Objective Through an analysis of three cases of ocular flutter-opsoclonus in adults and a review of the relevant literature,we summarized its characteritics to improve the clinical awareness of this sign.Methods Three cases of adult-onset ocular flutter-opsoclonus from July 2014 to July 2017 were retrospectively analyzed in terms of clinical features,cerebrospinal fluid (CSF) analysis,brain imaging,etiologies and treatment,and followed up through telephone calls.Results Case 1:A 68-year-old man presented with ocular flutter,vertigo,myoclonus,ataxia and conscious disturbance.CSF analysis demonstrated pleocytosis and mildly elevated protein level.Brain MR imaging revealed ischemia,and SPECT showed hypoperfusion involving left frontal and occipital lobes.Paraneoplastic syndrome was considered as the etiology.The symptoms subsided without any specific treatment.He died from lung cancer within one year.Case 2:A 66-year-old man presented with ocular flutter,vertigo,ataxia,conscious disturbance and fever.CSF protein level was severely elevated.Brain MR imaging revealed ischemia.Epstein-Barr virus infection was considered as the etiology.The symptoms improved with the administration of antiviral drugs and steroid.Relapse was not observed in the two-year follow-up.Case 3:A 34-year-old woman presented with opsoclonus,oscillopsia,vertigo,ataxia,conscious disturbance and fever.MR imaging showed midbrain lesions.Viral brainstem encephalitis was considered as the etiology.The symptoms improved with the administration of antiviral drugs,steroid,intravenous immunoglobulin and clonazepam.Relapse was not observed in the two-year follow-up.Conclusions Infection and tumors are common etiologies of ocular flutter-opsoclonus.Treatment includes etiological management for infection or tumors and immunosuppressive therapy.The clinical outcomes vary with the underlying etiologies.

OBJECTIVETo study the effect of Platycarya strobilacea Sieb. et Zucc (PSZ) extract on methuosis of human nasopharyngeal carcinoma CNE1 and CNE2 cells and explore the underlying mechanism.

METHODSCNE1 and CNE2 cells were treated with 1 mg/mL PSZ extract and the expressions of Rac1 mRNA and Rac1 protein were detected using RT-qPCR and Western blotting, respectively. Results CNE1 and CNE2 cells showed obvious morphological changes typical of methuosis following treatment with PSZ extract characterized by cell merging, accumulation of large cytoplasmic vacuoles, and membrane rupture without obvious changes in the nuclei. PSZ treatment resulted in up-regulated Rac1 mRNA and Rac1 protein expressions in the cells. Application of EHT 1864 obviously blocked the effect of PSZ extract in inducing methuosis in CNE1 and CNE2 cells.

CONCLUSIONPSZ extract can induce methuosis in CNE1 and CNE2 cells by inducing the overexpression of Rac1.

We assessed the role of diabetes mellitus (DM) on treatment effects in drug-susceptible initial pulmonary tuberculosis (PTB) patients. A prospective study was conducted in eight provinces of China from October 2008 to December 2010. We enrolled 1,313 confirmed drug-susceptible initial PTB patients, and all subjects received the treatment regimen (2H3R3E3Z3/4H3R3) as recommended by the national guidelines. Of the 1,313 PTB patients, 157 (11.9%) had DM; these patients had more sputum smear-positive rates at the end of the second month [adjusted odds ratios (aOR) 2.829, 95% confidence intervals (CI) 1.783-4.490], and higher treatment failure (aOR 2.120, 95% CI 1.565-3.477) and death rates (aOR 1.536, 95% CI 1.011-2.628). DM was a contributing factor for culture-positive rates at the end of the second month and treatment failure and death of PTB patients, thus playing an unfavorable role in treatment effects of PTB.
Antitubercular Agents ; therapeutic use ; China ; epidemiology ; Diabetes Mellitus ; epidemiology ; therapy ; Female ; Humans ; Male ; Mycobacterium tuberculosis ; drug effects ; Tuberculosis, Pulmonary ; complications ; drug therapy ; epidemiology ; microbiology

The objective of this prospective study of the risks of treatment failure in patients with drug-susceptible pulmonary tuberculosis (PTB) was to provide reference data to help develop a disease control strategy. Participants were recruited in eight provinces of China from October 2008 to December 2010. A total of 1447 patients with drug-susceptible PTB and older than 15 years of age were enrolled. Demographic characteristics, bacteriological test results, and patient outcome, i.e., cure or treatment failure were recorded and compared using the chi-square or Fisher's exact tests. Multivariate logistic regression was used to identify factors associated with risk of treatment failure. Of the 1447 patients who were enrolled, 1349 patients (93.2%) were successfully treated and 98 (6.8%) failed treatment. Failure was significantly associated with age 365 years [odds ratio (OR)=2.522, 95% confidence interval (CI): (1.097-5.801)], retreatment [OR=2.365, 95% CI: (1.276-4.381)], missed medicine [OR=1.836, 95% CI: (1.020-3.306)], treatment not observed [OR=1.879 95% CI: (1.105-3.195)], and positive culture result after the first [OR=1.971, 95% CI: (1.080-3.597)] and second month [OR=4.659, 95% CI: (2.590-8.382)]. The risk factors associated with treatment failure were age 365 years, retreatment, missed medication, treatment not observed, and positive culture at the end of month 1 or month 2. These risk factors should be monitored during treatment and interventions carried out to reduce or prevent treatment failure and optimize treatment success.
Adolescent ; Adult ; Aged ; Antitubercular Agents ; therapeutic use ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Mycobacterium tuberculosis ; drug effects ; physiology ; Prospective Studies ; Retreatment ; Risk Factors ; Treatment Failure ; Tuberculosis, Multidrug-Resistant ; drug therapy ; epidemiology ; microbiology ; Tuberculosis, Pulmonary ; drug therapy ; epidemiology ; microbiology ; Young Adult

Objective: To compare the early and long-term outcomes between on-pump and off-pump coronary artery bypass grafting (CABG) in elder female patients.
Methods: A total of 763 female patients elder than 65 years of age received isolated CABG in our hospital from 1999-01 to 2008-12 were retrospectively studied. The patients were divided into 2 groups according to operational method: On-pump group,n=331 and Off-pump group,n=432. The mortality at 30 days post-operation, in-hospital clinical indexes and long term mortality with MACCE as all cause death, myocardial infarction (MI), stroke and repeated revascularization were compared between 2 groups.
Results: Compared with On-pump group, the patients in Off-pump group had the elder age (P<0.01), with the higher rate of cerebral vascular accident (P=0.023); less family history of coronary artery disease (P=0.012), angina (P<0.001) and emergent operation (P=0.015), less venous distal anastomoses (P<0.001) ; while higher incomplete revascularization (P<0.001). Logistic regression model comparison indicated that Off-pump group had the lower mortality at 30 days post-operation (P=0.038), less application of blood products (P<0.001), lower rate of >24h mechanical ventilation (P<0.001), less renal failure (P=0.022), pulmonary complications (P<0.001) and re-exploration for bleeding (P=0.021). The morbidity of all post-operative complications were similar between 2 groups (P=0.110). Cox regression model comparison showed that long-term all cause mortality (P=0.477) and occurrence of MACCE (P=0.265) were similar between the two groups.
Conclusion: Off-pump CABG would reduce the mortality at 30 days post-operation, have less application of blood products, shorter post-operative mechanical ventilation, less early post-operative renal failure, pulmonary complications and re-exploration for bleeding. While it could not reduce the long-term mortality and MACCE occurrence.

In past decade, hydrogen sulfide (H₂S) as a novel gasotransmitter, covered many fields in biological and medical research. However, there is no effective, convenient and high-throughput method for determination of circulatory H₂S until now. Here, we aim to develop an easy method for measurement of circulatory H₂S by modified methylene blue method. In the present study, we added Zn²⁺ to plasma sample to deposit H₂S, HS⁻ and S²⁻, as well as plasma protein, then used NaOH to re-dissolve plasma protein. ZnS deposition was re-dissolved by the addition of N, N-dimethyl-p-phenylenediamine, and the remnant protein was deposited by trichloroacetic acid. After centrifugation, ferriammonium sulfate was added to the supernatant fluid to generate methylene blue, which was analyzed by spectrophotometer at 665 nm. Using the present method, we found that most ions including sulfate and thiosulfate did not affect detection of H₂S concentration, but albumin (physiological concentration) reduced the detection value, which suggested the binding of serum albumin and a certain amount of H₂S. The relative recovery ratio of present method is 81.9%, which implies that the method is relative accurate for the determination of H₂S concentration in plasma or serum. H₂S levels of frozen plasma samples from 65 healthy volunteers detected by the present method were (13.93 ± 4.98) µmol/L. There was no obvious difference between the detection values of fresh and frozen samples from the same SD rats. These results suggest the modified methylene blue assay is stable, sensitive, convenient and high-throughput. The method can be used to analyze the circulatory H₂S in clinical and basic research.
Animals ; Blood Chemical Analysis ; methods ; Humans ; Hydrogen Sulfide ; blood ; Methylene Blue ; chemistry ; Phenylenediamines ; chemistry ; Rats ; Rats, Sprague-Dawley ; Sulfides ; chemistry ; Zinc Compounds ; chemistry