[Analysis of changes in intrinsic neural timescales in male smoking addicts based on whole brain resting-state functional magnetic resonance imaging]

Objective: To investigate the abnormal changes of intrinsic neural time scale (INT) in male smoking addicts based on whole brain resting state functional magnetic resonance imaging (rs-fMRI). Methods: A case-control study. The clinical data and whole brain rs-fMRI data of 139 male subjects, aged (34.1±8.8) years, recruited through the online platform from January 2019 to December 2021 were retrospectively analyzed. According to the existence of smoking addiction, they were divided into smoking addiction group (n=83) and healthy control group (n=56).INT was calculated to reflect the brain neural activity dynamics. Single sample t test was used to obtain the whole brain spatial distribution maps of INT in smoking addiction group and the control group. Then two-sample t test was conducted to explore the difference of INT between the smoking addition group and the healthy control group, with age and years of education as covariates. Finally, Spearman correlation analysis was used to explore the relationship between INT and nicotine dependence scale score and smoking index. Results: Subjects with smoking addiction and healthy control group showed a similar pattern of hierarchical neural timescales, namely shorter INT in sensorimotor areas and longer INT in parietal lobe, posterior cingulate cortex. In addition, in the smoking addiction group, the left medial occipital gyrus (peak t=-3.18), left suproccipital gyrus (peak t=-3.66), bilateral pericalar cleft cortex (left: peak t=-3.02, right: peak t=-3.22), bilateral lingual gyrus (left: peak t=-3.10, right: t peak=-3.04), left cuneus (peak t=-2.97), default network associated brain region [left anterior cuneus(peak t=-3.23), left angular gyrus (peak t=-3.07), and left posterior cingulate cortex (peak t=-3.54) were significantly lower than those of healthy controls (gaussian random field correction, voxel level all P<0.005, mass level all P<0.05). However, there was no significant correlation between INT and nicotine dependence scale score and smoking index (both P>0.05 after Bonferroni correction). Conclusion: Compared with healthy controls, smoking addicts showed abnormal changes in the dynamics of neural activity in the visual cortex and the default network.

[Primary synovial sarcoma of lung: a clinicopathological analysis of 12 cases]

Objective: To investigate the clinicopathological features, immunophenotype, molecular features and differential diagnosis of primary synovial sarcoma of the lung (PSSL). Methods: Twelve cases of PSSL were collected at Henan Provincial People's Hospital, during May 2010 and April 2021, and their clinicopathological parameters were summarized. SS18-SSX, H3K27Me3, and SOX2 were added to the original immunomarkers to evaluate their diagnostic value for PSSL. Results: The age of 12 patients when diagnosed ranged from 32 to 75 years (mean of 50 years). There were 7 males and 5 females, 2 left lung cases and 10 right lung cases. Of the 6 patients who underwent surgical resection, five cases were confined to lung tissue (T1), one case had mediastinal invasion (T3), two cases had regional lymph node metastasis (N1), and none had distal metastasis. Microscopically, 11 cases showed monophasic spindle cell type and one case showed biphasic type composed of mainly epithelial cells consisting of cuboidal to columnar cells with glandular and cribriform structures. It was difficult to make the diagnosis by using the biopsy specimens. Immunohistochemistry (IHC) showed CKpan expression in 8 of 12 cases; EMA expression in 11 of 12 case; TLE1 expression in 8 of 12 cases; S-100 protein expression in two of 12 cases; various expression of bcl-2 and vimentin in 12 cases, but no expression of SOX10 and CD34 in all the cases. The Ki-67 index was 15%-30%. The expression of SS18-SSX fusion antibody was diffusely and strongly positive in all 12 cases. SOX2 was partially or diffusely expressed in 8 of 12 cases, with strong expression in the epithelial component. H3K27Me3 was absent in 3 of 12 cases. SS18 gene translocation was confirmed by fluorescence in situ hybridization (FISH) test in all 12 samples. Six cases underwent surgery and postoperative chemotherapy, while the other six cases had chemotherapy alone. Ten patients were followed up after 9-114 months, with an average of 41 months and a median of 26 months. Five patients survived and five died of the disease within two years. Conclusions: PSSL is rare and has a broad morphological spectrum. IHC and molecular tests are needed for definitive diagnosis. Compared with current commonly used IHC markers, SS18-SSX fusion antibody has better sensitivity to PSSL, which could be used as an alternative for FISH, reverse transcription-polymerase chain reaction or next generation sequencing in the diagnosis of PSSL.

Pressure-Induced Superconductivity up to 9 K in the Quasi-One-Dimensional KMn_{6}Bi_{5}

The Mn-based superconductor is rare owing to the strong magnetic pair-breaking effect. Here we report on the discovery of pressure-induced superconductivity in KMn_{6}Bi_{5}, which becomes the first ternary Mn-based superconductor. At ambient pressure, the quasi-one-dimensional KMn_{6}Bi_{5} is an antiferromagnetic metal with T_{N}≈75  K. By measuring resistance and ac magnetic susceptibility under hydrostatic pressures up to 14.2 GPa in a cubic anvil cell apparatus, we find that its antiferromagnetic transition can be suppressed completely at a critical pressure of P_{c}≈13  GPa, around which bulk superconductivity emerges and displays a superconducting dome with the maximal T_{c}^{onset}=9.3  K achieved at about 14 GPa. The close proximity of superconductivity to a magnetic instability in the temperature-pressure phase diagram of KMn_{6}Bi_{5} and an unusually large μ_{0}H_{c2}(0) exceeding the Pauli paramagnetic limit suggests an unconventional magnetism-mediated paring mechanism. In contrast to the binary MnP, the flexibility of the crystal structure and chemical compositions in the ternary AMn_{6}Bi_{5} (A=alkali metal) can open a new avenue for finding more Mn-based superconductors.

Structural, Optical, and Electronic Properties of Two Quaternary Chalcogenide Semiconductors: Ag2SrSiS4 and Ag2SrGeS4

Quaternary chalcogenide materials have long been a source of semiconductors for optoelectronic applications. Recent studies on I₂-II-IV-X₄ (I = Ag, Cu, Li; II = Ba, Sr, Eu, Pb; IV = Si, Ge, Sn; X = S, Se) materials have shown particular versatility and promise among these compounds. These semiconductors take advantage of a diverse bonding scheme and chemical differences among cations to target a degree of antisite defect resistance. Within this set of compounds, the materials containing both Ag and Sr have not been experimentally studied and leave a gap in the full understanding of the family. Here, we have synthesized powders and single crystals of two Ag- and Sr-containing compounds, Ag₂SrSiS₄ and Ag₂SrGeS₄, each found to form in the tetragonal I4̅2m structure of Ag₂BaGeS₄. During the synthesis targeting the title compounds, two additional materials, Ag₂Sr₃Si₂S₈ and Ag₂Sr₃Ge₂S₈, have also been identified. These cubic compounds represent impurity phases during the synthesis of Ag₂SrSiS₄ and Ag₂SrGeS₄. We show through hybrid density functional theory calculations that Ag₂SrSiS₄ and Ag₂SrGeS₄ have highly dispersive band-edge states and indirect band gaps, experimentally measured as 2.08(1) and 1.73(2) eV, respectively. Second-harmonic generation measurements on Ag₂SrSiS₄ and Ag₂SrGeS₄ powders show frequency-doubling capabilities in the near-infrared range.

Double Superconducting Dome and Triple Enhancement of T_{c} in the Kagome Superconductor CsV_{3}Sb_{5} under High Pressure

CsV_{3}Sb_{5} is a newly discovered Z_{2} topological kagome metal showing the coexistence of a charge-density-wave (CDW)-like order at T^{*}=94  K and superconductivity (SC) at T_{c}=2.5  K at ambient pressure. Here, we study the interplay between CDW and SC in CsV_{3}Sb_{5} via measurements of resistivity, dc and ac magnetic susceptibility under various pressures up to 6.6 GPa. We find that the CDW transition decreases with pressure and experience a subtle modification at P_{c1}≈0.6-0.9  GPa before it vanishes completely at P_{c2}≈2  GPa. Correspondingly, T_{c}(P) displays an unusual M-shaped double dome with two maxima around P_{c1} and P_{c2}, respectively, leading to a tripled enhancement of T_{c} to about 8 K at 2 GPa. The obtained temperature-pressure phase diagram resembles those of unconventional superconductors, illustrating an intimated competition between CDW-like order and SC. The competition is found to be particularly strong for the intermediate pressure range P_{c1}≤P≤P_{c2} as evidenced by the broad superconducting transition and reduced superconducting volume fraction. The modification of CDW order around P_{c1} has been discussed based on the band structure calculations. This work not only demonstrates the potential to raise T_{c} of the V-based kagome superconductors, but also offers more insights into the rich physics related to the electron correlations in this novel family of topological kagome metals.

[Written at the closing year of the "three 90%" strategic goal for AIDS prevention and treatment]

In 2014, Joint United Nations Programme on HIV/AIDS (UNAIDS) put forward the goal of ending HIV epidemic by 2030 at the International AIDS Conference and proposed the strategic goal of achieving "three 90%" by 2020. This year is the closing year of this strategic goal, and all regions have begun to evaluate the progress of implementing the goal. This article discussed the progress of the implementation of the "three 90%", and scientifically interpreted the strategic goal. It is proposed that the goal is a relative and dynamic concept, and only if we sieze the opportunity to achieve the strategic goal and continuously enhance comprehensive prevention and control, can the HIV epidemic be better controlled.

[Spatio-temporal distribution of Oncomelania hupensis snails along the Danyang section of the Beijing-Hangzhou Grand Canal and the Danyang-Jintan-Liyang Canal]

OBJECTIVE

To explore the spatio-temporal characteristics of Oncomelania hupensis snails along the Danyang section of the Beijing-Hangzhou Grand Canal and the Danyang-Jintan-Liyang Canal, so as to provide scientific evidence for the dynamic assessment of the risk of snail spread in this region.

METHODS

O. hupensis snail status was collected in the plain regions with waterway networks in the study area from 2012 to 2017. The spatio-temporal variations of snail distribution were investigated along the Danyang section of the Beijing-Hangzhou Grand Canal and the Danyang-Jintan-Liyang Canal using buffer zone analysis, spatial autocorrelation, hotspot analysis and standard deviational ellipse with the geographical information system (GIS) tools.

RESULTS

The number of snail habitats showed a tendency towards a rise in the study area from 2012 to 2017, and snail habitats were predominantly distributed in the 1 000 m long buffer zone of the Danyang-Jintan-Liyang Canal, notably along the Jiuqu River at the junction between the Beijing-Hangzhou Grand Canal and the Danyang-Jintan-Liyang Canal. The distribution of snail habitats appeared spatial autocorrelations in 2014, 2016 and 2017, and the hotspot areas were mainly identified at the junction between the Danyang-Jintan-Liyang Canal and the Beijing-Hangzhou Grand Canal. In addition, the overall distribution of snail habitats was located in the northeastern-southwestern part of the study aera, and gradually shifted to the southern and northern parts with the time.

CONCLUSIONS

The spatial distribution of O. hupensis snails is complex along the Danyang section of the Beijing-Hangzhou Grand Canal and the Danyang-Jintan-Liyang Canal, and there is a risk of snail spread from the upper reaches to the lower reaches, where snail control needs to be intensified.

Combination of the gamma-glutamyltransferase-to-prealbumin ratio and other indicators may be a novel marker for predicting the prognosis of patients with hepatocellular carcinoma undergoing locoregional ablative therapies

Objective

The aim of this study was to investigate the prognostic significance of the serum γ-glutamyltransferase (γ-GT)-to-prealbumin ratio (GPR) and whether combining this ratio with other parameters can lead to an improved prognostic value for patients with hepatocellular carcinoma (HCC) undergoing transcatheter arterial chemoembolization (TACE) combined with local ablation therapy.

Methods

A total of 235 HCC patients who were treated with combined therapies were retrospectively analyzed. The demographic data and clinicopathological data were collected. A fibrinogen (Fib)-GPR score of 2 was assigned to patients with elevated Fib and GPR values, and a score of 1 or 0 was assigned to patients with one or neither of these two markers, respectively. In addition, an N-score of 2 was assigned to patients with low neutrophil and high GPR values, and a score of 1 or 0 was assigned to patients with one or neither of these two markers, respectively. The optimal cutoff values and prognostic roles of GPR and other markers were identified according to the time-dependent receiver operating characteristic (ROC) curves and Youden’s index.

Results

Multiple tumors, high levels of α-fetoprotein (AFP) and Fib, as well as a high GPR, were found to be independent risk factors in recurrent patients, while multiple tumors, a low neutrophil count, and a high GPR were associated with reduced overall survival (OS) in patients with HCC who received combined therapies. Patients with a Fib-GPR score of 2 and N-GPR score of 2 had poor recurrence-free survival (RFS) and OS, respectively.

Conclusions

Fib-GPR and N-GPR scores may be helpful in predicting both recurrence and the prognosis of HCC patients, thereby assisting in the process to make a true clinical decision and optimize therapeutic options.

[Prognostic value of combined preoperative fibrinogen and platelet-lymphocyte ratio in patients with early recurrent hepatocellular carcinoma]

Objective: To explore the risk factors in HBV-associated hepatocellular carcinoma (HCC) patients with early recurrence after ablation and to establish predictive model. Methods: A total of 81 patients with HBV-related HCC who underwent ablation from January 2016 to December 2016 were included in Beijing Youan Hospital, including 66 males and 15 females. Standard medical records were collected, which were summarized as follows: demographic data, liver function, the number and size of tumors and the modality of ablation. Univariate and multivariate analysis were performed to identify the independent risk factors.The ROC curve was used to determine prognostic value. Cox proportional hazards model was used to establish predictive model, and the scores of risk factors were assigned according to HR value. Patients were divided into high-risk group and low-risk group in accordance with scores.The analysis of early recurrence rate was performed by the Kaplan-Meier method. Results: Tumor number, fibrinogen (Fib) and platelet-lymphocyte rate (PLR) were independently correlated with recurrence-free survival (RFS). The AUCs of Fib, PLR and Fib-PLR were 72.9%, 71.5% and 81.8%. The recurrence rates of the low-risk group were 4.9%,7.3% and 29.3% at 6 months,12 months and 24 months while 14.6%,43.9% and 78.1% in high-risk group. Two groups revealed statistically significant differences (all P<0.05). Conclusion: Tumor number, Fib, and PLR may be used as a set of predictive indicator of early recurrence in HBV-associated HCC patients after ablation.

[Development of a quantitative serum assay of Golgi protein 73 in hepatocellular carcinoma using xMAP technology]

Objective: To establish a quantitative assay of serum Golgi protein 73 (GP73) using xMAP technology and evaluate its performance. Methods: Monoclonal antibodies against GP73 were prepared and purified, and antibody pair screening was performed by double-antibody sandwich enzyme-linked immunosorbent assay. The screened antibodies were used to construct a Luminex liquid chip detection system, and the analysis performance of the detection system was evaluated. The serum levels of GP73 were detected in 90 clinical samples from healthy controls and patients with chronic hepatitis B infection (CHB) and hepatocellular carcinoma (HCC). Results: Five anti-GP73 monoclonal antibodies were prepared and purified, and 5 antibody pairs were successfully screened. The Luminex liquid chip detection system of GP73 was successfully constructed using 8F10D1 and 10B9F11 antibody pairs. The analytical performance evaluation showed that the sensitivity of this system was 0.25 ng/ml and the dynamic range was 0.25-100 ng/ml. No cross reactivity was observed. The intra- and inter-assay variation for GP73 was <8% and <11%, respectively. The recovery was 83%-92%. The linear regression equation was y=1.141x+ 6.436 (r(2)=0.998 4, P<0.001). The GP73 concentrations in the serum samples of healthy control, CHB group, and HCC group were 42.8 (38.68, 55.90) ng/ml, 61.49 (43.59, 81) ng/ml, and 122.78 (49.36 liter, 264.55) ng/ml, respectively. The levels of GP73 in HCC group were significantly higher than those in CHB group and healthy controls (P<0.05). Moreover, the levels of GP73 in CHB group were significantly higher than those in healthy controls (P<0.05). Conclusions: A liquid chip detection system of GP73 was successfully constructed. It provides a powerful tool for the clinical application of GP73 in the future.

Magnetic-Competition-Induced Colossal Magnetoresistance in n-Type HgCr_{2}Se_{4} under High Pressure

The n-type HgCr_{2}Se_{4} exhibits a sharp semiconductor-to-metal transition (SMT) in resistivity accompanying the ferromagnetic order at T_{C}=106  K. Here, we investigate the effects of pressure and magnetic field on the concomitant SMT and ferromagnetic order by measuring resistivity, dc and ac magnetic susceptibility, as well as single-crystal neutron diffraction under various pressures up to 8 GPa and magnetic fields up to 8 T. Our results demonstrate that the ferromagnetic metallic ground state of n-type HgCr_{2}Se_{4} is destabilized and gradually replaced by an antiferromagnetic, most likely a spiral magnetic, and insulating ground state upon the application of high pressure. On the other hand, the application of external magnetic fields can restore the ferromagnetic metallic state again at high pressures, resulting in a colossal magnetoresistance (CMR) as high as ∼ 3×10^{11}% under 5 T and 2 K at 4 GPa. The present study demonstrates that n-type HgCr_{2}Se_{4} is located at a peculiar critical point where the balance of competition between ferromagnetic and antiferromagnetic interactions can be easily tipped by external stimuli, providing a new platform for achieving CMR in a single-valent system.

Effect of pressure on the self-hole-doped superconductor RbGd2Fe4As4O2

RbGd₂Fe₄As₄O₂ is a newly discovered self-hole-doped stoichiometric superconductor, which has a hybrid structure with separated double FeAs layers and exhibits a high superconducting transition temperature T _c  =  35 K. Here, we report the effect of pressure (P) on its T _c and normal-state transport properties by measuring the temperature dependence of resistivity ρ(T) under various pressures up to 14 GPa with a cubic anvil cell apparatus. We found that the T _c is suppressed monotonically to ca. 12.5 K upon increasing pressure to 14 GPa with a slope change of T _c(P) at around 4 GPa. In addition, the low-temperature normal-state ρ(T), which is proportional to T ⁿ , also evolves gradually from a non-Fermi-liquid with n  =  1 at ambient pressure to a Fermi liquid with n  =  2 at P  ⩾  4 GPa. Accompanying with the non-Fermi-liquid to Fermi-liquid crossover, the quadratic temperature coefficient of resistivity, which reflects the effective mass of charge carriers, also experiences a significant reduction as commonly observed in the vicinity of a magnetic quantum critical point (QCP). Our results indicate that the stoichiometric RbGd₂Fe₄As₄O₂ at ambient pressure might be located near a QCP such that the enhanced critical spin fluctuations lead to high-T _c superconductivity. The application of pressure should broaden the electronic bandwidth and weaken the spin fluctuations, and then restore a Fermi-liquid ground state with lower T _c.

[The expressions and the roles of SDF-1/CXCR-4 and SDF-1/CXCR-4 in human endometriosis]

Objective: To investigate the expressions and significances of SDF-1 and its receptor CXCR-4 in endometriosis. Methods: 50 hysteromyoma patients treated at Beijing Tongren Hospital, Capital Medical University between 1(st) January 2016 and 31(st) December 2017 were divided into control group, that is, non-endometriosis group, while another 50 endometriosis patients were divided into experimental group.The endometrial tissues, endometriosis lesions, and peritoneal fluid samples of hysteromyoma patients were collected by operation.RT-PCR, ELISA and immunohistochemistry were adopted to detect the expressions of SDF-1 and CXCR-4 in the two groups.Cell count was used to analyze the roles of SDF-1 and CXCR4 in the mitosis and proliferation of endometrial stromal cells. Results: The mean value of SDF-1 and CXCR-4 expressions in ascites or peritoneal fluid of endometriosis patients were (2.56±0.33) mg/L and (4.47±0.32) mg/L, respectively. The mean concentrations in ascites or peritoneal fluid in hysteromyoma patients were (1.39±0.36) mg/L and (3.16±0.32) mg/L, respectively.The expressions of SDF-1 and CXCR-4 in ascites or peritoneal fluid of endometriosis patients were both significantly higher than those of patients in non-endometriosis group (P<0.05). SDF-1 and CXCR-4 were expressed in both endometriosis lesions and the glandular epithelial cells and mesenchymal cells of normal endometrial tissue.Positive staining sites were located in the cytoplasm.A value was used to calculate and analyze the expression of immune staining.The mean A value of SDF-1 and CXCR-4 in endometriosis group were 0.21±0.13 and 0.21±0.13, respectively, and the mean A value in normal endometrial tissues were 0.15±0.13 and 0.14±0.13, respectively.The expressions of these two in endometrial tissues were significantly higher than that in normal endometrial tissues, and the differences were statistically significant (P<0.05). The expression of CXCR-4 mRNA was abundant in the mesenchymal cells of endometriosis cultured in vitro.SDF-1 promoted the mitosis and proliferation of endometrial stromal cells cultured in vitro in a dose-dependent manner.The neutralizing antibody against CXCR-4 was obviously inhibited. Conclusion: The high expressions of SDF-1 and CXCR-4 in endometriosis as well as SDF-1 through its specific receptor CXCR-4 promoted the mitosis and proliferation of endometrial stromal cells, suggesting that SDF-1 and CXCR-4 played important roles in the pathogenesis of endometriosis.

Effect of hydrostatic pressure on the superconducting properties of quasi-1D superconductor K2Cr3As3

K₂Cr₃As₃ is a newly discovered quasi-1D superconductor with a T _c  =  6.1 K and an upper critical field µ ₀ H _c2(0)  ≈  40 T three times larger than the Pauli paramagnetic limit µ ₀ H _p that is suggestive of a spin-triplet Cooper pairing. In this paper, we have investigated the effects of hydrostatic pressure on its T _c and µ ₀ H _c2 by measuring the ac magnetic susceptibility χ'(T) under magnetic fields at various hydrostatic pressures up to 7.5 GPa. The major findings include: (1) T _c is suppressed gradually to below 2 K at 7.5 GPa; (2) the estimated µ ₀ H _c2(0) decreases dramatically to below µ ₀ H _p above ~2 GPa and becomes slight lower than the orbital limiting field [Formula: see text] estimated from the initial slope of upper critical field via [Formula: see text]  =  -0.73T _cdH _c2/[Formula: see text] in the clean limit; (3) the estimated Maki parameter α  =  √2[Formula: see text]/H _p drops from 4 at ambient pressure to well below 1 at P  >  2 GPa, suggesting the crossover from Pauli paramagnetic limiting to orbital limiting in the pair breaking process upon increasing pressure. These observations suggested that the application of hydrostatic pressure could drive K₂Cr₃As₃ away from the ferromagnetic instability and lead to a breakdown of the spin-triplet pairing channel. We have also made a side-by-side comparison and discussed the distinct effects of chemical and physical pressures on the superconducting properties of K₂Cr₃As₃.

[Analysis of Spatial Clustering of HIV infected in men who have sex with men in Chongqing of 2004-2015]

Objective: To analyze the spatial clustering characteristics of HIV/AIDS among men who have sex with men (MSM) in Chongqing from January 2004 to December 2015 and understand the HIV/AIDS related behaviors among MSM by interview. Methods: Data related to MSM who were infected with HIV and whose present address were in Chongqing, were collected from Information System on the HIV/AIDS Prevention and Control. Information included the age when the information was inputted, address, occupation, education level, and marital status. The total number of MSM who were infected with HIV and reported was 6 604 in Chongqing. Those with unknown address were ruled out. The spatial autocorrelation analysis and the local spatial autocorrelation analysis were carried out by using ArcGIS 10.3. In addition, in November 2015 and May 2016, using a convenience sampling, we conducted one-on-one interviews among 23 MSM in the Chongqing Center for Disease Control and prevention.

INCLUSION CRITERIA

Receiving voluntary counseling and testing in the urban area of Chongqing and willing to participate in the interview by oral informed consent; male and self-described as MSM. The content of the interview included basic information, sexual orientation, sexual role, the main place of making friends, the main place of sexual behavior, a long-term experience in other provinces and drug abuse. Results: The HIV/AIDS reported number in Chongqing from 2004 to 2015 showed an uptrend, except in 2010. The age distribution of 6 604 cases of HIV positive patients was mainly concentrated in the 15-34 years old, about 68.5% (4 522 cases). There was a positive spatial autocorrelation in MSM, except 2005 (Moran's I=-0.046, P=0.823), form 2004 to 2015, Global Moran's I values were 0.308, 0.254, 0.335, 0.683, 0.673, 0.558, 0.620, 0.673, 0.685, 0.654 and 0.649, respectively; all P values were <0.01. The result of local spatial autocorrelation analysis showed that high-high accumulation area development in Chongqing city was divided into two stages in 2004-2015, which were Yuzhong, Jiangbei, and Shapingba district in 2004-2007 and the expanded Jiulongpo, Nan'an, and Yubei district in 2008-2015. Qualitative interviews results revealed that the age of the respondents was 20-44, and the mainly way of making friends were using mobile phone App and internet (17 participants). Most of the participants (11 participants) were making friends in the bar. The majority of respondents would ask the friends or themselves to use condoms when meeting with them the first time (19 participants), and 8 of respondents reported that they would not use condoms when their old friends refused to use condoms. Conclusion: The HIV infected MSM mainly aged between 15-34 years old and the spatial distribution of HIV/AIDS among MSM was clustered in economically developed main area in Chongqing. MSM began to make friends on the Internet, and could not adhere to using condom, which indicated that we should focus on internet intervention to find more efficacious interventions.

[Expanding test and normalization for HIV/AIDS prevention and control]

Expanding real-name HIV test is the basis of the real-time reporting system in China, and it plays an important role for the progress. In year of 2003, there were 45 092 cases of HIV positives reported cumulatively, which accounted for only 5.4% of the estimated population of HIV positives. Since implementation of real-name HIV test and establishment, real-time reporting system, up to year 2005, the total of reported HIV positives was 577 000, which took up 67.9% of the estimated HIV positives. Also among reported cases, 387 000 cases have received the anti-retroviral treatment. Normalization of HIV prevention and control will pave the way to medical insurance for HIV positives. It is a goal that all the people have medical insurance in China, and the normalization is an ideal working condition, and real-name HIV test is a measure for it. The both are very closely connected and improving each anther.

[The social marketing models and policy advices for HIV rapid testing initiated by non-govermental organization]

Currently, a growing number of community-based organizations are providing rapid HIV testing service in various forms, some people with specific needs also purchase HIV rapid test papers through online sales channels, those imply that the demand of HIV self-test is in increasing year by year.In this paper, aims to understand the current situation of HIV rapid test led by CBOs and the approach, strategies and results of social marketing by means of expert interviews and site visits. Hope to illustrate the current situation, and make recommendations for future work.

High-T_{c} Superconductivity in FeSe at High Pressure: Dominant Hole Carriers and Enhanced Spin Fluctuations

The importance of electron-hole interband interactions is widely acknowledged for iron-pnictide superconductors with high transition temperatures (T_{c}). However, the absence of hole pockets near the Fermi level of the iron-selenide (FeSe) derived high-T_{c} superconductors raises a fundamental question of whether iron pnictides and chalcogenides have different pairing mechanisms. Here, we study the properties of electronic structure in the high-T_{c} phase induced by pressure in bulk FeSe from magnetotransport measurements and first-principles calculations. With increasing pressure, the low-T_{c} superconducting phase transforms into the high-T_{c} phase, where we find the normal-state Hall resistivity changes sign from negative to positive, demonstrating dominant hole carriers in contrast to other FeSe-derived high-T_{c} systems. Moreover, the Hall coefficient is enlarged and the magnetoresistance exhibits anomalous scaling behaviors, evidencing strongly enhanced interband spin fluctuations in the high-T_{c} phase. These results in FeSe highlight similarities with high-T_{c} phases of iron pnictides, constituting a step toward a unified understanding of iron-based superconductivity.

Exposure to famine in early life and the risk of obesity in adulthood in Qingdao: Evidence from the 1959-1961 Chinese famine

BACKGROUND AND AIMS

We aimed to evaluate the association between famine exposure during early life and obesity and obesity_max (obese at the highest weight) in adulthood.

METHODS AND RESULTS

Data were from two population-based cross-sectional surveys conducted in 2006 and 2009 in Qingdao, China. A total of 8185 subjects born between 1/1/1941 and 12/31/1971 were categorized into unexposed (born between 01/01/1962 and 12/31/1971), fetal/infant exposed (born between 01/01/1959 and 12/31/1961), childhood exposed (born between 01/01/1949 and 12/31/1958) and adolescence exposed (born between 01/01/1941 and 12/31/1948) according to their age when exposed to the Chinese famine from 1959 to 1961. Obesity was defined as BMI (body mass index) ≥28.0 and obesity_max was defined as BMI_max (BMI at the highest weight) ≥28.0. We compared fetal/infant exposed, childhood exposed and adolescence exposed to the unexposed using logistic regression models to assess the effect of famine exposure on later obesity and obesity_max. Fetal/infant exposed (OR = 1.59, P < 0.001), childhood exposed (OR = 1.42, P < 0.01) and adolescence exposed (OR = 1.86, P < 0.01) all had higher risks of obesity than the unexposed. Exposure groups were more likely to be obese at their highest weight than the unexposed, and ORs (95%CIs) for obesity_max in the fetal/infant exposed, childhood exposed and adolescence exposed were 1.49(1.20-1.86), 1.24(1.02-1.49) and 1.64 (1.40-1.93), respectively. Similar results were found in both men and women.

CONCLUSION

Exposure to famine in early life was associated with increased risks of obesity and obesity_max in adulthood. Preventing undernutrition in early life appears beneficial to reduce the prevalence of later obesity.

β-Arrestins promote podocyte injury by inhibition of autophagy in diabetic nephropathy

β-Arrestins are multifunctional proteins originally identified as negative adaptors of G protein-coupled receptors (GPCRs). Emerging evidence has also indicated that β-arrestins can activate signaling pathways independent of GPCR activation. This study was to elucidate the role of β-arrestins in diabetic nephropathy (DN) and hypothesized that β-arrestins contribute to diabetic renal injury by mediating podocyte autophagic process. We first found that both β-arrestin-1 and β-arrestin-2 were upregulated in the kidney from streptozotocin-induced diabetic mice, diabetic db/db mice and kidney biopsies from diabetic patients. We further revealed that either β-arrestin-1 or β-arrestin-2 deficiency (Arrb1^−/− or Arrb2^−/−) ameliorated renal injury in diabetic mice. In vitro, we observed that podocytes increased both β-arrestin-1 and β-arrestin-2 expression levels under hyperglycemia condition and further demonstrated that β-arrestin-1 and β-arrestin-2 shared common mechanisms to suppress podocyte autophagy by negative regulation of ATG12–ATG5 conjugation. Collectively, this study for the first time demonstrates that β-arrestin-1 and β-arrestin-2 mediate podocyte autophagic activity, indicating that β-arrestins are critical components of signal transduction pathways that link renal injury to reduce autophagy in DN. Modulation of these pathways may be an innovative therapeutic strategy for treating patients with DN.

The Silicon:Colloidal Quantum Dot Heterojunction

A heterojunction between crystalline silicon and colloidal quantum dots (CQDs) is realized. A special interface modification is developed to overcome an inherent energetic band mismatch between the two semiconductors, and realize the efficient collection of infrared photocarriers generated in the CQD film. This junction is used to produce a sensitive near infrared photodetector.

Perovskite-fullerene hybrid materials suppress hysteresis in planar diodes

Solution-processed planar perovskite devices are highly desirable in a wide variety of optoelectronic applications; however, they are prone to hysteresis and current instabilities. Here we report the first perovskite-PCBM hybrid solid with significantly reduced hysteresis and recombination loss achieved in a single step. This new material displays an efficient electrically coupled microstructure: PCBM is homogeneously distributed throughout the film at perovskite grain boundaries. The PCBM passivates the key PbI3(-) antisite defects during the perovskite self-assembly, as revealed by theory and experiment. Photoluminescence transient spectroscopy proves that the PCBM phase promotes electron extraction. We showcase this mixed material in planar solar cells that feature low hysteresis and enhanced photovoltage. Using conductive AFM studies, we reveal the memristive properties of perovskite films. We close by positing that PCBM, by tying up both halide-rich antisites and unincorporated halides, reduces electric field-induced anion migration that may give rise to hysteresis and unstable diode behaviour.

Pressure induced superconductivity on the border of magnetic order in MnP

We report the discovery of superconductivity on the border of long-range magnetic order in the itinerant-electron helimagnet MnP via the application of high pressure. Superconductivity with T(sc)≈1  K emerges and exists merely near the critical pressure P(c)≈8  GPa, where the long-range magnetic order just vanishes. The present finding makes MnP the first Mn-based superconductor. The close proximity of superconductivity to a magnetic instability suggests an unconventional pairing mechanism. Moreover, the detailed analysis of the normal-state transport properties evidenced non-Fermi-liquid behavior and the dramatic enhancement of the quasiparticle effective mass near P(c) associated with the magnetic quantum fluctuations.

The structural evolution of an isoindigo-based non-fullerene acceptor for use in organic photovoltaics

The structural evolution of an isoindigo molecule acceptor.

High open circuit voltage organic solar cells based upon fullerene free bulk heterojunction active layers

We have recently reported on a small organic molecule containing a bithiophene core with end-capping phthalimide units (PthTh2Pth) that exhibited a H-aggregation tendency in the solid state and high electron mobility in organic field effect transistors. In this contribution, we have studied both the physical and electrical properties of poly(3-hexylthiophene) (P3HT) and PthTh2Pth thin films by measuring the optical absorption, Frontier molecular orbital energy levels, photoluminescence quenching, thermal properties, and photovoltaic response. Our results have provided a useful insight into the use of PthTh2Pth as an electron acceptor material for organic photovoltaic applications. In comparison with high-performance, fullerene-based, solution-processed bulk heterojunction solar cells reported in the literature, a relatively high open circuit voltage (∼0.94 V) was obtained for various donor–acceptor blend ratios. These results highlight the potential for PthTh2Pth to act as an alternative to fullerenes as acceptors in organic solar cell devices.

Cardiovascular risk profiles in relation to newly diagnosed type 2 diabetes diagnosed by either glucose or HbA1c criteria in Chinese adults in Qingdao, China

AIMS

To study the cardiovascular disease risk profiles in newly diagnosed diabetes diagnosed by either glucose or/and HbA(1c) criteria in Chinese adults.

METHODS

Two population-based cross-sectional studies were conducted in 2006 and 2009, respectively. Data from 1987 men and 2815 women aged 35-74 years were analysed. Newly diagnosed diabetes was defined according to either glucose (fasting and/or 2-h glucose), HbA(1c) or both criteria.

RESULTS

Ageing, positive family history of diabetes, elevated levels of waist circumference, systolic blood pressure, total cholesterol, triglycerides and γ-glutamyl transferase were independently associated with newly diagnosed diabetes defined by glucose criterion alone, but not for diabetes defined by HbA(1c) criterion alone. Only waist circumference, total cholesterol and smoking were significantly associated with the presence of diabetes defined by HbA(1c) criterion alone.

CONCLUSIONS

Cardiovascular disease risk profiles were different in patients with newly diagnosed diabetes defined by the two diagnostic criteria for diabetes. This may have certain clinical implications on diabetes management and research.

Air-stable n-type colloidal quantum dot solids

Colloidal quantum dots (CQDs) offer promise in flexible electronics, light sensing and energy conversion. These applications rely on rectifying junctions that require the creation of high-quality CQD solids that are controllably n-type (electron-rich) or p-type (hole-rich). Unfortunately, n-type semiconductors made using soft matter are notoriously prone to oxidation within minutes of air exposure. Here we report high-performance, air-stable n-type CQD solids. Using density functional theory we identify inorganic passivants that bind strongly to the CQD surface and repel oxidative attack. A materials processing strategy that wards off strong protic attack by polar solvents enabled the synthesis of an air-stable n-type PbS CQD solid. This material was used to build an air-processed inverted quantum junction device, which shows the highest current density from any CQD solar cell and a solar power conversion efficiency as high as 8%. We also feature the n-type CQD solid in the rapid, sensitive, and specific detection of atmospheric NO2. This work paves the way for new families of electronic devices that leverage air-stable quantum-tuned materials.

Diabetes self-risk assessment questionnaires coupled with a multimedia health promotion campaign are cheap and effective tools to increase public awareness of diabetes in a large Chinese population

AIMS

To evaluate costs and effectiveness of implementing a diabetes self-risk assessment (Diabetes Risk Score) questionnaire coupled with a multimedia health promotion campaign on changes in diabetes awareness in a large diabetes prevention programme.

METHODS

Between 2007 and 2010, a multimedia health promotion campaign was conducted targeting the 1.94 million population of Qingdao, China, using newspapers, radio programmes, distribution of free booklets and Diabetes Risk Score flyers. Diabetes awareness questionnaires filled out by people first interviewed in 2006 (survey A), before the initiation of the campaign, were compared with those first interviewed between 2007 and 2010 during the campaign period (survey B). The rates of diabetes awareness in both surveys were studied amongst adults aged 35-74 years without a prior history of diabetes, but with a Diabetes Risk Score of ≥ 14.

RESULTS

In survey B, 85, 82 and 76% of the urban participants correctly recognized obesity, family history of diabetes and physical inactivity, respectively, as important risk factors for diabetes; while the awareness rates were 43, 46 and 25%, respectively, in survey A (P < 0.001). The corresponding figures among rural participants were 65, 63 and 53% in survey B and 29, 22 and 11% in survey A (P < 0.001). To cover 1000 individuals, the programme spent €5.4 on the use of the Diabetes Risk Score flyer, €31.3 on the education booklet, €7.7 on the newspaper campaign and €37.5 on radio programmes.

CONCLUSIONS

The combination of a Diabetes Risk Score questionnaire with a multimedia health promotion campaign is a cheap and effective health promotion tool to raise public awareness of diabetes.

Respiratory variation of mitral and pulmonary venous Doppler flow velocities in constrictive pericarditis before and after pericardiectomy

The objective of this study was to determine whether Doppler echocardiography is useful in assessing the effects of pericardiectomy in patients with constrictive pericarditis by studying the postoperative change in the respiratory variation of mitral inflow and pulmonary venous Doppler flows. The study population consisted of 35 cases with surgically proven constrictive pericarditis. Thirty-five patients had preoperative Doppler echocardiography, whereas 4 patients died of non-cardiac causes and 1 patient had a heart transplant before follow-up. Postoperative studies were performed at a mean of 1081 +/- 84 days (range 120-2700 days) after pericardiectomy. The mean (+/- SD) respiratory variation changed after surgery from a baseline value of 17% +/- 14% to 8% +/- 8% for peak mitral E velocity (P <.01); from 25% +/- 18% to 7% +/- 13% (P <.001) for pulmonary venous (PV) peak diastolic flow velocity, and from 21% +/- 13% to 11% +/- 13% (P =.009) for PV peak systolic flow velocity. The 23 patients who became asymptomatic after surgery had a significantly lower mean mitral and PV respiratory variation than the 7 patients who were NYHA class II (4% +/- 4% and 6% +/- 4% vs 21% +/- 6% and 19% +/- 10%, respectively, P <.0001 for both). Pulsed Doppler echocardiographic assessment of respiratory variation is useful for evaluating the outcome of pericardiectomy.

Clinical and echocardiographic characteristics of papillary fibroelastomas: a retrospective and prospective study in 162 patients

BACKGROUND

Cardiac papillary fibroelastoma (CPF) is a primary cardiac neoplasm that is increasingly detected by echocardiography. The clinical manifestations of this entity are not well described.

METHODS AND RESULTS

In a 16-year period, we identified patients with CPF from our pathology and echocardiography databases. A total of 162 patients had pathologically confirmed CPF. Echocardiography was performed in 141 patients with 158 CPFs, and 48 patients had CPFs that were not visible by echocardiography (<0.2 cm), leaving an echocardiographic subgroup of 93 patients with 110 CPFs. An additional 45 patients with a presumed diagnosis of CPF were identified. The mean age of the patients was 60+/-16 years of age, and 46.1% were male. Echocardiographically, the mean size of the CPFs was 9+/-4.6 mm; 82.7% occurred on valves (aortic more than mitral), 43.6% were mobile, and 91.4% were single. During a follow-up period of 11+/-22 months, 23 of 26 patients with a prospective diagnosis of CPF that was confirmed by pathological examination had symptoms that could be attributable to embolization. In the group of 45 patients with a presumed diagnosis of CPF, 3 patients had symptoms that were likely due to embolization (incidence, 6.6%) during a follow-up period of 552+/-706 days.

CONCLUSIONS

CPFs are generally small and single, occur most often on valvular surfaces, and may be mobile, resulting in embolization. Because of the potential for embolic events, symptomatic patients, patients undergoing cardiac surgery for other lesions, and those with highly mobile and large CPFs should be considered for surgical excision.

[Effects of fluid percussion injury on intracellular [Ca2+]i and pH in cultured rat neurons]

AIM

To study the change of intracellular [Ca2+]i and pH in cultured neurons after fluid percussion injury, and the therapeutic effect of drugs.

METHODS

The neurons of Sprague Dawley rats were cultured for 8-14 days, then treated them with fluid percussion injury (2.5 kPa, 20 ms). Alterations of [Ca2+]i and pH in single neural cells following fluid percussion injury were measured by a laser scanning confocal microscope. After being injured for several hours the cultured neurons were treated with nimodipine or D-(-)-2-amino-5-phosphonovaleric acid (D-AP-5). Two hours later, the effects of drugs on intracellular [Ca2+]i and pH were studied.

RESULTS

The Intracellular [Ca2+]i increased quickly after brain injury and reached peak in 12 hours. It then decreased gradually and became normal at 48 hours. The pH decreased slowly, reached minimum in 12 hours, and then kept at a lower level. It did not recover normal at 48 hours. Nimodipine and D-AP-5 decreased significantly the ascension of [Ca2+]i and the descent of pH. But nimodipine and D-AP-5 must be given within 10 hours after injury for a good therapeutic effect.

CONCLUSION

According to the change of intracellular [Ca2+]i and pH, early use of nimodipine and D-AP-5, will get a better therapeutic effect.

Normal values of regional left ventricular endocardial motion: multicenter color kinesis study

Our goal was to establish normal values for quantitative color kinesis indexes of left ventricular (LV) wall motion over a wide range of ages, which are required for objective diagnosis of regional systolic and diastolic dysfunction. Color-encoded images were obtained in 194 normal subjects (95 males, 99 females, age 2 mo to 79 yr) in four standard views. Quantitative indexes of magnitude and timing of systolic and diastolic function were studied for age- and gender-related differences. Normal limits of all ejection and filling indexes were in a narrow range (< or =25% of the mean), with no major gender-related differences. Despite invariable ejection fractions, both peak filling and ejection rates decreased with age (30 and 20%, correspondingly) with a concomitant increase in mean filling and ejection times, resulting in five- and twofold increases in the late to early filling and ejection ratios, correspondingly. Diastolic asynchrony increased with age (from 4.7 +/- 2.0 to 6.4 +/- 3.2 from the 2nd to 7th decade). The normal values of color kinesis indexes should allow objective detection of regional LV systolic and diastolic dysfunction.

Left ventricular diastolic dysfunction in lone atrial fibrillation determined by Doppler tissue imaging of mitral annular motion

In this study, we sought evidence for an underlying atrial or ventricular myopathy in patients with paroxysmal lone atrial fibrillation using standard echocardiographic parameters in addition to Doppler tissue imaging of mitral annular motion. No impairment in atrial contractile function was found, but there was evidence for impaired diastolic function in these patients.

New digital measurement methods for left ventricular volume using real-time three-dimensional echocardiography: comparison with electromagnetic flow method and magnetic resonance imaging

AIM

The aim of this study was to investigate the feasibility and accuracy of using symmetrically rotated apical long axis planes for the determination of left ventricular (LV) volumes with real-time three-dimensional echocardiography (3DE).

METHODS AND RESULTS

Real-time 3DE was performed in six sheep during 24 haemodynamic conditions with electromagnetic flow measurements (EM), and in 29 patients with magnetic resonance imaging measurements (MRI). LV volumes were calculated by Simpson's rule with five 3DE methods (i.e. apical biplane, four-plane, six-plane, nine-plane (in which the angle between each long axis plane was 90 degrees, 45 degrees, 30 degrees or 20 degrees, respectively) and standard short axis views (SAX)). Real-time 3DE correlated well with EM for LV stroke volumes in animals (r=0.68-0.95) and with MRI for absolute volumes in patients (r-values=0.93-0.98). However, agreement between MRI and apical nine-plane, six-plane, and SAX methods in patients was better than those with apical four-plane and bi-plane methods (mean difference = -15, -18, -13, vs. -31 and -48 ml for end-diastolic volume, respectively, P<0.05).

CONCLUSION

Apically rotated measurement methods of real-time 3DE correlated well with reference standards for calculating LV volumes. Balancing accuracy and required time for these LV volume measurements, the apical six-plane method is recommended for clinical use.

Cigarette smoke exposure causes constriction of rat lung

Cigarette smoke is known to cause acute increases in airway resistance, but the mechanisms behind this effect are unknown. Lung explants were utilized to examine the constrictive effects of acute cigarette smoke exposure on bronchioles from rats in vitro that had or had not been previously exposed to cigarette smoke in vivo. It was found that smoke induced a small but consistent degree of contraction of the airways in vitro, which could be reduced by an endothelin receptor antagonist in the animals which had had no previous smoke exposure in vivo, and reduced by the oxidant scavengers superoxide dismutase or catalase in the animals with previous smoke exposure. In conclusion, cigarette smoke induces acute small airways constriction through both endothelin release and direct oxidant effects; which mechanisms are operative depends on the prior smoking status.

Dissociation of chronic vascular cell proliferation and vascular contractility after chronic cigarette smoke exposure

In guinea pigs, chronic cigarette smoke exposure produces physiological and structural alterations in the pulmonary vasculature via unknown mechanisms. This study aimed to determine whether chronic cigarette smoke exposure can induce altered pulmonary vascular reactivity, and whether chronic smoke exposure would be associated with a continued increase in vascular cell deoxyribonucleic acid (DNA) synthesis, indicative of cell proliferation. Guinea-pigs were therefore exposed to two regimens of smoke. In the first experiment, animals were exposed once to the smoke of seven cigarettes, and sacrificed 24 h post-smoke, while in the second experiment, the guinea-pigs were exposed for 5 days each week for 4 months. Control animals were exposed to air. Lung explant preparations and computer linked image photography were utilized to determine vascular reactivity, and DNA synthesis was assessed using the 5-bromo-2'-deoxyuridine technique. Neither acute nor chronic smoke exposure affected vascular reactivity, although the older animals had lesser reactivity. In the chronically smoked animals, evidence was found of ongoing vascular DNA synthesis, and evidence of structural alterations with increased muscularization of the arterioles (34.7+/-7.6% of arterioles in control versus 62.7+/-5.5% after smoke exposure). Despite evidence of continued deoxyribonucleic acid synthesis in the peribronchiolar vessels, the alterations of vascular physiology previously found in this model cannot be ascribed to increased reactivity at this site. Instead, the chronic deoxyribonucleic acid synthesis in the arterioles adjacent to the alveolar ducts, culminating in an increased number of fully muscularized vessels, would suggest this compartment as the most probable source.

Inferior vena caval masses identified by echocardiography

The most common cause of an inferior vena caval mass is renal cell carcinoma that extends through the lumen, occurring in 47 of 62 patients (85%). Detection of an inferior vena caval mass affects the surgical approach requiring cardiopulmonary bypass for resection when the mass extends to the heart.

Assessment of diastolic function by tissue Doppler echocardiography: comparison with standard transmitral and pulmonary venous flow

The objective of this study was to determine the utility of Doppler tissue echocardiography in the evaluation of diastolic filling and in discriminating between normal subjects and those with various stages of diastolic dysfunction. We measured myocardial velocities in 51 patients with various stages of diastolic dysfunction and in 27 normal volunteers. The discriminating power of each of the standard Doppler indexes of left ventricular filling, pulmonary venous flow, and myocardial velocities was determined with the use of Spearman rank correlation and analysis of variance F statistics. Early diastolic myocardial velocity (E(m)) was higher in normal subjects (16.0 +/- 3.8 cm/s) than in patients with either delayed relaxation (n = 15, 7.5 +/- 2.2 cm/s), pseudonormal filling (n = 26, 7.6 +/- 2.3 cm/s), or restrictive filling (n = 10, 7.4 +/- 2.4 cm/s, P <.0001). E(m ) was the best single discriminator between control subjects and patients with diastolic dysfunction (P =.7, F = 64.5). Myocardial velocities assessed by Doppler tissue echocardiography are useful in differentiating patients with normal from those with abnormal diastolic function. Myocardial velocity remains reduced even in those stages of diastolic dysfunction characterized by increased preload compensation.

New echocardiographic windows for quantitative determination of aortic regurgitation volume using color Doppler flow convergence and vena contracta

Color Doppler images of aortic regurgitation (AR) flow acceleration, flow convergence (FC), and the vena contracta (VC) have been reported to be useful for evaluating severity of AR. However, clinical application of these methods has been limited because of the difficulty in clearly imaging the FC and VC. This study aimed to explore new windows for imaging the FC and VC to evaluate AR volumes in patients and to validate this in animals with chronic AR. Forty patients with AR and 17 hemodynamic states in 4 sheep with strictly quantified AR volumes were evaluated. A Toshiba SSH 380A with a 3.75-MHz transducer was used to image the FC and VC. After routine echo Doppler imaging, patients were repositioned in the right lateral decubitus position, and the FC and VC were imaged from high right parasternal windows. In only 15 of the 40 patients was it possible to image clearly and measure accurately the FC and VC from conventional (left decubitus) apical or parasternal views. In contrast, 31 of 40 patients had clearly imaged FC regions and VCs using the new windows. In patients, AR volumes derived from the FC and VC methods combined with continuous velocity agreed well with each other (r = 0.97, mean difference = -7.9 ml +/- 9.9 ml/beat). In chronic animal model studies, AR volumes derived from both the VC and the FC agreed well with the electromagnetically derived AR volumes (r = 0.92, mean difference = -1.3 +/- 4.0 ml/beat). By imaging from high right parasternal windows in the right decubitus position, complementary use of the FC and VC methods can provide clinically valuable information about AR volumes.

Quantification of mitral regurgitation by automated cardiac output measurement: experimental and clinical validation

OBJECTIVES

To develop and validate an automated noninvasive method to quantify mitral regurgitation.

BACKGROUND

Automated cardiac output measurement (ACM), which integrates digital color Doppler velocities in space and in time, has been validated for the left ventricular (LV) outflow tract but has not been tested for the LV inflow tract or to assess mitral regurgitation (MR).

METHODS

First, to validate ACM against a gold standard (ultrasonic flow meter), 8 dogs were studied at 40 different stages of cardiac output (CO). Second, to compare ACM to the LV outflow (ACMa) and inflow (ACMm) tracts, 50 normal volunteers without MR or aortic regurgitation (44+/-5 years, 31 male) were studied. Third, to compare ACM with the standard pulsed Doppler-two-dimensional echocardiographic (PD-2D) method for quantification of MR, 51 patients (61+/-14 years, 30 male) with MR were studied.

RESULTS

In the canine studies, CO by ACM (1.32+/-0.3 liter/min, y) and flow meter (1.35+/-0.3 liter/min, x) showed good correlation (r=0.95, y=0.89x+0.11) and agreement (deltaCO(y-x)=0.03+/-0.08 [mean+/-SD] liter/min). In the normal subjects, CO measured by ACMm agreed with CO by ACMa (r=0.90, p < 0.0001, deltaCO=-0.09+/-0.42 liter/min), PD (r=0.87, p < 0.0001, deltaCO=0.12+/-0.49 liter/min) and 2D (r=0.84, p < 0.0001, deltaCO=-0.16+/-0.48 liter/min). In the patients, mitral regurgitant volume (MRV) by ACMm-ACMa agreed with PD-2D (r= 0.88, y=0.88x+6.6, p < 0.0001, deltaMRV=2.68+/-9.7 ml).

CONCLUSIONS

We determined that ACM is a feasible new method for quantifying LV outflow and inflow volume to measure MRV and that ACM automatically performs calculations that are equivalent to more time-consuming Doppler and 2D measurements. Additionally, ACM should improve MR quantification in routine clinical practice.

Long term cigarette smoke exposure does not increase airway responsiveness in rats

To ascertain whether chronic cigarette smoke exposure induces increased airway responsiveness, we performed methacholine response tests in Sprague-Dawley rats by calculating pulmonary resistance after nebulization of saline followed by an increasing concentration of methacholine. We also calculated the concentration of methacholine which doubled the baseline resistance (R200). Tests were performed at baseline and after 2, 4, 8, and 12 months of exposure to the smoke of seven cigarettes per day, 5 days each week; control animals were exposed to room air. At the completion of the study, there were 13 rats in the smoke-exposed group and 7 rats remaining in the control group. Airway morphology was assessed using a point counting technique. We found that (1) chronic exposure to cigarette smoke did not alter either the baseline resistance or the R200; (2) the saline baseline resistance decreased over time in the control animals; and (3) at the 12-month time point, smokers with increased baseline airway resistance had greater amounts of airway smooth muscle compared with the smoke-exposed animals without increased resistance. We conclude that in this animal model, long term exposure to cigarette smoke did not alter the response to methacholine but did increase airway smooth muscle and baseline resistance in some but not all animals.

Comparison of mortality rates and progression of left ventricular dysfunction in patients with idiopathic dilated cardiomyopathy and dilated versus nondilated right ventricular cavities

This study assesses the influence of right ventricular (RV) dilation on the progression of left ventricular (LV) dysfunction and survival in patients with idiopathic dilated cardiomyopathy (IDC). Using transthoracic echocardiography, we studied 100 patients with IDC aged 20 to 80 years (mean 55 +/- 14); 67% were men. In the apical 4-chamber view, diastolic LV and RV chamber area measurements classified patients into 2 groups: group RV enlargement+ (RV area/LV area > 0.5) included 54 patients; group RV enlargement- (no RV enlargement) had RV area/LV area < or = 0.5. Echocardiographic studies were repeated in all patients after a mean of 33 +/- 16 months. At the time of the initial study, the 2 groups did not differ in age, gender, incidence of atrial fibrillation and diabetes, left ventricular mass, and LV ejection fraction, but the RV enlargement+ group had more severe tricuspid regurgitation and less LV enlargement. After 47 +/- 22 months (range 12 to 96), patients in group RV enlargement+ had lower LV ejection fraction (29% vs 34%, p = 0.006) than patients with initial RV enlargement-. At clinical follow-up, mortality was higher (43%) in patients with initial RV enlargement+ than the RV enlargement- patients (15%), p = 0.002. For survivors, the mitral deceleration time averaged 157 +/- 36 ms; for nonsurvivors or patients who required transplant, the mitral deceleration time averaged 97 +/- 12 ms (p < 0.0001). With use of a multivariate Cox model adjusting for LV ejection fraction, LV size, and age, the relative risk ratio of mortality from initial RV enlargement+ was 4.4 (95% confidence limits 1.7 to 11.1) (p = 0.002). Thus, patients with significant RV dilation had nearly triple the mortality over 4 years and more rapidly deteriorating LV function than patients with less initial RV dilation. In IDC, RV enlargement is a strong marker for adverse prognosis that may represent a different morphologic subset.

A longitudinal analysis of pulmonary function in rats during a 12 month cigarette smoke exposure

We wanted to examine the longitudinal effects of chronic cigarette smoke exposure, and to determine whether the chronic alterations in pulmonary function induced by long-term cigarette smoke exposure in an animal model could be predicted by initial or early alterations in function. A group of Sprague Dawley rats was exposed to the smoke of 7 cigarettes x day(-1) for 5 days x week(-1) during a total period of 12 months. Lung volume, flow-volume curves and pressure-volume curves were recorded at baseline, and after 2, 4, 8 and 12 months of smoke exposure. A control group of rats was subjected to the same regimen of testing, but was not exposed to smoke. Thirteen rats completed the study in the smoke-exposed group and seven rats in the control group. We found that chronic exposure to cigarette smoke produced early abnormalities in pulmonary function, with the forced expiratory volume in one second/forced vital capacity (FEV1/FVC) ratio showing an acceleration of ageing effect, particularly between 4 and 8 months of exposure. In this model, although the two groups had significantly different airflow after 12 months, the initial values in each group were remarkably similar, and we could not identify any pulmonary function test which had predictive value. We conclude that longitudinal studies of cigarette smoke exposure in this rat model allow better characterization of the nature and time course of the effects of smoking on the lung.

Guinea pig pulmonary hypertension caused by cigarette smoke cannot be explained by capillary bed destruction

Chronic exposure to cigarette smoke is known to produce pulmonary hypertension in humans and in animal models, but the etiology of this process is controversial. To evaluate whether alterations in the structure of the pulmonary capillary bed or the peribronchiolar arterioles could be correlated with the pulmonary arterial pressure (Ppa), we examined the pulmonary vasculature in guinea pigs that had developed pulmonary hypertension after being exposed to cigarette smoke for 6 mo. The smoke-exposed animals had a significant increased Ppa compared with the control (air-exposed) animals (14.4 +/- 2.4 vs. 9.9 +/- 0.9 cmH2O). In the smoke-exposed animals, there was an increased percentage of muscularized peribronchiolar arterioles (33.5 +/- 5.8% smoke exposed vs. 56.1 +/- 5.8% control), and the capillary diameter and density were significantly decreased in both the center and periphery of the lobule (center diameter 8.8 +/- 1.9, periphery diameter 10.0 +/- 2.0 microns, center density 79 +/- 5, and periphery density 84 +/- 4 in smoked exposed vs. center diameter 7.7 +/- 1.9, periphery diameter 8.6 +/- 2.0 microns, center density 73 +/- 6, and periphery density 77 +/- 6 in controls). Neither group showed any correlation between these values and the Ppa. We conclude that although chronic exposure to cigarette smoke produces alteration of the capillary bed and pulmonary arterioles secondary to emphysematous air-space enlargement, these structural findings cannot explain the increase in Ppa. It appears that pulmonary hypertension due to chronic cigarette smoke exposure is a result of a primary alteration of capillary or muscular arteriolar vascular structure but instead may be secondary to alterations of the dynamic properties of the vascular bed with subsequent increase in vascular resistance.