Study on Epidemiological Profile, Clinical Profile, and Angiographic Patterns in Acute Coronary Syndrome Patients in a Tertiary Health Care Center in Haryana

Background: Cardiovascular diseases are the leading cause of death in India, with coronary artery disease (CAD) accounting for a majority of the deaths. There are few large registries on acute coronary syndrome (ACS) from India. Our aim is to study the clinical and epidemiological profile of ACS PATIENTS presenting to our institute, including their angiographic features. Methods: This hospital-based observational, single tertiary care center, prospective study was conducted on patients admitted in the Department of Cardiology at a tertiary care center in Haryana. The study included 400 patients aged greater than 18 years who were admitted with the diagnosis of ACS, and it was carried out for 1 year. The epidemiological profile, clinical history, risk factors, electrocardiogram findings, and angiographic pattern were studied and analyzed with appropriate statistical tools. Results: The mean age of the study population was 55.12 ± 11.78 years. Male and female ratio was 2.4:1. The majority of the patients came from rural background (80%);24% of the patients were illiterate. Smoking was the most common risk factor (51.5%) in our study population followed by hypertension (40%) and diabetes (28%). Unstable angina was the most common type of ACS, which was found in 68.25% of patients. Premature CAD was found in 27.8% of patients and obstructive CAD was found in 63% of patients. Coronary angiography revealed that 39% had single vessel disease (SVD), 23.5% had double vessel disease (DVD), and 27.5% had triple vessel disease (TVD). LAD was more commonly involved, followed by RCA and LCX. Within the first 24 hours, 67% of patients sought medical assistance and only 38.5% received definitive treatment, suggesting a delay in seeking definitive treatment in our study population. Conclusion: The study suggests that unstable angina is the most common form of ACS in the study population, which is mostly of rural background with significant delay in seeking medical help. Smoking is the most common risk factor in the study population.

Associations of daily sedentary behavior,physical activity,and sleep with irritable bowel syndrome:A prospective analysis of 362,193 participants

Background:Irritable bowel syndrome(IBS)substantially affects quality of life and requires early prevention.This study aimed to elucidate the relationships between IBS and daily behaviors,including sedentary behavior(SB),physical activity(PA),and sleep.In particular,it seeks to identify healthy behaviors to reduce IBS risk,which previous studies have rarely addressed.Methods:Daily behaviors were retrieved from self-reported data of 362,193 eligible UK Biobank participants.Incident cases were determined by self-report or health care data according to RomeⅣcriteria.Results:A total of 345,388 participants were IBS-free at baseline,during a median follow-up of 8.45 years,19,885 incident IBS cases were recorded.When examined individually,SB and shorter(≤7 h/day)or longer(>7 h/day)sleep duration were each positively associated with increased IBS risk,and PA was associated with lower IBS risk.The isotemporal substitution model suggested that replacing SB with other activities could provide further protective effects against IBS risk.Among people sleeping≤7 h/day,replacing 1 h of SB with equivalent light PA,vigorous PA,or sleep was associated with 8.1%(95%confidence interval(95%CI):0.901-0.937),5.8%(95%CI:0.896-0.991),and 9.2%(95%CI:0.885-0.932)reduced IBS risk,respectively.For people sleeping>7 h/day,light and vigorous PA were associated with a 4.8%(95%CI:0.926-0.978)and a 12.0%(95%CI:0.815-0.949)lower IBS risk,respectively.These benefits were mostly independent of genetic risk for IBS.Conclusion:SB and unhealthy sleep duration are risk factors for IBS.A promising way to mitigate IBS risk for individuals sleeping≤7 h/day and for those sleeping>7 h/day appears to be by replacing SB with adequate sleep or vigorous PA,respectively,regardless of the genetic predisposition of IBS.

Chitin-glucan improves important pathophysiological features of irritable bowel syndrome

BACKGROUND Irritable bowel syndrome(IBS)is one of the most frequent and debilitating conditions leading to gastroenterological referrals.However,recommended treatments remain limited,yielding only limited therapeutic gains.Chitin-glucan(CG)is a novel dietary prebiotic classically used in humans at a dosage of 1.5-3.0 g/d and is considered a safe food ingredient by the European Food Safety Authority.To provide an alternative approach to managing patients with IBS,we performed preclinical molecular,cellular,and animal studies to evaluate the role of chitin-glucan in the main pathophysiological mechanisms involved in IBS.AIM To evaluate the roles of CG in visceral analgesia,intestinal inflammation,barrier function,and to develop computational molecular models.METHODS Visceral pain was recorded through colorectal distension(CRD)in a model of long-lasting colon hypersensitivity induced by an intra-rectal administration of TNBS[15 milligrams(mg)/kilogram(kg)]in 33 Sprague-Dawley rats.Intracolonic pressure was regularly assessed during the 9 wk-experiment(weeks 0,3,5,and 7)in animals receiving CG(n=14)at a human equivalent dose(HED)of 1.5 g/d or 3.0 g/d and compared to negative control(tap water,n=11)and positive control(phloroglucinol at 1.5 g/d HED,n=8)groups.The anti-inflammatory effect of CG was evaluated using clinical and histological scores in 30 C57bl6 male mice with colitis induced by dextran sodium sulfate(DSS)administered in their drinking water during 14 d.HT-29 cells under basal conditions and after stimulation with lipopolysaccharide(LPS)were treated with CG to evaluate changes in pathways related to analgesia μ-opioid receptor(MOR),cannabinoid receptor 2(CB2),peroxisome proliferator-activated receptor alpha,inflammation[interleukin(IL)-10,IL-1b,and IL-8]and barrier function[mucin 2-5AC,claudin-2,zonula occludens(ZO)-1,ZO-2]using the real-time PCR method.Molecular modelling of CG,LPS,lipoteichoic acid(LTA),and phospholipomannan(PLM)was developed,and the ability of CG to chelate microbial pathogenic lipids was evaluated by docking and molecular dynamics simulations.Data were expressed as the mean±SEM.RESULTS Daily CG orally-administered to rats or mice was well tolerated without including diarrhea,visceral hypersensitivity,or inflammation,as evaluated at histological and molecular levels.In a model of CRD,CG at a dosage of 3 g/d HED significantly decreased visceral pain perception by 14%after 2 wk of administration(P<0.01)and reduced inflammation intensity by 50%,resulting in complete regeneration of the colonic mucosa in mice with DSS-induced colitis.To better reproduce the characteristics of visceral pain in patients with IBS,we then measured the therapeutic impact of CG in rats with TNBS-induced inflammation to long-lasting visceral hypersensitivity.CG at a dosage of 1.5 g/d HED decreased visceral pain perception by 20%five weeks after colitis induction(P<0.01).When the CG dosage was increased to 3.0 g/d HED,this analgesic effect surpassed that of the spasmolytic agent phloroglucinol,manifesting more rapidly within 3 wk and leading to a 50%inhibition of pain perception(P<0.0001).The underlying molecular mechanisms contributing to these analgesic and anti-inflammatory effects of CG involved,at least in part,a significant induction of MOR,CB2 receptor,and IL-10,as well as a significant decrease in pro-inflammatory cytokines IL-1b and IL-8.CG also significantly upregulated barrier-related genes including muc5AC,claudin-2,and ZO-2.Molecular modelling of CG revealed a new property of the molecule as a chelator of microbial pathogenic lipids,sequestering gram-negative LPS and gram-positive LTA bacterial toxins,as well as PLM in fungi at the lowesr energy conformations.CONCLUSION CG decreased visceral perception and intestinal inflammation through master gene regulation and direct binding of microbial products,suggesting that CG may constitute a new therapeutic strategy for patients with IBS or IBSlike symptoms.

Memristors-coupled neuron models with multiple firing patterns and homogeneous and heterogeneous multistability

Memristors are extensively used to estimate the external electromagnetic stimulation and synapses for neurons.In this paper,two distinct scenarios,i.e.,an ideal memristor serves as external electromagnetic stimulation and a locally active memristor serves as a synapse,are formulated to investigate the impact of a memristor on a two-dimensional Hindmarsh-Rose neuron model.Numerical simulations show that the neuronal models in different scenarios have multiple burst firing patterns.The introduction of the memristor makes the neuronal model exhibit complex dynamical behaviors.Finally,the simulation circuit and DSP hardware implementation results validate the physical mechanism,as well as the reliability of the biological neuron model.

A Non-Stationary Beam-Enabled Stochastic Channel Model and Characterization over Non-Reciprocal Beam Patterns

The multiple-input multiple-output(MIMO)-enabled beamforming technology offers great data rate and channel quality for next-generation communication.In this paper,we propose a beam channel model and enable it with time-varying simulation capability by adopting the stochastic geometry theory.First,clusters are generated located within transceivers'beam ranges based on the Mate?rn hardcore Poisson cluster process.The line-of-sight,singlebounce,and double-bounce components are calculated when generating the complex channel impulse response.Furthermore,we elaborate on the expressions of channel links based on the propagation-graph theory.A birth-death process consisting of the effects of beams and cluster velocities is also formulated.Numerical simulation results prove that the proposed model can capture the channel non-stationarity.Besides,the non-reciprocal beam patterns yield severe channel dispersion compared to the reciprocal patterns.

Spatial patterns of the Brusselator model with asymmetric Lévy diffusion

The formation of spatial patterns is an important issue in reaction–diffusion systems.Previous studies have mainly focused on the spatial patterns in reaction–diffusion models equipped with symmetric diffusion(such as normal or fractional Laplace diffusion),namely,assuming that spatial environments of the systems are homogeneous.However,the complexity and heterogeneity of spatial environments of biochemical reactions in vivo can lead to asymmetric diffusion of reactants.Naturally,there arises an open question of how the asymmetric diffusion affects dynamical behaviors of biochemical reaction systems.To answer this,we build a general asymmetric L´evy diffusion model based on the theory of a continuous time random walk.In addition,we investigate the two-species Brusselator model with asymmetric L´evy diffusion,and obtain a general condition for the formation of Turing and wave patterns.More interestingly,we find that even though the Brusselator model with symmetric diffusion cannot produce steady spatial patterns for some parameters,the asymmetry of L´evy diffusion for this model can produce wave patterns.This is different from the previous result that wave instability requires at least a three-species model.In addition,the asymmetry of L´evy diffusion can significantly affect the amplitude and frequency of the spatial patterns.Our results enrich our knowledge of the mechanisms of pattern formation.

Spatio-temporal evolution analysis of landscape pattern and habitat quality in the Qinghai Province section of the Yellow River Basin from 2000 to 2022 based on InVEST model

Habitat quality is an important indicator for evaluating the quality of ecosystem.The Qinghai Province section of the Yellow River Basin plays an important role in the ecological protection of the upper reaches of the Yellow River Basin.To comprehensively analysis the alterations of habitat quality in the Qinghai Province section of the Yellow River Basin,this study utilized the Integrated Valuation of Ecosystem Services and Tradeoffs(InVEST)model to calculate the habitat quality index and analyze the spatio-temporal variation characteristics of habitat quality in the study area from 2000 to 2022,and calculated seven landscape pattern indices(number of patches,patch density,largest patch index(LPI),landscape shape index(LSI),contagion index(CONTAG),Shannon diversity index,and Shannon evenness index)to research the variation of landscape pattern in the study area.The results showed that the number of patches,patch density,LPI,LSI,Shannon diversity index,and Shannon evenness index increased from 2000 to 2022,while the CONTAG decreased,indicating that the landscape pattern in the Qinghai Province section of the Yellow River Basin changed in the direction of distribution fragmentation,shape complexity,and heterogeneity.The average value of the habitat quality index in the Qinghai Province section of the Yellow River Basin from 2000 to 2022 was 0.90.Based on the value of habitat quality index,we divided the level of habitat quality into five categories:lower(0.00-0.20),low(0.20-0.40),moderate(0.40-0.60),high(0.60-0.80),and higher(0.80-1.00).Most areas were at the higher habitat quality level.The lower habitat quality patches were mainly distributed in Longyang Gorge and Yellow River-Huangshui River Valley.From 2000 to 2022,the habitat quality in most areas was stable;the increase areas were mainly distributed in Guinan County,while the decrease areas were mainly distributed in Xining City,Maqen County,Xinghai County,Qumarleb County,and Darlag County.To show the extent of habitat quality variation,we calculated Sen index.The results showed that the higher habitat quality area had a decrease trending,while other categories had an increasing tendency,and the decreasing was faster than increasing.The research results provide scientific guidance for promoting ecological protection and high-quality development in the Qinghai Province section of the Yellow River Basin.

Framework to Model User Request Access Patterns in the World Wide Web

In this paper, we present a novel approach to model user request patterns in the World Wide Web. Instead of focusing on the user traffic for web pages, we capture the user interaction at the object level of the web pages. Our framework model consists of three sub-models: one for user file access, one for web pages, and one for storage servers. Web pages are assumed to consist of different types and sizes of objects, which are characterized using several categories: articles, media, and mosaics. The model is implemented with a discrete event simulation and then used to investigate the performance of our system over a variety of parameters in our model. Our performance measure of choice is mean response time and by varying the composition of web pages through our categories, we find that our framework model is able to capture a wide range of conditions that serve as a basis for generating a variety of user request patterns. In addition, we are able to establish a set of parameters that can be used as base cases. One of the goals of this research is for the framework model to be general enough that the parameters can be varied such that it can serve as input for investigating other distributed applications that require the generation of user request access patterns.

A novel mouse model of central cord syndrome

Patients with potential spinal stenosis are susceptible to central cord syndrome induced by blunt trauma.Suitable animal models are helpful for studying the pathogenesis and treatment of such injuries.In this study,we established a mouse model of acute blunt traumatic spinal cord injury by compressing the C6 spinal cord with 5 and 10 g/mm~2 compression weights to simulate cervical central cord syndrome.Behavioral testing confirmed that this model exhibited the characteristics of central cord syndrome because motor function in the front paws was impaired,whereas basic motor and sensory functions of the lower extremities were retained.Hematoxylin-eosin staining showed that the diseased region of the spinal cord in this mouse model was restricted to the gray matter of the central cord,whereas the white matter was rarely affected.Magnetic resonance imaging showed a hypointense signal in the lesion after mild and severe injury.In addition,immunofluorescence staining showed that the degree of nerve tract injury in the spinal cord white matter was mild,and that there was a chronic inflammation reaction.These findings suggest that this mouse model of central cord syndrome can be used as a model for preclinical research,and that gray matter is most vulnerable to injury in central cord syndrome,leading to impaired motor function.

Effect of low anterior resection syndrome on quality of life in colorectal cancer patients:A retrospective observational study

BACKGROUND Low anterior resection syndrome(LARS)is a common complication of anuspreserving surgery in patients with colorectal cancer,which significantly affects patients'quality of life.AIM To determine the relationship between the incidence of LARS and patient quality of life after colorectal cancer surgery and to establish a LARS prediction model to allow perioperative precision nursing.METHODS We reviewed the data from patients who underwent elective radical resection for colorectal cancer at our institution from April 2013 to June 2020 and completed the LARS score questionnaire and the European Organization for Research and Treatment of Cancer Core Quality of Life and Colorectal Cancer Module questionnaires.According to the LARS score results,the patients were divided into no LARS,mild LARS,and severe LARS groups.The incidence of LARS and the effects of this condition on patient quality of life were determined.Univariate and multivariate analyses were performed to identify independent risk factors for the occurrence of LARS.Based on these factors,we established a risk prediction model for LARS and evaluated its performance.RESULTS Among the 223 patients included,51 did not develop LARS and 171 had mild or severe LARS.The following quality of life indicators showed significant differences between patients without LARS and those with mild or severe LARS:Physical,role,emotional,and cognitive function,total health status,fatigue,pain,shortness of breath,insomnia,constipation,and diarrhea.Tumor size,partial/total mesorectal excision,colostomy,preoperative radiotherapy,and neoadjuvant chemotherapy were identified to be independent risk factors for LARS.A LARS prediction model was successfully established,which demonstrated an accuracy of 0.808 for predicting the occurrence of LARS.CONCLUSION The quality of life of patients with LARS after colorectal cancer surgery is significantly reduced.

Assessing the Validity of a Novel Model of Vertebral Artery Type of Cervical Syndrome Induced by Injecting Sclerosing Agent Next to Transverse Process of Cervical Vertebra

The efficacy of injecting sclerosing agent next to transverse process of cervical vertebra to induce vertebral artery type of cervical syndrome(CSA)was observed.Twenty rabbits were randomly divided into two groups:the model group and the control group.The rabbits in the model group were injected with sclerosing agent next to transverse process of cervical vertebray,on the contrary,the rabbits in the control group were injected with nothing.Transcranial Doppler(TCD)was used to detect the average speed of blo...

Key factors in developing the trinitrobenzene sulfonic acid-induced post-inflammatory irritable bowel syndrome model in rats

AIM:To investigate the key factors in developing the trinitrobenzene sulfonic acid(TNBS)-induced postinflammatory irritable bowel syndrome(PI-IBS)model in rats. METHODS:TNBS was administered to rats at the following conditions:(1)with different doses(20,10,5 mg/0.8 mL per rat);(2)with same dose in different concentrations(20 mg/rat,25,50 mg/mL);(3)in different ethanol percentage(25%,50%);and(4)at depth either 4 cm or 8 cm from anus.At 5 d and 4 wk after TNBS administration,inflammation severity and inflammation resolution were evaluated.At 4 and 8 wk after TNBS application,visceral hyperalgesia and enterochromaffin(EC)cell hyperplasia were assayed by abdominal withdrawal reflex test,silver staining and capillary electrophoresis. RESULTS:Our results showed that:(1)TNBS induced dose-dependent acute inflammation and inflammation resolution.At 5 d post TNBS,the pathological score and myeloperoxidase(MPO)activity in all TNBS treated rats were significantly elevated compared to that of the control(9.48±1.86,8.18±0.67,5.78± 0.77 vs 0,and 3.55±1.11,1.80±0.82,0.97±0.08 unit/mg vs 0.14±0.01 unit/mg,P<0.05).At 4 wk post TNBS,the pathological score in high and median dose TNBS-treated rats were still significantly higher than that of the control(1.52±0.38 and 0.80±0.35 vs 0,P<0.05);(2)Intracolonic TNBS administration position affected the persistence of visceral hyperalgesia.At 4 wk post TNBS,abdominal withdrawal reflex (AWR)threshold pressure in all TNBS-treated groups were decreased compared to that of the control(21.52 ±1.73 and 27.10±1.94 mmHg vs 34.44±1.89 mmHg,P<0.05).At 8 wk post TNBS,AWR threshold pressure in 8 cm administration group was still significantly decreased(23.33±1.33 mmHg vs 36.79±2.29 mmHg,P<0.05);(3)Ethanol percentage affected the TNBS-induced inflammation severity and visceral hyperalgesia.In TNBS-25%ethanol-treated group,the pathological score and MPO activity were significantly lowered compared to that of the TNBS-50%ethanoltreated group,while AWR threshold pressure were significantly elevated(36.33±0.61 mmHg vs 23.33±1.33 mmHg,P<0.05);and(4)TNBS(5 mg/0.8 mL per rat, in 50%ethanol,8 cm from anus)-treated rats recovered completely from the inflammation with acquired visceral hyperalgesia and EC cell hyperplasia at 4 wk after TNBS administration.CONCLUSION:TNBS dosage,concentration,intraco-lonic administration position,and ethanol percentage play important roles in developing visceral hyperalgesia and EC cell hyperplasia of TNBS-induced PI-IBS rats.

Effects of human mesenchymal stem cell transplantation in the bilateral corpus striatum in a rat model of Tourette's syndrome

Tourette＇s syndrome is treated by behavioral or pharmacological therapy.However,patients with malignant Tourette＇s syndrome also exhibit life-threatening symptoms,which are unresponsive to conservative treatments or neurosurgical procedures,such as deep brain stimulation.In recent years,mesenchymal stem cells（MSCs）have shown therapeutic potential in many neurological diseases.Therefore,the present study proposed to use MSC transplantation as a novel therapy for Tourette＇s syndrome.Stereotypic behaviors in Tourette＇s syndrome rats decreased significantly at21 days after human MSCs transplantation into the striatum.Immunohistochemistry analyses revealed survival of transplanted human MSCs and differentiation into neurons and astrocytes in the rat brain.Results suggest that intrastriatal transplantation of human MSCs could provide therapeutic potential for Tourette＇s syndrome.

Animal model of non-bacterial multiple organ dysfunction syndrome in the elderly

Objective To establish a model of multiple organ dysfunction syndrome in the elderly (MODSE) by intraperitoneal injection of different doses of zymosan, and to compare the multiple organ dysfunction syndrome (MODS) in adult and in the elderly rats. Methods Adult and senile rats, injected with different doses of zymosan intraperitoneally were examined for the changes in the function and morphology of the vital organs, including heart, liver, brain, lungs, and kidneys using blood gas and biochemistry analysis and histopathological examination methods. Results Compared with the normal controls of the adult and the elderly rats, the blood gas and blood biochemistry changed in different degrees in the different dosed zymosan groups. Pathological changes were also found in the vital organs including lungs, heart, liver, brain, kidneys, erc in the experimental groups. Under the same concentrations of zymosan, the reductions in respiratory, cardiac and renal functions in the senile groups were much more severe than those in the corresponding adult group. In the similar degree of model duplication, the senile rats had the tendency to die later than the adult rats. Conclusions Zymosan can be used in both elderly and adult rats to induce MODS model, and the best dosage for MODSE was 0.Sg/kg injected peritoneally. The model would hopefully be used in the study of mechanisms and the therapeutics on MODSE.

Construction of Rat Model of Hepatic Fibrosis with Blood Stasis Syndrome Integrated with Traditional Chinese Medicine(TCM)Syndrome and Western Medicine Disease

[ Objective ] According to the theory of blood stasis in traditional Chinese medicine （ TCM）, the animal modeling method of hepatic fibrosis integrated with pathology and symptoms was explored and improved, to construct a new type of rat model of hepatic fibrosis with blood stasis syndrome integrated with tradition- al Chinese and westem medicine. [ Method] The hepatic fibrosis model of blood stasis with blood stasis syndrome was constructed by jointing multi factors, inclu- ding intragastric administration of ethanol, high fat and low protein feeding, joint injection of dimethylnitrosamine （DMN）, bovine serum albumin （BSA） and nor- epinephrine （NE）. The modeling method was further compared with traditional CC14 single-factor modeling method from the aspects of mortality, blood stasis syn- drome of TCM, syndrome grading, general morphology of liver pathology, liver function changes, as well as expression levels of three kinds of collagen （type I and type III collagen, a-SMA） determined by immunohistochemical staining method, and four items of rat hepatic fibrosis （HA, P3NP, LN, CIV content） determined by radio enzyme immunoassay. [ Result ] In blood stasis group, （ 1 ） the mortality of rats was 20% ; （2） model rats appeared typical blood stasis syndromes of TCM such as ecchymosis, dark purple tongue, loose stool, and blood stasis syndrome grading was high; （3） fibrosis changes of liver such as dark white surface, dense gray nodules and brittle texture were observed in general morphological examination; （4） serological liver function tests found that ALT and AST of model rats, as well as TBIL, DBIL and IBIL contents increased significantly; （5） immunohistochemical staining demonstrated that the expression levels of three kinds of collagen （type I and type III collagen, ot-SMA） increased significantly; （6） four items of rat serum hepatic fibrosis, HA, P3NP, LN, CIV content, increased significantly; （7） the above results in blood stasis syndrome model group （except morality and liver function） were higher than those in CC14 modeling group, and the difference was statistically significant （P 〈 0.05 ）. [ Conclusion ] The new improved modeling method effectively reduces high mortality in traditional CC 14 modeling method. In addition to low mortality, the model animal has dual characteristics of disease in western medicine and syndrome in TCM. It is consistent with the pathological characteristics of hepatic fibrosis in western medicine when according with the basic characteristics of blood stasis syndrome in TCM.

Expression of Resistin mRNA in Adipose Tissue of Rat Model with Polycystic Ovarian Syndrome and Its Implication

Summary: To investigate the relationship between the insulin resistance (IR) of polycystic ovarian syndrome (PCOS) rat model induced by dehydroeplandrosterone (DHEA) and hormonal changes in the ovarium and the resistin mRNA levels in adipose tissue, 21-day-old female SD rats were divided into two groups in pairs. The rats in group 1 were injected daily (s.c) with DHEA for up to 20 days and the rats in group 2 injected with oil at the same time. Ovarian weight, serum insulin levels and sex hormone levels in rat blood of both groups were determined. Oral glucose tolerance tests, light microscopic and electronic microscopic examination were performed. The levels of resistin mRNA in adipose tissue were measured by reverse transcription-polymerase chain reaction (RT-PCR). Our results showed that the ovarian weight in group 1 was greater than that in group 2 (P<0.05). The ovaria in group 1 showed multiple follicular cysts, The serum testeosterone and etrasdiol concentration were significantly higher in group 1 than those in group 2 (P<0.001 and P<0.05 respectively), so as the fasting serum glucose (P<0.001) and fasting serum insulin (P<0.05). The value of 1/FINS×FGC was significantly higher in group 1 than that in group 2 (P<0.001). Moreover, the resistin mRNA level of white adipose tissue in the DHEA-induced group was significantly higher than that in the control rats (P<0.05). It is concluded that the DHEA-induced PCOS rat models were similar to those of the patients with PCOS, and the IR was observed. Resistin secreted by adipose tissue may mediate IR in PCOS, and it is likely involved in the pathogenesis and development of PCOS.

Development and external validation of models to predict acute respiratory distress syndrome related to severe acute pancreatitis

BACKGROUND Acute respiratory distress syndrome(ARDS)is a major cause of death in patients with severe acute pancreatitis(SAP).Although a series of prediction models have been developed for early identification of such patients,the majority are complicated or lack validation.A simpler and more credible model is required for clinical practice.AIM To develop and validate a predictive model for SAP related ARDS.METHODS Patients diagnosed with AP from four hospitals located at different regions of China were retrospectively grouped into derivation and validation cohorts.Statistically significant variables were identified using the least absolute shrinkage and selection operator regression method.Predictive models with nomograms were further built using multiple logistic regression analysis with these picked predictors.The discriminatory power of new models was compared with some common models.The performance of calibration ability and clinical utility of the predictive models were evaluated.RESULTS Out of 597 patients with AP,139 were diagnosed with SAP(80 in derivation cohort and 59 in validation cohort)and 99 with ARDS(62 in derivation cohort and 37 in validation cohort).Four identical variables were identified as independent risk factors for both SAP and ARDS:heart rate[odds ratio(OR)=1.05;95%CI:1.04-1.07;P<0.001;OR=1.05,95%CI:1.03-1.07,P<0.001],respiratory rate(OR=1.08,95%CI:1.0-1.17,P=0.047;OR=1.10,95%CI:1.02-1.19,P=0.014),serum calcium concentration(OR=0.26,95%CI:0.09-0.73,P=0.011;OR=0.17,95%CI:0.06-0.48,P=0.001)and blood urea nitrogen(OR=1.15,95%CI:1.09-1.23,P<0.001;OR=1.12,95%CI:1.05-1.19,P<0.001).The area under receiver operating characteristic curve was 0.879(95%CI:0.830-0.928)and 0.898(95%CI:0.848-0.949)for SAP prediction in derivation and validation cohorts,respectively.This value was 0.892(95%CI:0.843-0.941)and 0.833(95%CI:0.754-0.912)for ARDS prediction,respectively.The discriminatory power of our models was improved compared with that of other widely used models and the calibration ability and clinical utility of the prediction models performed adequately.CONCLUSION The present study constructed and validated a simple and accurate predictive model for SAPrelated ARDS in patients with AP.

Turing pattern selection for a plant-wrack model with cross-diffusion

We investigate the Turing instability and pattern formation mechanism of a plant-wrack model with both self-diffusion and cross-diffusion terms.We first study the effect of self-diffusion on the stability of equilibrium.We then derive the conditions for the occurrence of the Turing patterns induced by cross-diffusion based on self-diffusion stability.Next,we analyze the pattern selection by using the amplitude equation and obtain the exact parameter ranges of different types of patterns,including stripe patterns,hexagonal patterns and mixed states.Finally,numerical simulations confirm the theoretical results.

Venous Doppler flow patterns,venous congestion,heart disease and renal dysfunction:A complex liaison

The World Journal of Cardiology published an article written by Kuwahara et al that we take the pleasure to comment on.We focused our attention on venous congestion.In intensive care settings,it is now widely accepted that venous congestion is an important clinical feature worthy of investigation.Evaluating venous Doppler profile abnormalities at multiple sites could suggest adequate treatment and monitor its efficacy.Renal dysfunction could trigger or worsen fluid overload in heart disease,and cardio-renal syndrome is a well-characterized spectrum of disorders describing the complex interactions between heart and kidney diseases.Fluid overload and venous congestion,including renal venous hypertension,are major determinants of acute and chronic renal dysfunction arising in heart disease.Organ congestion from venous hypertension could be involved in the development of organ injury in several clinical situations,such as critical diseases,congestive heart failure,and chronic kidney disease.Ultrasonography and abnormal Doppler flow patterns diagnose clinically significant systemic venous congestion.Cardiologists and nephrologists might use this valuable,noninvasive,bedside diagnostic tool to establish fluid status and guide clinical choices.

Development of a rat model of D-galactosamine/lipopolysaccharide induced hepatorenal syndrome

AIM:To develop a practical and reproducible rat model of hepatorenal syndrome for further study of the pathophysiology of human hepatorenal syndrome. METHODS:Sprague-Dawley rats were intravenously injected with D-galactosamine and lipopolysaccharide(LPS) via the tail vein to induce fulminant hepatic failure to develop a model of hepatorenal syndrome. Liver and kidney function tests and plasma cytokine levels were measured after D-galactosamine/LPS administration,and hepatic and renal pathology was studied. Glomerular filtration rate was detected in conscious rats using micro-osmotic pump technology with fluorescein isothiocyanate-labelled inulin as a surrogate marker.RESULTS:Serum levels of biochemical indicators including liver and kidney function indexes and cytokines all significantly changed,especially at 12 h after D-galactosamine/LPS administration [alanine aminotransferase,3389.5 ± 499.5 IU/L; blood urea nitrogen,13.9 ± 1.3 mmol/L; Cr,78.1 ± 2.9 μmol/L; K+,6.1 ± 0.5 mmol/L; Na+,130.9 ± 1.9 mmol/L; Cl-,90.2 ± 1.9 mmol/L; tumor necrosis factor-α,1699.6 ± 599.1 pg/m L; endothelin-1,95.9 ± 25.9 pg/m L; P < 0.05 compared with normal saline control group]. Hepatocyte necrosis was aggravated gradually,which was most significant at 12 h after treatment with D-galactosamine/LPS,and was characterized by massive hepatocyte necrosis,while the structures of glomeruli,proximal and distal tubules were normal. Glomerular filtration rate was significantly decreased to 30%-35% of the control group at 12 h after D-galactosamine/LPS administration [Glomerular filtration rate(GFR)1,0.79 ± 0.11 m L/min; GFR2,3.58 ± 0.49 m L/min·kg BW-1; GFR3,0.39 ± 0.99 m L/min·g KW-1]. The decreasing timing of GFR was consistent with that of the presence of hepatocyte necrosis and liver and kidney dysfunction.CONCLUSION:The joint use of D-galactosamine and LPS can induce liver and kidney dysfunction and decline of glomerular filtration rate in rats which is a successful rat model of hepatorenal syndrome.