Aberrant Human Epididymal Protein 4 in Heart Failure Patients' Serum and its Association with C-Reactive Protein, Uric Acid and Homocysteine.

BACKGROUND: The goal was to explore the aberrant human epididymal protein 4 (HE4) in chronic heart failure (CHF) patients and its association with C-reactive protein (CRP), uric acid (UA), and homocysteine (HCY). METHODS: Analysis of serum HE4 and its relevance with associated indexes in 117 CHF patients was implemented. RESULTS: Serum HE4 in CHF patients was linked with the disease's severity and CRP, UA, and HCY. An assessment value was provided for it (p < 0.05). CONCLUSIONS: HE4 is aberrant in CHF patients' serum and is associated with the disease's severity and CRP, UA, and HCY's indexes.

Influence of intracranial hemorrhage on clinical outcome in acute vertebrobasilar artery occlusion undergoing endovascular treatment.

BACKGROUND AND PURPOSE: The effect of intracranial hemorrhage (ICH) on the outcome of patients with large-vessel occlusion undergoing endovascular treatment (EVT) has mainly focused on the anterior circulation. Knowledge of the relationship between ICH and outcomes in patients with acute vertebrobasilar artery occlusion (VBAO) receiving EVT is limited. We aimed to assess whether ICH is a prognostic marker for acute VBAO following EVT. METHODS: Patients who underwent EVT for acute VBAO in the acute posterior circulation ischemic stroke (PERSIST) registry were included. All patients were classified as having no or any-ICH. Any-ICH was subdivided into asymptomatic and symptomatic ICH. A multivariate regression analysis was performed to evaluate the association between ICH and functional outcomes in patients with acute VBAO after receiving EVT. RESULTS: Five hundred and forty-seven patients, including 107 patients with ICH (19.6%): 38 (7.0%) and 69 (12.6%) with symptomatic and asymptomatic ICH, respectively. After adjustment for potential confounders, any-ICH was independently associated with reduced chance of favorable outcome (OR 0.39, 95% CI 0.21-0.72, P=0.003), functional independence (OR 0.24, 95% CI 0.16-0.52, P<0.001), and excellent outcome (OR 0.34, 95% CI 0.15-0.75, P=0.008), and increased mortality risk (OR 2.14, 95% CI 1.30-3.51, P=0.003). Symptomatic ICH had a similar association. Moreover, asymptomatic ICH was a negative predictor of functional independence (OR 0.39, 95% CI 0.17-0.88, P=0.024). CONCLUSION: Any- and symptomatic ICH were strongly associated with worse clinical outcomes and increased mortality in patients with acute VBAO who underwent EVT. Asymptomatic ICH was an inverse predictor of functional independence.

[Research progress of macrophage polarization in silicosis fibrosis].

Silicosis is a common occupational disease, and its main characteristic pathological features are the formation of silicon nodules and diffuse pulmonary fibrosis. In the process of silicosis fibrosis, macrophages can be polarized into M1 macrophages and M2 macrophages. M1 macrophages play a pro-inflammatory role in the early stage of silicosis and release a variety of inflammatory factors, which is the core of inflammatory response. M2 macrophages promote inflammation resolution and tissue repair in silicosis fibrosis stage by secreting anti-inflammatory cytokines and pro-fibrotic mediators. M1/M2 polarization balance plays an important role in the occurrence and development of silicosis, and the regulation of macrophage polarization direction may play a positive role in the prevention and treatment of silicosis fibrosis. In this review, the role of macrophage polarization in silicosis fibrosis, the related signaling pathways regulating macrophage polarization in silicosis fibrosis, and the potential therapeutic targets based on macrophage polarization in silicosis fibrosis are reviewed, with a view to further strengthening the understanding of the mechanism of macrophage polarization in the pathogenesis and treatment of silicosis fibrosis.

[Determination of 22 phospholipids in serum by ultra performance liquid chromatography-tandem mass spectrometry].

Objective: To establish ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for the determination of 22 phospholipids in serum. Methods: In September 2022, Using synthetic non endogenous phospholipids as internal standard, phospholipids in serum were extracted by methanol-dichloromethane (2∶1, V/V) protein precipitation method. Chromatographic separation was achieved on an ACQUITY UPLC BEH shield RP18 column, and the mobile phase was methanol/water (5∶95, V/V) containing 10 mM ammonium formate and methanol. Detection was performed in multiple reaction monitoring mode with ion mode switching. And the method was applied by analyzing phospholipids in the serum of coal workers' pneumoconiosis patients. Results: The 22 phospholipids showed good linear relationships in their respective concentration ranges and the correlation coefficients were higher than 0.990. The spiked recoveries of the 22 phospholipids were 81.03%-121.63% at the three spiked levels. The intra-assay were less than 14.52%, and the inter-assay were less than 15.00%. Conclusion: The method with the advantages of simplicity, stability and high sensitivity, and it can be used for the analysis of phospholipids in serum.

[The effects of positive end-expiratory pressure on central venous pressure in patients with different chest wall elastic resistance].

Objective: To investigate the role of chest wall elastic resistance in determining the effects of positive end-expiratory pressure (PEEP) on central venous pressure (CVP) in patients with mechanical ventilation (MV). Methods: In this prospective study, according to the median of ratio of chest wall elastic resistance to respiratory system elastic resistance (Ers), patients were divided into high chest wall elastic resistance group (Ecw/Ers≥0.24) and low chest wall elastic resistance group [elastance of chest wall (Ecw)/Ers<0.24]. PEEP was set at 5, 10, 15 cmH2O (1 cmH2O=0.098 kPa) respectively. Clinical data including CVP, heart rate (HR), blood pressure (BP) and respiratory mechanics were recorded. Results: Seventy patients receiving MV were included from November 2017 to December 2018. Clinical characteristics including age, BP, HR, baseline PEEP, the ratio of arterial oxygen partial pressure to fractional inspired oxygen (P/F) and comorbidities were comparable in two groups. However, patients with high Ecw/Ers ratio presented higher body mass index (BMI) than those with low Ecw/Ers ratio[ (25.4±3.2) kg/m2 vs. (23.4±3.2) kg/m2, P=0.011]. As PEEP increased from 5 cmH2O to 10 cmH2O, CVP in high Ecw/Ers group increased significantly compared with that in low Ecw/Ers group [1.75(1.00, 2.13) mmHg (1 mmHg=0.133kPa) vs. 1.50(0.50, 2.00)mmHg,P=0.038], which was the same as PEEP increased from 10 cmH2O to 15 cmH2O [2.00(1.50, 3.00)mmHg vs. 1.50(1.00, 2.00)mmHg,P=0.041] or PEEP increased from 5 cmH2O to 15 cmH2O [ 3.75(3.00,4.63)mmHg vs. 3.00(1.63, 4.00)mmHg, P=0.012]. When PEEP increased from 5 cmH2O to 10 cmH2O, 10 cmH2O to 15 cmH2O and 10 cmH2O to 15 cmH2O, there were significant correlations between Ecw/Ers and CVP elevation (r=0.29, P=0.016; r=0.31, P=0.011; r=0.31, P=0.01 respectively). Conclusions: In patients receiving mechanical ventilation, elevation of PEEP leads to a synchronous change of CVP, which is corelated with patients' chest wall elastic resistances.

[Comparative study of short-term efficacy,effectiveness and safety at different stages of the laparoscopic pancreaticoduodenectomy learning curve].

Objective: To compare short-term efficacy,effectiveness and safety of laparoscopic pancreaticoduodenectomy(LPD) learning curve at different stages and at the same time with open pancreaticoduodenectomy(OPD). Methods: Clinical data of 488 patients who underwent pancreaticoduodenectomy at Department of Biliary-Pancreatic Surgery,Affiliated Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from July 2014 to December 2016 were collected. There were 40 cases at the groping stage of LPD surgery(100 cases at the same time of OPD),64 cases at the stable stage (89 cases at the same time of OPD),and 118 cases at the mature stage(77 cases at the same time of OPD).The clinical data of LPD and OPD in the same period were compared and analyzed by χ2 test,t test and U test,respectively. Results: There was no significant difference in preoperative indicators between the two groups at the three stages(all P>0.05). In terms of intraoperative blood volume of the LPD group was significantly lower than that of the OPD group at three stages(M(QR))(111.1(150.0)ml(range:0 to 700 ml) vs. 393.9(400.0)ml(range:0 to 3 000 ml),120.8(115.0)ml(range:0 to 1 000 ml) vs. 442.9(450.0)ml(range:0 to 2 000 ml) and 150.0(200.0)ml(range:10 to 1 500 ml) vs. 364.3(400.0)ml(range:0 to 1 500 ml))(all P<0.05). And in terms of operation time of the LPD group was significantly higher than that of the OPD group at the groping stage((461.1±123.9)min(range:220 to 690 minutes) vs. (385.9±113.9)minutes(range:150 to 655 minutes))(P<0.05),and there was no significant difference between the LPD group and the OPD group at the stable and mature stage(P>0.05). The incidence of B+C level pancreatic fistula of the LPD group was higher than that of the OPD group at groping stage(17.5% vs. 3.0%)(P<0.05). There was no significant difference between the LPD group and the OPD group at the stable and mature stage(P>0.05). The incidence of postoperative rebleeding(27.5%),bile leakage(20.0%) and abdominal infection(20.0%) of the LPD group was higher than those of the OPD group(11.0%(11/100),5.0%(5/100) and 7.0%(7/100)) at groping stage. There were no significant differences between the LPD group and the OPD group at the stable and mature stage(P>0.05). There were no significant differences of incidence gastrointestinal leakage,hepatic failure,renal failure,cardiac failure,pulmonary infection and 30-day death between the LPD group and the OPD group(all P>0.05). The incidence rate of gastroplegia in the LPD group was lower than that in the OPD group at the stable and mature stage(26.5%(17/64) vs. 44.9%(40/89) and 24.5%(29/118) vs. 38.9%(30/77))(all P<0.05),there was no significant difference between the LPD group and the OPD group at the groping stage(P>0.05). In terms of other incidence of complications,there were no significant differences between the LPD group and the OPD group at three stages(all P>0.05). There were no significant differences of positive margin rate of pancreas,bile duct,retroperitoneum,vascular channel,uncinate process and rate of R0 resection between the LPD group and the OPD group at three stages(all P>0.05). In terms of numbers of lymph nodes,there was no significant difference between the LPD group and the OPD group at three stages(all P>0.05).Postoperative hospital stay of the LPD group was shorter than that of the OPD group at the stable stage((14.8±6.9)days(range:10 to 38 days) vs. (17.0±9.0)days(range:4 to 56 days)) and the mature stage((13.0±7.4)days(range:3 to 57 days) vs. (15.8±6.7)days(range:6 to 69 days)(all P<0.05). Conclusion: with the stable and mature learning curve of LPD surgery,compared with traditional OPD surgery,it has the characteristics of less intraoperative bleeding,shorter postoperative hospitalization,lower incidence of delay gastric empty,safe and effective.

[Feasibility and safety of right ventricular endomyocardial biopsy via the right internal jugular vein approach].

Objective: To evaluate the feasibility and safety of right ventricular endomyocardial biopsy (EMB) via the right internal jugular vein approach. Methods: It was a retrospective and descriptive study. A total of 272 patients, who underwent right ventricular EMB from December 2014 to June 2020 in Fuwai Hospital and Peking Union Medical College Hospital were enrolled. The preliminary diagnosis included suspected myocarditis, myocardiopathy, unexplained heart failure etc after exclusion of coronary heart disease. Clinical characteristics including age, sex, height, weight, NYHA functional class, NT-proBNP, chest radiography, echocardiography, and hemodynamics parameters were collected at baseline. EMB was performed via right internal jugular vein approach under the biplane fluoroscopic guidance. Success rate was calculated in this study. Complications related to operation were recorded according the following definitions. Major complications included death, urgent cardiac surgery, advanced cardiac life support, pericardiocentesis in cardiac tamponade, permanent complete atrioventricular block requiring permanent pacing etc. Minor complications included pericardial effusion without pericardiocentesis, temporary (lasting less than 24 hours) or permanent right bundle-branch block, temporary Mobitz type Ⅱ atrioventricular block (AV block) with AV conduction 2∶1 requiring medical treatment with atropine, or additive temporary pacing, non-sustained ventricular tachycardia with long runs of more than 10 ventricular complexes, and an episode of atrial fibrillation lasting less than 12 hours or cardioversion of atrial fibrillation. Other complications included tricuspid anterior chorda rupture and new onset tricuspid regurgitation after EMB. Results: In this study, right ventricular EMB were performed successfully in 270 patients, the total success rate was 99.3% (270/272), and EMB were failed in 2 (0.7%) patients. Age of the enrolled patients was (42.7±16.9) years, and there were 164 (60.3%) males. Major complication including cardiac tamponade requiring pericardiocentesis occurred in 2 (0.7%) patients. Minor complications such as small amount pericardial effusion occurred in 18 (6.6%) patients, tricuspid anterior chorda rupture occurred in 1 (0.4%) patient. No patient died, or requiring permanent pacing, or requiring emergency cardiac surgery. The complication rate was 9.3% (13/140), 7.8% (7/90), and 2.4% (1/42) in operators with 1, 2, and 3 years' experience. Conclusions: EMB via the right jugular vein approach under fluoroscopic guidance is a simple, safe and feasible procedure. The complication rates decrease significantly with increasing operator experience.

A study on the indexing method of the electron backscatter diffraction pattern assisted by the Kikuchi bandwidth.

In this study, a new method is established for indexing electron backscatter diffraction (EBSD) patterns assisted by the Kikuchi bandwidth. This method utilises both interplanar angles and interplanar spacings to determine the Miller indices of the Kikuchi bands in EBSD patterns to improve the efficiency and precision of indexing in the EBSD system. Two samples of single-crystal silicon were investigated to validate the method based on (a) the detection of the edges of the EBSD Kikuchi bands and (b) the calculation of the Kikuchi bandwidths. The relationship between the Kikuchi bandwidth and the interplanar spacing at different positions was established, and the interplanar spacing of the corresponding lattice plane of each Kikuchi band was calculated with the use of the Kikuchi bandwidth information. The relative errors between the theoretical and experimental interplanar spacings are small, with an average relative error of 2.6% and a minimum relative error of 1.04%. The results indicated that the Miller index of each Kikuchi band can be determined accurately with this new method. It is demonstrated that use of this new method improves the efficiency and accuracy of the EBSD system. LAY DESCRIPTION: Electron backscatter diffraction (EBSD) is a scanning electron microscope-based technique. In our work, a new method is established for indexing EBSD patterns assisted by the Kikuchi bandwidth. This method utilizes both interplanar angles and interplanar spacings to determine the Miller indices of the Kikuchi bands in EBSD patterns to improve the efficiency and precision of indexing in the EBSD system. Two samples of single-crystal silicon were investigated to validate the method based on a) the detection of the edges of the EBSD Kikuchi bands and b) the calculation of the Kikuchi bandwidths. The relationship between the Kikuchi bandwidth and the interplanar spacing at different positions was established, and the interplanar spacing of the corresponding lattice plane of each Kikuchi band was calculated with the use of the Kikuchi bandwidth information. The relative errors between the theoretical and experimental interplanar spacings are small, with an average relative error of 2.6% and a minimum relative error of 1.04%. Compared with the results reported in the literature, the width-assisted Kikuchi pattern indexing method can well distinguish some cases with similar angles, and reduce the possibility of mis-indexing. After the introduction of the width information of the Kikuchi bands, the screening range can be narrowed by determining the crystal plane family, and the efficiency and accuracy of the indexing process can thus be improved. Specifically, for some materials with increased symmetry, such as cubic crystal materials, it is necessary to use the interplanar spacing for indexing when the interplanar angles are not diagnostic. The results indicated that the Miller index of each Kikuchi band can be determined accurately with this new method. It is demonstrated that use of this new method improves the efficiency and accuracy of the EBSD system.

[Serum metabolomics in latent pneumoconiosis tuberculosis patients based on ultra performance liquid chromatography tandem quadrupole time of flight mass spectrometry].

Objective: To explore the non-target metabonomics of serum in worker's pneumoconiosis (CWP) patients with latent tuberculosis and the biomarkers of latent tuberculosis infection of pneumoconiosis. Methods: In December 2018, 39 CWP inpatients from a hospital in Beijing were taken as subjects. The subjects were screened for latent tuberculosis using the in vitro release test of mycobacterium tuberculosis-interferon (IGRAs) test. According to the screening results, 21 positive patients with latent tuberculosis infection were selected as the latent tuberculosis group of pneumoconiosis. While 18 negative patients with CWP alone were selected as the pneumoconiosis group. Polarity components of metabolites were analyzed by UPLC-QTOF/MS. The data was processed with Progenesis QI software for multidimensional statistical analysis. Identification of structure of differential metabolites were matched through accurate mass and secondary mass spectrum. Searching the Human Metabolome Database (HMDB) , differential metabolites were imported into MetaboAnalyst 4.0 to analyze the metabolic pathways. Results: All 42 differential metabolites were screened out. Excepted for exogenous metabolites, 14 endogenous differential metabolites were identified. Compared with the pneumoconiosis group, 6 metabolites including PC [18∶4 (6Z, 9Z, 12Z, 15Z) /P-18∶1 (11Z) ], 3-Oxododecanoyl-CoA in the latent tuberculosis group were up-regulated, while 8 metabolites including the Stearoyl-CoA, (2S) -Pristanoyl-CoA were down-regulated. These results might be related to lipid, fatty acid and arachidonic acid metabolism pathways. Conclusion: There are significant differences in serum metabonomics between the patients with latent tuberculosis of pneumoconiosis and the patients with ordinary pneumoconiosis, which provide a reference for the study of biomarkers for the diagnosis of latent tuberculosis infection of pneumoconiosis.

Aneurysm Morphology Is a More Significant Predictor of Survival than Hardman's Index in Patients with Ruptured or Acutely Symptomatic Abdominal Aortic Aneurysms.

Scoring systems such as Hardman's index are used to predict outcomes and stratify patients with ruptured abdominal aortic aneurysm (RAAA) or acutely symptomatic abdominal aortic aneurysm (SAAA) to active treatment or palliation. Aneurysm morphology is not included in these scoring systems. The aim of this study was to assess whether aneurysm morphology was an independent predictor of survival. Consecutive patients admitted from January 2006 to March 2017 with emergency presentation and primary diagnosis of abdominal aortic aneurysm were identified. Patients were stratified by age, gender, mode of presentation (RAAA versus SAAA), Hardman's Index, aneurysm morphology (suitability for endovascular aneurysm repair [EVAR]), and the procedure performed (endovascular versus open). Multivariable logistic regression analysis was used to determine predictors of survival. A total of 346 patients were included (RAAA: 250, SAAA: 96). Median age of patients was 75 years (range: 44-96); 284 (79%) were men and 75 (21%) were women. Three hundred twenty-five patients underwent preoperative computed tomography (CT) scan of these 156 (48%) fulfilled conservative instructions for use (IFU) for EVAR and another 64 (20%) were within the liberal IFU for EVAR. Median Hardman Index was 1 (range 0-5). Age (odds ratio [OR]: 1.72 [95% confidence interval {CI}: 1.15-2.23] [P < 0.001]), mode of presentation [(OR: 2.05 (95% CI: 1.45-3.31) (P < 0.001)], and aneurysm morphology being within conservative IFU for EVAR [(OR: 1.61 (95% CI: 1.08-2.03) (P = 0.02)], modality of repair (open versus EVAR), (OR: 0.81 [95% CI: 0.67-0.92], [P < 0.001]) were independent predictors of survival. Hardman's index (OR: 0.86 [95% CI: 0.69-1.11], [P = 0.16]) and gender (OR: 1.15 [95% CI: 0.83-1.32], [P = 0.24]) were not. Aneurysm morphology is a significant predictor of survival after RAAA. This information should be included in any scoring system.

Highly selective resolution of racemic 1-phenyl-1,2-ethanediol by a novel strain Kurthia gibsonii SC0312.

Chiral 1-phenyl-1,2-ethanediol (PED) performs vital effect for the preparation of pharmaceuticals, agrochemicals and cosmetics. In the study, a newly isolated strain Kurthia gibsoniiSC0312 with the ability to selectively oxidize racemic PED to achieve (S)-PED was evaluated in the aqueous reaction system. The strain showed excellent catalytic performances within the range of pH 5·5-8·5, temperature 25-45°C and the amount of cell 15 mg ml-1 to 30 mg ml-1 . Besides, 2-hydroxyacetophenone (HAP) as the oxidation product displayed a stronger inhibition to the catalytic activity of cell, only remaining <63% of catalytic activity after incubation at 40 mmol l-1 HAP for 6 h. For various metal ions, Cu2+ can obviously improve 1·7 times of the catalytic activity of cell at the concentration of 0·2 mmol l-1 . Acetone can stimulate the catalytic capacity of cell to improve the optical purity of (S)-PED at the PED concentration of 80 mmol l-1 , up to appropriately 94% from 85·4%; compared to the resting cell, growing cell exerted no positive effect in the yield and optical purity. Finally, a highly effective kinetic resolution system of racemic PED by the new strain was obtained, with the (S)-PED yield of 41% and optical purity of 94%. SIGNIFICANCE AND IMPACT OF THE STUDY: Biocatalyst is a vital component in the process of biotransformation. There are a growing number of studies of biocatalyst reporting the preparation of enantiomer of 1-phenyl-1,2-ethanediol. And the performance of this preparation reaction is also gradually improving. This study is the first to demonstrate that Kurthia gibsonii can efficiently and selectively oxidize racemic 1-phenyl-1,2-ethanediol, and we assess the effect of various factors on the catalytic performance of the strain. The work adds to a growing body of evidence for using biocatalytic method in the synthesis of chiral 1-phenyl-1,2-ethanediol and provides a probable approach to mine excellent properties of enzymes.

[Efficacy analysis of LVIS and Enterprise stent assisted coil in the treatment of vertebral artery dissection aneurysm].

Objective: To observe and evaluate the therapeutic efficacy of LVIS stent and Enterprise stent assisted coil in embolization of vertebral artery dissection aneurysm (VDA). Methods: Clinical data of 96 patients with VDAs treated by LVIS stent and Enterprise stent assisted coil were analyzed retrospectively between January, 2013 and June, 2017.Of all, the LVIS stent assisted coil was performed in 28 patients (LVIS-stent group) and Enterprise in 68 patients (Enterprise-stent group). The clinical and imaging follow-up were performed. The instant embolization rate, complications, and recurrence rate were analyzed and compared between the two groups. Results: Instant angiographic results:in the LVIS stent group, complete occlusion was achieved in 17 VDAs (60.7%), near-complete occlusion in 10VDAs (35.7%), and partial occlusion in 1 VDA (3.6%). In the Enterprise stent group, complete occlusion was achieved in 27 VDAs (39.7%), near-complete occlusion in 34VDAs(50.0%), partial occlusion in 7VDAs (10.3%). Procedure-related complications occurred in 3 patients (10.7%) in LVIS stent group and 3 patients (4.4%) in Enterprise stent group. DSA follow-up was performed during 6 to 12 months after surgery, and 10 patients with vertebral artery dissection aneurysm recurred, 2 in the LVIS group and 8 in the Enterprise stent group. The latest modified Rankin Scale score was 0 in 55 patients,1 in 13, 2 in 1, 3 in 1, and 6 in 1. Among them, all follow-up patients in the LVIS stent group had good prognosis, while in the Enterprise stent group, 50 patients (94.4%) had a good prognosis. Conclusions: The stent-assisted coils have a higher degree of embolization in the vertebral artery dissection aneurysms, a higher rate of near-total embolization, a lower incidence of neurological complications, and a good prognosis. The complete andnear-complete occlusion rates and the incidence of neurological complicationsin the LVIS group was higher than that in the Enterprise groupand the recurrence ratesin the LVIS group was lower than that in the Enterprise group,both with no statistically significant difference.

[Outcome of kidney transplantation with graft from intracerebral hemorrhage donors].

Objective: To analyze the data of kidney transplantation with allografts from intracerebral hemorrhage donors of China donation after citizen's death (CDCD) and provide evidence to guide the clinical practice. Methods: The clinical data of CDCD donors (age ≥10 years)and corresponding kidney allograft recipients, which were done by Second Xiangya Hospital of Central South University during January 1 2013 to December 31 2017, were analyzed retrospectively. Results: 327 CDCD cases were analyzed, the number and percentage of intracerebral hemorrhage donors were gradually increasing and the percentage reached to 39.5% in 2017. The discarding rateof kidney allografts donated by intracerebral hemorrhage donors was higher than those donated by non-intracerebral hemorrhage donors, but intracerebral hemorrhage donor may not be a risk factor for DGF after the rigorous evaluation of kidney allografts. For 145 primary recipients transplanted in 2016 and had a 22±4 month follow-up, the recipients accepted the kidney from intracerebral hemorrhage donors had a higher level of serum creatinine[(130±60)µmol/L vs (111±38) µmol/L,P<0.05]and a lower eGFR[(61±23) ml·min(-1)·(1.73m(2))(-1) vs (70±23) ml·min(-1)·(1.73m(2))(-1),P<0.05] compared to the recipients accepted the kidney from non-intracerebral hemorrhage donors. Conclusion: The number and percentage of organ donation from intracerebral hemorrhage donor is increasing, but the intracerebral hemorrhage donor may be a risk factor for long-term outcome of kidney transplantation.

Methylation-Based Age Estimation Model Construction and Its Effectiveness Evaluation.

OBJECTIVES: To screen the DNA methylation loci associated with the age of Han males in northern China and to construct an age estimation model. METHODS: Twenty-one candidate methylation loci were screened. The DNA methylation levels of 476 blood samples from Chinese Han males were detected for 21 amplicons using EpiTYPER technology platform, and data on 153 DNA methylation loci were obtained. RESULTS: After correlation analysis, 8 age-related DNA methylation loci were finally screened. CpG1, CpG2, CpG4, CpG7, CpG8 were located on TRIM59, RASSF5, Clorf132, CSNK1D, ELOVL2,CpG5, CpG6 on PDE4C, and CpG3 on chr17:21452808. Based on the 8 loci, 352 samples were used for model construction. A multivariate linear regression age estimation model was constructed （R2=0.93）, with mean absolute deviation （MAD） of 2.69 years old. When 109 samples were used for model validation, the MAD was 3.80 years old. The test was repeated 3 times in 15 new samples, with MADs of 4.08, 4.68 and 3.93 years old, respectively. CONCLUSIONS: The age estimation model on Han males in northern China constructed in this study can be used to estimate the age of victims and suspects and to narrow the scope of investigation, and therefore has practical application value.

[Rapid determination of 21 elements in urine by inductively coupled plasma mass spectrometry].

Objective: To develop a rapid detection method for 21 elements in urine with inductively coupled plasma mass spectrometry (ICP-MS) . Methods: The urine samples were directly diluted 20 times by 1% HNO(3), and detected by ICP-MS, Indium, Yttrium, and Lutecium were used as on-line internal standard. Fe was analyzed by Dynamic Reaction Cell (DRC) mode, As, Cr, V and Zn were analyzed by collision cell technology (CCT) mode, and Be, Mn, Ni, Cd, Sn, Bi, Pb, Re, Sb, W, Li, Cu, Se, Sr, Mo were analyzed by standard mode. Dynamic band-pass tuning (DBT) was used to eliminate interference for Fe. Results: All the elements have good linearity in their determination range, with the correlation coefficient r>0.999 5. The limits of detection of the 21 elements were in the range of 0.017-11.14 µg/L. The inter-precision (relative standard deviation, RSD) was less than 9.96%, and the intra-precision was less than 13.90% (except As RSD<18.91%) . The spike recovery of all elements fell within 81.1%-116.4%. Conclusion: The method was proved to be simple, fast, and accurate, and met the needs of testing requirements of large amounts of specimens.

Do Integrated Systems of Stroke Care Improve Symptom to Surgery Times in Patients with Symptomatic Carotid Stenosis? A Single Centre Decision Tree Analysis.

OBJECTIVE: The objective of this study was to examine the impact of an integrated system of stroke care on symptom to surgery times, cost-effectiveness, and quality of life measures in patients with symptomatic carotid stenosis. METHODS: Patients who underwent carotid endarterectomy (CEA) in a regional vascular centre between April 1, 2011, and March 31, 2016, were identified from the National Vascular Registry (NVR). Risk of stroke on medical therapy for each patient was calculated using the Oxford stroke risk calculator. Symptom to surgery times were compared among patients referred from a stroke service providing an integrated stroke care and the stroke service in an adjacent NHS trust which provides standard urgent referral pathway. A decision analytic Markov process model was constructed to determine the cost-effectiveness of CEA versus medical treatment in patients who followed the standard and integrated pathways. This model examined the lifetime costs and health benefits of CEA through each pathway. RESULTS: A total of 376 patients underwent CEA, of whom 243 were managed through the integrated stroke pathway and 133 through the standard urgent referral pathway. Median symptom to surgery time was 11 (0-66) days for the former and 15 (3-90) days for the latter (p < .001). There was no significant difference in peri-operative stroke death rate between integrated (2.1%) and standard (1.5%) pathways (chi-square = 0.14, p = .73). CEA through the integrated pathway improved quality adjusted life expectancy by an additional 0.13 (0.64 QALYs [integrated pathway] to 0.51 QALYs [standard pathway]) and was associated with an incremental lifetime cost benefit of £2203.4. CONCLUSIONS: An integrated stroke system of care is cost-effective and associated with significant improvements in quality adjusted life years.

Efficacy and safety of uninterrupted low-intensity warfarin for cryoballoon ablation of atrial fibrillation in the elderly: A pilot study.

WHAT IS KNOWN AND OBJECTIVE: Uninterrupted warfarin during cryoballoon ablation (CB-A) of atrial fibrillation (AF) has been widely accepted. However, to our knowledge, no previous studies exist investigating the optimal intensity of anticoagulation with warfarin for CB-A. This study aimed to evaluate the efficacy and safety of uninterrupted low-intensity warfarin for CB-A of AF in the elderly. METHODS: Paroxysmal AF patients (age ≥ 70 years) who underwent CB-A were enrolled prospectively. The participants were stratified into 2 groups based on international normalized ratio (INR) before ablation (INR in group A: 1.5 to 2.0; INR in group B: 2.0-2.5). Primary endpoints included periprocedural thromboembolic complications and major bleeding. Secondary endpoints were new asymptomatic cerebral emboli (ACE) and minor bleeding. RESULTS AND DISCUSSION: A total of 144 patients were enrolled (group A: 65; group B: 79). In group A, the use of concomitant antiplatelet drugs was more common. Also, the mean HAS-BLED score was significantly higher (2.4 ± 0.8 vs 2.0 ± 0.6, P < .01) and the mean activated clotting time (ACT) during the procedure was significantly lower (302 ± 14 s vs 311 ± 11 s, P < .01). Other clinical characteristics were balanced between the 2 groups. No thromboembolic complications and major bleeding occurred in either group. The incidence of periprocedural ACE was comparable between the 2 groups (9.2% vs 6.3%, P = .74). The incidence of minor bleeding in group A and group B was 4.6% and 11.4%, respectively (P = .14). WHAT IS NEW AND CONCLUSION: Compared with standard-intensity warfarin, uninterrupted low-intensity warfarin might not increase the incidence of thromboembolic complications and might be associated with less bleeding risk during the perioperative period of cryoballoon ablation in the elderly. Large trials are needed to confirm these results.

miR-26a suppresses autophagy in swine Sertoli cells by targeting ULK2.

A large number of microRNAs (miRNAs) have been detected from porcine testicular tissues thanks to the development of high-throughput sequencing technology. However, the regulatory roles of most identified miRNAs in swine testicular development or spermatogenesis are poorly understood. In our previous study, ULK2 (uncoordinated-51-like kinase 2) was predicted as a target gene of miR-26a. In this study, we aimed to investigate the role of miR-26a in swine Sertoli cell autophagy. The relative expression of miR-26a and ULK2 levels has a significant negative correlation (R2  = .5964, p ≤ .01) in nine developmental stages of swine testicular tissue. Dual-luciferase reporter assay results show that miR-26a directly targets the 3'UTR of the ULK2 gene (position 618-624). In addition, both the mRNA and protein expression of ULK2 were downregulated by miR-26a in swine Sertoli cells. These results indicate that miR-26a targets the ULK2 gene and downregulates its expression in swine Sertoli cells. Based on the expression of marker genes (LC3, p62 and Beclin-1), overexpression of miR-26a or knock-down of ULK2 inhibits swine Sertoli cell autophagy. Taken together, these findings demonstrate that miR-26a suppresses autophagy in swine Sertoli cells by targeting ULK2.

[Efficacy analysis of the endovascular treatment for 175 unruptured vertebrobasilar dissecting aneurysms].

Objective: To analyze the clinical characteristics, clinical effect and follow-up outcome of the different endovascular treatment techniques in the treatment of unruptured vertebrobasilar dissecting aneurysms (VBDAs). Methods: The clinical data of 160 consecutive patients (175VBDAs) from January 2012 to December 2016 in Beijing Tiantan hospital were retrospectively analyzed.All of the 175 aneurysms were treated with endovascular embolization, including 115 stent-assisted coils, 27 simple stents, 21 blood flow diverting devices, and 12 parent arteries occlusion.The imaging and clinical follow-up were performed after the operation. Results: Headache including cervical-occipital pain(43.1%)was the most common clinical manifestation.The incidence of perioperative complications was 3.75%, no intraoperative bleeding and no deaths.The imaging findings of 113 aneurysms were followed up for (9.9±7.3) months.Of the 71 stent-assisted coils, 62 recovered well and 9 relapsed; of the 19 aneurysms treated with simple stent, 4 recovered well, 11 improved, 2 stable and 2 relapsed; of the 15 aneurysms treated by the blood flow diverting devices, 4 recovered and 11 improved; all of the 8 aneurysms with parent arteries occlusion recovered well.A total of 144 patients were follow-up (17.3±16.6) months by the Modified Rankin Scale(mRS) score: 140 patients were 0-2 score and 4 patients were 3-6 score. Conclusions: The clinical manifestations of the unruptured VBDAs are complex, and the headache is the most common clinical symptom.Endovascular treatment for the treatment of unruptured VBDAs is safe and feasible.The principle of individualization should be followed during embolization.