[Construction of a risk prediction model for diabetes after kidney transplantation based on genome-wide association study].

Objective: To explore the clinical risk factors and susceptibility genes of diabetes after kidney transplantation (PTDM) and construct a risk prediction model for PTDM. Methods: The data of kidney transplant recipients who underwent follow-up in the Affiliated Lihuili Hospital, Ningbo University and Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from January 2001 to December 2022 were retrospectively analyzed. The recipients were divided into PTDM group and Non-PTDM group according to whether they were complicated with PTDM. The differences in clinical indicators between the two groups were compared, the risk factors affecting the incidence of PTDM were determined, and susceptibility genes of PTDM were screened by genome-wide association study (GWAS). PTDM risk prediction models based only on clinical indicators (Model 1) and clinical indicators combined with susceptibility genes (Model 2) were established respectively, and the predictive performance of the two prediction models was compared. Finally, the Nomogram of the optimal model was drawn, and the discrimination, calibration and clinical applicability of the model were evaluated. Results: A total of 113 kidney transplant recipients (70 males and 43 females) were included, with an average age of (46.2±10.8) years. There were 51 cases in PTDM group and 62 cases in Non-PTDM group. The related factors screened by GWAS and logistic regression analysis included family history of diabetes (OR=88.912, 95%CI: 5.827-1 356.601, P=0.001), preoperative triglyceride (TG) (OR=1.888, 95 %CI: 1.150-3.098, P=0.012), uric acid (UA) (OR=1.011, 95%CI: 1.000-1.022, P=0.045) and rs802707 (OR=10.046, 95%CI: 1.462-69.042, P=0.019). The area under the curve (AUC) of the receiver operating characteristics analysis (ROC) predicted by Model 1 for PTDM was 0.891 (95%CI: 0.811-0.972), with the sensitivity of 0.889 and the specificity of 0.742. The AUC of ROC curve predicted by Model 2 for PTDM was 0.930 (95%CI: 0.864-0.995), with the sensitivity of 0.885 and the specificity of 0.900. Conclusions: Family history of diabetes, preoperative TG and UA, and rs802707 are significantly associated with the occurrence of PTDM. In addition, the combination of susceptibility genes could improve the predictive ability of clinical indicators for the risk of PTDM.

Vrille is required for larval moulting and metamorphosis of Helicoverpa armigera (Lepidoptera: Noctuidae).

Vrille (Vri), a basic leucine zipper transcription factor, plays important roles in insect circadian clock regulation, tracheal development, proliferation, flight and metamorphosis. Here, Helicoverpa armigera was used as a model to investigate the role of Vri in larval moulting and metamorphosis. Sequence analysis results revealed that H. armigera Vri (HaVri) shares a high amino acid identity with other Lepidoptera Vri homologues. Spatial-temporal expression pattern data showed that HaVri expression was highly abundant in larval moulting and metamorphosis stages and was mainly expressed in the midgut and Malpighian tubule during metamorphosis. HaVri knockdown by RNA interference in the fourth-instar larvae prevented larval moulting, and HaVri knockdown in the fifth-instar larvae suppressed midgut remodelling and delayed or blocked metamorphosis. Further studies confirmed that 20-hydroxyecdysone (20E) activated HaVri expression via its heterodimer receptors, ecdysone receptor (EcRB1) and ultraspiracle protein (USP1), whereas methoprene [juvenile hormone analogue (JHA)] promoted HaVri expression via its intracellular receptor methoprene-tolerant (Met1). However, 20E and JHA can counteract each other in the activation of HaVri expression. Together, the present results suggested that HaVri was involved in larval moulting and metamorphosis and was regulated by 20E and JHA in H. armigera.

Effects of ambient temperature on growth performance and carcass traits of male growing White Pekin ducks.

1. An experiment was conducted to investigate the effects of ambient temperature on growth performance and carcass traits in male growing Pekin ducks from 14 to 42 d of age in order to establish their optimal temperature requirements. 2. A total of 216 14 d old male White Pekin ducks were allocated randomly to six environmentally controlled chambers with ambient temperature set at 20°C, 22°C, 24°C, 26°C, 28°C, and 30°C from 14 to 42 d of age, respectively. 3. As ambient temperature increased from 20°C to 30°C, the body weight and weight gain decreased linearly or quadratically (P < 0.05) and was accompanied by linearly decreasing feed intake (P < 0.05). According to broken-line regression, the upper critical level of ambient temperature during the growing period for body weight, weight gain, and feed conversion ratio were 27.4°C, 27.4°C, and 26.0°C, respectively. 4. The weight of breast meat, leg meat, and abdominal fat decreased linearly or quadratically as ambient temperature increased and declined to a minimum when the temperature increased to 30°C (P < 0.05). The percentage of breast meat and abdominal fat showed a linear or quadratic decreasing response to increasing temperature, but leg meat percentage increased as temperature increased and reached maximum at 30°C (P < 0.05). According to broken-line regression, the upper critical ambient temperatures during the growing period for breast meat weight and percentage were 25.5°C and 25.6°C, respectively. 5. It was concluded that both growth performance and breast meat of growing ducks were sensitive to increasing ambient temperature and this should be kept below the upper critical temperature during the growing period in order to optimise growth performance and carcass traits at market age.

[Comparison of the translucency and color masking effect of the zirconia ceramics made by milling and gel deposition].

OBJECTIVE: Three kinds of zirconia specimens were made respectively by milling of the prisintered blocks and by three dimensional (3D) gel deposition for in vitro evaluation of their optical translucency under three different thicknesses and their color masking effect on discolored teeth. The study aims for establishing the principle for guiding the materials selection in clinical practice. METHODS: Ninety A2-colored zirconia disc specimens with diameter of 14 mm were prepared and were divided into three groups (n=30). (1) Group CZ, by milling of the presintered blanks; (2) Group NZW, by 3D gel deposition, without a color masking opaque inner layer; (3) Group NZY, by 3D gel deposition, with a color masking opaque inner layer. Furthermore, each group was divided into three sub-groups (n=10) according to the sample thickness, i.e., 0.6, 1.0 and 1.5 mm, respectively. The maxillary anterior teeth with severe discoloration, extracted owing to periodontal disease, were collected and embedded. By gentle gridding and polishing a plane, larger than 6 mm2×6 mm2, was generated on the labial surface of each tooth. Chromatic values(CIE1976-L*a*b*) of the zirconia samples in the nine sub-groups were measured by the spectrophotometer Crystaleye in front of the black or white background in a cassette, and the translucency parameter (TP) values were calculated for each sample. Thereafter the zirconia specimens were bonded onto the labial surface of the polished teeth for measuring the chromatic values, using the chromatic value of the medium 1/3 of the standardized Vita A2 as a control. The color aberration ΔE between each zirconia specimen and the control value was calculated, respectively. The results were statistically analyzed by One-way ANOVA and Bonferroni. RESULTS: (1) The optical transparency of the three kinds of zirconia disc specimens with the thickness of 0.6, 1.0 and 1.5 mm was 14.09, 12.31 and 10.45 for group CZ; 19.84, 16.54 and 12.44 for group NZW;14.81, 13.16 and 11.92 for group NZY. In each group, the degree of optical transparency of the specimens showed a clear tendency as in the sub-group 0.6 mm >1.0 mm >1.5 mm. The TP value of the specimens in the three groups with the same thickness showed a tendency of the group NZW >group NZY >group CZ. (2) After bonding onto the polished labial surface of the teeth, the color aberration ΔE of the specimens with the thickness of 0.6, 1.0 and 1.5 mm was calculated to be 10.77, 9.94 and 8.50 for group CZ; 6.84, 5.89 and 5.29 for group NZW; 4.16, 3.92 and 3.67 for group NZY. In each group, the color aberration of the specimens showed a clear tendency as in the sub-group 0.6 mm >1.0 mm >1.5 mm; the color aberration of the three groups with the same thickness was in the order of the group CZ >group NZW >group NZY. CONCLUSION: In all the specimen groups with a fixed specimen thickness, the optical translucency of the specimen was the highest in group NZW made by 3D gel deposition, and the best color masking effect was obtained in specimens with a color masking opaque inner layer in group NZY, where a thickness of 0.6 mm was sufficient enough for obtaining the ideal color masking effect.

[The expression and significance of microtubule - driven protein KIF2A in epithelial ovarian cancer].

Objective: To investigate the protein and mRNA expression of KIF2A in ovarian cancer, and to investigate the migration and invasion ability changes in ovarian cancer cell line HO-8910 transfected by KIF2A-siRNA. Methods: Immunohistochemical method was used to detect the expression of KIF2A in 30 cases of ovarian cancer and 20 cases of ovarian normal tissues. The expression of KIF2A mRNA was detected by RT-PCR. The mRNA and protein expression of KIF2A in cell line HO-8910 was detected by RT-PCR and Western blot after transfected by KIF2A-siRNA in vitro. After the transfection, the cell migration and invasion ability were observed by scratch test and transwell experiments. Result: The expression of KIF2A mRNA and protein in HO-8910 was significantly lower than that in normal ovarian tissue (P<0.05). The capacities of migration and invasion of HO-8910 was suppressed notably after the knockdown of KIF2A (P<0.05). Conclusion: KIF2A gene expression was increased in ovarian cancer, and knockdown of KIF2A gene can inhibit the migration and invasion of ovarian cancer cells. It suggested that KIF2A gene may be a new target for the development of ovarian cancer.

Changes in erectile organ structure and function in a rat model of chronic prostatitis/chronic pelvic pain syndrome.

There is a growing recognition of the association between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED); however, most of the reports are based on questionnaires which cannot distinguish between organic and functional ED. The purpose of this study was to determine the exact relationship between CP/CPPS and ED, and to investigate the changes in erectile organ structure and function in a rat model of CP/CPPS. We established a rat model of experimental autoimmune prostatitis (EAP), which is a valid model for CP/CPPS. Erectile function in EAP and normal rats was comparable after cavernous nerve electrostimulation. The serum testosterone and oestradiol levels, ultrastructure of the corpus cavernosum and expression of endothelial nitric oxide synthase and neuronal nitric oxide synthase in the two groups were similar; however, there was a decrease in smooth muscle-to-collagen ratio and alpha-smooth muscle actin expression and an increase in transforming growth factor-beta 1 expression was observed in EAP rats. Thus, organic ED may not exist in EAP rats. We speculate that ED complained by patients with CP/CPPS may be psychological, which could be caused by impairment in the quality of life; however, further studies are needed to fully understand the potential mechanisms underlying the penile fibrosis in EAP rats.

Diversity, population structure, and evolution of local peach cultivars in China identified by simple sequence repeats.

The fruit peach originated in China and has a history of domestication of more than 4000 years. Numerous local cultivars were selected during the long course of cultivation, and a great morphological diversity exists. To study the diversity and genetic background of local peach cultivars in China, a set of 158 accessions from different ecological regions, together with 27 modern varieties and 10 wild accessions, were evaluated using 49 simple sequence repeats (SSRs) covering the peach genome. Broad diversity was also observed in local cultivars at the SSR level. A total of 648 alleles were amplified with an average of 13.22 observed alleles per locus. The number of genotypes detected ranged from 9 (UDP96015) to 58 (BPPCT008) with an average of 27.00 genotypes per marker. Eight subpopulations divided by STRUCTURE basically coincided with the dendrogram of genetic relationships and could be explained by the traditional groups. The 8 subpopulations were juicy honey peach, southwestern peach I, wild peach, Buddha peach + southwestern peach II, northern peach, southern crisp peach, ornamental peach, and Prunus davidiana + P. kansuensis. Most modern varieties carried the genetic backgrounds of juicy honey peach and southwestern peach I, while others carried diverse genetic backgrounds, indicating that local cultivars were partly used in modern breeding programs. Based on the traditional evolution pathway, a modified pathway for the development of local peach cultivars in China was proposed using the genetic background of subpopulations that were identified by SSRs. Current status and prospects of utilization of Chinese local peach cultivars were also discussed according to the SSR information.

Thermophysical properties of multi-shock compressed dense argon.

In contrast to the single shock compression state that can be obtained directly via experimental measurements, the multi-shock compression states, however, have to be calculated with the aid of theoretical models. In order to determine experimentally the multiple shock states, a diagnostic approach with the Doppler pins system (DPS) and the pyrometer was used to probe multiple shocks in dense argon plasmas. Plasma was generated by a shock reverberation technique. The shock was produced using the flyer plate impact accelerated up to ∼6.1 km/s by a two-stage light gas gun and introduced into the plenum argon gas sample, which was pre-compressed from the environmental pressure to about 20 MPa. The time-resolved optical radiation histories were determined using a multi-wavelength channel optical transience radiance pyrometer. Simultaneously, the particle velocity profiles of the LiF window was measured with multi-DPS. The states of multi-shock compression argon plasma were determined from the measured shock velocities combining the particle velocity profiles. We performed the experiments on dense argon plasmas to determine the principal Hugonoit up to 21 GPa, the re-shock pressure up to 73 GPa, and the maximum measure pressure of the fourth shock up to 158 GPa. The results are used to validate the existing self-consistent variational theory model in the partial ionization region and create new theoretical models.

Genome-wide analysis of the homeodomain-leucine zipper (HD-ZIP) gene family in peach (Prunus persica).

In this study, 33 homeodomain-leucine zipper (HD-ZIP) genes were identified in peach using the HD-ZIP amino acid sequences of Arabidopsis thaliana as a probe. Based on the phylogenetic analysis and the individual gene or protein characteristics, the HD-ZIP gene family in peach can be classified into 4 subfamilies, HD-ZIP I, II, III, and IV, containing 14, 7, 4, and 8 members, respectively. The most closely related peach HD-ZIP members within the same subfamilies shared very similar gene structure in terms of either intron/exon numbers or lengths. Almost all members of the same subfamily shared common motif compositions, thereby implying that the HD-ZIP proteins within the same subfamily may have functional similarity. The 33 peach HD-ZIP genes were distributed across scaffolds 1 to 7. Although the primary structure varied among HD-ZIP family proteins, their tertiary structures were similar. The results from this study will be useful in selecting candidate genes from specific subfamilies for functional analysis.

[A prospective study of association between physical activity and ischemic stroke in adults].

Objective: To explore the prospective associations between physical activity and incident ischemic stroke in adults. Methods: Data of China Kadoorie Biobank study in Tongxiang of Zhejiang were used. After excluding participants with cancers, strokes, heart diseases and diabetes at baseline study, a total of 53 916 participants aged 30-79 years were included in the final analysis. The participants were divided into 5 groups according to the quintiles of their physical activity level. Cox proportional hazard regression models was used to calculate the hazard ratios (HR) for the analysis on the association between baseline physical activity level and risk for ischemic stroke. Results: The total physical activity level in the participants was (30.63±15.25) metabolic equivalent (MET)-h/d, and it was higher in men [(31.04±15.48) MET-h/d] than that in women [(30.33±15.07) MET-h/d] (P<0.001). In 595 526 person-years of the follow-up (average 11.4 years), a total of 1 138 men and 1 082 women were newly diagnosed with ischemic stroke. Compared to participants with the lowest physical activity level (<16.17 MET-h/d), after adjusting for socio-demographic factors, lifestyle, BMI, waist circumference, and SBP, the HRs for the risk for ischemic stroke in those with moderate low physical activity level (16.17-24.94 MET-h/d), moderate physical activity level (24.95-35.63 MET-h/d), moderate high physical activity level (35.64-43.86 MET-h/d) and the highest physical activity level (≥43.87 MET-h/d) were 0.93 (95%CI: 0.83-1.04), 0.87 (95%CI: 0.76-0.98), 0.82 (95%CI: 0.71-0.95) and 0.76 (95%CI: 0.64-0.89), respectively. Conclusion: Improving physical activity level has an effect on reducing the risk for ischemic stroke.

An improved strategy based on RAPD markers efficiently identified 95 peach cultivars.

DNA markers have useful applications in cultivar identification. A novel analysis approach called cultivar identification diagram (CID) was developed using DNA markers in the separation of plant individuals. This new strategy is less time- and cost-consuming, has reliable results, and was constructed for fingerprinting. Ten 11-mer primers were used to amplify the genotypes; all 95 peach genotypes (from the National Peach Germplasm Repository, in Nanjing, China) were distinguished by a combination of 54 primers. The utilization of the CID among these 95 peach cultivars was also verified by the identification of three randomly chosen groups of cultivars. This identification showed some advantages including the use of fewer primers and easy separation of all cultivars by the corresponding primers marked in the right position on the CID. This peach CID could provide the information to separate any peach cultivars of these 95, which may be of help to the peach industry in China and for the utilization of DNA markers to identify other plant species.

[Trend of collaboration and sharing in digitalized restorative dentistry].

To digitalize restorative dentistry means to digitalize all the approaches involved in the clinical diagnosis and treatment process, in the production of individualized restorations, in the information transmission and communication between dentists and patients respectively between dentists and technicians, and even in the personalized understanding of esthetics. This is a cross-disciplinary issue that interconnects a wide range of topics. The way of understanding the digital tendency and of integrating the-already-digitalized steps into a system have a strategic impact on the development of the dental industry. By following the trace of the development of digital procedures in restorative dentistry, in this paper, we intend to classify the digitalization into two categories as the special and general ones, and will point out the limitations in understanding the digitalization in prosthodontics merely from the perspective of diagnosis or the production of individualized restorations. The role of digitalization in leading the conceptual development and the new possibilities opened up by the integrated digital technologies will be emphasized. Digitalization has changed the way of interaction between dentists and technicians. It is beneficial to the reorganization of medical and technological resources. Its potential in upgrading the dental industry deserves attention. Digitalization promotes the establishment of a collaborative and sharing ecosystem in restorative dentistry, which would pave the way towards artificial intelligence.

Immunomodulatory drug FTY720 induces regulatory CD4(+)CD25(+) T cells in vitro.

As a novel immunosuppressant, FTY720 (2-amino-2-(2-[4-octylphenyl] ethyl)-1, 3-propanediol hydrochloride) has been used to prevent the allograft rejection in organ transplantation. FTY720 can prolong markedly survival of the allograft by inducing apoptosis of reactive lymphocytes and by redirecting the homing of lymphocytes. However, as the archetype of a new class of immune modulators, the potential effect of FTY720 on the immune response needs to be elucidated further. In this study, FTY720 was added into the mixed lymphocyte reaction (MLR) consisting of murine splenocytes from BALB/c and C57BL/6, to observe its direct effect on the induction of CD4(+)CD25(+) regulatory T cells. It was demonstrated that the proportion of CD4(+)CD25(+) and CD4(+)CD25(+)forkhead box P3 (FoxP3)(+) T cells in MLR were increased significantly by FTY720 treatment, and the expression of FoxP3 mRNA in lymphocytes was also enhanced markedly by the drug. A synergetic effect was observed between FTY720 and co-stimulation blockades. Moreover, analysis of the function of FTY720-treated cells manifested an increased suppressive activity in an in vitro antigen-specific proliferation assay. In conclusion, FTY720 can increase the number and enhance the functional activity of CD4(+)CD25(+) regulatory T cells in MLR, and these FTY720-treated cells possess the activity to down-regulate the alloreactivity of lymphocytes, indicating its potential use for therapeutic purposes.

Methyl palmitate, an acaricidal compound occurring in green walnut husks.

Walnut, Juglans regia L., is known for its insecticidal activities to a range of herbivores and microbes. Isolation and identification of bioactive compounds from walnut is a potential approach for the development of new pesticides. Laboratory experiments were carried out to investigate the acaricidal activities of green husk extracts of walnut. Bioassay-guided fractionation of petroleum-ether extracts of walnut led to the identification of a common plant-borne fatty acid ester, methyl palmitate (MP), which produced strong acaricidal activity (62.8% mortality) at 1 mg/ml at 24 h. The structure of MP was characterized with infrared spectrum and NMR, and the identification of MP confirmed using an authentic standard on high-performance liquid chromatography. Based on a slide dip bioassay, 10 mg/ml MP provided 97.9% mortality against adults of Tetranychus cinnabarinus (Boisduval) (Acari: Tetranychidae), whereas mortality against eggs was much lower (57.2%).

Telmisartan inhibits Ang II-induced MMP-9 expression in macrophages in stabilizing atheromatous plaque.

OBJECTIVE: To investigate the effects of telmisartan on matrix metalloproteinase-9 (MMP-9) expression in macrophages induced by angiotensin II (Ang II) and its mechanism. MATERIALS AND METHODS: THP-1 cells were adopted for research, and phorbol-12-myristate-13-acetate (PMA) was utilized to induce THP-1 cells to be transformed into macrophages, with Ang II as a stimulating factor and telmisartan as a therapeutic drug. Cell counting kit-8 (CCK8) and lactate dehydrogenase (LDH) were applied to detect cell viability and toxicity. Enzyme-linked immunosorbent assay (ELISA) was performed to measure the MMP-9 release level. Polymerase Chain Reaction (PCR) and Western blotting were conducted to detect the expressions of MMP-9 messenger ribonucleic acid (mRNA) and protein, respectively. The mechanism of action was further studied, and the activity of cyclooxygenase-2 (COX2)/macrophage-expressed gene 1 (mPEG1) pathway was determined via PCR and Western blotting. RESULTS: The 1 mM Ang II could remarkably activate the synthesis and release of MMP-9 as well as the COX2/mPEG1 pathway in macrophages. However, telmisartan could effectively repress the Ang II-induced MMP-9 synthesis and release in the macrophages, and suppress the COX2/mPEG1 pathway in the macrophages activated by Ang II. CONCLUSIONS: Telmisartan can inhibit the activation of MMP-9 in the macrophages by suppressing the COX2/mPEG1 pathway.

Predictive factors for open conversion of laparoscopic adrenalectomy: a 13-year review of 456 cases.

BACKGROUND AND PURPOSE: Laparoscopic adrenalectomy has largely replaced open adrenalectomy for the treatment of adrenal tumor. However, certain cases still require conversion to open procedures. Identifying the risk of conversion remains difficult. This study identified risk factors that may predict conversion from a laparoscopic to an open procedure. PATIENTS AND METHODS: From January 1993 to September 2006, a total of 456 laparoscopic adrenalectomies were performed at two urologic centers. A retrospective analysis of parameters, including tumor size, patient age, American Society of Anesthesiology classification, body mass index (BMI), sex, laparoscopic approach, previous abdominal surgery, laterality, type of tumor, laparoscopist experience, and surgeon, was performed. Multivariate logistic regression was used to identify those variables predicting conversion. RESULTS: A total of 25 (5.5%) laparoscopic adrenalectomies required conversion. Significant predictors of conversion according to univariate analysis were tumor size > or =5 cm, BMI > or =24 kg/m(2), and pheochromocytoma. Multivariate analysis showed that the significant independent predictive factors for conversion were tumor size > or =5 cm (8.884 greater odds ratio [OR] of conversion; 95% confidence interval 3.543, 22.277; P < 0.001), BMI > or = 24 kg/m(2) (OR 3.632; 95% confidence interval 1.367, 9.648; P = 0.010), and pheochromocytoma (OR 3.068; 95% confidence interval 1.175, 8.007; P = 0.022). CONCLUSIONS: Knowledge of tumor size, BMI, and tumor type can help in counseling patients undergoing laparoscopic adrenalectomy with regard to the probability of conversion. The size of the tumor was found to be the most important predictor.

Effect of aging on penile ultrastructure.

AIM: To clarify whether there are anatomical changes in tunica albuginea and corpora cavemosa in aged rats. METHODS: Seventeen male Sprague-Dawley rats were divided into three groups based on age. Group A consisted of young rats (9 weeks), Group B, middle aged rats (14 weeks) and Group C, old rats (62 weeks). The penile samples were obtained and observed under a scanning electron microscope. RESULTS: The thickness (mean +/- SD) of the tunica albuginea was 0.14 +/- 0.02, 0.16 +/- 0.03 and 0.06 +/- 0.02 mm in Groups A, B and C, respectively. The tunica albuginea of group C was significantly thinner than those of the other two groups (P < 0.05) and the elastic fibers were diminished in the old rats. In the corpora cavernosa of old rats, the intracavernous pillars were irregular, in which many large collagen fibers could be observed, and the smooth muscle and elastic fibers were reduced. CONCLUSION: In old rats, the tunica albuginea became thinner with diminished elastic fibers; the collagen fibers of corpora cavernosa were increased while the smooth muscle and elastic fibers were reduced.

ChoICE PT wire for recanalization of chronically occluded coronary arteries: multiple wires in one?

Percutaneous transluminal coronary angioplasty (PTCA) of chronic total occlusions may be technically difficult and the success rate is limited despite increasing operator experience and improvements in PTCA hardware. The number of guidewires required to cross totally occluded lesions is higher than that for stenotic lesions. The ChoICE polymer-tip (PT) wire (Boston Scientific/Scimed, Inc., Maple Grove, Minnesota) is a relatively new stainless-steel core wire with a hydrophilic-coated polyurethane tip. Though never described in the literature, we found that the distal 4 cm of the wire can be cut and reshaped according to the operator's needs. Thus, instead of reshaping a kinked tip or using another new wire, the former being time-consuming and the latter expensive, one can simply cut off the kinked tip and start again with a "new wire." As the tip is resected, the wire becomes progressively more "intermediate-like" and "standard-like." We report our experience with the ChoICE PT wire in 50 consecutive cases of chronic total occlusions. The cumulative crossing success rates were 13/50 (26%) before any resections, 24/50 (48%) after 1 resection, 41/50 (82%) after 2 resections and 42/50 (84%) after 3 resections. There were no perforations, deaths, myocardial infarctions or need for bypass surgery. Our findings suggest that successful recanalization of chronic total occlusions can be achieved with a high success rate using the ChoICE PT wire. A strategy of progressively resecting the more floppy and kinked distal end can provide multiple uses from a single wire, optimizing recanalization success and obviating the need for additional wires.

[Evaluation of clinical application of intravascular ultrasound image].

OBJECTIVE: To prospectively evaluate the clinical applications of intravascular ultrasound (IVUS). METHODS: Four hundred and thirty seven patients with coronary artery disease (CAD) or suspect CAD were imaged with CAD and IVUS, including (1) assessment IVUS in 135 cases with normal coronary angiography (CAG) (2) comparison IVUS with CAG pre and after angioplasty in 52 patients with CAD (3) assessment of detecting calcification lesions with CAG and IVUS in 150 patients (4) predicting the cardiac events after stent implantation guided by IVUS (n = 47) and CAG (N = 53). RESULTS: IVUS may detect coronary atherosclerosis lesions with normal by CAG. CAG overestimated effect of angioplasty. IVUS was more accurate to determine effect and complications of PTCA compared with CAG. IVUS interpreted the mechanism of vessel dilatation in PTCA. The cardiac events after stent implantation were significantly reduced after IVUS examination as compared with CAG. CONCLUSIONS: IVUS represents a radically different approach to vascular anatomy. Unlike angiography, which displays the coronary artery as a silhouette of the contrast-filled lumen, IVUS generates a cross-sectional tomographic image of the lumen and vessel wall. IVUS plays an important role as a guidance in cardiac intervention.