Statins and cholesterol absorption inhibitors lower the concentration of C-reactive protein(CRP). The genetic polymorphism of apolipoprotein(apo) E is a strong endogenous determinant of sterol homeostasis. We therefor...Statins and cholesterol absorption inhibitors lower the concentration of C-reactive protein(CRP). The genetic polymorphism of apolipoprotein(apo) E is a strong endogenous determinant of sterol homeostasis. We therefore examined the relationship of CRP to the apoE polymorphism. We studied 739 and 570 subjects with or without stable angiographic coronary artery disease(CAD), respectively. In carriers of apoE2, apoB was lower(P< 0.001) than in apoE3/3 homozygotes; in individuals with apoE3/4 and apoE4/4, it was higher (P< 0.001). Both in the presence and absence of CAD, CRP was higher in carriers of apoE2 (P=0.002) and apoE3/3 homozygotes (P=0.032) than in individuals with apoE3/4 or apoE4/4. Fibrinogen and white cell count were not related to the apoE genotype. CRP was associated with CAD. Compared to the lowest tertile, crude odds ratios were 1.87 (95%confidence interval (CI), 1.43-2.45, P< .0.001) and 2.24 (95%CI, 1.71-2.94, P< 0.001) in the second and third tertile. In carriers of apoE2, the use of tertiles defined in controls with apoE2 only diminished the odds ratios for CAD. In apoE3/4 heterozygotes or apoE4/4 homozygotes, the use of tertiles specific for this group only slightly increased the odds ratios. The concentration of CRP, but not fibrinogen nor white blood cells is associated with the apoE polymorphism. The activity of the mevalonate pathway in the liver may be related to the metabolism of CRP. The predictive value of CRP for CAD may be modified by the apoE polymorphism.展开更多
Background -Markers of systemic inflammation and LDL cholesterol(LDL-C) have been considered independent risk factors of coronary artery disease(CAD). We ex amined whether alterations of LDL metabolism not reflected b...Background -Markers of systemic inflammation and LDL cholesterol(LDL-C) have been considered independent risk factors of coronary artery disease(CAD). We ex amined whether alterations of LDL metabolism not reflected by LDL-C were associ ated with low-grade inflammation, vascular injury, and CAD. Methods and Results -We studied 739 subjects with stable angiographic CAD and 570 matched control subjects in which CAD had been ruled out by angiography. The association of LDL triglycerides(LDL-TGs)(odds ratio[OR], 1.30; 95%CI, 1.19 to 1.43; P< 0.001) wi th CAD was stronger than that of LDL-C (OR, 1.10; 95%CI, 1.00 to 1.21; P=0.047 ). The predictive value of LDL-TG for CAD was independent of LDL-C. "Sensitiv e"C-reactive protein(CRP), serum amyloid A, fibrinogen, interleukin 6, interce llular adhesion molecule-1(ICAM-1), and vascular adhesion molecule-1(VCAM-1) increased in parallel to LDL-TG. CRP, ICAM-1, and VCAM-1 were inversely rela ted to LDL-C. To examine whether LDL-TGs were associated with the distribution of LDL subfractions, we studied 114 individuals with impaired fasting glucose, impaired glucose tolerance, or type 2 diabetes mellitus. In subjects with high L DL-TG, LDLs were depleted of cholesteryl esters(CEs), and VLDLs, IDLs, and dens e LDLs were significantly elevated. Conclusions -Alterations of LDL metabolism characterized by high LDL-TG are related to CAD, systemic low-grade inflammati on, and vascular damage. High LDL-TGs are indicative of CE-depleted LDL, eleva ted IDL, and dense LDL. LDL-TG may better reflect the atherogenic potential of LDL than LDL-C.展开更多
Introduction: Early diagnosis and treatment of metastases have been shown to improve overall survival of melanoma patients. The purpose of this study was to evaluate the impact of extensive initial staging, including ...Introduction: Early diagnosis and treatment of metastases have been shown to improve overall survival of melanoma patients. The purpose of this study was to evaluate the impact of extensive initial staging, including positron emission tomography (PET) scan on the management of melanoma patients. Patients and methods: Forty-three patients with intermediate/poor prognosis primary melanoma benefited from complementary excision and sentinel lymph node biopsy (SLB) after clinical and paraclinical. staging (computed tomography, nuclear magnetic resonance and whole body fluorodeoxyglucose PET scan). Results: No systemic metastases were demonstrated, while the SLB procedure emphasized the presence of regional lymph node metastases in 10 patients as suggested by the PET scan in four patients (sensitivity of the PET scan 40% ). These 10 patients with early diagnosed lymph node involvement benefited from early surgery and were included in adju vant treatment protocols. A secondary primary cancer was fortuitously diagnosed and treated early in two patients. Conclusions: The development of new adjuvant therapies and therapeutic procedures (specific and non-specific immunotherapy, gamma-knife radiosurgery, etc.) now raises the relevance of extensive staging in intermediate/poor prognosis melanoma patients. We confirm in our series that PET scan is not useful to detect micrometastasis and cannot replace SLB in initial regional staging. However, we show in our study that 12 of 43 patients were treated early or were included early in treatment protocols thanks to the extensive staging procedure. Nevertheless, it seems important to evaluate through larger prospective trials the real impact of these early diagnoses and new treatments on overall survival before defining new diagnostic and therapeutic guidelines.展开更多
Context: Congestive heart failure(CHF)affects a substantial proportion of adults including those without preexisting coronary heart disease. The pathogenesis of CHF is uncertain, but microvascular disease has been hyp...Context: Congestive heart failure(CHF)affects a substantial proportion of adults including those without preexisting coronary heart disease. The pathogenesis of CHF is uncertain, but microvascular disease has been hypothesized as a possible factor. Objective: To determine the relationship of retinopathy, a marker of systemic microvascular disease, to risk of CHF. Design, Setting, and Participants: Population-based, prospective 7-year cohort study in 4 US communities using the Atherosclerosis Risk in Communities Study database. Participants(n=11612, aged 49 to 73 years)had retinal photographs taken between 1993 and 1995. The photographs were graded according to a standardized protocol for the presence of retinopathy(eg, microaneurysms, retinal hemorrhages, soft exudates), arteriovenous nicking, focal arteriolar narrowing, and generalized arteriolar narrowing. Main Outcome Measures: Association between retinopathy and incident CHF, identified from hospitalization and death records. Results: The 7-year cumulative incidence of CHF was 5.4%(492 events). Participants with retinopathy had a higher incidence of CHF compared with those without retinopathy(15.1 %vs 4.8%, P< .001). After controlling for age, sex, race, preexisting coronary heart disease, mean arterial blood pressure, diabetes, glucose level, cholesterol level, smoking, body mass index, and study site, the presence of retinopathy was associated with a 2-fold higher risk of CHF(relative risk, 1.96; 95%confidence interval, 1.51-2.54). Among participants without preexisting coronary heart disease, diabetes, or hypertension, retinopathy was associated with a 3-fold higher risk of CHF(relative risk, 2.98; 95%confidence interval, 1.50-5.92). Conclusions: Retinopathy is an independent predictor of CHF, even in persons without preexisting coronary heart disease, diabetes, or hypertension. This suggests that microvascular disease may play an important role in the development of heart failure in the general population. Some asymptomatic persons with retinopathy on an ophthalmologic examination may benefit from further assessment of CHF risk.展开更多
In this paper,we consider the price of catastrophe options with credit risk in a regime-switching model.We assume that the macroeconomic states are described by a continuous-time Markov chain with a finite state space...In this paper,we consider the price of catastrophe options with credit risk in a regime-switching model.We assume that the macroeconomic states are described by a continuous-time Markov chain with a finite state space.By using the measure change technique,we derive the price expressions of catastrophe put options.Moreover,we conduct some numerical analysis to demonstrate how the parameters of the model affect the price of the catastrophe put option.展开更多
Temporal and spatial variations of concentrations of heavy metals including mercury （Hg）, zinc （Zn）, lead （Pb）, arsenic （As）, copper （Cu）, and cadmium （Cd） in the sediments of the Yangshan Deepwater Harbor...Temporal and spatial variations of concentrations of heavy metals including mercury （Hg）, zinc （Zn）, lead （Pb）, arsenic （As）, copper （Cu）, and cadmium （Cd） in the sediments of the Yangshan Deepwater Harbor were determined based on 6 cruises in autumn and winter, respectively, from 2010 to 2013. The results demonstrated that the overall concentrations of heavy metals were low and distributed in uniform patterns. The concentrations of Hg, Zn, Pb, and Cd in autumn were significantly higher than those in winter with small fluctuations for As and Cu in terms of seasonal variations. Results of factor analysis showed that Pb, Cd, and Zn were derived from inland industrial and shipping discharges as well as the degradation of organic pollutants in marine environment. While agricultural pollutions, cargo shifting and construction debris from reclamation projects contributed to the sources of Cu, As, and Hg. Ecological risk assessment by Mean Sediment Quality Guideline Quotient （SQG-Q） revealed that the degree for eco-risk of the sediments was low-and-moderate in autumn, higher than that in winter. Hg and Cu were the dominant eco-risk factors. The results of Index of geoaccumulation （Igeo） showed that the whole sites of the sea area were barely influenced by Hg, As, Zn, and Pb, and the extents of Cd and Cu contaminations were in low grade. Contamination degree of all the six heavy metals could be ranked as the following： Cd〉Pb〉Zn〉Hg〉As. According to the results of integrated score of factor analysis, the contamination degree for heavy metals in sediments of the Yangshan Deepwater Harbor was low, despite sites No.5, No.4 and No.3, which were heavily contaminated compared with others.展开更多
In this paper, we construct the EB estim ation for the parameter of the two-dimensional one side truncat ed distribution fam ilies using Linex loss. The convergence rate of EB estimation is given and it is shown tha...In this paper, we construct the EB estim ation for the parameter of the two-dimensional one side truncat ed distribution fam ilies using Linex loss. The convergence rate of EB estimation is given and it is shown that the proposed empirical Bayes estimaiton can be arbitrarily close to 1 under certain conditions.展开更多
文摘Statins and cholesterol absorption inhibitors lower the concentration of C-reactive protein(CRP). The genetic polymorphism of apolipoprotein(apo) E is a strong endogenous determinant of sterol homeostasis. We therefore examined the relationship of CRP to the apoE polymorphism. We studied 739 and 570 subjects with or without stable angiographic coronary artery disease(CAD), respectively. In carriers of apoE2, apoB was lower(P< 0.001) than in apoE3/3 homozygotes; in individuals with apoE3/4 and apoE4/4, it was higher (P< 0.001). Both in the presence and absence of CAD, CRP was higher in carriers of apoE2 (P=0.002) and apoE3/3 homozygotes (P=0.032) than in individuals with apoE3/4 or apoE4/4. Fibrinogen and white cell count were not related to the apoE genotype. CRP was associated with CAD. Compared to the lowest tertile, crude odds ratios were 1.87 (95%confidence interval (CI), 1.43-2.45, P< .0.001) and 2.24 (95%CI, 1.71-2.94, P< 0.001) in the second and third tertile. In carriers of apoE2, the use of tertiles defined in controls with apoE2 only diminished the odds ratios for CAD. In apoE3/4 heterozygotes or apoE4/4 homozygotes, the use of tertiles specific for this group only slightly increased the odds ratios. The concentration of CRP, but not fibrinogen nor white blood cells is associated with the apoE polymorphism. The activity of the mevalonate pathway in the liver may be related to the metabolism of CRP. The predictive value of CRP for CAD may be modified by the apoE polymorphism.
文摘Background -Markers of systemic inflammation and LDL cholesterol(LDL-C) have been considered independent risk factors of coronary artery disease(CAD). We ex amined whether alterations of LDL metabolism not reflected by LDL-C were associ ated with low-grade inflammation, vascular injury, and CAD. Methods and Results -We studied 739 subjects with stable angiographic CAD and 570 matched control subjects in which CAD had been ruled out by angiography. The association of LDL triglycerides(LDL-TGs)(odds ratio[OR], 1.30; 95%CI, 1.19 to 1.43; P< 0.001) wi th CAD was stronger than that of LDL-C (OR, 1.10; 95%CI, 1.00 to 1.21; P=0.047 ). The predictive value of LDL-TG for CAD was independent of LDL-C. "Sensitiv e"C-reactive protein(CRP), serum amyloid A, fibrinogen, interleukin 6, interce llular adhesion molecule-1(ICAM-1), and vascular adhesion molecule-1(VCAM-1) increased in parallel to LDL-TG. CRP, ICAM-1, and VCAM-1 were inversely rela ted to LDL-C. To examine whether LDL-TGs were associated with the distribution of LDL subfractions, we studied 114 individuals with impaired fasting glucose, impaired glucose tolerance, or type 2 diabetes mellitus. In subjects with high L DL-TG, LDLs were depleted of cholesteryl esters(CEs), and VLDLs, IDLs, and dens e LDLs were significantly elevated. Conclusions -Alterations of LDL metabolism characterized by high LDL-TG are related to CAD, systemic low-grade inflammati on, and vascular damage. High LDL-TGs are indicative of CE-depleted LDL, eleva ted IDL, and dense LDL. LDL-TG may better reflect the atherogenic potential of LDL than LDL-C.
文摘Introduction: Early diagnosis and treatment of metastases have been shown to improve overall survival of melanoma patients. The purpose of this study was to evaluate the impact of extensive initial staging, including positron emission tomography (PET) scan on the management of melanoma patients. Patients and methods: Forty-three patients with intermediate/poor prognosis primary melanoma benefited from complementary excision and sentinel lymph node biopsy (SLB) after clinical and paraclinical. staging (computed tomography, nuclear magnetic resonance and whole body fluorodeoxyglucose PET scan). Results: No systemic metastases were demonstrated, while the SLB procedure emphasized the presence of regional lymph node metastases in 10 patients as suggested by the PET scan in four patients (sensitivity of the PET scan 40% ). These 10 patients with early diagnosed lymph node involvement benefited from early surgery and were included in adju vant treatment protocols. A secondary primary cancer was fortuitously diagnosed and treated early in two patients. Conclusions: The development of new adjuvant therapies and therapeutic procedures (specific and non-specific immunotherapy, gamma-knife radiosurgery, etc.) now raises the relevance of extensive staging in intermediate/poor prognosis melanoma patients. We confirm in our series that PET scan is not useful to detect micrometastasis and cannot replace SLB in initial regional staging. However, we show in our study that 12 of 43 patients were treated early or were included early in treatment protocols thanks to the extensive staging procedure. Nevertheless, it seems important to evaluate through larger prospective trials the real impact of these early diagnoses and new treatments on overall survival before defining new diagnostic and therapeutic guidelines.
文摘Context: Congestive heart failure(CHF)affects a substantial proportion of adults including those without preexisting coronary heart disease. The pathogenesis of CHF is uncertain, but microvascular disease has been hypothesized as a possible factor. Objective: To determine the relationship of retinopathy, a marker of systemic microvascular disease, to risk of CHF. Design, Setting, and Participants: Population-based, prospective 7-year cohort study in 4 US communities using the Atherosclerosis Risk in Communities Study database. Participants(n=11612, aged 49 to 73 years)had retinal photographs taken between 1993 and 1995. The photographs were graded according to a standardized protocol for the presence of retinopathy(eg, microaneurysms, retinal hemorrhages, soft exudates), arteriovenous nicking, focal arteriolar narrowing, and generalized arteriolar narrowing. Main Outcome Measures: Association between retinopathy and incident CHF, identified from hospitalization and death records. Results: The 7-year cumulative incidence of CHF was 5.4%(492 events). Participants with retinopathy had a higher incidence of CHF compared with those without retinopathy(15.1 %vs 4.8%, P< .001). After controlling for age, sex, race, preexisting coronary heart disease, mean arterial blood pressure, diabetes, glucose level, cholesterol level, smoking, body mass index, and study site, the presence of retinopathy was associated with a 2-fold higher risk of CHF(relative risk, 1.96; 95%confidence interval, 1.51-2.54). Among participants without preexisting coronary heart disease, diabetes, or hypertension, retinopathy was associated with a 3-fold higher risk of CHF(relative risk, 2.98; 95%confidence interval, 1.50-5.92). Conclusions: Retinopathy is an independent predictor of CHF, even in persons without preexisting coronary heart disease, diabetes, or hypertension. This suggests that microvascular disease may play an important role in the development of heart failure in the general population. Some asymptomatic persons with retinopathy on an ophthalmologic examination may benefit from further assessment of CHF risk.
基金supported by the Jiangsu University Philosophy and Social Science Research Project(Grant No.2019SJA1326).
文摘In this paper,we consider the price of catastrophe options with credit risk in a regime-switching model.We assume that the macroeconomic states are described by a continuous-time Markov chain with a finite state space.By using the measure change technique,we derive the price expressions of catastrophe put options.Moreover,we conduct some numerical analysis to demonstrate how the parameters of the model affect the price of the catastrophe put option.
基金supported by the Study on the Analysis of the Impacts of Reclamation Engineering on Marine Ecological Environment in Yangshan Deepwater Harbor and Protecting Measures of Shanghai Municipal Science and Technology Commission (No. 12231203402)
文摘Temporal and spatial variations of concentrations of heavy metals including mercury （Hg）, zinc （Zn）, lead （Pb）, arsenic （As）, copper （Cu）, and cadmium （Cd） in the sediments of the Yangshan Deepwater Harbor were determined based on 6 cruises in autumn and winter, respectively, from 2010 to 2013. The results demonstrated that the overall concentrations of heavy metals were low and distributed in uniform patterns. The concentrations of Hg, Zn, Pb, and Cd in autumn were significantly higher than those in winter with small fluctuations for As and Cu in terms of seasonal variations. Results of factor analysis showed that Pb, Cd, and Zn were derived from inland industrial and shipping discharges as well as the degradation of organic pollutants in marine environment. While agricultural pollutions, cargo shifting and construction debris from reclamation projects contributed to the sources of Cu, As, and Hg. Ecological risk assessment by Mean Sediment Quality Guideline Quotient （SQG-Q） revealed that the degree for eco-risk of the sediments was low-and-moderate in autumn, higher than that in winter. Hg and Cu were the dominant eco-risk factors. The results of Index of geoaccumulation （Igeo） showed that the whole sites of the sea area were barely influenced by Hg, As, Zn, and Pb, and the extents of Cd and Cu contaminations were in low grade. Contamination degree of all the six heavy metals could be ranked as the following： Cd〉Pb〉Zn〉Hg〉As. According to the results of integrated score of factor analysis, the contamination degree for heavy metals in sediments of the Yangshan Deepwater Harbor was low, despite sites No.5, No.4 and No.3, which were heavily contaminated compared with others.
文摘In this paper, we construct the EB estim ation for the parameter of the two-dimensional one side truncat ed distribution fam ilies using Linex loss. The convergence rate of EB estimation is given and it is shown that the proposed empirical Bayes estimaiton can be arbitrarily close to 1 under certain conditions.
