Dual-energy CT Portal Venography: Clinical Application Values and Future Opportunities.

Standard multidetector computed tomography (MDCT) uses a single X-ray tube to emit a mixed energy X-ray beam, which is received by a single detector. The difference is that dual-energy CT (DECT), a new equipment in recent years, employs a single X-ray tube or two X-ray tubes to emit two single-energy X-ray beams, which are received by a single or two detectors. The application of dual-energy technology to portal venography has become one of the research hotspots. This paper will elaborate on the clinical application values of DECT portal venography in improving portal vein image quality, distinguishing the nature of portal vein thrombus, reducing contrast agent dose and radiation dose, and will discuss the possibility of its movement from research to routine practice and future development opportunities.

[Mechanism of Shenling Baizhu Powder on treatment of alcoholic liver disease by regulating TLR4/NLRP3 pathway].

This study aims to investigate the regulatory effects of Shenling Baizhu Powder(SBP) on cellular autophagy in alcoholic liver disease(ALD) and its intervention effect through the TLR4/NLRP3 pathway. A rat model of chronic ALD was established by gavage of spirits. An ALD cell model was established by stimulating BRL3A cells with alcohol. High-performance liquid chromatography(HPLC) was utilized for the compositional analysis of SBP. Liver tissue from ALD rats underwent hematoxylin-eosin(HE) and oil red O staining for pathological evaluation. Enzyme-linked immunosorbent assay(ELISA) was applied to quantify lipopolysaccharides(LPS), tumor necrosis factor-alpha(TNF-α), interleukin-1 beta(IL-1ß), and interleukin-18(IL-18) levels. Quantitative reverse transcription polymerase chain reaction(qRT-PCR) was conducted to evaluate the mRNA expression of myeloid differentiation factor 88(MyD88) and Toll-like receptor 4(TLR4). The effect of different drugs on BRL3A cell proliferation activity was assessed through CCK-8 analysis. Western blot analysis was performed to examine the protein expression of NOD-like receptor pyrin domain-containing 3(NLRP3), nuclear factor-kappa B P65(NF-κB P65), phosphorylated nuclear factor-kappa B P65(p-P65), caspase-1, P62, Beclin1, and microtubule-associated protein 1 light chain 3(LC3Ⅱ). The results showed that SBP effectively ameliorated hepatic lipid accumulation, reduced liver function, mitigated hepatic tissue inflammation, and reduced levels of LPS, TNF-α, IL-1ß, and IL-18. Moreover, SBP exhibited the capacity to modulate hepatic autophagy induced by prolonged alcohol intake through the TLR4/NLRP3 signaling pathway. This modulation resulted in decreased expression of LC3Ⅱ and Beclin1, an elevation in P62 expression, and the promotion of autolysosome formation. These research findings imply that SBP can substantially enhance liver function and mitigate lipid irregularities in the context of chronic ALD. It achieves this by regulating excessive autophagic responses caused by prolonged spirit consumption, primarily through the inhibition of the TLR4/NLRP3 pathway.

Advances in amelioration of plasma electrolytic oxidation coatings on biodegradable magnesium and alloys.

Magnesium and its alloys are considered excellent materials for biodegradable implants because of their good biocompatibility and biodegradability as well as their mechanical properties. However, the rapid degradation rate severely limits their clinical applications. Plasma electrolytic oxidation (PEO), also known as micro-arc oxidation (MAO), is an effective surface modification technique. However, there are many pores and cracks on the coating surface under conventional PEO process. The corrosive products tend to penetrate deeply into the substrate, reducing its corrosion resistance and the biocompatibility, which makes PEO-coated Mg difficult to meet the long-term needs of in vivo implants. Hence, it is necessary to modify the PEO coating. This review discusses the formation mechanism and the influential parameters of PEO coatings on Mg. This is followed by a review of the latest research of the pretreatment and typical amelioration of PEO coating on biodegradable Mg alloys in the past 5 years, including calcium phosphate (Ca-P) coating, layered double hydroxide (LDH)-PEO coating, ZrO2 incorporated-PEO coating, antibacterial ingredients-PEO coating, drug-PEO coating, polymer-PEO composite coating, Plasma electrolytic fluorination (PEF) coating and self-healing coating. Meanwhile, the improvements of morphology, corrosion resistance, wear resistance, biocompatibility, antibacterial abilities, and drug loading abilities and the preparation methods of the modified PEO coatings are deeply discussed as well. Finally, the challenges and prospects of PEO coatings are discussed in detail for the purpose of promoting the clinical application of biodegradable Mg alloys.

[Characteristics and Source Analysis of Heavy Metal Pollution in Farmland Around a Coal-fired Power Plant].

To explore the impact of heavy metals in pollutant emissions from a coal-fired power plant on the soil environment of surrounding farmland, 31 farmland soil sampling sites were set up with the chimney of the power plant as the center using the radiation ring method. The contents of 10 heavy metals in the soil were determined using inductively coupled plasma mass spectrometry(ICP-MS). The characteristics and potential ecological risks of heavy metals in the soil were analyzed. The spatial differentiation and pollution characteristics of heavy metals were investigated based on geostatistical spatial interpolation and an AERMOD diffusion model, and the source analysis of heavy metals was conducted using a PMF receptor model. The results showed that:① the mean contents of the heavy metals ω(Pb), ω(Mn), ω(Zn), ω(Cr), ω(Ni), ω(Cu), ω(As), ω(Co), ω(Hg), and ω(Cd) in farmland around coal-fired power plants were 414.46, 286.38, 155.22, 69.54, 55.77, 53.48, 31.73, 19.86, 0.78, and 0.71 mg·kg-1, respectively. The contents of Hg, Pb, Cd, As, Zn, and Cu all exceeded the background values of Shaanxi Province by 26, 19.36, 7.88, 2.83, 2.23, 2.49, 1.87, 1.11, and 1.93 times, respectively. ② The mean value of the potential ecological risk index(RI) of heavy metals in the soil around the coal-fired power plant was 714.53, indicating a strong ecological risk level, and there were high-value rich areas near the Qianhe railway station and the oil and gas company. The single potential ecological risk index(Ei) of the Hg element was 520.92, which was at a very strong ecological risk level. ③ The main sources of heavy metals in the soil around the coal-fired power plant were dust removal sources from coal burning(32.16%), industrial and agricultural activities(19.78%), natural sources(26.25%), and traffic sources(21.81%). The high heavy metal content in the soil was distributed in the range of 1-2 km from the power plant, whereas the heavy metal content was low in the range of 1 km from the power plant, increasing gradually in the range of 1-2 km and then decreasing gradually when it was greater than 2 km. The spatial differentiation and enrichment characteristics of heavy metals in farmland around the power plant obtained in this study can provide theoretical and data support for soil pollution control.

Modification of titanium orthopedic implants with bioactive glass: a systematic review of in vivo and in vitro studies.

Bioactive glasses (BGs) are ideal biomaterials in the field of bio-restoration due to their excellent biocompatibility. Titanium alloys are widely used as a bone graft substitute material because of their excellent corrosion resistance and mechanical properties; however, their biological inertness makes them prone to clinical failure. Surface modification of titanium alloys with bioactive glass can effectively combine the superior mechanical properties of the substrate with the biological properties of the coating material. In this review, the relevant articles published from 2013 to the present were searched in four databases, namely, Web of Science, PubMed, Embase, and Scopus, and after screening, 49 studies were included. We systematically reviewed the basic information and the study types of the included studies, which comprise in vitro experiments, animal tests, and clinical trials. In addition, we summarized the applied coating technologies, which include pulsed laser deposition (PLD), electrophoretic deposition, dip coating, and magnetron sputtering deposition. The superior biocompatibility of the materials in terms of cytotoxicity, cell activity, hemocompatibility, anti-inflammatory properties, bioactivity, and their good bioactivity in terms of osseointegration, osteogenesis, angiogenesis, and soft tissue adhesion are discussed. We also analyzed the advantages of the existing materials and the prospects for further research. Even though the current research status is not extensive enough, it is still believed that BG-coated Ti implants have great clinical application prospects.

An ultrasound-guided percutaneous electrical nerve stimulation regimen devised using finite element modeling promotes functional recovery after median nerve transection.

Percutaneous electrical nerve stimulation of an injured nerve can promote and accelerate peripheral nerve regeneration and improve function. When performing acupuncture and moxibustion, locating the injured nerve using ultrasound before percutaneous nerve stimulation can help prevent further injury to an already injured nerve. However, stimulation parameters have not been standardized. In this study, we constructed a multi-layer human forearm model using finite element modeling. Taking current density and activated function as optimization indicators, the optimal percutaneous nerve stimulation parameters were established. The optimal parameters were parallel placement located 3 cm apart with the injury site at the midpoint between the needles. To validate the efficacy of this regimen, we performed a randomized controlled trial in 23 patients with median nerve transection who underwent neurorrhaphy. Patients who received conventional rehabilitation combined with percutaneous electrical nerve stimulation experienced greater improvement in sensory function, motor function, and grip strength than those who received conventional rehabilitation combined with transcutaneous electrical nerve stimulation. These findings suggest that the percutaneous electrical nerve stimulation regimen established in this study can improve global median nerve function in patients with median nerve transection.

[Therapeutic effect of Jingfang Granules on CCl_4-induced liver fibrosis in mice and its mechanism].

To investigate the therapeutic effect of Jingfang Granules on carbon tetrachloride(CCl_4)-induced liver fibrosis in mice and its mechanism. Forty-nine 8-week-old male C57 BL/6 J mice were randomly divided into a blank group, a CCl_4 group, a silybin group(positive control, 100 mg·kg~(-1))+CCl_4, a Jingfang high-dose(16 g·kg~(-1)) group, a Jingfang high-dose(16 g·kg~(-1))+CCl_4 group, a Jingfang medium-dose(8 g·kg~(-1))+CCl_4 group, and a Jingfang low-dose(4 g·kg~(-1))+CCl_4 group, with 7 mice in each group. The mice in the blank group and Jingfang high-dose group were intraperitoneally injected olive oil solution, and mice in other groups were intraperitoneally injected with 10% CCl_4 olive oil solution(5 mL·kg~(-1)) to induce liver fibrosis, twice a week with an interval of 3 d, for 8 weeks. At the same time, except for the blank group and CCl_4 group, which were given deionized water, the mice in other groups were given the corresponding dose of drugs by gavage once daily for 8 weeks with the gavage volume of 10 mL·kg~(-1). All mice were fasted and freely drank for 12 h after the last administration, and then the eyeballs were removed for blood collection. The liver and spleen were collected, and the organ index was calculated. The levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bile acid(TBA), and triglyceride(TG) in the serum of mice were detected by an automated analyzer. Tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and interleukin-1ß(IL-1ß) levels were detected by enzyme-linked immunosorbent assay(ELISA). Kits were used to detect the contents of superoxide dismutase(SOD), malondialdehyde(MDA), and glutathione(GSH) in the liver tissue. Pathological changes in the liver tissue were observed by hematoxylin-eosin(HE), Masson, and Sirius red staining. Western blot was used to detect protein expressions of transforming growth factor-ß(TGF-ß), α-smooth muscle actin(α-SMA) and Smad4 in the liver tissue. The results indicated that Jingfang Granules significantly reduced the organ index, levels of ALT, AST, TBA,TG, TNF-α, IL-6, and IL-1ß in the serum, and the content of MDA in the liver tissue of mice with CCl_4-induced liver fibrosis. Jingfang Granules also significantly increased the content of SOD and GSH in the liver tissue. Meanwhile, Jingfang Granules down-regulated the protein levels of TGF-ß, α-SMA, and Smad4. Furthermore, Jingfang Granules had no significant effect on the liver tissue morphology and the above indexes in the normal mice. In conclusion, Jingfang Granules has obvious therapeutic effect on CCl_4-induced liver fibrosis, and its mechanism may be related to reducing the expression of pro-inflammatory factors, anti-oxidation, and regulating TGF-ß/Smad4 signaling pathway.

A Systematic Review and Network Meta-Analysis of Biomedical Mg Alloy and Surface Coatings in Orthopedic Application.

Magnesium alloys have great application prospects as ideal bone implant materials. However, their poor corrosion resistance limits their clinical orthopedic application. Surface modification promotes the corrosion resistance of magnesium. Conversion coatings, such as calcium phosphate (Ca-P) coating, microarc oxidation (MAO) treatment, and fluoride (FLU) treatment, have been extensively investigated in in vivo studies. This systematic review and network meta-analysis compared the influence of different conversion coatings on bone repair, material properties, and systemic host response in orthopedic applications. Using the PICOS model, the inclusion criteria for biodegradable magnesium and its alloys were determined for in vivo studies. Four databases were used. The standard and weight mean differences with 95% confidence intervals were used to analyze new bone formation and degradation rate. Network structure and forest plots were created, and ranking probabilities were estimated. The risk of bias and quality of evidence were assessed using SYRCLE, CERQual, and GRADE tools. In the qualitative analysis, 43 studies were selected, and the evaluation of each outcome indicator was not entirely consistent from article to article. In the quantitative analysis, 21 articles were subjected to network meta-analysis, with 16 articles on implant degradation and 8 articles for new bone formation. Additionally, SUCRA indicated that Ca-P coating exhibited the highest corrosion resistance, followed by FLU treatment. MAO demonstrated the best capability for new bone formation, followed by Ca-P coating. Ca-P coating exhibited the highest overall performance. To conclude, coated Mg can promote better new bone formation than bare Mg and has considerable biocompatibility. Ca-P-coated Mg and MAO-coated Mg have the greatest potential to significantly promote corrosion resistance and bone regeneration, respectively. The findings of this study will provide a theoretical basis for the investigation of composite coatings and guidance for the orthopedic application of Mg bone implants.

Application of Nonsurgical Modalities in Improving Facial Aging.

OBJECTIVE: This review aims to summarize different kinds of applications of minimally invasive surgery in improving facial aging to provide a comprehensive and accurate introduction on the issue of esthetic treatment of facial skin. Overview. In the twentieth century, facial rejuvenation has become a new beauty trend. Facial cosmetology has entered a period of antiaging and rejuvenation therapies and microplastic surgery. The pursuit of beauty has promoted the development of minimally invasive plastic surgery. This review introduces the possible causes of facial aging and its related topics with a focus on facial injectable drugs, such as botulinum toxin, main filler materials (hyaluronic acid, calcium hydroxyapatite, poly L-lactic acid, collagen, autologous fat, and polymethyl methacrylate), and some current antiwrinkle technologies, such as thread lift and radiofrequency rhytidectomy. CONCLUSIONS: Despite the difference in mechanisms of action, each technique can address facial aging involving the loss of collagen, displacement and enlargement of fat, and muscle relaxation. Combinations of these treatments can provide patients with reasonable, comprehensive, and personalized treatment plans.

Fluoride Coatings on Magnesium Alloy Implants.

After several years of research and development, it has been reported that magnesium alloys can be used as degradable metals in some medical device applications. Over the years, fluoride coatings have received increasing research attention for improving the corrosion resistance of magnesium. In this paper, different methods for preparing fluoride coatings and the characteristics of these coatings are reported for the first time. The influence of the preparation conditions of fluoride coatings, including the magnesium substrate, voltage, and electrolyte, on the coatings is discussed. Various properties of magnesium fluoride coatings are also summarized, with an emphasis on corrosion resistance, mechanical properties, and biocompatibility. We screened experiments and papers that planned the application of magnesium fluoride coatings in living organisms. We have selected the literature with the aim of enhancing the performance of in vivo implants for reading and further detailed classification. The authors searched PubMed, SCOPUS, Web of Science, and other databases for 688 relevant papers published between 2005 and 2021, citing 105 of them. The selected time range is the last 16 years. Furthermore, this paper systematically discusses future prospects and challenges related to the application of magnesium fluoride coatings to medical products.

Basic mechanisms of peripheral nerve injury and treatment via electrical stimulation.

Previous studies on the mechanisms of peripheral nerve injury (PNI) have mainly focused on the pathophysiological changes within a single injury site. However, recent studies have indicated that within the central nervous system, PNI can lead to changes in both injury sites and target organs at the cellular and molecular levels. Therefore, the basic mechanisms of PNI have not been comprehensively understood. Although electrical stimulation was found to promote axonal regeneration and functional rehabilitation after PNI, as well as to alleviate neuropathic pain, the specific mechanisms of successful PNI treatment are unclear. We summarize and discuss the basic mechanisms of PNI and of treatment via electrical stimulation. After PNI, activity in the central nervous system (spinal cord) is altered, which can limit regeneration of the damaged nerve. For example, cell apoptosis and synaptic stripping in the anterior horn of the spinal cord can reduce the speed of nerve regeneration. The pathological changes in the posterior horn of the spinal cord can modulate sensory abnormalities after PNI. This can be observed in cases of ectopic discharge of the dorsal root ganglion leading to increased pain signal transmission. The injured site of the peripheral nerve is also an important factor affecting post-PNI repair. After PNI, the proximal end of the injured site sends out axial buds to innervate both the skin and muscle at the injury site. A slow speed of axon regeneration leads to low nerve regeneration. Therefore, it can take a long time for the proximal nerve to reinnervate the skin and muscle at the injured site. From the perspective of target organs, long-term denervation can cause atrophy of the corresponding skeletal muscle, which leads to abnormal sensory perception and hyperalgesia, and finally, the loss of target organ function. The mechanisms underlying the use of electrical stimulation to treat PNI include the inhibition of synaptic stripping, addressing the excessive excitability of the dorsal root ganglion, alleviating neuropathic pain, improving neurological function, and accelerating nerve regeneration. Electrical stimulation of target organs can reduce the atrophy of denervated skeletal muscle and promote the recovery of sensory function. Findings from the included studies confirm that after PNI, a series of physiological and pathological changes occur in the spinal cord, injury site, and target organs, leading to dysfunction. Electrical stimulation may address the pathophysiological changes mentioned above, thus promoting nerve regeneration and ameliorating dysfunction.

[Effect of Down-Regulation of LncRNA-HOTAIRM1 to Proliferation, Apoptosis and KIT/AKT Pathway of Jurkat Cells].

OBJECTIVE: To observe the effects of down-regulation of long non-coding RNA HOX antisense intergenic RNA myeloid 1 (LncRNA-HOTAIRM1) to the proliferation and apoptosis of Jurkat in human leukemia T lymphocytes, and explore its mechanism. METHODS: Jurkat cells were cultured in vitro and randomly divided into control group, HOTAIRM1 siRNA-NC group and HOTAIRM1 siRNA group; the expressions of LncRNA-HOTAIRM1 mRNA, KIT receptor tyrosine kinase (KIT) mRNA and serine threonine kinase (AKT) mRNA in Jurkat cells were detected by real-time fluorescence quantification (RT-qPCR); the proliferation of Jurkat cells in each groups was detected by CCK-8 method; the apoptosis of Jurkat cells in each groups was detected by Annexin V-FITC/PI double staining; the expressions of KIT, AKT, p-KIT, p-AKT, B-lymphoma-2 gene (BCL-2) and Caspase-3 were detected by Western blot. RESULTS: Compared with the cells in the control group and HOTAIRM1 siRNA-NC group, the expression level of LncRNA-HOTAIRM1 mRNA, cell survival rate, expression levels of KIT mRNA, AKT mRNA, p-KIT, p-AKT and BCL-2 proteins in Jurkat cells in HOTAIRM1 siRNA group were significantly lower (P<0.05), while the expression level of Cleared Caspase-3 protein and Jurkat cell apoptosis rate were significantly higher (P<0.05). CONCLUSION: LncRNA-HOTAIRM1 may inhibit Jurkat cell proliferation and induce apoptosis through KIT/AKT signaling pathway.

A Predictive Model Development of Hospital Admission during Triage in a Chinese Ear, Nose, and Throat Emergency Department.

INTRODUCTION: Triaging patients into correct severity categories in an emergency department is an advanced skill that depends on a quick assessment after obtaining very little information. The purpose of this study was to assess specific risk factors associated with hospital admissions in the emergency department environment of the specialized Eye, Ear, Nose, and Throat hospital located in Shanghai, China. METHODS: This study was a retrospective cohort study. Patients visiting the emergency department in a tertiary hospital in eastern China from February 2008 to August 2015 were included. Univariate and multivariate analyses were used to identify the risk factors related to hospital admissions. Combining variables calculated from the regression equation of multivariate analysis (binary logistic regression analysis) enabled the risk factors quantification. The receiver operating characteristic analysis was used to identify the most informative cutoff point of the combining predictors. RESULTS: A total of 188715 patients were enrolled in the study. Of them, 8395 patients (4.4%) required hospital admission. Hour of visit, season, age, sex, chief complaint, anatomical location, and locale of patients were independent risk factors of hospital admission by univariate and multivariate analysis. Combining predictors were calculated from the equation of the multivariate logistic model. The area under the curve of the combining predictors was 0.949, and the 95% confidence interval was 0.947 to 0.951 (P <.001), with a sensitivity of 95.2% and a specificity of 85.6%. A cutoff score of less than -35.1975 was associated with hospital admission. DISCUSSION: This study provided a method to build a feasible predictive model of hospital admission during triage. Understanding risk factors is an important part of the triage process in order to correctly assign priorities to the patients served. The outcomes of this study would add additional information for the triage nurse to consider in assessing the patient and assigning acuity ratings. The model developed here requires validation in future research.

Cationic IrIII Emitters with Near-Infrared Emission Beyond 800†nm and Their Use in Light-Emitting Electrochemical Cells.

Solid-state near-infrared (NIR) light-emitting devices have recently received considerable attention as NIR light sources that can penetrate deep into human tissue and are suitable for bioimaging and labeling. In addition, solid-state NIR light-emitting electrochemical cells (LECs) have shown several promising advantages over NIR organic light-emitting devices (OLEDs). However, among the reported NIR LECs based on ionic transition-metal complexes (iTMCs), there is currently no iridium-based LEC that displays NIR electroluminescence (EL) peaks near to or above 800 nm. In this report we demonstrate a simple method for adjusting the energy gap between the highest-occupied molecular orbital (HOMO) and the lowest-unoccupied molecular orbital (LUMO) of iridium-based iTMCs to generate NIR emission. We describe a series of novel ionic iridium complexes with very small energy gaps, namely NIR1-NIR6, in which 2,3-diphenylbenzo[g]quinoxaline moieties mainly take charge of the HOMO energy levels and 2,2'-biquinoline, 2-(quinolin-2-yl)quinazoline, and 2,2'-bibenzo[d]thiazole moieties mainly control the LUMO energy levels. All the complexes exhibited NIR phosphorescence, with emission maxima up to 850 nm, and have been applied as components in LECs, showing a maximum external quantum efficiency (EQE) of 0.05 % in the EL devices. By using a host-guest emissive system, with the iridium complex RED as the host and the complex NIR3 or NIR6 as guest, the highest EQE of the LECs can be further enhanced to above 0.1 %.

Effects of Different Oxidation Degrees of Graphene Oxide on P-Type and N-Type Si Heterojunction Photodetectors.

Oxygen-containing functional groups in graphene oxide (GO), a derivative of graphene, can widen the bandgap of graphene. In this study, we varied the amount of hydrogen peroxide used to prepare GO samples with different degrees of oxidation. Transmittance measurement, Raman spectroscopy, and X-ray photoelectron spectroscopy were used to completely characterize the change in oxidation degree. The effects of oxidation degree on p-type and n-type Si heterojunction photodetectors were compared. Notably, GO with a lower oxidation degree led to a larger photoresponse of p-type Si, whereas that with a higher oxidation degree achieved a larger photoresponse of n-type Si.

Influences of local habitat, tributary position, and dam characteristics on fish assemblages within impoundments of low-head dams in the tributaries of the Qingyi River, China.

Low-head dam impoundments modify local habitat and alter fish assemblages; however, to our knowledge, the pattern of how fish assemblages in the impoundments relate to local habitat, tributary position, and dam characteristics is still unclear. We used data collected in 62 impoundments created by low-head dams in headwater streams of the Qingyi River, China, to examine relationships between fish assemblages and local habitat, tributary position, and dam characteristics. We also assessed the relative importance of the three groups of factors in determining fish species richness and composition. Linear regression models showed that fish species richness was related to substrate heterogeneity, confluence link, and dam number upstream. Redundancy analysis showed that fish species compositions were influenced by substrate heterogeneity, confluence link, dam height, dam numbers upstream and downstream. Overall, dam characteristics were more important in affecting fish species richness but less important in determining fish species composition than local habitat (i.e., substrate heterogeneity) and tributary position. Our results suggest that low-head dam may affect fish species richness in impoundments by modifying local habitat and constraining fish movement, and the relative abundances of those fish species may depend more on species habitat presences and stream size than on impoundment size and number.

[Evaluation of PFA P2Y assay in monitoring platelet function in elderly patients with cardiovascular disease receiving clopidogrel treatment].

OBJECTIVE: To evaluate the value of a new platelet function test PFA P2Y (PFA-200) in monitoring clopidogrel treatment for cardiovascular disease in elderly patients. METHODS: Fifty-six elderly patients receiving clopidogrel therapy in the Department of Cardiology of General Hospital of PLA from March to August in 2016 and 85 healthy volunteers were recruited for analysis. All the subjects underwent PFA P2Y, LTA (light transmittance aggregometry) and TEG (Thromboelastograph) tests, and Spearman correlation coefficients were used to test the associations between test results. The agreement among the 3 platelet function test methods was assessed using Cohen's kappa coefficient. RESULTS: Correlation coefficient (r) was -0.701 (P<0.001) between PFA P2Y and LTA, and 0.475 (P<0.001) between PFA P2Y and TEG. The agreement was 75% between PFA P2Y and LTA and 67.9% between PFA P2Y and TEG. The κ value was 0.434 (P=0.001) between PFA P2Y and LTA and 0.242 (P=0.046) between PFA P2Y and TEG. With ADP-induced maximum platelet aggregation rate of LTA >50% as the laboratory clopidogrel resistance, the cut-off value of PFA P2Y was 119 s (AUC=0.733) with a sensitivity of 75.6% and a specificity of 73.3%. CONCLUSION: PFA P2Y has a moderate correlation and agreement with LTA, but has a poor correlation and agreement with TEG. PFA P2Y can be useful for assessing the effects of clopidogrel therapy and the association of the cut-off value (119 s) with the long-term clinical ischemic events needs be confirmed in further study.

Association between thrombelastography system and thromboembolic and bleeding events in Chinese aged people.

OBJECTIVES: This study was designed to obtain the knowledge about TEG indexes distribution in Chinese aged people, as well as to test the hypothesis that previous TEG indexes are associated with the subsequent thromboembolic and bleeding events in the aged population. METHODS: We conducted a two-year follow-up study in Chinese PLA General Hospital, Beijing, China. 403 aged people were enrolled in our study. They received TEG measurements at least once when they entered this study. We collected their demographical characteristics, clinical examination information and their outcome during their observational period. Structural equation modeling (SEM) was used to analyze the relationship between the four indexes from TEG and the outcome via a pathway of indicator. RESULTS: We found that in the "model of bleeding" (adjusted by confounding of Anticoagulants), the model fit indices with chi-square/df = 9.555/7, CFI was 0.997, TLI was 0.994 and standardized root mean square residual (SRMR) was 0.034; while in the "model of thromboembolic events" (adjusted by confounding of Anticoagulants), the model fit indices with chi-square/df = 6.070/7, CFI was1.000, TLI was 1.002 and standardized root mean square residual (SRMR) was 0.000. The "model of thromboembolic events" showed that the four indexes (R, K, MA and ANGLE) were all significantly associated with thromboembolic events, while this significance was not found in the "model of bleeding". CONCLUSIONS: Previous TEG indexes are significantly associated with the subsequent thromboembolic events in the aged population. Future study can test this association and provide more information for the clinical use.

[Agreement and repeatability of central corneal thickness measurement using the Pentacam and ultrasound pachymetry].

OBJECTIVE: To compare the agreement and repeatability of the OCULUS Pentacam (a new Scheimpflug-based imaging system) with ultrasound pachymetry in the measurement of central corneal thickness (CCT). METHODS: Central corneal thickness was measured in 112 subjects (112 eyes) separately by two examiners, first using the Pentacam instrument, then using an ultrasonic pachymetry. Measurements were repeated 3 times for each pachymetry. RESULTS: Mean values of CCT for each instrument were (538.63 ± 31.55) µm and (541.02 ± 30.45) µm using the Pentacam and the ultrasonic pachymeter, respectively. The difference is significant between the two instruments (t = -3.414, P = 0.001), the mean value of the difference is (-2.39 ± 7.42) µm. The Bland-Altman Plots displayed relatively good agreement (limits of agreement were -16.93 µm to 12.15 µm) between the two instruments. The intraclass correlation coefficient (ICC) of the two devices showed high repeatability (Separately 0.86 and 0.88). CONCLUSIONS: The agreement between the Pentacam instrument and the ultrasonic pachymetry was good, and the repeatability was also good for both instruments independently, however it is needed to increase measure times to improve the repeatability of the Pentacam which is a promising new instrument for anterior eye evaluation.

A novel polymer-lipid hybrid nanoparticle for efficient nonviral gene delivery.

AIM: To develop a novel non-viral vector with high transfection efficiency and low cytotoxicity. METHODS: Poly (ethylene glycol)-distearoylphosphatidylethanolamine (PEG-DSPE) was incorporated into polymer-lipid hybrid nanoparticles (PLN) to construct a PEG-DSPE modified long circulating PLN (L-PLN). The L-PLN was prepared by the emulsifying-solvent evaporation method, L-PLN and L-PLN/DNA complexes were characterized. Both HEK293 and MDA-MB-231 cells transfected by L-PLN/DNA complexes were observed under a fluorescence microscope. The transfection efficiency of the complexes to HEK293 cells was further evaluated by flow cytometry. RESULTS: The GFP fluorescence intensity in HEK293 cells transfected by the L-PLN/DNA complexes (N/P=10) was about 37.2%, which was higher than those transfected by PLN alone or commercial Lipofectamine 2000. The L-PLN exhibited minimal toxicity at a low N/P ratio compared with other vectors. CONCLUSION: L-PLN as a novel gene delivery system, has higher transfection efficiency and acceptable cytotoxicity compared to the corresponding PLN, which is beneficial for the development of non-viral gene transfer vectors and may offer an alternative strategy for the future gene therapy.