BACKGROUND: Fat embolism syndrome is a commonly seen severe complication in the field of opthopaedics in clinic. It frequently occurs after long bone fracture and hip-knee joint replacement. However, its etiological factors and pathogenesis are not identified.OBJECTIVE: To sum up the onset influencing factors, pathogenesis and therapeutic methods of long bone fracture and hip-knee joint replacement accompanied with fat embolism syndrome.RETRIEVE STRATEGY: Using the terms "fat embolism syndrome, pathogenesis, treatment, prevention, diagnosis", we retrieved PubMed database to identify studies published in the English language. Fifty-five literatures were searched.Meanwhile, we searched the medical information network of Shanghai Jiao Tong University with the same terms in the Chinese language. Inclusive criteria: studies, which can reflect the diagnosis and treatment as well as pathogenesis of fat embolism syndrome. Exclusive criteria: repetitive studies.LITERATURE EVALUATION: The involved 38 literatures are all about the diagnosis and treatment as well as pathogenesis of fat embolism syndrome, among which, 6 were review and the others were clinical or basic studies.DATA SYNTHESIS: ① The influencing factors of fat embolism syndrome included trauma factor, operation factor and other factors. ② The pathogenesis of fat embolism syndrome involved mechanical obstruction theory, biochemical theory,condensation theory and inflammatory reaction theory. ③ The treatments of fat embolism syndrome include respiration supporting, glucocorticoid application, protecting brain function, drug treatment, heat shock treatment and so on.CONCLUSION: Study on bone fracture and joint replacement accompanied with fat embolism syndrome can provide evidence for the diagnosis and treatment of this syndrome.

Aim To examine the inhibitory effect of re-combinant cardiac troponin fusion protein composed of subunit I and artificial peptide which was called CIS on tumor growth. Methods The CIS ’ s effect on the growth of human umbilical vein endothelial cells ( HU-VEC) was examined using MTT assay in vitro. Chick chorioallantoic membrane model was applied to study the alteration of angiogenesis treated with purified re-combinant CIS protein. The effect of tumor growth trea-ted with CIS was observed using several in vivo mice xenograft models. Results There was a statistically significant reduction in HUVEC cell proliferative rate when the cells were treated with purified CIS fusion protein, which was also shown in a dose-dependent manner. A decreased amount of new blood vessel for-mation ( angiogenesis) on chick embryo chorioallantoic membranes was observed in recombinant CIS protein treated group compared to the untreated control group. A significant inhibition of tumor growth rate was a-chieved in CIS treated mice compared to CIS untreated control mice in 6 different mouse xenograft models. Conclusions The fusion protein CIS shows the inhibi-tory effect on the tumor growth in our in vivo mouse models, and such inhibition could be mediated by the mechanism of CIS’ s effect on the decrease of HUVEC cell proliferation and further the reduction of angiogen-esis in tumor tissues. This work could provide the foundation for the in-depth investigations on the phar-maceutical application of CIS targeting anti-tumor ther-apy.

OBJECTIVETo investigate the contents of 16 basic amino acid and find out the variation of them in Dendrobium officinale with different germplasms and physiological ages, and then provide scientific basis for the quality evaluation and the breeding of D. officinale.

METHODThirty-three samples with 1-3 ages were collected from cultivated fields of Zhejiang. The samples were acid hydrolyzed, and then 16 basic amino acid contents of samples were determined by amino acid analyzer.

RESULTThe average contents of 7 necessary amino acid were in 0.28 - 2.96 mg x g(-1), the average contents of other 9 basic amino acid were in 0.53 - 4.20 mg x g(-1). The contents of many amino acids were impacted by germplasms significantly, and contents of several amino acids were impacted by physiological ages significantly.

CONCLUSIONThere were rich basic amino acids in D. officinale. The breeding of D. officinale can increase the contents of essential amino acids and other basic amino acids. The relations among physiological age and amino acid contents were as follows: three years > two years > one year. The contents of Asp and Tyr have significantly negative correlation with magnesium, the content of Pro has significantly positive correlation with copper.

Amino Acids, Basic ; analysis ; metabolism ; China ; Dendrobium ; chemistry ; growth & development ; metabolism

Objective:To evaluate the efficacy and related factors of high-flow nasal cannula (HFNC) for the treatment of adult typeⅠ respiratory failure.Methods:The medical records of the subjects with acute hypoxemic respiratory failure supported by HFNC therapy in the medical intensive care unit between October 2017 and February 2019 were reviewed retrospectively. The patients′ baseline characteristics and the serial changes in the respiratory parameters after HFNC therapy at 1 and 24 hours were measured. Therapy success was defined as the avoidance of intubation. The subjects were divided into two groups.Results:Of the 75 eligible patients, 62.7%(47/75) belonged to success group. Overall, HFNC therapy significantly improved the physiologic parameters, such as partial pressure of arterial oxygen (PaO 2), saturation of arterial oxygen (SaO 2), respiratory rate (RR), and heart rate (HR), throughout the first 24 hours. After the adjustment for the other clinical variables, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), sequential organ failure assessment (SOFA), cardiogenic pulmonary edema, and PaO 2 improvement at 1 and 24 hours were associated with therapy success. The overall intensive mortality was 25.3%. However, out of 37.3% of the patients who required belonged to failure group, the mortality was 67.9%. The mortality in the failure group was associated with the use of a vasopressor and a limited PaO 2 improvement at 1 hour. Conclusions:HFNC can significantly improve the physiological parameters of adult patients with acute type I respiratory failure and avoid endotracheal intubation in some patients. The failure to improve oxygenation within 24 hours was a useful predictor of intubation. Among the failure group, the vasopressor use and failed oxygenation improvement were associated with mortality.

Objective:To investigate the causal association between immune cell and different types of sepsis by using Mendelian randomization (MR) method, and to find the immune cell phenotypes causally associated with sepsis.Methods:Summary data for various circulating immune cell phenotypes were obtained from the GWAS catalog (GCST90001391-GCST90002121). Sepsis data were sourced from the UK Biobank database. Single nucleotide polymorphisms (SNP) were used as instrumental variables. The correlation threshold of P < 5×10 -6 was used to identify the strongly correlated instrumental variables, and the code was used to remove the linkage disequilibrium and the instrumental variables with F-value < 10. Inverse variance weighting (IVW) was used as the main research method to evaluate the stability and reliability of the results, including Cochran's Q test, MR-Egger regression and Leave one out. Reverse MR analysis was performed based on the immunophenotypic results of the removal of horizontal pleiotropy, and the immune cell phenotype with one-way causal association was obtained. Odds ratio ( OR) and 95% confidence interval (95% CI) were used to represent the effect value of the results. Results:CD16 on CD14 -CD16 + monocyte had horizontal pleiotropy in sepsis ( OR = 0.965?4, 95% CI was 0.933?5-0.998?3, P = 0.039?6). There were five immunophenotypes that had reverse causal associations with the types associated with sepsis. After excluding immune cell phenotypes with horizontal pleiotropy and reverse causation, a total of 42 immune cell phenotypes with sepsis, 36 immune cell phenotypes with sepsis (28-day death in critical care), 32 immune cell phenotypes with sepsis (critical care), 44 immune cell phenotypes with sepsis (28-day death), and 30 immune cell phenotypes had potential causal associations with sepsis (under 75 years old). After false discovery rate (FDR) correction, the correlations between BAFF-R on IgD - CD38br and sepsis (28-day death) were negative and strong ( OR = 0.737?8, 95% CI was 0.635?9-0.856?0, P = 6.05×10 -5, PFDR = 0.044?2). Conclusion:A variety of immune cell phenotypes may have a protective effect on sepsis, especially BAFF-R on IgD - CD38br expression is negatively correlated with sepsis (28-day death), which provides a new idea for immune modulation therapy in sepsis.