One-step integrated coronary-carotid-cerebral computed tomography angiography to evaluate cardiovascular and cerebrovascular atherosclerosis.

PURPOSE: This study aims to develop a low-radiation dose, one-step integrated coronary-carotid-cerebral computed tomography angiography (ICCC-CTA) technique to analyze the relationship between cardiovascular and cerebrovascular atherosclerosis and evaluate the risk factors of plaque to provide an early-stage treatment to patients and reduce vascular events. METHODS: A total of 300 consecutive asymptomatic patients with cardiovascular risk factors who underwent ICCC-CTA were enrolled in this prospective study. The association between coronary and carotid-cerebrovascular atherosclerosis was assessed. The primary cardiovascular risk factors for various plaque types in cardiovascular or cerebrovascular disease were evaluated using multivariate analysis. RESULTS: Among 300 patients, 189 (63%) had plaques in their coronary and cerebral arteries. The presence of calcified and mixed plaques in the carotid-cerebral and coronary arteries was strongly correlated (χ2 = 20.71, P = 0.001; χ2 = 8.96, P = 0.003, respectively). Multivariate logistic regression analysis revealed that abnormal blood glucose [OR = 1.44, 95% CI 0.12-0.62, P = 0.01] and abnormal total cholesterol [OR = 1.28, 95% CI 0.07-0.46, P = 0.01] are risk factors in all the models in the coronary artery, non-calcified plaque group. Abnormal blood glucose [OR = 1.43, 95% CI 0.11-0.61, P = 0.01] and abnormal systolic blood pressure [OR = 1.02, 95% CI 0.01-0.04, P = 0.02] are risk factors in all the models in the coronary artery calcified plaque group. Abnormal blood glucose level [OR = 1.44, 95% CI = 0.12-0.62, P = 0.01] was only a risk factor in the non-calcified plaque carotid-cerebral artery group. CONCLUSIONS: We confirm that elevated blood glucose and total cholesterol levels are associated with coronary and carotid-cerebrovascular plaques using the novel one-step low dose cerebral-carotid-cardiac CTA technique. These findings will provide insights for further studies focusing on developing low-radiation dose one-step ICCC-CTA to screen cardiovascular/cerebrovascular plaques in general population with cardiovascular risk factors. ADVANCES IN KNOWLEDGE: We developed a low-radiation dose, one-step ICCC-CTA technique to detect cardiovascular and cerebrovascular atherosclerosis. We evaluated the risk factors for plaque burden for the early treatment and reduction of vascular events. These findings supported the development of low-radiation dose one-step ICCC-CTA to screen for cardiovascular/cerebrovascular disease in general population with cardiovascular risk factors.

Determination of components in Radix paeoniae rubra based on QAMS.

The current study aimed to establish simple and quick quality evaluation method of Chishao based on QAMS. Oxypaeoniflorin is used as a marker in the Chishao root. Based on it, the content of other components could be obtained by establishing the mathematical relationship. UPLC method was used to collect data, and the detection wavelengths were 230nm (benzoic acid, paeoniflorin), 263nm (hydroxy paeoniflorin) 274nm (gallic acid, paeoniflorin, catechin), respectively. The stationary phase was an Agilent ZORBAX SB-C18 and the mobile phase was acetonitrile -0.1% formic acid-water. The gradient elution method was adopted at the certain flow rate (0.3 mL/min). The column temperature set 40oC, and the injection volume was 1µL. Multiple reaction monitoring mode was selected for data collection. The linear ranges of benzoic acid, paeoniflorin, hydroxy-paeoniflorin, gallic acid, catechin and paeoniflorinhad good linearity (r ≥0.9995). The UPLC method was established to determine the content of paeoniflorin, benzoic acid, catechin, gallic acid, paeoniflorin, andhydroxy-paeoniflorin in Radix Paeoniae Rubra. In the current study, the method for the chemical components in Radix Paeoniae Rubra to provide the evaluation basis of medicinal effects.

Ultrasound guided microwave ablation of thyroid nodular goiter and cystadenoma: A single center, large cohort study.

ABSTRACT: Thyroid nodules are one of the most common entities that affect the thyroid gland. Traditionally, their treatment was surgery. Currently, ablation combination with percutaneous procedure became a good option.To analyze safety, efficacy, and describe our experience in microwave-ablation using ultrasound-guidance for benign thyroid nodules.A total of 304 patients with 1180 thyroid nodules (thyroid cystadenoma and nodular goiter) were studied retrospectively. Two hundred sixty-seven patients who underwent microwave-ablation successfully in our hospital were enrolled in this study. The baseline, follow-up nodule volume, thyroid function tests, thyroid antibodies, and posttherapy complications were analyzed. The informed written consent was obtained from patients or guardians. The study was approved by the ethics committee of our hospital.The average age was 50.1 ±â€Š11.7 (21-83 years), 214 were women (80.1%) and 53 (19.9%) were men. The average number of nodules per patient was 4.02 ±â€Š1.8 (1-8), 9.86%, 6.13%, and 84% located in the right thyroid lobe, left lobe, and bilateral, respectively. The average size of the nodules was 5.28 cm2 ±â€Š3.63 (0.09-23.45 cm2). The average ablation time was 11 minutes ±â€Š5.36 (3-20 minutes). The hospitalization period was 24 hours ±â€Š10.16 (7-48 hours). Eighteen complications were reported. Postablation volume reduction rate was 54.74% and 93.3% at 3 and 12 months follow-up respectively (P < .05). The thyroid function tests, pre and postablation showed no significant changes (P > .05).Ultrasound-guided microwave-ablation of thyroid nodules is safe and effective. More clinical trials are needed to define the true use of microwave-ablation.

Catalytic degradation of organic pollutants in Fe(III)/peroxymonosulfate (PMS) system: performance, influencing factors, and pathway.

This study demonstrated, for the first time, Fe(III)/peroximonosulphate (PMS) could be an efficient advanced oxidation process (AOP) for wastewater treatment. Bisphenol A (BPA) was chosen as a model pollutant in the present study. Fe(III)-activated PMS system proved very effective to eliminate 92.18% of BPA (20 mg/L) for 30-min reaction time at 0.50 mM PMS, 1.5 g/L Fe(III), pH 7.0. The maximum degradation of BPA occurred at neutral pH, while it was suppressed at both strongly acidic and alkaline conditions. Organic and inorganic ions can interfere with system efficiency either positively or negatively, so their interaction was thoroughly investigated. Furthermore, the presence of organic acids also affected BPA degradation rate, especially the addition of 10 mM citric acid decreased the degradation rate from 92.18 to 66.08%. Radical scavenging experiments showed that SO4•- was the dominant reactive species in Fe(III)/PMS system. A total of 5 BPA intermediates were found by using LC/MS. A possible degradation pathway was proposed which underwent through bridge cleavage and hydroxylation processes. Acute toxicity of the BPA degradation products was assessed using Escherichia coli growth inhibition test. These findings proved to be promising and economical to deal with wastewater using iron mineral for the elimination of organic pollutants. Graphical abstract.

Dissolution rate enhancement of new co-crystals of ezetimibe with maleic acid and isonicotinamide.

Ezetimibe (EZT) is a selective cholesterol absorption inhibitor with poor aqueous solubility (0.012mg/ml 23oC) and low oral bioavailability (about 35-65% for a once 10mg dose). The present study illustrates the preparation and characterization of two new co-crystals of ezetimibe using maleic acid and isonicotinamide as the coformers by solid grinding method. The co-crystal structures were characterized by X-ray powder diffraction (PXRD), differential scanning calorimetry (DSC), infrared spectroscopy (IR) techniques. Crystallinity and surface morphological characteristics of these prepared co-crystals were observed by scanning electron microscope (SEM). Dissolution rate tests demonstrated that both of the new co-crystals showed significant improvement in sodium lauryl sulfate -sodium acetate buffer solution (PH=4.5) at 15min and 20min. This study enriched the types of EZT co-crystals and identified that pharmaceutical co-crystal engineering technique play an important role in the dissolution rate enhancement of ezetimibe.

Eupatilin attenuates the inflammatory response induced by intracerebral hemorrhage through the TLR4/MyD88 pathway.

BACKGROUND: Intracranial hemorrhage (ICH) is one of the most common brain traumas, and inflammation caused by ICH seriously affects the quality of life and prognosis of patients. Eupatilin has been shown to have anti-inflammatory effects in various diseases. However, only one paper has reported that Eupatilin has a therapeutic effect on the inflammatory response caused by ICH and the underlying mechanism needs to be studied. METHODS: We used erythrocyte lysis stimulation (ELS) to induce mouse microglia BV2 as the inflammation model. CCK-8 and Transwell assays were used to detect cell viability and migration. RT-PCR, western blotting, and ELISA were used to detect the secretion of inflammatory factors and the expression of related mechanism proteins. HE staining was used to detect cell edema and death. RESULT: We found that ELS significantly increased protein and mRNA levels and secretion of inflammatory factors IL-1ß and TNF-α, which Eupatilin attenuated through the Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88) pathway. The anti-inflammatory effect of Eupatilin was significantly attenuated after siRNA was used to reduce TLR4 expression. The experimental results and mechanism were also verified in TLR4 knockout mice in vivo. CONCLUSION: Eupatilin has a therapeutic effect on inflammation caused by ICH. The underlying mechanism may be related to TLR4/MyD88, which brings new hope for clinical patients to improve symptoms and prognosis.

Micro-computed tomography and microdissection of the temporal bone of tree shrews.

OBJECTIVE: To understand the morphology and anatomical data of the temporal bone of tree shrews through micro-computed tomography (micro-CT) and microdissection. METHODS: Skull specimens from 10 tree shrews were scanned using micro-CT examination. The acquired images were used for three-dimensional reconstruction and measurement using the Mimics 10.01 software. Twenty tree shrews were subjected to microdissection and the data were measured. RESULTS: Micro-CT and three-dimensional reconstruction could clearly define the three-dimensional spatial position of the ear structure. Micro-CT and microdissection showed that the otic vesicles of the tree shrews were located on both sides of posterior-inferior skull bone. The location of the otic vesicles was superficial, and the bone was thin. All of the structures of the middle and inner ear of the tree shrews were well developed. The ossicular chain was differentiated into the malleus, incus and stapes. The location of the three semi-circular canals of the tree shrews was superficial and easy to dissect. In vivo, the three semi-circular canals were easy to localize and the surface bone was thin. The contour and structure of the cochlea and number of cochlear turns were similar to those in humans. CONCLUSION: This study could provide anatomical data to allow tree shrews to be used as animal models for studying ear diseases.

Low estimated glomerular filtration rate is associated with high recurrence rate and poor prognosis of hemorrhage stroke.

This study investigated whether a low estimated glomerular filtration rate (eGFR) leads to a higher risk of stroke recurrence and a poor prognosis in hemorrhagic stroke patients. A total of 2000 stroke patients were recruited during 2000-2001 and prospectively followed up for a median of 4.5 years. The independent association of a low eGFR with stroke recurrence and poor prognosis was evaluated using Kaplan-Meier analysis and Cox regression models. Among the hemorrhagic stroke patients, the incidence rate of a low eGFR for the compound endpoints (stroke recurrence, myocardial infarction, and all-cause mortality) was greater than that of a normal eGFR (P=0.012). A similar result was observed for the incidence rate of recurrence and death caused by cardiovascular disease or stroke (Csdeath) (P=0.013, and P=0.001, respectively). After adjustment for age, sex, and other cardiovascular risk factors, a low eGFR was associated with a 2.93-fold increased risk of the compound endpoints (P=0.001, RR=2.93, 95% CI=1.58-5.43), 3.06-fold increased risk of recurrent stroke (P=0.003, RR=3.06, 95% CI=1.46-6.40), and 3.57-fold increased risk of Csdeath (P=0.005, RR=3.57, 95% CI=1.46-8.70) among hemorrhagic stroke patients. Among the hemorrhagic stroke patients, a low eGFR was a strong predictor of stroke recurrence and a poor prognosis.

Long-term clinical evaluation of 211 two-unit cantilevered resin-bonded fixed partial dentures.

OBJECTIVES: This retrospective study aims to evaluate the long term clinical performance of two-unit cantilevered resin-bonded fixed partial dentures (RBFPDs) relating to their retention, success and survival rate. MATERIALS AND METHODS: Prostheses that were placed at least four years previously were clinically reviewed to evaluate retention, success and survival rate. Additional information was also collected, including patient's gender, age and satisfaction on their prosthesis, operator's experience, prosthesis service life, root canal therapy if performed, abutment mobility, bone support, the presence of shim-stock contacts on the abutment or pontic in intercuspal position, and the presence of proximal axial contacts adjacent to the prosthesis. The date of any debonding with subsequent treatment was also recorded. RESULTS: A total of 211 two-unit RBFPDs were placed in 153 patients, with a mean service life of 113.2±33.5 months. Twenty-eight prostheses debonded, resulting in a retention rate of 86.7 percent, and another five teeth were extracted with the prostheses, resulting in a success rate of 84.4 percent. 90.0 percent prostheses were functioning (survival rate) by means of rebonding at the time of review. The location of the replaced tooth had a significant effect on the retention of RBFPDs with posterior RBFPDs lower than anterior (p=0.020). Kaplan-Meier analysis revealed 5-, 10- and 15-year cumulative probability of surviving was 0.97, 0.91 and 0.84, respectively. CONCLUSIONS: 211 two-unit RBFPDs were observed to have a success, retention and survival rate of 84.4, 86.7 and 90.0 percent, respectively, with a mean service life of 9.4 years. CLINICAL SIGNIFICANCE: Based on the clinical results, two-unit RBFPD are shown to be a durable prosthesis over the long term with high patient satisfaction. The posterior prostheses, particularly in the lower arch appeared to have a higher failure rate, and improved design features should be considered.

Cannulated screw fixation of fracture neck of femur in children with osteogenesis imperfecta.

Osteogenesis imperfecta is a disorder of abnormality in collagen metabolism due to genetic defects, which causes fragility fracture in children. Fragility fracture of the neck of femur can be difficult to treat in adults. The difficulties increase exponentially in children. The challenge becomes more severe when there is an intramedullary rod in situ in the femoral shaft. It is a technically demanding work to fix fracture caused by osteogenesis imperfecta. There is hardly any published study on the difficult fixation of fracture neck of femur in osteogensis imperfecta. Therefore, we present two cases using cannulated screw fixation for this type of fracture for the benefit of other orthopaedic surgeons.

A study of the health and economic effects of influenza-like illness on the working population under different working environments of a large corporation in Hong Kong.

OBJECTIVE: The incidence, health and economic impacts of influenza-like illness (ILI) among the working population in Hong Kong had never been studied. Due to the nature of the disease, ILIs can have a significant impact on the operation of a corporation in terms of loss of productivity and reduced work performance. The present study was undertaken to determine the health and economic impacts of ILIs under different environmental conditions on the working population of a large corporation. METHOD: Over 2,000 employees of a large corporation in the travelling and tourism industry were studied with three different types of working environment (confined, typical office and well ventilated) by two structured questionnaires. RESULTS: The most affected group in terms of productivity and health was the group working in a confined area, whilst those working in a well-ventilated area were least affected. However, symptoms of the confined area group seemed to disappear faster. The infection rate appeared to vary according to work environment for the studied population. CONCLUSION: Policies on preventive measures and early treatment are important for a corporation to reduce loss in productivity due to ILIs.