The Role of Grain Boundaries on Ion Migration and Charge Recombination in Halide Perovskites.

Grain boundaries (GBs) have a significant role in polycrystalline perovskite solar cells (PSCs). However, there is ongoing debate regarding the impact of GBs on the performance and long-term stability of PSCs. Employing the first-principles molecular dynamics for perovskites, the iodine vacancy defect migrations both in bulk and at GBs are investigated. i) The positive iodine vacancy (VI +) is found that have both lower formation energy (1.4 eV) and activation energy (0.18 eV) than those of neutral iodine vacancy (VI), statistically. It indicated the VI + acts as the dominant migrated iodine vacancy rather than VI; ii) the iodine vacancy at GBs has ≈0.48 eV higher activation energy than those in bulk, which leads to the accumulation of iodine vacancy at GBs; iii) the presence of VI + result in a 3-fold increase in charge recombination ratio at GBs, compared to pristine PSCs. Based on quantum molecular dynamics statistical results, which are consistent with experimental measurements, insights into iodine vacancy migration both at GBs and in the bulk are gained. This understanding can be valuable for defects engineering related to ion migration, in order to improve the long-term stability and promote the performance of PSCs.

Specific targeting of the KRAS mutational landscape in myeloma as a tool to unveil the elicited antitumor activity.

Alterations in KRAS have been identified as the most recurring somatic variants in the multiple myeloma (MM) mutational landscape. Combining DNA and RNA sequencing, we studied 756 patients and observed KRAS as the most frequently mutated gene in patients at diagnosis; in addition, we demonstrated the persistence or de novo occurrence of the KRAS aberration at disease relapse. Small-molecule inhibitors targeting KRAS have been developed; however, they are selective for tumors carrying the KRASG12C mutation. Therefore, there is still a need to develop novel therapeutic approaches to target the KRAS mutational events found in other tumor types, including MM. We used AZD4785, a potent and selective antisense oligonucleotide that selectively targets and downregulates all KRAS isoforms, as a tool to dissect the functional sequelae secondary to KRAS silencing in MM within the context of the bone marrow niche and demonstrated its ability to significantly silence KRAS, leading to inhibition of MM tumor growth, both in vitro and in vivo, and confirming KRAS as a driver and therapeutic target in MM.

Volumetric analysis of effectiveness of embolization for preventing type II endoleaks following endovascular aortic aneurysm repair.

OBJECTIVE: The presence of endoleak was associated with the failure of endovascular aortic aneurysm repair (EVAR) treatment. The key to eliminating type II endoleak has shifted from reintervention to prevention. This study aimed to evaluate the effectiveness and safety of applying fibrin sealant to prevent type II endoleak in conjunction with EVAR. METHODS: All patients with abdominal aortic aneurysm who underwent EVAR from June 2019 to July 2021 were reviewed. Patients were grouped as Group A: standard EVAR with preemptive embolization and Group B: standard EVAR alone. The primary endpoint was the incidence of type II endoleak. The secondary endpoints were aneurysm sac regression, the inferior mesenteric artery patency, the numbers of patent lumbar arteries, and all-cause mortality. RESULTS: A total of 104 patients were included in Group A, and 116 were included in Group B. Technical success rate was 100%. The overall incidence of type II endoleak in Group A was significantly lower than that in Group B (4.8% vs 19.0%). The mean time of freedom from type II endoleak was 22.71 months for Group A (95% confidence interval, 21.59-23.83 months) and 19.89 months for Group B (95% confidence interval, 18.08-21.70 months). The Kaplan-Meier estimate of freedom from type II endoleak showed a significantly longer duration of freedom from type II endoleak in Group A (81.0% vs 95.2%). Group A showed a continuous sac regression tendency. In Group B, the sac volume decreased within 12 months but increased by 3.07 cm3 at 24 months. No complications were noted in both groups. CONCLUSIONS: Nonselective preemptive embolization with porcine fibrin sealant during EVAR was safe and effective in preventing type II endoleak in the short and mid-term. Preemptive embolization can lead to a significantly higher sac regression rate. Larger patient populations and longer follow-ups with randomized control designed trials are expected to verify the long-term effectiveness and safety of preemptive embolization in preventing type II endoleak.

Measurement of Time-Dependent Drive Flux on the Capsule for Indirectly Driven Inertial Confinement Fusion Experiments.

A new method for measuring the time-dependent drive flux at the hohlraum center is proposed as a better alternative to conventional wall-based techniques. The drive flux here is obtained by simultaneous measurement of the reemitted flux and shock velocity from a three-layered "cakelike" sample. With these two independent observables, the influence induced by the uncertainty of the material parameters of the sample can be effectively decreased. The influence from the closure of the laser entrance hole, which was the main challenge in conventional wall-based techniques, was avoided through localized reemitted flux measurement, facilitating drive flux measurement throughout the entire time history. These studies pave a new way for probing the time-dependent drive flux, for both cylindrical hohlraums and novel hohlraums with six laser entrance holes.

Simultaneous Endovascular Repair for Thoracic and Abdominal Aortic Pathologies: Early and Midterm Results.

BACKGROUND: To analyze information from a single clinical center, evaluating early and midterm results of simultaneous thoracic endovascular aortic repair (TEVAR) and endovascular aneurysm repair (EVAR) for coexisting thoracic and abdominal aortic pathologies. METHODS: From January 2005 to December 2014, 13 patients (8 men, 5 women; mean age, 75.3 years; range, 69-82 years) with concomitant thoracic and abdominal aortic disease (aneurysms, type B dissection, penetrating aortic ulcers) were treated with simultaneous TEVAR and EVAR. All patients had significant comorbidities. No preoperative cerebrospinal fluid drainage was performed. The follow-up rate was 100% during a period of 36 months (range, 1-60 months). RESULTS: Technical success was achieved in all 13 patients, including deliberate partial or total coverage of the left subclavian artery in 3 patients, coverage of both internal iliac arteries in 1 patient, and coverage of left subclavian artery and unilateral internal iliac artery in 1 patient. The average procedural time was 160 min (range, 120-200 min). Mean blood loss was 140 mL (range, 100-250 mL). Four types of commercially available stent grafts (SGs) were used. The lengths of the thoracic SGs were 150-200 cm. Overall survival was 92.3% at 1- and 3-year follow-ups. None of the patients developed stroke or paralysis. The average hospital stay was 9 days (range, 7-12 days). No patients developed endoleak or SG migration. CONCLUSIONS: Combined TEVAR and EVAR can be performed successfully with minimal morbidity and mortality. When anatomically feasible, simultaneous TEVAR and EVAR is a viable alternative to staged or hybrid repair.

Successful Endovascular Repair in a Patient with Isolated Proximal Subclavian Artery Dissecting Aneurysm: Case Report and Literature Review.

Spontaneous isolated subclavian artery dissecting aneurysm is rare. This is to our knowledge the first case in the world's literature to report a patient with subclavian artery dissecting aneurysm. Although the endovascular approach of treating subclavian artery pathologies is not challenging, the choice of using a covered stent for this patient was a new attempt in treating subclavian artery dissections. This case report highlights the possibility and safety of using covered stent in treating patients with subclavian artery dissecting aneurysms after reassuring the patency of the cerebral circulation system.

Hybrid repair of penetrating aortic ulcer associated with right aortic arch and aberrant left innominate artery arising from aneurysmal Kommerell's diverticulum with simultaneous repair of bilateral common iliac artery aneurysms.

We present the first case of a hybrid endovascular approach to a penetrating aortic ulcer on the left descending aorta with a right aortic arch and aberrant left innominate artery arising from an aneurysmal Kommerell's diverticulum. The patient also had bilateral common iliac artery aneurysms. The three-step procedure consisted of a carotid-carotid bypass, followed by endovascular exclusion of the ulcer and the aneurysmal Kommerell's diverticulum, and then completion by covering the iliac aneurysms. The patient had no complications at 18 months after surgery. In such rare configurations, endovascular repair is a safe therapeutic option.

Large-scale kinetic simulations of colliding plasmas within a hohlraum of indirect-drive inertial confinement fusion.

The National Ignition Facility has recently achieved successful burning plasma and ignition using the inertial confinement fusion (ICF) approach. However, there are still many fundamental physics phenomena that are not well understood, including the kinetic processes in the hohlraum. Shan et al. [Phys. Rev. Lett. 120, 195001 (2018)0031-900710.1103/PhysRevLett.120.195001] utilized the energy spectra of neutrons to investigate the kinetic colliding plasma in a hohlraum of indirect drive ICF. However, due to the typical large spatial-temporal scales, this experiment could not be well simulated by using available codes at that time. Utilizing our advanced high-order implicit PIC code, LAPINS, we were able to successfully reproduce the experiment on a large scale of both spatial and temporal dimensions, in which the original computational scale was increased by approximately seven to eight orders of magnitude. Not only is the validity of the explanation of the experiment confirmed by our simulations, i.e., the abnormally large width of neutron spectra comes from beam-target nuclear fusions, but also a different physical insight into the source of energetic deuterium ions is provided. The acceleration of deuterium ions can be categorized into two components: one is propelled by a sheath electric field created by the charge separation at the onset, while the other is a result of the reflection of the potential of the shock wave. The robustness of the acceleration mechanism is analyzed with varying initial conditions, e.g., temperatures, drifting velocity, and ion components. This paper might serve as a reference for benchmark simulations of upcoming simulation codes and may be relevant for future research on mixtures and entropy increments at plasma interfaces.

Induction of leptin resistance through direct interaction of C-reactive protein with leptin.

The mechanisms underlying leptin resistance are still being defined. We report here the presence in human blood of several serum leptin-interacting proteins (SLIPs), isolated by leptin-affinity chromatography and identified by mass spectrometry and immunochemical analysis. We confirmed that one of the major SLIPs is C-reactive protein (CRP). In vitro, human CRP directly inhibits the binding of leptin to its receptors and blocks its ability to signal in cultured cells. In vivo, infusion of human CRP into ob/ob mice blocked the effects of leptin upon satiety and weight reduction. In mice that express a transgene encoding human CRP, the actions of human leptin were completely blunted. We also found that physiological concentrations of leptin can stimulate expression of CRP in human primary hepatocytes. Recently, human CRP has been correlated with increased adiposity and plasma leptin. Thus, our results suggest a potential mechanism contributing to leptin resistance, by which circulating CRP binds to leptin and attenuates its physiological functions.

Early human albumin administration is associated with reduced mortality in septic shock patients with acute respiratory distress syndrome: A retrospective study from the MIMIC-III database.

Background: Sepsis-induced acute respiratory distress syndrome (ARDS) was associated with higher mortality. It is unclear whether albumin supplementation early in the course of ARDS can affect the prognostic outcomes of septic shock (SS) patients with ARDS. Methods: The MIMIC-III database was employed to identify SS patients with ARDS. The effect of early application (<24 h after ICU admission) of human albumin on 28-day mortality in SS patients with ARDS was explored. The propensity score matching was used to minimize the bias between the non-albumin and early albumin treatment groups. Results: The analysis for all eligible patients who received human albumin showed significantly lower 28-hospital mortality rates than the non-albumin group (37% versus 47%, p = 0.018). After propensity matching, the difference between the two groups also significantly (34.8% versus 48.1%, p = 0.031). Moreover, we found that the relationship between albumin use and reduced 28-day mortality was inconsistent across SOFA score subgroups (Pinteraction = 0.004, non-adjustment for multiple testing). Conclusion: Early human albumin administration in SS patients with ARDS was independently associated with a reduction of 28-day mortality. Furthermore, the benefit of human albumin treatment appeared to be more pronounced in patients with a SOFA score of ≤ 10.

High-Fat Diet Promotes Adipogenesis in Offspring Female Rats Induced by Perinatal Exposure to 4-Nonylphenol.

Background: Both high-fat diet (HFD) and 4-nonylphenol (4-NP) could affect fat formation in adipose tissue individually. We investigated whether HFD promote abnormal adipose tissue formation caused by early exposure to 4-NP in life and preliminarily explore the possible mechanisms involved. Methods: The first-generation rats were treated with HFD on postnatal day after pregnant rats exposure to 5 ug/kg/day 4-NP. Then, the second generation rats started to only receive normal diet without 4-NP or HFD. We analyzed organ coefficient and histopathology of fat tissues, biochemical index, and gene level involved in lipid metabolism in female offspring rats. Results: HFD and 4-NP interaction synergistically increased birth weight, body weight, and organ coefficients of adipose tissue in offspring female rats. HFD accelerately aggravated abnormal lipid metabolism and increased the adipocyte mean areas around the uterus of the offspring female rats induced by prenatal exposure to 4-NP. HFD also facilitate the regulation of gene expression involved lipid metabolism in offspring female rats induced by perinatal exposure to 4-NP, even passed on to the second generation of female rats. Moreover, HFD and 4-NP interaction synergistically declined the gene and protein expression of estrogen receptor (ER) in the adipose tissue of second-generation female rats. Conclusion: HFD and 4-NP synergistically regulate the expression of lipid metabolism genes in adipose tissue of F2 female rats and promote adipose tissue generation, leading to obesity in offspring rats, which is closely related to low expression of ER. Therefore, ER genes and proteins may be involved in the synergistic effect of HFD and 4-NP.

Experimental confirmation of driving pressure boosting and smoothing for hybrid-drive inertial fusion at the 100-kJ laser facility.

In laser-driven inertial confinement fusion, driving pressure boosting and smoothing are major challenges. A proposed hybrid-drive (HD) scheme can offer such ideal HD pressure performing stable implosion and nonstagnation ignition. Here we report that in the hemispherical and planar ablator targets installed in the semicylindrical hohlraum scaled down from the spherical hohlraum of the designed ignition target, under indirect-drive (ID) laser energies of ~43-50 kJ, the peak radiation temperature of 200 ± 6 eV is achieved. And using only direct-drive (DD) laser energies of 3.6-4.0 kJ at an intensity of 1.8 × 1015 W/cm2, in the hemispherical and planar targets the boosted HD pressures reach 3.8-4.0 and 3.5-3.6 times the radiation ablation pressure respectively. In all the above experiments, significant HD pressure smoothing and the important phenomenon of how a symmetric strong HD shock suppresses the asymmetric ID shock pre-compressed fuel are demonstrated. The backscattering and hot-electron energy fractions both of which are about one-third of that in the DD scheme are also measured.

Study on the influence of different production factors on PSY and its correlation.

BACKGROUND: Finding out the key reproductive performance factors, affecting piglets weaned per sow per year (PSY) can improve the production efficiency and profitability of pig farms. The objective was to understand the actual distribution of different production factors and PSY of breeding pig farms, analyze the correlation to find the main production factors affecting PSY, and formulating a Production Efficiency Improvement Plan in practice. Data included 603 breeding pig farms from September 28, 2020 to September 26, 2021. Regression analysis was used to evaluate the relationship between PSY and key production factors, and the characteristics of total pig farms versus high performance (HP) pig farms (the production performance was in the top 10%) or top 5% pig farms were compared. Spearman's rank correlation coefficient was used to analyze the correlation between production factors and find the factors related to PSY. Non-linear support vector regression (NL-SVR) was used to analyze the personalized PSY improvement through a various change of the four key factors. RESULTS: The median distribution of 15 production factors and PSY in total pig farms were different from those of HP farms. All of data were distributed nonlinearly. Mating rate within 7 days after weaning (MR7DW), farrowing rate (FR), number of piglets born alive per litter (PBAL) and number of weaned piglets per litter (WPL) were moderately correlated with PSY, and the correlation coefficients were 0.5058, 0.4427, 0.3929 and 0.3839, respectively. When the four factors in NL-SVR changed in medium (0.5 piglet or 5%) or high level (1.0 piglet or 10%), PSY can be increased by more than 0.5. CONCLUSION: NL-SVR model can be used to analyze the impact of changes in key production factors on PSY. By taking measures to improve MR7DW, FR, PBAL and WPL, it may effectively improve the current PSY and fully develop the reproductive potential of sows.

Machine learning based personalized promotion strategy of piglets weaned per sow per year in large-scale pig farms.

BACKGROUND: The purpose of this study was to analyze the relationship between different productive factors and piglets weaned per sow per year (PSY) in 291 large-scale pig farms and analyze the impact of the changes in different factors on PSY. We chose nine different algorithm models based on machine learning to calculate the influence of each variable on every farm according to its current situation, leading to personalize the improvement of the impact in the specific circumstances of each farm, proposing a production guidance plan of PSY improvement for every farm. According to the comparison of mean absolute error (MAE), 95% confidence interval (CI) and R2, the optimal solution was conducted to calculate the influence of 17 production factors of each pig farm on PSY improvement, finding out the bottleneck corresponding to each pig farm. The level of PSY was further analyzed when the bottleneck factor of each pig farm changed by 0.5 standard deviation (SD). RESULTS: 17 production factors were non-linearly related to PSY. The top five production factors with the highest correlation with PSY were the number of weaned piglets per litter (WPL) (0.6694), mating rate within 7 days after weaning (MR7DW) (0.6606), number of piglets born alive per litter (PBAL) (0.6517), the total number of piglets per litter (TPL) (0.5706) and non-productive days (NPD) (- 0.5308). Among nine algorithm models, the gradient boosting regressor model had the highest R2, smallest MAE and 95% CI, applied for personalized analysis. When one of 17 production factors of 291 large-scale pig farms changed by 0.5 SD, 101 pig farms (34.7%) can increase 1.41 PSY (compared to its original value) on average by adding the production days, and 60 pig farms (20.6%) can increase 1.14 PSY on average by improving WPL, 45 pig farms (15.5%) can increase 1.63 PSY by lifting MR7DW. CONCLUSIONS: The main productive factors related to PSY included WPL, MR7DW, PBAL, TPL and NPD. The gradient boosting regressor model was the optimal method to individually analyze productive factors that are non-linearly related to PSY.

Complete Endovascular Repair for Abdominal Aortic Aneurysm With Concomitant Aorto-Left Retroaortic Renal Vein Fistula.

BACKGROUND: Abdominal aortic aneurysm (AAA) with concomitant aorto-retroarotic left renal vein fistula (ALRVF) is an extremely rare clinical condition. With the recent development of endovascular techniques, repair of such conditions with a complete minimal invasive approach is now possible. We reported here a case of endovascular repair of AAA with concomitant ALRVF. CASE PRESENTATION: A 62-year-old gentleman presenting with AAA and concomitant ALRVF underwent complete endovascular repair, including an endovascular aortic aneurysm repair (EVAR) with bifurcated aortic graft as well as embolization of the aneurysm sac and deployment of a covered stent in the left retroarotic renal vein to achieve sealing of the arterial-venous fistula. The patient required no blood transfusion and no ICU stay. He has been followed up closely for 4 years and has been well clinically. Aneurysm sac size has remained stable. CONCLUSIONS: Endovascular repair can be a safe and reliable surgical alternative to treat AAA with concomitant ALRVF. But long-term follow up and more clinical data are required to verify the durability of endovascular repair for such conditions.

[The treatment strategy of special distal landing zones in endovascular repair of abdominal aortic aneurysm].

OBJECTIVE: To study the assessment and management for abdominal aortic aneurysm (AAA)'s special distal landing zones in endovascular repair (EVAR). METHODS: The clinic data of 66 AAA patients with complicated distal landing zones From January 2007 to December 2010 was retrospectively analyzed. There were 45 male and 21 female patients, aged from 53 to 87 years with a mean of 62 years. All patients underwent the CT angiography examination (1 to 2 mm interval) to obtain the necessary anatomical data. In this group, there were 20 cases with type I and IIA lesions, including 10 cases with narrow common iliac arteries/external iliac arteries (> 50%), 6 cases with seriously distorted common iliac arteries/external iliac arteries, 4 cases with the characters of the above, 16 cases with bilateral common iliac aneurysms, 46 cases with bilateral common iliac aneurysms combined internal iliac aneurysms (unilateral 32 cases, bilateral 14 cases). The vascular stent-grafts' usage was as follow: Metronic 46 cases, COOK 14 cases, Microport 4 cases, Lifetech 2 cases. RESULTS: The mean operative time was 90 min. There were significant stent-graft shortening in 22 cases (33.3%), type II endoleak in 18 cases (27.3%), type III endoleak in 5 cases (7.6%), iliac stents' stenosis (> 50%) in 2 cases (3.0%), type II combined with type III endoleak in 5 cases (7.6%), iliac stents' stenosis combined with type III endoleak in 4 cases (6.1%). Patients were followed for a mean of 22 months (range from 3 to 36 months), during the time of follow-up, the following conditions were observed: stent-graft displacement (to the remote < 10 mm) in 2 cases (3.0%), iliac stents restenosis (> 50%) 2 cases, type II endoleak healed in 18 cases (18/23, 78.3%), and no type III endoleak remained. The fatality rate was 3.0% (2/66). CONCLUSIONS: Special distal landing zones increased the operative complication rate in EVAR. Being familiar with the features of stent-graft and appropriate use of various surgical management can increase the success ratio of EVAR.

Are We in a De-Globalization Process? The Evidence from Global Trade During 2007-2017.

Through the analysis of statistical data, some scholars believe that the globalization of trade is declining, and de-globalization has become a trend, even since the financial crisis in 2008. However, the superficial decline of global trade volume cannot be taken as a corollary of the de-globalization. It needs go deep into the structural analysis, and "globalization or de-globalization" should be discussed by analyzing whether the global trade structure has changed. This paper finds that during 2007-2017, the global trade resistances are clearly classified, and trade resistance in the global community has increased significantly. Second, an expectation maximization (EM) algorithm is applied to divide global trade relations into two categories: intimate trade relations, whose barriers are mainly related to geographical distance; and unfriendly trade relations with high artificial barriers. Third, the trade purity indicator (TPI) is introduced to describe the trade environment of countries, and its evolution indicates after the financial crisis and for quite a long time, the structure of global trade has not changed much. And it shows some deterioration trend and structural adjustment after 2015, which indicates an opportunity for the emergence of de-globalization in such an international environment full of uncertainty and challenges.

[The predictive value of medical big data for the prognosis of elderly patients with pneumonia: based on the result of clinical database of a Beijing Chaoyang Hospital Consortium Chaoyang Emergency Ward].

OBJECTIVE: To explore a medical big data algorithm to screen the core indicators in clinical database that can be used to evaluate the prognosis of elderly patients with pneumonia. METHODS: Based on the clinical database of a Beijing Chaoyang Hospital Consortium Chaoyang Emergency Ward in Beijing Chaoyang Hospital, Capital Medical University, patients with pulmonary infection were selected through the big data retrieval technology. According to the prognosis at the time of discharge, they were divided into death group and survival group. The general data of patients were collected, including gender, age, blood gas and laboratory indices. A computer language called Python was used to make batch calculations of key indicators that affect mortality in elderly patients with pneumonia. Logistic regression analysis was used to analyze the relationship between laboratory indicators and patients' prognosis. Receiver operating characteristic curve (ROC curve) was drawn to analyze the predictive value of screening method for patients' prognosis. RESULTS: A total of 265 patients were included in the study, 64 died and 201 survived. The data of the first detection indexes of each patient after admission were collected, and 23 key indicators with significant differences were selected from 472 indicators: blood routine indicators (n = 7), blood gas indicators (n = 3), tumor markers indicators (n = 3), coagulation related indicators (n = 4), and nutrition and organ function indicators (n = 6). (1) The key indicators of blood gas in patients died of pneumonia: Cl- was 97-111 mmol/L in 51.6% (33 cases) of patients, lactic acid (Lac) was 0.5-2.5 mmol/L in 81.2% (52 cases) of patients, and H+ was 0-46 mmol/L in 87.5% (56 cases) of patients. (2) The key indicators of blood routine of patients died of pneumonia: hemoglobin count (Hb) of 46.9% (30 cases) patients was 80-109 g/L, the eosinophils proportions (EOS%) in 67.2% (43 cases) patients was 0.000-0.009, the lymphocytes proportions (LYM%) in 51.6% (33 cases) patients was 0.00-0.09, the red blood cell count (RBC) in 50.0% (32 cases) patients was (3.0-3.9)×1012/L, the white blood cell count (WBC) in 54.7% (35 cases) patients was (0.0-9.9)×109/L, and the red blood cell volume distribution width coefficientof variability (RDW-CV) in 48.4% (31 cases) patients was 10.0%-14.9%, serum C-reactive protein (CRP) was 0.0-49.9 mg/L in 48.4% (31 cases) patients. (3) The key indicators of tumor markers in patients died of pneumonia: 76.6% (49 cases) of patients had negative free prostate specific antigen/total prostate specific antigen (FPSA/TPSA, the ratio was 0), 92.2% (59 cases) had cytokeratin 19 fragment (CYFRA21-1) between 0.0-11.0 µg/L, and 75.0% (48 cases) had carbohydrate antigen 125 (CA125) between 0-104 kU/L. (4) The key coagulation indexes of patients died of pneumonia: 68.8% (44 cases) of patients had activated partial thromboplastin time (APTT) of 57-96 s, 73.4% (47 cases) of patients had D-dimer of 0-6 mg/L, 93.8% (60 cases) of patients had thrombin time (TT) of 14-22 s, and 89.1% (57 cases) of patients had adenosine diphosphate (ADP) inhibition rate of 0%-53%. (5) Nutrition and organ function key indicatorsin patients died of pneumonia: 92.2% (59 cases) of brain natriuretic peptide (BNP) in patients with 0, 46.9% (30 cases) of patients had prealbumin (PA) of 71-140 mg/L, 90.6% (58 cases) of the patients with uric acid (UA) for 21-41 µmol/L, 75.0% (48 cases) of the patients with albumin (Alb) to 10-20 g/L, 93.5% (60 cases) of patients had albumin/globulin ratio (A/G ratio) of 0-0.9, 84.4% (54 cases) of the patients with lactate dehydrogenase (LDH) from 0-6.68 µmol/L×s-1×L-1. (6) Logistic regression analysis and ROC curve analysis: Logistic regression analysis showed that PA and Lac were the prognostic factors. PA could reduce the risk of death by 0.9%, Lac could increase the risk of death by 69.4%; the area under ROC curve (AUC) between laboratory indicators and the prediction effect of death prediction model for patients' prognosis was 0.80, which showed that the classification effect was better, and this study model could better predict the prognosis of elderly patients with pneumonia. CONCLUSIONS: By using big data technology, 23 core indicators for evaluating the prognosis of elderly patients with pneumonia can be screened from the clinical database of emergency ward, which provides a new perspective and method for clinical evaluation of the prognosis of elderly patients with pneumonia.

High-fat diet accelerate hepatic fatty acids synthesis in offspring male rats induced by perinatal exposure to nonylphenol.

BACKGROUND: Low dose of NP exposure can alter adipose tissue formation, and the intake of high-fat diet (HFD) can also lead to the fatty liver disease. We investigated the combined effect of NP and HFD on the first offspring of rats, and whether this effect can be passed to the next generation and the possible mechanisms involved. METHODS: Pregnant rats had access to be treated with 5 µg/kg/day NP and normal diet. The first generation rats were given normal diet and HFD on postnatal day 21, respectively. Then the second generation rats started to only receive normal diet without NP or HFD. Body weight, organ coefficient of liver tissues, lipid profile, biochemical indexes and the expression of genes involved in lipid metabolism, as well as liver histopathology were investigated in male offspring of rats. RESULTS: NP and HFD interaction had significant effect on the birth weight, body weight and liver tissue organ coefficient of first generation male rats. And HFD aggravated abnormal lipid metabolism, even abnormal liver function and liver histopathological damage of first generation male rats produced by the NP. And this effect can be passed on to the second generation rats. HFD also accelerated the mRNA level of fatty acid synthesis genes such as Lpl, Fas, Srebp-1 and Ppar-γ of first generation rats induced by perinatal exposure to NP, even passed on to the second generation of male rats. NP and HFD resulted in synergistical decrease of the protein expression level of ERα in liver tissue in F2 male rats. CONCLUSION: HFD and NP synergistically accelerated synthesis of fatty acids in liver of male offspring rats through reducing the expression of ERα, which induced abnormal lipid metabolism, abnormal liver function and hepatic steatosis. Moreover, all of these damage passed on to the next generation rats.

Extracorporeal Cardiac Shock Waves Therapy Improves the Function of Endothelial Progenitor Cells After Hypoxia Injury via Activating PI3K/Akt/eNOS Signal Pathway.

Background: Extracorporeal cardiac shock waves (ECSW) have great potential in the treatment of coronary heart disease. Endothelial progenitor cells (EPCs) are a class of pluripotent progenitor cells derived from bone marrow or peripheral blood, which have the capacity to migrate to ischemic myocardium and differentiate into mature endothelial cells and play an important role in neovascularization and endothelial repair. In this study, we investigated whether ECSW therapy can improve EPCs dysfunction and apoptosis induced by hypoxia and explored the underlying mechanisms. Methods: EPCs were separated from ApoE gene knockout rat bone marrow and identified using flow cytometry and fluorescence staining. EPCs were used to produce in vitro hypoxia-injury models which were then divided into six groups: Control, Hypoxia, Hypoxia + ECSW, Hypoxia + LY294002 + ECSW, Hypoxia + MK-2206 + ECSW, and Hypoxia + L-NAME + ECSW. EPCs from the Control, Hypoxia, and Hypoxia + ECSW groups were used in mRNA sequencing reactions. mRNA and protein expression levels were analyzed using qRT-PCR and western blot analysis, respectively. Proliferation, apoptosis, adhesion, migration, and angiogenesis were measured using CCK-8, flow cytometry, gelatin, transwell, and tube formation, respectively. Nitric oxide (NO) levels were measured using an NO assay kit. Results: Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis showed that differentially expressed genes were enriched in cancer signaling, PI3K-Akt signaling, and Rap1 signaling pathways. We selected differentially expressed genes in the PI3K-Akt signaling pathway and verified them using a series of experiments. The results showed that ECSW therapy (500 shots at 0.09 mJ/mm2) significantly improved proliferation, adhesion, migration, and tube formation abilities of EPCs following hypoxic injury, accompanied by upregulation of p-PI3K, p-Akt, p-eNOS, Bcl-2 protein and NO, PI3K, and Akt mRNA expression, and downregulation of Bax and Caspase3 protein expression. All these effects of ECSW were eliminated using inhibitors specific to PI3K (LY294002), Akt (MK-2206), and eNOS (L-NAME). Conclusion: ECSW exerted a strong repaired effect on EPCs suffering inhibited hypoxia injury by inhibiting cell apoptosis and promoting angiogenesis, mainly through activating the PI3K/Akt/eNOS signaling pathway, which provide new evidence for ECSW therapy in CHD.