Clinical factors associated with cerebral autoregulation in ischemic stroke related to small artery occlusion.

BACKGROUND: Existing data suggest that cerebral autoregulation (CA) varies among different subtypes of ischaemic stroke. CA is globally impaired in patients with small artery occlusion (SAO). However, the factors influencing CA impairment in patients remains to be elucidated. METHODS: Stroke patients with SAO who underwent brain magnetic resonance imaging (MRI) were prospectively studied. Within 7 days after stroke onset, CA was recorded from the middle cerebral artery blood flow velocity and arterial blood pressure was simultaneously measured. Transfer function analysis was used to derive CA parameters, including gain and phase. Clinical characteristics, mean arterial pressure (MAP), biochemical findings, and cerebral small vessel disease (CSVD) markers on MRI were assessed in each patient. Factors associated with CA parameters were investigated. Univariate and multivariate linear regression analyses were conducted to determine the relationship between clinical factors and CA parameters. RESULTS: Sixty-three SAO patients (age, 56.3 ± 9.9 years; 55 men) were enrolled in the study. In the multiple linear regression analysis, after controlling for relevant clinical factors, MAP on admission (ipsilateral OR = 0.99 and contralateral OR = 0.99, both P < 0.005) was a significant independent predictor of bilateral gain. MAP > 105 mmHg on admission (OR = 0.77, P = 0.019) was significantly associated with ipsilateral gain. Diabetes mellitus was a significant predictive factor for bilateral gain (ipsilateral OR = 1.32 and contralateral OR = 1.22, both P < 0.005). No correlations were found between CA parameters and CSVD characteristics. CONCLUSION: In SAO-related ischaemic stroke, patients with MAP > 105 mmHg on admission tended to have better ipsilateral CA. Diabetes mellitus appears to be an independent risk factor for CA impairment in patients with SAO-related stroke. CSVD may not be the main factor affecting bilateral CA in patients with SAO.

Towards characterizing the regional cerebral perfusion in evaluating the severity of major depression disorder with SPECT/CT.

BACKGROUND: Major depressive disorder (MDD) is a common mental disorder worldwide, but now there is a lack of clinically effective assessment and management of MDD. In this study, we used technetium-99 m ethylcysteinate dimer ([99mTc]ECD) SPECT/CT to characterize the regional cerebral blood flow (rCBF) status of MDD patients, and to explore an objective image assessment model of MDD which is non- or minimally-invasive, convenient and accurate in a clinical setting. METHODS: The severity of MDD was assessed by three trained psychiatrists, based on scores obtained from HAMD and HAMA. [99mTc]ECD rCBF SPECT/CT was performed in 20 healthy controls and 74 unipolar MDD patients before receiving the treatment. The CT attenuation-corrected SPECT images data were automatically registered, analyzed simultaneously by 3D-SSP and eZIS. RESULTS: The mean score of HAMD and HAMA in the MDD patients was 25.49 ± 6.00, and 23.12 ± 5.83, respectively. There was a positive correlation between two scores. The MDD women had higher HAMD scores than MDD men. The decreased rCBF of MDD patients in frontal lobes (bilateral B11, B47 and right B4, B6, B10, B46), temporal lobe (right B21, B41, B42) and cingulated cortex (bilateral B24, B33), while their increased rCBF in occipital lobe (bilateral B17, B19 and left B18). Additionally, the depression severity was negatively correlated with decreased rCBF in left ventral anterior cingulate cortex B24, and was positively correlated with decreased rCBF in left inferior prefrontal gyrus B47 and increased rCBF in right associative visual cortex B19. The anxiety severity was negatively correlated with decreased rCBF in left subgenual cortex B25. CONCLUSIONS: Although the mechanism underlying the correlation is not yet fully understood, our findings indicated that the rCBF SPECT/CT may provide an objective assessment for MDD severity. It might be used monitoring therapeutic efficacy in the management of MDD.

Design of robust fuzzy iterative learning control for nonlinear batch processes.

In this paper, a two-dimensional (2D) composite fuzzy iterative learning control (ILC) scheme for nonlinear batch processes is proposed. By employing the local-sector nonlinearity method, the nonlinear batch process is represented by a 2D uncertain T-S fuzzy model with non-repetitive disturbances. Then, the feedback control is integrated with the ILC scheme to be investigated under the constructed model. Sufficient conditions for robust asymptotic stability and 2D $ H_\infty $ performance requirements of the resulting closed-loop fuzzy system are established based on Lyapunov functions and some matrix transformation techniques. Furthermore, the corresponding controller gains can be derived from a set of linear matrix inequalities (LMIs). Finally, simulations on the three-tank system and the highly nonlinear continuous stirred tank reactor (CSTR) are carried out to prove the feasibility and efficiency of the proposed approach.

Multiplexed optical fiber cell temperature sensing system with high sensitivity and accuracy.

Significance: A multiplexed fiber laser sensing system for cell temperature is proposed. To the best of the authors' knowledge, this is the first multilongitudinal mode (MLM) optical fiber laser sensor array designed for cell temperature sensing. Aim: A two-channel cell temperature sensing system with high sensitivity and real-time sensing capability is achieved. The temperature change of human hepatoellular carcinomas (HepG2) cells under the influence of exogenous chemical aflatoxin B1 (AFB1) can be monitored in real time. Approach: A fiber laser cavity consists of a pair of fiber Bragg gratings (FBGs) with matched central wavelengths and a piece of erbium-doped fiber (EDF). The static FBG is utilized for design of fiber laser cavity and laser modes selection. In comparison, the sensing FBG is used for cell temperature sensing. The sensing FBG has a length of 10 mm and a diameter of 200 µ m . Beat frequency signals (BFS) are generated by MLM lasers after optical-to-electrical conversion at a photodetector. Frequency change of a BFS is closely related to the reflected wavelength change of the sensing FBG. Through frequency division multiplexing, two fiber laser cavities are designed in the sensing system for two-channel temperature sensing. Frequency shift of a BFS that represents temperature change of cells can be automatically recorded in seconds. Results: A two-channel cell temperature sensing system is designed with high sensitivities of 101.62 and 119.82 kHz / ° C , respectively. The temperature change of HepG2 cells under the influence of exogenous chemical AFB1 is monitored in real time. Conclusions: The proposed system has the advantages of simple structure, high sensitivity, and two-channel sensing capability. Our study provides a simple and effective method to design a fiber laser sensor system without complex demodulation techniques and expensive optical components.

Association Between Cerebral Autoregulation and Long-Term Outcome in Patients With Acute Ischemic Stroke.

BACKGROUND: Dynamic cerebral autoregulation (CA) is known to be impaired in patients with acute ischemic stroke (AIS), but whether or not dynamic CA can predict long-term outcomes is unclear. MATERIALS AND METHODS: This prospective study included 103 patients with AIS between September 2017 and April 2019. We measured the middle cerebral artery blood flow velocity and blood pressure within 7 days of AIS onset using a transcranial Doppler and Finometer, respectively. We conducted transfer function analysis to calculate dynamic CA indices (phase and gain), with lower phase and higher gain parameters reflecting less efficient CA. We followed up all patients after 3 and 12 months. Patients with 12-month modified Rankin Scale scores of <2 and ≥2 were defined as having favorable and unfavorable outcomes, respectively. We then analyzed the predictors of unfavorable outcomes after 3 and 12 months using logistic regression. RESULTS: The ipsilesional phase parameter was significantly lower in patients with unfavorable outcomes than in those with favorable outcomes. Multiple logistic regression analysis revealed that the ipsilesional phase parameter and the National Institutes of Health Stroke Scale score were nonmodifiable predictors of short-term and long-term outcomes. Moreover, in receiver operating characteristic analysis, the area under the curve of the ipsilesional phase parameter was 0.646 (95% confidence interval: 0.513-0.779, P =0.044). Notably, the optimal cut-off value was 20.33 degrees (sensitivity: 63%, specificity: 70%). CONCLUSION: Dynamic CA is an independent predictor of outcomes at 3 and 12 months in patients with AIS.

PdCl2(HNMe2)2-catalyzed highly selective cross [2 + 2 + 2] cyclization of alkynoates and alkenes under molecular oxygen.

In the course of our study on palladium-catalyzed aerobic oxidation synthesis, we found that the PdCl(2)/O(2)/DMF system consistently experienced DMF hydrolysis to afford PdCl(2)(HNMe(2))(2), which is the real active catalyst for the aerobic oxidation. Although in situ DMF hydrolysis has been widely used in generating supramolecular assembly architectures, as far as we know, it is the first successful example to utilize PdCl(2)(HNMe(2))(2) in synthetic reactions. The highly selective cross [2 + 2+2] cyclization of alkynoates and different alkenes with electron-withdrawing groups could be smoothly catalyzed by PdCl(2)(HNMe(2))(2)/O(2)/DMF to afford the corresponding functionalized pentasubstituted benzenes in good to excellent yields (70-97%). The extension of alkyne surrogates for cross [2 + 2 + 2] cyclization from special alkenes with leaving groups to simple alkenes under molecular oxygen led to a paradigm shift in arene synthesis.

Clinical Value of Combining 18F-FDG PET/CT and Routine Serum Tumor Markers in The Early Detection of Recurrence Among Follow-up Patients Treated for Cervical Squamous Cell Carcinoma.

Objective: The purpose of this retrospective study was to investigate the role of 18F-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET/CT) and evaluate if combined elevated serum tumor markers levels improve the accuracy of 18F-FDG PET/CT in detecting recurrence of cervical squamous cell carcinoma. Methods: A total number of 42 patients who were treated for cervical squamous cell carcinoma and had underwent 18F-FDG PET/CT for suspected recurrence of cervical cancer were retrospectively reviewed in this study and their clinical, pathological and serological data were collected and analyzed. The clinical value of combining 18F-FDG PET/CT with serum tumor markers was investigated. Results: Among the 42 patients, 18F-FDG PET/CT was true positive in 25 (59.5%), false positive in 5 (11.9%), true negative in 12 (28.5%) and false negative in none. The overall patient-based sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 18F-FDG PET/CT in detecting recurrent cervical cancer were 100%, 70.6, 88.1%, 83.3%, and 100%, respectively. The accuracy of 18F-FDG PET/CT with combined squamous cell carcinoma antigen (SCC Ag) and carcinoembryonic antigen (CEA) elevation was 100% compared to only SCC Ag elevation and only CEA elevation, 90% and 33.3%, respectively. The positive predictive value of a positive 18F-FDG PET/CT with combined SCC Ag and CEA elevation was 100% for detection of recurrent cervical cancer. Also, the negative predictive value of a negative 18F-FDG PET/CT combined with normal SCC Ag and CEA levels was 100%. Conclusion:18F-FDG PET/CT is highly sensitive in the diagnosis of recurrent cervical cancer. When 18F-FDG PET/CT is associated with both SCC Ag and CEA elevation or only SCC Ag elevation, the accuracy is increased but not when associated with only CEA elevation. Positive 18F-FDG PET/CT associated with both tumor markers elevation can precisely predict recurrence. Moreover, normal levels of both tumor markers with a negative 18F-FDG PET/CT result may clinically reassure that a recurrence is absent.

Dynamic status of metabolically healthy overweight/obesity and metabolically unhealthy and normal weight and the risk of type 2 diabetes mellitus: A cohort study of a rural adult Chinese population.

OBJECTIVE: We aimed to determine dynamic status of metabolically healthy overweight or obesity (MHO) and metabolically unhealthy and normal weight (MUNW) and the risk of incident type 2 diabetes mellitus (T2DM). METHODS: Body mass index and metabolic health were assessed on 11,865 eligible participants ≥18 years from 6-year follow-up cohort study of a rural Chinese population. Participants were classified as metabolically healthy and normal weight (MHNW), MHO, MUNW and metabolically unhealthy overweight or obesity (MUO) at both baseline and follow-up examinations. Hazard ratio (HR) and 95% confidence interval (CI) were used to assess baseline and their changes of BMI-metabolic status and the risk of incident T2DM. RESULTS: Risk of T2DM was increased for all participants with baseline MHO, MUNW, and MUO (adjusted HR 1.94, 95% CI 1.33-2.81; 3.10, 95% CI 2.19-4.39; and 6.63, 95% CI 4.94-8.90, all P<0.001, respectively). However, risk of T2DM was increased for participants with transformation from MHO to MUO (4.52, 95% CI 2.42-8.47, P<0.001) as compared with stable MHNW, but not stable MHO (0.53, 95CI 0.20-1.40, P=0.20). Risk of T2DM did not differ between participants with transformation from MUNW to metabolically healthy and those with stable MHNW (P>0.05), but was increased with stable MUNW (5.78, 95% CI 3.15-10.62, P<0.001). The results were consistent when analyses were restricted to participants without baseline impaired fasting glucose level. CONCLUSIONS: Our findings provide understanding for differentiating high-risk individuals for incident T2DM in Chinese population.

Adult B-Cell Acute Lymphoblastic Leukemia Dominated by Osteolytic Bone Involvement on CT But Less Impressive PET on FDG PET/CT Images.

A 47-year-old man presented with abdominal pain, vomiting, and bone pain. Laboratory findings revealed severe hypercalcemia, anemia, and renal insufficiency with decreased serum parathyroid hormone. FDG PET/CT was performed for characteristics suggestive of multiple myeloma and other occult malignancy. The images revealed widespread osteolytic lesions with only 1 focus of definite abnormal FDG uptake. B-cell acute lymphoblastic leukemia was confirmed by pathological examination following bone marrow biopsy.

Combining PET/CT with serum tumor markers to improve the evaluation of histological type of suspicious lung cancers.

OBJECTIVE: Histological type is important for determining the management of patients with suspicious lung cancers. In this study, PET/CT combined with serum tumor markers were used to evaluate the histological type of lung lesions. MATERIALS AND METHODS: Patients with suspicious lung cancers underwent 18F-FDG PET/CT and serum tumor markers detection. SUVmax of the tumor and serum levels of tumor markers were acquired. Differences in SUVmax and serum levels of tumor markers among different histological types of lung cancers and between EGFR mutation statues of adenocarcinoma were compared. The diagnostic efficiencies of SUVmax alone, each serum tumor marker alone, combined tumor markers and the combination of both methods were further assessed and compared. RESULTS: SCC had the highest level of SUVmax, followed by SCLC and adenocarcinoma, and benign lesions had a lowest level. CYFRA21-1 and SCC-Ag were significantly higher in SCC, NSE was significantly higher in SCLC (P<0.001), and CEA was higher in adenocarcinoma (P = 0.343). The diagnostic efficiencies in evaluating histological types of suspicious lung cancers were insufficient when using each serum tumor marker or SUVmax alone. When combined, the AUC, sensitivity and specificity increased significantly (P<0.05 for all). Additionally, to adenocarcinoma, no significant difference was found between EGFR mutation statuses in SUVmax or serum tumor markers (P>0.05 for all). CONCLUSIONS: SUVmax and serum tumor markers show values in evaluating the histological types of suspicious lung cancers. When properly combined, the diagnostic efficiency can increase significantly.

Association of type 2 diabetes mellitus with the interaction between low-density lipoprotein receptor-related protein 5 (LRP5) polymorphisms and overweight and obesity in rural Chinese adults.

BACKGROUND: Low-density lipoprotein receptor-related protein 5 (LRP5) plays an important role in glucose and cholesterol metabolism. The present cohort study evaluated associations of LRP5 variants with the incidence of type 2 diabetes mellitus (T2DM) in a rural adult Chinese population. METHODS: In all, 7751 subjects aged ≥18 years without T2DM underwent genotyping at baseline; 6326 subjects (81.62%) were followed-up, and 5511 with a clear disease outcome were eligible for analysis. The same questionnaire was administered and the same anthropometric and blood biochemical examinations were performed at baseline and follow-up. Association analysis was performed for five single nucleotide polymorphisms and haplotypes of LRP5. RESULTS: Cox proportional hazards testing of three different genetic models found no significant association between T2DM and LRP5 after adjusting for potential risk factors (P > 0.05). However, the incidence of T2DM in subjects with LRP5 mutational genotypes was higher in the overweight/obese than normal weight population. Under the dominant model, the risk of T2DM was increased with an interaction between rs11228303 and the waist-to-height ratio adjusted for baseline age, sex, and family history of T2DM (synergy index [SI] = 4.172; 95% confidence interval [CI] 1.014-17.166)], and body mass index (SI = 3.237; 95% CI 1.102-9.509). Furthermore, the A allele of rs3758644 was related to decreased fasting plasma insulin and homeostatic model assessment of ß-cell function levels, whereas the T allele of rs12363572 was related to increased high-density lipoprotein cholesterol levels in new-onset diabetes patients (P < 0.05). CONCLUSIONS: The risk of T2DM may be associated with interactions between the LRP5 gene and overweight and obesity. Polymorphisms of LRP5 are related to ß-cell function and lipid metabolism.

Histological characterization of the lateral root primordium development in rice.

BACKGROUND: Lateral root constitutes an important part of root system either in tap root plants or fibrous root plants. The development of lateral root primordium (LRP) in Arabidopsis, which has a tap root system with simple radial structure of primary root, has been well characterized. However, limited knowledge has been acquired on the plants with fibrous root system, such as rice. This is mainly due to their multiple cell layers coated on root, which disturb the observation of LRP. RESULTS: We used an easy and quick method to strip the epidermal and cortex tissues of primary root so that the LRP can be easily observed under microscope. In this way, we observed the developmental processes of LRP in rice. In addition, we described the expression dynamics of several root development related genes, especially OsPINs (PIN-FORWMED), during the process of LRP development. CONCLUSIONS: We reported an easy and quick method for LRP observation in rice and suggested a "fountain" model of auxin transport in LRP of rice, which is similar with that in Arabidopsis.

Intragenic suppressor of Osiaa23 revealed a conserved tryptophan residue crucial for protein-protein interactions.

The Auxin/Indole-3-Acetic Acid (Aux/IAA) and Auxin Response Factor (ARF) are two important families that play key roles in auxin signal transduction. Both of the families contain a similar carboxyl-terminal domain (Domain III/IV) that facilitates interactions between these two families. In spite of the importance of protein-protein interactions among these transcription factors, the mechanisms involved in these interactions are largely unknown. In this study, we isolated six intragenic suppressors of an auxin insensitive mutant, Osiaa23. Among these suppressors, Osiaa23-R5 successfully rescued all the defects of the mutant. Sequence analysis revealed that an amino acid substitution occurred in the Tryptophan (W) residue in Domain IV of Osiaa23. Yeast two-hybrid experiments showed that the mutation in Domain IV prevents the protein-protein interactions between Osiaa23 and OsARFs. Phylogenetic analysis revealed that the W residue is conserved in both OsIAAs and OsARFs. Next, we performed site-specific amino acid substitutions within Domain IV of OsARFs, and the conserved W in Domain IV was exchanged by Serine (S). The mutated OsARF(WS)s can be released from the inhibition of Osiaa23 and maintain the transcriptional activities. Expression of OsARF(WS)s in Osiaa23 mutant rescued different defects of the mutant. Our results suggest a previously unknown importance of Domain IV in both families and provide an indirect way to investigate functions of OsARFs.

Association of the rs11196218 polymorphism in TCF7L2 with type 2 diabetes mellitus in Asian population.

OBJECTIVE: To clarify the association of rs11196218 polymorphism in transcription factor 7-like 2 (TCF7L2) and type 2 diabetes mellitus (T2DM) in Asian population by a case-control study and meta-analysis. METHODS: In the case-control study, 1842 patients with T2DM and 7777 normal glucose-tolerant controls in the Henan province of China were genotyped for rs11196218 in TCF7L2 by PCR-ligase detection reaction. We used allele, co-dominant, dominant and recessive models to evaluate the risk association and performed a meta-analysis of the results of different genetic models in previous studies and the current study. RESULTS: The AG genotype of rs11196218 was associated with risk of T2DM in the Henan population (odds ratio 1.37, 95% confidence interval 1.06-1.78), and dominant model showed marginal significant association (1.28, 0.99-1.67). Meta-analysis of 10 studies revealed the dominant model associated with T2DM in the overall population (1.20, 1.05-1.36). When stratified by region (southern and northern China and Japan), both the AG genotype and the dominant model were associated with risk of T2DM in southern Chinese (1.31, 1.03-1.66; 1.27, 1.01-1.60, respectively). CONCLUSION: The rs11196218 polymorphism in TCF7L2 is associated with risk of T2DM in Asian population.