Preoperative Aspirin Does Not Increase Transfusion or Reoperation in Isolated Valve Surgery.

OBJECTIVE: Preoperative aspirin has been studied in patients undergoing isolated coronary artery bypass graft surgery. However, there is a paucity of clinical data available evaluating perioperative aspirin in other cardiac surgical procedures. This study was designed to investigate the effects of aspirin on bleeding and transfusion in patients undergoing non-emergent, isolated, heart valve repair or replacement. DESIGN: Retrospective, cohort study. SETTING: Academic medical center. PARTICIPANTS: A total of 694 consecutive patients having non-emergent, isolated, valve repair or replacement surgery at an academic medical center were identified. INTERVENTIONS: Of the 488 patients who met inclusion criteria, 2 groups were defined based on their preoperative use of aspirin: those taking (n = 282), and those not taking (n = 206) aspirin within 5 days of surgery. MEASUREMENTS AND MAIN RESULTS: Binary logistic regression was used to examine relationships among demographic and clinical variables. No significant difference was found between the aspirin and non-aspirin groups with respect to the percentage receiving red blood cell (RBC) transfusion, mean RBC units transfused in those who required transfusion, massive transfusion of RBC, or amounts of fresh frozen plasma, cryoprecipitate, or platelets. Aspirin was not associated with an increase in the rate of re-exploration for bleeding (5.3% v 6.3%, p = 0.478). Major adverse cardiocerebral events (MACE), 30-day mortality, and 30-day readmission rates were not statistically different between the aspirin-and non-aspirin-treated groups. CONCLUSIONS: Preoperative aspirin therapy in elective, isolated, valve surgery did not result in an increase in transfusion or reoperation for bleeding and was not associated with reduced readmission rate, MACE, or 30-day mortality.

Three-Dimensional Electrodes for High-Performance Bioelectrochemical Systems.

Bioelectrochemical systems (BES) are groups of bioelectrochemical technologies and platforms that could facilitate versatile environmental and biological applications. The performance of BES is mainly determined by the key process of electron transfer at the bacteria and electrode interface, which is known as extracellular electron transfer (EET). Thus, developing novel electrodes to encourage bacteria attachment and enhance EET efficiency is of great significance. Recently, three-dimensional (3D) electrodes, which provide large specific area for bacteria attachment and macroporous structures for substrate diffusion, have emerged as a promising electrode for high-performance BES. Herein, a comprehensive review of versatile methodology developed for 3D electrode fabrication is presented. This review article is organized based on the categorization of 3D electrode fabrication strategy and BES performance comparison. In particular, the advantages and shortcomings of these 3D electrodes are presented and their future development is discussed.

Enhanced power production from microbial fuel cells with high cell density culture.

Improvement of power production in a microbial fuel cell (MFC) with a high cell density culture strategy was developed. By using high cell density culture, the voltage output and power density output of the MFC were enhanced about 0.6 and 1.6 times compared to the control, respectively. Further analysis showed that riboflavin concentration in the MFC was dramatically increased from 0.1 mg/L to 1.2 mg/L by high cell density culture. Moreover, the biofilm formation on the anode surface was significantly enhanced by this new strategy. The increased accumulation of electron shuttle (riboflavin) as well as enhanced biofilm formation contributed to the improvement in anodic electrochemical activity and these factors were the underlying mechanism for MFC performance improvement by high cell density culture. This work demonstrated that high cell density culture would be a simple and practical strategy for MFC manipulation.

Microbial fuel cell-based biosensors for environmental monitoring: a review.

The microbial fuel cell (MFC) is an innovative technology that was initially designed to harness energy from organic waste using microorganisms. It is striking how many promising applications beyond energy production have been explored in recent decades. In particular, MFC-based biosensors are considered to be the next generation biosensing technology for environmental monitoring. This review describes recent advances in this emerging technology of MFC-based biosensors, with a special emphasis on monitoring of biochemical oxygen demand and toxicity in the environment. The progress confirms that MFC-based biosensors could be used as self-powered portable biosensing devices with great potential in long-term and remote environmental monitoring.

[Signifiance of brush sign on susceptibility-weighted imaging predicts hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke].

OBJECTIVE: To assess brush sign (BS) on susceptibility-weighted imaging (SWI) in prediction of hemorrhagic transformation (HT) in patients with acute ischemic stroke (AIS) after intravenous thrombolysis(IVT). METHODS: Patients with acute cerebral ischemic stroke, who had major cerebral artery occlusion (internal carotid artery, middle cerebral artery M1 and M2), treated with intravenous recombinant tissue plasminogen activator (rt-PA) from August 2009 to October 2014 in the Second Affiliated Hospital, Zhejiang University School of Medicine, were enrolled in the study. All patients underwent SWI scanning. The asymmetry index (AI) was defined as the difference of intensity between ischemic and normal hemispheres on the SWI phase map; according to AI values patients were divided into 3 groups: BS=0(n=9), BS=1 (n=39) and BS=2 (n=18). The relationships between BS and HT and the clinical outcome among the 3 groups were analyzed. RESULTS: Sixty-six patients aged 68 ± 13 years were included in the study, including 44 males (67%) and 22 females (33%), and 44 (67%) with acute ischemic stroke. The mean pre-treatment National Institutes of Health Stroke Scale (NIHSS) score was 13 (6-17), and the onset to needle time was (252 ± 88) min. Twenty-six (39.4%) patients had HT, including 18 cases (27.3%) with HI and 8 cases (12.1%) with PH; BS was observed more frequently in HT group than non-HT group. Binary logistic regression analysis showed that BS was independently associated with HT of patients with acute ischemic stroke following IVT (OR=2.589, 95% CI: 1.080-6.210, P=0.033). In those without reperfusion after IVT, patients with higher BS grade had higher HT rate (P=0.023). CONCLUSION: Brush sign on SWI can be used for predicting hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke.

[Cerebral lesions of DWI hyperintensity in patients with subacute stroke assessed by intravoxel incoherent motion technique].

OBJECTIVE: To investigate the cerebral lesions of diffusion weighted imaging (DWI) hyperintensity in patients with subacute stroke with intravoxel incoherent motion (IVIM) technique. METHODS: The clinical data of 20 patients with ischemic stroke (3 to 7 d after onset) who underwent DWI and IVIM scanning between June 2014 and July 2015, were retrospectively analyzed. The parameters from IVIM including slow diffusion coefficient (D), fast diffusion coefficient (D(*)) and perfusion fraction (f) were processed. DWI hyperintensity was segmented by its signal intensity greater than the mean+2 standard deviations of the value in the homologous contralateral region. Then, DWI hyperintensity was classified into two regions of interest (ROIs): infarction core and peri-core with the ADC threshold of 0.55 × 10⁻³ mm²/s. The mirrored ROIs of infarction core and peri-core were also obtained. Then, we measured the values of ADC and D, D(*) and f in these ROIs. The ratios of ADC (rADC), D (rD), D(*) (rD(*)) and f (rf) were also calculated (e.g., rADC=ADCinfarction core/ADCmirrored region). RESULTS: Compared with mirrored region, ADC, D and f in the infarction core region decreased by 45% (P<0.001), 42% (P<0.001) and 32% (P<0.001), respectively; while ADC, D and f in the peri-core region decreased by 22% (P<0.001), 32% (P<0.001) and 8% (P=0.009), respectively. The values of rADC, rD, rD(*) and rf in the infarction core region were significantly lower than those in the peri-core region (all P<0.001). Pearson analysis showed that rADC was positively correlated with rf in the peri-core region (r=0.467, P=0.038). CONCLUSION: During subacute stage of stroke, compared to the infarction core region within DWI hyperintensity, D and f increase in the peri-core region of DWI hyperintensity, reflecting the increased water diffusion in microstructure and perfusion volume in microvasculature. This result shows that the potential reason for the heterogeneous ADC signal is associated with the disappearance of cellular edema and microvascular compensatory with increased blood volume.

Adsorption and removal of triphenylmethane dyes from water by magnetic reduced graphene oxide.

Triphenylmethane (TPM) dye is one of the most prevalent and recalcitrant water contaminants. Magnetic reduced graphene oxide (rGO) is an efficient adsorbent for organic pollutants removal. However, the performance and adsorption kinetics of magnetic rGO towards TPM have not yet been studied. In this study, a magnetic Fe3O4@rGO nano-composite, which could be easily removed from water with a simple magnetic separation step was synthesized and characterized. The magnetic rGO showed fast adsorption rate and high adsorption capacity towards different TPM dyes (the Langmuir monolayer adsorption capacity is 64.93 mg/g for adsorption of crystal violet). The adsorption processes are well-fitted to the pseudo-second-order kinetic model (R(2) > 0.99) and the Langmuir isotherm model (R(2) = 0.9996). Moreover, the magnetic rGO also showed excellent recycling and regeneration capabilities. The results indicated that adsorption with magnetic rGO would be a promising strategy to clean up the TPM contamination.

Preoperative renin-angiotensin system inhibitors protect renal function in aging patients undergoing cardiac surgery.

BACKGROUND: Renal failure (RF) represents a major postoperative complication for elderly patients undergoing cardiac surgery. This observational cohort study examines effects of preoperative use of renin-angiotensin system (RAS) inhibitors on postoperative renal failure in aging patients undergoing cardiac surgery. METHODS AND RESULTS: We retrospectively analyzed a cohort of 1287 patients who underwent cardiac surgery at this institution (2003-2007). The patients included were ≥65 years old, scheduled for elective cardiac surgery, and without preexisting RF (defined by the criteria of the Society of Thoracic Surgeons as described in Method). Of all patients evaluated, 346 patients met the inclusion criteria and were divided into two groups: using (n = 122) or not using (n = 224) preoperative RAS inhibitors. A comparison of the two groups showed no significant differences in baseline parameters, including creatinine clearance, body mass index, history of diabetes and smoking, preoperative medicines (except that more patients with RAS inhibitors had a history of hypertension or congestive heart failure, fewer RAS inhibitor patients had chronic lung disease), in intraoperative perfusion and aortic cross-clamp time, and in postoperative complications and 30-d mortality. Multivariate logistic regression analysis demonstrated, however, that preoperative RAS inhibitors significantly and independently reduced the incidence of postoperative RF in the patients undergoing cardiac surgery compared with those not taking RAS inhibitors: 1.6% versus 7.6%, yielding an odds ratio of 0.19 (95 % CI 0.04-0.84, P = 0.029). CONCLUSIONS: Preoperative RAS inhibitors may have significant renoprotective effects for aging patients undergoing elective cardiac surgery.

[Long-term outcome of bronchial artery embolization in the treatment of massive hemoptysis].

OBJECTIVE: To study the long-term outcome, safety, and complications of bronchial artery embolization (BAE) in the treatment of patients with massive hemoptysis. METHODS: A retrospective analysis of 232 cases of massive hemoptysis treated with BAE from February 2000 to February 2009 in our hospital was carried out. All cases were followed by repeated X-ray or CT examination, telephone calls, or questionnaires, with the longest period up to 9 years. RESULTS: There were 627 blood vessels which were totally embolized by 741 coils for the 232 cases. The hemoptysis was stopped instantly in 100% of the patients. 91.8% (213/232) of the cases were cured and 19 cases (19/232, 8.18%) were improved. The overall effective rate was 100% (232/232). No serious or delayed complications occurred. None of the patients died. CONCLUSION: Bronchial artery embolization is effective in cases with massive hemoptysis for its immediate effect and safety.

[Biochemical metabolic changes detected by phosphorus-31 MR spectroscopy in liver of fasting rabbits].

OBJECTIVE: To investigate the biochemical metabolic changes detected by phosphorus-31 MR spectroscopy ((31)P MRS) with pathologic changes in the liver of fasting rabbits. METHODS: A total of 22 rabbits were under the starvation up to death to establish animal models. Hepatic (31)P MRS was performed in different period of 10 rabbits including normal condition, over-starvation, agonal condition and death after 30 min. Other 9 rabbits were divided into three type including over-starvation, agonal condition and death group with 3 rabbits in each group, and 3 healthy rabbits served as controls. All the 12 rabbits were sacrificed for the hepatic pathological examination. The MR examination was performed on a 1.5 T imager using a 1H/31P surface coil by the 2D chemical shift imaging technique. The relative quantities of phosphomonoesters (PME), phosphodiesters (PDE), inorganic phosphate (Pi) and adenosine triphosphate (ATP) were measured. RESULTS: All the relative quantification of phosphorus metabolites were changed significantly from starvation to death (X(2)=23.13-35.41, P<0.01). The relative quantifications of ATP of normal condition, over-starvation, agonal condition and death were 2.54 +/-0.53, 1.73 +/-0.14, 0.88 +/-0.23 and 0.05 +/-0.08, respectively (rs=1.0, P<0.01). The relative quantifications of PDE from normal to death were 1.25 +/-0.54, 2.76 +/-0.23, 3.33 +/-0.49 and 3.87 +/-0.43, respectively, and those of Pi were 0.42 +/-0.02, 0.65 +/-0.05, 0.89 +/-0.15 and 0.99 +/-0.08, respectively (rs=1.0, P <0.01). The relative quantifications of PME were also significantly changed (rs=0.4, P=0.6). The pathologic changes of normal condition, over-starvation, agonal condition and death: decreased size of hepatocytes, loss of cell number, cellular swelling, degeneration and cell necrosis or hepatic hemorrhage became more and more pronounced. CONCLUSION: (31)P MRS can monitor dynamic changes of relative quantification of phosphorus metabolites, which are correlated with the pathological severity of acute hepatic injury by fasting.

[Evaluation of biochemical metabolites by 31P MR spectroscopy in leukemic infiltration of liver].

OBJECTIVE: To evaluate the changes of phosphorus metabolites in leukemic infiltration of liver (LIL) with two-dimensional chemical shift imaging(2D CSI)(31)phosphorus MR spectroscopy ((31)P MRS). METHODS: Fifteen patients with LIL and 12 healthy subjects (control group) were scanned with liver 2D CSI(31)P MRS by a 1.5T MR Scanner(Sonata, Siemens Corporation). Relative quantification of phosphorus metabolites including phosphomonoesters (PME), inorganic phosphate (Pi), phosphodiesters (PDE) and beta-adenosine- triphosphate (beta-ATP) were detected and after calibrated with model factor, the ratios of PME/PDE, PME/(PME+PDE), PME/ATP, PDE/ATP and Pi/ATP were analyzed. RESULTS: Compared with control group, the PME value, PME/PDE ratio, PME/(PME+PDE) ratio and PME/ATP ratio were increased in LIL group (1.992 +/-0.876 Compared with 1.167 +/-0.427, P <0.05), (0.551 +/-0.339 Compared with 0.254 +/-0.059,P <0.01), (0.326 +/-0.13 Compared with 0.199 +/-0.049, P <0.01)and (1.402 +/-0.654 Compared with 0.792 +/-0.232, P <0.01) respectively. CONCLUSION: (31)P MRS examination can be used as a non-invasive procedure to evaluate the changes of phosphorus metabolites of leukemic infiltration of liver. The increase of PME value and its ratios to PDE, ATP and PME+PDE may indicate leukemic infiltration of liver.

Reduced field-of-view diffusion-weighted imaging (DWI) in patients with gastric cancer: Comparison with conventional DWI techniques at 3.0T: A preliminary study.

To evaluate the qualitative image quality and quantitative apparent diffusion coefficient (ADC) value of reduced field-of view (rFOV) and full field-of-view (fFOV) diffusion-weighted imaging (DWI) sequences at 3.0 T in patients with gastric cancer.Fifty-three patients (37 males, 16 females; mean age, 63.3 ±â€Š10.3 years) with 60 lesions with gastric cancer who underwent magnetic resonance (MR) scans, including both rFOV-DWI and fFOV-DWI, were retrospectively analyzed. Two observers subjectively evaluated image quality for both the fFOV-DWI and rFOV-DWI sequences regarding the anatomic details, distortion, lesion conspicuity, artifacts, and overall image quality. The mean ADC values of gastric cancer were calculated. The Wilcoxon test and paired samples t test were used. Interobserver agreement was assessed using kappa statistics.The mean scores based on the 2 observers demonstrated significant differences in image quality in terms of anatomic details, distortion, lesion conspicuity, artifacts and overall image quality at both b values between rFOV-DWI and fFOV-DWI (P < .05) in the whole gastric area. rFOV-DWI yielded significantly better scores in image quality at b = 800 seconds/mm (P < .05) in patients with esophagogastric junction cancers, but there were no significant differences in the gastric corpus and gastric antrum region. The mean tumor ADC values of rFOV-DWI were significantly lower than those of fFOV-DWI (1.237 ±â€Š0.228 × 10-3 mm/second vs 1.683 ±â€Š0.322 × 10-3 mm/second, P < .001).rFOV-DWI yielded significantly better image quality (anatomic details, distortion, lesion conspicuity, artifacts, overall image quality) and more accurate ADC measurements than fFOV-DWI did.

Tonic beta-adrenergic drive provokes proinflammatory and proapoptotic changes in aging mouse heart.

Tonic activation of adrenergic drive has been found to be associated with aging, and its further activation is also seen in aging patients with major surgery or congestive heart failure. Nevertheless, its potential effect on the aging heart remains enigmatic. In the present study, at baseline, significant inflammatory and apoptotic changes were found in the aging mouse (20 months old), as evidenced by increases in inducible nitric oxide synthase (iNOS) expression, myocardial apoptosis in the heart, and C-reactive protein (CRP) release in the circulation. These phenotypic changes in aging animals can be induced in young animals (3 months old) by chronic beta-adrenergic receptor (AR) stimulation with isoproterenol (ISO), and they can be markedly reduced in aging animals by chronic beta-blockade with propranolol. Compared with young animals, chronic beta-AR stimulation with ISO in aging animals induced larger increases in iNOS expression, nitrotyrosine formation in the heart, and nitric oxide (NO) production and CRP release in the circulation; it also accelerated myocardial apoptosis and resulted in an enlarged infarct size when animals were subjected to myocardial ischemia and reperfusion (MI/R). However, the pretreatment of 1400W (N-(3-(aminomethyl) benzyl)acetamidine)-a specific iNOS inhibitor-significantly reduced iNOS-mediated nitrative stress associated with a marked decrease in myocardial apoptosis and infarct size in aging mice. These results demonstrate that tonic activation of the beta-adrenergic system associated with aging induces proinflammatory and proapoptotic changes in the heart and that additional beta-AR stimulation results in an exaggerated nitrative stress, mediated by iNOS, that is associated with more severe myocardial injury in aging mice.

Relationship between nm23H1 genetic instability and clinical pathological characteristics in Chinese digestive system cancer patients.

AIM: To study the relationship between nm23H1 gene genetic instability and its clinical pathological characteristics in Chinese digestive system cancer patients. METHODS: Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) was used to analyze the microsatellite instability (MSI) and loss of heterozygosity (LOH). Immunohistochemistry was employed to detect the expression of nm23H1. RESULTS: The MSI was higher in TNM stage I + II than in stage III + IV of gastric, colonic and gallbladder carcinomas. The LOH was higher in TNM stage III + IV than in stage I + II of gastric, colonic and hepatocellular carcinomas. Lymphatic metastasis was also observed. The expression of nm23H1 protein was lower in TNM stage III + IV than in stage I + II of these tumors and in patients with lymphatic metastasis.The nm23H1 protein expression was higher in the LOH negative group than in the LOH positive group. CONCLUSION: MSI and LOH may independently control the biological behaviors of digestive system cancers. MSI could serve as an early biological marker of digestive system cancers. Enhanced expression of nm23H1 protein could efficiently inhibit cancer metastasis and improve its prognosis. LOH mostly appears in late digestive system cancer.

Interactions of Metarhizium anisoplae and tree-based mulches in repellence and mycoses against Coptotermes formosanus (Isoptera: Rhinotermitidae).

The use of mulch in urban landscapes has increased in the United States for the past decade. Tree-based organic mulches can supply Coptotermes formosanus Shiraki with food, moisture, and shelter. The current research contributes to mulch management technology in termite control. A choice test arena was designed to determine the repellence and mortality caused by commercial mulches treated with different concentrations of the fungus Metarhizium anisopliae (Metschnikoff) against C. formosanus. Each of six tree-based mulches (pine bark, pine straw, bald cypress, eucalyptus, water oak, and melaleuca) was coated with six conidial concentrations ranging from 1 x 10(3) to 1 x 10(8) conidia/ml. The foragers of C. formosanus were repelled significantly by the fungal-treated mulch substrates; the proportion of termites on fungal-treated mulch was usually <20% during the 28-d test. By day 28, >99% of the termites were killed in test arenas containing a chamber with mulch treated with 10(7) or 10(8) conidia/ml. M. anisopliae significantly reduced mulch consumption by 34-71%. Mulch consumption by the termites was negatively correlated with fungal concentration, and the type of mulch also affected consumption. The differences in termite foraging activities, mortality, and food consumption among mulches were usually confounded by differences in fungal concentrations of M. anisopliae. The results indicate that repellence and virulence of M. anisopliae conidia should significantly reduce the suitability of these six mulches as a habitat for C. formosanus.

[Comparison of composition of aetherolea and alcohol extraction from ChangBai Mountain purple common perilla].

OBJECTIVE: To compare the chemical constituents of Aetherolea and Alcohol Extraction of purple common perilla of ChangBai Mountain. METHODS: We used water vapor distillation and alcohol extraction method, then analyzed identification by thin-layer chromatography and GC-MS. RESULTS: The main chemical compositions of aetherolea were caryophyllen, caryophyllene oxid, ylangene, 4-(2-Methylcyclohex-1-enyl)-but-2-enal and 3,7-dimethyl-1,6-Octadien-3-ol and the main chemical compositions of alcohol extraction were 10-hendeca-acetylene-1-alcohol, n-hexsdecanoic acid (E)-7,11-dimethyl-3-methylene- 1,6,10-Dodecatriene and so on. CONCLUSION: Other specific compositions including tau. -Muurolol,3H-3a,7-Methanoazulene,2 ,4,5,6,7,8-hexahydro-1,4,9,9-Tetram-ethyl-, [3aR-(3a. alpha, 4. beta 7. alpha)], Astaxanthin and Curan-17-oicacid, 19-acetyl-2,16-didehydro-20-hydroxy-, methyl ester, (19S) have special functions of sterilizing, cancer preventing and immunity improving, which are significantly different from the compositions extracted from other species.

Characterization of a laccase from a wood-feeding termite, Coptotermes formosanus.

Coptotermes formosanus Shiraki is a wood-feeding termite which secretes a series of lignolytic and cellulolytic enzymes for woody biomass degradation. However, the lignin modification mechanism in the termite is largely elusive, and the characteristics of most lignolytic enzymes in termites remain unknown. In this study, a laccase gene lac1 from C. formosanus was heterogeneously expressed in insect Sf9 cells. The purified Lac1 showed strong activities toward hydroquinone (305 mU/mg) and 2,6-dimethoxyphenol (2.9 mU/mg) with low Km values, but not veratryl alcohol or 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid). Lac1 could function well from pH 4.5 to 7.5, and its activity was significantly inhibited by H2 O2 at above 4.85 mmol/L (P < 0.01). In addition, the lac1 gene was found to be mainly expressed in the salivary glands and foregut of C. formosanus, and seldom in the midgut or hindgut. These findings suggested that Lac1 is a phenol-oxidizing laccase like RflacA and RflacB from termite Reticulitermes flavipes, except that Lac1 was found to be more efficient in phenol oxidation, and it did not require H2 O2 for its function. It is suspected that this kind of termite laccase might only be able to directly oxidize low redox-potential substrates, and the high redox-potential groups in lignin might be oxidized by other enzymes in the termite or by using the Fenton reaction.