Sex modifies the predictive value of computed tomography combined with serum potassium for primary aldosteronism subtype diagnosis.

Objective: We aimed to investigate the predictive value of the CT findings combined with serum potassium levels for primary aldosteronism (PA) subtype diagnosis, with a particular interest in sex differences. Methods: In this retrospective study, we eventually included 482 PA patients who underwent successful adrenal venous sampling (AVS) and had available data. We diagnosed the subjects as having either unilateral (n = 289) or bilateral PA (n = 193) based on AVS. We analyzed the concordance rate between AVS and adrenal CT combined with serum potassium and performed a logistic regression analysis to assess the prevalence of unilateral PA on AVS. Results: The total diagnostic concordance rate between CT findings and AVS was 51.5% (248/482). The prevalence of hypokalemia in men and women was 47.96% (129/269) and 40.85% (87/213), respectively. The occurrence of unilateral lesions on CT and hypokalemia was significantly associated with an increased prevalence of unilateral PA [odds ratio (OR) 1.537; 95% confidence interval (CI) 1.364-1.731; p < 0.001]. In male participants, G2 (bilateral lesion on CT and normokalemia), G3 (unilateral lesion on CT and normokalemia), G4 (bilateral normal on CT and hypokalemia), G5 (bilateral lesion on CT and hypokalemia), and G6 (unilateral lesion on CT and hypokalemia) were significantly increased for the prevalence of unilateral PA on AVS (G2: OR 4.620, 95% CI 1.408-15.153; G3: OR 6.275, 95% CI 2.490-15.814; G4: OR 3.793, 95% CI 1.191-12.082; G5: OR 16.476, 95% CI 4.531-59.905; G6: OR 20.101, 95% CI 7.481-54.009; all p < 0.05), compared with G1 (patients with bilateral normal on CT and normokalemia). However, among female participants, we found an increased likelihood for unilateral PA in patients with unilateral lesions on CT and hypokalemia alone (OR 10.266, 95% CI 3.602-29.259, p < 0.001), while no associations were found in other groups (all p > 0.05). Sex had a significant effect on modifying the relationship between unilateral PA and the combination of CT findings and serum potassium (p for interaction <0.001). Conclusion: In conclusion, our results indicated that CT findings combined with serum potassium levels have a great value for predicting the subtype of PA and are stronger in men.

Insight into sludge dewatering by periodate driven directly with Fe(â ¡): Extracellular polymeric substances solubilization and mineralization.

The production of waste activated sludge is expanding in tandem with the significant growth in the global population. It is important to explore sludge pretreatment technology to achieve sludge reduction. In this study, deep sludge dewatering was achieved by using Fe2+-catalyzed periodate (Fe2+/PI) conditioning. The result showed that capillary suction time was reduced by 48.27% under the optimum Fe2+ and PI dosages. ·OH, FeⅣ, O2·-, 1O2, and IO3· generated from the reaction between Fe2+ and PI, while ·OH (49.79%) and FeⅣ (47.76%) contributed significantly to sludge dewatering. Investigations of the mechanism revealed that the synergistic action of radical species oxidation and iron species flocculation in Fe2+/PI conditioning led to the mineralization and aggregation of hydrophilic substances in extracellular polymeric substances. The hydrophobic groups on the protein surface were more exposed to soluble extracellular polymeric substances and reduced protein-water interaction. The variations in zeta potential and particle size also verified the presence of a synergistic effect of oxidation and flocculation. The morphology observations revealed that the increased frictional forces generated when water flowed over the raw sludge (RS) surface prevented the rapid passage of internal water. In addition, the hydrophobic and electrostatic interactions in the sludge samples were essential influences that promoted flocculation and sedimentation of the sludge. This research aids engineers by providing a new option to better optimize sludge management while also deepening understanding of the Fe2+/PI conditioning involved in sludge dewatering.

Dual promoted ciprofloxacin degradation by Fe0/PS system with ascorbic acid and pre-magnetization.

As a widely used and hard-to-degrade pharmaceuticals and personal care product (PPCP), ciprofloxacin (CIP) was frequently found in water environment and the detected concentration was gradually increased. Although zero-valent iron (ZVI) has been shown to be effective in destroying refractory organic pollutants, the practical application and sustained catalytic performance is not satisfactory. Herein, introduction of ascorbic acid (AA) and employment of pre-magnetized Fe0 was achieved to maintain a high-concentration of Fe2+ during persulfate (PS) activation. Pre-Fe0/PS/AA system presented the best performance for CIP degradation, achieving almost complete elimination of 5 mg/L CIP within 40 min in the reaction conditions of 0.2 g/L pre-Fe0，0.05 mM AA and 0.2 mM PS. The CIP degradation retarded as excess pre-Fe0 and AA were added, therefore, the optimum dosages of pre-Fe0 and AA were determined to be 0.2 g/L and 0.05 mM, respectively. The CIP degradation gradually decreased as the initial pH increased from 3.05 to 11.03. The presence of Cl-, HCO3-, Al3+, Cu2+ and humic acid significantly influenced the performance of CIP removal, while Zn2+, Mg2+, Mn2+, and NO3- slightly affected the CIP degradation. Combined with the results of HPLC analysis and previous literature, several possible degradation pathways of CIP were proposed.

Superselective adrenal arterial embolization for primary aldosteronism without lateralized aldosterone secretion: an efficacy and safety, proof-of-principle study.

Superselective adrenal arterial embolization (SAAE) appears to be beneficial in primary aldosteronism (PA) patients with lateralized aldosterone secretion (unilateral PA). As confirmed by adrenal vein sampling (AVS), nearly 40% of PA patients would be PA without lateralized aldosterone secretion (bilateral PA). We aimed to investigate the efficacy and safety of SAAE on bilateral PA. We identified 171 bilateral PA patients from 503 PA patients who completed AVS. Thirty-eight bilateral PA patients received SAAE, and 31 completed a median 12-month clinical follow-up. The blood pressure and biochemical improvements of these patients were carefully analyzed. 34% of patients were identified as bilateral PA. Plasma aldosterone concentration, plasma renin activity, and aldosterone/renin ratio (ARR) were significantly improved 24-h after SAAE. SAAE was associated with 38.7% and 58.6% of complete/partial clinical and biochemical success within a median 12-month follow-up. A significant reduction in left ventricular hypertrophy was shown in patients who obtained complete biochemical success compared with partial/absent biochemical success. SAAE was associated with a more apparent nighttime blood pressure reduction than daytime blood pressure reduction in patients with complete biochemical success. No major adverse safety events related to SAAE were reported during the intraoperative, postoperative, and follow-up periods. SAAE was associated with blood pressure and biochemical improvements in part of bilateral PA and appeared safe. The biochemistry success was accompanied by improved cardiac remodeling and a more prominent decrease in nocturnal blood pressure. This study was part of a trial registered with the Chinese Clinical Trial Registry, number ChiCTR2100047689.

Significance of computed tomography combined with postural stimulation test in predicting laterality of primary aldosteronism.

BACKGROUNDS: Adrenal venous sampling (AVS) represents the gold standard for classifying primary aldosteronism (PA). However, AVS is a technically demanding, expensive and invasive procedure. Computed tomography (CT) scans is recommended as the initial study of classification diagnosis by the current guidelines. In addition, postural stimulation test (PST) has been used to provide additional subtype diagnostic information. OBJECTIVE: This work aimed to evaluate the diagnostic utility of the adrenal CT combined with PST in the classification diagnosis of PA. METHODS: We analyzed PA patients who underwent AVS from November 2017 to February 2022 at a single center. Subtype classification of PA was determined by AVS. We analyzed the concordance rate between AVS outcomes, adrenal CT, and PST, and explored the value of adrenal CT combined with PST for predicting laterality of PA. RESULTS: Total 531 PA patients were included in the present study. The concordance rate between AVS and the adrenal CT was 51.0%(271/531). Receiver operating characteristic (ROC) curve of PST showed that the area under curve (AUC) was 0.604 [95% confidence interval (CI): 0.556, 0.652], the optimal cut-off value was 30%. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (+LR), and negative likelihood ratio (-LR) of PST for diagnosis bilateral PA on AVS was 72.8, 46.2%, 0.48, 0.71, 1.35, and 0.59, respectively. The prevalence of unilateral PA on AVS in patients with unilateral lesion on CT and negative PST, unilateral lesion on CT and positive PST, bilateral normal or lesions on CT and negative PST, and bilateral normal or lesions on CT and positive PST was 82.4% (108/131), 59.9% (91/152), 50.7% (37/73), and 44.6% (78/175), respectively. The sensitivity, specificity, PPV, NPV, +LR, and -LR of adrenal CT combined with PST for the diagnosis of unilateral PA were 34.4, 89.4%, 0.82, 0.49, 3.25, and 0.73, respectively. CONCLUSIONS: The combination of CT findings and PST can improve the accuracy of predicting laterality of PA.

Degradation of antiviral drug acyclovir by thermal activated persulfate process: Kinetics study and modeling.

Pharmaceutical and personal care products (PPCPs) pose a great threat to water environment security. In this study, acyclovir (ACV) was efficiently degraded by thermally activated persulfate (TAP) system. The ACV degradation increased with rising reaction temperature and persulfate dosage. With the existence of inorganic anions and humic acid, ACV removal was retarded to varying degrees. Under strong alkaline condition, it was observed that the degradation of ACV was significantly inhibited. In addition, Kintecus software was employed to simulate ACV removal and achieved a good fit with the experimental results. The contribution rates of main reactive radicals under acidic, neutral, and alkaline conditions were investigated, and the contribution of hydroxyl radical (⋅OH) increased significantly under alkaline condition. The main active species were identified as sulfate radical (SO4⋅-) and ⋅OH through quenching experiment, and the second-order reaction rate constants of SO4⋅- and ∙OH reacted with ACV were calculated to be 9.17 × 109 M-1 s-1 and 2.74 × 109 M-1 s-1, respectively. The main degradation pathways included addition of free radicals, oxidation of branch chain and ring opening. The acute and chronic toxicity of intermediates to organisms predicted by ECOSAR were significantly reduced compared with that of ACV.

MicroRNA-155-5p in serum derived-exosomes promotes ischaemia-reperfusion injury by reducing CypD ubiquitination by NEDD4.

AIMS: Recovery of blood flow is a therapeutic approach for myocardial infarction but paradoxically induces injury to the myocardium. Exosomes (exos) are pivotal mediators for intercellular communication that can be released by different cells and are involved in cardiovascular diseases. This study aimed to explore the possible effects and mechanisms of miR-155-5p loaded by serum-derived exos in myocardial infarction reperfusion injury (MIRI). METHODS AND RESULTS: Exos were isolated from mouse serum after induction of ischaemia reperfusion (I/R) and injected into I/R-treated mice to assess cardiac function, infarction size, and cardiomyocyte apoptosis. Primary cardiomyocytes were transfected with miR-155-5p inhibitor before treatment with oxygen-glucose deprivation and re-oxygenation (OGD/R) and exos derived from the serum of I/R-treated mice (I/R-Exos), in which Bcl-2, Bax, and cleaved-caspase-3 levels were detected. The interactions among miR-155-5p, NEDD4, and CypD were evaluated. miR-155-5p level was evidently increased in I/R-Exos than in exos from the serum of sham-operated mice (P < 0.05). In comparison with the I/R group, the I/R-Exos + I/R group had increased infarct size, elevated miR-155-5p expression, and boosted apoptotic rate in mouse myocardium (P < 0.05). In mice treated with I/R-Exos and I/R, miR-155-5p inhibition reduced cardiac infarct size and apoptosis (P < 0.05). NEDD4 was a target gene of miR-155-5p and promoted CypD ubiquitination. Cardiomyocyte apoptosis was markedly increased in the miR-155-5p inhibitor + shNEDD4 + OGD/R group versus the miR-155-5p inhibitor + OGD/R group (P < 0.05), but decreased in the miR-155-5p inhibitor + shNEDD4 + shCypD + OGD/R group than in the miR-155-5p inhibitor + shNEDD4 + OGD/R group (P < 0.05). CONCLUSIONS: miR-155-5p in I/R-Exos may facilitate MIRI by inhibiting CypD ubiquitination via targeting NEDD4.

An Output-Capacitorless Low-Dropout Regulator with Slew-Rate Enhancement.

A novel output-capacitorless low-dropout regulator (OCL-LDO) with an embedded slew-rate-enhancement (SRE) circuit is presented in this paper. The SRE circuit adopts a transient current-boost strategy to improve the slew rate at the gate of the power transistor when a large voltage spike at the output is detected. In addition, a feed-forward transconductance cell is introduced to form a push−pull output structure with the power transistor. The simulation results show that the maximum transient output voltage variation is 23.5 mV when the load current ILOAD is stepped from 0 to 100 mA in 100 ns with a load capacitance of 100 pF, and the settling time is 1.2 µs. The proposed OCL-LDO consumes a quiescent current of 30 µA and has a dropout voltage of 200 mV for the maximum output current of 100 mA.

A Fully Integrated Low-Dropout Regulator with Improved Load Regulation and Transient Responses.

A fully integrated low-dropout (LDO) regulator with improved load regulation and transient responses in 40 nm technology is presented in this paper. Combining adjustable threshold push-pull stage (ATPS) and master-slave power transistors topology, the proposed LDO maintains a three-stage structure within the full load range. The proposed structure ensures the steady-state performance of LDO and achieves 0.017 mV/mA load regulation. The ATPS consumes little quiescent current at light load current condition, and the turn-on threshold of the ATPS can be adjusted by a current source. Once the value of current source is set, the turn-on threshold is also determined. A benefit of the proposed structure is that the LDO can be stable from 0 to 100 mA load current with a maximum 100 pF parasitic load capacitance and a 0.7 pF compensation capacitor. It also shows good figure of merit (FOM) without an extra transient enhanced circuit. For the maximum 100 mA load transient with 100 ns edge time, the undershoot and overshoot are less than 33 mV. The dropout voltage of the regulator is 200 mV with input voltage of 1.1 V. The total current consumption of the LDO was 24.6 µA at no load.

A Nomogram model for predicting the occurrence of no-reflow phenomenon after percutaneous coronary intervention using the lncRNA TUG1/miR-30e/NPPB biomarkers.

Background: Studies have shown that percutaneous coronary intervention (PCI) is considered as the essential therapeutic strategy for the patients with ST-segment elevation myocardial infarction (STEMI). However; no-reflow could still occur in a few patients after PCI. Studies have reported that biomarkers related to no-reflow pathogenetic components could play a prognostic role in the prediction phenomenon. Hence, this study explored the establishment of nomogram model for predicting the occurrence of no-reflow phenomenon after PCI using the lncRNA TUG1/miR-30e/NPPB biomarkers in patients with STEMI after PCI. Methods: In this observational study, a total of 76 STEMI patients who underwent emergency PCI between January 2018 and December 2021were included. The patients after PCI, were divided into reflow (n=44) and no-reflow groups (n=32). The demographic, environmental and clinical risk factors were assessed and analysed between the groups. Quantitative RT-PCR was used to detect TUG1, miR-30e, and NPPB messenger RNA (mRNA) expression levels in the plasma of patients after PCI. Bioinformatic methods were used to predict the interaction of the plasma TUG1/miR-30e/NPPB axis. The risk factors in the no-reflow group were screened using a logistic-regression analysis, and a nomogram prediction model was constructed and validated. Subsequently, a gene set enrichment analysis revealed the function of lncRNA TUG1. Results: Plasma lncRNA TUG1 and NPPB were more highly expressed and miR-30e was more lowly expressed in the no-reflow group than the normal-reflow group (P<0.001). A negative correlation was observed between lncRNA TUG1 and miR-30e, and between miR-30e and NPPB. However, a positive correlation was observed between lncRNA TUG1 and NPPB mRNA. The bioinformatics analysis predicted multiple binding sites on the lncRNA TUG1 and miR-30e. LncRNA TUG1 [odds ratio (OR): 0.163, 95% confidence interval (CI): 0.021-0.944] and hs-CRP (OR: 2.151, 95% CI: 1.536-3.974) found to be as independent predictors. The C-index of this prediction model was 0.982 (95% CI: 0.956-1.000). Conclusions: TUG1 could function as an effective biomarker for no-reflow among patients with STEMI after PCT and the proposed nomogram may provide information for individualized treatment in patients with STEMI.

Extracellular vesicles derived from HBMSCs improved myocardial infarction through inhibiting zinc finger antisense 1 and activating Akt/Nrf2/HO-1 pathway.

Myocardial infarction (MI) is believed to be one of the most common cardiovascular diseases, and it is seriously threatening the health of people in the world. The extracellular vesicles (EVs) isolated from mesenchymal stem cells and zinc finger antisense 1 (ZFAS1) have been believed to be involved in the regulation of MI, but the mechanism has not been fully clarified. Left anterior descending artery ligation was used to establish MI animal model, hypoxia treatment was applied to establish MI cell model. CCK8, transwell, and wound healing methods were applied to measure cell proliferation, invasion, and migration. Overexpression of ZFAS1 was established via transfecting pcDNA-ZFAS1. Overexpression of ZFAS1 significantly reversed the influence of EVs on cell migration, invasion, and apoptosis. Similar effect of EVs and ZFAS1 on morphological changes of MI rat heart tissues were also observed. The activation of Akt/Nrf2/HO-1 pathway by EVs was remarkably suppressed by pcDNA-ZFAS1. Inhibitor of Akt/Nrf2/HO-1 pathway remarkably reversed the impact of EVs on the cell viability. EVs might improve MI through inhibiting ZFAS1 and promoting Akt/Nrf2/HO-1 pathway. This study might provide a new thought for the prevention and treatment of MI damage through regulating ZFAS1 or Akt/Nrf2/HO-1 pathway.

Knockdown of ZFAS1 improved the cardiac function of myocardial infarction rats via regulating Wnt/ß-catenin signaling pathway.

Myocardial infarction (MI) is a big health threat in the world, and it is characterized by high morbidity and mortality. However, current treatments are not effective enough, and novel therapeutic strategies need to be explored. ZFAS1 has been proved to be involved in the regulation of MI, but the specific mechanism remains unclear. MI rats were constructed through left anterior descending artery ligation, and hypoxia cell model was also established. The proliferation, invasion, and migration of cells were detected via CCK8, traswell, and wound healing methods. Immunohistochemistry staining, western blotting, and qRT-PCR were used to detect the levels of molecules. Knockdown of ZFAS1 significantly increased the proliferation, migration, and invasion of cardiac fibroblasts. Knockdown of ZFAS1 remarkably improved cardiac function via decreasing infarction ratio and increasing vWF expression, left ventricular ejection fraction, and left ventricular fractional shortening compared with group MI. Knockdown of ZFAS1 also suppressed Wnt/ß-catenin pathway in vivo. The inhibition of Wnt/ß-catenin remarkably reversed the influence of shZFAS1 on cardiac function and cardiac fibroblasts viability. Therefore, Knockdown of ZFAS1 could improve the cardiac function of myocardial infarction rats via regulating Wnt/ß-catenin signaling pathway. The present study might provide new thoughts for the prevention and treatment of MI damage.