Clinical characteristics and prognosis of patients with hypertrophic cardiomyopathy and heart failure with preserved ejection fraction

BACKGROUND

Whether heart failure with preserved ejection fraction (HFpEF) is associated with an increased risk of developing systolic dysfunction and a poor prognosis in hypertrophic cardiomyopathy (HCM) patients is unknown.

OBJECTIVE

We aimed to assess risk factors for the development of end-stage (ES) heart failure (HF) (ejection fraction < 50%) and compare the prognosis of different HF phenotypes.

METHODS

This retrospective study was conducted on patients with HCM in China between January 2009 and February 2023. Patients were stratified into three different groups: HCM-non-HF, HCM-HFpEF and HCM-heart failure with reduced ejection fraction (HCM-HFrEF). The primary outcome was a composite of major adverse cardiac events (MACEs), including all-cause deaths, HF hospitalization, sudden cardiac death and ventricular tachycardia.

RESULTS

Of 3,620 HCM patients enrolled, 1,553 (42.9%) had non-HF, 1,666 (46.0%) had HFpEF, and 579 patients (11.1%) had HFrEF at baseline. During the median follow-up period of 4.0 years (IQR 1.4-9.4 years), patients with HCM-HFpEF exhibited a higher incidence of ES-HF than those with HCM-non-HF (12.4% vs. 2.7%, P < 0.001). HFpEF was an independent risk factor for ES-HF development (HR 3.84, 2.54-5.80, P < 0.001). MACEs occurred in 26.9% with a higher incidence in HCM-HFpEF than HCM-non-HF (36.6% vs 12.2%, P < 0.001). HFpEF was an independent predictor of MACEs (HR 2.13, 1.75-2.59, P < 0.001).

CONCLUSIONS

HFpEF is common in HCM. Compared to non-HF, it increases the risk of LVEF decline and poor prognosis. It may aid in risk stratification and need close echocardiography follow-up.

Obesity Paradox in Patients with Acute Coronary Syndrome: Is Malnutrition the Answer?

BACKGROUND

Obesity paradox has been reported in patients with cardiovascular disease, showing an inverse association between obesity as defined by body mass index (BMI) and prognosis. Nutritional status is associated with systemic inflammatory response and affects cardiovascular disease outcomes.

OBJECTIVE

The authors sought to examine the influence of obesity and malnutrition on the prognosis of patients with acute coronary syndrome (ACS).

METHODS

This study included consecutive patients diagnosed with ACS and underwent coronary angiogram between January 2009 and February 2023. At baseline, patients were categorized according to their BMI as follows: underweight (<18 kg/m2), normal weight (18-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (>30.0 kg/m2). We assessed the nutritional status by Prognostic Nutritional Index (PNI). Malnutrition was defined as a PNI value<38.

RESULTS

Of the 21,651 patients with ACS, 582 (2.7%) deaths from any cause were observed over 28.7 months. Compared to the patient's state of normal weight, overweight and obesity were associated with a decreased risk of all-cause mortality. Malnutrition was independently associated with poor survival (HR 2.64, 95%CI 2.24-3.12, P<0.001). In malnourished patients, overweight and obesity showed a 39% and 72% reduction in the incidence of all-cause mortality, respectively. However, in nourished patients, no significant reduction in the incidence of all-cause mortality was observed (all P>0.05).

CONCLUSIONS

Obesity paradox appears to occur in patients with ACS. Malnutrition may be a significant independent risk factor for prognosis in patients with ACS. The obesity paradox is influenced by the status of malnutrition.

High-Sensitivity C-Reactive Protein Is Associated With Heart Failure Hospitalization in Patients With Metabolic Dysfunction-Associated Fatty Liver Disease and Normal Left Ventricular Ejection Fraction Undergoing Coronary Angiography

BACKGROUND

Systemic chronic inflammation plays a role in the pathophysiology of both heart failure with preserved ejection fraction (HFpEF) and metabolic dysfunction-associated fatty liver disease. This study aimed to investigate whether serum hs-CRP (high-sensitivity C-reactive protein) levels were associated with the future risk of heart failure (HF) hospitalization in patients with metabolic dysfunction-associated fatty liver disease and a normal left ventricular ejection fraction.

METHODS AND RESULTS

The study enrolled consecutive individuals with metabolic dysfunction-associated fatty liver disease and normal left ventricular ejection fraction who underwent coronary angiography for suspected coronary heart disease. The study population was subdivided into non-HF, pre-HFpEF, and HFpEF groups at baseline. The study outcome was time to the first hospitalization for HF. In 10 019 middle-aged individuals (mean age, 63.3±10.6 years; 38.5% women), the prevalence rates of HFpEF and pre-HFpEF were 34.2% and 34.5%, with a median serum hs-CRP level of 4.5 mg/L (interquartile range, 1.9-10 mg/L) and 5.0 mg/L (interquartile range, 2.1-10.1 mg/L), respectively. Serum hs-CRP levels were significantly higher in the pre-HFpEF and HFpEF groups than in the non-HF group. HF hospitalizations occurred in 1942 (19.4%) patients over a median of 3.2 years, with rates of 3.7% in non-HF, 20.8% in pre-HFpEF, and 32.1% in HFpEF, respectively. Cox regression analyses showed that patients in the highest hs-CRP quartile had a ≈4.5-fold increased risk of being hospitalized for HF compared with those in the lowest hs-CRP quartile (adjusted-hazard ratio, 4.42 [95% CI, 3.72-5.25]).

CONCLUSIONS

There was a high prevalence of baseline pre-HFpEF and HFpEF in patients with metabolic dysfunction-associated fatty liver disease and suspected coronary heart disease. There was an increased risk of HF hospitalization in those with elevated hs-CRP levels.

[A retrospective cohort study of case fatality rate of HIV/AIDS cases and influencing factors in Jingzhou, Hubei Province, 1996-2021]

Objective: To analyze the case fatality rate of HIV/AIDS cases and influencing factors in Jingzhou. Methods: The data were retrieved from HIV/AIDS Comprehensive Response Information System and the cases diagnosed with HIV/AIDS in Jingzhou during 1996-2021 and aged 15 years or older were selected for the study. The death curve was drawn with Kaplan-Meier method, and Cox proportional-hazards model was used to identify influencing factors for death. Results: A total of 3 304 HIV/AIDS cases were followed up for 16 091.5 person-years, and 893 cases died, with a case fatality rate of 5.5/100 person-years. The cumulative case fatality rates of 1, 5 and 10 years were 15.4%, 25.0% and 34.6% respectively, the cumulative case fatality rates of 1, 5 and 10 years were 6.9%, 14.4% and 23.7% in the cases with access to antiretroviral therapy (ART), and 68.0%, 90.1% and 98.7% in the cases without access to ART. The results of Cox proportional hazards regression model showed that the risk for death was higher in those without access to ART than in those with access to ART (aHR=9.85, 95%CI: 8.19-11.85). The risk factors for death in those with access to ART included being men (aHR=1.64, 95%CI: 1.29-2.08), age ≥60 years old at diagnosis (aHR=3.52, 95%CI: 2.38-5.20), being infected by injecting drug use/others (aHR=2.38, 95%CI:1.30-4.34), being detected by medical institution (aHR=1.53, 95%CI: 1.11-2.11), CD4+T lymphocytes(CD4) counts <50 cells/μl (aHR=2.58, 95%CI: 1.87-3.58). The protective factor for death was high education level (high school and technical secondary school: aHR=0.64,95%CI:0.46-0.90; college and above: aHR=0.42, 95%CI: 0.24-0.73). The risk factors for HIV/AIDS death in those without access to ART included older age at diagnosis (30-44 years old: aHR=2.32, 95%CI: 1.40-3.84; 45-59 years old:aHR=2.61, 95%CI: 1.59-4.27; ≥60 years old: aHR=3.31, 95%CI: 2.01-5.47), lower CD4 counts (<50 cells/μl: aHR=10.47, 95%CI: 6.47-16.56; 50-199 cells/μl: aHR=2.31, 95%CI: 1.08-4.94; 200-349 cells/μl: aHR=2.35, 95%CI: 1.46-3.79). Conclusions: The case fatality rate of HIV/AIDS was relatively high in Jingzhou from 1996 to 2021, the first CD4 counts, ART and age at diagnosis were the major factors affecting HIV/AIDS death, "Expanding testing" and "prompt treatment upon diagnosis" should be continued and enhanced to improve the efficacy of ART and HIV/AIDS case survival.

Clinical Outcome After Left Ventricular Thrombus Resolution: Who Needs Long-Term or Lifetime Use of Anticoagulants?

Background Patients with left ventricular thrombus (LVT) resolution can have LVT recurrence and risk for thromboembolism. However, these outcomes after LVT resolution are not well known. We aimed to assess the prevalence, risk factors, and clinical outcomes for LVT recurrence in patients with LVT resolution to inform follow-up and treatment. Methods and Results Patients with LVT resolution were identified retrospectively from a large echocardiography database between January 2009 and May 2022. Participants had echocardiograms at 3 time points, including baseline at LVT diagnosis, at LVT resolution, and a follow-up for identification of LVT recurrence. The cumulative LVT recurrence rate was estimated by the Kaplan-Meier method, and predictors of LVT recurrence were evaluated using Cox regression analysis. Among 115 patients with LVT resolution, 28 (24.3%) had LVT recurrence at a median follow-up of 1.2 (0.5-2.8) years. LV aneurysm (hazard ratio [HR], 2.59 [95% CI, 1.20-5.58], P=0.015) and anticoagulant use (HR, 0.12 [95% CI, 0.04-0.41], P=0.001) were predictors of LVT recurrence on multivariable analysis. Patients with an LV aneurysm who did not receive any anticoagulation demonstrated an LVT recurrence rate of 69.5%, whereas those without an LV aneurysm who received anticoagulation had a recurrence rate of 0%. Patients with LVT recurrence had a higher incidence of an embolic event (10.7% versus 1.1%, P=0.016). Conclusions LVT recurrence after LVT resolution is common, especially in those with an LV aneurysm, and is associated with a higher embolic risk. Continued anticoagulation is protective against LVT recurrence, although bleeding risk needs to be considered. These findings can inform follow-up and treatment of patients with documented LVT resolution.

[Characteristics of mortality density of HIV/AIDS cases after diagnosis in Jiamusi of Heilongjiang province, 2010-2020]

Objective: To analyze characteristics of mortality density and the influencing factors of HIV/AIDS after diagnosis in Jiamusi of Heilongjiang province. Methods: The data were retrieved from HIV/AIDS Comprehensive Response Information System and selected cases diagnosed with HIV/AIDS in Jiamusi of Heilongjiang province during 2010-2020 and aged 15 years or older as the study objects. The method of retrospective cohort study was used to collect baseline and follow-up information, and characteristics of mortality density after HIV diagnosis were described. Death after HIV diagnosis was divided into 1-6 months, 7-12 months, and ≥13 months after HIV diagnosis. The Cox proportional hazards model was used to analyze the associated factors of mortality density within six months after HIV diagnosis. Excel 2019 and SPSS 22.0 software were used for data processing and statistical analysis. Results: A total of 953 HIV/AIDS with 173 deaths were included during the study period. Most HIV/AIDS were men (89.19%, 850/953), single or divorced or widowed (76.50%, 729/953), educated in middle school and lower level (51.84%, 494/953), and men who have sex with men (77.02%, 734/953). There was a cumulative follow-up of 3 944.59 person-years, with an overall mortality density of 4.39 (95%CI: 3.79-5.07)/100 person- years. The mortality density was highest in 21.60 (95%CI: 18.04-25.86) 100 person-years within the first six months after diagnosis, then decreased to 2.02 (95%CI: 1.59-2.58)/100 person-years over 13 months or more after HIV diagnosis. HIV/AIDS who died within the first six months after diagnosis had a higher proportion of first CD4⁺T lymphocytes (CD4) counts untested (51.61%, 48/93) and AIDS-related deaths (32.26%, 30/93). In the multivariate analysis of the Cox proportional hazards regression model, mortality density within the first six months after HIV diagnosis was greater among HIV/AIDS who were older at diagnosis, detected by medical institutions, with lower first CD4 counts or no testing, and never receiving antiretroviral therapy (ART). Conclusions: Mortality density was generally low in Jiamusi of Heilongjiang province during 2010-2020 and declined over the follow-up time. However, early diagnosis and immediate ART initiation should be strengthened. Attention should also be paid to follow-up care management and referral services for HIV/AIDS within the first six months after HIV diagnosis to reduce the risk of death after HIV diagnosis.

Endothelial-T cell crosstalk contributes to vascular injury in fatty liver disease

 

Cardiovascular complications are often the fundamental causes of death in non-alcoholic fatty liver disease (NAFLD) patients. While there are known systemic mediators in NAFLD that may induce vascular inflammation, the mechanism of endothelial dysfunction remain understudied. In this work, we harnessed the replicative potential of blood outgrowth endothelial cells (BOECs) to develop personalized cell lines from NAFLD patients and healthy controls. Our transcriptomic analysis showed that the top interactome network enriched in NAFLD BOECs comprised of several C-C and C-X-C chemokine ligands involved in immune cell chemotaxis. We previously reported T cell infiltration in mouse model of non-alcoholic steatohepatitis, and here, we confirmed enhanced endothelial chemokine signatures in arterial histological sections. To elucidate endothelial-immune crosstalk, we performed single-cell analysis on human peripheral blood mononuclear cells and found T cell intensification in NAFLD patients compared to healthy controls. Our immunoprofiling by flow cytometry further revealed that NAFLD patients possessed higher levels CD8+ memory cells. Functionally, T cells, instead of monocytes, adhered more pronouncedly to NAFLD BOECs. In evaluating the CXCL12-CXCR4 axis in chemotaxis, CXCR4 antagonist (AMD3100) substantially modulated the migration of patient-derived CD8+ T cells towards NAFLD BOECs, which was not observed in healthy endothelial-T cell chemotaxis coculture. Finally, we validated NAFLD-associated endothelial dysfunction by enumerating two folds more circulating endothelial cells, a biomarker of vascular injury, in the blood samples of NAFLD patients than healthy controls. Our work provides insights for translation to restore blood vessel health and potentially mitigate adverse vascular events in NAFLD.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Industrial Alignment Fund Pre-Positioning grant from the Agency for Science, Technology and Research, Singapore Endothelial-T cell crosstalk in NAFLD

Transport properties of warm dense neon and krypton at high pressures

The transport properties of warm dense neon (Ne) and krypton (Kr) are studied by combining self-consistent fluid variational theory (SFVT) with linear response theory (LRT). The components are determined using the SFVT, and the transport parameters, including the electrical conductivity, thermal conductivity, and thermopower, are calculated with the LRT. The relevant scattering mechanisms, including electron-ion, electron-electron, and electron-atom scatterings, are taken into account. An effective potential model in combination with the Muffin-tin model is introduced to further improve the description for electron-atom scattering, which not only includes static, exchange, and polarization interactions but also considers the plasma environmental effects. It is found that for electron-atom scattering, the influence of the plasma density is significant at lower scattering energies but the effects are different for electron-Ne and electron-Kr scattering. For electron-Kr scattering, a plasma density-dependent Ramsauer-Townsend minimum is observed. The obtained transport parameters are compared with the available experiments and other simulations. The plasma phase transition of warm dense Kr is revisited from multiple perspectives based on the numerical simulation results for the electrical conductivity and thermopower. These observations may help one to better understand the transport properties of warm dense noble gases and are an important guide for future experimental designs and theoretical developments.

Helicobacter pylori infection with atrophic gastritis: An independent risk factor for colorectal adenomas

BACKGROUND

The significance of Helicobacter pylori (H. pylori) infection and atrophic gastritis (AG) in the prevalence of colorectal adenomas has been examined in a limited number of studies. However, these studies reported disputed conclusions.

AIM

To investigate whether H. pylori infection, AG, and H. pylori-related AG increase the risk of colorectal adenomas.

METHODS

This retrospective cross-sectional study included 6018 health-check individuals. The relevant data for physical examination, laboratory testing, ¹³C-urea breath testing, gastroscopy, colonoscopy and histopathological examination of gastric and colorectal biopsies were recorded. Univariate and multivariate logistic regression analyses were performed to determine the association between H. pylori-related AG and colorectal adenomas.

RESULTS

Overall, 1012 subjects (16.8%) were diagnosed with colorectal adenomas, of whom 143 (2.4%) had advanced adenomas. Among the enrolled patients, the prevalence of H. pylori infection and AG was observed as 49.5% (2981/6018) and 10.0% (602/6018), respectively. Subjects with H. pylori infection had an elevated risk of colorectal adenomas (adjusted odds ratio [OR] of 1.220, 95% confidence interval (CI): 1.053-1.413, P = 0.008) but no increased risk of advance adenomas (adjusted OR = 1.303, 95%CI: 0.922-1.842, P = 0.134). AG was significantly correlated to an increased risk of colorectal adenomas (unadjusted OR = 1.668, 95%CI: 1.352-2.059, P < 0.001; adjusted OR = 1.237, 95%CI: 0.988-1.549, P = 0.064). H. pylori infection accompanied by AG was significantly associated with an increased risk of adenomas (adjusted OR = 1.491, 95%CI: 1.103-2.015, P = 0.009) and advanced adenomas (adjusted OR = 1.910, 95%CI: 1.022-3.572, P = 0.043).

CONCLUSION

H. pylori-related AG was associated with a high risk of colorectal adenomas and advanced adenomas in Chinese individuals.

[Relationship between bile acid metabolism and chronic non - cholestatic liver disease]

Bile acid is a general term for a large class of cholic acid in bile and exerts its unique physiological functions by binding the relevant receptors and bile acid transporters. Bile acids not only promote the absorption of nutrients in the human body, but also as an important signaling molecule in the regulation of inflammatory processes and liver regeneration. Several studies have found that bile acid metabolism is involved in the occurrence and development of chronic non-cholestatic liver diseases. In this article, the latest research results are mentioned, and the relationship between nuclear receptors, membrane receptors, and bile acid transporters and chronic non-cholestatic liver disease that play a key role in the bile acid metabolism were emphatically reviewed.

Role of sLOX-1 in intracranial artery stenosis and in predicting long-term prognosis of acute ischemic stroke

OBJECTIVE

The role of sLOX-1 in acute ischemic stroke still remains unclear. This study aims to demonstrate the value of sLOX-1 in evaluating degrees of intracranial artery stenosis and to predict prognosis in stroke.

METHODS

Two hundred and seventy-two patients were included in this study and basic data were collected within 72 hr on admission. We assessed the association between sLOX-1 levels and stroke conditions in one-year duration. After adjusting for potential confounders, regression analyses were performed.

RESULTS

We found that sLOX-1 levels were increased significantly in severe patients compared to the mild stroke group (p = .011). After adjusting confounders, sLOX-1 was associated with a poor functional outcome in patients with an adjusted OR of 2. 946 (95% CI, 1.788-4.856, p < .001). There was also positive correlation between sLOX-1 levels and the degrees of intracranial artery stenosis in the different groups (p = .029).

CONCLUSIONS

Our study demonstrated that sLOX-1 levels could be used to evaluate the severity of stroke and the degrees of intracranial artery stenosis. Furthermore, sLOX-1 could be exploited to predict the long-term functional outcome of stroke.

Peripheral Arterial Disease in Type 2 Diabetes Is Associated with an Increase in Fibrinogen Levels

BACKGROUND

The present study is undertaken to investigate the fibrinogen levels in type 2 diabetes mellitus (T2DM) and its relation to peripheral artery disease (PAD) based on a more accurate and applied noninvasive measurements of duplex ultrasonography.

METHODS

We performed a cross-sectional study including 1096 T2DM patients (474 males and 622 females). The odds ratios (ORs) and 95% confidence intervals (CIs) were presented to show the association between PAD and fibrinogen in the subjects divided by fibrinogen levels quarterly. Furthermore, the univariate and multiple logistic analyses were performed to explore the correlation between PAD and fibrinogen levels, individual components in the cross-sectional study.

RESULTS

Finally, 887 (80.9%) T2DM patients meet the diagnostic criteria of PAD and these patients had considerably higher serum fibrinogen concentration than non-PAD group (P < 0.001). Multiple logistic analyses revealed that higher fibrinogen quartiles were positively related with the development of PAD in the adjusted model. After adjusting for known confounding parameters, the ORs for PAD were 1.993 (95% CI: 1.322-3.005, P < 0.001), 2.469 (95% CI: 1.591-3.831, P < 0.001), and 2.942 (95% CI, 1.838-4.711, P < 0.001) for Q2, Q3, and Q4, respectively (all P values <0.05).

CONCLUSIONS

Our results suggest that serum fibrinogen concentration can be considered as an independent risk factor for PAD in T2DM patients.

Scoring model to predict outcome in critically ill cirrhotic patients with acute respiratory failure: comparison with MELD scoring models and CLIF-SOFA score

BACKGROUND

Critically ill cirrhotic patients have a high mortality, particularly with concomitant respiratory failure on admission. There are no specific models in use for mortality risk assessment in critically ill cirrhotic patients with acute respiratory failure (CICRF). The aim is to develop a risk prediction model specific to CICRF in order to quantify the severity of illness.

METHODS

We analyzed 949 CICRF patients extracted from the MIMIC-III database. The novel model (ARF-CLIF-SOFA) was developed from the CLIF-SOFA score. Cox regression analysis and AUROC were implemented to test the predictive accuracy, compared with existing scores including the CLIF-SOFA score and MELD-related scores.

RESULTS

ARF-CLIF-SOFA contains PaO₂/FiO₂ ratio, lactate, MAP, vasopressor therapy, bilirubin and creatinine (1 point each; score range: 0-6). Based on our patient cohort, the ARF-CLIF-SOFA score had good predictive accuracy for predicting the 30-, 90-day and 1-year mortality (AUROC = 0.767 at 30-day, 0.768 at 90-day, 0.765 at 1-year, respectively). Additionally, the performance of the ARF-CLIF-SOFA is superior to existing scores (all P < 0.001).

CONCLUSION

The ARF-CLIF-SOFA score can be considered a CICRF specific score with a better predictive accuracy compared to the existing scores.

Remodeling the model for end-stage liver disease for predicting mortality risk in critically ill patients with cirrhosis and acute kidney injury

Serum creatinine measurement demonstrates a poor specificity and sensitivity for the early diagnosis of acute kidney injury (AKI) in patients with cirrhosis. The existing model for end‐stage liver disease (MELD) score reveals multiple pitfalls in critically ill patients with cirrhosis and acute kidney injury (CAKI). The aim of this study was to re‐evaluate the role of creatinine values in the existing MELD score and to develop a novel score for CAKI, named the “acute kidney injury–model for end‐stage liver disease score” (AKI‐MELD score). We extracted 651 CAKI from the Multiparameter Intelligent Monitoring in Intensive Care database. A time‐dependent Cox regression analysis was performed for developing remodeled MELD scores (Reweight‐MELD score, Del‐Cr‐MELD score, and AKI‐MELD score). The area under the receiver operating characteristic curve provided the discriminative power of scoring models related to outcome. The hazard ratio of creatinine was 1.104 (95% confidence interval [CI], 0.945‐1.290; P = 0.211). Reweight‐MELD score and Del‐Cr‐MELD score (decreasing the weight of creatinine) were superior to the original MELD score (all P < 0.001). The new AKI‐MELD score consists of bilirubin, the international normalized ratio, and the ratio of creatinine in 48 hours to creatinine at admission. It had competitive discriminative ability for predicting mortality (area under the receiver operating characteristic curve, 0.720 [95% CI, 0.653‐0.762] at 30 days, 0.688 [95% CI, 0.630‐0.742] at 90 days, and 0.671 [95% CI, 0.612‐0.725] at 1 year). Further, AKI‐MELD score had significantly higher predictive ability in comparison with MELD score, MELD‐Na score, and Updated MELD score (all P < 0.001). Conclusion: The predictive value of creatinine for CAKI should be re‐evaluated. AKI‐MELD score is a potentially reliable tool to determine the prognosis for mortality of CAKI. (Hepatology Communications 2017;1:748–756)

Sex-influenced association of non-alcoholic fatty liver disease with colorectal adenomatous and hyperplastic polyps

AIM

To investigate the relationship between non-alcoholic fatty liver disease (NAFLD) and colorectal adenomatous and hyperplastic polyps.

METHODS

A retrospective cross-sectional study was conducted on 3686 individuals undergoing health checkups (2430 males and 1256 females). All subjects underwent laboratory testing, abdominal ultrasonography, colonoscopy, and an interview to ascertain the baseline characteristics and general state of health. Multinomial logistic regression analysis was performed to examine the association between NAFLD and the prevalence of colorectal adenomatous and hyperplastic polyps. Furthermore, the relationship was analyzed in different sex groups. Subgroup analysis was performed based on number, size, and location of colorectal polyps.

RESULTS

The prevalence of colorectal polyps was 38.8% in males (16.2% for adenomatous polyps and 9.8% for hyperplastic polyps) and 19.3% in females (8.4% for adenomatous polyps and 3.9% for hyperplastic polyps). When adjusting for confounding variables, NAFLD was significantly associated with the prevalence of adenomatous polyps (OR = 1.28, 95%CI: 1.05-1.51, P < 0.05) and hyperplastic polyps (OR = 1.35, 95%CI: 1.01-1.82, P < 0.05). However, upon analyzing adenomatous and hyperplastic polyps in different sex groups, the significant association remained in males (OR = 1.53, 95%CI: 1.18-2.00, P < 0.05; OR = 1.42, 95%CI: 1.04-1.95, P < 0.05) but not in females (OR = 0.44, 95%CI: 0.18-1.04, P > 0.05; OR = 1.18, 95%CI: 0.50-2.78, P > 0.05).

CONCLUSION

NAFLD is specifically associated with an increased risk of colorectal adenomatous and hyperplastic polyps in men. However, NAFLD may not be a significant factor in the prevalence of colorectal polyps in women.

Equations of state, transport properties, and compositions of argon plasma: combination of self-consistent fluid variation theory and linear response theory

A consistent theoretical model that can be applied in a wide range of densities and temperatures is necessary for understanding the variation of a material's properties during compression and heating. Taking argon as an example, we show that the combination of self-consistent fluid variational theory and linear response theory is a promising route for studying warm dense matter. Following this route, the compositions, equations of state, and transport properties of argon plasma are calculated in a wide range of densities (0.001-20 g/cm(3)) and temperatures (5-100 kK). The obtained equations of state and electrical conductivities are found in good agreement with available experimental data. The plasma phase transition of argon is observed at temperatures below 30 kK and density about 2-6g/cm(3). The minimum density for the metallization of argon is found to be about 5.8 g/cm(3), occurring at 30-40 kK. The effects of many-particle correlations and dynamic screening on the electrical conductivity are also discussed through the effective potentials.

[Effects and clinical significance of virus load on red blood cell parameters in different stage of hepatitis B]

OBJECTIVE

To evaluate the effect of the viral load on the red blood cell parameters in chronic hepatitis B patients and its clinical significance.

METHODS

In the study, 373 chronic hepatitis B patients were recruited, including 123 alanine transaminase (ALT) normal patients (ALT<40 U/L),128 ALT greater than or equal to the upper limit of normal, and less than 2 times higher than the upper limit of normal patients(40 U/L ≤ALT<80 U/L), and 122 ALT greater than or equal to 2 times higher than the upper limit of normal patients (ALT≥80 U/L). The blood routine parameters were measured by automatic blood cell counter. The liver function parameters were measured by automatic biochemical analyzer, the hepatitis B virus loads were measured by quantitative PCR analyzer and the results were analyzed by covariance analysis.

RESULTS

In the ALT normal chronic hepatitis B patients group, the viral load had minor effects on the red blood cell parameters.But in the ALT abnormal chronic hepatitis B patients group, the viral load had a significant effect on the red blood cell parameters, and the effect was most manifest in the ALT≥ double upper limit of normal group. The specific performance was that with the viral load increasing, the red blood cell [low copies group (4.10±0.67)×10(12)/L,medium copies group (3.92±0.69)×10(12)/L,high copies group (3.54±0.90) ×10(12)/L], the hemoglobin[low copies group (129.66±21.12 ) g/L, medium copies group (126.23±23.38) g/L, high copies group (112.98±27.77) g/L], the hematocrit (low copies group 37.66±5.68, medium copies group 37.03±6.03, high copies group 33.34±8.15) decreased(P=0.006,0.007,0.010),the mean corpuscular volume [low copies group (92.17±6.53) fL, medium copies group (94.85±7.95) fL, high copies group (101.63±11.33) fL], the mean corpuscular hemoglobin [low copies group (31.70±2.22) pg, medium copies group (33.11±3.62) pg, high copies group (34.65±3.13) pg], the mean corpuscular hemoglobin concentration [low copies group (344.28±17.17) g/L, medium copies group (351.33±16.90) g/L, high copies group (358.12±15.67) g/L], and the red blood cell distribution width-standard deviation [low copies group (52.49±9.04) fL, medium copies group (56.96±7.19) fL, high copies group (61.23 ±7.23) fL] increased(P=0.000,0.000,0.002,0.000).

CONCLUSION

Observing the effect of the viral load on the red blood cell parameters in chronic hepatitis B patients can reflect the effect of hepatitis B virus on the immune response and liver function in the different pathological stages, providing theoretical support for the clinical antiviral treatment.

RNA-seq reveals the downregulated proteins related to photosynthesis in growth-inhibited rice seedlings induced by low-energy N+ beam implantation

Transcriptomic research based on RNA sequencing (RNA-seq) technology is innovative and will provide new opportunities and biological perspectives for the use of ion-beam implantation in plants. Using RNA-seq, transcriptomes of whole rice seedlings generated from seeds implanted with a low-energy N+ beam were analyzed 96 h after planting. We identified 544 transcripts that were differentially expressed genes (DEGs) in the non-growth-inhibited sample implanted by an N+ beam, including 262 upregulated transcripts and 282 downregulated transcripts. Next, 776 transcripts were identified as DEGs in significantly damaged and growth-inhibited rice seedlings induced by N+ beam implantation, including 283 upregulated transcripts and 493 downregulated transcripts. The Gene Ontology (GO) analysis showed that 19 downregulated DEGs in the injured rice seedlings are enriched for the biological process GO term photosynthesis. The Kyoto Encyclopedia of Genes and Genomes pathway analysis also showed that 11 downregulated DEGs related to chlorophyll a/b-binding proteins are statistically significantly enriched in the photosynthesis-antenna protein pathway (Pathwayid: map00196). This result suggested that the downregulated and injured photosynthesis system contributed to the growth inhibition of rice seedlings induced by low-energy N+ beam implantation.

Mesothelin promotes invasion and metastasis in breast cancer cells

OBJECTIVE

The presence of mesothelin (encoded by the mesothelin [MSLN] gene) in breast cancer is associated with tumour infiltration of the lymph node. This study evaluated whether MSLN overexpression promotes breast cancer cell invasiveness and metastasis.

METHODS

This study evaluated the effects of overexpression of MSLN on extracellular signal-regulated kinase (ERK1/2) and matrix metalloproteinase (MMP)-9 levels, and the invasiveness and angiogenesis of the breast cancer cell line MCF-7 in vitro, and on MCF-7-derived tumour development in vivo.

RESULTS

MSLN overexpression significantly increased ERK1/2 and MMP9 protein levels and activity, and the invasive and angiogenic capability of MCF-7 cells, in vitro. Inhibition of ERK1/2 suppressed MMP-9 and the invasive and angiogenic capability of MSLN overexpressing MCF-7 cells. MSLN overexpression also increased MCF-7-derived tumour metastasis in vivo.

CONCLUSION

MSLN overexpression promoted the invasive potential of MCF-7 cells through ERK1/2-dependent upregulation of MMP-9; this association may have contributed to metastasis of MCF-7 cells in vivo. Mesothelin may be a useful biomarker for cancer progression and a novel therapeutic or chemopreventive target in human breast cancer.

Hugoniot measurements of double-shocked precompressed dense xenon plasmas

The current partially ionized plasmas models for xenon show substantial differences since the description of pressure and thermal ionization region becomes a formidable task, prompting the need for an improved understanding of dense xenon plasmas behavior at above 100 GPa. We performed double-shock compression experiments on dense xenon to determine accurately the Hugoniot up to 172 GPa using a time-resolved optical radiation method. The planar strong shock wave was produced using a flyer plate impactor accelerated up to ∼6 km/s with a two-stage light-gas gun. The time-resolved optical radiation histories were acquired by using a multiwavelength channel optical transience radiance pyrometer. Shock velocity was measured and mass velocity was determined by the impedance-matching methods. The experimental equation of state of dense xenon plasmas are compared with the self-consistent fluid variational calculations of dense xenon in the region of partial ionization over a wide range of pressures and temperatures.

Isolated primary non-Hodgkin's lymphoma of the thoracic spine: a case report with a review of the literature

A case of isolated primary non-Hodgkin's lymphoma of the spine is presented along with a review of previous cases reported in the literature. An 80-year old immunocompetent man was admitted with progressive numbness and weakness of both lower extremities of 2 weeks' duration. Magnetic resonance imaging (MRI) of the cervicothoracic spine revealed an extradural spinal mass at the T1 - T3 level, with invasion into the T3 vertebral body. The lesion was at first thought to be a metastatic tumour. Because of the manifestations of compression, the patient underwent laminectomy and posterior decompression. Histopathological examination revealed diffuse large B-cell non-Hodgkin's lymphoma. All other investigations (including computed tomography of the chest and abdomen, bone scan, peripheral blood examination and tumour marker examination) were negative for occult disease. This case demonstrates that neurosurgeons should be aware of the occurrence of isolated primary spinal lymphoma, which should be included in the differential diagnosis of metastatic tumours.

Measurements of the equations of state and spectrum of nonideal xenon plasma under shock compression

Experimental equations of state on generation of nonideal xenon plasma by intense shock wave compression was presented in the ranges of pressure of 2-16 GPa and temperature of 31-50 kK, and the xenon plasma with the nonideal coupling parameter Γ range from 0.6-2.1 was generated. The shock wave was produced using the flyer plate impact and accelerated up to ∼6 km/s with a two-stage light gas gun. Gaseous specimens were shocked from two initial pressures of 0.80 and 4.72 MPa at room temperature. Time-resolved spectral radiation histories were recorded by using a multiwavelength channel pyrometer. The transient spectra with the wavelength range of 460-700 nm were recorded by using a spectrometer to evaluate the shock temperature. Shock velocity was measured and particle velocity was determined by the impedance matching methods. The equations of state of xenon plasma and ionization degree have been discussed in terms of the self-consistent fluid variational theory.

Ionization and equation of state of dense xenon at high pressures and high temperatures

The ionization degree and equation of state of dense xenon plasma were calculated by using self-consistent fluid variational theory for temperature of 4-30kK and density of 0.01-8.5gcm;{3} . The dense fluid xenon will be ionized at high pressures and temperatures. The ionization energy of xenon will be lowered due to the interactions among all particles of Xe, Xe+ , Xe2+ , and e . The ionization degree is obtained from nonideal ionization equilibrium, taking into account the correlative contributions to the chemical potential which is determined self-consistently by the free energy function. The composition of xenon has been calculated with given densities and temperatures in the region of partial ionization. The calculated results show a pressure softening regime at the onset of ionization. Comparison is performed with available shock-wave experiments and other theoretical calculations.

[Efficacy of diacetyl hexamethylene diamine in treatment of patients with high risk myelodysplastic syndrome]

The aim of this study was to investigate the efficacy of diacetyl hexamethylene diamine (CAHB) for patients with high risk myelodysplastic syndrome (MDS), and to explore the effect of CAHB on HL-60 cells in vitro and its possible mechanism. 8 patients with high risk MDS were treated with CAHB by continuous intravenous infusion for 10 days, and repeated once after an interval of 28 days. The count of the granulo- and mono-blasts in bone marrow (BM) aspirate was measured before and after treatment. HL-60 cells were treated with different concentrations of CAHB for 72 hours in vitro. The inhibitory effect of CAHB on proliferation of HL-60 cells in vitro was measured by MTT assay. Differentiation of HL-60 cells was detected by the changes of CD11b and CD14 expression on cell surface. Apoptosis of HL-60 cells was detected by double staining of Annexin V and PI. The cell cycle distribution change of HL-60 cells was analyzed by flow-cytometry. The results indicated that the granulo- and mono-blasts in BM decreased in all the 8 patients after CAHB treatment. The main side effect of CAHB on hematological system was thrombocytopenia. After being treated with 1, 2, 3, 4 mmol/L CAHB for 72 hours in vitro, the result of MTT assay showed the inhibitory effect of CAHB on the proliferation of HL-60 cells in dose-dependent manner. After being treated manner 1, 2, 3, 4 mmol/L CAHB for 72 hours, the CD11b positive HL-60 cells were 22.39+/-3.97%, 33.12+/-4.46%, 49.25+/-5.27%, 78.05+/-5.66%, respectively, which were significantly different from the control group (CD11b positive HL-60 cells was 5.89+/-2.94%) (p<0.01). The CD14 expression was negative in all the 5 groups. These results suggested that CAHB could induce HL-60 cells to differentiate into mature granulocytes, and the effect of CAHB appeared in dose-dependent manner. After being treated for 72 hours by 1, 2, 3, 4 mmol/L CAHB, the apoptotic cells (Annexin V(+)/PI(-) cells) increased mildly, which suggested that CAHB only weakly induces HL-60 cells to apoptosis at the concentration of 1 to 4 mmol/L. Along with the concentration increase of CAHB, the ratio of cells in G(0)/G(1) phase increased, and ratio of cells in S phase and G(2)/M phase decreased correspondingly, it indicated that CAHB could arrest HL-60 cells in G(0)/G(1) phase in a dose-dependent manner. It is concluded that induction of cell differentiation may be the primary effect of CAHB on MDS. Cell cycle arrest may be essential to the effect of CAHB as well. Side effect of CAHB on platelet count may correlated with its inhibitory effect on hematopoiesis.

First-principles study of the elastic and thermodynamic properties of CaSiO(3) perovskite

The thermodynamic and elastic properties of CaSiO(3) perovskite are investigated at high pressures and temperatures using the plane wave pseudopotential method within the local density approximation. The athermal elastic moduli of CaSiO(3) perovskite are calculated as a function of pressure up to 200 GPa. The calculated results are in excellent agreement with available experimental data at high pressure, and compare favourably with other pseudopotential predictions over the pressure regime studied. It is also found that the elastic anisotropy drops rapidly with the increase of pressure initially, and then decreases more slowly at higher pressures. The thermodynamic properties of CaSiO(3) perovskite are predicted using the quasi-harmonic Debye model for the first time; the heat capacity and the thermal expansion coefficient agree with the observed values at ambient conditions and the other calculations at high pressures and temperatures.

Real time air monitoring of hydrogen chloride and chlorine gas during a chemical fire

On 9 August 2000 a fire started at a facility that manufactures pool chemicals in Guelph, Ontario. A mobile trace atmospheric gas analyzer (TAGA) unit was summoned to provide on-site air monitoring operated by the Ontario Ministry of the Environment (OMOE). The responsibility of the TAGA unit was to monitor in real time the airborne contaminants released through the combustion of pool chemicals. This was accomplished by using an atmospheric pressure chemical ionization (APCI) source with the newest TAGA (model IIe): a triple quadrupole mass spectrometer which allows for the direct sampling and real time analysis of air for a wide range of toxics at low parts-per-billion (ppb) levels. The ionization mechanism under negative APCI conditions is dominated by charge transfer reactions, yielding parent ions which are selected in Q1, dissociated in Q2 and the resultant daughter ions are identified in Q3. By monitoring specific parent/daughter (P/D) ion pairs, the TAGA IIe was able to simultaneously measure, in real time, levels of hydrogen chloride (HCl) and chlorine (Cl2) present in the air. The response of the TAGA IIe was characterized by multi-point calibration curves which were linear up to 250 microg/m3 for HCl and up to 600 microg/m3 for Cl2. The average detection limit (DL) for this application was 0.50 microg/m3 for both HCl and Cl2. On-site measurements of HCl and Cl2 were made at several locations upwind and downwind of the fire site over a period of 3 days. The data collected by the TAGA unit was used by the local officials for a real time assessment of the airborne levels of HCl and Cl2.

[Proliferation and IFN-gamma secretion of autologous T lymphocytes stimulated by myeloid leukemia cells induced with rhGM-CSF and rhIL-4]

To observe the proliferation of T lymphocytes stimulated by CML and AML cells which were induced by rhGM-CSF and rhIL-4, and the secretion of IFN-gamma from proliferated T lymphocytes, the expression of CD80, CD86 and HLA-DR on CML and AML cells induced by GM-CSF and IL-4 was assayed by flow cytometry in vitro. Then one-way mixed lymphocyte reaction was carried out, with induced leukemia cells as stimulating cells and auto-T lymphocytes as reactive cells. The secretion of IFN-gamma from T lymphocytes was determined by double antibody sandwich ELISA. The results showed that GM-CSF and IL-4 significantly upregulated the expression of CD80, CD86 and HLA-DR on CML cells and CD80 and CD86 on AML cells, which could stimulate the T lymphocyte proliferation and high secretion of IFN-gamma (in CML group) of autologous T lymphocytes. It is concluded that the CML and AML cells induced by GM-CSF and IL-4 have the ability to present tumor specific antigen to auto-T lymphocyte.

Surgical treatment of myasthenia gravis and evaluation of its efficacy

This paper reports 30 cases of myasthenia gravis (MG) treated by thymectomy from 1965 to 1990 in our hospital. Of all the 30 cases of MG, peripheral blood lymphocyte subpopulation was determined in 10, and anti-acetylcholine receptor antibody titer in 6, before and after operation. The results demonstrated the efficacy of thymectomy against MG. We considered that with application of hormone before and after operation to regulate immune function of the body, and/or with plasma exchange to remiss symptoms, all the patients with generalized MG may be indicated for treatment by thymectomy. Indication of treatment does not depend on age, sex and the course of the disease. But radical operation, proper anesthesia and appropriate use of antibiotics may ensure safety of the operation and its curative effect.