Incidence, treatment and outcomes of coronary artery dissection during percutaneous coronary intervention.

BACKGROUND: Coronary artery dissection is a feared and potentially life-threatening complication of percutaneous coronary intervention (PCI). METHODS: We examined the clinical, angiographic, and procedural characteristics, and outcomes of coronary dissection at a tertiary care institution. RESULTS: Between 2014 and 2019, unplanned coronary dissection occurred in 141 of 10,278 PCIs (1.4%). Median patient age was 68 (60, 78) years, 68% were men, and 83% had hypertension. The prevalence of diabetes (29%), and prior PCI (37%) was high. Most target vessels were significantly diseased: 48% had moderate/severe tortuosity and 62% had moderate/severe calcification. The most common cause of dissection was guidewire advancement (30%), followed by stenting (22%), balloon angioplasty (20%), and guide-catheter engagement (18%). TIMI flow was 0 in 33% and 1-2 in 41% of cases. Intravascular imaging was used in 17% of the cases. Stenting was used to treat the dissection in 73% of patients. There was no consequence of dissection in 43% of patients. Technical and procedural success was 65% and 55%, respectively. In-hospital major adverse cardiovascular events occurred in 23% of patients: 13 (9%) had an acute myocardial infarction (MI), 3 (2%) had emergency coronary artery bypass graft surgery, and 10 (7%) died. During a mean follow up of 1612 days, 28 (20%) patients died, and the rate of target lesion revascularization was 11.3% (n=16). CONCLUSION: Coronary artery dissection is an infrequent complication of PCI, but is associated with adverse clinical outcomes, such as death and acute MI.

Effect of soluble phosphate and bentonite amendments on lead and cadmium bioavailability and bioaccessibility in a contaminated soil.

Effect of commonly used heavy metal immobilizing agents on risks of soil heavy metals has not been well investigated. In this work, a contaminated acidic soil (total Cd = 8.05, total Pb = 261 mg kg-1) was amended with soluble phosphate (P: 160 mg kg-1) and bentonite (3 g kg-1) and incubated for 360 d. The soil was then added to mouse feed at 1:9 soil: feed ratio (weight) and fed to mouse for 10 days, after which the liver, kidney and bone Pb and Cd concentrations were measured. The amended soils were extracted with SBRC and PBET to assay bioaccessibility, and extracted with DTPA to assess the environmental availability. The amendments did not affect the DTPA-Pb/Cd significantly (p > 0.05), while the Cd bioaccessibility in the gastric phase of the SBRC assay was reduced from 90.0 to 20.4 % for the bentonite amended treatment (p < 0.05). Kidney Pb and Cd concentrations of the mice fed with feed containing phosphate spiked soil was 80.2 and 66.0 % lower than the control mice fed with unamended soil (CK), respectively. Significant linear correlations were found between DTPA-extractable concentration and kidney concentrations for Pb/Cd. The effect of amendment on Pb/Cd bioavailability differed between the results calculated with different endpoints. The phosphate amendment resulted in 82.7 and 34.3 % lower Pb RBA compared with the unamended soil calculated with kidney and kidney+liver+bone Pb concentrations, respectively, and 68.8 and 49.7 % lower Cd RBA than the control with kidney and kidney+liver concentrations, respectively. However, no significant effect was observed with both amendments when the RBA was calculated with liver or bone Pb/Cd concentrations, or on Pb RBA with kidney, liver or bone metal concentrations. Results indicate the complex effect of amendments on organ, tissue and overall health risk of soil Pb/Cd to animal/human.

Cadmium and lead bioavailability to poultry fed with contaminated soil-spiked feed.

Geophagy is common for free-range chickens, however, the relative bioavailability (RBA) of heavy metals in contaminated soils consumed by chickens has not fully investigated. In this work, chickens were fed diets increasingly spiked with a contaminated soil (Cd = 105, Pb = 4840 mg kg-1; 3, 5, 10, 20 and 30 % of overall feed by weight), or Cd/Pb reagent spikes (from CdCl2 or Pb(Ac)2), for 23 d. After the study period, chicken liver, kidney, femur and gizzard samples were analyzed for Cd and Pb concentrations, and organ/tissue metal concentrations were used to calculate Cd and Pb RBA. Linear dose response curves (DRCs) were established for both Cd/Pb reagents-spiked and soil-spiked treatments. Femur Cd concentrations of soil-spiked treatments were two times of Cd-spiked treatments with similar feed Cd levels, while feed spiked with Cd or Pb also resulted in elevated Pb or Cd concentrations in some organ/tissues. Metal RBA was calculated using three different methods. Most Cd and Pb RBA values were in the range 50-70 %, with the chicken gizzard as a potential endpoint for bioaccessible Cd and Pb. Cadmium and Pb bioavailability values can help with more precise estimation of Cd and Pb accumulation in chicken following heavy metal-contaminated soil ingestion, with overall results helping to protect human health.

Endovascular Ultrasound Renal Denervation to Treat Hypertension: The RADIANCE II Randomized Clinical Trial.

Importance: Two initial sham-controlled trials demonstrated that ultrasound renal denervation decreases blood pressure (BP) in patients with mild to moderate hypertension and hypertension that is resistant to treatment. Objective: To study the efficacy and safety of ultrasound renal denervation without the confounding influence of antihypertensive medications in patients with hypertension. Design, Setting, and Participants: Sham-controlled, randomized clinical trial with patients and outcome assessors blinded to treatment assignment that was conducted between January 14, 2019, and March 25, 2022, at 37 centers in the US and 24 centers in Europe, with randomization stratified by center. Patients aged 18 years to 75 years with hypertension (seated office systolic BP [SBP] ≥140 mm Hg and diastolic BP [DBP] ≥90 mm Hg despite taking up to 2 antihypertensive medications) were eligible if they had an ambulatory SBP/DBP of 135/85 mm Hg or greater and an SBP/DBP less than 170/105 mm Hg after a 4-week washout of their medications. Patients with an estimated glomerular filtration rate of 40 mL/min/1.73 m2 or greater and with suitable renal artery anatomy were randomized 2:1 to undergo ultrasound renal denervation or a sham procedure. Patients were to abstain from antihypertensive medications until the 2-month follow-up unless prespecified BP criteria were exceeded and were associated with clinical symptoms. Interventions: Ultrasound renal denervation vs a sham procedure. Main Outcomes and Measures: The primary efficacy outcome was the mean change in daytime ambulatory SBP at 2 months. The primary safety composite outcome of major adverse events included death, kidney failure, and major embolic, vascular, cardiovascular, cerebrovascular, and hypertensive events at 30 days and renal artery stenosis greater than 70% detected at 6 months. The secondary outcomes included mean change in 24-hour ambulatory SBP, home SBP, office SBP, and all DBP parameters at 2 months. Results: Among 1038 eligible patients, 150 were randomized to ultrasound renal denervation and 74 to a sham procedure (mean age, 55 years [SD, 9.3 years]; 28.6% female; and 16.1% self-identified as Black or African American). The reduction in daytime ambulatory SBP was greater with ultrasound renal denervation (mean, -7.9 mm Hg [SD, 11.6 mm Hg]) vs the sham procedure (mean, -1.8 mm Hg [SD, 9.5 mm Hg]) (baseline-adjusted between-group difference, -6.3 mm Hg [95% CI, -9.3 to -3.2 mm Hg], P < .001), with a consistent effect of ultrasound renal denervation throughout the 24-hour circadian cycle. Among 7 secondary BP outcomes, 6 were significantly improved with ultrasound renal denervation vs the sham procedure. No major adverse events were reported in either group. Conclusions and Relevance: In patients with hypertension, ultrasound renal denervation reduced daytime ambulatory SBP at 2 months in the absence of antihypertensive medications vs a sham procedure without postprocedural major adverse events. Trial Registration: ClinicalTrials.gov Identifier: NCT03614260.

Accumulation and speciation of arsenic in Eisenia fetida in sodium arsenite spiked soils - A dynamic interaction between soil and earthworms.

Arsenic (As) is a toxic metalloid that is a significant global pollutant of the environment and a persistent bioaccumulation carcinogen. Earthworms are frequently employed as sentinel organisms to investigate the bioavailability of As in contaminated soils. However, the process of As accumulation in earthworms and the mechanism of transformation of As species in their bodies are not well understood. The accumulation of As and variation of As species in the earthworms (Eisenia fetida) exposed to sodium arsenite (0, 20, and 80 mg kg-1 As) were investigated in this study. The total As concentration of earthworms in the three treatments at various sample times was dose-dependent on soil As content. After 56 days of exposure, the high concentration treatment had the highest total As content (772 ± 21 mg kg-1) in earthworms, followed by the low concentration treatment (579 ± 42 mg kg-1) and control (31 ± 1 mg kg-1). During 56 days, the proportion of trivalent As in earthworms increased from 70% to more than 90%, while pentavalent As decreased by 11-18%. On day 28, the sum of the four organic As species reached a maximum (<1%). Changes in soil As species and an increase in bioavailable As cause earthworms to accumulate more As. The total As in soil after 56 days of exposure was 9.51 ± 0.50, 25.6 ± 0.60, and 82.8 ± 0.28 mg kg-1, which was not significantly different from the total As in soil before the experiment. These findings are useful in assessing the risk of earthworm exposure to sodium arsenite in the soil.

Bioaccessibility, source and human health risk of Pb, Cd, Cu and Zn in windowsill dusts from an area affected by long-term Pb smelting.

Non-ferrous metal smelting results in heterogenous spatial distribution of potentially toxic metals (PTM) near smelters. In this work, windowsill dusts were collected from smelting (SA) and urban (UJ) sub-areas of Jiyuan (a city affected by >70 years of Pb smelting) to investigate PTM source and bioaccessibility. The <10 µm fraction of dusts were analyzed for total and bioaccessible Pb, Cd, Cu and Zn concentrations; bioaccessibility was analyzed by a three-stage assay (i.e., lung phase, gastric phase and gastrointestinal phase) using artificial lysosomal fluid (ALF, L phase) followed by simulated gastric and gastrointestinal fluids (G and GI phases). This assay mimicked the movement of particles phagocytosed by alveolar macrophages in the respiratory system, then transported up the oropharynx and subsequently swallowed and transported into the digestive system. Zinc had greater bioaccessible concentrations in L and GI phases than other metals, and the mean L phase bioaccessible PTM concentrations in SA were greater than in UJ. The mean L + GI phase bioaccessible concentrations of Pb, Cd, Cu and Zn in SA were 280, 79, 124 and 1458 mg kg-1, while those in UJ were 215, 54, 116 and 598 mg kg-1, respectively. The L phase extracted 87.7 to 98.8 % of PTM within the L + GI assay. Lead had a lower L + GI bioaccessibility than Cd, Cu and Zn (70-76 % vs. 82-92 %). Higher tolerable Cd carcinogenic risks based on bioaccessibility were found in SA sub-area than in UJ while no carcinogenic or non-carcinogenic risk was found for other metals. Lead isotopic ratios indicated that both Pb ore and smelting bottom ash contributed to dust Pb accumulation in SA, while coal burning, lead ore, Pb smelting bottom ash and diesel engine exhaust contributed to dust Pb accumulation in UJ. Overall, results indicated heterogenous distribution of PTM source and bioaccessibility in the vicinity of Pb smelters.

Incidence, Treatment, and Outcomes of Coronary Artery Perforation During Percutaneous Coronary Intervention.

OBJECTIVES: To examine the incidence, treatment and outcomes of perforation during percutaneous coronary intervention (PCI). BACKGROUND: Coronary perforation is a potentially life-threatening PCI complication. METHODS: We examined the clinical, angiographic, and procedural characteristics, management, and outcomes of coronary perforation at a tertiary care institution. RESULTS: Between 2014 and 2019, perforation occurred in 70 of 10,278 PCIs (0.7%). Patient age was 71 ± 12 years, 66% were men, and 30% had prior coronary artery bypass graft surgery. Among perforation cases, the prevalence of chronic total occlusions was 33%, moderate/severe calcification was 66% and moderate/severe tortuosity was 41%. The frequency of Ellis class 1, 2, and 3 perforations was 14%, 50%, and 36%, respectively. Most (n = 51; 73%) were large vessel perforations, 16 (23%) were distal vessel perforations and 3 (4%) were collateral vessel perforations (1 septal and 2 epicardial). Hypotension occurred in 26%, pericardial effusion in 36% and tamponade in 13%; 47% of perforations did not have clinical consequences. Perforations were most often treated with prolonged balloon inflation (63%), reversal of anticoagulation (39%), and covered stent implantation (33%). Technical and procedural success were 73% and 60%, respectively, and major periprocedural adverse cardiac events occurred in 21% of the patients. Three patients (4%) required emergent CABG surgery and four (6%) died. CONCLUSIONS: Coronary perforation is an infrequent complication of PCI. Most perforations are large vessel perforations and often require further intervention. The incidence of death or emergent cardiac surgery is low.

Renal Artery Variations in Patients With Mild-to-Moderate Hypertension From the RADIANCE-HTN SOLO Trial.

PURPOSE: To assess the variability of renal artery (RA) anatomy and presence of RA-pathology in patients with mild-to-moderate hypertension enrolled in the RADIANCE-HTN SOLO trial. BACKGROUND: RADIANCE-HTN SOLO was a multicenter, international, blinded, randomized, sham-controlled trial evaluating ultrasound-based endovascular renal denervation (RDN) in patients with mild-to-moderate hypertension while off antihypertensive medications. METHODS: Eligible subjects had pre-randomization renal CT- or MR- angiography (CTA, MRA) to confirm anatomic suitability and to define RA ablation sites. All images were sent for independent review for evaluation of RA anatomy and other vascular pathology. RESULTS: A total of 324 patients underwent RA imaging (282 CTA and 42 MRA). Of those, 178 had simple anatomy with a single left and single right RA with mean diameters of 5.4 ± 0.9 and 5.1 ± 0.8 mm and mean lengths of 40.0 ± 12.9 and 52.0 ± 13.1 mm, respectively. Twenty-seven patients (8.3%) had unilateral or bilateral dual RAs with mean diameters of 4.0 ± 0.9 mm on the left and 3.9 ± 0.9 mm on the right. Forty percent (129/324) of patients had at least 1 accessory RA, with mean accessory diameters of 2.4 ± 0.8 mm on the left and 2.3 ± 0.8 mm on the right. Twenty-eight patients (8.6%) had at least 1 short (<25 mm) main RA. Incidental findings included: 9 patients (2.8%) with atherosclerotic RA stenosis ≥30%, 9 patients (2.8%) with fibromuscular dysplasia of RA and 2 patients (0.6%) with kidney and adrenal gland tumors. CONCLUSIONS: Pre-procedure CTA or MRA imaging is a valuable aid in assessing RA anatomy prior to RDN because of variable RA anatomy. CTA or MRA may detect RA lesions, and renal or adrenal tumors which may need additional workup prior to consideration of RDN. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT02649426.

Comparison of Outcomes of Patients with vs without Previous Coronary Artery Bypass Graft Surgery Presenting with ST-Segment Elevation Acute Myocardial Infarction.

The outcomes of patients with previous coronary bypass graft surgery (CABG) presenting with ST-segment elevation acute myocardial infarction (STEMI) have received limited study. We compared the clinical and procedural characteristics and outcomes of STEMI patients with and without previous CABG in a contemporary multicenter STEMI registry between 2003 and 2020. The primary outcomes of the study were mortality and major cardiac adverse events (MACE: death, MI or stroke). Survival curves were derived using the Kaplan-Meier method and compared with the log-rank test. Of the 13,893 patients included in the analyses, 7.2% had previous CABG. Mean age was 62.4 ± 13.6 years, most patients (71%) were men and 22% had diabetes. Previous CABG patients were older (69.0 ± 11.7 vs 61.9 ± 13.6 years, p <0.001) and more likely to have diabetes (40% vs 21%, p <0.001) compared with patients without previous CABG. Previous CABG patients had higher mortality and MACE at 5 years (p <0.001). Outcomes were similar with saphenous vein graft vs native coronary culprits. Previous CABG remained associated with mortality from discharge to 18 months (p = 0.044) and from 18 months to 5 years (p <0.001) after adjusting for baseline characteristics. Long term outcomes after STEMI were worse among patients with previous CABG compared with patients without previous CABG, even after adjustment for baseline characteristics.

Effect of sterilization on cadmium immobilization and bacterial community in alkaline soil remediated by mercapto-palygorskite.

Cadmium (Cd) pollution in alkaline soil in some areas of northern China has seriously threatened wheat production and human health. However, there are still few effective amendments for alkaline soil, and the mechanism of amendments with a good immobilization effect remains unclear. In this study, soil sterilization experiments were conducted to investigate the effects of soil microorganisms on the immobilization of a novel amendment-mercapto palygorskite (MPAL) in Cd-contaminated alkaline soils. The results showed that the mercapto on the MPAL surface was not affected by autoclaving. Compared with the control, the available Cd concentration in 0.025% MPAL treatments decreased by 18.80-29.23% after 1 d of aging and stabled after 10 d of aging. Importantly, the immobilization of MPAL on Cd in sterilized soil was significantly better than that in natural soil due to the changes in Cd fractions. Compared with MPAL-treated natural soil, exchangeable Cd fraction and carbonate-bound Cd fraction in MPAL-treated sterilized soil decreased by 20.79-27.09% and 20.05-26.45%, while Fe/Mn oxide-bound Cd fraction and organic matter-bound Cd fraction increased by 17.77-22.68% and 18.85-27.32%. Phylogenetic investigation of communities by reconstruction of unobserved states (PICRUSt) analysis found that the potential functions of the microbial community in normal and sterilized soil were different significantly. Soil sterilization increased the soil pH and decreased the arylsulfatase activity, but did not change the soil zeta potential and available sulfur. The changes in Cd fractions in MPAL-treated sterilized soil may be related to the reduction in the bacterial community and the changes in function microbial, but not to the soil properties. In addition, MPAL application had little effects on the bacterial community, soil pH value, zeta potential, available sulfur, and arylsulfatase. These results showed that the immobilization of MPAL on Cd in alkaline soil was stable and effective, and was not affected by soil sterilization and soil microorganism reduction.

Green Synthesis of Gold Nanoparticles Using Upland Cress and Their Biochemical Characterization and Assessment.

This research focuses on the plant-mediated green synthesis process to produce gold nanoparticles (Au NPs) using upland cress (Barbarea verna), as various biomolecules within the upland cress act as both reducing and capping agents. The synthesized gold nanoparticles were thoroughly characterized using UV-vis spectroscopy, surface charge (zeta potential) analysis, scanning electron microscopy-energy-dispersive X-ray spectroscopy (SEM-EDX), atomic force microscopy (AFM), attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR), and X-ray diffraction (XRD). The results indicated the synthesized Au NPs are spherical and well-dispersed with an average diameter ~11 nm and a characteristic absorbance peak at ~529 nm. EDX results showed an 11.13% gold content. Colloidal Au NP stability was confirmed with a zeta potential (ζ) value of -36.8 mV. X-ray diffraction analysis verified the production of crystalline face-centered cubic gold. Moreover, the antimicrobial activity of the Au NPs was evaluated using Gram-negative Escherichiacoli and Gram-positive Bacillus megaterium. Results demonstrated concentration-dependent antimicrobial properties. Lastly, applications of the Au NPs in catalysis and biomedicine were evaluated. The catalytic activity of Au NPs was demonstrated through the conversion of 4-nitrophenol to 4-aminophenol which followed first-order kinetics. Cellular uptake and cytotoxicity were evaluated using both BMSCs (stem) and HeLa (cancer) cells and the results were cell type dependent. The synthesized Au NPs show great potential for various applications such as catalysis, pharmaceutics, and biomedicine.

Outcomes of intravascular brachytherapy for recurrent drug-eluting in-stent restenosis.

OBJECTIVES: To examine the outcomes of vascular brachytherapy (VBT) for recurrent drug-eluting stents (DES) in-stent restenosis (ISR). BACKGROUND: Recurrent DES-ISR can be challenging to treat. VBT has been used with encouraging results. METHODS: We report the long-term outcomes of patients with recurrent DES-ISR treated with VBT between January 2014 and September 2018 at a tertiary care institution. The main outcome was target lesion failure (TLF), defined as the composite of clinically driven target lesion revascularization (TLR), target lesion myocardial infarction (MI), and target lesion-related cardiac death. Cox proportional hazards analysis was performed to identify variables associated with recurrent TLF. RESULTS: During the study period, 116 patients (143 lesions) underwent VBT. Median follow-up was 24.7 (14.5-35.4) months. The incidence of TLR, target-lesion MI, and TLF was 18.9%, 5.6%,and 20.1% at 1 year, and 29.4%, 10.5%, and 32.9% at 2 years.Initial presentation with acute coronary syndrome (ACS) was independently associated with TLF (hazard ratio = 1.975, 95% CI [1.120, 3.485], p = .019). Lesions treated with intravascular ultrasound (IVUS) guidance had a lower incidence of TLR (14.3% vs. 39.6%, log-rank p = .038), and a trend toward lower incidence of TLF (19% vs. 42.6%, log-rank p = .086). CONCLUSIONS: VBT can improve the treatment of recurrent DES-ISR, but TLF occurs in approximately one in three patients at 2 years. Initial presentation with ACS was associated with higher TLF and the use of IVUS with a trend for lower incidence of TLF.

Outcomes With Combined Laser Atherectomy and Intravascular Brachytherapy in Recurrent Drug-Eluting Stent In-Stent Restenosis.

BACKGROUND: Recurrent drug-eluting stents (DES) in-stent restenosis (ISR) can be challenging to treat. The combined use of excimer laser atherectomy (ELCA) and vascular brachytherapy (VBT) for this indication has received limited study. METHODS: We report the long-term outcomes of patients with recurrent DES ISR treated with combined VBT and ELCA from January 2014 to September 2018 at a single institution. Outcomes included target lesion failure (TLF), defined as the composite of clinically driven target lesion revascularization (TLR), target lesion myocardial infarction (MI), and target lesion-related cardiac death. RESULTS: During the study period, 116 patients (143 lesions) underwent VBT, of which 19 patients (19 lesions) underwent combined laser atherectomy and VBT. All procedures were successful without no-reflow or dissection. Two propensity-score matched cohorts (ELCA + VBT (n = 18) vs. VBT only (n = 18)) were compared. During a median follow-up of 25.5 (14.5-40) months, there was no difference in the incidence of TLF (38.9% vs. 38.9%, log-rank p = 0.688), target-lesion MI (5.6% vs. 5.6%, log-rank p = 0.915), or TLR (38.9% vs. 33.3%, log-rank p = 0.933) between both groups. There was no cardiac death related to the target lesion. CONCLUSIONS: When compared with VBT alone for the treatment of resistant DES ISR, combined use of ELCA and brachytherapy is associated with comparable long-term outcomes. ELCA should be considered in ISR lesions due to stent underexpansion.

Coronary Intravascular Brachytherapy for Recurrent Coronary Drug-Eluting Stent In-Stent Restenosis: A Systematic Review and Meta-Analysis.

OBJECTIVE: To examine the outcomes with intravascular brachytherapy (IVBT) in recurrent in-stent restenosis (ISR). BACKGROUND: Recurrent ISR can be challenging to treat and IVBT can be used for recurrent ISR but has received limited study. METHODS: We performed a systematic review and meta-analysis of five observational studies, including 917 patients (1014 lesions) with recurrent ISR, defined as having at least two prior ISR episodes with previous treatment with a stent, who underwent treatment with IVBT. Outcomes of interest included target vessel revascularization (TVR), myocardial infarction (MI), and all-cause mortality. RESULTS: During a mean follow-up of 24 ± 7 months, the incidence of TVR was 29.2% (95% CI 18.0-40.4%). The incidence of MI and all-cause mortality were 4.3% (95% CI 1.7%-6.9%) and 7.3% (95% CI 3.2-11.5%), respectively. At one- and two-years after PCI the incidence of TVR was 17.5% (95% CI 13.6%-21.4%) and 26.7% (95% CI 16.6%-36.9%), respectively and the incidence of MI was 3.1% (95% CI 2-4.2%) and 3.9% (95% CI 1-6.8%), respectively. CONCLUSION: Intravascular brachytherapy can be used to treat recurrent ISR, although TVR is needed in approximately one of four patients at two years.

The Impact of Novel X-Ray Systems and X-Ray System Optimization on Patient Radiation Dose Administered During Cardiac Catheterization.

INTRODUCTION: The effect of x-ray system optimization on patient radiation dose has received limited study. METHODS: We analyzed patient radiation dose in 1786 cardiac catheterization procedures (diagnostic coronary angiography and/or percutaneous coronary intervention [PCI]) performed at a single tertiary-care center before and after x-ray system optimization. RESULTS: After optimization, cineangiography dose-area product (DAP) dose was lower in the overall group of patients who underwent diagnostic angiography and/or PCI (1347 µGy•m² [IQR, 645-2345 µGy•m²] vs 1658 µGy•m² [IQR, 640- 2757 µGy•m²]; P=.03), as well as in the diagnostic angiography group (1795 µGy•m² [IQR, 1140-2994 µGy•m²] vs 2356 µGy•m² [IQR, 311-3576 µGy•m²]; P<.01) and PCI group (2152 µGy•m² [IQR, 1338-3477 µGy•m²] vs 2562 µGy•m² [IQR, 1681-3859 µGy•m²]; P=.02). Cineangiography DAP per exposure was also lower in the overall group (143 µGy•m² [IQR, 91-212 µGy•m²] vs 164 µGy•m² [IQR, 106-233 µGy•m²] per exposure; P<.01) and in the diagnostic angiography group (158 µGy•m² [IQR, 102-225 µGy•m²] vs 184 µGy•m² [IQR, 125-271 µGy•m²] per exposure; P<.01). After optimization, cineangiography air kerma (AK) dose (319 mGy [IQR, 197-531 mGy] vs 421 mGy [IQR, 241-600 mGy]; P=.01) and cineangiography AK per exposure (20.7 mGy [IQR, 12.9-29.0 mGy] vs 23.6 mGy [IQR, 14.1-32.9 mGy] per exposure; P=.03) were also lower in the PCI group. There was no significant change in fluoroscopy AK dose after optimization (20.7 mGy [IQR, 12.7-30.1 mGy] vs 20.4 mGy [IQR, 12.8-31.3 mGy] per minute; P=.71) and fluoroscopy DAP dose (156 µGy•m² [IQR, 101-242 µGy•m²] vs 156 µGy•m² [IQR, 102-236 µGy•m²] per minute; P=.91). CONCLUSION: X-ray system optimization was associated with lower cineangiography DAP, but similar fluoroscopy radiation dose.

Tumor-targeting oncolytic virus elicits potent immunotherapeutic vaccine responses to tumor antigens.

Oncolytic viruses represent a promising therapeutic modality, but they have yet to live up to their therapeutic potential. Safety and efficacy concerns impel us to identify least toxic oncolytic agents that would generate durable and multifaceted anti-tumor immune responses to disrupt the tumors. Here we describe a rational engineered oncolytic herpes virus (OVH) that is a selective killer for targeting tumors, has strong safety records, induces complete regression of tumors in multiple tumor models, and elicits potent antitumor immunity. By far, the potential of OVs in promoting the tumor antigen-specific humoral immune responses remains obscure. In this study, we found that effective treatment by OVH induced immunogenic cell death, which facilitates to elicit humoral immune responses. Depletion experiments revealed that B cells were required for maximal antitumor efficacy of oncolytic immunotherapy. Both serum transfer and antibody treatment experiments revealed that endogenous oncolysis-induced antigen-targeting therapeutic antibodies can lead to systemic tumor regression. Our data demonstrate that tumor-targeting immune modulatory properties confer oncolytic OVH virotherapy as potent immunotherapeutic cancer vaccines that can generate specific and efficacious antitumor humoral responses by eliciting endogenous tumor antigen-targeting therapeutic antibodies in situ, resulting in an efficacious and tumor-specific therapeutic effect.

Andrographolide ameliorates oxidative stress, inflammation and histological outcome in complete Freund's adjuvant-induced arthritis.

OBJECTIVES: As one of the main active ingredients of Chinese herbal medicine Andrographis paniculate, andrographolide is used in domestic clinical treatment for respiratory infections and inflammation. This study was designed to investigate the effects of andrographolide as an antioxidant on the level of oxidative stress, neutrophil accumulation and infiltration in joints and synovial tissue of arthritis rats induced by complete freund's adjuvant. METHODS: A rat model of rheumatoid arthritis was induced by subcutaneous injection of complete Freund's adjuvant in the footpad. The model was established 14 days after induction. The treatment was performed from 14th day to 35th day with different doses of andrographolide (25, 50, 100 mg/kg) and positive control methotrexate (3 mg/kg). The effects of andrographolide on oxidative stress, neutrophil accumulation and infiltration were measured by the paw swelling, arthritis score, the hot plate test, biochemical analysis, and histology. RESULTS: The medium and high-dose andrographolide (50, 100 mg/kg) group declined the levels of tumor necrosis factor-α, interleukin-6 and CXC chemokine ligand2, articular elastase and myeloperoxidase, and increased the levels of antioxidant enzymes superoxide dismutase, catalase, and glutathione. The activity of malondialdehyde and nitrite/nitrate in andrographolide (50, 100 mg/kg) group was weakened than the model group. The degree of swelling and arthritis score of andrographolide group was lower than the model group. The results of hot plate test showed that high dose of andrographolide significantly improved the anti-injury ability of rats; Radiological and histological results showed that the joint osteoporosis, inflammatory cell infiltration, synovial hyperplasia and other phenomena in the andrographolide group were significantly improved. CONCLUSIONS: Andrographolide acts as a protective agent for the treatment of complete freund's adjuvant induced rheumatoid arthritis by inhibiting lipid peroxidation and nitrite/nitrate levels in a dose-dependent manner, enhancing antioxidant enzyme activity, reducing levels of chemokines and inflammatory factors, preventing neutrophil accumulation and infiltration.

Leaching behavior and efficiency of cadmium in alkaline soil by adding two novel immobilization materials.

The seriousness and harmfulness of cadmium (Cd) pollution have been gradually attracting wide attention. Remediation materials currently play a critical role in the remediation of Cd-polluted soils. However, the amendments that can efficiently remediate Cd-polluted alkaline soils are relatively few. In this study, a column leaching experiment was conducted to determine the effects of mercapto-palygorskite (MPAL) and mercapto-sepiolite (MSEP) on the leaching behavior and chemical fraction distribution of heavy metals, and to explore the remediation efficiency of two novel materials in alkaline soils through aging experiments. The results showed that, under DTPA-assisted leaching, the maximum concentration of leachate Cd in MPAL and MSEP was below 1/30 (0.1 mg·kg-1) of the total Cd concentration among leaching and significantly lower than that in CK, palygorskite (PAL), and sepiolite (SEP) treatments. Meanwhile, MPAL and MSEP decreased the leaching efficiency of Cd stability, had negligible effects on the essential micronutrients Cu and Zn, and did not influence the pH and electrical conductivity (EC) values of leachate. After leaching, the Fe/Mn oxide-bound Cd increased in MPAL and MSEP, whereas the exchange fraction Cd and carbonate-bound Cd decreased. Aging results showed that MPAL and MSEP effectively reduced 62.39% and 44.89% of DTPA-Cd after 1 day of aging, while at same dosage (0.3%) PAL and SEP reduced 7.79% and 6.75% of DTPA-Cd after 30 days of aging and showed no obvious efficiency. It was thus concluded that MPAL and MSEP can be considered as two novel and efficient soil remediation materials for Cd-polluted alkaline soils.

Therapeutic effects of gentiopicroside on adjuvant-induced arthritis by inhibiting inflammation and oxidative stress in rats.

The purpose of this research was to evaluate the therapeutic effects of gentiopicroside (GPS) on adjuvant-induced arthritis (AA) rats. Rats were injected with complete Freund's adjuvant (CFA) for 0.1 mL in the right hind paw to induce AA. Thirty rats from three groups were treated with GPS (30, 60, 90 mg/kg) from day 15 to day 26. Arthritis was evaluated by arthritis index, paw volume, paw thickness, and X-ray. The effect of GPS on inflammation was assessed by measuring the levels of interleukin (IL)-1ß, tumor necrosis factor (TNF)-α, IL-6 and IL-17, as well as related mRNA. Glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), glutathione (GSH) protein carbonyl (PCO) and malondialdehyde (MDA) were measured to assess the effect of GPS on oxidative stress. These results indicate that GPS increases the levels of GSH-Px, SOD and GSH, and reduces the levels of MDA and PCO. GPS can significantly down-regulate the levels of IL-1ß, TNF-α, IL-6 and IL-17, as well as related mRNA. In addition, X-ray and histopathological results show that GPS has a therapeutic effect on joints in AA rats. In summary, the therapeutic effects of GPS on AA rats are associated with anti-inflammation and antioxidation.

Multifunctional UV and Gas Sensors Based on Vertically Nanostructured Zinc Oxide: Volume Versus Surface Effect.

This article reports that it is possible to make multifunctional sensing devices with ZnO infiltrated polymers while the sensing interactions could occur throughout the polymer. As such, we find that infiltrated devices with SU-8 polymer can result in highly sensitive UV sensors. Mesh dielectric core devices were found to make sensitive gas sensors with a better than 5 ppm sensitivity for formaldehyde and NO2. A new type of p-n junction device is further demonstrated that is sensitive to UV illumination, thus making it an enhanced UV sensor. Sensing devices relying on volume interactions, such as light absorption, can significantly benefit from the infiltrated polymer. In contrast, devices that rely on surface interactions, such as gas sensors, do not gain performance in any significant way with or without the infiltrated polymer.