Value of GRACE and SYNTAX scores for predicting the prognosis of patients with non-ST elevation acute coronary syndrome.

BACKGROUND: GRACE and SYNTAX scores are important tools to assess prognosis in non-ST-elevation acute coronary syndrome (NSTE-ACS). However, there have been few studies on their value in patients receiving different types of therapies. AIM: To explore the value of GRACE and SYNTAX scores in predicting the prognosis of patients with NSTE-ACS receiving different types of therapies. METHODS: The data of 386 patients with NSTE-ACS were retrospectively analyzed and categorized into different groups. A total of 195 patients who received agents alone comprised the medication group, 156 who received medical therapy combined with stents comprised the stent group, and 35 patients who were given agents and underwent coronary artery bypass grafting (CABG) comprised the CABG group. General information was compared among the three groups. GRACE and SYNTAX scores were calculated. The association between the relationship between GRACE and SYNTAX scores and the occurrence of major adverse cardiovascular events (MACEs) was analyzed. Pearson's correlation analysis was used to determine the factors influencing prognosis in patients with NSTE-ACS. Univariate and multivariate analyses were conducted to analyze the predictive value of GRACE and SYNTAX scores for predicting prognosis in patients with NSTE-ACS using the Cox proportional-hazards model. RESULTS: The incidence of MACE increased with the elevation of GRACE and SYNTAX scores (all P < 0.05). The incidence of MACE was 18.5%, 36.5%, and 42.9% in the medication group, stent group, and CABG group, respectively. By comparison, the incidence of MACE was significantly lower in the medication group than in the stent and CABG groups (all P < 0.05). The incidence of MACE was 6.2%, 28.0% and 40.0% in patients with a low GRACE score in the medication group, stent group, and CABG group, respectively (P < 0.05). The incidence of MACE was 31.0%, 30.3% and 42.9% in patients with a medium GRACE score in the medication group, stent group, and CABG group, respectively (P > 0.05). The incidence of MACE was 16.9%, 46.2%, and 43.8% in patients with a high GRACE score in the medication group, stent group, and CABG group, respectively (P < 0.05). The incidence of MACE was 16.2%, 35.4% and 60.0% in patients with a low SYNTAX score in the medication group, stent group, and CABG group, respectively (P < 0.05). The incidence of MACE was 37.5%, 40.9%, and 41.7% in patients with a medium SYNTAX score in the medication group, stent group, and CABG group, respectively (P > 0.05). MACE incidence was 50.0%, 75.0%, and 25.0% in patients with a high SYNTAX score in the medication group, stent group, and CABG group, respectively (P < 0.05). Univariate Cox regression analyses showed that both GRACE score (hazard ratio [HR] = 1.212, 95% confidence interval [CI]: 1.083 to 1.176; P < 0.05) and SYNTAX score (HR = 1.160, 95%CI: 1.104 to 1.192; P < 0.05) were factors influencing MACE (all P < 0.05). Multivariate Cox regression analyses showed that GRACE (HR = 1.091, 95%CI: 1.015 to 1.037; P < 0.05) and SYNTAX scores (HR = 1.031, 95%CI: 1.076 to 1.143; P < 0.05) were independent predictors of MACE (all P < 0.05). CONCLUSION: GRACE and SYNTAX scores are of great value for evaluating the prognosis of NSTE-ACS patients, and prevention and early intervention strategies should be used in clinical practice targeting different risk scores.

Differential expression of type I interferon mRNA and protein levels induced by virulent Marek's disease virus infection in chickens.

Marek's disease virus (MDV), an α-herpesvirus targeting avian species, causes fatal Marek's disease (MD) in chickens. The host interferon (IFN) responses play a key role in resisting viral infection. However, host IFN responses following MDV infection in the chicken central immune organs (thymus and bursa of Fabricius), which contain numerous MDV target cells, is poorly understood. In this study, we performed animal experiments in specific pathogen-free chickens infected with two virulent MDV strains (BS/15 and Md5) or without infection as negative controls. Specifically, the type I IFN (IFN-α and IFN-ß) transcriptional and proteomic expression levels at 7, 10, 14, 17, and 21 days post infection (dpi) were detected and analyzed. Our results indicated that the mRNA and protein expression levels of IFN-α and IFN-ß in the thymus and bursa of Fabricius were mainly downregulated in cytolytic infection (such as 10 dpi) and reactivation (such as 17 dpi) stages, but not the latent (such as 14 dpi) stage of MDV infection, which was determined by comprehensively analyzing the MDV viral load and immune organ damage caused by MDV infection. These data suggest that MDV could inhibit the expression of host type I IFNs, which may be involved in the MDV-induced host immunosuppression and contribute to the immune escape of MDV from host immunity. Furthermore, we found that the downregulated expression of the host type I IFNs induced by BS/15 and Md5 infection was significantly different, which we speculated may be related to the diverse virulence and pathogenicity of MDV strains. In conclusion, our study demonstrated that MDV mostly inhibited the expression of type I IFNs in infected hosts, which may be associated to its pathogenesis.

Co-Infection with Marek's Disease Virus and Reticuloendotheliosis Virus Increases Illness Severity and Reduces Marek's Disease Vaccine Efficacy.

Marek's disease virus (MDV) and reticuloendotheliosis virus (REV) cause Marek's disease (MD) and reticuloendotheliosis (RE), respectively. Co-infection with MDV and REV is common in chickens, causing serious losses to the poultry industry. However, experimental studies of such co-infection are lacking. In this study, Chinese field strains of MDV (ZW/15) and REV (JLR1501) were used as challenge viruses to evaluate the pathogenicity of co-infection and the influence of MD vaccination in chickens. Compared to the MDV-challenged group, the mortality and tumor rates increased significantly by 20.0% (76.7 to 96.7%) and 26.7% (53.3 to 80.0%), in the co-challenged group, respectively. The protective index of the MD vaccines CVI988 and 814 decreased by 33.3 (80.0 to 47.7) and 13.3 (90.0 to 76.7), respectively. These results indicated that MDV and REV co-infection significantly increased disease severity and reduced the vaccine efficacy. The MDV genome load showed no difference in the feather pulps and spleen, and pathogenicity-related MDV gene expression (meq, pp38, vIL-8, and ICP4) in the spleen significantly increased at some time points in the co-challenged group. Clearly, synergistic pathogenicity occurred between MDV and REV, and the protective efficacy of existing MD vaccines was attenuated by co-infection with Chinese field MDV and REV strains.

A Chinese Variant Marek's Disease Virus Strain with Divergence between Virulence and Vaccine Resistance.

Marek's disease (MD) virus (MDV) has been evolving continuously, leading to increasing vaccination failure. Here, the MDV field strain BS/15 was isolated from a severely diseased Chinese chicken flock previously vaccinated with CVI988. To explore the causes of vaccination failure, specific-pathogen free (SPF) chickens vaccinated with CVI988 or 814 and unvaccinated controls were challenged with either BS/15 or the reference strain Md5. Both strains induced MD lesions in unvaccinated chickens with similar mortality rates of 85.7% and 80.0% during the experimental period, respectively. However, unvaccinated chickens inoculated with BS/15 exhibited a higher tumor development rate (64.3% vs. 40.0%), but prolonged survival and diminished immune defects compared to Md5-challenged counterparts. These results suggest that BS/15 and Md5 show a similar virulence but manifest with different pathogenic characteristics. Moreover, the protective indices of CVI988 and 814 were 33.3 and 66.7 for BS/15, and 92.9 and 100 for Md5, respectively, indicating that neither vaccine could provide efficient protection against BS/15. Taken together, these data suggest that MD vaccination failure is probably due to the existence of variant MDV strains with known virulence and unexpected vaccine resistance. Our findings should be helpful for understanding the pathogenicity and evolution of MDV strains prevalent in China.

Characterization of a Gallid herpesvirus 2 strain with novel reticuloendotheliosis virus long terminal repeat inserts.

A bacterial artificial chromosome clone, designated LCY, was constructed from a Gallid herpesvirus 2 (GaHV-2) isolate from a GaHV-2 and reticuloendotheliosis virus co-infected clinical sample. The LCY GaHV-2 insert was sequenced and found to consist of 175,319 nucleotides. LCY GaHV-2 open reading frames (ORFs) had a high sequence identity to those of reference strains. The major difference was that two REV long terminal repeats (LTRs), in the same direction, were inserted at the internal repeat short (IRs)/unique short (Us) and Us/terminal repeat short (TRs) junctions. In addition, the a-like sequence and UL36 were different from other strains. Phylogenetic analysis revealed that LCY was closely related to pandemic strains in China. A pathogenicity study and a vaccination-challenge test were performed on LCY and the reference strain, GA. The results showed that LCY induced gross Marek's disease (MD) lesions and mortality in 71.4 and 7.1% of chickens, respectively, which are lower rates than those observed for the reference strain GA (85.7 and 35.7%). The commercially available CVI988 vaccine provided complete protection against LCY and GA (100%). These results showed that the isolate exhibited lower pathogenicity in SPF chickens. This study revealed that a novel pattern of LTR inserts was found in the strain LCY and that the strain was of low virulence. The present work expands the available genetic information for GaHV-2 and will be useful for the control of MD in China.

Lead enrichment in different genotypes of rice grains.

Using environmental scanning electron microscopy and X-ray electron probe microanalysis, the lead content was studied in inner and outer surface of rice glume, surface of caryopsis, center of caryopsis, near aleuronic layer and aleuronic layer in 21 genotypes of rice grains. The results showed that the lead content in different part of 21 genotypes of rice grains changed as inner surface of rice glume > aleuronic layer > near aleuronic layer > surface of caryopsis > outer surface of rice glume > center of caryopsis. There were genetic differences in lead enrichment in different genotypes of rice grains, which reflected as the differences of lead content in the same part and different part of rice grains. In different genotypes of rice grains, there were significant non-linear correlations between lead content in the inner surface of rice glume, center of caryopsis, aleuronic layer and that in the other parts of rice grain. The results also indicated that the lead enrichment in the center of caryopsis regulated by glume and aleuronic layer. In addition, in different genotypes of rice grains, there were differences in regulation of lead enrichment among different parts, which changed non-linearly.

UV-catalytic treatment of spent caustic from ethene plant with hydrogen peroxide and ozone oxidation.

The performance of UV/H2O2, UV/O3 and UV/H2O2/O3 oxidation systems for treating spent caustic from an ethylene plant was investigated. In UV/H2O2 system, with the increase of H2O2 dosage, removal efficiencies of COD and the ratio of biochemical oxygen demand (BOD) to chemical oxygen demand (COD) of the effluent were increased and a better performance was obtained than the H2O2 system alone. In UV/H2O2 system, removal efficiency of COD reach 68% under the optimum condition, and BOD/COD ratio was significantly increased from 0.22 to 0.52. In UV/O3 system, with the increase of O3 dosage, removal efficiency of COD and BOD/COD ratio were increased, and a better performance was obtained than the O3 system alone. Under the optimum condition, removal efficiency of COD was 54%, and BOD/COD ratio was significantly increased from 0.22 to 0.48. In UV/H2O2/O3 system, COD removal efficiency was found to be 22.0% higher than UV/O3 system.