BACKGROUND GRACE and SYNTAX scores are important tools to assess prognosis in non-STelevation acute coronary syndrome(NSTE-ACS).However,there have been few studies on their value in patients receiving different types ...BACKGROUND GRACE and SYNTAX scores are important tools to assess prognosis in non-STelevation acute coronary syndrome(NSTE-ACS).However,there have been few studies on their value in patients receiving different types of therapies.AIM To explore the value of GRACE and SYNTAX scores in predicting the prognosis of patients with NSTE-ACS receiving different types of therapies.METHODS The data of 386 patients with NSTE-ACS were retrospectively analyzed and categorized into different groups.A total of 195 patients who received agents alone comprised the medication group,156 who received medical therapy combined with stents comprised the stent group,and 35 patients who were given agents and underwent coronary artery bypass grafting(CABG)comprised the CABG group.General information was compared among the three groups.GRACE and SYNTAX scores were calculated.The association between the relationship between GRACE and SYNTAX scores and the occurrence of major adverse cardiovascular events(MACEs)was analyzed.Pearson’s correlation analysis was used to determine the factors influencing prognosis in patients with NSTE-ACS.Univariate and multivariate analyses were conducted to analyze the predictive value of GRACE and SYNTAX scores for predicting prognosis in patients with NSTE-ACS using the Cox proportional-hazards model.RESULTS The incidence of MACE increased with the elevation of GRACE and SYNTAX scores(all P<0.05).The incidence of MACE was 18.5%,36.5%,and 42.9%in the medication group,stent group,and CABG group,respectively.By comparison,the incidence of MACE was significantly lower in the medication group than in the stent and CABG groups(all P<0.05).The incidence of MACE was 6.2%,28.0%and 40.0%in patients with a low GRACE score in the medication group,stent group,and CABG group,respectively(P<0.05).The incidence of MACE was 31.0%,30.3%and 42.9%in patients with a medium GRACE score in the medication group,stent group,and CABG group,respectively(P>0.05).The incidence of MACE was 16.9%,46.2%,and 43.8%in patients with a high GRACE score in the medication group,stent group,and CABG group,respectively(P<0.05).The incidence of MACE was 16.2%,35.4%and 60.0%in patients with a low SYNTAX score in the medication group,stent group,and CABG group,respectively(P<0.05).The incidence of MACE was 37.5%,40.9%,and 41.7%in patients with a medium SYNTAX score in the medication group,stent group,and CABG group,respectively(P>0.05).MACE incidence was 50.0%,75.0%,and 25.0%in patients with a high SYNTAX score in the medication group,stent group,and CABG group,respectively(P<0.05).Univariate Cox regression analyses showed that both GRACE score(hazard ratio[HR]=1.212,95%confidence interval[CI]:1.083 to 1.176;P<0.05)and SYNTAX score(HR=1.160,95%CI:1.104 to 1.192;P<0.05)were factors influencing MACE(all P<0.05).Multivariate Cox regression analyses showed that GRACE(HR=1.091,95%CI:1.015 to 1.037;P<0.05)and SYNTAX scores(HR=1.031,95%CI:1.076 to 1.143;P<0.05)were independent predictors of MACE(all P<0.05).CONCLUSION GRACE and SYNTAX scores are of great value for evaluating the prognosis of NSTE-ACS patients,and prevention and early intervention strategies should be used in clinical practice targeting different risk scores.展开更多
BACKGROUND The incidence of acute myocardial infarction(AMI)is rising,with cardiac rupture accounting for approximately 2%of deaths in patients with acute ST-segment elevation myocardial infarction(STEMI).Ventricular ...BACKGROUND The incidence of acute myocardial infarction(AMI)is rising,with cardiac rupture accounting for approximately 2%of deaths in patients with acute ST-segment elevation myocardial infarction(STEMI).Ventricular free wall rupture(FWR)occurs in approximately 2%of AMI patients and is notably rare in patients with non-STEMI.Types of cardiac rupture include left ventricular FWR,ventricular septal rupture,and papillary muscle rupture.The FWR usually leads to acute cardiac tamponade or electromechanical dissociation,where standard resuscitation efforts may not be effective.Ventricular septal rupture and papillary muscle rupture often result in refractory heart failure,with mortality rates over 50%,even with surgical or percutaneous repair options.CASE SUMMARY We present a rare case of an acute non-STEMI patient who suffered sudden FWR causing cardiac tamponade and loss of consciousness immediate before undergoing coronary angiography.Prompt resuscitation and emergency open-heart repair along with coronary artery bypass grafting resulted in successful patient recovery.CONCLUSION This case emphasizes the risks of AMI complications,shares a successful treatment scenario,and discusses measures to prevent such complications.展开更多
Background Antithrombotic and antiplatelet therapies have been proposed to treat non-ST elevation acute coronary syndrome (NSTEACS), yet limited information is available about their applications from a multicenter ...Background Antithrombotic and antiplatelet therapies have been proposed to treat non-ST elevation acute coronary syndrome (NSTEACS), yet limited information is available about their applications from a multicenter "real-world" clinical procedure, especially in China. This study was undertaken to characterize the use of antithrombotic and antiplatelet agents in relation to the risk levels of the NSTEACS patients who were enrolled in Sino-Global Registry of Acute Coronary Events (GRACEs) registry study. Methods We analyzed the data from 618 Chinese NSTEACS patients stratified into low-(n=151), intermediate-(n=233), and high-risk groups (n=-234) based on GRACE risk scores. The baseline characteristics, clinical presentations, antithrombotic and antiplatelet agents were recorded and compared among the three groups. Results The administration rates of low-molecular-weight heparins (LMWHs) (86.08%) and thienopyridines (85.92%) were higher whereas the administration rate of glycoprotein Ⅱb/Ⅲa inhibitor (1.78%) was much lower than those reported previously. Meanwhile, within the first 24 hours of admission, the use of heparin/LMWHs in the high-risk group was more than that in the intermediate- and low-risk groups (73.50% vs 63.09% vs 55.63%, P=0.001). Furthermore, the combination of antithrombotic and antiplatelet medications showed no significant differences in all groups. Conclusions In the "real world" practice of China, the antithrombotic and antiplatelet therapies on NSTEACS are well adherent to the current guidelines except for several gaps, such as the very low use of glycoprotein Ⅱb/Ⅲa inhibitor. Moreover, these antithrombotic and antiplatelet treatments usually tend to be underused for the high-risk ones.展开更多
BackgroundFew studies have compared change in the health-related quality of life (HRQL) following treatment of non-ST-elevation acute coronary syndrome (NSTE-ACS) with either percutaneous coronary intervention (...BackgroundFew studies have compared change in the health-related quality of life (HRQL) following treatment of non-ST-elevation acute coronary syndrome (NSTE-ACS) with either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). This study is tocompare changes in HRQL six months after hospital discharge between NSTE-ACS pa-tients who underwent either PCI or CABG.Methods HRQL was assessed using the Seattle angina questionnaire at admission and six months after discharge in 1012 consecutive patients with NSTE-ACS. To assess associations of PCI and CABG with HRQL changes, logistic regression models were constructed treating changes in the score of each dimension of the Seattle angina question-naire as dependent variables.Results Although both the PCI and CABG groups experienced angina relief and other improvements at 6-month follow-up (P〈0.001), the CABG relative to PCI group showed more significant improvements in angina frequency (P= 0.044) and quality of life (P= 0.028). In multivariable logistic analysis, CABG also was an independent predictor for both im-provement of angina frequency (OR: 1.62, 95%CI: 1.09-4.63,P= 0.042) and quality of life (OR: 2.04, 95%CI: 1.26-6.92,P= 0.038) relative to PCI.Conclusions In patients with NSTE-ACS, both PCI and CABG provide great improvement in disease-specific health status at six months, with that of CABG being more prominent in terms of angina frequency and quality of life.展开更多
[Objective] The aim was to compare the content changes between the non-structural carbohydrates(NSC)and the total nitrogen in various growing seasons,and to explore the response relationship between altitude and the...[Objective] The aim was to compare the content changes between the non-structural carbohydrates(NSC)and the total nitrogen in various growing seasons,and to explore the response relationship between altitude and the contents.[Method] Taking Quercus aquifolioides scrub which widely distributed in Zheduoshan in the west of Sichuan as the experimental objects,the changes between NSC and the toal nitrogen in various growing seasons at different altitude were studied.[Result] The results showed that the content of NSC in Quercus aquifolioides underground increased with the lift of elevation in the dormancy,but decreased in the early germination,growing period and growth stage.The content of NSC in the ground tissue changed non-linearly with increasing elevation.In addition,the total nitrogen of Quercus aquifolioides organizations was decreasing with increasing elevation in the dormant period,which did not change significantly in the other periods.This result implied that the content of NSC in Quercus aquifolioides underground was more sensitive to temperature.[Conclusion] The experiment laid basis for the exploration of the physical and ecological mechanism of underground plants adaptability to highland environment,their response to global climate changes and adjustment to high altitude ecological system.展开更多
Basalt is a major component of the earth and moon crust.Mineral composition and temperature influence frictional instability and thus the potential for seismicity on basaltic faults.We performed velocitystepping shear...Basalt is a major component of the earth and moon crust.Mineral composition and temperature influence frictional instability and thus the potential for seismicity on basaltic faults.We performed velocitystepping shear experiments on basalt gouges at a confining pressure of 100 MPa,temperatures in the range of 100-400℃ and with varied obsidian mass fractions of 0-100%under wet/dry conditions to investigate the frictional strength and stability of basaltic faults.We observe a transition from velocity-neutral to velocity-weakening behaviors with increasing obsidian content.The frictional stability response of the mixed obsidian/basalt gouges is characterized by a transition from velocitystrengthening to velocity-weakening at 200℃ and another transition to velocity-strengthening at temperatures>300℃.Conversely,frictional strengths of the obsidian-bearing gouges are insensitive to temperature and wet/dry conditions.These results suggest that obsidian content dominates the potential seismic response of basaltic faults with the effect of temperature controlling the range of seismogenic depths.Thus,shallow moonquakes tend to occur in the lower lunar crust due to the corresponding anticipated higher glass content and a projected temperature range conducive to velocity-weakening behavior.These observations contribute to a better understanding of the nucleation mechanism of shallow seismicity in basaltic faults.展开更多
Objective To investigate whether the very elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) will benefit from an invasive strategy versus a conservative strategy. Methods 190 consecutive pa...Objective To investigate whether the very elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) will benefit from an invasive strategy versus a conservative strategy. Methods 190 consecutive patients aged 80 years or older with NSTEMI were included in the retrospective study from September 2014 to August 2017, of which 69 patients received conservative strategy and 121 patients received invasive strategy. The primary outcome was death. Multivariate Cox regression models were used to assess the statistical association between strategies and mortality. The survival probability was further analyzed. Results The primary outcome occurred in 17.4% patients in the invasive group and in 42.0% patients in the conservative group (P = 0.0002). The readmission rate in the invasive group (14.9%) was higher than that in the conservative group (7.2%). Creatinine level (OR = 1.01, 95% CI: 0.10–1.03, P = 0.05) and use of diuretic (OR = 3.65, 95% CI: 1.56–8.53, P = 0.003) were independent influential factors for invasive strategy. HRs for multivariate Cox regression models were 3.45 (95% CI: 1.77–6.75, P = 0.0003), 3.02 (95% CI: 1.52–6.01, P = 0.0017), 2.93 (95% CI: 1. 46–5.86, P = 0.0024) and 2.47 (95% CI: 1.20–5.07, P = 0.0137). Compared with the patients received invasive strategy, the conservative group had remarkably reduced survival probability with time since treatment (P < 0.001). Conclusions An invasive strategy is superior to a conservative strategy in reducing mortality of patients aged 80 years or older with NSTEMI. Our results suggest that an invasive strategy is more suitable for the very elderly patients with NSTEMI in China.展开更多
BACKGROUND Myocardial infarction,particularly ST-segment elevation myocardial infarction(STEMI),is a key global mortality cause.Our study investigated predictors of mortality in 96 STEMI patients undergoing primary pe...BACKGROUND Myocardial infarction,particularly ST-segment elevation myocardial infarction(STEMI),is a key global mortality cause.Our study investigated predictors of mortality in 96 STEMI patients undergoing primary percutaneous coronary intervention at Erbil Cardiac Center.Multiple factors were identified influencing in-hospital mortality.Significantly,time from symptom onset to hospital arrival emerged as a decisive factor.Consequently,our study hypothesis is:"Reducing time from symptom onset to hospital arrival significantly improves STEMI prognosis."AIM To determine the key factors influencing mortality rates in STEMI patients.METHODS We studied 96 consecutive STEMI patients undergoing primary percutaneous coronary intervention(PPCI)at the Erbil Cardiac Center.Their clinical histories were compiled,and coronary evaluations were performed via angiography on admission.Data included comorbid conditions,onset of cardiogenic shock,complications during PPCI,and more.Post-discharge,one-month follow-up assessments were completed.Statistical significance was set at P<0.05.RESULTS Our results unearthed several significant findings.The in-hospital and 30-d mortality rates among the 96 STEMI patients were 11.2%and 2.3%respectively.On the investigation of independent predictors of in-hospital mortality,we identified atypical presentation,onset of cardiogenic shock,presence of chronic kidney disease,Thrombolysis In Myocardial Infarction grades 0/1/2,triple vessel disease,ventricular tachycardia/ventricular fibrillation,coronary dissection,and the no-reflow phenomenon.Specifically,the recorded average time from symptom onset to hospital arrival amongst patients who did not survive was significantly longer(6.92±3.86 h)compared to those who survived(3.61±1.67 h),P<0.001.These findings underscore the critical role of timely intervention in improving the survival outcomes of STEMI patients.CONCLUSION Our results affirm that early hospital arrival after symptom onset significantly improves survival rates in STEMI patients,highlighting the critical need for prompt intervention.展开更多
Background: It has been shown that administration of statins reduced the risk of peri-procedural myocardial damage. However, it remains unclear whether Chinese medicine Danlou Tablet (~)~), similar to statins, may...Background: It has been shown that administration of statins reduced the risk of peri-procedural myocardial damage. However, it remains unclear whether Chinese medicine Danlou Tablet (~)~), similar to statins, may protect patients undergoing percutaneous coronary intervention (PCI) from peri-procedural myocardial damage. Objective: To demonstrate the hypothesis whether treatment with Danlou Tablet would improve clinical outcome in patients undergoing selective PCI with non-ST elevation acute coronary syndrome (NSTE-ACS) in China. Methods: Approximately 220 patients with unstable angina or non-ST-segment elevation myocardial infarction undergoing PCI will be enrolled and randomized to Danlou Tablet treatment (4.5 g/day for 2 days before intervention, with a further 4.5 g/day for 90 days thereafter) or placebo. All patients will not receive Danlou Tablet before procedure. The primary end point is to evaluate the incidence of cardiac death, myocardial infarction or unplanned re-hospitalization and revascularization after 30 days in patients undergoing selective PCI treated with Danlou Tablet compared with placebo. Secondary endpoints include the incidence of peri-procedural myocardial injury, 3-month clinical outcomes, the quality of life and Chinese medicine syndromes assessment. Conclusion: This study protocol will provide important evidence of Danlou Tablet treatment on the peri-procedural myocardial injury in patients with NSTE-ACS undergoing selective PCI, which may support a strategy of routine Danlou Tablet therapy to improve the clinical outcomes.展开更多
Background: This study evaluated the effect of omeprazole or pantoprazole on platelet reactivity in non-STsegment elevation acute coronary syndrome(NSTE-ACS) patients receiving clopidogrel.Methods: Consecutive patient...Background: This study evaluated the effect of omeprazole or pantoprazole on platelet reactivity in non-STsegment elevation acute coronary syndrome(NSTE-ACS) patients receiving clopidogrel.Methods: Consecutive patients with NSTE-ACS(n =620) from general hospital of Shenyang Military Command were randomized to the omeprazole or pantoprazole(20mg/d) group(1:1), and received routine dual antiplatelet treatment. Patients' reversion rate of adenosine diphosphate-induced platelet aggregation(ADP-PA) was assessed at baseline, 12 to 24 h after administration of medication, and after 72 h of percutaneous coronary intervention(PCI). The primary endpoint of the study was platelet reactivity assessed with ADP-PA at 30 days after PCI. Adverse events(AEs) were recorded for 30-day and 180-day follow-up periods.Results: There were no significant differences between both the groups in platelet response to clopidogrel at 12–24h after drug administration(54.09%±18.90% vs. 51.62%±19.85%, P=0.12), 72 h after PCI(52.15%±19.45% vs. 49.66%±20.05%, P=0.18), and 30 days after PCI(50.44%±14.54% vs. 48.52%±15.08%, P=0.17). The rate of AEs did not differ significantly between groups during the 30-day(15.2% vs. 14.8%, P=0.91) and 180-day(16.5% vs. 14.5%, P=0.50) follow-up periods after PCI.Conclusion: The addition of omeprazole or pantoprazole to clopidogrel did not restrict the effect of platelet aggregation by reducing the conversion of clopidogrel. Compared with clopidogrel alone, pantoprazole-clopidogrel and omeprazoleclopidogrel combinations did not increase the incidence of adverse clinical events during 30-day and 180-day follow-up periods after PCI.展开更多
Background The benefit/risk ratio of stenting in acute ST-segment elevation myocardial infarction (STEMI) patients with single vessel intermediate stenosis culprit lesions merits further study, therefore the subject...Background The benefit/risk ratio of stenting in acute ST-segment elevation myocardial infarction (STEMI) patients with single vessel intermediate stenosis culprit lesions merits further study, therefore the subject of the present study. Methods and results It was a pro- spective, multicenter, randomized controlled trial. Between April 2012 and July 2015, 399 acute STEMI patients with single vessel disease and intermediate (40%-70%) stenosis of the culprit lesion before or after aspiration thrombectomy and/or intracoronary tirofiban (15 pg/kg) were enrolled and were randomly assigned (h 1) to stenting group (n = 201) and non-stenting group (n = 198). In stenting group, patients received pharmacologic therapy plus standard percutaneous coronary intervention (PCI) with stent implantation. In non-stenting group, pa- tients received pharmacologic therapy and PCI (thrombectomy), but without dilatation or stenting. Primary endpoint was 12-month rate of major adverse cardiac and eerebrovascular events (MACCE), a composite of cardiac death, non-fatal myocardial infarction (M1), repeat re- vascularization and stroke. Secondary endpoints were 12-month rates of all cause death, ischemia driven admission and bleeding complica- tion. Median follow-up time was 12.4 ~ 3.1 months. At 12 months, MACCE occurred in 8.0% of the patients in stenting group, as compared with 15.2% in the non-stenting group (adjusted HR: 0.42, 95% Ch 0.19-0.89, P = 0.02). The stenting group had lower non-fatal MI rate than non-stenting group, (1.5% vs. 5.5%, P = 0.03). The two groups shared similar cardiac death, repeat revascularization, stroke, all cause death, ischemia driven readmission and bleeding rates at 12 months. Conclusions Stent implantation had better efficacy and safety in reducing MACCE risks among acute STEMI patients with single vessel intermediate stenosis culprit lesions.展开更多
Beamspace super-resolution methods for elevation estimation in multipath environment has attracted significant attention, especially the beamspace maximum likelihood(BML)algorithm. However, the difference beam is rare...Beamspace super-resolution methods for elevation estimation in multipath environment has attracted significant attention, especially the beamspace maximum likelihood(BML)algorithm. However, the difference beam is rarely used in superresolution methods, especially in low elevation estimation. The target airspace information in the difference beam is different from the target airspace information in the sum beam. And the use of difference beams does not significantly increase the complexity of the system and algorithms. Thus, this paper applies the difference beam to the beamformer to improve the elevation estimation performance of BML algorithm. And the direction and number of beams can be adjusted according to the actual needs. The theoretical target elevation angle root means square error(RMSE) and the computational complexity of the proposed algorithms are analyzed. Finally, computer simulations and real data processing results demonstrate the effectiveness of the proposed algorithms.展开更多
Introduction: This study aimed to compare the frequency of diabetic and non-diabetic patients admitted for ST-elevation myocardial infarction (STEMI), assess their epidemiological, clinical, and paraclinical profiles,...Introduction: This study aimed to compare the frequency of diabetic and non-diabetic patients admitted for ST-elevation myocardial infarction (STEMI), assess their epidemiological, clinical, and paraclinical profiles, and evaluate their therapeutic strategies and outcomes. Methodology: A descriptive, analytical, comparative study with prospective and retrospective data collection was conducted from April 1, 2020, to March 31, 2021. Diabetic and non-diabetic patients with STEMI admitted to a cardiology department were included. STEMI diagnosis was based on clinical and electrocardiographic criteria showing persistent ST-segment elevation in at least two leads. All patients included in the study signed a written, informed consent form. Data analysis was performed using SPSS, with a p-value ≤ 0.05 considered statistically significant. Results: STEMI prevalence was 15.27%, with 37.11% of patients being diabetic and 62.89% non-diabetic. Diabetic patients had a mean age of 59.2 ± 10.9 years, while non-diabetics averaged 58 ± 13.4 years. Diabetics were predominantly female (72.2%), whereas non-diabetics were mainly male (83.6%). Smoking was less frequent among diabetics (25% vs. 47.54%), but hypertension, obesity, and sedentary lifestyle were more common. Diabetics had an average of 3.5 ± 1.1 risk factors compared to 2.6 ± 1.2 in non-diabetics. Admission delay was longer for diabetics (34.8 ± 51.6 hours vs. 23.3 ± 52.3 hours). Chest pain was the main symptom in both groups. Electrocardiograms showed that anterior and inferior infarctions were most frequent. Triple vessel disease and severe complications, such as cardiogenic shock, were more common in diabetics, who also had higher mortality (5.56% vs. 3.28%). Conclusion: Diabetic STEMI patients represent a high-risk group with distinct clinical features, longer admission delays, and a greater accumulation of cardiovascular risk factors, emphasizing the need for targeted interventions.展开更多
Much of the world's biodiversity lies in heterogeneous mountain areas with their diverse environments.As an example,Iranian montane ranges are highly diverse,particularly in the Irano-Turanian phytogeographical re...Much of the world's biodiversity lies in heterogeneous mountain areas with their diverse environments.As an example,Iranian montane ranges are highly diverse,particularly in the Irano-Turanian phytogeographical region.Understanding plant diversity patterns with increasing elevation is of high significance,not least for conservation planning.We studied the pattern of species richness,Shannon diversity,endemic richness,endemics ratio,and richness of life forms along a 3900 m elevational transect in Mount Palvar,overlooking the Lut Desert in Southeast Iran.We also analyzed the effect of environmental variables on species turnover along the vertical gradient.A total of 120 vegetation plots(10 m×10 m)were sampled along the elevational transect containing species and environmental data.To discover plant diversity pattern along the elevational gradient,generalized additive model(GAM)was used.Non-metric multidimensional scaling(NMDS)was applied for illustrating the correlation between species composition and environmental variables.We found hump-shaped pattern for species richness,Shannon diversity,endemic richness,and species richness of different life forms,but a monotonic increasing pattern for ratio of endemic species from low to high elevations.Our study confirms the humped pattern of species richness peaking at intermediate elevations along a complete elevational gradient in a semi-arid mountain.The monotonic increase of endemics ratio with elevation in our area as a case study is consistent with global increase of endemism with elevation.According to our results,temperature and precipitation are two important climatic variables that drive elevational plant diversity,particularly in seasonally dry areas.Our study suggests that effective conservation and management are needed for this low latitude mountain area along with calling for long-term monitoring for species redistribution.展开更多
Reproductive strategies of sexually dimorphic plants vary in response to the environment.Here,we ask whether the sexual systems of Fagopyrum species(i.e.,selfing homostylous and out-crossing distylous)represent distin...Reproductive strategies of sexually dimorphic plants vary in response to the environment.Here,we ask whether the sexual systems of Fagopyrum species(i.e.,selfing homostylous and out-crossing distylous)represent distinct adaptive strategies to increase reproductive success in changing alpine environments.To answer this question,we determined how spatial and temporal factors(e.g.,elevation and peak flowering time)affect reproductive success(i.e.,stigmatic pollen load)in nine wild Fagopyrum species(seven distylous and two homostylous)among 28 populations along an elevation gradient of 1299-3315 m in the Hengduan Mountains,southwestern China.We also observed pollinators and conducted hundreds of hand pollinations to investigate inter/intra-morph compatibility,self-compatibility and pollen limitation in four Fagopyrum species(two distylous and two homostylous).We found that Fagopyrum species at higher elevation generally had bigger flowers and more stigmatic pollen loads;lateflowering individuals had smaller flowers and lower pollen deposition.Stigmatic pollen deposition was more variable in distylous species than in homostylous species.Although seed set was not pollenlimited in all species,we found that fruit set was much lower in distylous species,which rely on frequent pollinator visits,than in homostylous species capable of autonomous self-pollination.Our findings that pollination success increases at high elevations and decreases during the flowering season suggest that distylous and homostylous species have spatially and temporally distinct reproductive strategies related to environment-dependent pollinator activity.展开更多
Intraocular pressure elevation can induce retinal ganglion cell death and is a clinically reversible risk factor for glaucoma,the leading cause of irreversible blindness.We previously demonstrated that casein kinase-2...Intraocular pressure elevation can induce retinal ganglion cell death and is a clinically reversible risk factor for glaucoma,the leading cause of irreversible blindness.We previously demonstrated that casein kinase-2 inhibition can promote retinal ganglion cell survival and axonal regeneration in rats after optic nerve injury.To investigate the underlying mechanism,in the current study we increased the intraocular pressure of adult rats to 75 mmHg for 2 hours and then administered a casein kinase-2 inhibitor(4,5,6,7-tetrabromo-2-azabenzimidazole or 2-dimethylamino-4,5,6,7-tetrabromo-1H-benzimidazole)by intravitreal injection.We found that intravitreal injection of 4,5,6,7-tetrabromo-2-azabenzimidazole or 2-dimethylamino-4,5,6,7-tetrabromo-1H-benzimidazole promoted retinal ganglion cell survival and reduced the number of infiltrating macrophages.Transcriptomic analysis showed that the mitogen activated protein kinase signaling pathway was involved in the response to intraocular pressure elevation but was not modulated by the casein kinase-2 inhibitors.Furthermore,casein kinase-2 inhibition downregulated the expression of genes(Cck,Htrsa,Nef1,Htrlb,Prph,Chat,Slc18a3,Slc5a7,Scn1b,Crybb2,Tsga10ip,and Vstm21)involved in intraocular pressure elevation.Our data indicate that inhibition of casein kinase-2 can enhance retinal ganglion cell survival in rats after acute intraocular pressure elevation via macrophage inactivation.展开更多
Global climate change can affect tree growth and carbon sink function by influencing plant carbohydrate synthesis and utilization,while elevation can be used as an ideal setting under natural conditions to simulate cl...Global climate change can affect tree growth and carbon sink function by influencing plant carbohydrate synthesis and utilization,while elevation can be used as an ideal setting under natural conditions to simulate climate change effects.The effect of elevation on tree growth may depend on organ type.However,the allocation patterns of nonstructural and structural carbohydrates(NSCs and SCs,respectively)in different tree organs and their response to elevation remain unclear.We selected four dominant tree species,Schima superba,Castanopsis eyrei,Castanopsis fargesii and Michelia maudiae,along an elevation gradient from 609 to 1,207 m in subtropical evergreen broad-leaved forests and analyzed leaf,trunk,and fine root NSCs,carbon(C),nitrogen(N)and phosphorus(P)concentrations and the relative abundance of SCs.Leaf NSCs increased initially and then decreased,and trunk NSCs increased with increasing elevation.However,root NSCs decreased with increasing elevation.The relative abundance of SCs in leaves and trunks decreased,while the relative abundance of root SCs increased with increasing elevation.No significant correlations between SCs and NSCs in leaves were detected,while there were negative correlations between SCs and NSCs in trunks,roots,and all organs.Hierarchical partitioning analysis indicated that plant C/N and C/P were the main predictors of changes in SCs and NSCs.Our results suggest that tree organs have divergent responses to elevation and that increasing elevation will inhibit the aboveground part growth and enhance the root growth of trees.A tradeoff between the C distribution used for growth and storage was confirmed along the elevation gradient,which is mainly manifested in the"sink"organs of NSCs.Our results provide insight into tree growth in the context of global climate change scenarios in subtropical forest ecosystems.展开更多
Elevation is one of many components that influence agriculture, and this in turn affects the level of both inputs and outputs of farmers. This article focuses on the productivity and technical efficiency of 100 cocoa ...Elevation is one of many components that influence agriculture, and this in turn affects the level of both inputs and outputs of farmers. This article focuses on the productivity and technical efficiency of 100 cocoa farms using cross-sectional data from areas ranging from 190 to 1021 m above sea level which were classified as low, medium, and high elevation in Davao City, considered as the chocolate capital of the Philippines. Using stochastic frontier analysis, the results showed that the cost of inputs per ha and the number of cocoa trees per ha significantly increase yield. Farms at high elevations were less technically efficient, as this entails lower temperatures and increased rainfall, and cocoa farming in those areas and conditions can be more challenging, especially with changes in farming practices, terrain, and distance to markets. Other significant variables were age of cocoa farms, married farmers, and age of the farmers. Older farms may be more developed, farmers who are married benefit from their spouses being able to readily contribute as farm labor, and lastly, older farmers' inefficiency may likely stem from nonadaptation of newer farming practices. With an average technical efficiency of 0.61, 0.63, and 0.26 in low, medium, and high elevation areas, respectively, farmers therefore have an incentive to improve farm practices and consider topographical variations found in high elevation areas. Recommendations for the improvement of technical efficiency of cocoa farms are better connectivity to markets, enhancing farm practices, and continuation and improvement of government programs on cocoa with an added emphasis on research. For farmers in high elevation areas, mitigating solutions such as sustainable agriculture practices and ecolabelling are key to improving efficiency and minimizing the potential negative impact on upland farming systems. Moreover, such adaptation measures may also contribute to sustainability of cocoa farming in high elevation areas.展开更多
●AIM:To study the changes and effect factors of posterior corneal surface after small incision lenticule extraction(SMILE)with different myopic diopters.●METHODS:Ninety eyes of 90 patients who underwent SMILE were i...●AIM:To study the changes and effect factors of posterior corneal surface after small incision lenticule extraction(SMILE)with different myopic diopters.●METHODS:Ninety eyes of 90 patients who underwent SMILE were included in this retrospective study.Patients were allocated into three groups based on the preoperative spherical equivalent(SE):low myopia(SE≥-3.00 D),moderate myopia(-3.00 D>SE>-6.00 D)and high myopia(SE≤-6.00 D).Posterior corneal surfaces were measured by a Scheimpflug camera preoperatively and different postoperative times(1wk,1,3,6mo,and 1y).Posterior mean elevation(PME)at 25 predetermined points of 3 concentric circles(2-,4-,and 6-mm diameter)above the best fit sphere was analyzed.●RESULTS:All surgeries were completed uneventfully and no ectasia was found through the observation.The difference of myopia group was significant at the 2-mm ring at 1 and 3mo postoperatively(1mo:P=0.017;3mo:P=0.018).The effect of time onΔPME was statistically significant(2-mm ring:P=0.001;4-mm ring:P<0.001;6-mm ring:P<0.001).The effect of different corneal locations onΔPME was significant except 1wk postoperatively(1mo:P=0.000;3mo:P=0.000;6mo:P=0.001;1y:P=0.001).Posterior corneal stability was linearly correlated with SE,central corneal thickness,ablation depth,residual bed thickness,percent ablation depth and percent stromal bed thickness.●CONCLUSION:The posterior corneal surface changes dynamically after SMILE.No protrusion is observed on the posterior corneal surface in patients with different degrees of myopia within one year after surgery.SMILE has good stability,accuracy,safety and predictability.展开更多
High Mountain Asia(HMA),recognized as a third pole,needs regular and intense studies as it is susceptible to climate change.An accurate and high-resolution Digital Elevation Model(DEM)for this region enables us to ana...High Mountain Asia(HMA),recognized as a third pole,needs regular and intense studies as it is susceptible to climate change.An accurate and high-resolution Digital Elevation Model(DEM)for this region enables us to analyze it in a 3D environment and understand its intricate role as the Water Tower of Asia.The science teams of NASA realized an 8-m DEM using satellite stereo imagery for HMA,termed HMA 8-m DEM.In this research,we assessed the vertical accuracy of HMA 8-m DEM using reference elevations from ICESat-2 geolocated photons at three test sites of varied topography and land covers.Inferences were made from statistical quantifiers and elevation profiles.For the world’s highest mountain,Mount Everest,and its surroundings,Root Mean Squared Error(RMSE)and Mean Absolute Error(MAE)resulted in 1.94 m and 1.66 m,respectively;however,a uniform positive bias observed in the elevation profiles indicates the seasonal snow cover change will dent the accurate estimation of the elevation in this sort of test sites.The second test site containing gentle slopes with forest patches has exhibited the Digital Surface Model(DSM)features with RMSE and MAE of 0.58 m and 0.52 m,respectively.The third test site,situated in the Zanda County of the Qinghai-Tibet,is a relatively flat terrain bed,mostly bare earth with sudden river cuts,and has minimal errors with RMSE and MAE of 0.32 m and 0.29 m,respectively,and with a negligible bias.Additionally,in one more test site,the feasibility of detecting the glacial lakes was tested,which resulted in exhibiting a flat surface over the surface of the lakes,indicating the potential of HMA 8-m DEM for deriving the hydrological parameters.The results accrued in this investigation confirm that the HMA 8-m DEM has the best vertical accuracy and should be of high use for analyzing natural hazards and monitoring glacier surfaces.展开更多
文摘BACKGROUND GRACE and SYNTAX scores are important tools to assess prognosis in non-STelevation acute coronary syndrome(NSTE-ACS).However,there have been few studies on their value in patients receiving different types of therapies.AIM To explore the value of GRACE and SYNTAX scores in predicting the prognosis of patients with NSTE-ACS receiving different types of therapies.METHODS The data of 386 patients with NSTE-ACS were retrospectively analyzed and categorized into different groups.A total of 195 patients who received agents alone comprised the medication group,156 who received medical therapy combined with stents comprised the stent group,and 35 patients who were given agents and underwent coronary artery bypass grafting(CABG)comprised the CABG group.General information was compared among the three groups.GRACE and SYNTAX scores were calculated.The association between the relationship between GRACE and SYNTAX scores and the occurrence of major adverse cardiovascular events(MACEs)was analyzed.Pearson’s correlation analysis was used to determine the factors influencing prognosis in patients with NSTE-ACS.Univariate and multivariate analyses were conducted to analyze the predictive value of GRACE and SYNTAX scores for predicting prognosis in patients with NSTE-ACS using the Cox proportional-hazards model.RESULTS The incidence of MACE increased with the elevation of GRACE and SYNTAX scores(all P<0.05).The incidence of MACE was 18.5%,36.5%,and 42.9%in the medication group,stent group,and CABG group,respectively.By comparison,the incidence of MACE was significantly lower in the medication group than in the stent and CABG groups(all P<0.05).The incidence of MACE was 6.2%,28.0%and 40.0%in patients with a low GRACE score in the medication group,stent group,and CABG group,respectively(P<0.05).The incidence of MACE was 31.0%,30.3%and 42.9%in patients with a medium GRACE score in the medication group,stent group,and CABG group,respectively(P>0.05).The incidence of MACE was 16.9%,46.2%,and 43.8%in patients with a high GRACE score in the medication group,stent group,and CABG group,respectively(P<0.05).The incidence of MACE was 16.2%,35.4%and 60.0%in patients with a low SYNTAX score in the medication group,stent group,and CABG group,respectively(P<0.05).The incidence of MACE was 37.5%,40.9%,and 41.7%in patients with a medium SYNTAX score in the medication group,stent group,and CABG group,respectively(P>0.05).MACE incidence was 50.0%,75.0%,and 25.0%in patients with a high SYNTAX score in the medication group,stent group,and CABG group,respectively(P<0.05).Univariate Cox regression analyses showed that both GRACE score(hazard ratio[HR]=1.212,95%confidence interval[CI]:1.083 to 1.176;P<0.05)and SYNTAX score(HR=1.160,95%CI:1.104 to 1.192;P<0.05)were factors influencing MACE(all P<0.05).Multivariate Cox regression analyses showed that GRACE(HR=1.091,95%CI:1.015 to 1.037;P<0.05)and SYNTAX scores(HR=1.031,95%CI:1.076 to 1.143;P<0.05)were independent predictors of MACE(all P<0.05).CONCLUSION GRACE and SYNTAX scores are of great value for evaluating the prognosis of NSTE-ACS patients,and prevention and early intervention strategies should be used in clinical practice targeting different risk scores.
文摘BACKGROUND The incidence of acute myocardial infarction(AMI)is rising,with cardiac rupture accounting for approximately 2%of deaths in patients with acute ST-segment elevation myocardial infarction(STEMI).Ventricular free wall rupture(FWR)occurs in approximately 2%of AMI patients and is notably rare in patients with non-STEMI.Types of cardiac rupture include left ventricular FWR,ventricular septal rupture,and papillary muscle rupture.The FWR usually leads to acute cardiac tamponade or electromechanical dissociation,where standard resuscitation efforts may not be effective.Ventricular septal rupture and papillary muscle rupture often result in refractory heart failure,with mortality rates over 50%,even with surgical or percutaneous repair options.CASE SUMMARY We present a rare case of an acute non-STEMI patient who suffered sudden FWR causing cardiac tamponade and loss of consciousness immediate before undergoing coronary angiography.Prompt resuscitation and emergency open-heart repair along with coronary artery bypass grafting resulted in successful patient recovery.CONCLUSION This case emphasizes the risks of AMI complications,shares a successful treatment scenario,and discusses measures to prevent such complications.
文摘Background Antithrombotic and antiplatelet therapies have been proposed to treat non-ST elevation acute coronary syndrome (NSTEACS), yet limited information is available about their applications from a multicenter "real-world" clinical procedure, especially in China. This study was undertaken to characterize the use of antithrombotic and antiplatelet agents in relation to the risk levels of the NSTEACS patients who were enrolled in Sino-Global Registry of Acute Coronary Events (GRACEs) registry study. Methods We analyzed the data from 618 Chinese NSTEACS patients stratified into low-(n=151), intermediate-(n=233), and high-risk groups (n=-234) based on GRACE risk scores. The baseline characteristics, clinical presentations, antithrombotic and antiplatelet agents were recorded and compared among the three groups. Results The administration rates of low-molecular-weight heparins (LMWHs) (86.08%) and thienopyridines (85.92%) were higher whereas the administration rate of glycoprotein Ⅱb/Ⅲa inhibitor (1.78%) was much lower than those reported previously. Meanwhile, within the first 24 hours of admission, the use of heparin/LMWHs in the high-risk group was more than that in the intermediate- and low-risk groups (73.50% vs 63.09% vs 55.63%, P=0.001). Furthermore, the combination of antithrombotic and antiplatelet medications showed no significant differences in all groups. Conclusions In the "real world" practice of China, the antithrombotic and antiplatelet therapies on NSTEACS are well adherent to the current guidelines except for several gaps, such as the very low use of glycoprotein Ⅱb/Ⅲa inhibitor. Moreover, these antithrombotic and antiplatelet treatments usually tend to be underused for the high-risk ones.
文摘BackgroundFew studies have compared change in the health-related quality of life (HRQL) following treatment of non-ST-elevation acute coronary syndrome (NSTE-ACS) with either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). This study is tocompare changes in HRQL six months after hospital discharge between NSTE-ACS pa-tients who underwent either PCI or CABG.Methods HRQL was assessed using the Seattle angina questionnaire at admission and six months after discharge in 1012 consecutive patients with NSTE-ACS. To assess associations of PCI and CABG with HRQL changes, logistic regression models were constructed treating changes in the score of each dimension of the Seattle angina question-naire as dependent variables.Results Although both the PCI and CABG groups experienced angina relief and other improvements at 6-month follow-up (P〈0.001), the CABG relative to PCI group showed more significant improvements in angina frequency (P= 0.044) and quality of life (P= 0.028). In multivariable logistic analysis, CABG also was an independent predictor for both im-provement of angina frequency (OR: 1.62, 95%CI: 1.09-4.63,P= 0.042) and quality of life (OR: 2.04, 95%CI: 1.26-6.92,P= 0.038) relative to PCI.Conclusions In patients with NSTE-ACS, both PCI and CABG provide great improvement in disease-specific health status at six months, with that of CABG being more prominent in terms of angina frequency and quality of life.
基金Supported by National Natural Science Fund(30872017)China Science Academy Knowledge Innovation Engineering Project Important Direction Program(KZCX2-YW-331-3,KSCX2-YW-N-066)Central University Basic Science Research Operation Special Fund(XDJK2009C110)~~
文摘[Objective] The aim was to compare the content changes between the non-structural carbohydrates(NSC)and the total nitrogen in various growing seasons,and to explore the response relationship between altitude and the contents.[Method] Taking Quercus aquifolioides scrub which widely distributed in Zheduoshan in the west of Sichuan as the experimental objects,the changes between NSC and the toal nitrogen in various growing seasons at different altitude were studied.[Result] The results showed that the content of NSC in Quercus aquifolioides underground increased with the lift of elevation in the dormancy,but decreased in the early germination,growing period and growth stage.The content of NSC in the ground tissue changed non-linearly with increasing elevation.In addition,the total nitrogen of Quercus aquifolioides organizations was decreasing with increasing elevation in the dormant period,which did not change significantly in the other periods.This result implied that the content of NSC in Quercus aquifolioides underground was more sensitive to temperature.[Conclusion] The experiment laid basis for the exploration of the physical and ecological mechanism of underground plants adaptability to highland environment,their response to global climate changes and adjustment to high altitude ecological system.
基金funded by the National Natural Science Foundation of China(Nos.42320104003 and 42107163)the Funda mental Research Funds for the Central Universities.Derek Elsworth acknowledges support from the G.Albert Shoemaker endowment.
文摘Basalt is a major component of the earth and moon crust.Mineral composition and temperature influence frictional instability and thus the potential for seismicity on basaltic faults.We performed velocitystepping shear experiments on basalt gouges at a confining pressure of 100 MPa,temperatures in the range of 100-400℃ and with varied obsidian mass fractions of 0-100%under wet/dry conditions to investigate the frictional strength and stability of basaltic faults.We observe a transition from velocity-neutral to velocity-weakening behaviors with increasing obsidian content.The frictional stability response of the mixed obsidian/basalt gouges is characterized by a transition from velocitystrengthening to velocity-weakening at 200℃ and another transition to velocity-strengthening at temperatures>300℃.Conversely,frictional strengths of the obsidian-bearing gouges are insensitive to temperature and wet/dry conditions.These results suggest that obsidian content dominates the potential seismic response of basaltic faults with the effect of temperature controlling the range of seismogenic depths.Thus,shallow moonquakes tend to occur in the lower lunar crust due to the corresponding anticipated higher glass content and a projected temperature range conducive to velocity-weakening behavior.These observations contribute to a better understanding of the nucleation mechanism of shallow seismicity in basaltic faults.
文摘Objective To investigate whether the very elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI) will benefit from an invasive strategy versus a conservative strategy. Methods 190 consecutive patients aged 80 years or older with NSTEMI were included in the retrospective study from September 2014 to August 2017, of which 69 patients received conservative strategy and 121 patients received invasive strategy. The primary outcome was death. Multivariate Cox regression models were used to assess the statistical association between strategies and mortality. The survival probability was further analyzed. Results The primary outcome occurred in 17.4% patients in the invasive group and in 42.0% patients in the conservative group (P = 0.0002). The readmission rate in the invasive group (14.9%) was higher than that in the conservative group (7.2%). Creatinine level (OR = 1.01, 95% CI: 0.10–1.03, P = 0.05) and use of diuretic (OR = 3.65, 95% CI: 1.56–8.53, P = 0.003) were independent influential factors for invasive strategy. HRs for multivariate Cox regression models were 3.45 (95% CI: 1.77–6.75, P = 0.0003), 3.02 (95% CI: 1.52–6.01, P = 0.0017), 2.93 (95% CI: 1. 46–5.86, P = 0.0024) and 2.47 (95% CI: 1.20–5.07, P = 0.0137). Compared with the patients received invasive strategy, the conservative group had remarkably reduced survival probability with time since treatment (P < 0.001). Conclusions An invasive strategy is superior to a conservative strategy in reducing mortality of patients aged 80 years or older with NSTEMI. Our results suggest that an invasive strategy is more suitable for the very elderly patients with NSTEMI in China.
文摘BACKGROUND Myocardial infarction,particularly ST-segment elevation myocardial infarction(STEMI),is a key global mortality cause.Our study investigated predictors of mortality in 96 STEMI patients undergoing primary percutaneous coronary intervention at Erbil Cardiac Center.Multiple factors were identified influencing in-hospital mortality.Significantly,time from symptom onset to hospital arrival emerged as a decisive factor.Consequently,our study hypothesis is:"Reducing time from symptom onset to hospital arrival significantly improves STEMI prognosis."AIM To determine the key factors influencing mortality rates in STEMI patients.METHODS We studied 96 consecutive STEMI patients undergoing primary percutaneous coronary intervention(PPCI)at the Erbil Cardiac Center.Their clinical histories were compiled,and coronary evaluations were performed via angiography on admission.Data included comorbid conditions,onset of cardiogenic shock,complications during PPCI,and more.Post-discharge,one-month follow-up assessments were completed.Statistical significance was set at P<0.05.RESULTS Our results unearthed several significant findings.The in-hospital and 30-d mortality rates among the 96 STEMI patients were 11.2%and 2.3%respectively.On the investigation of independent predictors of in-hospital mortality,we identified atypical presentation,onset of cardiogenic shock,presence of chronic kidney disease,Thrombolysis In Myocardial Infarction grades 0/1/2,triple vessel disease,ventricular tachycardia/ventricular fibrillation,coronary dissection,and the no-reflow phenomenon.Specifically,the recorded average time from symptom onset to hospital arrival amongst patients who did not survive was significantly longer(6.92±3.86 h)compared to those who survived(3.61±1.67 h),P<0.001.These findings underscore the critical role of timely intervention in improving the survival outcomes of STEMI patients.CONCLUSION Our results affirm that early hospital arrival after symptom onset significantly improves survival rates in STEMI patients,highlighting the critical need for prompt intervention.
基金Supported by the National Natural Science Foundation of China(No.81202782)a grant from the Department of Science and Technology and the Academy of Traditional Chinese Medicine of Guangdong Province,China(No.2012A032500013)
文摘Background: It has been shown that administration of statins reduced the risk of peri-procedural myocardial damage. However, it remains unclear whether Chinese medicine Danlou Tablet (~)~), similar to statins, may protect patients undergoing percutaneous coronary intervention (PCI) from peri-procedural myocardial damage. Objective: To demonstrate the hypothesis whether treatment with Danlou Tablet would improve clinical outcome in patients undergoing selective PCI with non-ST elevation acute coronary syndrome (NSTE-ACS) in China. Methods: Approximately 220 patients with unstable angina or non-ST-segment elevation myocardial infarction undergoing PCI will be enrolled and randomized to Danlou Tablet treatment (4.5 g/day for 2 days before intervention, with a further 4.5 g/day for 90 days thereafter) or placebo. All patients will not receive Danlou Tablet before procedure. The primary end point is to evaluate the incidence of cardiac death, myocardial infarction or unplanned re-hospitalization and revascularization after 30 days in patients undergoing selective PCI treated with Danlou Tablet compared with placebo. Secondary endpoints include the incidence of peri-procedural myocardial injury, 3-month clinical outcomes, the quality of life and Chinese medicine syndromes assessment. Conclusion: This study protocol will provide important evidence of Danlou Tablet treatment on the peri-procedural myocardial injury in patients with NSTE-ACS undergoing selective PCI, which may support a strategy of routine Danlou Tablet therapy to improve the clinical outcomes.
基金supported by National Key Technology R&D Program in the "Twelfth Five-Year" Plan of China(2011BAI11B07)
文摘Background: This study evaluated the effect of omeprazole or pantoprazole on platelet reactivity in non-STsegment elevation acute coronary syndrome(NSTE-ACS) patients receiving clopidogrel.Methods: Consecutive patients with NSTE-ACS(n =620) from general hospital of Shenyang Military Command were randomized to the omeprazole or pantoprazole(20mg/d) group(1:1), and received routine dual antiplatelet treatment. Patients' reversion rate of adenosine diphosphate-induced platelet aggregation(ADP-PA) was assessed at baseline, 12 to 24 h after administration of medication, and after 72 h of percutaneous coronary intervention(PCI). The primary endpoint of the study was platelet reactivity assessed with ADP-PA at 30 days after PCI. Adverse events(AEs) were recorded for 30-day and 180-day follow-up periods.Results: There were no significant differences between both the groups in platelet response to clopidogrel at 12–24h after drug administration(54.09%±18.90% vs. 51.62%±19.85%, P=0.12), 72 h after PCI(52.15%±19.45% vs. 49.66%±20.05%, P=0.18), and 30 days after PCI(50.44%±14.54% vs. 48.52%±15.08%, P=0.17). The rate of AEs did not differ significantly between groups during the 30-day(15.2% vs. 14.8%, P=0.91) and 180-day(16.5% vs. 14.5%, P=0.50) follow-up periods after PCI.Conclusion: The addition of omeprazole or pantoprazole to clopidogrel did not restrict the effect of platelet aggregation by reducing the conversion of clopidogrel. Compared with clopidogrel alone, pantoprazole-clopidogrel and omeprazoleclopidogrel combinations did not increase the incidence of adverse clinical events during 30-day and 180-day follow-up periods after PCI.
文摘Background The benefit/risk ratio of stenting in acute ST-segment elevation myocardial infarction (STEMI) patients with single vessel intermediate stenosis culprit lesions merits further study, therefore the subject of the present study. Methods and results It was a pro- spective, multicenter, randomized controlled trial. Between April 2012 and July 2015, 399 acute STEMI patients with single vessel disease and intermediate (40%-70%) stenosis of the culprit lesion before or after aspiration thrombectomy and/or intracoronary tirofiban (15 pg/kg) were enrolled and were randomly assigned (h 1) to stenting group (n = 201) and non-stenting group (n = 198). In stenting group, patients received pharmacologic therapy plus standard percutaneous coronary intervention (PCI) with stent implantation. In non-stenting group, pa- tients received pharmacologic therapy and PCI (thrombectomy), but without dilatation or stenting. Primary endpoint was 12-month rate of major adverse cardiac and eerebrovascular events (MACCE), a composite of cardiac death, non-fatal myocardial infarction (M1), repeat re- vascularization and stroke. Secondary endpoints were 12-month rates of all cause death, ischemia driven admission and bleeding complica- tion. Median follow-up time was 12.4 ~ 3.1 months. At 12 months, MACCE occurred in 8.0% of the patients in stenting group, as compared with 15.2% in the non-stenting group (adjusted HR: 0.42, 95% Ch 0.19-0.89, P = 0.02). The stenting group had lower non-fatal MI rate than non-stenting group, (1.5% vs. 5.5%, P = 0.03). The two groups shared similar cardiac death, repeat revascularization, stroke, all cause death, ischemia driven readmission and bleeding rates at 12 months. Conclusions Stent implantation had better efficacy and safety in reducing MACCE risks among acute STEMI patients with single vessel intermediate stenosis culprit lesions.
基金supported by the Fund for Foreign Scholars in University Research and Teaching Programs (B18039)。
文摘Beamspace super-resolution methods for elevation estimation in multipath environment has attracted significant attention, especially the beamspace maximum likelihood(BML)algorithm. However, the difference beam is rarely used in superresolution methods, especially in low elevation estimation. The target airspace information in the difference beam is different from the target airspace information in the sum beam. And the use of difference beams does not significantly increase the complexity of the system and algorithms. Thus, this paper applies the difference beam to the beamformer to improve the elevation estimation performance of BML algorithm. And the direction and number of beams can be adjusted according to the actual needs. The theoretical target elevation angle root means square error(RMSE) and the computational complexity of the proposed algorithms are analyzed. Finally, computer simulations and real data processing results demonstrate the effectiveness of the proposed algorithms.
文摘Introduction: This study aimed to compare the frequency of diabetic and non-diabetic patients admitted for ST-elevation myocardial infarction (STEMI), assess their epidemiological, clinical, and paraclinical profiles, and evaluate their therapeutic strategies and outcomes. Methodology: A descriptive, analytical, comparative study with prospective and retrospective data collection was conducted from April 1, 2020, to March 31, 2021. Diabetic and non-diabetic patients with STEMI admitted to a cardiology department were included. STEMI diagnosis was based on clinical and electrocardiographic criteria showing persistent ST-segment elevation in at least two leads. All patients included in the study signed a written, informed consent form. Data analysis was performed using SPSS, with a p-value ≤ 0.05 considered statistically significant. Results: STEMI prevalence was 15.27%, with 37.11% of patients being diabetic and 62.89% non-diabetic. Diabetic patients had a mean age of 59.2 ± 10.9 years, while non-diabetics averaged 58 ± 13.4 years. Diabetics were predominantly female (72.2%), whereas non-diabetics were mainly male (83.6%). Smoking was less frequent among diabetics (25% vs. 47.54%), but hypertension, obesity, and sedentary lifestyle were more common. Diabetics had an average of 3.5 ± 1.1 risk factors compared to 2.6 ± 1.2 in non-diabetics. Admission delay was longer for diabetics (34.8 ± 51.6 hours vs. 23.3 ± 52.3 hours). Chest pain was the main symptom in both groups. Electrocardiograms showed that anterior and inferior infarctions were most frequent. Triple vessel disease and severe complications, such as cardiogenic shock, were more common in diabetics, who also had higher mortality (5.56% vs. 3.28%). Conclusion: Diabetic STEMI patients represent a high-risk group with distinct clinical features, longer admission delays, and a greater accumulation of cardiovascular risk factors, emphasizing the need for targeted interventions.
文摘Much of the world's biodiversity lies in heterogeneous mountain areas with their diverse environments.As an example,Iranian montane ranges are highly diverse,particularly in the Irano-Turanian phytogeographical region.Understanding plant diversity patterns with increasing elevation is of high significance,not least for conservation planning.We studied the pattern of species richness,Shannon diversity,endemic richness,endemics ratio,and richness of life forms along a 3900 m elevational transect in Mount Palvar,overlooking the Lut Desert in Southeast Iran.We also analyzed the effect of environmental variables on species turnover along the vertical gradient.A total of 120 vegetation plots(10 m×10 m)were sampled along the elevational transect containing species and environmental data.To discover plant diversity pattern along the elevational gradient,generalized additive model(GAM)was used.Non-metric multidimensional scaling(NMDS)was applied for illustrating the correlation between species composition and environmental variables.We found hump-shaped pattern for species richness,Shannon diversity,endemic richness,and species richness of different life forms,but a monotonic increasing pattern for ratio of endemic species from low to high elevations.Our study confirms the humped pattern of species richness peaking at intermediate elevations along a complete elevational gradient in a semi-arid mountain.The monotonic increase of endemics ratio with elevation in our area as a case study is consistent with global increase of endemism with elevation.According to our results,temperature and precipitation are two important climatic variables that drive elevational plant diversity,particularly in seasonally dry areas.Our study suggests that effective conservation and management are needed for this low latitude mountain area along with calling for long-term monitoring for species redistribution.
基金supported by the National Natural Science Foundation of China(Nos.31900204,32071671,32030071)the Postdoctoral Research Foundation of China(grant no.2019M652674)the Fundamental Research Funds for the Central Universities(grant no.CCNU22LJ003).
文摘Reproductive strategies of sexually dimorphic plants vary in response to the environment.Here,we ask whether the sexual systems of Fagopyrum species(i.e.,selfing homostylous and out-crossing distylous)represent distinct adaptive strategies to increase reproductive success in changing alpine environments.To answer this question,we determined how spatial and temporal factors(e.g.,elevation and peak flowering time)affect reproductive success(i.e.,stigmatic pollen load)in nine wild Fagopyrum species(seven distylous and two homostylous)among 28 populations along an elevation gradient of 1299-3315 m in the Hengduan Mountains,southwestern China.We also observed pollinators and conducted hundreds of hand pollinations to investigate inter/intra-morph compatibility,self-compatibility and pollen limitation in four Fagopyrum species(two distylous and two homostylous).We found that Fagopyrum species at higher elevation generally had bigger flowers and more stigmatic pollen loads;lateflowering individuals had smaller flowers and lower pollen deposition.Stigmatic pollen deposition was more variable in distylous species than in homostylous species.Although seed set was not pollenlimited in all species,we found that fruit set was much lower in distylous species,which rely on frequent pollinator visits,than in homostylous species capable of autonomous self-pollination.Our findings that pollination success increases at high elevations and decreases during the flowering season suggest that distylous and homostylous species have spatially and temporally distinct reproductive strategies related to environment-dependent pollinator activity.
基金supported by the National Natural Science Foundation of China,Nos.81570849,81100931the Natural Science Foundation of Guangdong Province of China,Nos.2015A030313446,2020A1515011413(all to LPC).
文摘Intraocular pressure elevation can induce retinal ganglion cell death and is a clinically reversible risk factor for glaucoma,the leading cause of irreversible blindness.We previously demonstrated that casein kinase-2 inhibition can promote retinal ganglion cell survival and axonal regeneration in rats after optic nerve injury.To investigate the underlying mechanism,in the current study we increased the intraocular pressure of adult rats to 75 mmHg for 2 hours and then administered a casein kinase-2 inhibitor(4,5,6,7-tetrabromo-2-azabenzimidazole or 2-dimethylamino-4,5,6,7-tetrabromo-1H-benzimidazole)by intravitreal injection.We found that intravitreal injection of 4,5,6,7-tetrabromo-2-azabenzimidazole or 2-dimethylamino-4,5,6,7-tetrabromo-1H-benzimidazole promoted retinal ganglion cell survival and reduced the number of infiltrating macrophages.Transcriptomic analysis showed that the mitogen activated protein kinase signaling pathway was involved in the response to intraocular pressure elevation but was not modulated by the casein kinase-2 inhibitors.Furthermore,casein kinase-2 inhibition downregulated the expression of genes(Cck,Htrsa,Nef1,Htrlb,Prph,Chat,Slc18a3,Slc5a7,Scn1b,Crybb2,Tsga10ip,and Vstm21)involved in intraocular pressure elevation.Our data indicate that inhibition of casein kinase-2 can enhance retinal ganglion cell survival in rats after acute intraocular pressure elevation via macrophage inactivation.
基金the National Natural Science Foundation of China(32260379&32371852)the Jiangxi Provincial Natural Science Foundation(20224ACB215005)
文摘Global climate change can affect tree growth and carbon sink function by influencing plant carbohydrate synthesis and utilization,while elevation can be used as an ideal setting under natural conditions to simulate climate change effects.The effect of elevation on tree growth may depend on organ type.However,the allocation patterns of nonstructural and structural carbohydrates(NSCs and SCs,respectively)in different tree organs and their response to elevation remain unclear.We selected four dominant tree species,Schima superba,Castanopsis eyrei,Castanopsis fargesii and Michelia maudiae,along an elevation gradient from 609 to 1,207 m in subtropical evergreen broad-leaved forests and analyzed leaf,trunk,and fine root NSCs,carbon(C),nitrogen(N)and phosphorus(P)concentrations and the relative abundance of SCs.Leaf NSCs increased initially and then decreased,and trunk NSCs increased with increasing elevation.However,root NSCs decreased with increasing elevation.The relative abundance of SCs in leaves and trunks decreased,while the relative abundance of root SCs increased with increasing elevation.No significant correlations between SCs and NSCs in leaves were detected,while there were negative correlations between SCs and NSCs in trunks,roots,and all organs.Hierarchical partitioning analysis indicated that plant C/N and C/P were the main predictors of changes in SCs and NSCs.Our results suggest that tree organs have divergent responses to elevation and that increasing elevation will inhibit the aboveground part growth and enhance the root growth of trees.A tradeoff between the C distribution used for growth and storage was confirmed along the elevation gradient,which is mainly manifested in the"sink"organs of NSCs.Our results provide insight into tree growth in the context of global climate change scenarios in subtropical forest ecosystems.
文摘Elevation is one of many components that influence agriculture, and this in turn affects the level of both inputs and outputs of farmers. This article focuses on the productivity and technical efficiency of 100 cocoa farms using cross-sectional data from areas ranging from 190 to 1021 m above sea level which were classified as low, medium, and high elevation in Davao City, considered as the chocolate capital of the Philippines. Using stochastic frontier analysis, the results showed that the cost of inputs per ha and the number of cocoa trees per ha significantly increase yield. Farms at high elevations were less technically efficient, as this entails lower temperatures and increased rainfall, and cocoa farming in those areas and conditions can be more challenging, especially with changes in farming practices, terrain, and distance to markets. Other significant variables were age of cocoa farms, married farmers, and age of the farmers. Older farms may be more developed, farmers who are married benefit from their spouses being able to readily contribute as farm labor, and lastly, older farmers' inefficiency may likely stem from nonadaptation of newer farming practices. With an average technical efficiency of 0.61, 0.63, and 0.26 in low, medium, and high elevation areas, respectively, farmers therefore have an incentive to improve farm practices and consider topographical variations found in high elevation areas. Recommendations for the improvement of technical efficiency of cocoa farms are better connectivity to markets, enhancing farm practices, and continuation and improvement of government programs on cocoa with an added emphasis on research. For farmers in high elevation areas, mitigating solutions such as sustainable agriculture practices and ecolabelling are key to improving efficiency and minimizing the potential negative impact on upland farming systems. Moreover, such adaptation measures may also contribute to sustainability of cocoa farming in high elevation areas.
基金Supported by Shandong Provincial Natural Science Foundation(No.ZR2022QH384).
文摘●AIM:To study the changes and effect factors of posterior corneal surface after small incision lenticule extraction(SMILE)with different myopic diopters.●METHODS:Ninety eyes of 90 patients who underwent SMILE were included in this retrospective study.Patients were allocated into three groups based on the preoperative spherical equivalent(SE):low myopia(SE≥-3.00 D),moderate myopia(-3.00 D>SE>-6.00 D)and high myopia(SE≤-6.00 D).Posterior corneal surfaces were measured by a Scheimpflug camera preoperatively and different postoperative times(1wk,1,3,6mo,and 1y).Posterior mean elevation(PME)at 25 predetermined points of 3 concentric circles(2-,4-,and 6-mm diameter)above the best fit sphere was analyzed.●RESULTS:All surgeries were completed uneventfully and no ectasia was found through the observation.The difference of myopia group was significant at the 2-mm ring at 1 and 3mo postoperatively(1mo:P=0.017;3mo:P=0.018).The effect of time onΔPME was statistically significant(2-mm ring:P=0.001;4-mm ring:P<0.001;6-mm ring:P<0.001).The effect of different corneal locations onΔPME was significant except 1wk postoperatively(1mo:P=0.000;3mo:P=0.000;6mo:P=0.001;1y:P=0.001).Posterior corneal stability was linearly correlated with SE,central corneal thickness,ablation depth,residual bed thickness,percent ablation depth and percent stromal bed thickness.●CONCLUSION:The posterior corneal surface changes dynamically after SMILE.No protrusion is observed on the posterior corneal surface in patients with different degrees of myopia within one year after surgery.SMILE has good stability,accuracy,safety and predictability.
基金The authors gratefully acknowledge the science teams of NASA High Mountain Asia 8-meter DEM and NASA ICESat-2 for providing access to the data.This work was conducted with the infrastructure provided by the National Remote Sensing Centre(NRSC),for which the authors were indebted to the Director,NRSC,Hyderabad.We acknowledge the continued support and scientific insights from Mr.Rakesh Fararoda,Mr.Sagar S Salunkhe,Mr.Hansraj Meena,Mr.Ashish K.Jain and other staff members of Regional Remote Sensing Centre-West,NRSC/ISRO,Jodhpur.The authors want to acknowledge Dr.Kamal Pandey,Scientist,IIRS,Dehradun,for sharing field-level information about the Auli-Joshimath.This research did not receive any specific grant from funding agencies in the public,commercial,or not-for-profit sectors.
文摘High Mountain Asia(HMA),recognized as a third pole,needs regular and intense studies as it is susceptible to climate change.An accurate and high-resolution Digital Elevation Model(DEM)for this region enables us to analyze it in a 3D environment and understand its intricate role as the Water Tower of Asia.The science teams of NASA realized an 8-m DEM using satellite stereo imagery for HMA,termed HMA 8-m DEM.In this research,we assessed the vertical accuracy of HMA 8-m DEM using reference elevations from ICESat-2 geolocated photons at three test sites of varied topography and land covers.Inferences were made from statistical quantifiers and elevation profiles.For the world’s highest mountain,Mount Everest,and its surroundings,Root Mean Squared Error(RMSE)and Mean Absolute Error(MAE)resulted in 1.94 m and 1.66 m,respectively;however,a uniform positive bias observed in the elevation profiles indicates the seasonal snow cover change will dent the accurate estimation of the elevation in this sort of test sites.The second test site containing gentle slopes with forest patches has exhibited the Digital Surface Model(DSM)features with RMSE and MAE of 0.58 m and 0.52 m,respectively.The third test site,situated in the Zanda County of the Qinghai-Tibet,is a relatively flat terrain bed,mostly bare earth with sudden river cuts,and has minimal errors with RMSE and MAE of 0.32 m and 0.29 m,respectively,and with a negligible bias.Additionally,in one more test site,the feasibility of detecting the glacial lakes was tested,which resulted in exhibiting a flat surface over the surface of the lakes,indicating the potential of HMA 8-m DEM for deriving the hydrological parameters.The results accrued in this investigation confirm that the HMA 8-m DEM has the best vertical accuracy and should be of high use for analyzing natural hazards and monitoring glacier surfaces.