PCSK9 inhibitor added to high-intensity statin therapy to prevent cardiovascular events in patients with acute coronary syndrome after percutaneous coronary intervention: a randomized, double- blind, placebo-controlled, multicenter SHAWN study.

BACKGROUND: It is currently uncertain whether the combination of a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor and high-intensity statin treatment can effectively reduce cardiovascular events in patients with acute coronary syndrome (ACS) who have undergone percutaneous coronary intervention (PCI) for culprit lesions. METHODS: This study protocol describes a double-blind, randomized, placebo-controlled, multicenter study aiming to investigate the efficacy and safety of combining a PCSK9 inhibitor with high-intensity statin therapy in patients with ACS following PCI. A total of 1,212 patients with ACS and multiple lesions will be enrolled and randomly assigned to receive either PCSK9 inhibitor plus high-intensity statin therapy or high-intensity statin monotherapy. The randomization process will be stratified by sites, diabetes, initial presentation and use of stable (≥4 weeks) statin treatment at presentation. PCSK 9 inhibitor or its placebo is injected within 4 hours after PCI for the culprit lesion. The primary endpoint is the composite of cardiovascular death, myocardial infarction, stroke, re-hospitalization due to ACS or heart failure, or any ischemia-driven coronary revascularization at 1-year follow-up between 2 groups. Safety endpoints mean PCSK 9 inhibitor and statin intolerance. CONCLUSION: The SHAWN study has been specifically designed to evaluate the effectiveness and safety of adding a PCSK9 inhibitor to high-intensity statin therapy in patients who have experienced ACS following PCI. The primary objective of this study is to generate new evidence regarding the potential benefits of combining a PCSK9 inhibitor with high-intensity statin treatment in reducing cardiovascular events among these patients.

Performance of T2 mapping in the staging of Graves' ophthalmopathy based on different region of interest selection methods.

BACKGROUND: Discriminating the stage of Graves' ophthalmopathy (GO) is crucial for clinical decision. Application of conventional T2-weighted imaging in the staging is still limited. PURPOSE: To evaluate the performance of T2 mapping based on two different regions of interest (ROIs) for staging GO. MATERIAL AND METHODS: In total, 56 GO patients were retrospectively enrolled and divided into two groups according to the clinical activity score (CAS). T2 relaxation time (T2RT) of extraocular muscle (EOM) on T2 mapping based on two different ROIs (T2RTROI-1: ROIs were drawn separately in the four EOMs; T2RTROI-2: ROI was drawn in the most inflamed EOM) was measured and compared between active and inactive groups. RESULTS: Both T2RTROI-1 and T2RTROI-2 values in the active GO were significantly higher than those of inactive GO (P <0.001). T2RTROI-1 and T2RTROI-2 values were positively correlated with CAS (rs=0.73, 0.69; P <0.001). When the T2RTROI-1 value of 83.3 ms and T2RTROI-2 value of 106.3 ms were used as cutoff values for staging GO, respectively, the best results were obtained with areas under the curve (AUCs) of 0.822 and 0.827. There was no significant difference for AUCs between T2RTROI-1 and T2RTROI-2 (P = 0.751). Excellent and good inter-observer agreements were achieved in quantitative measurements for T2RTROI-1 and T2RTROI-2 values, respectively, with intraclass correlation coefficients of 0.954 and 0.882. CONCLUSION: The T2RT values derived from two different ROIs were useful for assessment of disease activity. Taking reproducibility and diagnostic performance into consideration, T2RTROI-1 would be an ideal image biomarker for staging GO compared to T2RTROI-2.

Multicentre, randomized comparison of two-stent and provisional stenting techniques in patients with complex coronary bifurcation lesions: the DEFINITION II trial.

AIM: The present study aimed to assess the benefits of two-stent techniques for patients with DEFINITION criteria-defined complex coronary bifurcation lesions. METHODS AND RESULTS: In total, 653 patients with complex bifurcation lesions at 49 international centres were randomly assigned to undergo the systematic two-stent technique (two-stent group) or provisional stenting (provisional group). The primary endpoint was the composite of target lesion failure (TLF) at the 1-year follow-up, including cardiac death, target vessel myocardial infarction (TVMI), and clinically driven target lesion revascularization (TLR). The safety endpoint was definite or probable stent thrombosis. At the 1-year follow-up, TLF occurred in 37 (11.4%) and 20 (6.1%) patients in the provisional and two-stent groups, respectively [77.8%: double-kissing crush; hazard ratio (HR) 0.52, 95% confidence interval (CI) 0.30-0.90; P = 0.019], largely driven by increased TVMI (7.1%, HR 0.43, 95% CI 0.20-0.90; P = 0.025) and clinically driven TLR (5.5%, HR 0.43, 95% CI 0.19-1.00; P = 0.049) in the provisional group. At the 1 year after indexed procedures, the incidence of cardiac death was 2.5% in the provisional group, non-significant to 2.1% in the two-stent group (HR 0.86, 95% CI 0.31-2.37; P = 0.772). CONCLUSION: For DEFINITION criteria-defined complex coronary bifurcation lesions, the systematic two-stent approach was associated with a significant improvement in clinical outcomes compared with the provisional stenting approach. Further study is urgently warranted to identify the mechanisms contributing to the increased rate of TVMI after provisional stenting. STUDY REGISTRATION: http://www.clinicaltrials.com; Identifier: NCT02284750.

Comparison of three surgical approaches for thoracolumbar junction (T12-L1) tuberculosis: a multicentre, retrospective study.

BACKGROUND: The surgical approaches to thoracolumbar junction (T12-L1) tuberculosis were controversial. We aimed to compare the safety and efficacy of three different procedures through a multicentre retrospective study. METHODS: The medical records of thoracolumbar junction tuberculosis patients (n = 177) from January 2005 to January 2015 were collected and reviewed. Forty-five patients underwent anterior debridement and instrumented fusion (Group A), 52 underwent anterior combined with posterior debridement and instrumented fusion (Group B) and 80 underwent posterior-only debridement and instrumented fusion (Group C). Patients with neurological deficit were 10 in Group A, 23 in Group B, 36 in Group C. All patients had a standard preoperative and postoperative anti - tuberculous therapy regimen. Clinical outcomes, laboratory indexes and radiological evaluation of the three groups were compared. Operations at each centre were performed by the respective senior medical teams of the six different hospitals. RESULTS: All three surgical approaches achieved bone fusion and pain relief. Cases with neurological deficits had different degrees of improvement after surgery. The operative time was 330.2 ± 45.4 min, 408.0 ± 54.3 min, 227.9 ± 58.5 min, and the blood loss was 744.0 ± 193.8 ml, 1134.6 ± 328.2 ml, 349.8 ± 289.4 ml in groups A, B and C respectively. The average loss of correction was 5.5 ± 3.7° in group A, 1.6 ± 1.9° in group B, 1.7 ± 2.2° in group C, and the difference between groups except B vs C were of statistically significant (P < 0.05). CONCLUSIONS: For patients with thoracolumbar junction (T12-L1) tuberculosis, the posterior-only procedure is the better than the anterior-only procedure in the correction of kyphosis and maintenance of spinal stability. The posterior-only procedure is recommended because it achieves the same efficacy as combined procedure with shorter operation time, less blood loss and trauma.

Single-stage posterior debridement, decompression and transpedicular screw fixation for the treatment of thoracolumbar junction (T12-L1) tuberculosis with associated neurological deficit: a multicentre retrospective study.

BACKGROUND: A multicentre retrospective study was conducted to evaluate the safety and efficacy of single-stage posterior debridement, decompression and transpedicular screw fixation for the treatment of thoracolumbar junction (T12-L1) tuberculosis in patients with associated neurological deficit. METHODS: Thoracolumbar junction (T12-L1) tuberculosis patients (n = 69) with neurological deficit who underwent single-stage posterior debridement, decompression and transpedicular screw fixation from January 2005 to January 2015 were included in the study. Antituberculosis therapy was performed both before and after surgery. The surgery duration and patient blood loss were evaluated, in addition to the change in pain visual analogue score (pVAS), kyphotic angle, Oswestry disability index (ODI) score and American Spinal Injury Association (ASIA) grade assessed preoperatively, immediate postoperatively and at the final follow-up visit. RESULTS: The average blood loss was 354 ± 291 mL. The average kyphosis angle was corrected from 21 ± 9° preoperatively to 9 ± 4° postoperatively, with a mean decrease in pVAS and ODI scores of 3.4 and 16, respectively. The postoperative ASIA grading was grade A for five patients, grade C for 15 and grade D for 49 patients, which had improved to grade C for four patients, grade D for three patients and grade E for 62 patients at the final follow-up. The neurological deficit did not worsen in any of the patients. CONCLUSIONS: Single-stage posterior debridement, decompression and transpedicular screw fixation is an effective treatment method in thoracolumbar junction (T12-L1) tuberculosis patients with neurological deficit, with good neurological recovery and no progression of kyphosis.

February-May temperature reconstruction based on tree-ring widths of Abies fargesii from the Shennongjia area in central China.

February-May temperature strongly affects ecological processes and socio-economics in central China, yet its long-term variability has not been thoroughly assessed due to the shortness of instrumental records. In order to improve the understanding of the regularities of temperature variability in central China, in this study, we present a new tree-ring chronology from the Shengnongjia Mountains in central China which provides a valuable 245-year record of temperature variability. The reconstructed temperature correlated strongly with February-May mean temperature records of the Fangxian meteorological station from AD 1958 to AD 2011, and the derived reconstruction explained 44.5 % of the instrumental temperature variation during this period. The study shows that this region experienced three warm periods and two cool periods, i.e., the major warm periods occurred in AD 1783-1806, AD 1879-1909, and AD 1975 to the present, whereas the cool intervals occurred in AD 1807-1878 and AD 1910-1974. This reconstruction could aid in the evaluation of regional climate variability in subtropical China.

Transoral anterior release, odontoid partial resection, and reduction with posterior fusion for the treatment of irreducible atlantoaxial dislocation caused by odontoid fracture malunion.

PURPOSE: Several techniques have been introduced to manage irreducible atlantoaxial dislocation (IAAD). However, no study has reported the surgical method for the management of IAAD caused by odontoid fracture malunion. This study aimed to introduce a surgical method of transoral anterior release, odontoid partial resection, and reduction with sequential posterior fusion for the treatment of IAAD caused by odontoid fracture malunion. We also evaluated the clinical efficacy of this surgery. METHODS: This study included seven cases of IAAD caused by odontoid fracture malunion, collected from January 2008 to January 2011. Anterior atlantoaxial release was performed through anterior transoral approach, followed by partial resection of the odontoid process. C1-C2 were then fixed through pedicle screws and rods, and then fused posteriorly by single stage. Neurologic status was evaluated using the Japanese Orthopaedic Association (JOA) scoring system. RESULTS: All seven patients had complete release, and satisfactory reduction. Bony fusion was seen in all patients postoperatively. The patients were followed up for an average of 19.6 months (ranged from 9 to 36 months). The average of patients JOA scores at the final follow-up was significantly higher than that of their preoperative scores. Furthermore, the average improvement in neurological function was 87.4 %. No screw loosening, implant migration or implant failures, atlantoaxial redislocation, or signs of instability were observed in any of the patients during the follow-up period. CONCLUSIONS: Transoral anterior release, odontoid partial resection, and reduction combined with posterior fusion are effective, reliable, and safe procedures for the treatment of IAAD caused by odontoid fracture malunion.

[Colorimetric assay of perfluorooctanesulfonate based on gold nanoparticles].

For the property of persistent, bioaccumulation and genetic toxicity, perfluorooctanesulfonate (PFOS) is classified as a sort of persistent organic pollutants (POPs). It is significant to develop a novel assay for the determination of PFOS. In this work, we create a new colorimetric assay for PFOS in which the positively-charged gold nanoparticles (AuNPs) work as a nano-probe. This method works on the aggregation of AuNPs induced by PFOS via electrostatic interaction. The stable monodisperse AuNPs coated by cysteamine present color of red wine and the addition of PFOS can make the monodispersed AuNPs aggregated resulting in the color change from wine red to reddish purple with a red-shift in ultraviolet-visible absorption spectrum. The experimental results show that AuNPs has a characteristic absorption peak (524 nm), as well as a wide absorption peak (650 nm) and the absorption signal intensity is proportional to the PFOS content in a range of 0. 8-8. 0 µmo .l L-1. According to these, we developed a method based on ultraviolet-visible absorption and colorimetric to detect PFOS with the detection limit of 80 nmol . L-1. The scanning electron microscope (SEM) was investigated and the photos show that the stable AuNPs are made and the degree of AuNPs aggregation is related with PFOS concentration. The effect tests of coexisting substances in system show that common anions had less impact on the system and inorganic metal ions had some interference, which can be get rid of by cat- ion exchange resin in real sample. This assay was applied to detect PFOS in tap water with a recovery range of 87. 5%-118% and RSD 4. 4%. It is a novel application of AuNPs-based probe for PFOS detection. The proposed method has more advantages such as rapidity, low-cost and simplicity than conventional ones. In addition, it has the visual sensing function and the difference of color can be sensed by naked eyes directly, which produce ideas of real-time colorimetric strategies of nanoprobe application in environmental pollutant detection.

The expression of programmed cell death ligand 1 (PD-L1) involves in the clinicopathologic characteristics and prognostic implications of testicular germ cell tumor (TGCT): a systematic review and meta-analysis.

Background: Testicular germ cell tumor (TGCT) is a type of tumor with relatively lower incidence but being more prevalent in young men. The expression of programmed cell death ligand 1 (PD-L1) serves as a potential biomarker for predicting the survival outcomes of other tumors. Some studies discovered higher prevalence of PD-L1 in TGCT patients who achieved favorable treatment outcomes, while other studies showed lower or absent expression of PD-L1 in TGCT with the better prognosis as well. Therefore, in order to address this controversy and clarify the association between the expression of PD-L1 and pathological features and prognosis of TGCT, this meta-analysis was conducted. Methods: A comprehensive literature search was performed using following search terms: "testis", "testicle", "testicular", "cancer", "carcinoma", "tumor", "neoplasm", "programmed cell death ligand 1", "programmed death ligand 1", "PD-L1", "PDL1", "B7 homolog 1", "B7-H1", "B7H1" and "CD274". Relevant studies were retrieved according to the inclusion criteria from reputable databases including PubMed, Embase, Web of Science, Cochrane Library and China National Knowledge Infrastructure (CNKI). These studies investigated the expression of PD-L1 in both tumor cells and tumor infiltrating immune cells (TIICs) in TGCT. The overall proportion of PD-L1 positivity was assessed using R programming. Pooled hazard ratio (HR) and odds ratio (OR) with corresponding 95% confidence interval (CI) were calculated using Revman software to evaluate the involvement of PD-L1 expression in TGCT. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality assessment of included studies. Sensitivity analysis and publication bias evaluation were subsequently performed. Results: A total of eight eligible studies compromising 1,589 patients diagnosed with TGCT were finally included in this study. PD-L1 positivity was detected in 31% and 41% of TGCT patients' tumor cells and TIICs, respectively. The pooled data demonstrated a significant association between elevated PD-L1 expression levels in TIICs and a favorable prognosis characterized by the reduced disease progression and relapse events (HR =0.21, 95% CI: 0.13-0.33). Furthermore, PD-L1+ TIICs exhibited higher prevalence rates in seminoma (OR =2.11, 95% CI: 1.57-2.84) and embryonal carcinoma (OR =6.23, 95% CI: 2.42-16.02) patients. Notably, PD-L1 expression in TIICs displayed a tendency to increase in TGCT patients with lower stages or without lymph node metastasis. Conclusions: PD-L1 expression was observed in choriocarcinoma tumor cells, while yolk sac tumor and teratoma tumor cells exhibited lower or absent expression of PD-L1. Conversely, PD-L1 expression in TIICs was associated with seminoma and embryonal carcinoma, which was more commonly observed in TGCT patients with lower stages and better prognosis, thereby providing a theoretical foundation for the application of immunotherapy in relapsed/refractory TGCT patients.

MiR-24-3p modulates cardiac function in doxorubicin -induced heart failure via the Sp1/PI3K signaling pathway.

PURPOSE: The goal of this research was to explore the role of miR-24-3p in heart failure (HF), with a focus on its impact on the specificity protein 1 (Sp1)/phosphoinositide 3-kinase (PI3K) pathway. METHODS: HF rat and HF cell models were established using doxorubicin(Dox). Cardiac function was assessed through echocardiography, while histological changes were observed via hematoxylin-eosin (HE) staining. To further investigate the underlying mechanisms, HF cell models were treated with either an Sp1 inhibitor or a PI3K inhibitor. Additionally, models with miR-24-3p overexpression or silencing were constructed. N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were determined by ELISA. Cell apoptosis was evaluated using TUNEL staining, and lactate dehydrogenase (LDH) levels were measured by colorimetry. Reactive oxygen species (ROS) production was analyzed using flow cytometry. Related gene and protein expressions were assessed via qRT-PCR and Western blotting. Finally, the relationship between miR-24-3p and Sp1 was confirmed through dual-luciferase assays. RESULTS: Dox treatment increased the left ventricular internal diameter (LVIDd) while decreasing ejection fraction (EF) and fractional shortening (FS), leading to disorganized cardiomyocyte arrangement, cellular edema, and necrosis in rats. In HF rats, NT-proBNP, Caspase-3, and miR-24-3p expression levels were elevated, whereas Sp1 and PI3K mRNA and protein expression levels were decreased. Similarly, Dox-induced damage in H9c2 cardiomyocytes resulted in increased NT-proBNP, apoptosis, Caspase-3, LDH, ROS, and miR-24-3p expression, along with decreased Sp1 and PI3K expression. Treatment with either Sp1 or PI3K inhibitors exacerbated the Dox-induced cardiomyocyte damage, further elevating NT-proBNP, apoptosis, Caspase-3, LDH, ROS, and miR-24-3p expression levels. Notably, Sp1 inhibition reduced PI3K expression, and PI3K inhibition, in turn, suppressed Sp1 expression. Overexpression of miR-24-3p worsened Dox-induced cardiomyocyte damage, characterized by increased NT-proBNP, apoptosis, Caspase-3, LDH, and ROS expression, alongside reduced Sp1 and PI3K expression. In contrast, silencing miR-24-3p mitigated these detrimental effects and increased Sp1 and PI3K expression. Dual-luciferase assays confirmed that miR-24-3p directly targets Sp1. CONCLUSION: Dox induces cardiomyocyte damage, impairs cardiac function, and promotes cardiomyocyte apoptosis and oxidative stress. Silencing miR-24-3p offers a protective effect by activating the Sp1/PI3K signaling pathway in heart failure.

Distribution Characteristics of Low-Molecular-Weight Organic Acids in Reclaimed Soil Filled with Fly Ash: A Study.

This study aims to assess the contents of different kinds of low-molecular-weight organic acids (LMWOAs) in reclaimed soil filled with fly ash in the Huainan mining area in China using high-performance liquid chromatography (HPLC). Using a mobile phase consisting of 0.1% phosphoric acid and acetonitrile in a volume ratio of 98:2, the detection was performed at a wavelength of 210 nm for 15 min. In addition, a cluster analysis was performed on the detected LMWOAs in the reclaimed soil. The correlations between the LMWOA and nutrient contents in the reclaimed soil were also analyzed. In total, eight and seven LMWOAs were detected in the reclaimed soil and filled fly ash, respectively. In contrast, no LMWOAs were detected in the fresh fly ash from a thermal power plant. The order of total LMWOA contents at different sampling points followed the order of farmland control soil > 1# (Triticum aestivum) > 4# (Phragmites australis) > 5# (Vigna radiata) > 2# (Sorghum bicolor) > 3# (Tamarix ramosissima) > fly ash-filled soil. The farmland control soil and fly ash-filled soil exhibited the highest and lowest LMWOA contents of 648.22 and 85.09 µg·g-1, respectively. The LMWOA contents in the reclaimed soil followed the order of oxalic acid > tartaric acid > malonic acid > lactic acid > acetic acid > citric acid > propionic acid > succinic acid. Indeed, oxalic acids exhibited the highest total amount of 1445.79 µg·g-1 and succinic acids exhibited the lowest total amount of 6.50 µg·g-1. The LMWOA contents in the reclaimed soil decreased with increasing soil depth, showing statistically significant differences between the 0-10 and 10-40 cm soil layers (p < 0.05). According to the obtained clustering results, the detected LMWOAs can be divided into two categories. The first category consisted of oxalic acid, while the second category included the remaining LMWOAs. The soil LMWOA contents of 4# (Phragmites australis) and 5# (Vigna radiata) were significantly different from those at the other sampling points. According to the Pearson correlation analysis results, the occurrence and characteristics of the soil LMWOAs can be controlled by regulating the pH values and available nutrient contents in the soil, thereby improving the eco-environmental conditions of the reclaimed rhizosphere.

The value of coordinated analysis of multimodal atherosclerotic plaque imaging in the assessment of cardiovascular and cerebrovascular events.

Background: Although atherosclerosis (AS) can affect multiple vascular beds, previous studies have focused on the analysis of single-site AS plaques. Objective: The aim of this study is to explore the differences or similarities in the characteristics of atherosclerotic plaque found in the internal carotid artery, cerebral artery, and coronary artery between patients with atherosclerotic cardiovascular disease (ASCVD) and those without events. Methods: Patients aged ≥ 18 years who underwent both high-resolution vessel wall imaging (HR-VWI) and coronary computed tomography angiography (CCTA) were retrospectively collected and categorized into the ASCVD group and the non-event group. The plaques were then categorized into culprit plaques, non-culprit plaques, and non-event plaques. Plaque morphological data such as stenosis, stenosis grades, plaque length (PL), plaque volume (PV), minimal lumen area (MLA), enhancement grade, and plaque composition data such as calcified plaque volume (CPV), fibrotic plaque volume (FPV), fibro-lipid plaque volume (FLPV), lipid plaque volume (LPV), calcified plaque volume ratio (CPR), fibrotic plaque volume ratio (FPR), fibro-lipid plaque ratio (FLPR), lipid plaque volume ratio (LPR), intraplaque hemorrhage volume (IPHV), and intraplaque hemorrhage volume ratio (IPHR)were recorded and analyzed. Results: A total of 44 patients (mean age 66 years, SD 9 years, 28 men) were included. In cervicocephalic plaques, the ASCVD group had more severe stenosis grades (p = 0.030) and demonstrated significant differences in LPV, LPR, and CPV (p = 0.044, 0.030, 0.020) compared with the non-event group. In coronary plaques, the ASCVD group had plaques with greater stenosis (p < 0.001), more severe stenosis grades (p < 0.001), larger volumes (p = 0.001), longer length (p = 0.008), larger FLPV (p = 0.012), larger FPV (p = 0.002), and higher FPR (p = 0.043) compared with the non-event group. There were significant differences observed in stenosis (HR-VWI, CCTA: p < 0.001, p < 0.001), stenosis grades (HR-VWI, CCTA: p < 0.001, p < 0.001), plaque length (HR-VWI, CCTA: p = 0.028, p < 0.001), and plaque volume (HR-VWI, CCTA: p = 0.013, p = 0.018) between the non-event plaque, non-culprit plaque, and culprit plaque. In the image analysis of HR-VWI, there were differences observed between IPHR (p < 0.001), LPR (p = 0.001), FPV (p = 0.011), and CPV (p = 0.015) among the three groups of plaques. FLPV and FPV were significantly different among the three different plaque types from the coronary artery (p = 0.043, p = 0.022). Conclusion: There is a consistent pattern of change in plaque characteristics between the cervicocephalic and coronary arteries in the same patient.

Inflammatory activity evaluation in patients with axial spondyloarthritis using MRI relaxometry and mucosal-associated invariant T cells.

Background: Currently, there is a lack of an objective quantitative measure to comprehensively evaluate the inflammatory activity of axSpA, which poses certain challenges in accurately assessing the disease activity. Objective: To explore the value of combined-parameter models of sacroiliac joints (SIJs) MRI relaxometry and peripheral blood Mucosal-associated invariant T (MAIT) cells in evaluating the inflammatory activity of axial spondyloarthritis (axSpA). Methods: This retrospective clinical study included 88 axSpA patients (median age 31.0 (22.0, 41.8) years, 21.6% females) and 20 controls (median age 28.0 (20.5, 49.5) years, 40.0% females). The axSpA group was classified into active subgroup (n=50) and inactive subgroup (n=38) based on ASDAS-CRP. All participants underwent SIJs MRI examination including T1 and T2* mapping, and peripheral blood flow cytometry analysis of MAIT cells (defined as CD3+Vα7.2+CD161+) and their activation markers (CD69). The T1 and T2* values, as were the percentages of MAIT cells and CD69+MAIT cells were compared between different groups. Combined-parameter models were established using logistic regression, and ROC curves were employed to evaluate the diagnostic efficacy. Results: The T1 values of SIJs and %CD69+MAIT cells in the axSpA group and its subgroup were higher than the control group (p<0.05), while %MAIT cells were lower than the control group (p<0.05). The T1 values and %CD69+MAIT cells correlated positively, while %MAIT cells correlated negatively, with the ASDAS-CRP (r=0.555, 0.524, -0.357, p<0.001). Between the control and axSpA groups, and between the inactive and active subgroups, the combined-parameter model T1 mapping+%CD69+MAIT cells has the best efficacy (AUC=0.959, 0.879, sensibility=88.6, 70%, specificity=95.0, 94.7%, respectively). Conclusion: The combined-parameter model T1 mapping+%CD69+MAIT cells allows a more accurate evaluation of the level of inflammatory activity.

Associations between microstructural tissue changes, white matter hyperintensity severity, and cognitive impairment: an intravoxel incoherent motion imaging study.

Introduction: White matter hyperintensities (WMHs) are a common age- and vascular risk factor-related disease and have been recognized to play an important role in cognitive impairment. However, it is still unclear what the mechanism of this effect is. In this study, intravoxel incoherent motion (IVIM) was employed to assess the microvasculature and parenchymal microstructure changes of WMHs and explore their relationship with cognitive function. Methods: Forty-nine WMH patients and thirty-one healthy controls underwent IVIM imaging, a diffusion technique that provides parenchymal diffusivity D, intravascular diffusivity D*, and perfusion fraction f . The IVIM dual exponential model parameters were obtained in specific regions of interest, including deep white matter hyperintensities (DWMHs), periventricular white matter hyperintensities (PWMHs), and normal-appearing white matter (NAWM). The independent-sample t-test or Mann-Whitney U-test was utilized to compare IVIM parameters between patients and controls. The Kruskal-Wallis test or one-way analysis of variance was used to compare IVIM parameters among DWMH, PWMH, and NAWM for patients. The Wilcoxon two-sample test or independent-sample t-test was used to assess the differences in IVIM parameters based on the severity of WMH. The multivariate linear regression analysis was conducted to explore the factors influencing cognitive scores. Results: WMH patients exhibited significantly higher parenchymal diffusivity D than controls in DWMH, PWMH, and NAWM (all p < 0.05). IVIM parameters in the three groups (DWMH, PWMH, and NAWM) were significantly different for patients (all p < 0.001). The severe WMH group had a significantly higher parenchymal diffusivity D (DWMH and PWMH) than mild WMH (both p < 0.05). The multiple linear regression analysis identified D in DWMH and PWMH as influencing cognitive function scores (all p < 0.05). Conclusion: IVIM has the potential to provide a quantitative marker of parenchymal diffusivity for assessing the severity of WMH and may serve as a quantitative marker of cognitive dysfunction in WMH patients.

Construction and Implementation of Procedural Nursing System for General Surgery Laparoscopic Surgery Based on Deep Learning.

In order to explore the construction and implementation effect of a procedural nursing system for laparoscopic surgery in general surgery based on deep learning, this article selects 150 cases of laparoscopic surgery patients admitted to our hospital from January 2020 to January 2021 for research. According to the time of enrollment, the control set and the study set were included in order, with 75 cases in each set. The control set was given routine nursing methods, and the research set was given the management of programmed nursing system based on deep learning. The nursing quality, pain, postoperative recovery, and incidence of complications were compared between the two sets. Logistic regression multivariate analysis of the risk factors for postoperative complications in patients undergoing laparoscopic surgery in general surgery was performed. Based on deep learning, the construction of the procedural nursing system for laparoscopic surgery in general surgery is applied to the nursing management of general surgery laparoscopic surgery, which can improve the quality of care and the VAS score of the patient's pain level, and reduce the incidence of complications. Underlying diseases and routine nursing are risk factors for complications of general surgery laparoscopic surgery, suggesting that corresponding prevention and control work should be done in the procedural nursing of general surgery laparoscopic surgery based on deep learning.

Case Report: A Chinese Family of Hypertrophic Cardiomyopathy Caused by a Novel Splicing Mutation in the FLNC Gene.

Hypertrophic cardiomyopathy (HCM) is a type of primary cardiomyopathy with genetic etiology, and it carries a high risk of diastolic dysfunction, heart failure, and malignant arrhythmias. We reported the first familial HCM in China, caused by a novel FLNC splicing mutation. We performed duo exome sequencing (ES) to examine the genome of the proband and his mother. For 10 days, a 15-year-old boy was presented to our hospital due to non-exercise-associated chest tightness and asthma. He was diagnosed with HCM [end-diastolic interventricular septal thickness was about 18 mm by transthoracic echocardiography (TTE)]. His mother and sister performed TTE to screen familial cardiomyopathy, which revealed hypertrophic cardiomyopathy only in the proband's mother. In ES of the mother-son duo, we identified a novel heterozygous mutation of the FLNC gene (chr7:128492808, NM_001127487, c.5905+2T>C, rs1808874360) as the candidate cause of autosomal dominant HCM. Sanger sequencing confirmed this novel mutation in the proband and his mother but absent in the proband's sister. The potential impact of the novel mutation was predicted by MutationTaster, dbscSNV_ADA_SCORE, dbscSNV_RF_SCORE, CADD_phred, PhyloP20way_mammalian, PhyloP100way_vertebrate, SiPhy_29way_logOdds, and GERP++_RS software. After the administration of furosemide, spironolactone, and metoprolol, the proband's heart function was improved, and symptoms were alleviated. We presented the first familial HCM caused by a novel FLNC splicing mutation via exome sequencing in China. Therefore, it is necessary that familial screening for patients with HCM should be performed for the early detection of HCM intervention in malignant cardiac events in advance and block genes.

Ecological Risk Assessment and Influencing Factors of Heavy-Metal Leaching From Coal-Based Solid Waste Fly Ash.

In order to promote and broaden the utilization of fly ash as a resource, the fly ash from a 2,660-MW coal-fired power plant in Huainan (China) was investigated. The physical and chemical properties of fly ash were characterized by scanning electron microscopy, energy spectrum analysis, and XRD. The content and different forms of the heavy metals Cd, Cr, Cu, Co, and Ni were determined by acid digestion, oscillation leaching, and Tessier five-step extraction. The effect of pH, temperature, and particle size on the leached amount of heavy metals was studied. Finally, the ecological risk index was calculated for each heavy metal via the risk assessment coding (RAC) method and Hakanson ecological risk assessment method, allowing the ecological risk of fly ash to be determined under different environmental conditions. Results showed that the average concentrations of Cd, Cr, Co, and Ni were all below the risk screening values reported for environmental pollutants (pH > 7.5). Under varying pH, temperature, and particle size conditions, the leached amounts (oscillation leaching) were below the soil risk screening values for agricultural land in China. An RAC-Cd value of >50% indicates a high ecological risk, while the RAC values of Co and Ni were between 10 and 30%, indicating a medium ecological risk, and the RAC values of Cr and Cu were <10%, indicating a low ecological risk. With increasing pH, the potential ecological risk index (RI) decreased, with a maximum RI of 59.62 observed at pH 2.8. With increasing temperature, the potential ecological RI increased initially to a maximum of 27.69 at 25°C and then decreased thereafter. With increasing particle size, the ecological RI decreased, with the highest RI of 4.06 occurring at <0.075 mm. The Hakanson ecological RI value was below 150, indicating a slight ecological risk. Therefore, fly ash can be considered as a soil additive and conditioner that is suitable for use in the improvement of reclamation soil in coal mining subsidence areas.

Effect of Low-Molecular-Weight Organic Acids on Migration Characteristics of Pb in Reclaimed Soil.

The effect of low-molecular-weight organic acids (citric acid and malic acid) on the migration characteristics of Pb in contaminated soils was explored in this study. Reclaimed soil was collected from the coal gangue hill area of the Panyi mine in Huainan City (China). The effect of citric acid and malic acid on the form of Pb present in the reclaimed soil was analyzed by spiking soil samples and simulating Pb-contaminated soil. The results indicate the following. 1) With increased concentration of exogenous Pb, the activity of Pb in the reclaimed soil was effectively improved. 2) The addition of citric acid and malic acid both resulted in an increased fraction of exchangeable Pb in the soil, which effectively promoted the active Pb fraction. As the concentrations of citric acid and malic acid increased, the active Pb fraction of the reclaimed soil increased accordingly. The Pb activation effect of citric acid was observed to be greater than that of malic acid. 3) With extended soil aging time, the activation effect of organic acids on Pb weakened, with the loosely bound Pb gradually transforming into strongly bound Pb. Chelating agents can activate heavy metals in soil, mainly through the combination of chelating agents and heavy metal ions in the soil solution to form soluble metal chelates, so as to increase the bioavailability of heavy metals in soil to plant roots. Therefore, adding citric acid can be considered as a strategy to enhance the efficiency of reclaimed soil remediation because of the ability of Pb activation.

The Correlation between Type 2 Diabetes and Fat Fraction in Liver and Pancreas: A Study using MR Dixon Technique.

Objective: The increased obesity results in ectopic fat deposits in liver and pancreas, which will affect insulin resistance and elevated plasma glucose with type 2 diabetes. To assess the relationship between obesity and ectopic fat deposits and diabetes, this study used the MR Dixon method for the quantification of liver and pancreas fat fraction (FF) in type 2 diabetes mellitus (T2DM) patients and healthy controls. Methods: The FF of whole liver (FFWL) and pancreas (FFWP), the maximum diameters of the pancreas, the abdominal subcutaneous adipose area (SAT), the visceral adipose tissue area (VAT), and the total abdominal adipose tissue area (TAT) were measured for 157 subjects using the MR Dixon data. Four groups were established on the basis of BMI value. For statistics, intra- and intergroup comparisons were made by employing independent sample t-test. Results: FFWL, FFWP, and VAT varied significantly between T2DM (BMI < 25) and control group (BMI < 25), T2DM (BMI ≥ 25) and control group (BMI ≥ 25), T2DM (BMI < 25) and T2DM (BMI ≥ 25) (all P < 0.05). The FF of pancreas tail, SAT, and TAT varied significantly between control group (BMI < 25) and control group (BMI ≥ 25) (P < 0.05). FFWP and the FF of pancreas tail varied significantly between T2DM and normal volunteers (P < 0.05), with normal or mild liver fat content. Conclusion: The tissue FF, which has a close relationship with T2DM, can be assessed by the MR Dixon technique. T2DM patients should pay attention to tissue fat content regardless of BMI values.

Effect of Low-Molecular Organic Acids on the Migration Characteristics of Nickel in Reclaimed Soil from The Panyi Mine Area in China.

This study investigated the effects of low molecular weight organic acids (citric acid and malic acid) on the migration properties of nickel in soil. A reclaimed soil sample was obtained from the Panyi Mine in Huainan City, China. The effects of adding different concentrations of Ni, citric acid (CA) and malic acid (MA) were assessed on the migration and transformation of soil Ni forms. The results showed: (1) An increase in soil Ni activity with increasing Ni concentrations. (2) An increased proportion of exchangeable forms of Ni in soil with increased malic acid and citric acid concentrations, effectively promoting Ni mobility. In addition, the active Ni fraction in reclaimed soil increased significantly with increasing concentrations of citric and malic acid. The nickel activation effect of citric acid was found to be higher than that of malic acid. (3) The activation effect of organic acids on Ni weakened with aging, exhibiting a gradual transformation from the loosely bound form of Ni, to the strongly bound form. The results of this study provide a theoretical basis for improving the effectiveness and efficiency of the phytoremediation techniques used for the treatment of Ni-polluted soils.