Stop Ischemic Event to the Brain: Screening Risk Factors of Cerebrovascular Stenosis in Coronary Artery Disease Patients.

OBJECTIVES: In this study, we investigated the difference in risk factors between the 2 diseases, aiming to further clarify who needs to do ischemic cerebrovascular disease (ICVD)-related screening among coronary artery disease (CAD) patients. METHODS: Clinical data of 326 patients with first-episode CAD from June 1, 2017, to July 31, 2020, in the Chinese PLA General Hospital were retrospectively reviewed. Outcomes, including clinical features and laboratory examination, were taken. Features related to ICVD including the extension of intracranial arterial (internal carotid artery intracranial segment, middle cerebral artery M1 segment, anterior cerebral A1 segment, vertebrobasilar artery intracranial segment, posterior cerebral artery P1 segment) and carotid arterial (internal carotid artery extracranial segment, common carotid artery, subclavian artery) stenosis were detected. Risk factors for the occurrence of ICVD in patients with CAD were analyzed. RESULTS: Among patients with the onset of CAD, in comparison of the nonstenosis and stenosis of intracranial artery subgroups, there were statistical differences in the onset age, hypertension, and duration of hypertension as well as the biochemical indicators, including high-density lipoprotein and glycosylated hemoglobin. In addition, statistical differences were detected in the onset age as well as the biochemical indicators, including glycosylated hemoglobin and blood glucose serum protein, along with the difference in the degree of cardiovascular stenosis. CONCLUSIONS: The onset age of CAD was shown to serve as a vital risk factor for ICVD. The primary prevention of ICVD in patients with CAD should lay more emphasis on the management of hypertension and diabetes.

Development of unenhanced CT-based imaging signature for BAP1 mutation status prediction in malignant pleural mesothelioma: Consideration of 2D and 3D segmentation.

OBJECTIVES: We aimed to explore the feasibility of 2D and 3D radiomics signature based on the unenhanced computed tomography (CT) images to predict BRCA1-associated protein 1 (BAP1) gene mutation status for malignant pleural mesothelioma (MPM) patients. MATERIALS AND METHODS: 74 patients with MPM were retrospectively enrolled (22 mutant BAP1, 52 wild-type BAP1 demonstrated by Sanger sequencing). The radiomic features were extracted respectively from the 2D and 3D segmentation of unenhanced pre-treatment CT images, and the dataset was randomly divided into training (n = 51) and test (n = 23) sets for radiomics model development and internal validation. The synthetic minority over-sampling technique (SMOTE) was used for data balancing in the training set. 2D or 3D features were sequentially selected by ICC > 0.8, correlation analysis (cut-value 0.7), univariate analysis or univariate logistic regression (LR), which were involved into multivariate LR for LR model construction. Following the comparison of the 2D and 3D models by the ROC analysis and Delong test for AUC, the calibration and clinical utility of 2D and 3D models were evaluated. RESULTS: 3D radiomic features showed better ICCs compared with 2D in both intra- (P < 0.001) and inter-observer (P < 0.001) analysis. 3D radiomic model based on selected features developed from a balanced training dataset presented a favorable predictive performance with AUC of 0.786 and 0.768 in the training and test sets, respectively. The predictive performance of 3D model was superior to 2D model (1 feature) both in the training (AUC 0.786 vs. 0.683, P = 0.036) and the test (AUC 0.768 vs.0.652, P = 0.441) set. The calibration curve and decision curves also indicate a better BAP1 prediction performance and clinical benefit for 3D model than that of 2D model. CONCLUSION: The developed unenhanced CT-based 3D radiomics signature is potential as a noninvasive marker for predicting BAP1 mutation status.

Functional changes of the lateral pterygoid muscle in patients with temporomandibular disorders: a pilot magnetic resonance images texture study.

BACKGROUND: Texture features were the intrinsic properties of the human tissues and could efficiently detect the subtle functional changes of involved tissue. The pathologic changes of the lateral pterygoid muscle (LPM) were significantly correlated with the temporomandibular disc displacement. However, the occult functional changes of LPM could not be detected by the naked eye on the medical images. The current study was aimed to evaluate the functional changes of the LPM in the patients with temporomandibular disorders (TMDs) using texture analysis. METHODS: Twenty-nine patients with TMD were performed with magnetic resonance (MR) imaging on a 3.0T MR scanner, who were consecutively recruited from the TMD clinic of Hainan Hospital of Chinese People's Liberation Army General Hospital from February 2019 to September 2019. The patients were classified into three groups according to the disc displacement: disc without displacement (DWoD), disc displacement with reduction (DDWR) and disc displacement without reduction (DDWoR). The gray-level co-occurrence matrix method was applied with the texture analysis of LPM on the axial T2-weighted imaging. The texture features included angular second moment, contrast, correlation, inverse different moment, and entropy. One-way analysis of variance was used for grouped comparisons and receiver operating characteristics (ROC) curve analysis was applied to evaluate the diagnostic efficacy of the texture parameters. RESULTS: Texture contrast of LPM presented significantly lower in DDWoR (46.30 [35.03, 94.48]) than that in DWoD (123.85 [105.06, 143.23]; test statistic = 23.05; P < 0.001). Texture entropy of LPM showed significant differences among DWoD (7.62 ±â€Š0.33), DDWR (6.76 ±â€Š0.35), and DDWoR (6.46 ±â€Š0.39) (PDWoD-DDWR < 0.001, PDWoD-DDWoR < 0.001, and PDDWR-DDWoR = 0.014). Area under the ROC curve (AUC) demonstrated that texture entropy had an excellent diagnostic accuracy for DWoD-DDWR (AUC = 0.96) and DWoD-DDWoR (AUC = 0.98). CONCLUSION: The texture contrast and entropy could identify the altered functional status of LPM in patients with TMD and could be considered as the effective imaging biomarker to evaluate the functional changes of LPM in TMD.

GC-MS based metabolomics strategy to distinguish three types of acute pancreatitis.

Acute pancreatitis (AP) is a progressive systemic inflammatory response with high morbidity and high mortality, which is mainly caused by alcohol, bulimia, gallstones and hyperlipidemia. The early diagnosis of different types of AP and further explore potential pathophysiological mechanism of each type of AP is beneficial for optimized treatment strategies and better patient's care. In this study, a metabolomics approach based on gas chromatography-mass spectrometry (GC-MS), and random forests algorithm was established to distinguish biliary acute pancreatitis (BAP), Hyperlipidemia acute pancreatitis (HLAP), and alcoholic acute pancreatitis (AAP), from healthy controls. The classification accuracies for BAP, HLAP, and AAP patients compared with healthy control, were 0.886, 0.906 and 0.857, respectively, by using 5-fold cross-validation method. And some special metabolites for each type of AP were discovered, such as l-Lactic acid, (R)-3-Hydroxybutyric acid, Phosphoric acid, Glycine, Erythronic acid, l-Phenylalanine, d-Galactose, l-Tyrosine, Arachidonic acid, Glycerol 1-hexadecanoate. Furthermore, associations between these metabolites with the metabolism of amino acids, fatty acids were identified. Our studies have illuminated the biomarkers and physiological mechanism of disease in a clinical setting, which suggested that metabolomics is a valuable tool for identifying the molecular mechanisms that are involved in the etiology of BAP, AAP, HLAP and thus novel therapeutic targets.

Identification of potential diagnostic biomarkers of acute pancreatitis by serum metabolomic profiles.

Acute pancreatitis (AP) is defined as an acute inflammation of pancreas that may cause damage to other tissues and organs depending upon the severity of symptoms. The diagnosis of AP is usually made by detection of raised circulating pancreatic enzyme levels, but there are occasional false positive and false negative diagnoses and such tests are often normal in delayed presentations. More accurate biomarkers would help in such situations. In this study, the global metabolites' changes of AP patients (APP) were profiled by using gas chromatography-mass spectrometry (GC-MS). Multivariate pattern recognition techniques were used to establish the classification models to distinguish APP from healthy participants (HP). Some significant metabolites including 3-hydroxybutyric acid, phosphoric acid, glycerol, citric acid, d-galactose, d-mannose, d-glucose, hexadecanoic acid and serotonin were selected as potential biomarkers for helping clinical diagnosis of AP. Furthermore, the metabolite changes in APP with severe and mild symptoms were also analyzed. Based on the selected biomarkers, some relevant pathways were also identified. Our results suggested that GC-MS based serum metabolomics method can be used in the clinical diagnosis of AP by profiling potential biomarkers.

Combination of a Copper-Ion Selective Electrode and Fluorometric Titration for the Determination of Copper(II) Ion Conditional Stability Constants of Humic Substances.

A fluorescence quenching model using copper(II) ion (Cu(2+)) ion selective electrode (Cu-ISE) is developed. It uses parallel factor analysis (PARAFAC) to model fluorescence excitation-emission matrices (EEMs) of humic acid (HA) samples titrated with Cu(2+) to resolve fluorescence response of fluorescent components to Cu(2+) titration. Meanwhile, Cu-ISE is employed to monitor free Cu(2+) concentration ([Cu]) at each titration step. The fluorescence response of each component is fit individually to a nonlinear function of [Cu] to find the Cu(2+) conditional stability constant for that component. This approach differs from other fluorescence quenching models, including the most up-to-date multi-response model that has a problematic assumption on Cu(2+) speciation, i.e., an assumption that total Cu(2+) present in samples is a sum of [Cu] and those bound by fluorescent components without taking into consideration the contribution of non-fluorescent organic ligands and inorganic ligands to speciation of Cu(2+). This paper employs the new approach to investigate Cu(2+) binding by Pahokee peat HA (PPHA) at pH values of 6.0, 7.0, and 8.0 buffered by phosphate or without buffer. Two fluorescent components (C1 and C2) were identified by PARAFAC. For the new quenching model, the conditional stability constants (logK1 and logK2) of the two components all increased with increasing pH. In buffered solutions, the new quenching model reported logK1 = 7.11, 7.89, 8.04 for C1 and logK2 = 7.04, 7.64, 8.11 for C2 at pH 6.0, 7.0, and 8.0, respectively, nearly two log units higher than the results of the multi-response model. Without buffer, logK1 and logK2 decreased but were still high (>7) at pH 8.0 (logK1 = 7.54, logK2 = 7.95), and all the values were at least 0.5 log unit higher than those (4.83 ~ 5.55) of the multi-response model. These observations indicate that the new quenching model is more intrinsically sensitive than the multi-response model in revealing strong fluorescent binding sites of PPHA in different experimental conditions. The new model was validated by testing it with a mixture of two fluorescing Cu(2+) chelating organic compounds, i.e., l-tryptophan and salicylic acid mixed with one non-fluorescent binding compound oxalic acid titrated with Cu(2+) at pH 5.0.

[Adsorption of calcium ion from aqueous solution using Na(+)-conditioned clinoptilolite for hot-water softening].

This work investigated adsorptive removal of calcium ion (Ca2+) by virtue of Na(+) -conditioned clinoptilolite simulating the process of softening for industrial hot-water system. Influential factors such as the activation/regeneration of sorbent and solution pH were tested. The kinetics/thermodynamics for adsorption of Ca2+ were analyzed and discussed. Results showed that: (1) The adsorption rate was in good agreement with the pseudo-second order kinetic models, and the process of adsorption better followed the Langmuir model; (2) Higher solution temperature allowed an enhanced efficiency on Ca2+ removal, albeit the maximum adsorption capacity of Na(+)-conditioned clinoptilolite was hardly affected; (3) The process of adsorption was dominated by chemisorption, and also characterized by entropy increase with spontaneous/endothermic nature; (4) Solution temperature was suggested to be controlled within the range of 6 to 10, and more than 9 times of sorbent regeneration could be ensured for an effective adsorption towards Ca2+ with initial concentration less than 20 mg x L(-1). It was demonstrated that the activated clinoptilolite should be a promising alternative adsorbent for industrial hot-water softening.

[The relationship between matrix metalloproteinase-9, high-sensitivity C-reactive protein and stroke of stable stage].

OBJECTIVE: Plasma levels of matrix metalloproteinase-9 (MMP-9) and serum level of high-sensitivity C reactive protein (hs-CRP) were detected to investigate their distributions between patients with stable stroke and those with asymptomatic intracranial artery stenosis and to explore their clinical significance. METHODS: The mean level of the serum hs-CRP of the group with recurrent stroke (2.34 mg/L) was the highest, followed by that of the group with the stable stroke (1.45 mg/L), asymptomatic intracranial artery stenosis (1.31 mg/L) and control group (0.96 mg/L) (P = 0.001). The level of the MMP-9 was in sequence of recurrent stroke group (121.82 ± 72.99) µg/L > asymptomatic intracranial artery stenosis group (119.18 ± 80.01) µg/L > stable stroke group (112.76 ± 59.66) µg/L, while no statistical significance was found among groups (P = 0.947). However, the level of MMP-9 of three patient groups (118.08 ± 71.06) µg/L was significant higher than control group (57.55 ± 10.44) µg/L (P < 0.001). The spearman analysis for the relationship showed that the concentration of MMP-9 was positively associated with that of hs-CRP (r = 0.337, P < 0.001). CONCLUSIONS: The hs-CRP maintained a high level in stable stage of stroke. The MMP-9 level in the patients group was significant higher than control group and the level of MMP-9 was positively associated with that of hs-CRP which suggested MMP-9 might be correlated with atherosclerosis other than stroke occurrence.

[Enrichment of denitrifying phosphate accumulating organisms in sequencing batch membrane bioreactors].

The enrichment and characteristics of denitrifying phosphate accumulating organisms (DPAO), which are capable of utilizing nitrate as electron acceptor, was investigated in a laboratory-scale sequencing batch membrane bioreactors (SBMBR). The results demonstrated that the proportion of DPAO increased from 19.4% to 69.6% of total phosphate accumulating organisms after anaerobic-aerobic and anaerobic-anoxic-aerobic phases. SBMBR system could operate steadily when 120 mg nitrate was added continuously during the anoxic phase every period. Simultaneous phosphate uptake and biological denitrification with good performance could be obtained in SBMBR operated in steady-state. Nitrate and phosphorus removal efficiency were above 100% and 84% respectively during anoxic phase, however, the effluent TP concentration was low than 0.5 mg/L, the total phosphorus removal efficiency was 96.1%. Furthermore, the ammonium nitrogen removal efficiency of SBMBR could be maintained at 92.2%, and the cumulation of nitrite and nitrate was not observed clearly.

[Effect of activated sludge properties on short-term membrane fouling in submerged membrane bioreactor based on statistical analysis].

The influence of activated sludge properties on membrane fouling was investigated using statistical method. The results show that extracelluler polymeric substances (EPS), soluble microbial products (SMP), suspended solids in the supernatant (SSs), dynamic viscosity (micro), relative hydrophobicity (RH) and Zeta potential all have a significant influence on membrane permeability during microfiltration of activated sludge wastewater. The pearson's correlation coefficient (r(p)) for linear correlations between membrane fouling resistance and these sludge properties are 0.898, 0.712, 0.810, 0.691, 0.837, -0.881, respectively. The statistical results also show that SMP, micro, SSs, Zeta potential, and RH are mostly determined by EPS, indicating that EPS is the main and essential factor affecting membrane fouling in activated sludge properties. The pearson's correlation coefficient (r(p)) for linear correlations between total EPS and other sludge properties are 0.682, 0.633, 0.783, -0.953, 0.877, respectively. EPS should be controlled in the operation of membrane bioreactor to achieve a suitable permeation.

[Comparisons of simultaneous phosphorus and nitrogen removal in sequencing batch membrane bioreactors].

Two SBMBRs run in AO and A2O mode were operated in parallel to compare their ability of simultaneous phosphorus and nitrogen removal. The results showed that the removals of COD and ammonium nitrogen were averaged over 90% and 95%, respectively. A2O MBR has the stronger anaerobic phosphorus release ability; its SPRR30 outdoes 47.5% compared to AO MBR. SPUR30 of A2O MBR was lower which may attribute to the higher effluent TP content. The ratio of DPAO was enhanced 57% compared to AO MBR. And when nitrate as the only electron accepter, the phosphorus uptake mass with unit electron transfer was 30% higher in A2O MBR. This two factors lead to the stronger denitrifying phosphorus removal ability of A2O MBR. Furthermore, the membrane fouling was mitigated in A2O MBR though the aerobic time was half to that of AO MBR. The membrane filter function made SBMBR's effluent free of the sludge settlement ability.

Cultivation of aerobic granules for simultaneous nitrification and denitrification by seeding different inoculated sludge.

Cultivation of aerobic granules for simultaneous nitrification and denitrification in two sequencing batch airlift bioreactors was studied. Conventional activated floc and anaerobic granules served as main two inoculated sludge in the systems. Morphological variations of sludge in the reactors were observed. It was found that the cultivation of aerobic granules was closely associated with the kind of inoculated sludge. Round and regular aerobic granules were prevailed in both reactors, and the physical characteristics of the aerobic granules in terms of settling ability, specific gravity, and ratio of water containing were distinct when the inoculate sludge was different. Aerobic granules formed by seeding activated floc are more excellent in simultaneous nitrification and denitrification than that by aerobic granules formed from anaerobic granules. It was concluded that inoculated sludge plays a crucial role in the cultivation of aerobic granules for simultaneous nitrification and denitrification.