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Aspheric cylindrical lenses, including fast axis collimators (FACs), are commonly used to collimate laser beams in the fast axis direction. Precision glass molding (PGM) is applied in the production of these optical lenses due to its high accuracy and efficiency. However, the profile errors and surface topography transferred from the mold reduce the optical performance of aspheric cylindrical lenses. In this paper, the surface errors of a FAC fabricated by combining ultraprecision diamond cutting and precision glass molding are analyzed. An optical simulation model is then established to qualitatively analyze the effects of tool marks on the optical defects, and the numerical calculations are carried out to determine the relative intensity distribution of light spots. Experiments are conducted to verify the theoretical results, which prove that the tool marks cause diffractive fringes and that the geometric parameters of the tool marks that are caused by cutting conditions affect the distribution of the fringe line defects. Finally, the critical conditions to eliminate diffractive fringes and improve the optical performance of the FAC are determined based on the experimental results.
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Integrating geometric and diffractive optics functions is urgently needed to develop compact equipment for integrating diffraction manipulation and arrayed outputs. In this Letter, a superimposed three-level-grooved surface is proposed to manipulate the diffraction of visible light and provide an array output. Structure design, vibration-assisted fly-cutting, finite-difference time-domain calculations, and diffraction tests are conducted to fabricate the three-level grooves and explore the diffraction mechanism. Nanogrooves with a period close to the middle wavelength of the spectrum primarily enhances the diffraction at low diffraction orders and angles because of resonance. Optical tests prove that these superimposed three-level nanogrooves have a large bandwidth when providing the array output and serving to control and transmit diffracted light. They also show stronger performance for manipulating low diffraction orders.
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Hypertrophic cardiomyopathy (HCM) patients with nonvalvular atrial fibrillation (AF) have an increased risk of suffering thromboembolic events. Vitamin K antagonists (VKA) are recommended as therapy but there is still limited data regarding the efficacy of prescribing non-vitamin K antagonist oral anticoagulants (NOACs). This retrospective study investigates the effectiveness and safety of NOAC administration in patients with HCM and AF. A total of 124 patients with HCM and AF on an oral anticoagulant therapy were recruited between January 2015 and December 2019; these patients were followed up until March 31, 2020. Kaplan-Meier analysis was used to compare the clinical outcomes in patients treated with NOACs versus warfarin. The Cox model was used to estimate the risk of clinically relevant bleeding. Our study included 124 patients, of which 48 (38.7%) received warfarin and 76 (61.3%) received NOACs. Survival analysis showed the patients undergoing NOACs had a lower risk of clinically relevant bleeding (log-rank P = 0.039) over a period of 53.6 months. The median time in therapeutic range (TTR) score was 50% (interquartile range: 40.43 to 57.08%). A total of nine patients (18.75%) had a good TTR with a median score of 66.35% (interquartile range: 64.58 to 77.75%). The incidence of death by all causes, cardiovascular death and thromboembolism were similar between NOAC and warfarin-treated patients (log-rank P = 0.239, log-rank P = 0.386, and log-rank P = 0.257, respectively). Patients treated with NOACs showed a significant reduction in the risk of clinical (P = 0.011) and gastrointestinal bleeding (P = 0.032). Cox multiple regression analysis showed age (HR 1.13, 95% CI 1.03-1.24; P = 0.013) and warfarin therapy (HR 7.37, 95% CI 1.63-33.36; P = 0.010) were independent predictors of clinically relevant bleeding. Compared to warfarin, NOACs were associated with a lower incidence of clinically relevant bleeding in HCM patients with AF, as demonstrated by the similar incidence of death by all causes, cardiovascular death and thromboembolic events.
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Fibrilación Atrial , Cardiomiopatía Hipertrófica , Accidente Cerebrovascular , Tromboembolia , Administración Oral , Anticoagulantes , Fibrilación Atrial/complicaciones , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/tratamiento farmacológico , Cardiomiopatía Hipertrófica/complicaciones , Cardiomiopatía Hipertrófica/diagnóstico , Cardiomiopatía Hipertrófica/tratamiento farmacológico , Fibrinolíticos/uso terapéutico , Hemorragia Gastrointestinal/inducido químicamente , Humanos , Estudios Retrospectivos , Accidente Cerebrovascular/epidemiología , Tromboembolia/epidemiología , Tromboembolia/etiología , Tromboembolia/prevención & control , WarfarinaRESUMEN
The structural coloration of glass induced by submicron structures is eco-friendly, ink-free, and has profound scientific significance. However, it is difficult to manufacture the submicron structures for glass optics due to the high hardness of glass and the miniature size of the microstructures. In this paper, the diffraction manipulation mechanism of groove shape to structural coloration and optimization theory are studied by establishing the theoretical and simulation mode. Moreover, a newly-developed axial-feed fly-cutting (AFC) technology and the PGM technology are introduced to precisely create the designed submicron V-shape grooves and structural color pattern on a Ni-P mold and then replicating them on a glass surface. Between these two kinds of typical submicron grooves that can be machined by mechanical cutting technology, it is found that the diffraction intensity and efficiency of V-shape grooves are higher than these of jagged-shape grooves, which indicates that V-shape grooves is more suitable to be used for structural coloration with high brightness. The structural color resolution is dramatically increased with the reduction of groove spacing and can be flexibly regulated by AFC, which significantly contributes to the structural coloration manufacturing. Structural pixel segments composed of submicron grooves are arranged row-by-row to form color patterns, and the letters of different colors are fabricated on the mold and transferred to the glass surface. Methods of optical diffraction manipulation, flexible manufacturing of submicron structures, and structural color image construction proposed in this paper for the production of a structural color pattern are beneficial to a wide range of fields.
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Although graphite materials have been applied as commercial anodes in lithium-ion batteries (LIBs), there still remain abundant spaces in the development of carbon-based anode materials for sodium-ion batteries (SIBs). Herein, an electrospinning route is reported to fabricate nitrogen-doped carbon nanofibers with interweaved nanochannels (NCNFs-IWNC) that contain robust interconnected 1D porous channels, produced by removal of a Te nanowire template that is coelectrospun within carbon nanofibers during the electrospinning process. The NCNFs-IWNC features favorable properties, including a conductive 1D interconnected porous structure, a large specific surface area, expanded interlayer graphite-like spacing, enriched N-doped defects and active sites, toward rapid access and transport of electrolyte and electron/sodium ions. Systematic electrochemical studies indicate that the NCNFs-IWNC exhibits an impressively high rate capability, delivering a capacity of 148 mA h g-1 at current density of as high as 10 A g-1 , and has an attractively stable performance over 5000 cycles. The practical application of the as-designed NCNFs-IWNC for a full SIBs cell is further verified by coupling the NCNFs-IWNC anode with a FeFe(CN)6 cathode, which displays a desirable cycle performance, maintaining acapacity of 97 mA h g-1 over 100 cycles.
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Three-dimensional (3D) bioprinting has become a flexible tool in regenerative medicine with potential for various applications. Further development of the new 3D bioprinting field lies in suitable bioink materials with satisfied printability, mechanical integrity, and biocompatibility. Natural polymers from marine resources have been attracting increasing attention in recent years, as they are biologically active and abundant when comparing to polymers from other resources. This review focuses on research and applications of marine biomaterials for 3D bioprinting. Special attention is paid to the mechanisms, material requirements, and applications of commonly used 3D bioprinting technologies based on marine-derived resources. Commonly used marine materials for 3D bioprinting including alginate, carrageenan, chitosan, hyaluronic acid, collagen, and gelatin are also discussed, especially in regards to their advantages and applications.
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Organismos Acuáticos/química , Materiales Biocompatibles/química , Biopolímeros/química , Bioimpresión , Impresión Tridimensional , Gelatina/química , Humanos , Polisacáridos/química , Medicina Regenerativa/métodos , Ingeniería de Tejidos/métodos , Andamios del Tejido/químicaRESUMEN
Pregnane X receptor (PXR) is a member of nuclear receptor superfamily and responsible for the detoxification of xenobiotics. Our previously study demonstrated that PXR is expressed in endothelial cells (ECs) and acts as a master regulator of detoxification genes to protect ECs against xenobiotics. Vascular endothelial cells are key sentinel cells to sense the pathogens and xenobiotics. In this study, we examined the potential function of PXR in the regulation of innate immunity in vasculatures. Treatments with PXR agonists or overexpression of a constitutively active PXR in cultured ECs increased gene expression of the key pattern recognition receptors, including Toll-like receptors (TLR-2, -4, -9) and NOD-like receptors (NOD-1 and -2 and NLRP3). In particular, PXR agonism triggered the activation of NLRP3 inflammasome and the ensuing cleavage and maturation of caspase-1 and interleukin-1ß (IL-1ß). Conversely, selective antagonism or gene silencing of PXR abrogated NLRP3 inflammasome activation. In addition, we identified NLRP3 as a transcriptional target of PXR by using the promoter-reporter and ChIP assays. In summary, our findings revealed a novel regulatory mechanism of innate immune by PXR, which may act as a master transcription factor controlling the convergence between the detoxification of xenobiotics and the innate immunity against them.
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Proteínas Portadoras/metabolismo , Células Endoteliales/metabolismo , Inmunidad Innata , Inflamasomas/metabolismo , Receptores de Esteroides/metabolismo , Xenobióticos/metabolismo , Secuencia de Aminoácidos , Animales , Sitios de Unión , Proteínas Portadoras/genética , Bovinos , Regulación de la Expresión Génica , Técnicas de Silenciamiento del Gen , Células Hep G2 , Células Endoteliales de la Vena Umbilical Humana/metabolismo , Humanos , Datos de Secuencia Molecular , Proteína con Dominio Pirina 3 de la Familia NLR , Receptor X de Pregnano , Receptores de Reconocimiento de Patrones/genética , Receptores de Reconocimiento de Patrones/metabolismo , Receptores de Esteroides/agonistas , Receptores de Esteroides/antagonistas & inhibidores , Elementos de Respuesta/genéticaRESUMEN
As highly promising devices for odor recognition, current electronic noses are still not comparable to human olfaction due to the significant disparity in the number of gas sensors versus human olfactory receptors. Inspired by the sniffing skills of wine tasters to achieve better odor perception, a multiple overlapping sniffs (MOSS) strategy is proposed in this study. The MOSS strategy involves rapid and continuous inhalation of odorants to stimulate the sensor array to generate feature-rich temporal signals. Computational fluid dynamics simulations are performed to reveal the mechanism of complex dynamic flows affecting transient responses. The proposed strategy shows over 95% accuracy in the recognition experiments of three gaseous alkanes and six liquors. Results demonstrate that the MOSS strategy can accurately and easily recognize odors with a limited sensor number. The proposed strategy has potential applications in various odor recognition scenarios, such as medical diagnosis, food quality assessment, and environmental surveillance.
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Odorantes , Vino , Humanos , Nariz Electrónica , Olfato/fisiología , Monitoreo del AmbienteRESUMEN
Tissue injury is a collective term for various disorders associated with organs and tissues induced by extrinsic or intrinsic factors, which significantly concerns human health. In vivo bioprinting, an emerging tissue engineering approach, allows for the direct deposition of bioink into the defect sites inside the patient's body, effectively addressing the challenges associated with the fabrication and implantation of irregularly shaped scaffolds and enabling the rapid on-site management of tissue injuries. This strategy complements operative therapy as well as pharmacotherapy, and broadens the therapeutic horizon for tissue injuries. The implementation of in vivo bioprinting requires targeted investigations in printing modalities, bioinks, and devices to accommodate the unique intracorporal microenvironment, as well as effective integrations with intraoperative procedures to facilitate its clinical application. In this review, we summarize the developments of in vivo bioprinting from three perspectives: modalities and bioinks, devices, and clinical integrations, and further discuss the current challenges and potential improvements in the future.
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Large skin defects caused by accidents or disease can cause fluid loss, water and electrolyte disorders, hypoproteinemia and serious infection and remain a difficult problem in clinical practice. In situ bioprinting is a promising, recently developed technology that involves timely, customized, and morphologically adapted bioprinting of bioink into tissue defects to promote the recovery of human tissues or organs. During this process, bioink is a key factor. In this study, we synthesized a biocompatible, photosensitive hydrogel material comprising gelatin methacrylate (GelMA) for robot-assisted in situ bioprinting of skin wounds. The results showed that GelMA demonstrated good printability of that supported the proliferation of skin-derived precursors (SKPs) and maintained their properties. Furthermore, in situ bioprinting of GelMA hydrogels with epidermal stem cells (Epi-SCs) and SKPs onto skin wounds showed complete wound healing and functional tissue skin regeneration. The regenerated skin contains epidermis, dermis, blood vessels, hair follicles, and sebaceous glands and resembling native skin. These results provide an effective strategy for skin repair through the combined application of GelMA hydrogels, Epi-SCs, SKPs and in situ bioprinting and its promising clinical translational potential for further applications.
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Bioimpresión , Robótica , Humanos , Gelatina/farmacología , Folículo Piloso , Hidrogeles/farmacología , Metacrilatos , Células Madre , Materiales Biocompatibles , Ingeniería de Tejidos , Andamios del TejidoRESUMEN
Superalloy parts place high demands on machined surface integrity and serviceability. In the machining process of superalloys, the cutting fluid is usually used to improve the machining performance. Cutting fluids with cooling and lubrication functions have a relatively large effect on the surface microstructure and residual stress as well. The corrosion damage caused by cutting fluid to the machined surface, during machining and residual, are also worth considering. In this paper, the machining performance of typical binary Ni Cr solid solution, age-hardened, nickel-based superalloy NiCr20TiAl T6, under two commonly used cutting fluids, Blasocut and E709, was analyzed, including cutting performance, surface quality, machining surface corrosion characteristics, and so on. The results showed that the surface residual stress could be improved by adding both cutting fluids compared with the deionized water. Blasocut had better lubrication properties, which could reduce friction and heat production. Pitting holes were found on the polished surface after 45 days with E709 cutting fluid, which was more corrosive than Blasocut. According to this research, a reasonable cutting fluid can be selected to reduce the surface corrosion and improve the service life and performance of parts.
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The machining process of aluminum alloy usually produces built-up edge and tool sticking problems due to their low hardness and large plastic deformation, which may further affect the machined surface quality and tool life. This paper aims to investigate the influence of different cutting fluids on the machined surface quality and tool life during the milling process of 7050 aluminum alloy. A novel cutting fluid (QC-2803) was considered in the study, which is synthesized by addition of alkyl alcohol amide and chlorinated polyolefin, and the traditional cutting fluid (CCF-10) was used as the control group. The physical and chemical properties of two cutting fluids were characterized. The milling process of 7050 aluminum alloy was carried out under two different cutting fluid conditions. The machined surface morphology, cutting force and tool wear morphology were observed during the process. Results show that the surface tension of the novel cutting fluid is significantly lower than that of the traditional cutting fluid, which makes it easier to produce a lubricating film between the aluminum alloy and tool, and further benefits the machined surface quality and tool life. As a result, the surface roughness and cutting force are reduced by ~20.0% and ~42.9%, respectively, and the tool life is increased by 25.6% in the case of the novel cutting fluid (QC-2803). The results in this paper revealed the important laws of cutting fluid with metal surface quality, cutting performance and tool wear, which helps to control the machined surface quality and tool life by the selection of cutting fluid during metal milling.
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Osteosarcoma (OS) is the most common primary cancer in the skeletal system, characterized by a high incidence of lung metastasis, local recurrence and death. Systemic treatment of this aggressive cancer has not improved significantly since the introduction of chemotherapy regimens, underscoring a critical need for new treatment strategies. TRAIL receptors have long been proposed to be therapeutic targets for cancer treatment, but their role in osteosarcoma remains unclear. In this study, we investigated the expression profile of four TRAIL receptors in human OS cells using total RNA-seq and single-cell RNA-seq (scRNA-seq). The results revealed that TNFRSF10B and TNFRSF10D but not TNFRSF10A and TNFRSF10C are differentially expressed in human OS cells as compared to normal cells. At the single cell level by scRNA-seq analyses, TNFRSF10B, TNFRSF10D, TNFRSF10A and TNFRSF10C are most abundantly expressed in endothelial cells of OS tissues among nine distinct cell clusters. Notably, in osteoblastic OS cells, TNFRSF10B is most abundantly expressed, followed by TNFRSF10D, TNFRSF10A and TNFRSF10C. Similarly, in an OS cell line U2-OS using RNA-seq, TNFRSF10B is most abundantly expressed, followed by TNFRSF10D, TNFRSF10A and TNFRSF10C. According to the TARGET online database, poor patient outcomes were associated with low expression of TNFRSF10C. These results could provide a new perspective to design novel therapeutic targets of TRAIL receptors for the diagnosis, prognosis and treatment of OS and other cancers.
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Previously, 12 protease-deficient mutants of the Xanthomonas oryzae pv. oryzicola (Xoc) RS105 strain were recovered from a Tn5-tagged mutant library. In the current study, the Tn5 insertion site in each mutant was mapped. Mutations in genes encoding components of the type II secretion apparatus, cAMP regulatory protein, integral membrane protease subunit, S-adenosylmethionine decarboxylase proenzyme and extracellular protease (ecpA(Xoc)) either partially or completely abolished extracellular protease activity (ECPA) and reduced virulence in rice. Transcription of ecpA(Xoc) was induced in planta in all the mutants except RΔecpA. Complementation of RΔecpA with ecpA(Xoc) in trans restored ECPA, virulence and bacterial growth in planta. Purified EcpA(Xoc) induced chlorosis- and necrosis-like symptoms similar to those induced by the pathogen when injected into rice leaves. Heterologous expression of ecpA(Xoc) conferred ECPA upon the vascular bacterium X. oryzae pv. oryzae (Xoo) and upon non-pathogenic Escherichia coli. Genetic analysis demonstrated that the C-terminal residues of EcpA in Xoo PXO99(A) and Xoc RS105 are different, and a frame shift in ecpA(Xoo) may explain the absence of EcpA activity in Xoo. Collectively, these results suggest that EcpA(Xoc) is a tissue-specific virulence factor for Xoc but not Xoo, although the two pathovars are closely related bacterial pathogens of rice.
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Oryza/microbiología , Péptido Hidrolasas/genética , Péptido Hidrolasas/metabolismo , Enfermedades de las Plantas/microbiología , Xanthomonas/enzimología , Xanthomonas/patogenicidad , Elementos Transponibles de ADN , Escherichia coli/enzimología , Escherichia coli/genética , Escherichia coli/patogenicidad , Perfilación de la Expresión Génica , Prueba de Complementación Genética , Mutagénesis Insercional , Virulencia , Factores de Virulencia/genética , Factores de Virulencia/metabolismoRESUMEN
Percutaneous coronary intervention (PCI) with stent implantation is one of the most effective treatments for cardiovascular diseases (CVDs). However, there are still many complications after stent implantation. As a medical device with a complex structure and small size, the manufacture and post-processing technology greatly impact the mechanical and medical performances of stents. In this paper, the development history, material, manufacturing method, and post-processing technology of vascular stents are introduced. In particular, this paper focuses on the existing manufacturing technology and post-processing technology of vascular stents and the impact of these technologies on stent performance is described and discussed. Moreover, the future development of vascular stent manufacturing technology will be prospected and proposed.
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Skin acts as an essential barrier, protecting organisms from their environment. For skin trauma caused by accidental injuries, rapid healing, personalization, and functionality are vital requirements in clinical, which are the bottlenecks hindering the translation of skin repair from benchside to bedside. Herein, we described a novel design and a proof-of-concept demonstration of an adaptive bioprinting robot to proceed rapid in situ bioprinting on a full-thickness excisional wound in mice. The three-dimensional (3D) scanning and closed-loop visual system integrated in the robot and the multi-degree-of-freedom mechanism provide immediate, precise, and complete wound coverage through stereotactic bioprinting, which hits the key requirements of rapid-healing and personalization in skin repair. Combined with the robot, epidermal stem cells and skin-derived precursors isolated from neonatal mice mixed with Matrigel were directly printed into the injured area to replicate the skin structure. Excisional wounds after bioprinting showed complete wound healing and functional skin tissue regeneration that closely resembling native skin, including epidermis, dermis, blood vessels, hair follicles and sebaceous glands etc. This study provides an effective strategy for skin repair through the combination of the novel robot and a bioactive bioink, and has a promising clinical translational potential for further applications.
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Magnesium alloys have been widely used as lightweight engineering structural materials, but their service performances are severely restricted by corrosion failure. In this paper, the influence of corrosive medium and surface defect energy on the corrosion behavior of rolled ZK61M alloy was investigated. The corrosion tests were conducted in different concentrations of sodium chloride solution for different durations, and the polarization curves and electrochemical impedance spectroscopy were reported. The surface morphology of rolled ZK61M alloy before and after corrosion tests were analyzed. The results showed that the corrosion tendency became stronger with the increase of the concentration of corrosive medium and the number of surface defects of ZK61M alloy. Moreover, the initial corrosion pattern was the pitting caused by micro galvanic corrosion at the surface defect, which gradually developed into uniform corrosion. Furthermore, the main damage occurred at the grain boundary, resulting in the destruction of grain bonding force and the removal of material along the rheological layer. The oxidation corrosion mechanism was mainly the anodic dissolution mechanism.
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Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the joints and is associated with excessive immune cell infiltration. However, the complex interactions between the immune cell populations in the RA synovium remain unknown. Here, we demonstrate that inflammatory macrophages in the synovium exacerbate neutrophil-driven joint damage in RA through ADP/P2Y1 signaling. We show that extracellular ADP (eADP) and its receptors are obviously increased in synovial tissues of RA patients as well as collagen-induced arthritis (CIA) mice, and eADP enhances neutrophil infiltration into joints through macrophages producing the chemokine CXCL2, aggravating disease development. Accordingly, the arthritis mouse model had more neutrophils in inflamed joints following ADP injection, whereas P2Y1 deficiency and pharmacologic inhibition restored arthritis severity to basal levels, suggesting a dominant role of ADP/P2Y1 signaling in RA pathology. Moreover, cellular activity of ADP/P2Y1-mediated CXCL2 production was dependent on the Gαq/Ca2+-NF-κB/NFAT pathway in macrophages. Overall, this study reveals a non-redundant role of eADP as a trigger in the pathogenesis of RA through neutrophil recruitment and disrupted tissue homeostasis and function.
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Artritis Experimental , Artritis Reumatoide , Adenosina Difosfato/metabolismo , Animales , Artritis Experimental/metabolismo , Artritis Experimental/patología , Artritis Reumatoide/patología , Humanos , Macrófagos , Ratones , Neutrófilos/metabolismoRESUMEN
OBJECTIVE: Primary OA and Kashin-Beck disease (KBD) show similar pathological changes in articular cartilage. The objective was to screen differentially expressed genes between OA and normal cartilage, confirm the candidate gene expression among OA, KBD and normal cartilage, and then clarify its role in vitro. METHODS: Differentially expressed genes in OA cartilage were screened by suppression subtractive hybridization (SSH) and verified by real-time quantitative PCR (Q-PCR) analysis. Heparan sulphate 6-O-sulphotransferase 2 (HS6ST2) expression was identified by Q-PCR and immunohistochemistry. After suppressing HS6ST2 by RNA interference in C28/I2 human chondrocyte line, the effects were analysed through determining the cell viability by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), the aggrecan contents by toluidine blue staining and the mRNA expression levels of SRY-type high mobility group box 9 (SOX9), AGC1, MMP3, a disintegrin and metalloproteinase domain with thrombospondin motifs 4 (ADAMTS4) and ADAMTS5 by Q-PCR. RESULTS: HS6ST2 in the reverse subtraction library was identified as a down-regulated gene in OA and KBD at both mRNA and protein levels. The percentage of safranion O staining area was correlated positively with the percentage of HS6ST2-positive chondrocytes in OA and KBD cartilage. After HS6ST2-specific short interfering RNA (siRNA) transfection to C28/I2 cells, the cell viability was inhibited significantly, and the mRNA expression levels of SOX9 and AGC1 were reduced markedly, while MMP3 expression was increased significantly. CONCLUSION; HS6ST2 down-regulation was identified in both OA and KBD cartilage. The findings first suggest that HS6ST2 may participate in the pathogenesis of OA and KBD by influencing aggrecan metabolism.
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Agrecanos/metabolismo , Condrocitos/metabolismo , Enfermedad de Kashin-Beck/genética , Osteoartritis/genética , Sulfotransferasas/genética , Proteínas ADAM/metabolismo , Adulto , Anciano , Análisis de Varianza , Cartílago Articular/metabolismo , Línea Celular , Supervivencia Celular/fisiología , ADN Complementario/metabolismo , Regulación hacia Abajo , Femenino , Expresión Génica , Humanos , Masculino , Metaloproteinasa 3 de la Matriz/metabolismo , Persona de Mediana Edad , Fenotipo , ARN Mensajero/metabolismo , ARN Interferente Pequeño/farmacología , Factor de Transcripción SOX9/metabolismo , TransfecciónRESUMEN
ABSTRACT: We aimed to identify potential clinical predictors associated with the risk of fulminant myocarditis, and further to establish and assess a nomogram model based on significant attributes for clinical practicability.This is a retrospective, cross-sectional study, involving 28 patients with fulminant myocarditis and 35 age-, and sex-matched patients with non-fulminant myocarditis. Effect-size estimates are expressed as odds ratio (OR) and 95% confidence interval (CI).Fifteen factors were primarily identified to be associated with the significant risk of fulminant myocarditis after adjusting for confounders. Due to strong correlation, 6 factors were retained, including mean arterial pressure (OR, 95% CI, P: .82, .72-.94, .005), creatinine (2.15, 1.13-4.10, 0.020), blood urea nitrogen (1.45, 1.04-2.02, 0.028), aspartate aminotransferase (2.62, 1.16-5.91, 0.021), troponin I (1.43, 1.07-1.90, 0.015), and ventricular wall motion abnormality (25.81, 2.52-264.69, 0.006). The contribution of the 6 significant factors to predicting fulminant myocarditis risk was significant from multi-angle analyses, and regressing these factors in a nomogram model exhibited good predictive accuracy, as reflected by both C-index (>90%, Pâ<â.001).We have identified 6 clinical factors in significant association with fulminant myocarditis, and their prediction capability was more obvious in a nomogram model. Further investigations with larger sample sizes and longer follow-up intervals are warranted.