[Diagnostic value of urethral pressure profile for female bladder neck obstruction using air-charged catheters].

Objective: To evaluate the measurements of urethral pressure profile (UPP) using air-charged catheters (ACC) in women with bladder neck obstruction and to preliminarily analyze the diagnostic value of UPP based on ACC for female bladder neck obstruction. Methods: Retrospective inclusion of 63 female patients with bladder neck obstruction diagnosed in the Department of Urology of Beijing Chao-yang Hospital from September 2020 to December 2021 were included as the observation group, and 45 female patients who came to the hospital due to lower urinary tract symptoms with non-bladder neck obstruction during the same period were selected as the control group. All patients received urodynamic examination and UPP examination based on ACC, and urethral pressure measurements [M (Q1, Q3)] were compared between the two groups and analyzed the predictive value of the relevant measurements for female bladder neck obstruction. Results: The age of the observation group was 61 (47, 67) years and body mass index (BMI) was 24.1 (21.6, 27.9) kg/m2, the age of the control group was 65 (58, 71) years and BMI was 25.0 (22.8, 27.6) kg/m2. The urethral pressure at the bladder neck and urinary sphincter position in the observation group were higher than control group[104.00 (83.00, 124.00) cmH2O (1 cmH2O=0.098 kPa) vs 42.00 (31.00, 65.50) cmH2O, 125.0 (107.0, 154.0) cmH2O vs 99.0 (77.0, 124.0) cmH2O, P<0.001]. The results of the receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of urethral pressure at the bladder neck position had the highest predictive value for female bladder neck obstruction (AUC: 0.946, 95%CI: 0.886-0.981, sensitivity: 87.3%, specificity: 91.1%), and the results of interaction point plot showed that the cut-off value was 72 cmH2O. The cut-off value of urethral pressure at the bladder neck position was used as positive cut-off value to predict female patients with bladder neck obstruction. Sixty-three patients with bladder neck obstruction were detected by UPP measurement using ACC in 59 cases (59/63, 93.7%) and the Kappa value was 0.774 (95%CI: 0.654-0.894), indicating that UPP had high consistency with pressure-flow study. Conclusions: UPP examination based on ACC can show the pressure values of the bladder neck and urethral sphincter position. When the urethral pressure of the bladder neck position is greater than 72 cmH2O, it is helpful for the diagnosis of female bladder neck obstruction and has guiding significance for the diagnosis and treatment of this disease.

[Curative effect of complete transperitoneal laparoscopic nephroureterectomy in post kidney transplantation patients with upper tract urothelial carcinoma].

Objective: To investigate the efficacy and safety of complete transabdominal laparoscopic nephroureterectomy in treating primary upper tract urothelial carcinoma (UTUC) for post kidney transplantation patients. Methods: The clinical data of patients with primary renal pelvis and ureter tumors after kidney transplantation in Beijing Chaoyang Hospital from May 2016 to December 2019 were retrospectively analyzed. Seventeen patients (including 9 patients in ipsilateral transplanted kidney group and 8 patients in contralateral transplanted kidney group) underwent traditional retroperitoneoscopic nephroureterectomy (TRNU), and 24 patients (including 14 patients in ipsilateral transplanted kidney group and 10 patients in contralateral transplanted kidney group) underwent complete transperitoneal laparoscopic nephroureterectomy (CTNU). The perioperative clinical indicators of all patients were recorded and analyzed, and the surgical indicators of two techniques were compared. Results: Forty-one patients [16 males and 25 females, with a median age of 57 (53, 70) years old] were finally included. The operation time in the contralateral transplanted kidney group [(95±44) min] from CTNU was significantly decreased compared with that in the ipsilateral group from CTNU [(159±49) min] and the contralateral [(196±20) min] or ipsilateral [(205±21) min] groups from TRNU (all P<0.01). The blood loss volume [(84±39) ml vs (106±44) ml vs (109±20) ml vs (112±21) ml, P=0.271] and postoperative hospital stay [(10.6±2.1) d vs (11.8±1.7) d vs (10.3±1.5) d vs (11.4±1.5) d, P=0.171] were not statistically different among these four groups. During the median follow-up of 24 months, 13 patients developed contralateral recurrence or metastasis, 8 patients developed intravesical recurrence, and 5 patients died of UTUC. Conclusions: Single-position complete transabdominal laparoscopic nephroureterectomy for the treatment of primary renal ureteral tumors after kidney transplantation has the advantage of a short operation time, without increasing intraoperative blood loss or perioperative complications. It is suitable for the treatment of urothelial carcinoma after kidney transplantation, especially for the contralateral side of the transplanted kidney.

Bulk Flow and Near Wall Hemodynamics of the Rabbit Aortic Arch and Descending Thoracic Aorta: A 4D PC-MRI Derived Computational Fluid Dynamics Study.

Animal models offer a flexible experimental environment for studying atherosclerosis. The mouse is the most commonly used animal, however, the underlying hemodynamics in larger animals such as the rabbit are far closer to that of humans. The aortic arch is a vessel with complex helical flow and highly heterogeneous shear stress patterns which may influence where atherosclerotic lesions form. A better understanding of intraspecies flow variation and the impact of geometry on flow may improve our understanding of where disease forms. In this work, we use magnetic resonance angiography (MRA) and 4D phase contrast magnetic resonance imaging (PC-MRI) to image and measure blood velocity in the rabbit aortic arch. Measured flow rates from the PC-MRI were used as boundary conditions in computational fluid dynamics (CFD) models of the arches. Helical flow, cross flow index (CFI), and time-averaged wall shear stress (TAWSS) were determined from the simulated flow field. Both traditional geometric metrics and shape modes derived from statistical shape analysis were analyzed with respect to flow helicity. High CFI and low TAWSS were found to colocalize in the ascending aorta and to a lesser extent on the inner curvature of the aortic arch. The Reynolds number was linearly associated with an increase in helical flow intensity (R = 0.85, p < 0.05). Both traditional and statistical shape analyses correlated with increased helical flow symmetry. However, a stronger correlation was obtained from the statistical shape analysis demonstrating its potential for discerning the role of shape in hemodynamic studies.

[The roles of IL-17 and CXCR4 in chronic allograft nephropathy in rat models].

Objective: To investigate the role and mechanism of IL-17 and CXCR4 in chronic graft nephropathy (CAN) in rat models. Methods: CAN rat models were established using Fisher 344 to Lewis rats. In the control group(n=10), Lewis rats were performed isotransplantation. CAN rat models were established in experimental group(n=10). All the rats were havested 6 weeks after transplantation. Kidneys were examined by pathology to evaluate the injury of the renal allograft. SDF-1/CXCR4, IL-17 and α-SMA expression level in serum and renal graft were detected by immunohistochemical staining and Enzyme-linked immunosorbent assays(ELISA). The percent and the absolute amount of CD4(+) cells、CXCR4(+) cells and IL-17(+) cells were detected by flow cytometry. Results: The graft of the experiment group showed obvious pathological features of CAN. The protein expression levels of SDF-1/CXCR4 and IL-17 in the experiment group are significantly higher than in the control group. We could also observe the number of Th17 cells has a significant increase in the experiment group[blood (0.19±0.05)% vs (0.12±0.03)%; kidney (0.52±0.21)% vs (0.17±0.12)%]. The IL-17 level also showed the same differences between the experiment[blood (243.12±17.63) pg/ml, kidney (521.54±21.76) pg/ml]and the control group[blood (35.78±7.3) pg/ml, kidney (77.34±11.1) pg/ml]. Conclusions: The Th17 cells increase in the CAN rats model, maybe the SDF-1/CXCR4 has a chemotaxis to collect Th17 cells to the injured kidney. And its expression of IL-17 may promote the renal cells to transform into fibroblasts.

Conceptual convergence: increased inflammation is associated with increased basal ganglia glutamate in patients with major depression.

Inflammation and altered glutamate metabolism are two pathways implicated in the pathophysiology of depression. Interestingly, these pathways may be linked given that administration of inflammatory cytokines such as interferon-α to otherwise non-depressed controls increased glutamate in the basal ganglia and dorsal anterior cingulate cortex (dACC) as measured by magnetic resonance spectroscopy (MRS). Whether increased inflammation is associated with increased glutamate among patients with major depression is unknown. Accordingly, we conducted a cross-sectional study of 50 medication-free, depressed outpatients using single-voxel MRS, to measure absolute glutamate concentrations in basal ganglia and dACC. Multivoxel chemical shift imaging (CSI) was used to explore creatine-normalized measures of other metabolites in basal ganglia. Plasma and cerebrospinal fluid (CSF) inflammatory markers were assessed along with anhedonia and psychomotor speed. Increased log plasma C-reactive protein (CRP) was significantly associated with increased log left basal ganglia glutamate controlling for age, sex, race, body mass index, smoking status and depression severity. In turn, log left basal ganglia glutamate was associated with anhedonia and psychomotor slowing measured by the finger-tapping test, simple reaction time task and the Digit Symbol Substitution Task. Plasma CRP was not associated with dACC glutamate. Plasma and CSF CRP were also associated with CSI measures of basal ganglia glutamate and the glial marker myoinositol. These data indicate that increased inflammation in major depression may lead to increased glutamate in the basal ganglia in association with glial dysfunction and suggest that therapeutic strategies targeting glutamate may be preferentially effective in depressed patients with increased inflammation as measured by CRP.

[Risk factors for acute rejection in living-donor kidney transplant recipients in China: a subgroup analysis of a multi-center, registry study].

Objective: To evaluate pre-and early post-transplantation risk factors for acute rejection(AR) in kidney recipients. Methods: This subgroup analysis of a multi-center registry study was conducted on living-donor kidney transplant recipients in China with 10 years of follow-up. This study analyzed 1 255 recipients including 921 males(73.4%) and with a mean age of (33±10)years. Data from patients were first analyzed with univariate analysis and then multivariate analysis was used for finding out the potential risk factors of AR. Results: A total of 106(8.4%) patients were suspected with AR after kidney transplantation, while 1 149 patients were considered as non-AR. Multivariable analysis demonstrated a significant influence of recipient age and cold ischemia time(CIT) on the occurrence of AR(OR: 0.956, 95% CI: 0.923-0.990; OR: 1.006, 95% CI: 1.002-1.011, respectively). The frequency of severe infection was significantly higher in the AR group than non-AR group(38.7% vs 10.8%; P<0.000 1). The occurrence of new-onset diabetes mellitus and tumors was similar in the two groups. Conclusions: Recipient age and CIT are risk factors for AR after living-donor kidney transplantation. Reducing CIT and intensive management of younger recipient could benefit kidney transplant patients.

Antimicrobial and antitumor activity and diversity of endophytic fungi from traditional Chinese medicinal plant Cephalotaxus hainanensis Li.

Endophytes from Cephalotaxus hainanensis Li, an important source of anti-leukemia drugs, have not been widely explored. In this study, 265 endophytic fungal isolates from C. hainanensis Li were screened for antimicrobial activities against tilapia, banana, rice, and rape and for antitumor activities against human leukemia cell lines (K562, NB4, and HL-60). Diversity was also analyzed. The results showed that 17.7% of the endophytic fungi had antimicrobial activities against at least three different test microbes, and activity against Fusarium oxysporum RKY102 was the highest at 15.8%. Cytotoxicity against at least one tumor cell line tested was observed in 18.5% of the endophytic fungi; with the highest value of 10.6% against K562. The endophytic fungal strains also showed relatively high activities against K562, NB4, and HL-60 while relatively fewer strains were cytotoxic against the human hepatic Hep-G2 and colon LoVo cancer cell lines. Thirty endophytic fungal strains showed both high antimicrobial and antitumor activities. Moreover, the analyses of the diversity of the 30 highly active strains showed they belonged to 20 species from 14 genera, and this is the first report of endophytic fungi Albonectria rigidiuscula, Colletotrichum magnisporum, and Nemania diffusa being isolated from Cephalotaxus plants. These findings suggest that natural antibacterial products for humans and tilapia; antifungal compounds for rice, rape, and banana; and antitumor compounds for leukemia therapy could be isolated from fungal strains derived from C. hainanensis Li.

Effect of hyperphosphatemia on gene expression of the Na-Pi cotransporter in rats.

We investigated the effect of high phosphorus content on the sodium-phosphate cotransporter (NaPi-IIa and NaPi-IIl). Forty-eight Sprague-Dawley rats were divided into 3 groups: high-phosphorus group (HP) with fructose diphosphate sodium injection; self-manufactured low-phosphorus diet group (LP); and normal diet group (NP). At the 1st, 2nd, 4th, and 6th weeks, 4 rats from each group were sacrificed for detecting serum levels of calcium, phosphorus, and intact parathyroid hormone. Semi-quantitative retrovirus-polymerase chain reaction was used to detect the expression of NaPi-IIa and NaPi-III mRNA in kidney. At the 1st, 2nd, 4th, and 6th weeks, serum phosphorus and parathyroid hormone levels in HP group were significantly higher than those in LP and NP groups (P < 0.05). Serum calcium levels in the 3 groups showed no difference (P > 0.05). Comparing the expression of NaPi-IIa mRNA in HP group with LP and NP groups, NaPi-IIa mRNA expression was significantly reduced in HP group (P < 0.05), while NaPi-IIa mRNA expression in LP group began increasing at the 4th week (P < 0.05). At the 1st, 2nd, and 4th weeks, the expression of NaPi-III mRNA in HP, LP, and NP groups showed no clear differences (P > 0.05), while at the 6th week in HP group, NaPi-III mRNA expression was slightly increased compared to in LP and NP groups (P < 0.05). Hyperphosphatemia significantly affected NaPi-IIa and NaPi-III mRNA expression, and a factor promote an increase in intact parathyroid hormone independently of calcium.

[Safety and efficacy of preoperative induction therapy using a single high dose ATG-F in renal transplantation: a meta-analysis of randomized controlled trials].

OBJECTIVE: This study aimed to evaluate the safety and efficacy of preoperative induction therapy using a single high dose (9 mg/kg) of antithymocyte globulin-Fresenius S (ATG-F) for patients undergoing renal transplantation. METHODS: Randomized controlled clinical trials (RCTs) on the safety and efficacy of preoperative induction therapy using a single high dose of ATG-F for patients undergoing renal transplantation were searched in Cochrane Library, PubMed, EMBASE covering a period from the beginning of databases to July 2015. The meta-analysis was conducted using RevMan 5.2. RESULTS: Five RCTs with 346 patients were included in this study. The meta-analysis showed that the incidences of acute rejection for the patients with renal transplantation were 20.6% (37/180) in the induction therapy group using a single high dose of ATG and 42.8% (71/166) in the control group, with a combined relative risk (RR) of 0.49 and 95% confidence interval (CI) of[0.36, 0.69](P<0.000 1). The patient survival rate (1 year: RR=1.02, 95% CI[0.98, 1.06], P=0.43; 5 years: RR=1.01, 95% CI[0.94, 1.08], P=0.83) and the graft survival rate (RR=1.04, 95% CI[0.97, 1.12], P=0.24) of the two groups were similar. The incidences of CMV infection, urinary tract infection, and malignant tumor were also similar in the two groups. CONCLUSION: The induction therapy using a single high dose of ATG-F significantly reduced the incidence of acute rejection after transplantation and showed no increased incidence of urinary tract infection, CMV infection, or malignant tumor. The results of our meta-analysis suggest that the application of a high dose of ATG-F may be a safe and effective induction therapy.

Simultaneous directional emissions of multiple quantum emitters with cross plasmonic antenna.

We introduce a cross plasmonic antenna (CPA) for the system of multiple quantum emitters (QEs) with different emission wavelengths, where the excitation light scattering and emission fluorescence of different QEs are spatially separated in four different directions. By considering the CPA as oscillating dipoles, this phenomenon is attributed to the phase differences between them. The enhancement for QEs are very strong in correponding directions. In addition, the fluorescence is strongly polarized. By adding a silver plate as substrate, the directivity can be further tuned in the whole upper half space. Our result shows that the CPA is promising for realization of an efficient, directional and strongly polarized nano-scale light source, which will have potential application in Nano-Optics.

Diversity and antimicrobial activity of endophytic fungi isolated from Cephalotaxus hainanensis Li, a well-known medicinal plant in China.

UNLABELLED: About 1051 endophytic fungi were isolated from leaves, branches, barks and stems of Cephalotaxus hainanensis Li from four sites in Hainan, China. The fungi were identified as 21 genera by morphology and ITS sequences. One dominant species was Phomopsis quercella in Hainan Tropical Botanical Garden and Bawangling Nature Reserve, with relative frequency of 42·06 and 34·88% respectively. Another dominant species was Colletotrichum boninense in Wuzhishan and Jianfengling Nature Reserves, with relative frequency of 36·84 and 46·97% respectively. Among the selected 21 endophytic fungi, 17 strains (80·95%) had activity against at least one pathogenic bacteria, and 14 strains (66·67%) exhibited activity against at least one fungal pathogens. Neonectria macroconidialis showed strong inhibition against Staphylococcus aureus (inhibition zone being 20 mm), Bacillus subtilis (14 mm) and Streptococcus agalactiae (28 mm). Xylaria sp. showed strong inhibition against Escherichia coli (20 mm), Rhizoctonia solani (20 mm) and Sclerotinia sclerotiorum (17 mm). Verticillium bulbillosum showed great activity against Strep. agalactiae (32 mm) and Fusarium oxysporum (22 mm). These endophytic fungi showed potentials in medicine development. SIGNIFICANCE AND IMPACT OF THE STUDY: Endophytic fungi from medicinal plants are an important source of novel and viable drugs. Cephalotaxus hainanensis Li is well known for leukaemia treatment and its endophytic fungi were isolated to investigate the diversity and antimicrobial activity. It was found that Ce. hainanensis Li had rich endophytic fungi, and some fungi showed strong antimicrobial activity against certain pathogens. These fungi can be used in medicine development.

Detection of autoantibodies to a panel of tumor-associated antigens for the diagnosis values of gastric cardia adenocarcinoma.

To evaluate the diagnostic values of using autoantibodies in sera to a panel of eight tumor-associated antigens (TAAs) of P53, Koc, P62, C-myc, IMP1, Survivn, P16 and Cyclin B1 full-length recombinant proteins for early detection of patients with gastric cardia adenocarcinoma (GCA) and high-risk subjects screening. Enzyme-linked immunosorbent assay was used to detect autoantibodies against the eight selected TAAs in 383 sera samples from four groups, including 140 subjects with normal gastric cardia epithelia (NOR), 76 patients with chronic atrophic gastritis (CAG), 79 patients with gastric cardia dysplasia (DYS) and 88 patients with GCA. In addition, the expression of the eight antigens was analyzed in gastric cardia tissues by immunohistochemical method. The individual autoantibodies to six TAAs (P53, P62, IMP1, Survivn P16 and Cyclin B1) were significantly higher in sera from patients with GCA than that in normal subjects (P < 0.05). When autoantibody assay successively accumulated to seven TAAs (P53, Koc, P62, C-myc, IMP1, Survivn and P16), a stepwise increased detection frequency of autoantibodies was found in the four sera groups (13% in NOR, 39% in CAG, 46% in DYS, and 64% in GCA, respectively), the risks to CAG, DYS and GCA steadily increased about 4.4-, 5.7- and 12.0-fold. The sensitivity and the specificity for autoantibodies against the seven TAAs in diagnosing GCA reached up to 64% and 87%, respectively. The area under the receiver operating characteristic curve for the seven anti-TAA autoantibodies was 0.73 (95%CI: 0.68-0.78) No more increase in sensitivity was found with the addition of new anti-TAA autoantibodies. A combination detection of autoantibodies to TAAs might be helpful to distinguish GCA patients from normal subjects and the patients with gastric cardia precancerous lesions. In addition, further studies in patients with GCA and precancerous lesions using enlarged TAA panels might improve the sensitivity and specificity of cancer detection and high-risk subjects screening.

Analysis of the association between polymorphisms in the vitamin D receptor (VDR) gene and dental caries in a Chinese population.

Environmental influences on the development and progression of dental caries are well known; however, there is little evidence of a genetic component imparting susceptibility to dental caries. The aim of this study was to investigate the relationship between a single nucleotide polymorphism in the vitamin D receptor TaqI locus and dental caries susceptibility in a Chinese population. This case-control study was conducted with a case group (264 patients with dental caries from northwestern China) and a control group (219 individuals without dental caries or systemic disease from the same area). DNA was extracted from the peripheral venous blood of the study participants; the distribution of TaqI locus genotypes and allele frequencies was determined via polymerase chain reaction-restriction fragment length polymorphism. The data obtained were statistically analyzed using the Hardy-Weinberg equilibrium and Chi-square test. The frequency of the Tt genotype in the case group (14.0%) was significantly higher than that in the control group (4.3%), as determined using the genotype TT as the reference. The risk of dental caries was increased 3.8-fold in individuals with the heterozygous Tt genotype compared to that in the individuals with the TT genotype. The proportion of the 't' allele in the case group (7.0%) and the control group (2.1%) was observed to be significantly different [P = 0.0003; OR = 3.592, confidence interval 95% (1.790-7.208)]. Our results therefore suggested that the allele 't' might be a genetic factor determining dental caries susceptibility in individuals from the northwest of China.

Genetic polymorphisms in the carbonic anhydrase VI gene and dental caries susceptibility.

We investigated the role of 7 single nucleotide polymorphisms in the carbonic anhydrase (CA) VI gene (rs2274328, rs17032907, rs11576766, rs2274333, rs10864376, rs3765964, and rs6680186) and the possible association between these polymorphisms and dental caries susceptibility in a Northwestern Chinese population. We collected samples from 164 high caries experience and 191 very low caries experience and conducted a case-control study according to the number of decayed, missing, and filled teeth index and genotyped the 7 polymorphisms using a 384-well plate format with the Sequenom MassARRAY platform. Individuals carrying the rs17032907 TT genotype were more likely to have an increased risk of dental caries compared with carriers of the C/C genotype in the co-dominant model, with an odds ratio (95% confidence interval) of 2.144 (1.096-4.195). We also found that the haplotype (ACA) (rs2274328, rs17032907 and rs11576766) was associated with a low number of decayed, missing, and filled teeth index with an odds ratio (95% confidence interval) of 0.635 (0.440-0.918). However, we found no association between dental caries susceptibility and the rs2274328, rs11576766, rs2274333, rs10864376, rs3765964, and rs6680186 polymorphisms and other haplotypes. The rs17032907 genetic variant and the haplotype (ACA) of CA VI may be associated with dental caries susceptibility.

Establishment and characterization of a rat model of hyperphosphatemia.

We established a rat model of hyperphosphatemia and investigated the systemic effects of high phosphorus (P). Sprague Dawley rats were randomly divided into high (HP), low (LP), and normal (NP) P groups (N = 12 each), which received injections of fructose diphosphate sodium, or were fed self-manufactured low phosphorus or normal diets, respectively. In each group, 4 rats were sacrificed at the first, third, and sixth week to detect the serum (Scr) and urinary creatinine and P, and calcium (Ca) levels. The HP group's serum P and intact parathyroid hormone (iPTH) were significantly higher than those in the other groups at the first, third, and sixth weeks, (P < 0.05); the LP group's serum P was lower than the NP group's at the third week (P < 0.05), while at the sixth week, the serum P and iPTH were lower (P < 0.05). No significant differences were detected for blood Ca+ (P > 0.05). The HP group's Scr increased (P < 0.01), whereas the fractional excretion decreased (P < 0.05) significantly. Thighbone and lumbar spine bone densities differed significantly between groups in the third week (P < 0.05); LP group densities were lower than NP group measures (P < 0.05). Crystallized stones were not observed microscopically following hematoxylin and eosin staining of the kidney. We successfully established a hyperphosphatemia rat model, and high blood P was found to significantly influence renal function and bone density. These results might provide a foundation to study the effects of hyperphosphatemia in rats.

Diode-pumped 1988-nm Tm:YAP laser mode-locked by intracavity second-harmonic generation in periodically poled LiNbO3.

We report a diode-pumped intracavity second-harmonic generation mode-locked solid-state Tm:YAP laser operating at 1988 nm using a periodically poled congruent LiNbO3 as the nonlinear crystal. The threshold of continuous wave mode locking is 11.6 W. The maximum output power is 1.67 W, while the shortest pulse obtained is 4.7 ps at a repetition rate of 97.09 MHz.

Radial artery graft vs. saphenous vein graft for coronary artery bypass surgery : which conduit offers better efficacy?

OBJECTIVES: Coronary artery bypass grafting (CABG) is the best therapeutic option for multivessel coronary artery diseases. The internal thoracic artery is usually used for the left anterior descending coronary artery. However, it is still not clear what the best conduit is for non-left anterior descending coronary arteries. This research sought to assess the efficacy of the radial artery versus the saphenous vein in this context. METHODS: A systematic literature search was performed for randomized clinical trials (RCT) published in MEDLINE, EMBASE, and the Cochrane Library. RCTs reporting angiographic comparisons and clinical events of the radial artery versus the saphenous vein were included. RESULTS: Six trials (1,860 participants, 1,188 radial artery grafts, 1,178 saphenous vein grafts) were included in this review. The radial artery was associated with a significantly lower incidence of graft failure (p < 0.05) and of repeat coronary operation (p < 0.05). There was no significant trend toward decreased cardiac death and myocardial infarction with the use of a radial artery (p > 0.05; p > 0.05). As determined by the GRADE method, the evidence quality was low for repeat operation and very low for other variables. CONCLUSION: The radial artery can be weakly recommended as a selective conduit but cannot always be considered better than the saphenous vein.

Lower dosing of enteric-coated mycophenolate sodium (Myfortic) can achieve target mycophenolic acid exposure rapidly in most Chinese renal transplant patients: a pilot study.

AIMS: There are few pharmacokinetic data for enteric-coated mycophenolate sodium (EC-MPS) in Chinese kidney transplant recipients. Previously, we demonstrated that patients with 540 mg EC-MPS reached target exposure on day 4 after transplantation. The aim of this study was further to confirm that mycophenolic acid (MPA) delivery with a daily total dose 1080 mg EC-MPS is adequate during the early-phase posttransplantation and preliminarily assess the pharmacokinetics after a single dose and multiple doses of EC-MPS in Chinese live-donor kidney transplant recipients. METHODS: Twelve patients (eight men and four women, mean age 41.3 ± 6.78 years) treated with EC-MPS, cyclosporine and corticosteroids were included in this study. Patients received a single oral dose of EC-MPS 540 mg, then 540 mg twice daily. MPA concentrations were measured by high-performance liquid chromatography. Twelve-hour pharmacokinetic profiles were obtained after the single oral dose and multiple doses on day 4 postoperation. The pharmacokinetic parameters were compared between a single dose and multiple doses. By using multiple stepwise regression analysis, we obtained two predictive equations of MPA systemic exposure. Bland-Altman analysis was developed to test agreement between the observed MPA area under the concentration-time curve (AUC) and the predicted MPA AUC. RESULTS: The mean (range) MPA AUC was 42 ± 14.67 (29.29-75.95) mg/l h after the first dose, and 44.72 ± 14.57 (32.06-80.79) mg/l h on day 4 after operation. MPA exposure provided by a single dose and multiple doses were similar (p > 0.05). The best equations obtained were the following: 20.003 + 1.181C6 h  + 7.22C8 h (r = 0.936) and 17.023 + 3.11C1 h  + 1.245 + 4.988C8 h (r = 0.964). These equation models showed an optimal agreement between the observed MPA AUC and the predicted MPA AUC. CONCLUSIONS: Lower dosing of EC-MPS, compared with the standard dose (720 mg twice daily), may provide enough MPA exposure for Chinese live-donor kidney transplant patients on day 4. Given that the MPA exposure by AUC correlates with the incidence of acute rejection episodes and transplant vasculopathy, the present findings may have clinical implications, and the optimum dose range of EC-MPS for patients in all ranges of body weight should also be determined.

Quasi-phase-matched second-harmonic Talbot self-imaging in a 2D periodically-poled LiTaO3 crystal.

We demonstrate the improved second-harmonic Talbot self-imaging through the quasi-phase-matching technique in a 2D periodically-poled LiTaO(3) crystal. The domain structure not only composes a nonlinear optical grating which is necessary to realize nonlinear Talbot self-imaging, but also provides reciprocal vectors to satisfy the phase-matching condition for second-harmonic generation. Our experimental results show that quasi-phase-matching can improve the intensity of the second-harmonic Talbot self-imaging by a factor of 21.

High-performance cavity-phase matching by pump reflection.

Since cavity-phase matching has been experimentally realized, the efficiency is limited to 20%. In this Letter, we successfully achieved a conversion efficiency as high as 41% with a slope efficiency of 48.5% using cavity-phase matching, by reflecting the pump beam at the end surface of the KTiOPO(4) crystal. The high performance of the device makes it a promising candidate to substitute for quasi-phase-matching material.