Transjugular closure of secundum atrial septal defects.

OBJECTIVE: This study reports the results of a steerable delivery system under the guidance of transesophageal echocardiography (TEE) for the treatment of transjugular closure of secundum atrial septal defects (ASD). METHODS: From July 2015 to May 2016, 33 patients underwent transjugular closure of a secundum ASD under general anesthesia with TEE guidance. The right internal jugular vein was punctured and a FuStar™ steerable sheath was implanted into the right atrium and aligned vertically with the septum, and a closure device was deployed to close the defect. RESULTS: Thirty-two patients with an ASD were successfully occluded; one patient required ASD closure on cardiopulmonary bypass. Procedure time ranged from 5 to 15 (8.2 ± 3.8) min. The length of stay was three to five days after the operation. The follow-up time ranged from 1.1 to 11.0 (5.5 ± 1.5) months. There was no valve regurgitation, no malignant arrhythmias, no device dislocation, or other serious complications. CONCLUSIONS: A steerable delivery system under the guidance of TEE is a safe, effective, and cosmetic method for the transjugular closure of secundum ASDs.

Strong Response of Stem Photosynthesis to Defoliation in Mikania micrantha Highlights the Contribution of Phenotypic Plasticity to Plant Invasiveness.

Phenotypic plasticity affords invasive plant species the ability to colonize a wide range of habitats, but physiological plasticity of their stems is seldom recognized. Investigation of the stem plasticity of invasive plant species could lead to a better understanding of their invasiveness. We performed pot experiments involving defoliation treatments and isolated culture experiments to determine whether the invasive species Mikania micrantha exhibits greater plasticity in the stems than do three non-invasive species that co-occur in southern China and then explored the mechanism underlying the modification of its stem photosynthesis. Our results showed that the stems of M. micrantha exhibited higher plasticity in terms of either net or gross photosynthetic rate in response to the defoliation treatment. These effects were positively related to an increased stem elongation rate. The enhancement of stem photosynthesis in M. micrantha resulted from the comprehensive action involving increases in the Chl a/b ratio, D1 protein and stomatal aperture, changes in chloroplast morphology and a decrease in anthocyanins. Increased plasticity of stem photosynthesis may improve the survival of M. micrantha under harsh conditions and allow it to rapidly recover from defoliation injuries. Our results highlight that phenotypic plasticity promotes the invasion success of alien plant invaders.

The safety and effectiveness of salvianolate in preventing perioperative venous thromboembolism in China: A PRISMA-compliant meta-analysis based on RCTs.

BACKGROUND: Salvianolate, a common drug for stabilizing heart disease and Angina Pectoris, is considered to be off-label for preventing venous thromboembolism (VTE) or anticoagulation at present. However, many clinical studies have showed that salvianolate can effectively inhibit the deep-vein thrombosis (DVT) incidence, and prevent VTE of perioperative patients in the real world in China. OBJECTIVE: This analysis aimed to evaluate the effectiveness and safety of salvianolate in preventing VTE in perioperative patients. METHODS: Databases of PubMed, Cochrane Library, Embase, CNKI, Wanfang and VIP were searched until July 2019. Literature retrieval, data extraction and quality assessment were independently completed by two researchers and checked with each other. Review Manager 5.2 software was applied for meta-analysis. RESULTS: A total of 429 studies were retrieved, including 11 randomized controlled trials (RCTs) with a total of 1149 subjects. Compared with low molecular weight heparin (LMWH) group alone, salvianolate combined LMWH group had lower DVT incidence in preventing perioperative thrombosis (2.75% and 14.23%, OR: 0.21, 95% CI:[0.08,0.53]; P = .0009). The incidence of adverse reactions of experimental group was similar to that of control group (1.79% and 2.31%, OR: 0.65, 95% CI:[0.18,2.35]. P = .51). Compared with the control group, D-dimer level (D-D), platelet count (PLT), fibrinogen (FIB), whole blood high shear viscosity (WBHSV), and whole blood low shear viscosity (WBLSV) were all significantly decreased (P < .01), and prothrombin time (PT) was significantly increased (P < .05). CONCLUSION: Salvianolate combined LMWH has better effectiveness and the same safety in preventing venous thromboembolism in perioperative patients. However, due to the small number of included literatures, large sample studies are still needed to further verify this conclusion.

Trajectories of hepatic and coagulation dysfunctions related to a rapidly fatal outcome among hospitalized patients with dengue fever in Tainan, 2015.

BACKGROUND: Hepatic dysfunction and coagulopathy are common in acute dengue illness. We analyzed the trajectories of the above parameters in the survivors and fatal patients in the outbreak in Tainan, 2015. METHODS: A retrospective study was conducted using data from a tertiary hospital between January and December 2015. Multilevel modeling (MLM) was used to identify the changes in aminotransferase (AST), alanine aminotransferase (ALT), activated partial thromboplastin time (aPTT), and platelet counts from Day 0 to Day 7 of the onset of dengue infection. The machine-learning algorithm was used by purity measure assumption to calculate the accuracy of serum transaminases and coagulation variables to discriminate between the fatal and survival groups. RESULTS: There were 4,069 dengue patients, of which 0.9% died in one week after illness onset (i.e., early mortality). Case fatality rate was the highest for those aged ≥70 years. Both AST and ALT values of the fatal group were significantly higher than those of the survivor group from Day 3 (AST median, 624 U/L vs. 60 U/L, p < 0.001; ALT median, 116 U/L vs. 29 U/L, p = 0.01) of illness onset and peaked on Day 6 (AST median, 9805 U/L vs. 90 U/L, p < 0.001; ALT median, 1504 U/L vs. 49 U/L, p < 0.001). AST ≥ 203 U/L, ALT ≥ 55 U/L, AST2/ALT criteria ≥337.35, or AST/platelet count ratio index (APRI) ≥ 19.18 on Day 3 of dengue infection had a high true positive rate, 90%, 78%, 100%, or 100%, respectively, of early mortality. The platelet counts of the fatal group declined significantly than those of the survivor group since Day 3 of illness onset (median, 19 x103/µl vs. 91 x103/µl, p < 0.01), and aPTT values of the fatal group significantly prolonged longer since Day 5 (median, 68.7 seconds vs. 40.1 seconds, p < 0.001). CONCLUSIONS: AST, ALT, and platelet counts should be monitored closely from Day 0 to Day 3 of dengue infection, and aPTT be followed up on Day 5 of infection to identify the individuals at risk for early mortality.

Hexagonal Boron Nitride/Microfibril Cellulose/Poly(vinyl alcohol) Ternary Composite Film with Thermal Conductivity and Flexibility.

Microfibril cellulose (MFC), which is detrimental to soil cultivation and environmental protection, is derived from waste pineapple leaves. Hexagonal boron nitride (h-BN) was modified with polydopamine (PDA)-PDA@h-BN named pBN, and then combined with MFC to prepare a novel hybrid powder. The effect of PDA on h-BN and the binding effect between pBN and MFC were characterized by X-ray photoelectron spectroscopy (XPS), Thermogravimetric (TG), scanning electron microscopy (SEM), and Fourier Transform-Infrared (FT-IR). Poly (vinyl alcohol) (PVA) was used as an eco-friendly polymeric matrix to prepare a pBN-MFC-PVA composite film. The mechanical strength, hydrophobicity, and thermal conductivity of the film were studied and the results confirmed that h-BN was chemically modified with PDA and was uniformly distributed along the MFC. The thermal conductivity of the pBN-MFC-PVA composite film increased with the addition of a pBN-MFC novel powder. MFC acted as "guides" to mitigate the h-BN agglomerate. In addition to the possible usage in the pBN-MFC-PVA composite film itself, the pBN-MFC hybrid powder may be a potential filler candidate for manufacturing thermal interface materials and wearable devices or protective materials.

[Sonographic features and clinical significance of transrectal ultrasonography in obstructive azoospermia].

OBJECTIVE: To investigate the ultrasonographic features of obstructive azoospermia and to evaluate transrectal ultrasonography in the diagnosis of the disease. METHODS: We performed transrectal ultrasonography for 248 patients with obstructive azoospermia, observed the sonographic features of the prostate gland, seminal vesicle and ejaculatory duct. RESULTS: The average volume of the prostate gland of the studied group was 13.2 ml. A total of 111 cases showed normal sonographic features, 39 cases bilateral seminal vesicle defect, 33 cases bilateral seminal vesicle aplasia, 23 cases unilateral seminal vesicle defect and contralateral seminal vesicle aplasia, 28 cases bilateral and 14 cases unilateral seminal vesicle dilatation. Of the 42 cases of seminal vesicle dilatation, 18 had ejaculatory duct dilatation and 17 had cysts in the midline of the prostate. CONCLUSION: Obstructive azoospermia varies in kind. Transrectal ultrasonography can reveal the details of the prostate, seminal vesicle and ejaculatory duct and help to classify obstructive azoospermia and determine the location of the lesion.

Clinical significance of costimulatory molecules CD40/CD40L and CD134/CD134L in coronary heart disease: A case-control study.

The aim of the study was to evaluate the potential role of CD40/CD40 ligand (CD40L) and CD134/CD134 ligand (CD134L) in the development of coronary heart disease (CHD) via the performance of a case-control study.The research objects were 234 cases of CHD patients and 120 cases of well-matched normal controls. Following the separation of peripheral blood mononuclear cells (PBMCs), real-time quantitative PCR (qRT-PCR), Western blot, immunohistochemistry, and flow cytometry were applied for the detection of mRNA levels and expression levels of CD40/CD40L and CD134/CD134L; meanwhile, intercellular adhesion molecule-1 (ICAM-1) and Fas protein mRNA levels were detected using qRT-PCR.There was no statistical difference in the comparison of baseline characteristics between groups, indicating comparability between groups. qRT-PCR and Western blot analysis indicated that CD40/CD40L and CD134/CD134L mRNA and protein expression levels were all increased in the CHD group than those in the control group. Flow cytometry further confirmed the similar tendency. Meanwhile, ICAM-1 and Fas protein mRNA levels were elevated in the CHD group and positively correlated with the above parameters. Furthermore, CD40/CD40L expression rates were negatively correlated with gender and different types of CHD. Meanwhile, CD134/CD134L expressions were also higher in male patients, in patients with family history, previous history of hypertension, diabetes, and cerebrovascular diseases.CD40/CD40L and CD134/CD134L are increased and may have potential correlation with clinical pathological features of patients with CHD. Further in-depth exploration of costimulatory molecules for CHD guidance as well as intrinsic mechanisms are needed combined with in vivo and in vitro experiments.

[Diagnostic value of urodynamic parameters multianalysis in the evaluation of bladder outlet obstruction resulting from benign prostatic hyperplasia].

OBJECTIVE: To construct a function model that can be used in the diagnosis bladder outlet obstruction (BOO) resulting from benign prostatic hyperplasia, and to develop a diagram allowing the judgement of bladder outlet for patients with different detrusor contractility, especially with impaired one. METHODS: Urodynamic and clinical data of 131 men were analyzed retrospectively. By Logistic analysis, a function model was constructed. Based on the model, a diagram allowing the evaluation of bladder outlet was drawn. The cutoff point for diagnosing BOO with the function model and the curve was confirmed by ROC curve analysis. RESULTS: The function model (BOOI) was obtained by the formula 5.03 x residual fraction + 0.04 x PdetatQmax - 0.20 x Qmax - 0.91 + alpha (alpha = 0 for those with low pressure-low flow on P-FS, alpha = 1.42 for high pressure-low flow, alpha = -7.30 for high pressure-high flow). The cutoff point for BOOI diagnosing BOO was 0.36. When validated, the sensitivity, specificity, positive predictive value, and negative predictive value were 85.7%, 91.7%, 96.0% and 73.3% respectively. CONCLUSION: The BOOI, with an easy calculation mode, could predict the probability of BOO. The sensitivity and specificity of the criterion for the diagnosis of BOO were satisfactory. The curve we drew could help to differentiate the obstructed men with low pressure-low flow and thus benefit them by surgical relief of their obstruction.

[Clinical research on auricular point therapy for 1477 cases of biased constitution].

OBJECTIVE: To observe the efficacy of biased constitution patients treated by auricular point therapy on the basis of "preventive treatment" theory. METHODS: By means of self-control, 1477 cases of biased constitution were regulated by auricular point sticking therapy or acupuncture, and follow-up and statistical analysis were conducted to observe the efficacy. RESULTS: There were 322 markedly effective patients, 914 effective patients, 241 failed patients and the total effective rate was 83.7% (1236/1477). CONCLUSION: The comprehensive auricular treatment which is easy to operate and acceptable for patients has obvious effect in biased constitution patients. As a new direction of the "preventive treatment" theory, it can be promoted to be a new intervention way of health care.