Background The CRUSADE, ACTION and ACUITY-HORIZONS scores are commonly used for predicting in-hospital major bleeding events in patients with acute coronary syndrome （ACS）, but the homogeneous nature of these models...Background The CRUSADE, ACTION and ACUITY-HORIZONS scores are commonly used for predicting in-hospital major bleeding events in patients with acute coronary syndrome （ACS）, but the homogeneous nature of these models＇ population limits simple ex- trapolation to other local population. We aimed to compare the performance of the three risk models in Chinese patients. Methods We evaluated the performance of the three predicting scores for predicting in-hospital major bleeding events defined by thrombolysis in myocar- dial infarction （TIMI） serious （major and minor） episodes, in a cohort of Chinese ACS patients with either non-ST-elevation ACS （NSTE-ACS） or ST-elevation myocardial infarction （STEMI）. Calibration and discrimination of the three risk models were evaluated by the Hosmer-Lemeshow test and C-statistic, respectively. We compared the predictive accuracy of the risk scores by the Delong non-parametric test. Results TIMI serious bleeding rate was 1.1% overall （1.9% and 0.86% for STEMI and NSTE-ACS, respectively）. The CRUSADE, ACTION and ACUTIY-HOR/ZONS scores showed an adequate discriminatory capacity for major bleeding： in overall patients, the C-statistic was 0.80, 0.77, and 0.70, respectively; in NSTE-ACS patients, the C-statistic was 0.73, 0.72, and 0.64, respectively; in STEMI patients, the C-statistic was 0.91, 0.92, and 0.75, respectively. The C-statistic for the ACUITY-HORIZONS model was significantly lower than those of the CRUSADE and ACTION scores for the prediction of TIM/serious bleeding in overall patients （compared with CRUSADE, z = 3.83, P = 0.02; compared with ACTION, z = 3.51, P = 0.03）; in NSTE-ACS patients （compared with CRUSADE, z = 2.37, P = 0.01; compared with ACTION, z = 2.11, P = 0.04）, and in STEMI patients （compared with CRUSADE, z = 2.6.77, P = 0.02; compared with AC- TION, z = 7.91, P = 0.002）. No differences were observed when the CRUSADE and ACTION models were compared to each other, regard- less of overall patients （z = 0.68, P = 0.31） and both of ACS types （NSTE-ACS, z = 0.52, P = 0.60）, and STEMI patients （z = 0.36, P = 0.74）. However, the three risk scores all overestimated the absolute major bleeding risk in each risk stratification in our study. For example, the predicted rate of CRUSADE score at high risk stratification was 11.9% vs. an actual rate of 5.3%. Conclusions The CRUSADE and AC- TION scores had a greater calibration and discrimination for in-hospital major bleeding compared with the ACUITY-HORIZONS score in Chinese patients with ACS undergoing PCI. However, they all overestimated the bleeding risk rate for Chinese populations. Calibration of these risk scores would be useful for the generalization in Chinese populations.展开更多
Polyvinyl alcohol （PVA）-sodium polyacrylate （PAAS）-KOH-H2O alkaline polymer electrolyte film with high ionic conductivity was prepared by a solution-casting method. Polymer Ni（OH）2/activated carbon （AC） hybrid...Polyvinyl alcohol （PVA）-sodium polyacrylate （PAAS）-KOH-H2O alkaline polymer electrolyte film with high ionic conductivity was prepared by a solution-casting method. Polymer Ni（OH）2/activated carbon （AC） hybrid supercapacitors with different electrode active material mass ratios （positive to negative） were fabricated using this alkaline polymer electrolyte, nickel hydroxide positive electrodes, and AC negative electrodes. Galvanostatic charge/ discharge and electrochemical impedance spectroscopy （EIS） methods were used to study the electrochemical performance of the capacitors, such as charge/discharge specific capacitance, rate charge/discharge ability, and charge/discharge cyclic stability. Experimental results showed that with the decreasing of active material mass ratio m（Ni（OH）2）/m（AC）, the charge/discharge specific capacitance increases, but the rate charge/discharge ability and the charge/discharge cyclic stability decrease.展开更多
The conversion of electromagnetic energy into heat by nanomagnets has the potential to be a powerful, non-invasive technique for cancer therapy by hyperthermia and hyperthermia-based drug release, while temperature co...The conversion of electromagnetic energy into heat by nanomagnets has the potential to be a powerful, non-invasive technique for cancer therapy by hyperthermia and hyperthermia-based drug release, while temperature controllability and targeted heating are challenges to developing applications of such magnetic inductive hyperthermia. This study was designed to control the hyperthermia position and area using a combination of alternating current （AC） and a static magnetic field. MnZn ferrite （MZF） nanoparticles which exhibited excellent hyperthermia properties were first prepared and characterized as an inductive heating mediator. We built model static magnetic fields simply using a pair of permanent magnets and studied the static magnetic field distributions by measurements and numerical simulations. The influence of the transverse static magnetic fields on hyperthermia properties was then investigated on MZF magnetic fluid, gel phantoms and SMMC-7721 cells in vitro. The results showed a static magnetic field can inhibit the temperature rise of MZF nanoparticles in an AC magnetic field. But in the uneven static magnetic field formed by a magnet pair with repelling poles face-to-face, the heating area can be restricted in a central low static field; meanwhile the side effects of hyperthermia can be reduced by a surrounding high static field. As a result we can position the hyperthermia area, protect the non-therapeutic area, and reduce the side effects lust by using a well-designed combination of AC and static field.展开更多
文摘Background The CRUSADE, ACTION and ACUITY-HORIZONS scores are commonly used for predicting in-hospital major bleeding events in patients with acute coronary syndrome （ACS）, but the homogeneous nature of these models＇ population limits simple ex- trapolation to other local population. We aimed to compare the performance of the three risk models in Chinese patients. Methods We evaluated the performance of the three predicting scores for predicting in-hospital major bleeding events defined by thrombolysis in myocar- dial infarction （TIMI） serious （major and minor） episodes, in a cohort of Chinese ACS patients with either non-ST-elevation ACS （NSTE-ACS） or ST-elevation myocardial infarction （STEMI）. Calibration and discrimination of the three risk models were evaluated by the Hosmer-Lemeshow test and C-statistic, respectively. We compared the predictive accuracy of the risk scores by the Delong non-parametric test. Results TIMI serious bleeding rate was 1.1% overall （1.9% and 0.86% for STEMI and NSTE-ACS, respectively）. The CRUSADE, ACTION and ACUTIY-HOR/ZONS scores showed an adequate discriminatory capacity for major bleeding： in overall patients, the C-statistic was 0.80, 0.77, and 0.70, respectively; in NSTE-ACS patients, the C-statistic was 0.73, 0.72, and 0.64, respectively; in STEMI patients, the C-statistic was 0.91, 0.92, and 0.75, respectively. The C-statistic for the ACUITY-HORIZONS model was significantly lower than those of the CRUSADE and ACTION scores for the prediction of TIM/serious bleeding in overall patients （compared with CRUSADE, z = 3.83, P = 0.02; compared with ACTION, z = 3.51, P = 0.03）; in NSTE-ACS patients （compared with CRUSADE, z = 2.37, P = 0.01; compared with ACTION, z = 2.11, P = 0.04）, and in STEMI patients （compared with CRUSADE, z = 2.6.77, P = 0.02; compared with AC- TION, z = 7.91, P = 0.002）. No differences were observed when the CRUSADE and ACTION models were compared to each other, regard- less of overall patients （z = 0.68, P = 0.31） and both of ACS types （NSTE-ACS, z = 0.52, P = 0.60）, and STEMI patients （z = 0.36, P = 0.74）. However, the three risk scores all overestimated the absolute major bleeding risk in each risk stratification in our study. For example, the predicted rate of CRUSADE score at high risk stratification was 11.9% vs. an actual rate of 5.3%. Conclusions The CRUSADE and AC- TION scores had a greater calibration and discrimination for in-hospital major bleeding compared with the ACUITY-HORIZONS score in Chinese patients with ACS undergoing PCI. However, they all overestimated the bleeding risk rate for Chinese populations. Calibration of these risk scores would be useful for the generalization in Chinese populations.
基金Supported by Leading Academic Discipline Project of Shanghai Municipal Education Commission (J50102)
文摘Polyvinyl alcohol （PVA）-sodium polyacrylate （PAAS）-KOH-H2O alkaline polymer electrolyte film with high ionic conductivity was prepared by a solution-casting method. Polymer Ni（OH）2/activated carbon （AC） hybrid supercapacitors with different electrode active material mass ratios （positive to negative） were fabricated using this alkaline polymer electrolyte, nickel hydroxide positive electrodes, and AC negative electrodes. Galvanostatic charge/ discharge and electrochemical impedance spectroscopy （EIS） methods were used to study the electrochemical performance of the capacitors, such as charge/discharge specific capacitance, rate charge/discharge ability, and charge/discharge cyclic stability. Experimental results showed that with the decreasing of active material mass ratio m（Ni（OH）2）/m（AC）, the charge/discharge specific capacitance increases, but the rate charge/discharge ability and the charge/discharge cyclic stability decrease.
文摘The conversion of electromagnetic energy into heat by nanomagnets has the potential to be a powerful, non-invasive technique for cancer therapy by hyperthermia and hyperthermia-based drug release, while temperature controllability and targeted heating are challenges to developing applications of such magnetic inductive hyperthermia. This study was designed to control the hyperthermia position and area using a combination of alternating current （AC） and a static magnetic field. MnZn ferrite （MZF） nanoparticles which exhibited excellent hyperthermia properties were first prepared and characterized as an inductive heating mediator. We built model static magnetic fields simply using a pair of permanent magnets and studied the static magnetic field distributions by measurements and numerical simulations. The influence of the transverse static magnetic fields on hyperthermia properties was then investigated on MZF magnetic fluid, gel phantoms and SMMC-7721 cells in vitro. The results showed a static magnetic field can inhibit the temperature rise of MZF nanoparticles in an AC magnetic field. But in the uneven static magnetic field formed by a magnet pair with repelling poles face-to-face, the heating area can be restricted in a central low static field; meanwhile the side effects of hyperthermia can be reduced by a surrounding high static field. As a result we can position the hyperthermia area, protect the non-therapeutic area, and reduce the side effects lust by using a well-designed combination of AC and static field.
