[The value of ischemia modified albumin level for predicting in-hospital mortality in patients with acute aortic dissection].

Objective: To investigate the value of ischemia modified albumin (IMA) level for predicting in-hospital mortality in patients with acute aortic dissection (AAD). Methods: A total of 195 patients with AAD from the Department of Cardio-Vascular Surgery of Affiliated Hospital of North Sichuan Medical College from January 2017 to November 2019 were consecutively collected, with 126 males and 69 females. Based on whether they died during hospitalization or not, these patients were divided into 2 groups: survival group and mortality group. The baseline data and IMA levels at admission of the two groups were recorded. Univariate logistic regression analysis was used to identify the independent risk factors, and multivariate logistic regression analysis was further performed on variables with statistical significance in univariate analysis. The area under the receiver operating characteristic (ROC) curve was calculated to determine the value of IMA for predicting in-hospital mortality in patients with AAD. Results: Forty-two AAD patients died and 153 survived, and the mortality rate was 21.5%. Logistic regression analysis showed that age (OR=2.143,95%CI:1.247-4.826,P=0.011), Stanford type A (OR=6.751,95%CI:3.189-14.291,P<0.001), drug therapy (OR=5.133,95%CI:2.463-10.700,P<0.001), IMA level (OR=4.452,95%CI:2.231-8.953,P=0.004) were independent risk factors for in-hospital mortality in patients with AAD, however surgery was a protective factor (OR=0.195,95%CI:0.093-0.406,P<0.001). The area under the ROC curve for IMA level in predicting in-hospital mortality with AAD was 0.838 (95%CI: 0.774-0.901, P<0.001), with a cut-off value of 86.55 U/ml, and the sensitivity and specificity were 83.3% and 75.2%, respectively. Conclusions: IMA may serve as a simple risk assessment indicator for patients with AAD. IMA level at admission is an independent predictor of in-hospital mortality. For patients with higher IMA level, early surgical intervention should be performed.

[The multicenter study on the registration and follow-up of low anticoagulation therapy for the heart valve operation in China].

OBJECTIVE: To investigate the optimal anticoagulation methods and monitoring strategy for Chinese patients undergoing heart valve replacement, which is potentially quite different from western populations. METHODS: In this multicenter prospective cohort study, the anticoagulation and monitoring strategy data was acquired from 25 773 in-hospital patients in 35 medical centers and 20 519 patients in outpatient clinic in 11 medical centers from January 1st, 2011 to December 31th, 2015. RESULTS: As for in-hospital patients, mean age of study population was (48.6±11.2) years old; main etiology of valve pathology was rheumatic (87.5%) origin among study cohort; 94.8% of study population received mechanical valve implantation; international normalized ratio (INR) monitoring (in all the study centers) and low-intensity anticoagulation strategy (31 hospitals chose target INR range of 1.5-2.5, and actual values of INR among 89.2% of 100 069 in-hospital monitoring samples were 1.5-2.5), with mean actual INR values of 1.84±0.53, and warfarin dosage of (2.82±0.93) mg/d were widely adopted among the study centers; strategies of in-hospital warfarin administration were similar in all the study centers; complication rates of low-intensity anticoagulation strategy were low in severe hemorrhage (0.02%), thrombosis (0.05%), and thromboembolism (0.05%) events, without anticoagulation-related death.As for 18 974 outpatient clinic patients, the follow-up rate was 92.47%, with a total of 30 012 patient-years (Pty). Anticoagulation-related morbidity and mortality rates were 0.67% and 0.15% Pty; major hemorrhage morbidity and mortality rates were 0.25% and 0.13% Pty; thromboembolism morbidity and mortality rates were 0.45% and 0.03% Pty.The mean dosage of warfarin daily dosage was (2.85±1.23) mg/d and INR value was 1.82±0.57.No significant regional difference in the intensity of anticoagulation therapy was noted during the study. CONCLUSIONS: INR can be used as a normalized indicator for intensity of anticoagulation therapy in China.The optimal anticoagulation intensity with INR range from 1.5 to 2.5 is safe and effective for Chinese patients with heart valve replacement, and there is no significant regional difference in the intensity of anticoagulation therapy.

[A multicenter study on the effects of congenital cytomegalovirus infection on hearing loss].

Objective: To assess the clinical features and effectiveness of antiviral therapy in newborns with sensorineural hearing loss (SNHL) caused by congenital congenital cytomegalovirus (cCMV) infection, and to speculate the risk factors for poor hearing outcomes. Methods: A multicenter prospective cohort study wasconducted, enrolling 176 newborns diagnosed with cCMV at four research centers in Zhejiang Province from March 1, 2021, to April 30, 2024. Clinical characteristics at birth were recorded and hearing was followed up. The children were divided into groups based on their condition at birth, specifically into asymptomatic, mild symptom, and moderate to severe symptom groups. Additionally, they were divided into SNHL and normal hearing groups based on the results of air conduction brainstem audiometry at birth. And they were also divided into treatment and untreated groups according to antiviral treatment. Mann Whitney U test, and chi square test were used for inter group comparison to analyze the differences in clinical features between different disease groups, and to analyze the effects of clinical features, antiviral therapy, and other factors on hearing improvement. Logistic regression analysis was employed to identify the risk factors influencing hearing outcomes. Results: Among the cohort of 176 children diagnosed infection with cCMV, 90 cases were male and 86 cases were female. Of these, 79 cases were asymptomatic, 12 cases classified as mild cCMV and 85 cases as moderate to severe cCMV. Fifty cases belonged to SNHL group, with different degrees of severity, including 30 cases of mild, 9 cases of moderate, 5 cases of severe, and 6 cases of extremely severe SNHL. Among the 121 cases in the normal hearing group, 2 cases (1.7%) exhibited late-onset hearing loss despite having normal hearing at birth. Among 81 cases (46.0%) who completed the hearing follow-up, 71 cases (87.7%) had good hearing outcomes and 10 cases (12.3%) had poor hearing outcomes. Among the 81 children, 29 cases (35.8%) had SNHL at birth. During follow-up, the hearing threshold improved in 19 cases (65.5%), remained stable in 7 cases (24.1%) and progressed in 3 cases (10.3%). A total of 26 cases in the treatment group and 55 cases in the untreated group completed the hearing follow-up assessment. The rate of hearing improvement in the treatment group was found to be higher compared to the untreated group (13 cases (50.0%) vs. 6 cases (10.9%), χ2=15.00, P<0.01), with individuals in the treatment group having a 4.58 times greater likelihood of experiencing hearing improvement (RR=4.58,95%CI 1.96-10.70, P<0.05). However, no statistically significant difference was observed in hearing outcomes between the antiviral treatment group and the untreated group (RR=0.90, 95%CI 0.57-1.41, P=0.517). Multivariate analysis further confirmed SNHL (OR=11.58, 95%CI 2.10-63.93, P=0.005) and preterm birth (OR=4.98, 95%CI 1.06-23.41, P=0.042) as independent risk factors for poor hearing outcomes. Conclusions: SNHL resulting from cCMV infection presents symptoms at birth and can be improved by antiviral therapy. Poor hearing outcomes are associated with SNHL and prematurity.

Cycle oxidation behavior and anti-oxidation mechanism of hot-dipped aluminum coating on TiBw/Ti6Al4V composites with network microstructure.

Controlled and compacted TiAl3 coating was successfully fabricated on the network structured TiBw/Ti6Al4V composites by hot-dipping aluminum and subsequent interdiffusion treatment. The network structure of the composites was inherited to the TiAl3 coating, which effectively reduces the thermal stress and avoids the cracks appeared in the coating. Moreover, TiB reinforcements could pin the TiAl3 coating which can effectively improve the bonding strength between the coating and composite substrate. The cycle oxidation behavior of the network structured coating on 873 K, 973 K and 1073 K for 100 h were investigated. The results showed the coating can remarkably improve the high temperature oxidation resistance of the TiBw/Ti6Al4V composites. The network structure was also inherited to the Al2O3 oxide scale, which effectively decreases the tendency of cracking even spalling about the oxide scale. Certainly, no crack was observed in the coating after long-term oxidation due to the division effect of network structured coating and pinning effect of TiB reinforcements. Interfacial reaction between the coating and the composite substrate occurred and a bilayer structure of TiAl/TiAl2 formed next to the substrate after oxidation at 973 K and 1073 K. The anti-oxidation mechanism of the network structured coating was also discussed.

Controllable two-scale network architecture and enhanced mechanical properties of (Ti5Si3+TiBw)/Ti6Al4V composites.

Novel Ti6Al4V alloy matrix composites with a controllable two-scale network architecture were successfully fabricated by reaction hot pressing (RHP). TiB whiskers (TiBw) were in-situ synthesized around the Ti6Al4V matrix particles, and formed the first-scale network structure (FSNS). Ti5Si3 needles (Ti5Si3) precipitated in the ß phase around the equiaxed α phase, and formed the secondary-scale network structure (SSNS). This resulted in increased deformation compatibility accompanied with enhanced mechanical properties. Apart from the reinforcement distribution and the volume fraction, the ratio between Ti5Si3 and TiBw fraction were controlled. The prepared (Ti5Si3 + TiBw)/Ti6Al4V composites showed higher tensile strength and ductility than the composites with a one-scale microstructure, and superior wear resistance over the Ti6Al4V alloy under dry sliding wear conditions at room temperature.

Common genes in coronary artery disease from Europe, Asia and North America regardless of race and lifestyle.

OBJECTIVE: Coronary artery disease (CAD) remains one of the major causes of death worldwide. Despite considerable advances in the prevention and treatment of CAD, its complications, morbidity and mortality still remain very high, and vary widely across different ethnic groups. MATERIALS AND METHODS: To detect genes involved in the development of CAD, we collected gene expression studies in the blood samples of CAD patients from different continents by searching the Gene Expression Omnibus database (GEO), performed a comparative analysis of gene expression between CAD patients and normal controls (NC) in each continent and identified the common set of differentially expressed genes (DEGs) between CAD patients and NC across different continents. PPI networks of the common set of DEGs were established by Cytoscape software to understand their biological role in CAD. RESULTS: A total of 575, 868 and 476 genes were identified to be significantly differentially expressed between CAD patients and NC in Asia, Europe and North America. 24 genes were found common in three different continents, and 6 genes were previously linked to CAD or atherosclerosis. In the PPIs network the significant hub proteins contained IRF4 (Degree = 23), PLAUR (Degree = 17) and HIST1H2AE (Degree = 15). CONCLUSIONS: Not only did we detect gene expression differences in the blood samples between CAD and NC in Asia, Europe and North America population, but analysis of the three population groups revealed a common set of 24 genes regardless of differences related to race, ethnicity, lifestyle, and environmental factor which may provide key factors to understand the pathogenesis of CAD and lead to development of diagnostic markers and/or effective therapeutic strategies.

Percutaneous internal maxillary arterial embolization with ethylcellulose microspheres. Results in an animal model.

RATIONALE AND OBJECTIVES: To investigate the use of ethylcellulose microspheres as long-term and peripheral emboli for percutaneous maxillofacial arterial embolization. METHODS: Eight mongrel dogs were selected randomly for internal maxillary artery embolization with ethylcellulose microspheres. After embolization, angiographic, microangiographic, and histologic examinations were performed. RESULTS: Ethylcellulose microspheres were trapped in the peripheral arterioles from 24 hours to 6 months after embolization. Degenerative changes of maxilla, mandible, and dental pulp occurred after the embolization of the internal maxillary artery with the microspheres. No evidence of whole or focal necrosis of the bones and surrounding soft tissues was found between 24 hours and 6 months after embolization. CONCLUSION: Ethylcellulose microspheres can be used as an alternative long-term and peripheral embolic agent, with potential for percutaneous maxillofacial arterial embolization.

An investigation of pulsatile release tablets with ethylcellulose and Eudragit L as film coating materials and cross-linked polyvinylpyrrolidone in the core tablets.

To develop new pulsatile release tablets, which can suppress drug release in stomach and release the drug rapidly after a predetermined lag time of about 3 h in intestine, the use of tablets with ethylcellulose/Eudragit L as a coating film and cross-linked polyvinylpyrrolidone in the core tablets was investigated. The release of diltiazem hydrochloride (DIL) as a model drug in the core tablets was investigated in vitro. The lag time (t10) was prolonged with an increase of the coating level, whereas the drug release rate was almost constant, irrespective of the coating level. The water-uptake study and electron microscope photographs suggested the mechanism of pulsatile release of drug. Pulsatile release tablets containing 60 mg DIL with 4.4 h of lag time (t10) in vitro were administrated to eight volunteers. The mean plasma concentration curves showed 4.9 h of lag time (tlag), 8.0 h of time to maximum concentration (tmax) and 3.1 h of time between tmax and tlag (t(psi)) in vivo. Relative bioavailability was 1.05 for pulsatile release tablets compared to conventional tablets.

Experimental maxillofacial arterial chemoembolization with encased-cisplatin ethylcellulose microspheres.

PURPOSE: To compare chemoembolization with conventional chemotherapy and explore the possibility of chemoembolization in the oral and maxillofacial region using encased-anticancer-drug microspheres. METHOD: Six mongrel dogs were divided into two equal groups, an experimental group undergoing maxillofacial arterial chemoembolization with cisplatin encased in ethylcellulose microspheres, and a control group undergoing the conventional chemotherapy with cisplatin. The peripheral venous cisplatin concentration and the cisplatin concentration at the local tissue were determined. RESULT: The experiment showed a significant difference in the peripheral venous cisplatin concentration between the two groups and between the time period. There was also a significant interaction between groups and time. The peak concentration in the experimental group appeared 12 to 24 hours after chemoembolization. The peak concentration in the control group appeared immediately after the anticancer drug was infused. There was a significant difference in the concentration in the local tissue between the two groups, when all time periods were aggregated. CONCLUSION: Compared with conventional chemotherapy, the maxillofacial arterial chemoembolization with cisplatin encased in ethylcellulose microspheres significantly decreases the cisplatin concentration in the peripheral venous circulation and increases the concentration in the local tissues, allowing for the possibility of target cancer therapy.

Studies on pathological morphology, clinical features and nuclear DNA contents by flow cytometry in adrenal neoplasms.

Pathological morphology, clinical features and nuclear DNA contents determined by flow cytometry (FCM) were studied in 11 cases of normal adrenals and 41 cases of adrenal neoplasms. It was found that despite differences in clinical manifestations and in degrees of cellular atypia of the adenomas their DNA contents were the same as in normal adrenals. On the other hand, the pheochromocytomas were benign in nature, but most of them (16/19) showed DNA aneuploidy and the DNA indices were correlated with their clinical and morphological features.

Lanthanides enhance pulmonary absorption of insulin.

In an effort to investigate the enhancement effect of lanthanide ions (Ln3+) on the absorption of larger molecules from the pulmonary pathway, insulin (mol. wt. = 5730) was chosen as a model peptide. The absorption of insulin preadministered or coadministered with Ln3+ from the lung was investigated by means of an in situ pulmonary absorption experiment. The enhancement absorption of insulin by Ln3+ ions was evaluated by calculating the various bioavailabilities (Fr) of insulin from pulmonary absorption. Moreover, the temporal change of Gd content in serum was also investigated. Results showed that the promoting effect of Ln3+ on the bioavailability of insulin is closely related to its species, concentration, and delivery order. The effect of the median Ln3+ series was remarkably greater than that of light and heavy Ln3+. The anionic form of Gadolinium (Fr = 68.4%) seemed to be more effective compared with its cationic form (Fr = 59.5%). Coadministration of Gd3+ with insulin (Fr = 80.1%) was the most effective in increasing insulin absorption from the lung. Gd3+ was rapidly absorbed and metabolized to a normal level after 4 h. It was suggested that lanthanides in a very low concentration might become potent absorption enhancers to improve absorption of larger molecules via the pulmonary pathway.

[Study of magnetic microspheres for purging cancer cells from bone marrow. II. Preparation of polystyrene magnetic microspheres. ].

Magnetic microspheres (MS) used to purge tumor cells from human bone marrow were prepared with a two step method. Main factors that can influence the magnetization result were discussed. The MS were coated with polyacrolein which has active aldehyde group. The magnetic material content and the magnetic response of MS were determined and showed that the magnetic material y-Fe(2)O(3) by X-ray diffraction.

[Studies on pharmacokinetics of cisplatin-ethylcellulose microspheres for maxillary arterial embolization in dogs].

This paper reports the preparation and pharmacokinetic studies of DDP-EC-ms. The DDP-EC-ms were infused into the maxillary artery of dogs and DDP were infused into the vein as control. The concentration of DDP in peripheral venous blood and tissue was determined by FAAS. Results showed that the DDP level of DDP-EC-ms in the circulating blood was significantly lower than that in dogs given DDP intravenously. However, a significantly higher DDP concentration in tissues was found in dogs treated with DDP-EC-ms. These facts suggest that maxillary arterial embolization with DDP-EC-ms, which significantly reduced the systematic side effects and increased the level of DDP in the embolized local tissue, could achieve the purpose of targeted cancer therapy.

[Long-term immunogenicity and immunologic priming of animals to pulsed controlled-release system for tetanus toxoid vaccine delivery].

AIM: To evaluate the immunogenicity of tetanus toxoid (TT) encapsulated in biodegradable polymer microspheres composed of polylactide (PLA). METHODS: The antibody levels elicited by microsphere formulations in mice for 1 year were examined, the anamnestic responses to a low dose booster 1 year after priming were also examined. RESULTS: Microsphere formulations made from PLA were characterized by pulse controlled-release models, differing in polymer molecular weight, protein loading and particle size of the microspheres. Microsphere formulations elicited significantly higher IgG antibody levels than a single injection of soluble TT. The antibody levels elicited by microsphere formulations were similar to those elicited by three doses of soluble TT. CONCLUSION: A single-dose tetanus toxoid based on pulsed release from biodegradable and biocompatible polymer microspheres has been developed. The formulations showed great benefits and pharmaceutical application.

[Studies on gelatin microspheres-in-oil emulsion of pingyangmycin].

As a drug for lymphosarcoma, pingyangmycin (A5) is not widely used because of its toxicities, short half-life and low affinity to lymph. For the purpose of delivering A5 to the lymph system to strengthen and sustain its effects and to lower its toxicities, its gelatin microspheres-in-oil emulsion (S/O) was studied in vitro and in vivo. By ultrasonication, gelatin microspheres with diameters of 1.67 +/- 0.69 microns were homogeneously dispersed in oil to form the S/O, which was a pseudoplastic flow and stable under 0 degrees C for at least 1 month. With the content of 14.03 +/- 0.15 mg.ml-1, A5 released from the emulsion in a zero order rate with t0.5 of 12.0 h. In vivo experiments showed that the S/O emulsion exhibited potent lymphotropicity, prolonged plasma concentration and a probably lower pulmonary toxicity.

[Study on the specific killing activity of albumin nanoparticles containing adriamycin targeted by monoclonal antibody BDI-1 to human bladder cancer cells].

A highly specific immuno-nanoparticle (ADR-NP-Ab) has been constituted by chemically coupling a monoclonal antibody BDI-1 to albumin nanoparticle containing adriamycin (ADR-NP). Different molecular ratios of antibody to ADR-NP were tried to determine the optimal condition for preparing the immuno-nanoparticle. The results of immunoflurecence and microphotographic analysis showed that the activity of ADR-NP-Ab was well preserved. The result of the cytotoxicity of ADR-NP-Ab in vitro assay showed strong killing activity of ADR-NP-Ab to bladder cancer cells (EJ), while no apparent cytotoxic activity to non-targeted human colon carcinoma cells (Lovo) was observed.

[Studies on streptomycin albumin microspheres for injection].

Streptomycin albumin microspheres were prepared by polymeric dispersing agents. Some physical properties including the size, distribution and surface state of the microspheres were determined. The results showed that the diameter of the microspheres ranged from 10 to 30 microns and the content was 20.3 +/- 0.5%. Drug release from the microspheres was performed by a dynamic dialysis system. Tissue distribution of streptomycin albumin microspheres in rats was studied by both fluorescein isothiocyanate and 125I labelled microspheres. The experiments revealed that the major part of the microspheres accumulated in the lung following intravenous injection. The effectiveness and side effects of the streptomycin in the microspheres remain to be determined.

[Studies on magnetic responsiveness and renal embolization with magnetic microspheres in dogs].

The responsiveness and transcatheter embolization with magnetic gelatin microspheres (MG-ms) in dog kidney were reported. In experiments with magnet using a constant flow apparatus such as roller pump, the percent retention was determined by counting the carrier retained by the magnetic field and divided by the total starting counts. Factors influencing the percent retention of MG-ms include: velocity of medium flow, magnetic field intensity, alpha-Fe2O3 content in the MG-ms, viscosity of the medium and so on. Transcatheter embolization with MG-ms (10-30 microns) was performed under external magnet control in dog kidney. The result of angiogram and histological section showed that the MG-ms were in the arteries, arterioles, and glomerular capillaries with no adverse reactions. The embolized effect with magnet field was more prominent than the group without magnet field. These results show that the MG-ms is a promising embolic agent for treatment of renal cancer under external magnet control.

[Interactions of insulin with dipalmitoylphosphatidylcholine liposomes].

AIM: To study the interactions of insulin with dipalmitoylphosphatidylcholine liposomes. METHODS: The liposomes were prepared by reverse-phase evaporation vesicle method. The entrapped efficiency, size and distribution of the liposomes were determined, and the influences of insulin on entrapped efficiency, size and distribution of the liposomes were investigated. The influences of liposomes on the fluorescence emission spectra of insulin and the calcein leakage from the liposomes entrapped calcein induced by insulin were measured. RESULTS: Insulin has little influence on the size and distribution of the liposomes while the sizes of the liposomes were about 170-190 nm. The insertion of tyrosine of insulin into dipalmitoylphosphatidylcholine liposomes membrane was not deep. The insulin disturbed the liposomes membrane, induced the calcein leakage from the calcein-loaded liposomes. CONCLUSION: Amphiphilic, example insulin, may disturb the intact membrane of liposome through the interaction either hydrophobic or hydrophilic. The attention should be paid to the entrapment process of peptides into liposomes.

[Characteristics of CDDP-PLA microspheres in vitro and in vivo].

Studies on the drug release in vitro and hepatic arterial chemoembolization in vivo were carried out with the newly developed CDDP-PLA microspheres. The mechanism of the in vitro release was shown to conform to Higuchi equation. After chemoembolization the CDDP-PLA microspheres showed remarkably lower CDDP concentrations in the general circulation and much higher concentrations in the hepatic tissue e. g. up to 21.55 +/- 12.18 micrograms/g at 8 h, which is much higher than that (3.16 +/- 0.09 micrograms/g) of the CDDP in hepatic arterial infusions. Thus, the CDDP-PLA microspheres may improve the curative effects and lower the side effects, especially the kidney toxicity, of the anticancer drug cisplatin.