A 51-year-old man presented with a 4-month history of upper abdominal distending pain and 1-month history of cutaneous nodules and plaques on the neck, trunk and bilateral thighs. The patient underwent many gastrointestinal tract examinations in several local hospitals, and symptomatic treatment did not work. The biopsy of nodules on the abdomen revealed medium- to large-sized atypical lymphoid cells within numerous small vessels in lower dermis and subcutaneous fat tissue. Additionally, the atypical cells were present exclusively within vascular lumina. Immunohistochemical labeling showed the reactivity of neoplastic cells to CD2, CD99, CD3ε, CD43, CD56, Epstein-Barr virus-encoded small nuclear RNAs (EBER), and cytotoxic proteins such as T-cell intracellular antigen-1 (TIA-1) and perforin, but not to CD4, CD8, CD20, CD79a,CD30, cytokeratin (CK), S100, or CD68. The endothelial cells lining the involved vessels exhibited the reactivity to CD31 and CD34. Based on the above findings, the patient was diagnosed with intravascular NK/T-cell lymphoma firstly manifesting as gastrointestinal tract symptom and complicated by skin lesions. Following combined chemotherapy with cyclophosphamide, daunorubicin, vincristine, prednisone and etoposide, the patient experienced a quick and satisfactory recovery and the follow-up still continued.

Objective:To investigate the variations in ocular biometry and its influencing factors in adult Tibetans of Lhasa.Methods:A cross-sectional study was adopted.A total of 100 consecutive adult Tibetans (100 eyes) with cataract, who were treated in Tibet Autonomous Region People's Hospital from March 2017 to July 2017 were enrolled, including 51 males and 49 females, with an average age of (63.38±12.80) years.The subjects were divided into two groups, with 57 subjects (57 eyes) older than 60 years in the elder group and 43 subjects (43 eyes) younger than 60 years in the youth group.Corneal curvature, corneal astigmatism, anterior chamber depth and axial length of subjects were measured and compared with those of Beijing population which were used as standardized data of Han Chinese.The differences in ocular parameters associated with age and gender were analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Tibet Autonomous Region People's Hospital (No.ME-TBHP-21-KJ-005).Written informed consent was obtained from each subject prior to any examination.Results:The mean corneal curvature, corneal astigmatism, anterior chamber depth and axial length of the 100 Tibetans were (43.68±1.62)D, 0.750 (0.375, 1.000)D, (3.05±0.41)mm, (23.07±0.86)mm, respectively.The axial length of Tibetan was shorter than that of Beijing Han people and the difference was significant ( t=2.65, P<0.01).Corneal astigmatism of the elder group was higher than that of youth group and the difference was significant ( t=2.11, P<0.05).There were no significant differences in corneal curvature, anterior chamber depth and axial length between the elder group and youth group (all at P>0.05).The anterior chamber depth and axial length of males were much longer than those of females, and the differences were significant ( t=2.71, 2.25; both at P<0.05). Conclusions:In adult Tibetan population, the axial length is short, and the anterior chamber is deep.The corneal astigmatism increases with age and there is a gender difference in axial length and anterior chamber depth.

Objective To analyze the features of health economics in the treatment of leukemia;To evaluate the improvement trend of levels of clinical diagnosis, treatment and management. Methods TCM medical information dtatabase and electronic medical system in Zhejing Province TCM Hospital from January 2010 to December 2015 were retrived. According to inclusion and exclusion criteria, leukemia patients’ materials that met the critiria were screened. The total hospitalization fees, cost of Western medicine, the cost of Chinese patent medicine, cost of TCM decoction pieces, and cost of blood transfusion were set as costs, while white blood cell count, hemoglobin concentration, and platelet count were set as effectiveness indicators for cost effectiveness analysis. Results In patients with low white blood cell count increased unit white blood cell count, patients with high white blood cell count declined unit white blood cell count, patients with low hemoglobin increased unit hemoglobin count and patients with low platelet count increased unit platelet count, the total hospitalization fees, cost of Western medicine, the cost of Chinese patent medicine, cost of TCM decoction pieces, and blood transfusionfor the above increases showed a decreasing trend. Conclusion Health economics advantages in three blood routine indicators after treatment of integrated traditional Chinese and western medicine for leukemia is increasing year by year.

· AIM: This study was designed to evaluate the effectiveness of anterior lens capsule inclusion in combined trabeculectomy and cataract surgery in preventing scar formation of the filtering bleb in rabbit model.· METHODS: Twerty-Four eyes (12 rabbits) with glaucoma model were studied, anterior lens capsule inclusion in trabeculectomy with the small-incision cataract surgery were performed on all right eyes (experimental group) and no implants were applicator in trabeculectomy with the small-incision cataract surgery on all left eyes (control group). These operated eyes were followed up from day 1 to 6 months postoperatively. Intraocular pressure (IOP) was measured and filtering blebs were observed after surgery. Other main outcome measures: cornea、conjunctiva、formation of the anterior chamber, anterior chamber depth、inflammatory reaction、achievement ratio of operation and complications were analyzed. On week 1, 2, 4, 12 and 24 after surgery the animal were killed in batch. Tissue was harvested from the bleb area and was made pathological section. HE staining、light microscope and micro photo analysis technique were applied to observe the cytological and histopathologic characteristics of the filtering tunnels.· RESULTS: There were significant differences between the two groups on IOP (1, 2, 4 weeks)、filtration bleb, achievement ratio of operation and complications. In experimental group, at the first month postoperatively, anterior lens capsule absorption started with inflammatory characteristics. The peak of inflammatory reaction occurred 1 week after operation and all the cells in the filtrating tunnel disappeared 6month after surgery. The fibroblast proliferation in control group occurred at I week and the filtrating tunnel closed with angiogenesis at 1 month after surgery. Fibroblast proliferation started 1week after surgery with no statistical difference during the time course (P ＞0.05). Significant statistical differences were observed by comparing the fibro blasts numbers per unit area in the filtrating tunnel in experimental group and those in control groups (P＜0.05).· CONCLUSION: Anterior lens capsule was totally absorbed at 6 months postoperatively. Anterior lens capsule inclusion in trabeculectomy with cataract surgery can possibly control intraocular pressure effectively, long-term sustainability of functional filtration bleb, inhibition of the proliferation of fibroblasts and opening of the filtrating pathway in the experimental animal models were satisfied. Compared to the control group, anterior lens capsule application has less complication.

Uvaria kweichowensis is a folk nongovernmental herb used to treat cure inflammation and tumour in the Southwest area of China. During the course of our investigation for antitumour agents from the stems of Uvaria kweichowensis, six amides were obtained by means of solvent extraction, chromatography on silica gel and Sephadex LH-20 repeatedly. And their structures were identified as uvariadiamide (1), cepharanone (2), aristololactam A II (3), enterocarpam II (4), aristololactam A Ia (5), and 4,5-dioxodehydroasimilobine (6) on the basis of chemical methods and spectral analyses (EI-MS, 1H NMR, 13C NMR). Among them, compound 1 is a new compound; the other compounds were obtained from this plant for the first time.
Amides ; chemistry ; isolation & purification ; Aristolochic Acids ; chemistry ; isolation & purification ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Plant Stems ; chemistry ; Plants, Medicinal ; chemistry ; Spectrometry, Mass, Electrospray Ionization ; Uvaria ; chemistry

AIMTo synthesize the selenophosphocholine analogues containing tegafur and test their antitumor activities.

METHODSThe cyclic glyceroselenophospholopid conjugate of tegafur was synthesized by the reaction of hexaethylphosphorous triamide with N1-(2-furanidyl)-N3-(hydroxyalkyl)-5-fluyorouracil and 1-O-hexadecyl glycerol as well as selenium in one-pot. Cyclic glyceroselenophospholopid conjugate of tegafur reacted with triethylamine to give title compounds.

RESULTSSix new compounds have been synthesized. Their structures were confirmed by 1H NMR, 13P NMR and elemental analysis. Antitumor activity of the title compounds against PGA1 was tested.

CONCLUSIONThe reaction of triethylamine with cyclic glyceroselenophospholopid conjugate of tegafur very readily occurred, which was finished within 2 h at room temperature. The opening-ring products of trans isomers showed antimutor activity against human uriaryl bladder cancer cell more effective than that of the tegafur.

Antineoplastic Agents ; chemical synthesis ; pharmacology ; Cell Line, Tumor ; Humans ; Magnetic Resonance Spectroscopy ; Organoselenium Compounds ; chemical synthesis ; pharmacology ; Phosphorylcholine ; analogs & derivatives ; Tegafur ; chemical synthesis ; pharmacology ; Urinary Bladder Neoplasms ; drug therapy ; pathology

Heart failure (HF) is the end stage of various kinds of cardiovascular diseases and leads to a high mortality worldwide.Numerous studies have demonstrated that frequencies of CD4+CD25+Foxp3+ regulatory T cells (Tregs) are reduced in HF patients and properly expanding Tregs attenuates HF progression.Histone deacetylase (HDAC) 9 has been revealed to contribute to several cardiovascular and cerebrovascular diseases.Plenty of studies showed that HDAC9 negatively regulated the number and function of Tregs.Thus,we aim to investigate the expression of HDAC 9 in patients with chronic heart failure (CHF) and the relationship among HDAC9,Tregs and CHF.Our research showed a reduced number of Tregs and an increased expression of HDAC9 mRNA in CHF patients.Patients with CHF were divided into two groups by heart function grade of New York Heart Association (NYHA),we found that the HDAC9 mRNA expression level in NYHA grade Ⅱ-Ⅲ group were lower than that in NYHA grade Ⅳ group.More importantly,the correlation study suggested that the expression of HDAC9 mRNA was negatively correlated to Tregs frequency and left ventricular ejection fraction (LVEF),whereas positively correlated to larger left ventricular end-diastolic dimension (LVEDD) and B-type natriuretic peptide (BNP) in patients with CHF.The correlation studies also showed a positive correlation between HDAC9 and the severity of CHF.Our research suggests that HDAC9 may be a new indicator for assessing CHF and it may offer a new direction for research of CHF.

Objective To investigate the recurrence rate, the efficacy and safety of auxiliary hepatic arterial chemoembolization after the treatment of microvascular invasion (MIV) of hepatocellular carcinoma. Methods A total of 104 patients with hepatocellular carcinoma clinical staging of early metaphase were collected from the First Affiliated Hospital of Xi'an Jiaotong University in Jan.2010 to Dec.2016, all treated with liver resection and follow-ups. Adopting the method of retrospective analysis, univariate and multivariate analyses were performed to investigate the risk factors for recurrence-free survival (RFS) and overall survival (OS). Multiple logistic regression was used to identify the clinicopathological characteristics associated with MVI. The rates of RFS and OS were compared among patients with or without MVI treated with liver resection alone or followed by PA-TACE. Results In HCC patients, the gender HBs Ag, total bilirubin, and prothrombin time, AFP, HBV-DNA, the size of largest tumor, capsule, operation type, hepatic door block, Child-Pugh grade, classification comparison differences had no statistical significance between the two groups of with or without TACE (P＞0.05); Age, nodules, tumor cell resection, and BCLC were statistically significant in the non-MIV infiltration group (P＜0.05).Hypersplenism and recurrence rate were statistically significant in MIV group (P＜0.05).Univariate and multivariate analyses demonstrated that AFP (＞ 400 ng/m L), tumor diameter, membrane integrity, MVI, and most liver resection were significantly associated with overall survival rates (P＜0.05), the AFP (＞400 ng/m L), Child-Pugh, grade B, tumor diameter, hepatocellular carcinoma (HCC) and other abnormal degree, membrane integrity, MVI have significant correlation with disease-free survival rate (P＜0.05). Multiple logistic regression identified serum AFP level＞ 400 ng/L, tumor size＞ 5 cm, and incomplete tumor envelope was independent correlation factor (P＞0.05). In the HCC patients with MIV, both OS and DFS were significantly improved in patients who received PA-TACE as compared to those who underwent liver resection alone (P＞ 0.05), but no significant effect in HCC patients wieh no MIV invasion (P＞ 0.05).Conclusions There is a certain correlation between microvascular infiltration and the recurrence rate and survival rate of hepatocellular carcinoma, and the method of using adjuvant hepatic arterial chemoembolization is helpful to reduce the recurrence rate and prolong the survival period.

OBJECTIVETo study the clinicopathologic features of various types of mature T-cell and natural killer (NK)/T-cell lymphoma in Guangdong, China, with respect to the 2008 WHO classification of lymphoid neoplasms.

METHODSEleven hundred and thirty-seven (1137) cases of mature T-cell or NK/T-cell lymphoma diagnosed during the period from 2002 to 2006 in Guangzhou area were retrieved. The clinical data, histologic features and immunohistochemical findings were reviewed by a panel of experienced hematopathologists. Additional immunostaining was performed if indicated. The cases were re-classified according to the 2008 WHO classification of lymphoid neoplasms.

RESULTSNine hundred and sixty-three (963) cases fulfilled the diagnostic criteria of mature T-cell or NK/T-cell lymphoma and accounted for 20.1% of all cases of lymphoma encountered during the same period (963/4801). A predominance of extranodal involvement was noted in 644 cases (66.9%), while 319 cases (33.1%) showed mainly nodal disease. The prevalence of various lymphoma subtypes was as follows: peripheral T-cell lymphoma, unspecified (PTCL, NOS) 293 cases (30.4%), extranodal NK/T-cell lymphoma, nasal type 281 cases (29.2%), anaplastic large cell lymphoma (ALCL) 198 cases (20.6%), and angioimmunoblastic T-cell lymphoma (AILT) 46 cases (4.8%). The male-to-female ratio was 1.99. The median age of the patients was 44 years, with the peak age of PTCL, NOS, extranodal NK/T-cell lymphoma, nasal type and AILT being 55 to 64 years, 25 to 54 years and 65 to 74 years, respectively. ALK-positive ALCL occurred more frequently in young age, while the ALK-negative ALCL cases occurred mainly in the elderly.

CONCLUSIONSExtranodal lesions predominate in mature T-cell and NK/T-cell lymphomas occurring in Guangzhou area. There is a male predominance and the overall incidence shows no increasing trend with age of the patient. The peak age of various subtypes however varies. The most common subtype was PTCL, NOS, followed by extranodal NK/T-cell lymphoma, nasal type, ALCL and AILT. The relatively frequent occurrence of extranodal NK/T-cell lymphoma, nasal type in Guangdong area is likely associated with the high incidence of Epstein-Barr virus infection there.

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; Epstein-Barr Virus Infections ; Female ; Humans ; Immunoblastic Lymphadenopathy ; metabolism ; pathology ; virology ; Infant ; Lymphoma, Extranodal NK-T-Cell ; metabolism ; pathology ; virology ; Lymphoma, Large-Cell, Anaplastic ; metabolism ; pathology ; virology ; Lymphoma, T-Cell ; classification ; metabolism ; pathology ; virology ; Lymphoma, T-Cell, Peripheral ; metabolism ; pathology ; virology ; Male ; Middle Aged ; Protein-Tyrosine Kinases ; metabolism ; Receptor Protein-Tyrosine Kinases ; Retrospective Studies ; Sex Factors ; World Health Organization ; Young Adult

Objective: To explore the occurrence of cognitive impairment in Chinese heart failure (HF) patients and it's impact on prognosis. Methods: In this prospective observational study, a total of 990 HF patients were enrolled from 24 hospitals in China during December 2012 to November 2014. All patients were administrated with the interview-format Montreal Cognitive Assessment (MoCA), according to which they were divided into MoCA<26 (with cognitive impairment) group and MoCA≥26 (without cognitive impairment) group. Baseline data were collected and a 1-year follow up was carried out. Univariate and multivariate logistic or Cox regression were performed for 1-year outcomes. Results: Cognitive impairment was evidenced in 628 patients (63.4%) and they were more likely to be older, female, and with higher proportion of New York Heart Association(NYHA) class Ⅲ-Ⅳ, chronic obstructive pulmonary disease (COPD), ischemic heart disease, while body mass index (BMI), education level, and medical insurance rate were lower (all P<0.05) as compared to patients in MoCA≥26 group. The rate of percutaneous intervention, device implantation, cardiac surgery and evidence-based medications were significantly lower in MoCA<26 group than in MoCA≥26 group (all P<0.05). During the 1-year follow up, patients in the MoCA<26 group had higher all-cause mortality (10.2%(64/628) vs. 2.2%(8/362), P<0.01), cardiovascular mortality (5.9%(37/628) vs. 0.8%(3/362), P<0.01) and major adverse cardiac and cerebrovascular events (MACCE) (9.6%(60/628) vs. 2.5%(8/362), P<0.01) than patients in the MoCA≥26 group. In univariate regression, MoCA<26 was associated with increased all-cause mortality (HR(95%CI):4.739(2.272-9.885), P<0.01), cardiovascular mortality (HR(95%CI):7.258(2.237-23.548), P=0.001) and MACCE (OR(95%CI):4.143(2.031-8.453), P<0.01). After adjustment by multivariate regression, MoCA<26 was indicated as an independent risk factor for all-cause mortality (HR(95%CI): 6.387(2.533-16.104), P<0.01), cardiovascular mortality (HR(95%CI): 10.848(2.586-45.506), P=0.001) and MACCE (OR(95%CI): 4.081(1.299-12.816), P=0.016), while not for re-hospitalization for HF (OR(95%CI):1.010(0.700-1.457), P=0.957). Conclusions: Cognitive impairment is common in HF patients,and it is an independent prognostic factor for 1-year outcomes. Routine cognitive function assessment and active intervention are thus recommended for HF patients.
China ; Female ; Heart Failure ; Humans ; Mental Status and Dementia Tests ; Prognosis ; Prospective Studies