Comparison of the prognostic value of SYNTAX score and clinical SYNTAX score on outcomes of Chinese patients underwent percutaneous coronary intervention.

BACKGROUND: Previous studies have validated the capability of SYNTAX score (SS) and clinical SYNTAX score (CSS) in the prediction of clinical outcomes in patients who have undergone PCI; however, studies on comparison of these two scoring systems in Chinese population have been sparse. METHODS: To study the ability of SS and CSS in prediction of clinical outcomes of Chinese patients underwent percutaneous coronary intervention (PCI). We retrospectively calculated SS and CSS for 547 Chinese patients from a single center who underwent PCI. Patients were stratified into tertiles according to their SS and CSS. We compared the 2-year clinical outcomes in these patients stratified separately by SS and CSS tertiles. RESULTS: The incidence of major adverse cardiac and cerebro-vascular events (MACCE) was the highest in patients with SSHIGH (13.5%), comparing to 6.8% in SSMED and 0% in SSLOW (p < 0.0001). The Cox multivariable analysis showed that the SS and CSS were both strong independent predictors for MACCE [1.100 (1.069-1.133), 1.017 (1.010-1.025), both p < 0.0001]. The receiver operating characteristic (ROC) curves showed the areas-under-the-curves for all-cause death by CSS was slightly larger comparing to SS but not significantly (AUC SS, 0.64; AUC CSS, 0.71; p = 0.23). CONCLUSION: We concluded that both the SS and CSS were capable of risk stratification of clinical outcomes in all-comers population as well as in low and moderate risk Chinese patients undergoing PCI with CSS showing slightly better advantage.

Study on the impact of comprehensive geriatric assessment on anxiety and depression in chronic obstructive pulmonary disease patients.

BACKGROUND: Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease (COPD) patients and reduce the quality of life of patients, but also affect the treatment effect and long-term prognosis. Therefore, it is of great significance to explore the clinical application of senile comprehensive assessment in the treatment of COPD and its influence on psychological factors such as anxiety and depression. AIM: To explore the clinical application of comprehensive geriatric assessment in COPD care and its impact on anxiety and depression in elderly patents. METHODS: In this retrospective study, 60 patients with COPD who were hospitalized in our hospital from 2019 to 2020 were randomly divided into two groups with 30 patients in each group. The control group was given routine nursing, and the observation group was given comprehensive assessment. Clinical symptoms, quality of life [COPD assessment test (CAT) score], anxiety and depression Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) were compared between the two groups. RESULTS: CAT scores in the observation group decreased from an average of 24.5 points at admission to an average of 18.3 points at discharge, and in the control group from an average of 24.7 points at admission to an average of 18.3 points at discharge. The average score was 22.1 (P < 0.05). In the observation group, HAMA scores decreased from 14.2 points at admission to 8.6 points at discharge, and HAMD scores decreased from 13.8 points at admission to 7.4 points at discharge. The mean HAMD scores in the control group decreased from an average of 14.5 at admission to an average of 12.3 at discharge, and from an average of 14.1 at admission to an average of 11.8 at discharge. CONCLUSION: The application of comprehensive geriatric assessment in COPD care has a significant effect on improving patients' clinical symptoms and quality of life, and can effectively reduce patients' anxiety and depression.

Neutron reflectivity characterization of the photoacid reaction-diffusion latent and developed images of molecular resists for extreme ultraviolet lithography.

Lithographic feature size requirements have approached a few radius of gyration of photoresist polymers used in thin-film patterning. Furthermore, the feature dimensions are commensurate with the photoacid diffusion length that defines the underlying latent image. Smaller imaging building blocks may enable reduced feature sizes; however, resolution limits are also dependent upon the spatial extent of the photoacid-catalyzed reaction diffusion front and subsequent dissolution mechanism. The reaction-diffusion front was characterized by neutron reflectivity for ccc stereoisomer-purified, deuterium-labeled tert-butoxycarbonyloxy calix[4]resorcinarene molecular resists. The spatial extent of the reaction front exceeds the size of the molecular resist with an effective diffusion constant of (0.13 ± 0.06) nm(2)/s for reaction times longer than 60 s, with the maximum at shorter times. Comparison to a mean-field reaction-diffusion model shows that a photoacid trapping process provides bounds to the spatial and extent of reaction via a reaction-limited mechanism whereas the ratio of the reaction rate to trapping rate constants recovers the effective diffusion peak. Under the ideal step-exposure conditions, surface roughness was observed after either positive- or negative-tone development. However, negative-tone development follows a surface-restructuring mechanism rather than etch-like dissolution in positive-tone development.

[Community-based management for chronic heart failure patients under the professional guidance of upper first-class hospital staff].

OBJECTIVE: To establish a community-based management model for heart failure patients under the professional guidance of upper first-class hospital staff. METHODS: Two hundreds heart failure (New York Heart Function II-IV) patients aged from 35 to 85 in two communities of Chengdu city were divided into two groups by cluster randomization: the management group and the control group. The community hospital doctors were trained for the evaluation and management of heart failure according standardized guidelines by upper first-class hospital doctors, and responsible for the management of patients in the management group. Meanwhile, the management group patients also received self-care education. Patients in control group were treated by community doctors without special training. Data including the community hospital doctors' knowledge rate of heart failure, positive diagnosis rate, and the rate for standardized medication for heart failure; the patients' knowledge rate of heart failure, the rate of drug compliance, the rate of standardized drug taken for heart failure, the rate of self-care in daily-life, the quality of life, the incidence of cardiovascular events, hospitalization time and cost were compared between the two groups. RESULTS: The community hospital doctors' knowledge rate of heart failure, the related knowledge for prevention and treatment on the causes of heart failure, the positive diagnosis rate, and the rate for standardized medication for heart failure [ß receptor blocker 77.3% (17/22); angiotensin-converting enzyme inhibitors 63.6% (14/22)] were significantly higher than doctors in the control group (all P < 0.05). There were 96 in the management group and 97 in the control group. Data were similar between the two groups at baseline. After (18.5 ± 0.5) months, the patient's knowledge rate of heart failure [100% (96/96) vs. 71.1% (69/97)], the rate of drug compliance [78.1% (75/96) vs. 13.4% (13/97)], the rate of standardized drug taken for heart failure[ß receptor blocker: 75.0% (72/96) vs. 8.2% (8/97); angiotensin-converting enzyme inhibitors: 60.4% (58/96)vs. 10.3% (10/97)], and the rate of self-care in daily-life [salt and food restriction:88.5% (85/96) vs. 29.9% (23/97); blood pressure monitoring: 83.3% (80/96) vs. 56.7% (55/97); weight monitoring:78.1% (75/96) vs. 13.4% (13/97)] were all significantly higher in the management group than in control group. For patients with New York Heart Function III-IV, the score of the LiHFe questionnaire (43.7 ± 9.2 vs. 49.5 ± 11.3), the incidence of cardiovascular events [63.3% (19/30) vs. 90.3% (28/31)], the days of hospitalization [(8.2 ± 3.2)days vs. (13.9 ± 10.9) days], and the cost for hospitalization [(2873.3 ± 401.6) Yuan vs. (4525.8 ± 6417.8) Yuan] were all significantly lower in the management group (n = 30) than in the control group (n = 31) (all P < 0.05). CONCLUSIONS: The community-based management model for heart failure patients in the community level is effective to improve the management and outcome in this cohort.

Measurements of an Effective Longitudinal Coherence Length in Transmission Small Angle X-ray Scatterings.

The notion of an effective longitudinal coherence length with its value much greater than λ2/(2Δλ) has been adopted in small-angle X-ray scattering communities for years, where λ and Δλ denote the incident wavelength and its spread, respectively. Often the implications of the effective longitudinal coherence length do not even enter considerations in the designing and data treatment of small-angle scattering experiments. In this work, conventional transmission small-angle X-ray scattering (tSAXS) was performed to reveal a clear angular dependence on effective longitudinal coherence length. The measured values of effective longitudinal coherence length can be as high as one millimeter, whereas the value of calculated λ2/(2Δλ) is in nanometers.

Electron Reflectometry for Measuring Nanostructures on Opaque Substrates.

Here, we present a method for measuring dimensions of nanostructures using specular reflection of electrons from an electronically opaque surface. Development of this method has been motivated by measurement needs of the semiconductor industry1-4, and it can also be more broadly applicable to any periodic, pseudo-periodic or statistically stationary nanostructures or nanopattern on an opaque substrate. In prior work5,6, it was demonstrated through the presentation of proof of concept experiments and simulated examples that Reflective Small Angle Electron Scattering (RSAES) can meet certain dimensional metrology requirements of the semiconductor industry. In RSAES, an entire reflected scattering pattern is measured, with the scattered electrons being of primary interest. Later, in the process of further simulating RSAES, it was serendipitously discovered that dimensional measurement using reflected electrons might be greatly simplified by Electron Reflectometry (ER), whereby the intensity of the specularly reflected electron beam is measured and the scattered beams ignored.7 This innovation may allow faster and cheaper development and deployment or at the very least provide an alternate pathway to exploit the phenomenon of reflected electrons for dimensional measurement. Here we discuss how ER complements existing dimensional measurement techniques, show simulated applications with an emphasis an defect detection and line-width measurements.

Multiphase contrast-enhanced computed tomography imaging features of salivary duct carcinoma: differentiation from other salivary gland malignancies.

OBJECTIVE: The aim of this study was to investigate the imaging features of salivary duct carcinoma (SDC) with multiphase contrast-enhanced computed tomography (CECT) and to compare them with those of mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma (ACC), and acinic cell carcinoma. STUDY DESIGN: A total of 63 patients with histologically diagnosed salivary gland malignancies underwent preoperative multiphase CECT. Clinical information, location, size, mass pattern, enhancement pattern, borders, invasion of adjacent tissues, and lymph node metastasis were evaluated. Computed tomography (CT) number attenuation patterns were calculated. RESULTS: SDCs were significantly more common in males and in the parotid gland (P ≤ .018). They were more likely to invade into adjacent tissues and metastasize to lymph nodes (P ≤ .032). Six SDCs (66.7%) had comedonecrosis, as detected on histopathologic examination, and 3 lesions presented cribriform necrosis on CECT. CT numbers during delayed-phase scanning were significantly higher in SDC than in ACC (P = .031). Significant differences were discovered between MEC and ACC for CT numbers during arterial-phase scanning (P = .047) and in the ratio of CT numbers (P = .018). CONCLUSIONS: SDC exhibits some specific CT features, and multiphase CECT imaging is useful in the differential diagnosis of salivary gland malignancies.

A novel lipid droplets-targeting ratiometric fluorescence probe for hypochlorous acid in living cells.

Lipid droplets were found to be involved in many organism activities. Here, a lipid droplets-targeted near-infrared fluorescence probe (named XHZ) for ratiometric detection of endogenous hypochlorous acid/hypochlorite (HClO/ClO-) in living cells was developed, which was constructed by a coumarin moiety and a malononitrile derivative. XHZ could detect HClO/ClO- with high selectivity and sensitivity in a ratiometric manner based on FRET (Förster Resonance Energy Transfer) mechanism. The two well-resolved emission (470/672 nm) bands could ensure accurate detection of HClO/ClO- in vitro as well as in vivo. XHZ was successfully used for ratiometric fluorescence imaging of exogenous and endogenous HClO/ClO- in RAW264.7 cells. A good linear relationship between the fluorescence intensity ratios of the two emissions and HClO/ClO- concentrations from 0 to 40 µM was obtained. Importantly, XHZ could localize mainly in lipid droplets of RAW264.7 cells. To the best of our knowledge, XHZ is the first lipid droplets-targeted ratiometric fluorescence probe for HClO/ClO-.

Thermodynamic interactions in double-network hydrogels.

Double-network hydrogels (DN-gels) prepared from the combination of a moderately cross-linked anionic polyelectrolyte (PE) and an uncross-linked linear polymer solution (NP) exhibit mechanical properties such as fracture toughness that are intriguingly superior to that of their individual constituents. The scheme of double-network preparation, however, is not equally successful for all polyelectrolyte/neutral polymer pairs. A successful example is the combination of poly(2-acrylamido-2-methyl-1-propane sulfonic acid) (PAMPS) cross-linked network and linear polyacrylamide (PAAm), which results in DN-gels with fracture strength under compression approaching that of articular cartilage ( approximately 20 MPa). Small-angle neutron scattering was used to determine the thermodynamic interaction parameters for PAMPS and PAAm in water as a first step to elucidate the molecular origin responsible for this superior property. Measurements on PAMPS/PAAm DN-gels and their solution blend counterparts indicate that the two polymers interact favorably with each other while in water. This favorable PAMPS/PAAm interaction given by the condition chi(PE-NP) < chi(PE-water)

Molecular model for toughening in double-network hydrogels.

A molecular mechanism is proposed for the toughness enhancement observed in double-network (DN) hydrogels prepared from poly(2-acrylamido-2-methyl-1-propanesulfonic acid) (PAMPS) polyelectrolyte network and poly(acrylamide) (PAAm) linear polymer. It is an extension of the phenomenological model set forth recently by Gong et al. ( Macromolecules 2007, 40, 6658- 6664 ). This mechanism rationalizes the changes in molecular structure of the DN gel constituents observed via in situ neutron scattering measurements, the composition dependence of the solution viscosity, and the thermodynamic interaction parameters of PAMPS and PAAm molecules obtained previously from neutron scattering studies. More specifically, this proposed mechanism provides an explanation for the observed periodic compositional fluctuations in the micrometer range induced by large strain deformation.

[Therapeutic effects of scalp-acupuncture in patients with vascular dementia induced by cerebral infarction: a randomized controlled trial].

OBJECTIVE: To investigate the effects of scalp-acupuncture on intelligence in patients with vascular dementia (VaD). METHODS: A total of 108 VaD patients were randomly divided into two groups: scalp-acupuncture group and Western medicine group. The scores of Mini-Mental State Examination (MMSE), Blesse Dementia Scale (BDS), Hasegawa Dementia Scale (HDS), Abilities of Daily Life (ADL) before and after treatment in the two groups were detected. RESULTS: A total of 92 patients completed the treatment. The scores of MMSE, BDS and HDS in the two groups were significantly increased, and the ADL scores significantly declined (P<0.05). There was no difference in the scores of MMSE, BDS, HDS and ADL between the two groups before and after the treatment. There was no difference in the total effectiveness between the two groups (P>0.05). CONCLUSION: Scalp-acupuncture therapy could improve the clinical intelligence level of VaD patients.

Reflective Small Angle Electron Scattering to Characterize Nanostructures on Opaque Substrates.

Features sizes in integrated circuits (ICs) are often at the scale of 10 nm and are ever shrinking. ICs appearing in today's computers and hand held devices are perhaps the most prominent examples. These smaller feature sizes demand equivalent advances in fast and accurate dimensional metrology for both development and manufacturing. Techniques in use and continuing to be developed include X-ray based techniques, optical scattering and of course the electron and scanning probe microscopy techniques. Each of these techniques have their advantages and limitations. Here the use of small angle electron beam scattering measurements in a reflection mode (RSAES) to characterize the dimensions and the shape of nanostructures on flat and opaque substrates is demonstrated using both experimental and theoretical evidence. In RSAES, focused electrons are scattered at angles smaller than 1° with the assistance of electron optics typically used in transmission electron microscopy. A proof-of-concept experiment is combined with rigorous electron reflection simulations to demonstrate the efficiency and accuracy of RSAES as a method of non-destructive measurement of shapes of features less than 10 nm in size on flat and opaque substrates.

A mitochondria-targeted fluorescence probe for ratiometric detection of endogenous hypochlorite in the living cells.

A mitochondria-targeted fluorescence probe (CPBT) for ratiometric detection of endogenous hypochlorite in the living cells was developed. CPBT could detect hypochlorite with high selectivity and sensitivity in a ratiometric manner based on FRET mechanism. In absence of hypochlorite, when CPBT was excited with absorption maximum wavelength of the donor moiety, it showed the emission of acceptor moiety because of FRET process. However, in the presence of hypochlorite, the reaction of CC double bond with hypochlorite interrupted the conjugation system resulting in the inhibition of FRET process and the emission of the donor moiety. The two well-resolved emission bands can ensure accurate detection of hypochlorite. A good linear relationship between the fluorescence intensity ratios of the two emissions and the ClO- concentrations in the range from 41.8 nM (detection limit) to 12.5 µM was established. Importantly, CPBT could localize mainly in the mitochondria of RAW264.7 cells. CPBT was successfully used to fluorescence ratiometric imaging of endogenous hypochlorite in RAW264.7 cells.

An effective colorimetric and ratiometric fluorescent probe based FRET with a large Stokes shift for bisulfite.

Bisulfite plays crucial roles in diverse physiological processes. Therefore, the efficient detection of bisulfite is very important. In this study, we report a colorimetric and ratiometric fluorescent probe (CPT) with a large Stokes shift (162 nm) for bisulfite (HSO3(-)) based FRET mechanism. The probe can quantitatively detect HSO3(-) with low detection limit (45 nM) and high specificity over other common anions and biothiols. A nucleophilic addition reaction was proposed for the sensing mechanism, which was confirmed by HRMS spectra. The test strips of the probe were made and used easily. Moreover, probe CPT was used to ratiometric fluorescent imaging of exogenous and endogenous HSO3(-) in living cells.

Specular X-ray reflectivity and small angle neutron scattering for structure determination of ordered mesoporous dielectric films.

Specular X-ray reflectivity (SXR) and small-angle neutron scattering (SANS) are used to characterize the structure of a thin film containing cylindrical mesopores. The 3-D structure of the mesoporous film was determined from SANS measurements taken at multiple rotation angles between the incident beam and the film. The film was found to be composed of a randomly packed core and surface layers within which the hollow cylinders were regularly packed and oriented along the surface. The packing of the cylindrical mesopores was not hexagonal but rather rectangular with a conical angle of 55.7 degrees instead of 60 degrees expected for hexagonal packing. The extent of the planar orientation of the cylindrical mesopores within the surface layers was estimated from the width of the Bragg reflection in the SXR result to be about 25 repeating layers at both interfaces. This was further confirmed from cross-section transmission electron microscopy (TEM) results. The SXR results of this film exhibit an anomalous decrease in reflected intensity after each Bragg reflection. This anomaly in SXR can be modeled in a Parratt formulism using a depth profile composed of two characteristic lengths, the repeating distance among layers and the curvature of the density profile of each layer.

A water-soluble pH fluorescence probe based on quaternary ammonium salt for bioanalytical applications.

A novel fluorescence probe Rhodamine-Ethanediamine-Iodomethane (REI) was successfully prepared to serve as an efficient sensing platform for H(+) with fully reversibility mainly between the pH 4.2 and 7.2 in simple buffer solution. The introduction of quaternary ammonium salt with positive charge can not only manage to increase the solubility and sensitivity of probe REI, but also avoid the "alkalizing effect" due to charge-induced effect compared to the reference probe Rhodamine-Ethanediamine (RE). In particular, probe REI was well used for monitoring the weak acid pH fluctuations in lysosome of the live HeLa cells due to its excellent biological properties, including low cytotoxicity, high selectivity, good sensitivity and membrane permeability.

Determination of the internal morphology of nanostructures patterned by directed self assembly.

The directed self-assembly (DSA) of block copolymers (BCP) is an emerging resolution enhancement tool that can multiply or subdivide the pitch of a lithographically defined chemical or topological pattern and is a resolution enhancement candidate to augment conventional lithography for patterning sub-20 nm features. Continuing the development of this technology will require an improved understanding of the polymer physics involved as well as experimental confirmation of the simulations used to guide the design process. Both of these endeavors would be greatly facilitated by a metrology, which is capable of probing the internal morphology of a DSA film. We have developed a new measurement technique, resonant critical-dimension small-angle X-ray scattering (res-CDSAXS), to evaluate the 3D buried features inside the film. This is an X-ray scattering measurement where the sample angle is varied to probe the 3D structure of the film, while resonant soft X-rays are used to enhance the scattering contrast. By measuring the same sample with both res-CDSAXS and traditional CDSAXS (with hard X-rays), we are able to demonstrate the dramatic improvement in scattering obtained through the use of resonant soft X-rays. Analysis of the reciprocal space map constructed from the res-CDSAXS measurements allowed us to reconstruct the complex buried features in DSA BCP films. We studied a series of DSA BCP films with varying template widths, and the internal morphologies for these samples were compared to the results of single chain in mean-field simulations. The measurements revealed a range of morphologies that occur with changing template width, including results that suggest the presence of mixed morphologies composed of both whole and necking lamella. The development of res-CDSAXS will enable a better understanding of the fundamental physics behind the formation of buried features in DSA BCP films.

[Effects of dexamethasone on IL-13-induced mCLCA3 and Muc5ac expressions in nasal mucosa of rats].

AIM: To study the effects of dexamethasone on the IL-13-induced mCLCA3 and Muc5ac expressions in nasal mucosa of rats, and the role in mucus secretion of allergic rhinitis. METHODS: Thirty SD rats were randomly divided into control group, IL-13 group and dexamethasone group. Expressions of mCLCA3 mRNA and Muc5ac protein in nasal mucosa were detected by RT-PCR and immunohistochemistry, respectively. RESULTS: No mCLCA3 mRNA expression in the nasal mucosa was detected in the control group, while it was 0.319±0.121 in the IL-13 group (P<0.05 vs control group) and 0.144±0.105 in the dexamethasone group (P<0.05 vs IL-13 group). The expression of Muc5ac protein increased in the IL-13 group (1.389±0.499) as compared with the control group (0.300±0.145, P<0.05). After treatment with dexamethasone, the expression of Muc5ac protein was notably lower (0.901±0.390) than that in IL-13 group (P<0.05). CONCLUSION: IL-13 up-regulates the expressions of mCLCA3 mRNA and Muc5ac protein in nasal mucosa, which may play a pivotal role in the mucus overproduction of nasal mucosa. Dexamethasone substantially down-regulates the expressions of mCLCA3 mRNA and Muc5ac protein, which may have an inhibiting effect on mucus overproduction of nasal mucosa.

Directed Self-Assembly of Lamellar Copolymers: Effects of Interfacial Interactions on Domain Shape.

The depth-dependent structure of a poly(styrene-b-methylmethacrylate) (PS-PMMA) line grating (46 nm pitch) was calculated from quantitative analysis of small-angle X-ray scattering profiles. These data demonstrate that domain shapes are significantly deformed near the substrate interface, where the local PS domain shape resembles an hourglass. The bulk equilibrium dimension is recovered near the center of a 64 nm thick film. Simulations based on self-consistent field theory suggest that deformations near the substrate are caused by extensive penetration of the copolymer domains into the underlying substrate coating (a PS-brush). These findings suggest that new coatings for block copolymer directed self-assembly should consider copolymer penetration lengths in addition to tailoring surface energetics. Furthermore, given the resolution and ensemble-averaging features of synchrotron X-ray scattering, we argue that it has the potential to emerge as a "gold-standard" or "benchmark" dimensional metrology and library validation tool for high density, sub-10 nm features.