Inferring Mycobacterium Tuberculosis Drug Resistance and Transmission using Whole-genome Sequencing in a High TB-burden Setting in China.

Objective: China is among the 30 countries with a high burden of tuberculosis (TB) worldwide, and TB remains a public health concern. Kashgar Prefecture in the southern Xinjiang Autonomous Region is considered as one of the highest TB burden regions in China. However, molecular epidemiological studies of Kashgar are lacking. Methods: A population-based retrospective study was conducted using whole-genome sequencing (WGS) to determine the characteristics of drug resistance and the transmission patterns. Results: A total of 1,668 isolates collected in 2020 were classified into lineages 2 (46.0%), 3 (27.5%), and 4 (26.5%). The drug resistance rates revealed by WGS showed that the top three drugs in terms of the resistance rate were isoniazid (7.4%, 124/1,668), streptomycin (6.0%, 100/1,668), and rifampicin (3.3%, 55/1,668). The rate of rifampicin resistance was 1.8% (23/1,290) in the new cases and 9.4% (32/340) in the previously treated cases. Known resistance mutations were detected more frequently in lineage 2 strains than in lineage 3 or 4 strains, respectively: 18.6% vs. 8.7 or 9%, P < 0.001. The estimated proportion of recent transmissions was 25.9% (432/1,668). Multivariate logistic analyses indicated that sex, age, occupation, lineage, and drug resistance were the risk factors for recent transmission. Despite the low rate of drug resistance, drug-resistant strains had a higher risk of recent transmission than the susceptible strains (adjusted odds ratio, 1.414; 95% CI, 1.023-1.954; P = 0.036). Among all patients with drug-resistant tuberculosis (DR-TB), 78.4% (171/218) were attributed to the transmission of DR-TB strains. Conclusion: Our results suggest that drug-resistant strains are more transmissible than susceptible strains and that transmission is the major driving force of the current DR-TB epidemic in Kashgar.

Interval from transurethral resection of prostate to laparoscopic radical prostatectomy does not affect outcomes for incidental prostate cancer.

Introduction: Laparoscopic radical prostatectomy (LRP) has become a common option for the treatment of prostate cancer. The aim of our study was to examine whether LRP performed within 12 weeks of transurethral resection of the prostate (TURP) is associated with surgical difficulty or outcomes. Material and methods: A single-institutional retrospective analysis was performed on patients who underwent LRP for incidental prostate cancer after TURP between July 2009 and December 2017. The interval between TURP and LRP was determined and patients with intervals of ≤ 12 weeks were compared to those with intervals of > 12 weeks. Patient characteristics, perioperative, pathological, and postoperative functional outcomes were analyzed to determine statistically significant differences between the 2 groups. Multivariable analyses were performed to determine whether the interval between TURP and LRP was a significant independent predictor of these outcomes. Results: A total of 56 incidental prostate cancer patients detected by TURP were included in this study. No significant differences were detected in estimated blood loss, operative duration, postoperative length of stay, and rate of positive margin, Gleason score upgrading, major complications, incontinence and prostate-specific antigen (PSA) recurrence in patients with a TURP to LRP interval above and below 12 weeks. The TURP to LRP interval was not an independent predictor of outcomes during or after LRP. Conclusions: Our results showed that performing LRP within 12 weeks after TURP does not adversely influence surgical difficulty or outcomes.

Evaluating the impact of China's MSW sorting pilot policy on urban sustainable development: Empirical evidence from 95 cities.

The escalating challenge of municipal solid waste (MSW) critically tests the sustainable development capacities of urban centers. In response, China initiated pilot policies in 2017 aimed at bolstering MSW management. The effectiveness of these initiatives, however, necessitates empirical scrutiny. This study leverages panel data spanning 95 cities at the prefectural level or higher, covering the period from 2006 to 2020, to assess the impact of the MSW sorting pilot policy on urban sustainable development using a difference-in-differences approach. The research found that the MSW sorting pilot policy has significantly increased the processing volume of MSW, thereby enhancing the sustainable development capabilities of cities. Further, the study identifies augmented fixed asset investments as a key mechanism through which pilot cities have enhanced their MSW management capabilities. Notably, the policy's stimulative effects are more pronounced in less densely populated and economically lagging regions. These findings provide critical insights for developing nations in shaping MSW sorting strategies and advancing urban sustainability.

A novel approach for transforming breast cancer stem cells into endothelial cells.

Tumor vascular endothelial cells play a pivotal in the tumor microenvironment, influencing the proliferation, invasion, and metastasis of tumor progression. The present study investigated a novel method for inducing the transformation of breast cancer stem cells into endothelial cells, providing a cellular model investigating anti-angiogenic mechanisms in vitro. The breast cancer cell line MCF-7 was used, and the expression of CD133 was initially detected using flow cytometry. CD133+ breast cancer cells were purified using immunomagnetic bead sorting technology, yielding an MCF-7CD133+ subpopulation. The proliferation ability of these cells was assessed using an MTT assay, while their microsphere formation ability was evaluated using a microsphere formation assay. Post-transformation in an optimized endothelial cell culture medium, expression of endothelial cell markers CD31 and CD105 were detected using flow cytometry. Endothelial cell tube formation assays and DiI-labeled acetylated low-density lipoprotein (DiI-Ac-LDL) assays were employed to analyze the endothelial cell function of the MCF-7CD133+ cells. MDM2/CEN12 gene amplification was detected through fluorescence in situ hybridization (FISH). The MCF-7 breast cancer cell line exhibited 1.7±0.3% trace cells expressing the stem cell surface marker CD133. After anti-CD133 immunomagnetic bead sorting, MCF-7CD133+ and MCF-7CD133- subpopulation cells were obtained, with CD133 expression rates of 85.6±2.8 and 0.18±0.08%, respectively. MTT assay results demonstrated that, after 7 days, the proliferation rate of MCF-7CD133+ cells was significantly higher compared with MCF-7CD133- cells. MCF-7CD133+ subpopulation cells displayed strong stem cell characteristics, growing in suspension in serum-free media and forming tumor cell spheres. In contrast, MCF-7CD133- cells failed to form microspheres. After culturing cells in endothelial cell differentiation and maintenance media, the percentage of MCF-7CD133+ cells before and after endothelial cell culture was 0.3±0.16 and 81.4±8.37% for CD31+ cells and 0.2±0.08 and 83.8±7.24% for CD105+ cells, respectively. Vascular-like structure formation and Ac-LDL phagocytosis with red fluorescence in the tube formation assays confirmed endothelial cell function in the MCF-7CD133+ cells. FISH was used to verify MDM2/CEN12 gene amplification in the induced MCF-7CD133+ cells, indicating tumor cell characteristics. The modified endothelial cell transformation medium effectively induced differentiated tumor stem cells to express vascular endothelial cell markers and exhibit endothelial functions, ideal for in vitro anti-angiogenesis research.

Association of multiple blood metals and systemic atherosclerosis: A cross-sectional study in the CAD population.

BACKGROUND: Coronary atherosclerotic disease (CAD) is often accompanied by peripheral atherosclerosis, resulting in a higher risk of ischemia and cardiovascular death. Exposure to metals is associated with atherosclerotic plaques at specific sites. However, less is known about the effects of mixed metals on systemic atherosclerotic burden in CAD patients. OBJECTIVES: To investigate the association of metal mixtures with systemic atherosclerotic burden in a CAD population. METHODS: A cross-sectional study including 1562 CAD patients from Southwest China was conducted. The levels of 10 blood metals were measured via inductively coupled plasma spectrometry. More than one vessel with a stenosis ≥50% vessel diameter was defined as CAD. Carotid and lower limb atherosclerosis was assessed by using ultrasound, and coronary atherosclerosis was quantified via arterial angiography. Systemic atherosclerosis was scored according to the presence or absence of lesions at the three sites and the total number of lesions. To investigate the combined impacts and interaction effects of metals, Bayesian kernel machine regression was used. Weighted quantile regression was used to identify the contributions of the metals. RESULTS: Significant overall associations of mixed metals with systemic atherosclerotic burden were found. These positive overall associations were mainly driven by Cd, Cu and Pb in systemic atherosclerosis. The main contributing factors were As and Cu for coronary atherosclerosis as well as Cd, Cu and Pb for carotid and lower limb atherosclerosis. Cd and Pb or Cr can interact, and Pb interacts with age, sex and alcohol. CONCLUSIONS: In CAD patients, exposure to combinations of metals was highly positively associated with systemic atherosclerotic burden. These significant trends were more pronounced in the peripheral arteries and carotid arteries. Controlling environmental metal exposure can contribute to reducing systemic atherosclerosis in CAD patients.

Scalable Face Image Coding via StyleGAN Prior: Toward Compression for Human-Machine Collaborative Vision.

The accelerated proliferation of visual content and the rapid development of machine vision technologies bring significant challenges in delivering visual data on a gigantic scale, which shall be effectively represented to satisfy both human and machine requirements. In this work, we investigate how hierarchical representations derived from the advanced generative prior facilitate constructing an efficient scalable coding paradigm for human-machine collaborative vision. Our key insight is that by exploiting the StyleGAN prior, we can learn three-layered representations encoding hierarchical semantics, which are elaborately designed into the basic, middle, and enhanced layers, supporting machine intelligence and human visual perception in a progressive fashion. With the aim of achieving efficient compression, we propose the layer-wise scalable entropy transformer to reduce the redundancy between layers. Based on the multi-task scalable rate-distortion objective, the proposed scheme is jointly optimized to achieve optimal machine analysis performance, human perception experience, and compression ratio. We validate the proposed paradigm's feasibility in face image compression. Extensive qualitative and quantitative experimental results demonstrate the superiority of the proposed paradigm over the latest compression standard Versatile Video Coding (VVC) in terms of both machine analysis as well as human perception at extremely low bitrates (< 0.01 bpp), offering new insights for human-machine collaborative compression.

Dmbg-Net: Dilated multiresidual boundary guidance network for COVID-19 infection segmentation.

Accurate segmentation of infected regions in lung computed tomography (CT) images is essential for the detection and diagnosis of coronavirus disease 2019 (COVID-19). However, lung lesion segmentation has some challenges, such as obscure boundaries, low contrast and scattered infection areas. In this paper, the dilated multiresidual boundary guidance network (Dmbg-Net) is proposed for COVID-19 infection segmentation in CT images of the lungs. This method focuses on semantic relationship modelling and boundary detail guidance. First, to effectively minimize the loss of significant features, a dilated residual block is substituted for a convolutional operation, and dilated convolutions are employed to expand the receptive field of the convolution kernel. Second, an edge-attention guidance preservation block is designed to incorporate boundary guidance of low-level features into feature integration, which is conducive to extracting the boundaries of the region of interest. Third, the various depths of features are used to generate the final prediction, and the utilization of a progressive multi-scale supervision strategy facilitates enhanced representations and highly accurate saliency maps. The proposed method is used to analyze COVID-19 datasets, and the experimental results reveal that the proposed method has a Dice similarity coefficient of 85.6% and a sensitivity of 84.2%. Extensive experimental results and ablation studies have shown the effectiveness of Dmbg-Net. Therefore, the proposed method has a potential application in the detection, labeling and segmentation of other lesion areas.

A Co-Sputtering Process Optimization for the Preparation of FeGaB Alloy Magnetostrictive Thin Films.

A co-sputtering process for the deposition of Fe0.8Ga0.2B alloy magnetostrictive thin films is studied in this paper. The soft magnetic performance of Fe0.8Ga0.2B thin films is modulated by the direct-current (DC) sputtering power of an FeGa target and the radio-frequency (RF) sputtering power of a B target. Characterization results show that the prepared Fe0.8Ga0.2B films are amorphous with uniform thickness and low coercivity. With increasing FeGa DC sputtering power, coercivity raises, resulting from the enhancement of magnetism and grain growth. On the other hand, when the RF sputtering power of the B target increases, the coercivity decreases first and then increases because of the conversion of the films from a crystalline to an amorphous state. The lowest coercivity of 7.51 Oe is finally obtained with the sputtering power of 20 W for the FeGa target and 60 W for the B target. Potentially, this optimization provides a simple way for improving the magnetoelectric coefficient of magnetoelectric composite materials and the sensitivity of magnetoelectric sensors.

Spatio-temporal variation and environmental drivers of chlorophyll a concentration and diatom community in four small urban lakes of Kunming, China.

Chlorophyll a (Chla) and diatom community structure are two indicators of lake water quality. In this study, we investigated the environmental parameters, chlorophyll a, and diatom community of four small urban lakes in Kunming (Beitan, Beihu, Nanhu and Longtan lakes in the campus of Yunnan Normal University) between March 2017 and December 2019. The results showed that the concentrations of total nitrogen (TN), total phosphorus (TP), and Chla in the four lakes showed significant seasonal fluctuation. The Chla concentration in Nanhu Lake, which had the highest nutrient level among the four lakes, was significantly higher than that in the other three lakes and largely affected by TN. In comparison, water temperature significantly contributed to the increases in Chla concentration in the other three lakes. Water temperature and TN were significantly correlated with Chla across the four lakes. Diatom assemblages in Beitan, Nanhu, and Longtan lakes were dominated by planktonic diatoms, and benthic diatoms were dominant in the shallowest lake Beihu, suggesting that water depth significantly affected the proportion of planktonic diatoms and dominant taxa. Water depth, TN, TP, transparency, and water temperature affected the spatio-temporal changes of diatom community structure, with water temperature as the major factor in causing the seasonal variation in diatom community, and TN and TP as the major drivers for community variation among lakes within the same season.

A Flexible Pressure Sensor Based on Graphene/Epoxy Resin Composite Film and Screen Printing Process.

At present, flexible pressure-sensitive materials generally have problems with weak adhesion and poor wear resistance, which easily result in friction failure when used for plantar pressure detection. In this study, a flexible pressure sensor with the advantages of a wide detection range, fast recovery, and good abrasive resistance was designed and prepared based on the screen printing process. The pressure-sensitive unit with a structural size of 5 mm× 8 mm was a functional material system due to the use of graphene and epoxy resin. The influence of the different mass ratios of the graphene and epoxy resin on the sensing properties was also studied. The test results showed that when the mass ratio of graphene to epoxy resin was 1:4, the response time and recovery time of the sensing unit were 40.8 ms and 3.7 ms, respectively, and the pressure detection range was 2.5-500 kPa. The sensor can detect dynamic pressure at 0.5 Hz, 1 Hz, 2 Hz, 10 Hz, and 20 Hz and can withstand 11,000 cycles of bending. In addition, adhesion tests showed that the high viscosity of the epoxy helped to improve the interlayer bond between the pressure-sensitive materials and the flexible substrate, which makes it more suitable for plantar pressure detection environments, where friction is common.

High-Efficiency and Reliable Value Geometric Standard: Integrated Periodic Structure Reference Materials.

Integrated periodic structure reference materials are crucial for calibration in optical instruments and micro-computed tomography (micro-CT), yet they face limitations concerning a restricted measurement range, a single pattern type, and a single calibration parameter. In this study, we address these challenges by developing integrated periodic structure reference materials with an expanded measurement range, diverse pattern types, and multiple calibration parameters through a combination of photolithography and inductively coupled plasma (ICP) etching process. These reference materials facilitate high-efficiency and multi-value calibration, finding applications in the calibration of optical instruments and micro-CT systems. The simulations were conducted using MATLAB (R2022b) to examine the structure-morphology changes during the single-step ICP etching process. The variation rules governing line widths, periods, etching depths, and side wall verticality in integrated periodic structure reference materials were thoroughly evaluated. Linewidths were accurately extracted utilizing an advanced image processing algorithm, while average period values were determined through the precise Fast Fourier Transform method. The experimental results demonstrate that the relative errors of line widths do not exceed 17.5%, and the relative errors of periods do not exceed 1.5%. Furthermore, precise control of the etching depth was achieved, ranging from 30 to 60 µm for grids with line widths 2-20 µm. The side wall verticality exhibited remarkable consistency with an angle of 90° ± 0.8°, and its relative error was found to be less than 0.9%.

Effects of penehyclidine hydrochloride combined with dexmedetomidine on pulmonary function in patients undergoing heart valve surgery: a double-blind, randomized trial.

AIM: To investigate the effects of penehyclidine hydrochloride combined with dexmedetomidine on pulmonary function in patients undergoing heart valve surgery with cardiopulmonary bypass (CPB). METHODS: A total of 180 patients undergoing elective heart valve surgery with CPB were randomly divided into four groups: 45 in group P (intravenous penehyclidine hydrochloride 0.02 mg/kg 10 min before anesthesia induction and at the beginning of CPB, total 0.04 mg/kg); 43 in group D (dexmedetomidine 0.5 µg/kg/h after induction of anesthesia until the end of anesthesia); 44 in group PD ( penehyclidine hydrochloride 0.04 mg/kg combined with dexmedetomidine 0.5 µg/kg/h intravenously during anesthesia); and 43 in group C (same amount of normal saline 10 min before and after anesthesia induction, to the end of anesthesia, and at the beginning of CPB). The main outcomes were the incidence and severity of postoperative pulmonary complications (PPCs). The secondary outcomes were: (1) extubation time, length of stay in intensive care, and postoperative hospital stay, and adverse events; and (2) pulmonary function evaluation indices (oxygenation index and respiratory index) and plasma inflammatory factor concentrations (tumor necrosis factor-α, interleukin-6, C-reactive protein and procalcitonin) during the perioperative period. RESULTS: The incidence of PPCs in groups P, D and PD after CPB was lower than that in group C (P < 0.05), and the incidence in group PD was significantly lower than that in groups P and D (P < 0.05). The scores for PPCs in groups P, D and PD were lower than those in group C (P < 0.05). CONCLUSION: Combined use of penehyclidine hydrochloride and dexmedetomidine during anesthesia reduced the occurrence of postoperative pulmonary dysfunction, and improved the prognosis of patients undergoing heart valve surgery with CPB. TRIAL REGISTRATION: The trial was registered in the Chinese Clinical Trial Registry on 3/11/2020 (Registration No.: ChiCTR2000039610).

Overlapping filter bank convolutional neural network for multisubject multicategory motor imagery brain-computer interface.

BACKGROUND: Motor imagery brain-computer interfaces (BCIs) is a classic and potential BCI technology achieving brain computer integration. In motor imagery BCI, the operational frequency band of the EEG greatly affects the performance of motor imagery EEG recognition model. However, as most algorithms used a broad frequency band, the discrimination from multiple sub-bands were not fully utilized. Thus, using convolutional neural network (CNNs) to extract discriminative features from EEG signals of different frequency components is a promising method in multisubject EEG recognition. METHODS: This paper presents a novel overlapping filter bank CNN to incorporate discriminative information from multiple frequency components in multisubject motor imagery recognition. Specifically, two overlapping filter banks with fixed low-cut frequency or sliding low-cut frequency are employed to obtain multiple frequency component representations of EEG signals. Then, multiple CNN models are trained separately. Finally, the output probabilities of multiple CNN models are integrated to determine the predicted EEG label. RESULTS: Experiments were conducted based on four popular CNN backbone models and three public datasets. And the results showed that the overlapping filter bank CNN was efficient and universal in improving multisubject motor imagery BCI performance. Specifically, compared with the original backbone model, the proposed method can improve the average accuracy by 3.69 percentage points, F1 score by 0.04, and AUC by 0.03. In addition, the proposed method performed best among the comparison with the state-of-the-art methods. CONCLUSION: The proposed overlapping filter bank CNN framework with fixed low-cut frequency is an efficient and universal method to improve the performance of multisubject motor imagery BCI.

The safety and immunogenicity of a recombinant five-antigen Staphylococcus aureus vaccine among patients undergoing elective surgery for closed fractures: A randomized, double-blind, placebo-controlled, multicenter phase 2 clinical trial.

BACKGROUND: Vaccines are urgently required to control Staphylococcus aureus hospital and community infections and reduce the use of antibiotics. Here, we report the safety and immunogenicity of a recombinant five-antigen Staphylococcus aureus vaccine (rFSAV) in patients undergoing elective surgery for closed fractures. METHODS: A randomized, double-blind, placebo-controlled, multicenter phase 2 clinical trial was carried out in 10 clinical research centers in China. Patients undergoing elective surgery for closed fractures, aged 18-70 years, were randomly allocated at a ratio of 1:1 to receive the rFSAV or placebo at a regimen of two doses on day 0 and another dose on day 7. All participants and investigators remained blinded during the study period. The safety endpoint was the incidence of adverse events within 180 days. The immunogenicity endpoints included the level of specific antibodies to five antigens after vaccination, as well as opsonophagocytic antibodies. RESULTS: A total of 348 eligible participants were randomized to the rFSAV (n = 174) and placebo (n = 174) groups. No grade 3 local adverse events occurred. There was no significant difference in the incidence of overall systemic adverse events between the experimental (40.24 %) and control groups (33.72 %) within 180 days after the first immunization. The antigen-specific binding antibodies started to increase at days 7 and reached their peaks at 10-14 days after the first immunization. The rapid and potent opsonophagocytic antibodies were also substantially above the background levels. CONCLUSIONS: rFSAV is safe and well-tolerated in patients undergoing elective surgery for closed fractures. It elicited rapid and robust specific humoral immune responses using the perioperative immunization procedure. These results provide evidence for further clinical trials to confirm the vaccine efficacy. China's Drug Clinical Trials Registration and Information Publicity Platform registration number: CTR20181788. WHO International Clinical Trial Registry Platform identifier: ChiCTR2200066259.

Iodixanol-associated acute kidney injury and prognosis in patients undergoing elective percutaneous coronary intervention: a prospective, multi-center study.

OBJECTIVE: To evaluate iodixanol-associated acute kidney injury (AKI) and prognosis in patients undergoing elective percutaneous coronary intervention (PCI). METHODS: Patients undergoing elective PCI and iodixanol administration were prospectively enrolled in 8 centers between May 2020 and November 2021. The primary endpoint was AKI, defined as an increase in SCr of ≥ 0.3 mg/dL (26.4 µmol/L) or relative elevation ≥ 50% from baseline in the 48-72 h after PCI. Prognosis evaluations included the major adverse renal and cardiovascular events (MARCE): all-cause mortality, new-onset renal replacement therapy (NRRT), non-fatal myocardial infarction, and non-fatal stroke. AKI predictors were identified using multivariable logistic regression and associations between AKI and outcomes were examined using Cox regression. RESULTS: A total of 3630 patients were included in the final analysis and 2.9% of patients (107/3,630) suffered AKI. Among them, 95.3% (102/107) of AKI were stage 1, and 4.6% (5/107) of stage 2. The multivariable analysis indicated that age over 75-year-old, diabetes, NT-pro-BNP > 300 pg/mL, hemoglobin < 110 g/L, eGFR < 60 mL/min/1.73m2, and diuretics were independently associated with AKI (p < 0.05). After a median follow-up of 13 months, MARCE occurred in 3.6% (131/3630) of the study population, and their incidence was higher in AKI (9.4%, 10/107) vs. non-AKI patients (3.4%, 121/3,523). However, after multivariable adjustment, there was no statistically significant association between AKI and MARCE (p = 0.382). CONCLUSIONS: In patients undergoing elective PCI, cases of iodixanol-associated AKI were mostly mild and, after multivariable adjustment, held no statistically significant association with MARCE on mid-term follow-up. CLINICAL RELEVANCE STATEMENT: The incidence of iodixanol-associated AKI was low and mainly limited to mild renal impairment in patients undergoing elective PCI. Physicians should provide adequate contrast for coronary artery evaluation and, at the same time, minimize the contrast volume. KEY POINTS: • The incidence of iodixanol-associated acute kidney injury was low and mostly limited to mild renal impairment. • Iodixanol administration had no statistically significant impact on the major adverse renal and cardiovascular events in patients undergoing elective percutaneous coronary intervention.

ERK and USP5 govern PD-1 homeostasis via deubiquitination to modulate tumor immunotherapy.

The programmed cell death protein 1 (PD-1) is an inhibitory receptor on T cells and plays an important role in promoting cancer immune evasion. While ubiquitin E3 ligases regulating PD-1 stability have been reported, deubiquitinases governing PD-1 homeostasis to modulate tumor immunotherapy remain unknown. Here, we identify the ubiquitin-specific protease 5 (USP5) as a bona fide deubiquitinase for PD-1. Mechanistically, USP5 interacts with PD-1, leading to deubiquitination and stabilization of PD-1. Moreover, extracellular signal-regulated kinase (ERK) phosphorylates PD-1 at Thr234 and promotes PD-1 interaction with USP5. Conditional knockout of Usp5 in T cells increases the production of effector cytokines and retards tumor growth in mice. USP5 inhibition in combination with Trametinib or anti-CTLA-4 has an additive effect on suppressing tumor growth in mice. Together, this study describes a molecular mechanism of ERK/USP5-mediated regulation of PD-1 and identifies potential combinatorial therapeutic strategies for enhancing anti-tumor efficacy.

Low serum Klotho reflects senile inflammation in middle-aged and elderly patients with coronary atherosclerosis.

BACKGROUND: Anti-aging protein Klotho has been reported to be associated with atherosclerosis, which was considered as a chronic inflammatory disease. However, the relationship between Klotho and senile inflammation remained unclear. The present study aims to ascertain the correlation of Klotho with inflammation in middle-aged and elderly coronary atherosclerotic disease (CAD). METHODS: A total of 302 patients with CAD were included in this study. Coronary atherosclerosis was confirmed and quantified for all patients by coronary angiography. Serum Klotho was detected by enzyme linked immunosorbent assay. Serum concentrations of IL-6 and IL-8 were quantified by chemiluminescence assay. T-lymphocyte subsets were measured using flow cytometry. RESULTS: Multivariate linear regression analysis showed that serum Klotho was an independent predictor for circulating monocytes (standard ß = -0.321, P < 0.001) and CD4+/CD8+ ratio (standard ß = -0.522, P < 0.001). After adjustment, serum Klotho was still independently associated with IL-6 (standard ß = -0.395, P < 0.001) and IL-8 (standard ß = -0.296, P < 0.001). Moreover, circulating monocytes, CD4+ and CD8+ lymphocytes were correlated with increased serum concentrations of IL-6 and IL-8, independent of CRP (P < 0.05). In receiver operating characteristic curve analysis, CD4+/CD8+ ratio (AUC = 0.863, P < 0.001), IL-6 (AUC = 0.893, P < 0.001) and IL-8 (AUC = 0.884, P < 0.001) presented the excellent predictive performance for significant CAD. CONCLUSIONS: Decreased concentrations in serum Klotho reflect senile inflammation, which is related to the severity of CAD in middle-aged and elderly patients.

Association of non-HDL-C-to-HDL-C ratio with coronary lesions and its prognostic performance in first-onset NSTEMI.

Aim: The study sought to investigate the association of non-high-density-lipoprotein cholesterol-to-high-density-lipoprotein cholesterol ratio (NON-HDL-C:HDL-C) with coronary lesions and major adverse cardiovascular events (MACE) in first-onset non-ST-segment elevation acute myocardial infarction. Methods: A cohort of 426 patients undergoing early invasive therapy was enrolled in the final analysis. MACE included cardiac death, nonfatal myocardial infarction, target vessel revascularization, congestive heart failure and nonfatal stroke. Results: NON-HDL-C:HDL-C revealed a powerful diagnostic performance for multiple cardiovascular risk factors (p < 0.05). NON-HDL-C:HDL-C was an independent predictor for severe coronary lesions and MACE (p < 0.05). Subgroup analysis further examined the robustness, especially in elderly, male, dyslipidemic or nondiabetic patients. Conclusion: NON-HDL-C:HDL-C is associated with coronary lesions and prognosis in non-ST-segment elevation acute myocardial infarction.

Acute myocardial infarction is the leading cause of cardiovascular emergencies worldwide. A novel marker, the NON-HDL-C-to-HDL-C ratio, represents the level of insulin resistance and atherogenic capacity to some extent. We analyzed the levels of this ratio in plasma to identify patients with poor prognosis. The present study indicates that high ratio was significantly associated with severe coronary artery disease and poor cardiovascular prognosis.

Single-Crystalline BaZr0.2 Ti0.8 O3 Membranes Enabled High Energy Density in PEI-Based Composites for High-Temperature Electrostatic Capacitors.

Dielectric capacitors are promising for high power energy storage, but their breakdown strength (Eb ) and energy density (Ue ) usually degrade rapidly at high temperatures. Adding boron nitride (BN) nanosheets can improve the Eb and high-temperature endurance but with a limited Ue due to its low dielectric constant. Here, freestanding single-crystalline BaZr0.2 Ti0.8 O3 (BZT) membranes with high dielectric constant are fabricated, and introduced into BN doped polyetherimide (PEI) to obtain laminated PEI-BN/BZT/PEI-BN composites. At room temperature, the composite shows a maximum Ue of 17.94 J cm-3  at 730 MV m-1 , which is more than two times the pure PEI. Particularly, the composites exhibit excellent dielectric-temperature stability between 25 and 150 °C. An outstanding Ue  = 7.90 J cm-3  is obtained at a relatively large electric field of 650 MV m-1  under 150 °C, which is superior to the most high-temperature dielectric capacitors reported so far. Phase-field simulation reveals that the depolarization electric field generated at the BZT/PEI-BN interfaces can effectively reduce carrier mobility, leading to the remarkable enhancement of the Eb and Ue over a wide temperature range. This work provides a promising and scalable route to develop sandwich-structured composites with prominent energy storage performances for high-temperature capacitive applications.

A correlative study between IVIM-DWI parameters and VEGF and MMPs expression in hepatocellular carcinoma.

Background: Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related death worldwide. Angiogenic factors may be valuable indices of tumor recurrence and treatment and potentially useful markers for predicting the response to antiangiogenesis therapy. Vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs) are major drivers of tumor angiogenesis. Preoperatively predicting the expression of VEGF and MMPs is crucial for treating HCC. Intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) has been successfully used in the differential diagnosis of HCC, pathological grading, and treatment response evaluation. However, the correlations between IVIM-DWI parameters and VEGF and MMP expression have not been reported. This study provides a preliminary analysis of the correlation between IVIM-DWI parameters and the expression of VEGF, MMP-2, and MMP-9 to investigate the value of IVIM-DWI in the noninvasive evaluation of angiogenesis in HCC. Methods: IVIM-DWI was performed in 61 patients with HCC 1 week before they underwent surgical resection. VEGF, MMP-2, and MMP-9 expression was detected using immunohistochemistry staining. Spearman correlation analysis was used to analyze the correlations between the IVIM-DWI parameters and VEGF, MMP-2, and MMP-9 expression in HCC. Results: The fast apparent diffusion coefficient fraction (f) value was positively correlated with the expression of VEGF (P<0.001), MMP-2 (P=0.002), and MMP-9 (P<0.001). The fast apparent diffusion coefficient (D*) was positively correlated with VEGF (P<0.001) and MMP-9 (P<0.001) expression but was not correlated with MMP-2 (P=0.659) expression. The apparent diffusion coefficient (ADC) and slow apparent diffusion coefficient (D) values were not significantly correlated with the expression of VEGF (P=0.103 and P=0.543, respectively), MMP-2 (P=0.596 and P=0.338, respectively), or MMP-9 (P=0.102 and P=0.660, respectively). Conclusions: IVIM-DWI can be used to noninvasively evaluate angiogenesis in HCC.