Hyperhomocysteinemia is an independent risk factor for arterial and venous obstructive vascular di-seases. Raised plasma homocysteine concentrations are caused by genetic and non-genetic factors. The pathogenic mechanism is not clear. It may be associated with endothelium dysfunction, abnormal lipid metabolism, hypertrophy of intima media, increased platelet aggregation and several clotting factors interfered, etc. The metabolism and pathogenic mechanism of homocysteine are reviewed in this article, which provides theoretical foundation for the treatement of hyperhomocysteinemia.

Objective To evaluate the clinical application of GlideScope~ video laryngoscope in anesthetic endotracheal intubation.Methods Two hundred patients who received surgery under general anesthesia with ASA I or II were involved in this study.One hundred patients were assigned to be intubated with GlideScope~(GS group) and the other 100 with size 3 Macintosh laryngoscope(ML group).The following data were recorded and analyzed: noninvasive blood pressure(NBP),heart rate(HR) at the different time points of intubation process,glottic exposure time,CormarkLehane grade,tracheal intubation time and total intubation attempts. Results The rise of NBP and HR in ML group were significantly higher than those in GS group(P

Objective To analysis the risk factors in ventilator-associated pneumonia (VAP) in mechanically ventilated patients.Methods Seventy-eight adult inpatients on mechanical ventilation (MV) through oral endotracheal intubation were studied prospectively by observation between June,2007 and May,2010.Clinical associated factors including patients'predisposition related,medical personnel or device related and nutritional state related factors,etc.were recorded and analyzed.Results In 78 ventilated patients,the incidence of VAP was 23.1％,the fatality rate was 22.2％.Preventive antibiotic treatment (OR=6.038; 95％ CI:1.319-27.641; P =0.021),applying glucocorticoid (OR =5.385; 95％ CI:1.191-24.346; P =0.029) and prealbumin (PA) ≤ 69.7 mg/L (OR =0.975; 95％ CI:0.956-0.995 ; P =0.013) were risk factors in VAP.Conclusions The risk factors in VAP were PA ≤ 69.7mg/L,preventive antibiotic treatment and employment of glucocorticoid.

AIM: To compare the postoperative quality of life between patients who underwent binocular and unilateral Symfony continuous-vision intraocular lens(IOL)implantation.

METHODS: A population-based cross-sectional study was performed. The visual function-related quality of life(QoL)was evaluated with the National Eye Institute Visual Functioning Questionnaire-25(NEI VFQ-25)which was developed by the National Eye Institute. Thirty patients(60 eyes)who underwent phacoemulsification combined with IOL implantation from March 2017 to March 2018 were divided into two groups according to the type of implanted IOL. For bilateral group(36 eyes in 18 cases), patients accepted TECNIS Symfony(ZXR00, AMO)in both eyes. For unilateral group(24 eyes in 12 cases), patients accepted TECNIS Symfony(ZXR00, AMO)in one eye and an aspherical monofocal IOL(PCB00,AMO)in the other eye. Follow-up was performed 3-6mo after surgery. Postoperative binocular uncorrected distant, intermediate and near visual acuity(bUCDVA, bUCIVA and bUCNVA)were compared and the quality of life was evaluated for every patient.

RESULTS:There were no statistical differences in bUCDVA, bUCIVA and bUCNVA between two groups(P>0.05). There was no significant difference in composite scores of the NEI VFQ-25 questionnaire between bilateral group and unilateral group(88.95±4.01 vs 88.99±4.22, t=-0.025, P=0.980). A comparison of the 12 scales acquired from the questionnaire showed that there were no statistical differences in visual function-related quality of life in the two groups(P>0.05).

CONCLUSION:Compared with bilateral implantation of ZXR00, the patients with the implantation of ZXR00 in one eye and PCB00 in the other eye share the excellent binocular uncorrected distant, intermediate and near visual acuity and postoperative quality of life. For patients who have undergone monofocal IOL implantation in one eye or whose one eye is not suitable for multifocal IOLs, unilateral implantation of Symfony continuous-vision IOL is feasible to meet patients' need for spectacle independency.

Objective To assess the value of procalcitonin(PCT)measurement to differentiate infection from non-infection in critically ill patients requiring long-term immunosuppressive therapy.Methods A prospective study was conducted in patients with underlying diseases requiring corticosteroids or chemotherapy in ICU from January 2008 to December 2009.Patients were divided into the infection group and the non-infection group and their PCT levels were compared.Results A total of 103 patients (65 women)were enrolled in this prospective study[aged(47.9 ± 21.9)years old]with 84 in the infection group and 19 in the non-infection group.The baseline level of PCT was significantly higher in infection than in non-infection patients[2.58(0.08-44.65)pg/L vs 0.62(0.15-6.00)pg/L,P =0.002].Different levels of PCT were manifested in different pathogen groups with 3.41(0.45-44.65)pg/L in bacteria infection,0.99(0.28-6.67)pg/L in fungus infection,0.11(0.08-0.20)pg/L in virus infection group(P =0.018).The AUCROC of PCT was 0.867 for diagnostic bacterial infection.By multivariate analysis,the factors associated with the level of PCT were bacteria infection(OR 5.1,P =0.031)and septic shock(OR 7.5,P =0.027),while the factors not associated with the level of PCT were age,renal function,infection site and prognosis(P ＞ 0.05).Conclusions The level of PCT is increased in the critically ill patients requiring immunosuppressive therapy with infection and it can be used for diagnosis for bacterial infection.

OBJECTIVETo explore the inhibitory effect of cinnamaldehyde on invasion capacities of human breast cancer cell line MDA-MB-435S and its relation with regulating the expression of miR-27a.

METHODSThe effect of cinnamaldehyde on invasive capacities of MDA-MB-435S was measured by Transwell matrigel invasion assay. The effect of miR-27a expression on invasive capabilities of MDA-MB-435S, the intervention of cinnamaldehyde in the miR-27a expression, and its relation with its effect on invasive capabilities were defected with liposome 2000 transinfection miRNA27a mimics/inhibitors, real time-polymerase chain reaction (Real-time PCR), and Transwell chamber model.

RESULTSCompared with the control group, the number of cells passing through the transwell chamber was more significantly reduced after treated by cinnamaldehyde for 12 h (P < 0.05). The miR-27a expression was 962.07 times and 40% of that of the control group after transinfected by miR-27a mimics and miR-27a inhibitors. After transinfected by miR-27a inhibitors, the number of cells passing through the transwell chamber was more significantly reduced (P < 0.05). The miR-27a expression of MDA-MB-435S was down-regulated by 12-h treatment of cinnamaldehyde (2(-deltaCt) = 0.56, 0.18, 0.18, respectively). The number of miR-27a mimics transinfection pretreated MDA-MB-435S cells passing through the transwell chamber increased more obviously than the number of un-pretreated MDA-MB-435S cells in the control group (P < 0.05).

CONCLUSIONSCinnamaldehyde could inhibit invasive capabilities of human breast cancer cell line MDA-MB-435S. The over-expression of miR-27a played an important role in the invasive capability of MDA-MB-435S. The inhibition of cinnamaldehyde on invasive capabilities of MDA-MB-435S cells was correlated with down-regulating the expression of miR-27a.

Acrolein ; analogs & derivatives ; pharmacology ; Breast Neoplasms ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Female ; Humans ; MicroRNAs ; genetics

Objective To approach curative effect of using DLI +IL-2 as immunobiotherapy after Mixed-HSCT in acute myelogenous leukemia.MethodAfter times of chemotherapy,8 cases of patients with acute myelogenous leukemia received Mixed-HSCT,then were treated with DLI +IL-2 for 2-7 times.Observed clinical effect for 1 to 5 years.Result DFS in 8 cases of patients with acute myelogenous leukemia received Mixed-HSCT and treated with DLI +IL-2 for 2-7 times were 62.5%.There were no GVHD.Conclusion Immuno-biotherapy with DLI +IL-2 after Mixed-HSCT in patients of acute myelogenous leukemia may be a method to increase DFS efficiently.

BACKGROUND:The incidence rate of peripheral T cel lymphoma is high in Asia, and peripheral T cel lymphoma is aggressive with generaly poor prognosis. However, there is no standard treatment strategy. OBJECTIVE:To retrospectively analyze the therapeutic effect of autologous hematopoietic stem cel transplantation on peripheral T cel lymphoma as wel as relevant toxic and side effects. METHODS:A retrospective review was conducted in 35 patients with peripheral T cel lymphoma who underwent autologous hematopoietic stem cel transplantation from March 2003 to April 2014, including 22 cases of extranodal NK/T-cel lymphoma (nasal type), 1 case of angioimmunoblastic T-cel lymphoma, 8 cases of peripheral T cel lymphoma (non-specific), 3 cases of ALK-positive anaplastic large cel lymphoma, and 1 case of ALK-negative anaplastic large cel lymphoma. Al of 35 patients were classified pathologicaly according to WHO pathological type in 2001 and 2008, and received the high-dose chemotherapy with vincristine, cytarabine, etoposide, mitoxantrone, semustine, cyclophosphamide, and total body irradiation. RESULTS AND CONCLUSION: After a median folow-up of 54 (9-120) months, the probabilities of overal survival and disease-free survival after transplantation were 80% (n=28) and 71% (n=25), respectively. Eight cases (23%) relapsed after transplantation, seven of which died. It was safe with mild and moderate transplantation related side-effects on opportunistic infections, oral cavity mucosa and bladder responses and so on, and there were no severe, life-threatening late complications. Autologous hematopoietic stem cel transplantation may be an effective and safe treatment for peripheral T cel lymphoma, and there is a better benefit in peripheral T cel lymphoma patients with first complete remission.

Objective To evaluate fluid responsiveness by stroke volume variation (SVV) in mechanically ventilated patients with refractory septic shock.Methods Forty-two refractory septic shock patients were enrolled in the study.According to the responsiveness of fluid loading, the patients were divided into responsive group and non-responsive group.The SVV values of two groups were retrospectively analyzed.The receiver operating characteristic curve was drafted to determine the cut-off value of SVV for predicting fluid responsiveness.Results Among the 42 refractory septic shock patients, 24 were found responsive to fluid loading, 18 were not;before the fluid loading, central venous pressure, heart rate, mean arterial pressure and global end-diastolic volume index in the both groups showed no significant differences whereas the SVV in the responsive group was much higher than that in the nonresponsive group (P =0.006).Using SVV ≥ 12% as the threshold to predict fluid responsiveness, the sensitivity was 77%,specificity was 85%.Conclusion SVV can accurately predict fluid responsiveness in refractory septic shock patients.

AIM: To observe the effects of different duration of diabetes on dry eye and ocular surface before cataract surgery.

METHODS: The patients with diabetes and cataract were included from March to August in 2018. According to the duration of diabetes, the patients were divided into three groups(<5a, 5-15a, >15a). Age, sex, break-up time(BUT), Schirmer Ⅰ test, corneal fluorescein cornea staining(FL), palpebral margin staining score, meibomian glands secretion function score, and ocular surface disease score(OSDI)were compared between the three groups.

RESULTS: There were no significant differences in age and sex between the three groups. There were no significant difference in BUT and Schirmer Ⅰ test and OSDI score among the three groups, but the more duration of diabetes was, the more OSDI score was. FL and the secretion of tarsal gland were significantly different between groups(χ²=8.372, 9.346, P=0.015, 0.009, respectively). There was no significant difference in the shape of palpebral margin(χ²= 0.353, P=0.838).

CONCLUSION: The more duration of diabetes is, more serious the ocular surface and dry eye diseases may be. For the patient with long-term diabetic, more attention should be paid to the eye surface health and perioperative recovery.