed lymphoid progenitor/precursor cells(CLP)with V-D-J recombination are stem cells of follicular lymphoma(FL)and mantle cell lymphoma (MCL).Conversely,B lymphocytes within the germinal center as the diffuse large B-cell lymphoma (DLBCL)and sporadic Burkitt lymphoma (BL)stem cells.An alternative model supports an epigenetic modification of genes as the first occurring hit,which leads to retaining stem-cell features in hematopoietic cells, followed by secondary chromosomal translocations that eventually transformed into lymphoma.Isolation and characterization of the different B-cell non-Hodgkin lymphomas will provide critical insights into the disease pathogenesis and will represent a step towards the development of more effective therapies.

Myeloid leukemias are clonal disorders originating from a primitive multipotential hematopoietic cell and characterized by aberrant proliferation, differentiation and maturation of leukemic progenitors and precursor cells. Studies have identified sub-populations of leukemic cells possessing different functional capabilities. Hypothesis hold that the heterogeneity is mainly due to leukemia stem cells (LSC). Data from the past decade implied that LSC has impact on the care of myeloid leukemias. The history of LSCs and the more recent data of the origin, immunophenotype, frequency and self-renew ability of LSCs are reviewed.

Neonatology probation teaching is one of the difficulties in eight-year program pediatric teaching.There are some problems in the neonatology probation teaching,including partial comprehension of neonatal basic theoretical knowledge,few opportunities of clinical operations and observation,lack of effective physician-patient communication method,defective mastering of neonatal clinics skills.In order to refine the neonatology probation of eight-year program medical students and to improve the quality of hospitals' clinical teaching,an appropriate neonatology clerkship program of eightyear medical students should be investigated.A variety of teaching methods should be applied to enhance students' interest of learning the basic theory.Before entering the neonatal ward,it is necessary for eight-year program medical students to understand the workflow and a standard appraisal system should be established.At the same time,it is essential to strengthen the training of their interpersonal communication skills,clinical thinking and clinical skills.Finally,a standard out-department examination system should be established to evaluate the eight-year program medical students' neonatology learning effect objectively.

Objective To investigate the changes of human leukocyte antigen-G (HLA-G) protein expression and Th1/Th2 type cytokines in intrahepatic cholestasis of pregnancy (ICP) and their relativity to the etiology of ICP. Methods Peripheral blood and placental tissues were obtained from 26 ICP patients (the ICP group) and 22 normal pregnant women (the NP group) in the operation room for Cesarean birth. Immunohistochemistry was used to detect the expression of HLA-G protein in the placental tissues. Meanwhile we tested the concentrations of tumor necrosis factor-α (TNF-α) and interleukin-4 (IL-4) by enzyme-linked immunosorbent assay (ELISA) in the peripheral blood and checked the levels of TBA in the serum.Results TBA level in the ICP group was (27.05±6.08) μmol/L, significant higher than that in the NP group (4.35±2.68)μmol/L (P＜0.01). The positive expression of HLA-G protein in extravillous trophoblast in the ICP group was significantly lower than that in the NP group (P＜0.01). The mean optical density (MOD) of positive expression of HLA-G protein in the placenta tissues in the ICP group (52.91±7.19) was significantly lower than that in the NP group (69.26±7.72) (P＜0.01). The concentration of TNF-α was significantly higher in the ICP group (101.31±19.30) pg/mL than that in the NP group (54.51±23.72) pg/mL (P＜0.01). The concentration of IL-4 was lower in the ICP group (22.16±6.55) pg/mL than that in the NP group (31.69±8.25) pg/mL (P＜0.01). The ratio of TNF-α/IL-4 was higher in the ICP group (4.52±1.91) than that in the NP group (1.72±0.61) (P＜0.01). There was a negative correlation between the MOD of HLA-G protein and TNF-α (r=-0.98, P＜0.01) in the ICP group. No correlation with IL-4 and TNF-α/IL-4 was seen (P＞0.05). There was a positive correlation between TBA and TNF-α (r=0.99, P＜0.01), and a negative correlation between TBA and the MOD of HLA-G protein (r=-1.00, P＜0.01) in the ICP group. No correlation with IL-4 and TNF-α/IL-4 was seen (P＞0.05). Conclusion There is an imbalance of Th1/Th2 cytokines to the Th1 type in the peripheral blood of ICP patients. The expression of HLA-G protein in the placenta of ICP patients decreases, leading to an increase of Th1 type cytokines that may be one of the reasons for liver destroy in ICP.

Objective; To elucidate the mechanism of the role of ER-a in fat metabolism by regulating the expression of ER-a in SD rats marrow mesenchymal stem cells during differentiating into adipocytes in vitro. Methods ;SD rats marrow mesenchymal stem cells were separated and cultivated. The ER-a was transfected into the rBMSCs in group one. Tamoxifen Citrate was used to restrain the expression of ER-a in group two, the group without any treatment was used as control. Western blot was used to identify the difference of ER-a expression among different groups and Oil-Red-0 staining was employed to identify the adipocytes in vitro. Results; There was significant difference between the number of lipids and different groups (P <0. 01) ,the number of lipid droplet changed concomitantly with ER-a: Low-expression ER-a group > Control group > High-expression ER-a group. Conclusion; ER-a in SD rats marrow mesenchymal stem cells may restrain the adipocyte differentiation.

Pediatric head injury is the leading cause of death and disability,about 40% to 60% of kids of head injury get a CT,and the majority are those with minor head injury,about 10% of these CT scans are positive.Clinical decision rules for pediatric head injury exist to identify children at risk of traumatic brain injury.Those of the highest quality are children's head injury algorithm for the prediction of important clinical events(CHALICE),Pediatric Emergency Care Applied Research Network(PECARN)and the Canadian as-sessment of tomography for childhood head injury(CATCH)clinical decision rules.This review aimed to systematically introduce primary clinical decision rules for children with minor head injury and compare them for diagnostic accuracy in detecting intracranial injury and injury requiring neurosurgery.

Objective:To observe the effectiveness and security of piperacillin sodium/sulbactam sodium in the treatment of bacte-rial infections and perform the pharmacoeconomics evaluation. Methods: Totally 126 patients with hand trauma bacterial infections were divided into the control group and the treatment group. The control group was given piperacillin sodium/tazobactam sodium 2. 5g, ivd, bid, while the treatment group was treated with piperacillin sodium/sulbactam sodium 1. 25g, ivd, bid. After 14-day treatment, the clinical therapeutic effect and adverse reactions of the two groups were observed, and the cost-minimization analysis was carried out. Results:The effective rate of the treatment group was 93. 65%while that of the control group was 92. 06%(P>0. 05). The bac-terial clearance rate of the treatment group was 96. 83%while that of the control group was 95. 24% (P>0. 05). The incidence of ad-verse reactions of the treatment group was 4. 76% (3/63) while that of the control group was 9. 52%(P>0. 05). The cost-effective-ness of piperacillin/sulbactam was significantly lower than that of the control group (P<0. 05). Conclusion: The effectiveness and safety of the two groups show no obvious differences in the treatment of hand trauma bacterial infections, and both have good antibacte-rial effect with low incidence of adverse reactions. For the better economic benefits, piperacillin /sulbactam is worthy of promoted ap-plication.

Objective To analyze the effect of persistent nursing intervention on long-term therapeutic compliance of statins in elderly patients with coronary heart disease. Methods A total of 100 cases of elderly patients with coronary heart disease from December 24, 2015 to February 24, 2017 in Hangzhou city of Zhejiang Province, the Red Cross Hospital as the research object. They were divided into two groups by dynamic randomized odd number grouping. Two groups of patients were treated with statins for a long time, while were given general care, continuous care intervention, to explore the two groups of patients with lipid changes, the total effective rate of treatment, the incidence of adverse reactions, treatment compliance differences. Results Large differences are observed in lipid changes group and control group, the total efficiency of treatment and treatment compliance than the control group, the adverse reaction was lower than that of control group, the difference was statistically significant (P<0.05). Conclusion Continuing nursing intervention has a certain effect of intervention in long-term treatment compliance of statins in elderly patients with coronary heart disease.

Objective To analyze nursing intervention and digoxin treatment of elderly heart failure patients taking digoxin drug compliance reasons. Methods Select Red Cross Hospital of Hangzhou on March 21, 2015 to March 21, 2016, 110 cases of senile heart failure patients as the research object, take the envelope random grouping scheme, divided into normal group and experimental group two groups, each group are occupying 55 cases. Among them to digoxin therapy on conventional therapy alone, in the experimental group were markedly drug treatment and corresponding nursing intervention, compared two groups of patients' medication compliance and quality of life score. Results the patients in the experimental group were 98.18% and 81.82% respectively, and the comparison groups were significantly different(P<0.05). The experimental group after treatment the patient's quality of life score of each dimension (physical function, psychological state, the doctor-patient relationship, independence, social relations, the personal faith and the general quality of life) were significantly better than the conventional group(P<0.05). Conclusion For elderly patients with heart failure to take scientific and reasonable method for nursing to improve the adherence of digoxin drugs, improve the quality of life, is worth popularizing practice.

Microcirculation is closely related to occurrence and development of disease, so it is of significance in noninvasive imaging of microcirculatory structure and function in vivo.Photoacoustic imaging is one of the main techniques in microcirculation imaging, which has the characteristics of high contrast, high detection depth and high sensitivity to tissue function.A review of the literature showed that photoacoustic technique can noninvasively image and quantitatively measure microcirculatory structure, vasoconstriction and vasodilation, concentration of hemoglobin, oxygen saturation, blood velocity and direction, oxygen metabolism level in a certain depth of living tissue in real time.Research progress in photoacoustic imaging of microcirculation in subcutis, cerebral cortex, tumor, eye and other tissues is reviewed in this paper.