Effect of admission time of arrival on quality of in-hospital care in acute ischemic stroke patients in China.

OBJECTIVES: The quality of care for patients may be partly determined by the time they are admitted to the hospital. This study was conducted to explore the effect of admission time and describe the pattern and magnitude of weekly variation in the quality of patient care. STUDY DESIGN: A retrospective observational study. METHODS: Data were collected from the Medical Care Quality Management and Control System for Specific (Single) Diseases in China. A total of 238,122 patients treated for acute ischemic stroke between January 2015 and December 2017 were included. The primary outcomes were completion of the ten process indicators and in-hospital death. RESULTS: The quality of in-hospital care varied according to hospital arrival time. We identified several patterns of variation across the days of the week. In the first pattern, the quality of four indicators, such as stroke physicians within 15 min, was lowest for arrivals between 08:00 and 11:59, increased throughout the day, and peaked for arrivals between 20:00 and 23:59 or 00:00 and 03:59. In the second pattern, the quality of four indicators, such as the application of antiplatelet therapy within 48 h, was not significantly different between days and weeks. There was no difference in in-hospital mortality between the different admission times. CONCLUSIONS: The effect of admission time on the quality of in-hospital care of patients with acute ischemic stroke showed several diurnal patterns. Detecting the times when quality is relatively low may lead to quality improvements in health care. Quality improvement should also focus on reducing diurnal temporal variation.

[A clinical randomized controlled study on the psycho-cardiological therapy for patients with coronary atherosclerosis disease].

Objective: To explore the prognosis efficacy of psycho-cardiological therapy and management on patients with coronary atherosclerosis disease (CAD). Methods: This was a clinical randomized controlled study. This study included inpatients with CAD at the cardiology department in Beijing Anzhen Hospital, Capital Medical University from August 2021 to January 2024. The patients enrolled in this study were asked for basic information, and received measurements for depression, anxiety, sleep quality and living quality by the scales of Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder scale-7 (GAD-7), Athens Insomnia Scale (AIS), EuroQol 5-dimension 5-level (EQ-5D-5L) respectively. The patients were randomly grouped into a regular treatment group and a psycho-cardiological treatment group which included WeChat management or antidepressant/antianxiety medical therapy according to the situation. After the patients discharging from hospital for 2, 4, 12, 24, 48, 72, and 96 weeks, professional cardiovascular doctors would follow up by telephone, WeChat, and outpatient department, including scales (2-48 weeks), and cardiac events (2-96 weeks). Kaplan-Meier survival curve and multivariate Cox proportional hazards model were used for analyzing the association between psycho-cardiological treatment and cardiac events. Results: This study recruited a total of 552 patients with CAD, aged 61.0(54.0, 67.0) years, and 379 (68.7%) were male. There were 279(50.5%) in the regular treatment group and 273(49.5%) in the psycho-cardiological treatment group. After treatment for 4, 12 and 48 weeks, the PHQ-9 score in psycho-cardiological was significantly lower than the regular treatment group; After treatment for 12 weeks, the EQ-5D-5L effective value in psycho-cardiological group was higher than the regular treatment group; After treatment for 2, 4, 12, 24 and 48 weeks, the EQ-5D-5L VAS score in psycho-cardiological group was higher than the regular therapy group (all P<0.05). The Kaplan-Meier survival curve showed that, during the different follow-up periods, the rate of cardiac events in psycho-cardiological treatment group was lower than regular treatment group (log-rank P<0.001). The multivariate Cox proportional hazards model adjusted the factor of age, the psycho-cardiological treatment contributed to reducing the cardiac events rate by 80.3% (HR=0.197, 95%CI: 0.067-0.582, P=0.003). Conclusion: Psycho-cardiological treatment is beneficial for improving psychological stress, living quality, and reducing cardiac events, and helps to improve prognosis and psycho-cardiological rehabilitation in CAD patients.

[Analysis of the clinical characteristics of 25 cases with parenchymal neuro-Behcet's disease].

Objective: To retrospectively investigate the clinical data, radiological characteristics, treatment, and outcome of patients with parenchymal neuro-Behcet's disease (P-NBD) with particular emphasis on dizziness. Methods: This was a cross-sectional study of clinical data from 25 patients with a confirmed diagnosis of P-NBD who were admitted to the Department of Neurology of the First Medical Center of Chinese People's Liberation Army General Hospital between 2010 and 2022. The median age of the population was 37 years (range: 17-85 years). Clinical data were retrospectively analyzed, including gender, age of onset, disease duration, clinical manifestations, serum immune indicators, cerebrospinal fluid (CSF) routine biochemical and cytokine levels, cranial and spinal magnetic resonance imaging (MRI) findings, treatment, and outcome. Results: The majority of patients were male (16 cases; 64.0%), the mean age of onset was (28±14) (range: 4-58 years), and the disease course was acute or subacute. Fever was the most common clinical presentation, and the complaint of dizziness was not uncommon (8/25 patients). Analysis of serum immune indices, including complement (C3 and C4), erythrocyte sedimentation rate, interleukin-1 (IL-1), IL-6, IL-8 and tumor necrotic factor-alpha were abnormal in 80.0% of patients (20/25). Most of the 16/25 patients who underwent lumbar puncture tests had normal intracranial pressure and increased CSF white cell count and protein [median values were 44 (15-380) ×106/L and 0.73 (0.49-2.81) g/L, respectively]. Of the five patients who underwent CSF cytokine tests, four patients had abnormal results; of these, an elevated level of IL-6 was most common, followed by IL-1 and IL-8. The most common site of involvement in cranial MRI was the brainstem and basal ganglia (60.0% respectively), followed by white matter (48.0%) and the cortex (44.0%). Nine cases (36.0%) showed lesions with enhancement and six cases (24.0%) showed mass-like lesions. Three patients (12.0%) patients had lesions in the spinal cord, most frequently in the thoracic cord. All patients received immunological intervention therapy; during follow up, the majority had a favorable outcome. Conclusions: P-NBD is an autoimmune disease with multiple system involvement and diverse clinical manifestations. The symptom of dizziness is not uncommon and can be easily ignored. Early treatment with immunotherapy is important and can improve the outcome of these patients.

[Clinical analysis of adult oculomoclonus-myoclonus syndrome with vertigo].

The clinical manifestation, physical and laboratory examination, electrophysiological, and imaging data of 2 female adult OMS patients with vertigo were analyzed at the Department of Neurology of the First Medical Center of Chinese PLA General Hospital from February 2021 to March 2022. The treatment strategy and clinical outcome were followed up. The two female patients were aged 42 and 66 years. Anti-NMDA receptor antibody and anti-GABAB receptor antibody were detected in serological screening, respectively. The two patients met the diagnostic criteria for OMS, and one was screened for breast tumor. The clinical symptoms of the two patients were relieved after immunomodulation therapy. OMS is a group of rare clinical syndromes; its clinical evaluation process should be standardized and the etiology should be actively searched for.

[The characteristics and risk factors of cardiovascular diseases and psychological status in science and technologyists].

Objectives: To investigate the prevalence and related factors of cardiovascular diseases (CVD) and psychological problems in Chinese science and technology workers. Methods: The investigation was organized and conducted by the Innovative and Development Institute of China Association of Senior Scientists and Technologists and Capital Medical University Affiliated Beijing Anzhen Hospital, and included science and technology workers from research institutions and medical institutions in China by random sampling methods through face-to-face and online questionnaire investigation from July 1, 2019 to March 31, 2021. Information including age, sex, work stress status, CVD history, sleep, depression, and anxiety were included in the questionnaire. Results: This survey included 14 552 subjects. Among them, 25.5% were suffered from CVD, 48.6% were with insomnia, 28.8% experienced depression/anxiety (including only depression, only anxiety, depression combined with anxiety), and 15.6% had CVD in combined with depression/anxiety. Taking those without CVD and depression/anxiety as reference group, multiple logistic regression analyses showed that work stress increased the risk of depression/anxiety in subjects without CVD (manageable work stress, OR=2.253, 95%CI 1.583-3.206, overwhelming work stress OR=7.899, 95%CI 5.094-12.250), and drinking increased the risk of CVD (OR=1.978, 95%CI 1.382-2.833). Moreover, overwhelming work stress (OR=4.012, 95%CI 2.515-6.399) and smoking (OR=2.342, 95%CI 1.603-3.421) increased the risk of depression/anxiety in subjects with CVD (all P<0.001). Conclusion: The high morbidities of depression/anxiety, CVD, and CVD in combination with depression/anxiety urge us to take actions to protect the heart and mental health of scientific and technological workers.

[Effects of reduced portosystemic flow on hepatic myelopathy in patients with cirrhosis after TIPS].

Objective: To investigate the impact of a reduced portacaval shunt on hepatic myelopathy (HM) in patients with cirrhosis after a transjugular intrahepatic portosystemic shunt (TIPS). Methods: Patients who developed HM after receiving TIPS at the First Affiliated Hospital of Xi'an Jiaotong University from January 2013 to June 2018 were retrospectively analyzed. HM severity was quantified by clinical spasticity index (CSI) and Fugl-Meyer Assessment (FMA) of the lower extremity. Clinical manifestations were combined with grades Ⅰ-Ⅳ. HM patients were divided into drug treatment (group A) and flow restriction group (group B) according to different treatment methods. The changes in CSI and FMA of the lower extremity after treatment were statistically analyzed in the two groups. P<0.05 was considered a statistically significant difference. Results: A total of 421 cases of cirrhosis who underwent TIPS were enrolled. Among them, 30 developed HM, with 22 in group A and 8 in group B. The incidence of HM after TIPS surgery was about 7.13%. After treatment, CSI was gradually increased and FMA of lower extremity was gradually decreased in group A, while vice-versa in group B. CSI in the two groups were differed significantly at 6, 12, 18, and 24 months after treatment (P<0.05), while the difference in FMA of the lower extremity was statistically significant at 12, 18, and 24 months after treatment (P<0.05). CSI was decreased and FMA of lower extremity was increased after treatment in patients with group A HM grade I. CSI, and FMA of lower extremity changes were statistically significant (P<0.05) when compared with patients with HM grades Ⅱ-Ⅳ. The incidence of hepatic encephalopathy was significantly lower in group B than that in group A (P=0.034), but there was no statistically significant difference between the two groups in the incidence of gastrointestinal bleeding, ascites, infection, MELD score and mortality. Conclusion: A reduced portacaval shunt can improve HM in patients with liver cirrhosis after TIPS, and drug therapy alone is effective for patients with early HM grade I.

First Detection of sub-PeV Diffuse Gamma Rays from the Galactic Disk: Evidence for Ubiquitous Galactic Cosmic Rays beyond PeV Energies.

We report, for the first time, the long-awaited detection of diffuse gamma rays with energies between 100 TeV and 1 PeV in the Galactic disk. Particularly, all gamma rays above 398 TeV are observed apart from known TeV gamma-ray sources and compatible with expectations from the hadronic emission scenario in which gamma rays originate from the decay of π^{0}'s produced through the interaction of protons with the interstellar medium in the Galaxy. This is strong evidence that cosmic rays are accelerated beyond PeV energies in our Galaxy and spread over the Galactic disk.

Gamma-Ray Observation of the Cygnus Region in the 100-TeV Energy Region.

We report observations of gamma-ray emissions with energies in the 100-TeV energy region from the Cygnus region in our Galaxy. Two sources are significantly detected in the directions of the Cygnus OB1 and OB2 associations. Based on their positional coincidences, we associate one with a pulsar PSR J2032+4127 and the other mainly with a pulsar wind nebula PWN G75.2+0.1, with the pulsar moving away from its original birthplace situated around the centroid of the observed gamma-ray emission. This work would stimulate further studies of particle acceleration mechanisms at these gamma-ray sources.

[Prognostic analysis of patients with T1 stage high grade of bladder urothelial carcinoma and glandular differentiation].

Objective: To evaluate the recurrence and progression of patients with pT1 high grade urothelial carcinoma of bladder (UCB) and glandular differentiation. Methods: We retrospectively analyzed the clinical and pathological information of 208 patients diagnosed as pT1 high grade urothelial carcinoma in the Fifth Central Hospital of Tianjin from January 2006 to February 2019.Among them, 78 cases were diagnosed as glandular differentiation (UCGD), the other 130 patients without histologic variants were served as control. The UCGD group included 62 male and 16 female, whose median age was 67 years old (range 38-81 years old). The control group contained 105 male and 25 female, whose median age was 66 years old (range 40-82 years old). Kaplan-Meier and Cox proportional hazard regression analyses were used to evaluate the predictors of oncologic outcomes. Results: The disease recurrence rate and progression rate in UCGD group were 65.4% (51/78) and 28.2% (22/78), higher than 38.5%(50/130) and 14.6%(19/130) of control group (P<0.05). The median recurrence time in UCGD group was 41 months while 55 months in the control group. The median progression time in UCGD group was 39 months while 54 months in the control group. According to the univariate analysis, largest tumor size (P=0.030), UCGD (P=0.003) and lymphovascular invasion (LVI) (P=0.032) were associated with disease recurrence. UCGD (P=0.036) and LVI (P=0.011) were associated with progression. Additionally, Cox multivariate analysis revealed that UCGD (P=0.001), LVI (P=0.038) were the independent factors of disease recurrence. UCGD (P=0.007) and LVI (P=0.037) were also found to be the independent factors of disease progression. Conclusions: Patients with T1 stage UCB and UCGD are at higher risk of disease recurrence and progression. Therefore, these patients should be followed up closely after being diagnosed and undergo individual treatment according to the situation.

[Three-dimensional movement of posterior teeth after losing the interproximal and occlusal contacts in adults].

OBJECTIVE: To observe the movement of posterior teeth after losing the interproximal and occlusal contacts in adults from the amount and speed of mesial-distal, buccal-lingual, occlusal-gingival and three-dimensional movements. METHODS: Twenty cases of metal post-core restoration from the Department of Prosthodontics, Peking University School and Hospital of Stomatology were recruited into this study, which was an observational study. The restored teeth had complete mesial, distal, and occlusal contacts before treatment. All the interproximal and occlusal contacts were removed during the preparation for the post-core. The three-dimensional positions of the post-core preparation were obtained by the intraoral scanner at the day of tooth preparation and that of post-core placement. The amounts of mesial-distal, buccal-lingual and occlusal-gingival tooth movement were measured in the software. On this basis, the amount of three-dimensional tooth movement was calculated. The speed of tooth movement was calculated based on the elapsed time between the two scans. RESULTS: Ten females and ten males with an average age of (29.5±4.9) years were recruited. The average elapsed time was (10.9±2.7) days. The amount of the mesial-distal tooth movement was (134.8±61.2) µm, of the buccal-lingual tooth movement was (110.3±39.5) µm, of the occlusal-gingival tooth movement was (104.8±57.5) µm, and of the three-dimensional tooth movement was (211.4±71.0) µm, respectively. The amounts of mesial-distal, buccal-lingual and three-dimensional tooth movements were larger in female than in male (P < 0.05). The speed of the mesial-distal tooth movement was (13.1±7.8) µm/d, of the buccal-lingual tooth movement was (10.6±4.5) µm/d, of the occlusal-gingival tooth movement was (10.1±6.8) µm/d, and of the three-dimensional tooth movement was (20.5±9.7) µm/d, respectively. The speed of mesial-distal and buccal-lingual tooth movements were larger in female than in male (P < 0.05). The speed of three-dimensional tooth movement was slightly larger in female than in male, while there was no significant difference between different genders (P>0.05). CONCLUSION: The three-dimensional position of posterior teeth changed after losing the interproximal and occlusal contacts in adults. The female had more significant and faster tooth movement than the male.

[Epidemiological characteristics of novel coronavirus pneumonia in Shijiazhuang, China].

Objective: To analyze the epidemiological characteristics of an outbreak of novel coronavirus pneumonia (COVID-19) in Shijiazhuang, Hebei Province in 2021 and to provide scientific basis for developing improved strategies to prevent and control the outbreak of COVID-19. Methods: Descriptive analysis of the outbreak of COVID-19 in Shijiazhuang, Hebei Province was performed with SPSS 21.0 and Excel software. The statistical analysis of the incubation period was performed using the rstan package in R4.0.4. Results: As of February 14th 2021, a total of 942 local confirmed cases were reported in Hebei Province, 869 cases in Shijiazhuang, of which 847 cases were available for case information. This outbreak was mainly in rural areas, with the largest number of confirmed cases in Xiaoguozhuang village, 249 (29.4%); followed by Nanqiaozhai village, 128 (15.1%); and Liujiazuo village, 85 (10.0%). The outbreak lasted from January 2nd, 2021 to February 14th, 2021, and was mainly transmitted among the farmers as well as the students through dining parties, public gatherings and family contacts, showing an obvious time and occupation concentration trend. An analysis of 116 local confirmed cases in this outbreak with specific exposure time and onset time indicated that the median incubation period was 6 [interquartile range(IQR): 3.3, 10.0] days; whereas another report including 264 local confirmed cases with specific exposure time window showed that a median incubation period was 8.5 [95% confidence interval (CI): 1.8-18.8] days. Conclusions: This outbreak was mainly related to rural areas, and was associated with parties, public gatherings and family gatherings. Self-protection and isolation of key areas and populations at risk should be effectively implemented to avoid close contact and other measures to reduce the occurrence of COVID-19 aggregation. Based on the results of the incubation period of this outbreak, the isolation period could be recommended to be extended to three weeks.

[The impact of KIT and other concomitant gene mutations on the prognoses of patients with core-binding factor acute myeloid leukemia].

Objective: To study the impact of KIT and other concomitant gene mutations on the prognoses of patients with core-binding factor acute myeloid leukemia (CBF-AML). Methods: A total of 104 newly diagnosed patients with CBF-AML in Hebei Yanda Lu Daopei Hospital from January 2014 to February 2018 were analyzed, and high-throughput gene sequencing for the detection of mutations among 58 genes was executed. Also, the clinical features of KIT mutation-positive CBF-AML (KIT+CBF-AML) patients and the effects of other concomitant gene mutations on the prognoses of patients were also analyzed. Results: A total of 56 cases (53.85%) with KIT mutations were found in 104 CBF-AML patients. Among this, KIT D816 mutation was the most common (32 patients), followed by the N822 mutation (17 patients). Patients with KIT+CBF-AML have a higher proportion of bone marrow blasts at the time of diagnoses and are more likely to have sex chromosome loss. Among the 52 patients with KIT+CBF-AML who were followed up, the allogeneic hematopoietic stem cell transplantation (allo-HSCT) group had a higher overall survival rate (OS) than that of the chemotherapy group (88.9% vs 57.1%, χ(2)=6.076, P<0.05). The event-free survival (EFS) and OS of patients with KIT+CBF-AML with FLT3 mutation were both significantly lower than those of the FLT3 mutation-negative group (EFS: 40.0% vs 72.3%, χ(2)=6.557, P<0.05; OS: 60.0% vs 87.2%, χ(2)=8.305, P<0.05). The OS of the patient with TET2 mutation was lower than that of the TET2 mutation-negative group (50.0% vs 87.5%, χ(2)=4.130, P<0.05). Conclusion: Patients with KIT+CBF-AML with concomitant gene mutations, especially FLT3 and TET2, have poor prognoses, which can be improved by allo-HSCT.

First Detection of Photons with Energy beyond 100 TeV from an Astrophysical Source.

We report on the highest energy photons from the Crab Nebula observed by the Tibet air shower array with the underground water-Cherenkov-type muon detector array. Based on the criterion of a muon number measured in an air shower, we successfully suppress 99.92% of the cosmic-ray background events with energies E>100 TeV. As a result, we observed 24 photonlike events with E>100 TeV against 5.5 background events, which corresponds to a 5.6σ statistical significance. This is the first detection of photons with E>100 TeV from an astrophysical source.

[Immunogenicity analysis of sequential inoculation of different strains of poliomyelitis vaccines in Shanghai].

Objective: To evaluate the immunogenicity of different strains of inactivated poliomyelitis vaccines (IPV) by sequential program. Methods: This parallel-group controlled trial was conducted in immunization clinics in Shanghai from March 2016 to September 2017. Sabin strains inactivated poliomyelitis vaccines (sIPV), WPV strains inactivated poliomyelitis vaccines (wIPV) and live poliomyelitis Type Ⅰ Type Ⅲ vaccine (bOPV) as the investigational vaccine were used at 2, 3, 4 months old in 325 infants in Shanghai. Infants vaccinated by four sequential program were divided into 4 groups: sIPV+sIPV+bOPV, sIPV+wIPV+bOPV, wIPV+sIPV+bOPV and wIPV+wIPV+bOPV. A total of 230 investigators' blood samples were collected before primary immunization and 163 investigators' blood samples were collected after primary immunization. A total of 151 investigators (36, 44, 30 and 41 in each group) finished primary immunization and blood sampling before and after the primary immunization. The geometric mean titer (GMT) of poliovirus typesⅠ and Ⅲ neutralizing antibody was tested and calculated, and the positive results of antibody before and after primary immunization were analyzed. Results: Among the 151 investigators, the age were (2.27±0.61) months and birth weight were (3.27±0.43) kg, and 70 were male. The positive rates of typeⅠwas 98.68% (149 cases), and type Ⅲ was 97.35% (147 cases); the number of investigators tested in each group was 36, 44, 30 and 41, respectively; the positive rates of typeⅠwas 97.22% (35 cases), 100.00% (44 cases), 96.67% (29 cases) and 100.00% (41 cases) (P=0.345); the positive rates of type Ⅲ were 97.22% (35 cases), 95.45% (42 cases), 96.67% (29 cases) and 100.00% (41 cases) (P=0.614). Conclusion: Using sIPV and wIPV simultaneously or alternately for sequential immunization of poliomyelitis vaccines showed good immunogenicity for infants at appropriate age.

[Descemet's stripping endothelial keratoplasty (DSAEK) in failed penetrating keratoplasty patients: graft survival rate and its associated factors].

Objective: To explore graft survival rate and its associated factors of DSAEK in patients with endothelial decompensation after penetrating keratoplasty (PKP). Methods: A retrospective case study was conducted, including 51 patients (51 eyes) that underwent DSAEK for endothelial decompensation after PKP in Department of Ophthalmology in Peking University Third Hospital from June 2009 to September 2017. The mean recipient age was (43.3±21.0) years. There were 36 males and 15 females. Data comprising demographic details,surgical methods, complications,follow-up durations,final states of grafts,preoperative and postoperative risk factors were collected. Kaplan-Meier analysis was used to determine the cumulative probability of graft survival. Cox regression model was developed to examine for factors associated with graft survival. Results: Among 51 eyes,the overall graft survival rate was 78%(40/51). The cumulative probability was 85% (95%CI: 0.73-0.96) and 69% (95%CI: 0.52-0.86) at 1 year and 2 years, respectively. The median survival time was 42 months. The diameter of DSAEK graft and postoperative intraocular pressure correlated with the long-term survival of graft. Larger diameter of DSAEK graft was a protective factor for graft survival (HR=0.29, 95%CI: 0.12-0.73), while postoperative high intraocular pressure was a risk factor (HR=1.08, 95%CI: 1.00-1.16, HR=1.10, 95%CI:1.01-1.12). Recipient age, sex, lens status, the number of previous PKPs and previous glaucoma surgery had no significant effect on long-term survival (P>0.05). Conclusions: DSAEK is an effective treatment for endothelial decompensation after PKP,with favorable graft survival rate. Larger diameter of graft is beneficial to the long-term survival,while high postoperative intraocular pressure is a risk factor for graft failure. (Chin J Ophthalmol, 2019, 55: 428-434).

Determination of Place of Residence Using the Gene Information of Plants Carried by the Human Body.

ABSTRACT: Objective To identify the plant species using the DNA sequence of plant pollen from lung tissues of a unidentified body, infer the possible long-term places of residence of the deceased according to the distribution area of the pollen in the lung tissues, therefore narrow the scope of criminal investigation and provide clues for case solving. Methods Lung tissues were extracted from the deceased, total DNA was extracted by the mCTAB method. Gene fragments of the two plant DNA barcodes, matK and rbcL, were acquired using specific primers for amplification, then sequenced. The DNA sequences of target gene fragments were acquired through bioinformatics analysis. The sequences were combined with reference sequence data. Phylogenetic analysis was made to identify the species that the DNA sequences belonged to. The places where the deceased could have lived for a long time were inferred, according to the distribution information of plant species. Results Gene fragments of 32 plant species which belonged to 31 genera of 27 families were in the lung tissues of the deceased. Among them, plants of 9 genera that had certain indicative function were mainly endemic plants from Hainan, Guangdong, Guangxi and Yunnan. These results showed that the deceased may have stayed in these areas for a long time before death. After further investigation, the victim was confirmed to have come from a county in southern Guangxi, which was in accordance with the research results. Conclusion The method of using gene information of plants from lung tissues of human bodies to infer places of residence can assist inference of the places where the deceased could have lived for a long time. The present study may also provide new ideas for locating sources of the corpses in cases with unidentified victims.

Evaluation of the Interplanetary Magnetic Field Strength Using the Cosmic-Ray Shadow of the Sun.

We analyze the Sun's shadow observed with the Tibet-III air shower array and find that the shadow's center deviates northward (southward) from the optical solar disk center in the "away" ("toward") interplanetary magnetic field (IMF) sector. By comparing with numerical simulations based on the solar magnetic field model, we find that the average IMF strength in the away (toward) sector is 1.54±0.21_{stat}±0.20_{syst} (1.62±0.15_{stat}±0.22_{syst}) times larger than the model prediction. These demonstrate that the observed Sun's shadow is a useful tool for the quantitative evaluation of the average solar magnetic field.

[A clinical study of mental stress-induced myocardial ischemia in patients with stable coronary artery disease and depression/anxiety].

Objectives: Exploring the association between depression/anxiety and mental stress-induced myocardial ischemia (MSIMI) in patients with stable coronary artery disease (CAD). Methods: A total of 178 subjects was enrolled according to the inclusion and exclusion criterion with 88 men and 90 women at age of (54±12)years. The subjects were divided into four groups including CAD with depression/anxiety, CAD without depression/anxiety, depression/anxiety without CAD, and control group based on the state of coronary artery, the scores of Patient Health Questionnaire 9-item (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7) . MSIMI was diagnosed by echocardiography. Data were analyzed by SPSS19.0. Results: The incidence of MSIMI in all CAD patients was 17.24%. Within each group, 35.00% patients were MSIMI in CAD with depression/anxiety, 2.13% were in CAD without depression/anxiety, 14.29% were in depression/anxiety without CAD, and 2.38% were in control group. The risks of MSIMI in depression/anxiety without CAD and with CAD groups were 6.83 (P>0.05) and 22.08 times (P<0.05) higher than that in control group, respectively. Logistic regression showed that a 1-point increment in the GAD-7 score, but not PHQ-9 score [OR=0.95, 95% CI (0.77-1.17), P=0.63], was associated with 1.22-fold increase in the likehood of MSIMI [95% CI (1.07-1.38), P=0.00]. Conclusions: The MSIMI rate is much higher in patients with CAD comorbid depression/anxiety compared with CAD without depression/anxiety. Anxiety, but not depression, is an independent risk factor of MSIMI in CAD patients.

[Coronary microvascular resistance and its relevant factors in patients with moderate coronary stenosis and chest pain].

Objective: To evaluate the impact of cardiovascular risk factors on index of microvascular resistance (IMR) and coronary flow reserve (CFR) and to explore the characteristics of IMR and CFR and the relationship between IMR and angiographic features in patients with intermediate coronary stenosis and chest pain. Methods: Fractional flow reserve (FFR), CFR, and IMR were measured in patients who underwent invasive coronary angiography with 40%-70% stenosis by visual assessment. All patients with FFR>0.75 were enrolled and grouped with the cut-off points of IMR≥25 and CFR≤2.0. Patients with IMR≥25 were group H, including two sub-groups (high IMR-low CFR, group H1 and high IMR-high CFR, group H2), while those with IMR<25 were group N. The thrombolysis in myocardial infarction (TIMI) frame were counted. Results: A total of 34 patients with FFR>0.75 were enrolled with 61.8%(21 cases) of males and 38.2% (13 cases) of females. The mean age was (57.3±8.1) years old. High IMR accounted for 47.1% of all cases. There was significant difference between group H and N in TIMI frame (33.0 vs. 20.8, P=0.031). There were significant differences between group H1 and H2 in homocysteine (17.8 µmol/L vs. 12.0 µmol/L, P=0.005) and IMRcorr (58.0 vs. 36.1, P=0.002). IMRcorr was correlated to TIMI frame (r=0.40, P=0.012) for all cases. The sensitivity and specificity of inferring IMR≥35.3 by TIMI frame were 0.75 and 0.65 (P=0.049) with TIMI frame over 40.5. Conclusions: High IMR may be one of the reasons for chest pain in patients with intermediate coronary stenosis. There is no correlation between vascular risk factors and IMR or CFR, while there is positive correlation between TIMI frame and IMR. The specificity is 65% for inferring IMR rise with TIMI frame over 40.5.

[Role of Ginkgo biloba extract in regulating 5-hydroxytrytamine and its receptor in heart failure mice].

Objective: Exploring the modulation of periphery and central serotonin (5-hydroxytrytamine, 5-HT) and 5-HT(2A) receptor (5-HT(2A)R) in mice with heart failure during the process of heart failure and after treatment. Methods: Thirty mice were allocated into three groups randomly including normal group (NG), heart failure group (HFG) and treatment group (TG) (n=10). Mice in the NG were sacrificed after evaluating left ventricular ejection fraction (EF) with echocardiogram. Mice in HFG and TG experienced myocardial infarction surgery to achieve EF≤30%, HFG was treated with saline and TG with Ginkgo biloba pills (GBP), once a day for 4 weeks, then EF was assessed again before sacrifice. Cardiac muscle tissue fibrosis was observed and the severity of fibrosis was assessed by semiquantitative method. All the indexes including BNP, serum 5-HT, 5-HT and 5-HT(2A)R in platelet and brain were detected. The data were analyzed by SPSS 19.0. Results: EF: EF in HFG and TG were much lower than that in NG (P<0.05), TG was much higher than HFG (P<0.05). BNP: BNP in HFG and TG were much higher than that in NG (P<0.05), TG was significantly lower than HFG (P<0.05). HFG showed ventricular remodeling, increased myocardial fibrosis; while myocardial fibrosis decreased in TG. 5-HT in serum: serum 5-HT in HFG was much higher than NG (212±29 ng/L vs 146±5 ng/L, P<0.05), TG was much lower than HFG (163±8 ng/L vs 212±29 ng/L, P<0.05). 5-HT in platelet: platelet 5-HT in HFG was much lower than NG (165±22 ng/L vs 193±19 ng/L, P<0.05), platelet 5-HT in TC was higher than HFG and NG (224±27 ng/L vs 193±19 ng/L, 165±22 ng/L, P<0.05). 5-HT(2A)R in platelet: platelet 5-HT(2A)R in HFG was much lower than NG (P<0.05), TG was much higher than NG and HFG (P<0.05). 5-HT in cortex: cortex 5-HT in HFG and TG were much higher than NG (253±4 ng/L, 231±31 ng/L vs 179±9 ng/L, P<0.05), TG was a little lower than HFG (231±31 ng/L vs 253±4 ng/L, P>0.05). 5-HT(2A)R in cortex: cortex 5-HT(2A)R in HFG and TG were much higher than NG (P<0.05), TG was much lower than HFG (P<0.05). 5-HT in hippocampus: hippocampus 5-HT in HFG was much higher than NG (250±7 ng/L vs 179±5 ng/L, P<0.05), TG was much lower than HFG (164±6 ng/L vs 250±7 ng/L, P<0.05). 5-HT(2A)R in hippocampus: hippocampus 5-HT in both HFG and TG were much higher than NG (P<0.05), there was no significant difference between TG and HFG (P>0.05). Conclusion: Significant changes of 5-HT and 5-HT(2A)R are found in heart failure mice during the process of heart failure and after treatment, indicating the potential value of 5-HT modulation in the diagnose and treatment of heart failure.