Objective:To analyze the clinical manifestations and laboratory features in patients with myeloid neoplasms complicated with clonal T large granular lymphocyte (T-LGL) proliferation.Methods:The clinical data of 5 patients with myeloid neoplasms complicated with clonal T-LGL proliferation from November 2017 to November 2018 in Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College were analyzed retrospectively.Results:The median age was 60 years old. All patients had a history of abnormal peripheral blood cell counts for over 6 months. The absolute lymphocyte count in peripheral blood was less than 1.0×10 9/L. In addition to the typical T-LGL phenotype, the immunophenotype was heterogenous including CD4 +CD8 - in 2 patients, the other 3 CD4 -CD8 +. Four patients were αβ type T cells, the other one was γδ type. STAT3 mutation was detected in 1 patient by next-generation sequencing, the other 4 cases were negative. Conclusions:Clonal T-LGL proliferation with myeloid neoplasm develops in an indolent manner, mainly in elderly patients. Hemocytopenia is the most common manifestation. The diagnosis of T-LGL proliferation does not have specific criteria, that it should be differentiated from other T cell proliferative disorders, such as T-cell clones of undetermined significance. STAT3 or STAT5b mutation may help distinguish.

Objective To compare the clinical efficacy of minimally invasive surgery and traditional surgery in the treatment of multiple benign mammary lumps.Methods A retrospective study was conducted to select 158 patients with multiple benign breast masses admitted to Yijishan Hospital of Wannan Medical College from July 2016 to February 2018,all of them were female,average age was (28.3 ± 6.6) years old,range from 19 to 51 years old.The patients were divided into minimally invasive group (n =122) and traditional group (n =36) according to different surgical methods.The minimally invasive group was treated by minimally invasive rotary excision,while the traditional group was treated by traditional surgery.The operation time,number of incisions,average length of incisions,cumulative length of incisions and healing time of incisions were compared between the two groups.The incidence of local hematoma,local infection,breast deformity and local residual were compared after operation,and the satisfaction of the two groups was aslo compared.Normal distribution measurements were expressed by mean ± standard deviation (Mean ± SD),independent sample t test was used for inter-group comparison;non-normal distribution measurements were expressed by median (quartile spacing) [M(P25,P75)],Mann-Whitney U test was used for inter-group comparison.Chi-square test or Fisher exact probability test was used to compare the count data between the two groups.Results As compared to the traditional group,the minimally invasive group had shorter operation time (20.0 min vs 40.0 min,Z =-8.590,P ＜ 0.001),less number of incisions (1.0 vs 2.0,Z =-4.423,P ＜0.001),smaller average surgical incision length (3.8 mm vs 35.5 mm,Z =-9.211,P ＜ 0.001),smaller cumulative surgical incision length (4.0 mm vs 67.2 mm,Z =-9.130,P ＜ 0.001),quicker postoperative recovery (4.0 d vs 7.0 d,Z =-9.334,P ＜ 0.001).There were no significant differences between the two groups in incidence of postoperative hematoma (4.1％ vs 2.8％,x2 =0.000,P =1.000),incidence of infection (0 vs 2.8％,P =0.228),incidence of postoperative breast shape change (1.6％ vs 2.8％,x2 =0.000,P =1.000),and incidence of residual (0.8％ vs 0,P =1.000).Psychological satisfaction of patients in minimally invasive group (95.1％) was significantly higher than that in traditional group (58.3％),the difference was statistically significant (P ＜ 0.001).Conclusions Compared with traditional surgery,the application of minimally invasive surgery in the treatment of multiple benign mammary lumps has many advantages,such as shorter operation time,less number of incisions,smaller surgical incision length,quicker postoperative recovery and higher satisfaction of patients after operation.It has not significantly increased postoperative complications.It is worthy of clinical application and promotion.

Objective To study the effect of baseline clinical characteristics of elderly female patients on their long-term ischemic cardiovascular events.Methods Of the 614elderly patients admitted to our center from April 2008to July 2010,144elderly female patients were divided into female cardiovascular events group(n=43)and female control group(n=101),470elderly male patients were divided into male cardiovascular events group(n=127)and male control group(n= 343).Their baseline clinical characteristics were compared.The patients were followed up for 4.5-6.7(5.6±0.9)years,during which the relationship between first ever acute ischemic cardiovascular events and their clinical factors were analyzed.Results The incidence of grade 2hypertension,grade 3hypertension and hypercholesterolemia,the ratios of antiplatelet drug therapy,CCB therapy and hypoglycemic drug therapy were significantly higher while the history of smoking was significantly shorter,the incidence of chronic renal insufficiency and the ratios of statins therapy,nitrates therapy and ACEI/ARB therapy were significantly lower in female patients than in male patients.The incidence of chronic renal insufficiency was significantly higher in female cardiovascular events group than in female control group(9.3％vs 1.0％,P=0.03).The age was significantly older,the incidence of CHD,ischemic cerebral stroke,chronic obstructive pulmonary disease and the ratio of nitrates therapy were significantly higher in male cardiovascular events group than in male control group.Cox multivariate regression analysis showed that the endpoint events were related with CHD,grade 2hypertension,grade 3hypertension,hypercholesterolemia,chronic renal insufficiency in female patients(HR=2.56,95％CI:1.19-5.54,P=0.017;HR=3.29,95％ CI:1.14-9.52,P=0.028;HR=2.77,95％CI:1.08-7.12,P=0.034;HR=2.61,95％CI:1.27-5.36,P=0.009;HR=22.70,95％CI:5.22-98.78,P=0.000)and were related with age,CHD and ischemic cerebral stroke in male patients(P＜0.05,P＜0.01).Conclusion The effect of baseline clinical characteristics of elderly patients on their long-term ischemic cardiovascular events is different in males and females.The incidence of long-term cardiovascular events is closely related with the risk factors for cardiovascular disease in elderly females.

Objective To evaluate the effect of electric vagal stimulation on postoperative cognitive dysfunction in aged rats.Methods Thirty healthy Sprague-Dawley rats of both sexes,aged 18-20 months,weighing 390-550 g,were randomly divided into 3 groups (n=10 each) using a random number table:control group (group C),surgery group (group S),and electric vagal stimulation group (group V).Incision of the right carotid sheath was performed,and the vagal nerve was exposed after anesthesia in S and V groups.The right vagus nerve was stimulated for 30 min with continuous electric rectangular pulses (1 ms,10 Hz,1-2 V) after surgery in group V.The Morris water maze place navigation test was performed at 4,3,2 and 1 days before surgery and 2 days after surgery.The cognitive function was assessed using spatial probe and open field tests conducted at 2 days after surgery.The escape latency,the number of crossing the platform,the number of crossing the grid,the number of standing on the back legs,and the time animals spent in the central square were recorded.After the end of behavioral testing,venous blood samples were collected from the jugular vein for determination of concentrations of serum tumor necrosis factor-alpha (TNF-α),interleukin (IL)-1β and IL-6 using enzyme-linked immunosorbent assay.Results Compared with group C,the number of crossing the platform,the number of crossing the grid,and the number of standing on the back legs were significantly decreased,the escape latency and the time animals spent in the central square were significantly prolonged,and the concentrations of serum TNF-α,IL-1β and IL-6 were significantly increased at 2 days after surgery in group S (P＜0.05).Compared with group S,the number of crossing the platform,the number of crossing the grid,and the number of standing on the back legs were significantly increased,the escape latency and the time animals spent in the central square were significantly shortened,and the concentrations of serum TNF-α,IL-1β and IL-6 were significantly decreased at 2 days after surgery in group V (P＜0.05).Conclusion Electric vagal stimulation can improve the postoperative cognitive dysfunction in aged rats.

Objective To investigate long-term care needs and its influencing factors among old people with chronic diseases in nursing homes in rural area of Liaoning. Methods A total of 502 elderly with chronic diseases were recruited using convenience sampling method from eight nursing homes in rural area of Liaoning, and were investigated with the general information questionnaire, Short Form 36-item Health Survey (SF-36) and long-term care needs questionnaire from March 2015 to January 2016. Results Logistic regression analyses were used to identify that age (P=0.000), old patients′ disease condition (P=0.008), marriage (P=0.013) and quality of life (P=0.000) were major factors affecting long-term care needs. The top three highest percentage services were seeing the doctor 85.26% (428/502), assisting with taking the medicine 80.28% (403/502), assisting with bathing 70.32% (353/502). Conclusions This study suggests that we should improve the quality of services of long-term care needs based on the demands of old people with chronic diseases in nursing homes in rural area.

AIM: To investigate whether glucosylceramide synthase (GCS) regulates apoptosis-related gene bcl-2 expression via MEK/ERK signaling pathway , thus enhancing drug resistance of K 562/A02 human leukemia multidrug resistant cell line.METHODS:siRNA targeting GCS was transfected into K562/A02 cells.Bcl-2, p-ERK and total ERK expression at mRNA and protein levels after GCS knockdown were detected by real-time PCR and Western blotting .After exposed to MEK-ERK pathway inhibitor U0126, the expression of Bcl-2 at mRNA and protein levels also was analyzed by real-time PCR and Western blotting , respectively.The viability of the cells was evaluated by CCK-8 assay.RESULTS:The expression of GCS and Bcl-2, as well as MEK/ERK signaling were significantly inhibited in K 562/A02 cells by GCS siRNA transfection compared with negative control group .Inactivation of MEK/ERK signaling due to U0126 treatment de-creased Bcl-2 mRNA and protein levels in a concentration-dependent manner , and sensitized K562/A02 cells to adriamy-cin.CONCLUSION:GCS may affect the expression of apoptosis-related gene bcl-2 by MEK/ERK signaling pathway , thus regulating multidrug resistance of human leukemia K 562/A02 cells.

Introduction: To determine the relationship between participation in supervised and unsupervised therapy, and predictors of participation in supervised therapy during the first post-stroke year. Materials & Methods: Design: Prospective longitudinal study with interviews at admission, discharge, one month, six months and one year after discharge. Setting: Two subacute inpatient rehabilitation units and the community after discharge in Singapore. Participants: 215 subacute non-aphasic stroke patients. Intervention: Participation rate in supervised therapy (at outpatient rehabilitation centres) and unsupervised therapy (at home) defined as proportion of time spent performing therapy as prescribed by the subacute hospital’s multidisciplinary rehabilitation team at discharge. Main Outcome Measure: Predictors of participation in supervised and unsupervised therapy. Results: Patients who participated in supervised therapy (i.e. at an outpatient rehabilitation centre) >25% of the time recommended were more likely to participate in unsupervised therapy (i.e. at home) >75% of the time recommended at one, six and 12 months (crude odds ratio, OR = 4.41 [95%CI:2.09–10.17], 4.45 [95%CI:2.17–9.12], 6.93 [95%CI:2.60–18.48] respectively). Greater participation in supervised therapy at one and six months independently predicted greater participation in supervised therapy at six (adjusted OR=11.64 [95%CI:4.52-29.97]) and twelve months (adjusted OR=76.46 [95%CI:12.52-466.98]) respectively. Caregiver availability at six months independently predicted poorer participation in supervised therapy at 12 months. Conclusion: Interventions to increase participation in supervised therapy in the first post-stroke year should focus on transition of care in the first month after discharge. Further studies are needed to understand why caregiver availability was associated with low participation in supervised therapy.

Ginsenoside Rb3 (GRb3) is one of the main components in plasma of Panax quinquefolius Saponin of stem and leaf (PQS), which can be into human plasma. Previous studies have found PQS has estrogen-like vascular protective effects. In the present study, we investigated the estrogen-like protective effect of GRb3 on oxidative stress and dysfunction of endothelial cells induced by oxidized low-density lipoprotein. The activities of SOD, NOS and the contents of MDA in the cell lysate were examined by enzyme method or spectrophotometry. The NO and ET-1 concentrations in the cell culture supernatant were measured by ELISA method. The iNOS and eNOS mRNA expression were measured by real time RT-PCR, while the phosphorylation levels of Akt was measured by Western blotting. The results showed that GRb3 could enhance the activity of SOD, reduce the content of MDA, increase the level of NOS, NO, ET-1 and iNOS mRNA expression while decrease the eNOS mRNA expression and the phosphorylation level of Akt. These effects were blocked by estrogen receptor antagonist ICI182780. GRb3 can play a role in protecting vascular endothelial cells by estrogen receptors, the protective mechanism is similar to 17-β estrodiol.

Objective To assess mutations in the ALDH3A2 gene in two patients with Sj(o)gren-Larsson syndrome manifesting primarily as congenital ichthyosis,mental retardation and spastic paraplegia.Methods Two patients,a 2-year-old girl and a 1.5-year-old boy,with Sj(o)gren-Larsson syndrome were included in this study.None of their family members suffered from this disease.Peripheral blood samples were collected from the two patients,their family members (an elder brother and both parents),and 100 unrelated healthy controls.DNA was extracted from the blood samples,and subjected to PCR for the amplification of 10 encoding exons and their flanking sequences of the ALDH3A2 gene followed by DNA sequencing.Results A homozygous missense mutation c.325G ＞ A,which leads to the substitution of glycine by arginine at position 109,was detected in the ALDH3A2 gene of patient 1,whose parents and elder brother were heterozygous carriers of this mutation.The patient 2 carried compound heterozygous mutations,including c.1157A ＞ G (p.Asn386Ser) inherited from his father and c.1294A ＞ T (p.Arg432X) inherited from his mother.None of these mutations was detected in the unrelated healthy controls.Conclusion The homozygous mutation p.Gly109Arg and compound heterozygous mutations p.Asn386Ser and p.Arg432X present in these patients may be associated with clinical phenotypes of Sj(o)grenLarsson syndrome.

Objective: To investigate the effects of Chinese herbal drug-containing serum, prepared by administration of Chinese herbal medicine for activating blood (Xiongshao Capsule, XS) or for activating blood and detoxifying (Xiongshao Capsule plus Huanglian Capsule, XSHL) in rats, on cell viability, oxidative damage and apoptosis of human umbilical vein endothelial cells (HUVECs) induced by oxidized low-density lipoprotein (ox-LDL). Methods: Thirty-two rats were randomly divided into 4 groups: control group, positive control group (simvastatin 1.8 mg/kg), activating blood (XS, 0.135 g/kg) group, and activating blood and detoxifying (XS Capsule 0.135 g/kg and Huanglian Capsule 0.135 g/kg, XSHL) group. Corresponding drugs were continuously administered to the rats for 7 days and then drug-containing serum was harvested 1 hour after the last administration. HUVECs isolated from newborn children by collagenase digestion were stimulated by ox-LDL (100 μg/L) and incubated with corresponding drug-containing serum for 24 hours. Untreated HUVECs were also used as a normal control. The morphology and structure of HUVECs were observed by an inverted microscope. Cell viability was measured by methyl thiazolyl tetrazolium method, and cell membrane damage was determined by lactate dehydrogenase (LDH) leakage. Activity of superoxide dismutase (SOD) was examined by spectrophotometry, and content of malondialdehyde (MDA) in the cell lysate was examined by thiobarbituric acid assay. HUVECs were stained with Annexin V-fluorescein isothiocyanate and propidium iodide and analyzed on a flow cytometry to determine apoptosis. Results: Compared with the normal HUVECs, the cell viability and the activity of SOD were significantly decreased while the content of MDA and apoptosis rate were significantly increased after 24-hour ox-LDL stimulation (P<0.01, P<0.05). Simvastatin-, XS-, and XSHL-containing serum significantly promoted the ox-LDL-stimulated HUVEC viability and inhibited early apoptosis (P<0.01, P<0.05), while had no significant effect on LDH leakage. Simvastatin-containing serum and XS-containing serum also showed significant decrease in MDA content and increase in SOD activity, while XSHL-containing serum showed no significant effects. There was no significant difference between the XS-containing serum group and the XSHL-containing serum group. Conclusion: Both sera containing XSHL and XS show protective action against the oxidative damage and apoptosis of HUVECs induced by ox-LDL.