Anticoagulation Intensity during Appendage Occlusion:Lessons from Silent Cerebral Embolism.

INTRODUCTION: Endovascular left atrial appendage occlusion (LAAO) is associated with a high incidence of peri-procedure silent cerebral embolisms (SCE), while the recommended activated clotting time (ACT) level by the expert consensus is lower than that in atrial fibrillation (AF) ablation. The aim of our study is to investigate whether raising the targeted ACT level during LAAO to the same level as AF ablation could decrease the incidence of SCE. METHODS: It was a prospective observational cohort study. Consecutive AF patients receiving LAAO between January 2021 and December 2022 were included and categorized into two groups based on the time of enrollment. Patients enrolled in 2021 (group 250) maintained a target ACT level of ≥250 s during LAAO procedure, while patients enrolled in 2022 (group 300) maintained the peri-procedure ACT ≥300 s. All patients underwent cerebral magnetic resonance imaging (MRI) before and after the procedure. RESULTS: A total of 81 patients were included (38 in the group 250 and 43 in the group 300). After inverse probability of treatment weighting (IPTW), patients in the group 250 showed a significantly lower incidence of SCE than group 300 (IPTW p = 0.038). Only a stable high ACT pattern could decrease the risk of SCE. No significant differences were found between other ACT change patterns on the SCE incidence. CONCLUSION: Raising the peri-procedure ACT level to a stable 300 seconds could decrease the risk of the SCE without increasing the major bleeding events.

Effects of salinity stress on anxiety behavior and antioxidant capability of guppy (Poecilia reticulata).

The objective of this study was to determine the effect of salinity on anxiety behavior and liver antioxidant capacity in the guppy (Poecilia reticulata). Guppies were exposed to salinities of 0‰, 5‰, 10‰, 15‰ and 20‰ for acute stress tests, and then we analyzed the activity of antioxidant enzymes at 3, 6, 12, 24, 48, 72 and 96 h. During the experiment, the anxiety behavior of guppy was enhanced at salinities of 10‰, 15‰, and 20‰, as evidenced by a significantly higher latency time for the first passage through the upper part than that of the control group (P < 0.05). CAT activity was highest at 24 h in the treatment with the salinity of 10‰, and SOD and GPX activities were highest at 12 h into the treatment with the salinity of 10‰. The SOD and CAT activities were significantly higher than the control group after 96 h of treatment at different salinities (P < 0.05). The MDA contents of the experimental groups at salinities of 5‰ and 10‰ were not significantly different from the control group after 96 h of treatment (P > 0.05). While the MDA contents of the experimental groups at salinities of 15‰ and 20‰ were still significantly higher than the control group after 96 h of treatment (P < 0.05). The experimental results indicated that elevated salinity could lead to oxidative stress in the guppy, altering their anxiety behavior as well as the activity of antioxidant enzymes. In conclusion, drastic changes in salinity during culture should be avoided.

Effects of Alkalinity Exposure on Antioxidant Status, Metabolic Function, and Immune Response in the Hepatopancreas of Macrobrachium nipponense.

The oriental river prawn Macrobrachium nipponense is an important freshwater economic species in China, producing huge economic benefits. However, M. nipponense shows lower alkali tolerance than fish species, thus genetic selection is urgently needed in order to improve alkali tolerance in this species. In the present study, the effects of alkalinity exposure on the hepatopancreas of M. nipponense were measured under the alkali concentrations of 0 (control), 4, 8, and 12 mmol/L with the exposure time of 96 h through histological observations, measurement of antioxidant enzymes, metabolic profiling analysis, and transcriptome profiling analysis. The present study identified that the low concentration of alkali treatment (<4 mmol/L) did not result in morphological changes in the hepatopancreas and activity changes in antioxidant enzymes, while high-alkali treatment (>8 mmol/L) damaged the normal structures of the lumen and vacuoles and significantly stimulated the levels of superoxide dismutase, catalase, and total antioxidant capacity, indicating these antioxidant enzymes play essential roles in the protection of the body from the damage caused by the alkali treatment. Metabolic profiling analysis revealed that the main enriched metabolic pathways of differentially expressed metabolites in the present study were consistent with the metabolic pathways caused by environmental stress in plants and other aquatic animals. Transcriptome profiling analysis revealed that the alkali concentration of <8 mmol/L did not lead to significant changes in gene expression. The main enriched metabolic pathways were selected from the comparison between 0 mmol/L vs. 12 mmol/L, and some significantly up-regulated genes were selected from these metabolic pathways, predicting these selected metabolic pathways and genes are involved in the adaptation to alkali treatment in M. nipponense. The expressions of Ras-like GTP-binding protein, Doublesex and mab-3 related transcription factor 1a, and Hypothetical protein JAY84 are sensitive to changes in alkali concentrations, suggesting these three genes participated in the process of alkali adaptation in M. nipponense. The present study identified the effects of alkalinity exposure on the hepatopancreas of M. nipponense, including the changes in antioxidant status and the expressions of metabolites and genes, contributing to further studies of alkali tolerance in this species.

Effects of ammonia exposure on anxiety behavior, oxidative stress and inflammation in guppy (Poecilia reticulate).

Ammonia is one of the most important aquatic environmental factors, which is of great concern. In order to evaluate the effect of ammonia on guppy (Poecilia reticulate), fish were exposed to increased concentrations (0, 12.50, 25.00, 41.67, 62.50 mg/L) of ammonia for 48 h. After exposure, we measured the anxiety behavior, antioxidant enzymes and pro-inflammation genes (TNF-α, IL-1ß and IL-6) of guppy. The results showed that ammonia stress induced fish anxiety, which was manifested by the increased latency to enter the upper half and decreased time spent in upper half compared with control fish. The guppy showed oxidative stress after 48 h of ammonia stress as evidenced by decreases in the activities of antioxidant enzymes and an increase in lipid hydroperoxide content. With prolonged ammonia stress, the expressions of HSP70, HSP90, TNF-α, IL-1ß and IL-6 mRNA at first had an increasing trend, and then decreased, all of which were significantly higher than the control levels at 12 h and 24 h after ammonia stress (P < 0.05). Ammonia significantly upregulated these genes mRNA levels after 48 h exposure, suggesting that heat shock proteins and innate immune system may try to protect cells from oxidative stress induced by ammonia stress. Our study showed that higher ammonia exposure induced oxidative stress in exposed fish, since inhibition of antioxidant enzymes activity and increases in lipid peroxidation, and inflammation occurred. Furthermore, the results will be helpful to understand the mechanism of ammonia toxicity in guppys.

Effects of Water Ratio in Hydrous Ethanol on the Combustion and Emissions of a Hydrous Ethanol/Gasoline Combined Injection Engine under Different Excess Air Ratios.

Ethanol is usually combined with gasoline to manufacture ethanol-gasoline with excellent combustion characteristics. However, extracting water from hydrous ethanol to manufacture anhydrous ethanol consumed much energy, which increases the production cost of ethanol-gasoline. Many researchers have studied the combustion and emissions of hydrous ethanol-gasoline to explore the application of hydrous ethanol-gasoline as the fuel for spark-ignition engines. Most previous studies changed the hydrous ethanol ratio with fixed purity in hydrous ethanol-gasoline to study the effects of hydrous ethanol. Different from previous studies, this paper studied the effects of water ratio (Wr) in hydrous ethanol on the combustion and emissions of a hydrous ethanol/gasoline combined injection engine under different excess air ratio (λ) values. The ratios of ethanol and gasoline keep constant, while the purity of hydrous ethanol changes during the research. The experiment adopted the combined injection mode with hydrous ethanol direct injection plus gasoline port injection; the direct injection ratio was 20%. The experiment set three λ (0.9, 1, and 1.2) and five Wrs (0, 5, 10, 15, and 20%). The test engine's speed was 1500 rpm, and the intake manifold absolute pressure was 48 kPa. Results showed that water inhibited combustion, prolonged CA 0-10 and CA 10-90, reduced P max and T max, and delayed APmax; larger λ made the deterioration on combustion more obvious, and the smaller λ had a larger tolerance to water. Water could increase torque and improve emissions, but different parameters corresponded to different optimal Wrs. For torque, the optimal Wr was 5%. For HC emissions, the optimal Wr was 0%; for CO emissions, the optimal value was 5%; and for NO x emissions, the best value was 20%. The best Wr was 10% for particle number (PN) emissions. Under the optimal Wr condition, when λ values were 0.9, 1, and 1.2, compared with pure gasoline, the torque increased by 7.5, 5.54, and 5.31%; HC emissions decreased by 21.37, 23.43, and 26.58%; NO x emissions decreased by 4.26, 11.47, and 12.55%; CO emissions decreased by 17.51, 34.56, -50%; and the total PN emissions decreased by 87.64, 89.64, and 76.07%.

Impaired ghrelin response after high-fat meals is associated with decreased satiety in obese and lean Chinese young adults.

Ghrelin and peptide tyrosine tyrosine (PYY) are known to affect appetite and body weight, but the acute effects of fat-rich and carbohydrate-rich meals on plasma ghrelin, PYY response, and appetite remain unclear. We hypothesized that obese individuals had impaired postprandial ghrelin and PYY response based on macronutrient content of meals, affecting appetite and energy intake. We conducted a randomized crossover trail comparing fasting ghrelin and PYY concentrations, postprandial ghrelin and PYY responses, and subjective appetite in 15 obese and 12 lean Chinese young adults after they consumed isocaloric high-carbohydrate [HC; 88% energy carbohydrate, 4% energy fat, 8% energy protein] and high-fat (HF; 25% energy carbohydrate, 71% energy fat, 4% energy protein) meals. Ghrelin concentrations over time differed between HC and HF meals (P < 0.01) via repeated measures of ANOVA, with lower postprandial ghrelin suppression after HF meals, especially among obese participants. PYY response differed between meals among lean participants, with a delayed and higher postprandial PYY peak after the HF meal (P < 0.01); however, PYY response did not differ among obese participants. The incremental area under the curve of PYY was higher in lean than in obese participants after the HF meal (P < 0.01). These results suggest that impaired ghrelin response after HF meals may contribute to reduced satiety and overeating, especially among obese individuals. Whether an attenuated response of PYY in obese participants after a HF meal bears any physiological consequences warrants further study.

High-fat diet up-regulates caveolin-1 expression in aorta of diet-induced obese but not in diet-resistant rats.

OBJECTIVE: Caveolin-1 (Cav-1) is considered as a negative regulator of endothelial nitric oxide synthase (eNOS) and influences various cardiovascular functions. The objective of the study is to investigate the effects of high-fat diet on vascular Cav-1 expression and eNOS activities. METHODS: Male outbred Sprague-Dawley rats were fed with a high-fat diet for 15 weeks to induce obesity. The diet-induced obese (DIO) rats were then divided into two groups. One group (DIO-LF) was fed a normal diet and another group (DIO-HF) along with diet-resistance (DR) rats were fed a high-fat diet for 8 more weeks. Cav-1 expression was determined using reverse transcription (RT)-PCR, Western blotting, and immunohistochemistry techniques. NOS activities were assessed using Griess reagents. Protein kinase B (PKB/Akt) and eNOS expression and phosphorylation were determined by Western blotting. RESULTS: A high-fat diet up-regulated Cav-1 and down-regulated eNOS expression in aorta of DIO rats, but not in that of DR rats. These effects were reversed in DIO rats after switching to a low-fat diet for 8 weeks. Decreased NOS activities in aortas were observed in DIO rats, but not in DR rats. Phosphorylation of PKB/Akt and eNOS (Ser1177) were enhanced in aortas of DIO rats of both DIO-HF and DIO-LF groups. CONCLUSION: These findings suggest that the decrease of vascular NOS activities in rats fed a high-fat diet were due, at least in part, to the up-regulation of Cav-1 expression.

[Relation between peptide YY 3-36 and dietary induced obesity resistant rats].

OBJECTIVE: To study the plasma concentration of peptide YY3 - 36 (PYY3-36) and the expression levels of PYY mRNA of ileum and colon in dietary induced obesity (DIO) and dietary induced obesity resistant (DIO-R) rats and the relation between PYY3-36 and DIO-R rats. METHODS: Thirty-six female SD rats were randomly divided into high-fat diet group (n = 27) and chow fed control group (n = 9), after 13 weeks of either a high-fat diet or chew fed diet, the high-fat diet group was subdivided into DIO and DIO-R group according to the final body weight. Weight gain, caloric intake, the concentration of PYY3-36 and the expression levels of PYY mRNA were measured and compared. RESULTS: The total caloric intake of DIO-R rats was lower than DIO rats (P < 0.01), while no significant difference was found between DIO-R and control rats (P > 0.05). The concentration of PYY3-36 and the expressions of PYY mRNA of ileum and colon in DIO-R rats were higher significantly than that of the DIO and control rats (P < 0.01), while no significant difference was found between DIO and control group (P > 0.05), except that PYY mRNA of ileum was advanced in DIO group (P < 0.01). CONCLUSION: On the High-fat diet, SD rats showed different susceptibility to obese and energy intake, increased levels of PYY3-36 and PYY mRNA might be related to dietary induced obesity resistant.

Interaction of dietary composition and PYY gene expression in diet-induced obesity in rats.

The interaction of high-fat diet and the peptide YY (PYY) gene expression in diet-induced obesity and the mechanisms which predisposed some individuals to become obese on high-fat diet were explored. Thirty-six male SD rats were randomly divided into high-fat diet group (n=27) and chow fed control group (n=9). After 15 weeks of either a high-fat diet or chew fed diet, the high-fat diet group was subdivided into dietary induced obesity (DIO) and dietary induced obesity resistant (DIR) group according to the final body weight. Then the DIO rats were subdivided into two groups for a 8-week secondary dietary intervention. One of the group was switched to chew fed diet, whereas the other DIO and DIR rats continued on the initial high-fat diet. Weight gain and food intake were measured, food efficiency was calculated, and the concentrations of plasma neuropeptide Y (NPY) and PYY were assayed. Hypothalamic NPY mRNA expression and PYY mRNA expression in ileum and colon was detected by RT-PCR. The results showed that at the end of 15th week, the levels of body weight and caloric intake were significantly higher in DIO group than in DIR or control group (P<0. 01), while no significant difference was found between DIR and control group (P>0.05). The concentration of plasma PYY was significantly higher in DIR group than in DIO and CF group, while no significant difference was found between DIO and CF group (P <0.01). After switching the DIO rats to chow fed diet, their body weight gains were significantly lower than that of the DIO-HF group. The expression of PYY mRNA was increased in DIO-HF/ CF rats than in DIO-HF rats, and the expression of hypothalamic NPY mRNA was decreased in DIO-HF/CF rats than in DIO-HF group. It was concluded that both dietary composition and PYY gene expression could potently alter the hypothalamic NPY expression and result in different susceptibility to obese and overeating. The decreased PYY was associated with the increased NPY expression and their predisposal to obese and overeating in rats.

[UCPs and PPARgamma2 mRNA in diet induced obesity resistant rats].

OBJECTIVE: To explore the expression of uncoupling proteins (UCP) and peroxisome proliferator activated receptorgamma2 (PPARgamma2) mRNA in white adipose of high-fat diet induced obesity resistant rats. METHODS: Thirty-six female SD rats were randomly divided into high-fat diet group (n = 27) and chow fed control group (n = 9), and given either high-fat diet or chow for thirteen weeks. Then the high-fat diet group was subdivided into Dietary Induced Obesity (DIO) and Dietary Induced Obesity Resistant (DIO-R) group according to the final body weight. Basic parameters, fasting blood glucose (FBG), blood lipid levels were measured and compared. Reverse transcription-polymerase chain reaction (RT-PCR) was used to measure the expression of UCP2, UCP3, and PPARgamma2 mRNA in white adipose. RESULTS: Adipose deposits, body fat percent, TC, and TG conceration of both DIO-R and DIO groups were significantly higher than those in control group, while body weight, body fat percent and TG level were significantly lower in DIO-R than DIO rats. The expression of UCP2 and UCP3 mRNA in white adipose of DIO-R rats were significantly higher than those of DIO and control group. The expression of PPARgamma2 mRNA in white adipose of DIO-R group was significantly lower than that in DIO group. CONCLUSION: High-fat diet induced obesity resistance were closely associated with the increased UCP2, UCP3, and decreased PPARgamma2 mRNA in white adipose.

Heat-related illness in Jinshan District of Shanghai: A retrospective analysis of 70 patients.

BACKGROUND: This study aimed to investigate the epidemiological and clinical characteristics of patients with heat-related illness, and guide the prevention, diagnosis and treatment of heat-related illness. METHODS: From June 2013 to August 2013, seventy patients with heat-related illness were treated at Jinshan Hospital of Fudan University, and their epidemiological characteristics, laboratory results, treatment and prognosis were retrospectively analyzed. RESULTS: In the 70 patients, 18 patients suffered from heat stroke and 52 patients from non-heat stroke. When the environmnent temperature was above 35 °C, the body temperature of the patients began to increase markedly. The patients with heat stroke were significantly older than those with non-heat stroke (P<0.05). The body temperature, heart rate, blood glucose, blood lactate dehydrogenase and blood creatine kinase in the patients with heat stroke were higher than those in the patients with non-heat stroke (P<0.05). Blood lactate dehydrogenase and blood creatine kinase were positively correlated with body temperature (r=0.801). CONCLUSION: When the environmental temperature goes above 35 °C, heat-related illness should be prevented, especially in the elderly. The body temperature, heart rate, blood glucose, blood lactate dehydrogenase and blood creatine kinase in patients with heat stroke are higher than those in patients with non-heat stroke. Blood lactate dehydrogenase and blood creatine kinase are positively correlated with body temperature, but their relationship with heat-related illness awaits further study.