Development and validation of a model integrating clinical and coronary lesion-based functional assessment for longterm risk prediction in PCI patients

OBJECTIVES To establish a scoring system combining the ACEF score and the quantitative blood flow ratio(QFR) to improve the long-term risk prediction of patients undergoing percutaneous coronary intervention(PCI).METHODS In this population-based cohort study, a total of 46 features, including patient clinical and coronary lesion characteristics, were assessed for analysis through machine learning models. The ACEF-QFR scoring system was developed using 1263consecutive cases of CAD patients after PCI in PANDA Ⅲ trial database. The newly developed score was then validated on the other remaining 542 patients in the cohort.RESULTS In both the Random Forest Model and the Deep Surv Model, age, renal function(creatinine), cardiac function(LVEF)and post-PCI coronary physiological index(QFR) were identified and confirmed to be significant predictive factors for 2-year adverse cardiac events. The ACEF-QFR score was constructed based on the developmental dataset and computed as age(years)/EF(%) + 1(if creatinine ≥ 2.0 mg/d L) + 1(if post-PCI QFR ≤ 0.92). The performance of the ACEF-QFR scoring system was preliminarily evaluated in the developmental dataset, and then further explored in the validation dataset. The ACEF-QFR score showed superior discrimination(C-statistic = 0.651;95% CI: 0.611-0.691, P < 0.05 versus post-PCI physiological index and other commonly used risk scores) and excellent calibration(Hosmer–Lemeshow χ^(2)= 7.070;P = 0.529) for predicting 2-year patient-oriented composite endpoint(POCE). The good prognostic value of the ACEF-QFR score was further validated by multivariable Cox regression and Kaplan–Meier analysis(adjusted HR = 1.89;95% CI: 1.18–3.04;log-rank P < 0.01) after stratified the patients into high-risk group and low-risk group.CONCLUSIONS An improved scoring system combining clinical and coronary lesion-based functional variables(ACEF-QFR)was developed, and its ability for prognostic prediction in patients with PCI was further validated to be significantly better than the post-PCI physiological index and other commonly used risk scores.

Protective Effect of Shenfu Injection on Rats with Chronic Heart Failure Induced by Doxorubicin

[Objectives] To determine the protective effect of Shenfu injection( SFI) on chronic heart failure( CHF) in rats induced by doxorubicin. [Methods] CHF was induced by doxorubicin via intraperitoneal injection in rats. The cardiac function parameters,the heart index,the serum brain natriuretic peptide( BNP) level and cardiac histopathology were measured 4 weeks after Shenfu injection treatment. [Results]Shenfu injection remarkably improved the heart index and cardiac histopathology,increased the heart rate( HR),left ventricular systolic pressure( LVSP),maximum rising rate of left ventricular pressure( + dp/dtmax) and dropping rate of left ventricular pressure(-dp/dtmax),reduced the left ventricular end-diastolic pressure( LVEDP) and serum BNP level of rats with CHF induced by doxorubicin. [Conclusions]Shenfu injection exerts protective effect on CHF induced by doxorubicin.

ASSESSMENT OF LEFT VENTRICULAR FUNCTION IN HEALTHY SUBJECTS BY PUSLED WAVE DOPPLER TISSUE IMAGING

Objective To examine the clinical application of pulsed Doppler tissue imaging(DTI)for regional left ventricular function assessment in normal subjects. Methods We examined 50 healthy subjects(range 12-42 years,mean age 28.3 ± 6.9 years)using pulsed Doppler tissue imaging to characterize the diastolic and systolic velocity profiles of mitral annulus. Recordings were made along the long axis in the apical 4-chamber, 2-chamber, and long apical views of 6 sites(posterior-septum, lateral, anterior, inferior, anterior-septum, posterior)at the mitral annulus. Myocardial velocities were determined with use of variance F statistical analysis. Correlation analysis was employed to test the relationship between age and mitral annular velocities. Results Both early diastolic and systolic velocities at the septum were lower than other sites. There were no differences in mitral annulus late diastolic velocities. Mean early diastolic and systolic velocities was negatively correlated with age. Conclusions Doppler tissue imaging can directly reflect regional left ventricular function.

Evaluation and Analysis of Nutrients in Tobacco-Planting Soil in Fuzhou City

[Objective] The aim was to explore the nutrient status of tobacco-planting soil, and find out the fertilization strategy for flue-cured tobacco. [Method] The nutrient contents in 142 soil samples from 7 tobacco planting counties in Fu Zhou city were determined and evaluated. [Result] The organic matter content was on the high side, and most soil was acid soil. The soil had abundant total nitrogen, total phosphorus and total potassium, moderate available nitrogen and available phosphorus, low available potassium, high water soluble chlorine, low soil cation exchange capacity and rich effective zinc, but effective boron was famine. [Conclusion] The meta-acid soil should be conducted with pH adjustment, and rational nitrogen, phosphorus and potassium application.

Efficacy and safety of on demand tadalafil in the treatment of East and Southeast Asian men with erectile dysfunction:a randomized double-blind,parallel,placebo-controlled clinical study

Aim： To assess the efficacy and safety of tadalafil in comparison to a placebo, when taken on demand for 12 weeks by East/Southeast Asian men with erectile dysfunction （ED）, Methods： This multicenter, randomized, double-blind, parallel group, placebo-controlled study was conducted at 17 centers across East and Southeast Asia between August 2002 and February 2003. Men more than 18 years of age with mild to severe ED of various etiologies were randomized to receive a placebo or 20 mg of tadalafil taken as needed （maximum once daily）. Efficacy assessments included the International Index of Erectile Function, the Sexual Encounter Profile diary and Global Assessment Questions. Results： Tadalafil significantly improved erectile function as compared to the placebo （P 〈 0.001）. At the endpoint, the patients receiving 20 mg of tadalafil reported a greater mean per patient percentage of successful intercourse attempts （Sexual Encounter Profile question 3： 70.9% compared to 33.5% in the placebo） and a greater proportion of improved erections （Global Assessment Question： 86.2% compared to 30.1%）. Most （≥3%） treatment emergent adverse events were mild or moderate. The most common treatment emergent adverse events were headache, back pain, dizziness and dyspepsia. Conclusion： Tadalafil was an effective and well-tolerated treatment for ED in East and Southeast Asian men.

Efficacy and safety of tadalafil taken as needed for the treatment of erectile dysfunction in Asian men： results of an integrated analysis

We evaluated the efficacy and safety of as-needed tadalafil in a diverse clinical population （with varying patient demographics, disease severity, and comorbid medical conditions） of Asian men with erectile dysfunction （ED）. An integrated analysis of five double-blind, placebo-controlled trials （N = 1 046） was performed. Patients were randomly assigned to receive 10 mg tadalafil （N = 185）, 20 mg tadalafil （N = 510）, or placebo （N = 351）. Efficacy assessments included the International Index of Erectile Function （IIEF）, Sexual Encounter Profile （SEP） diary and Global Assessment Question （GAQ）. Patients receiving 10 mg or 20 mg tadalafil showed significant improvement from baseline-to-end point on the Erectile Function domain of the International Index of Erectile Function （IIEF-EF） domain score in all clinical sub-populations analyzed, compared with patients receiving placebo （P 〈 0.001）. The 10-mg and 20-mg tadalafil groups showed a mean success rate of 64.1% and 70.5% for sexual intercourse attempts （SEP3, successful intercourse）, respectively, compared with 33.4% in the placebo group （P 〈 0.001）, and 85.5% and 85.4% reported improved erections at end point GAQ, respectively, versus 43.5% in the placebo group （P 〈 0.001）. Tadalafil was well tolerated across all groups studied. Headache and back pain were the most frequently reported adverse events. Overall, tadalafil was effective and well tolerated across a diverse clinical spectrum of Asian men with ED.

Efficient Catalytic Conversion of Polysulfides by Biomimetic Design of “Branch‑Leaf” Electrode for High‑Energy Sodium–Sulfur Batteries

Rechargeable room temperature sodium–sulfur(RT Na–S)batteries are seriously limited by low sulfur utilization and sluggish electrochemical reaction activity of polysulfide intermediates.Herein,a 3D“branch-leaf”biomimetic design proposed for high performance Na–S batteries,where the leaves constructed from Co nanoparticles on carbon nanofibers(CNF)are fully to expose the active sites of Co.The CNF network acts as conductive“branches”to ensure adequate electron and electrolyte supply for the Co leaves.As an effective electrocatalytic battery system,the 3D“branch-leaf”conductive network with abundant active sites and voids can effectively trap polysulfides and provide plentiful electron/ions pathways for electrochemical reaction.DFT calculation reveals that the Co nanoparticles can induce the formation of a unique Co–S–Na molecular layer on the Co surface,which can enable a fast reduction reaction of the polysulfides.Therefore,the prepared“branch-leaf”CNF-L@Co/S electrode exhibits a high initial specific capacity of 1201 mAh g^−1 at 0.1 C and superior rate performance.

Advances in Researches of Functional Rice

Functional rice has functions of adjusting human physiological functions of and preventing diseases. At present,there are researches both at home and abroad about the relationship between nutritional quality and physiological active substances of rice and human physiological activities. Through conventional breeding,gene mutation technology,and molecular-assisted selection( MAS) technology,it is feasible to select and breed new rice varieties and plants with certain health care functions.

实施会计统管改革创新财会集中核算——宜昌市Fu亭区会计统管新模式的运作及效果

从2000年1月1日起，宜昌市Fu亭区在全区行政事业单位落实财会集中核算制度中，全面实施了以会计委派，会计代理，会计任命为形式的会计统管改革，并向区直企业，街办企业延伸，形成了以“坚持三不变，采取三形式，实施三统一”为框架的会计统管模式。建立起了财政部门对会计工作和会计人员集中统一管理的会计管理新体制。

Changes of cTnI in myocardial ischemic and reperfusion injury during correction of cardiac defects in children

Objective The purpose of this study is to investgate changes of cTnI in myocardial ischemic and reperfusion injury during correction of cardiac defects in children. Methods From June, 1999 to May,2000,45 children (30 male, 15 female) undergoing correction of cardiac defects were divided into three groups randomly: group Ⅰ no myocardial ischemia,group Ⅱ myocardial ischemia less than 60 minutes, group Ⅲmyocardial ischemia 】 60 minutes. There were no significant differences in the three groups in age, sex ratio, C/T ratio, or left ventricular function. Blood samples for analysis were collected before skin incision and at time intervals up to 6 days postoperatively. Analysis of creatine kinase MB.LDH and cardiac-specific troponin I was used for the detection of myocardial damage. Meantime, the ECG was checked for myocardial infarction. After the reperfusion, myocardial tissue was obtained from the free wall of right ventricle myocardial structure studies. Results The level of cTnI was increased

Successful treatment of liver abscess secondary to foreign body penetration of the alimentary tract: A case report and literature review

Hepatic abscess caused by foreign body penetration of the alimentary tract is rare. We report a case of gastric antrum penetration due to a toothpick complicated by liver abscess formation. A 41-year-old man was admitted to our hospital with the chief complaint of upper abdominal pain for 2 mo. Esophagogastroduodenoscopy performed at a local clinic revealed a toothpick penetrating the gastric antrum. Computed tomography (CT) of the abdomen at our hospital revealed a gastric foreign body embedded in the posterior wall of gastric antrum with regional phlegmon over the lesser sac and adhesion to the pancreatic body without notable vascular injury, and a hepatic abscess seven cm in diameter over the left liver lobe. Endoscopic removal of the foreign body was successfully performed without complication. The liver abscess was treated with parenteral antibiotics without drainage. The patient&#x02019;s recovery was uneventful. Abdominal ultrasonography demonstrated complete resolution of the hepatic abscess six months after discharge. Relevant literature from the PubMed database was reviewed and the clinical presentations, diagnostic modalities, treatment strategies and outcomes of 88 reported cases were analyzed. The results showed that only 6 patients received conservative treatment with parenteral antibiotics, while the majority underwent either image-guided abscess drainage or laparotomy. Patients receiving abscess drainage via laparotomy had a significantly shorter length of hospitalization compared with those undergoing image-guided drainage. There was no significant difference in age between those who survived and those who died, however, the latter presented to hospitals in a more critical condition than the former. The overall mortality rate was 7.95%.

Chronic care model in the diabetes pay-for-performance program in Taiwan:Benefits,challenges and future directions

In this review,we discuss the chronic care model(CCM)in relation to the diabetes pay-for-performance(P4P)program in Taiwan.We first introduce the 6 components of the CCM and provide a detailed description of each of the activities in the P4P program implemented in Taiwan,mapping them onto the 6 components of the CCM.For each CCM component,the following three topics are described:the definition of the CCM component,the general activities implemented related to this component,and practical and empirical practices based on hospital or local government cases.We then conclude by describing the possible successful features of this P4P program and its challenges and future directions.We conclude that the successful characteristics of this P4P program in Taiwan include its focus on extrinsic and intrinsic incentives(i.e.,shared care network),physician-led P4P and the implementation of activities based on the CCM components.However,due to the low rate of P4P program coverage,approximately 50%of patients with diabetes cannot enjoy the benefits of CCMrelated activities or receive necessary examinations.In addition,most of these CCM-related activities are not allotted an adequate amount of incentives,and these activities are mainly implemented in hospitals,which compared with primary care providers,are unable to execute these activities flexibly.All of these issues,as well as insufficient implementation of the e-CCM model,could hinder the advanced improvement of diabetes care in Taiwan.

REACTIVITY OF METAL(O) DITHIOCARBAMATO CARBONYL COMPLEXES [Mo(CO)_4(S_2CNEt_2)]^- (M=Mo, W): SYNTHESIS AND STRUCTURE OF A NEW MIXED-VALENCE DINUCLEAR MOLYBDENUM-SULFUR COMPLEX, [Et_4N]_2[(CO)_4MoS_2MoS_2]

The reaction of [Et4N][Mo(CO)4(S2CNEt2)] with tetraethylam-monium tetrathiomolybdate affords a new mixed-valence dinuclear molybdenum complex [Et4N]2[(CO)4MoS2MoS2] (1). 1 crystallizes in the orthorhombic space group Pbom with a = 18.403(2), b = 11.963(1), c= 13. 482(1)(?) , Z = 4, V = 2986(?)3, Dc=1. 55g/cm3, Mr = 6S2. 69. R =0. 042 and Rw =0. 057 for 1975 independent reflections with I≥3σ(I), F(000) = 1416, μ =11. 2cm-1. The structure of the anion of 1 consists of an octahedron for the lowvalent Mo atom and a tetrahedron for the high-valent Mo atom sharing an S - S edge. The Mo - Mo bond distance is 2. 992 (2) (?) and the bimetallic center MoS2Mo is planar with Mo-S of 2. 517 and 2. 231 A and MoSMo angles of 78. 04° and 77. 67°. The electron delocalization between the two Mo atoms with wide separated oxidation states is also discussed.

DmpIRFs and DmpST:DAMPE instrument response functions and science tools for gamma-ray data analysis

Observing GeV gamma-rays is an important goal of the DArk Matter Particle Explorer(DAMPE)for indirect dark matter searching and high energy astrophysics. In this work, we present a set of accurate instrument response functions for DAMPE(DmpIRFs) including the effective area, point-spread function and energy dispersion, which are crucial for gamma-ray data analysis based on statistics from simulation data. A dedicated software named DmpST is developed to facilitate the scientific analyses of DAMPE gamma-ray data. Considering the limited number of photons and angular resolution of DAMPE, the maximum likelihood method is adopted in DmpST to better disentangle different source components. The basic mathematics and framework regarding this software are also introduced in this paper.

Successful bailout stenting strategy against rare spontaneous retrograde dissection of partially absorbed magnesium-based resorbable scaffold:A case report

BACKGROUND In the development of coronary stent technology,bioresorbable scaffolds are promising milestones in improving the clinical treatment of coronary artery disease.The“leave nothing behind”motto is the premise of the fourth revolution in percutaneous coronary intervention(PCI).Studies proving the safety and efficacy of the magnesium-based resorbable scaffolds(MgBRSs)include the BIOSOLVE-I and BIOSOLVE-II trials and the latest BIOSOLVE-IV registry.However,spontaneous retrograde dissection of a partially absorbed MgBRS may still occur,albeit rarely.CASE SUMMARY We describe an unusual case of coronary artery disease in a patient who had undergone a successful PCI 8 mo earlier,where an MgBRS was implanted into the left anterior descending artery(LAD)and left circumflex artery with drug-coated balloons for a ramus intermedius branch stenosis to achieve the“leave nothing behind”therapeutic intention and was currently presenting with a gradual worsening of chest tightness.The distal edge vascular response,during subsequent attempts with balloon angioplasty was performed smoothly.However,spontaneous retrograde dissection of a partially absorbed MgBRS in the LAD ensued.Successful bailout stenting was performed with revascularization of the entry and exit sites created by spontaneous dissection and complete sealing of the intramural hematoma.The patient recovered well and was discharged after 2 d of intervention.When followed up in August 2020(7 mo later),the patient showed uneventful recovery.CONCLUSION Spontaneous retrograde dissection of a partially absorbed MgBRS was successfully treated using bailout sirolimus-eluting coronary stent strategy.

Abnormal liver function and central obesity associate with work-related fatigue among the Taiwan Residents workers

AIM: To examine the associations between objective health indicators and high need for recovery (NFR) after work, one of the subjective presentations of work related-fatigue, among apparently healthy workers in modern workplaces. METHODS: From October to December, 2007, an annual health examination was performed for the workers from an electronics manufacturing factory in Taiwan. Health records of 1216 workers with a relatively homogeneous socioeconomic status were used for analysis. The health checkups included personal and NFR scale questionnaires, physical examinations, blood tests for biochemistry and hematology. The workers within the top tertile NFR score were defi ned as high-NFR workers. RESULTS: After adjusted for potential confounders, the workers with elevated alanine aminotransferase (ALT) and central obesity had a significantly higher NFR after work, with increased risks of 1.4-fold [95% confi dence interval (CI) = 1.01-2.0] and 1.8-fold (95% CI = 1.2-2.7), respectively. Shiftworkers had a 2.0-fold (95% CI = 1.5-2.6) increased risk for high-NFR. The associations between high-NFR and lipid profi les, blood sugar, hematology indexes or blood pressure were insignifi cant after controlling for confounders.CONCLUSION: For apparently healthy workers, high NFR after work is not simply a subjective experience. Objective health measures, such as elevated ALT and increased waist circumference, should be carefully evaluated for the apparently healthy workers having a higher NFR after work.

The single-cell landscape reveals unique tumor subsets and microenvironments associated with poor clinical outcomes in primary testicular diffuse large B-cell lymphoma

Diffuse large B cell lymphoma(DLBCL)is one of the most prevalent lymphoid malignancies.The current standard of care can cure about two-thirds of DLBCL patients.1 Primary testicular diffuse large B-cell lymphoma(PT-DLBCL)is a rare but highly aggressive form of mature B-cell lymphoma that accounts for approximately 1%-9%of testicular malignancies.Different from nodal DLBCL,PT-DLBCL has a markedly worse prognosis because of inferior response to the current treatment regimens and significant extranodal tropism.2 Three main questions remained unresolved in the field of PT-DLBCL research.

Bifurcated Rhodaelectro-catalyzed C−H Activation for the Synthesis of Pyrroles and Lactones

While electrocatalyzed alkyne annulations of arenes represent a powerful strategy for the assembly of heteroaromatic motives,electrochemical C(sp2)−H activations of alkenes remain scarce.Herein,a strategy for the rhodaelectro-catalyzed function-alization of enamides is presented for the efficient construction of pyrroles using electricity as a sustainable oxidant.Moreover,the tuning of the solvent system allowed a fascinating switch in chemoselectivity,which is not possible with traditionally used chemical oxidants,giving rise to lactone architectures.The rhoda-electrocatalysis features a broad scope as well as high regio-and chemoselectivities.

武夷山不同种植模式下茶园土壤理化性质和酶活性的季节变化特征

土壤酶活性是表征土壤肥力水平和养分转化的重要指标,揭示种植模式和季节变化对茶园土壤酶活性影响,阐明影响茶园土壤酶活性变化的主要环境因子,为合理评估有机茶种植的土壤生态效应提供理论依据。结合野外调查和室内分析方法,以武夷山茶区3种类型样地,即林地(FD)、常规茶园(CT)和有机茶园(OT)为研究对象,测定了参与土壤碳、氮和磷循环的6种酶活性,研究不同种植模式下土壤酶活性的季节变化规律及影响因子。结果显示,与林地土壤相比,常规种植模式茶园土壤铵态氮、全磷、有效磷和有效钾含量显著增加,土壤全钾和pH显著降低;相比常规茶园,有机茶园土壤有机质和全氮含量显著增加,土壤全磷、有效磷、全钾和速效钾含量显著降低,土壤pH有所增加,土壤养分比例更为协调。种植模式和季节及其交互作用对土壤脲酶和过氧化氢酶活性影响显著。与林地土壤相比,常规茶园土壤脲酶、多酚氧化酶、过氧化氢酶和酸性磷酸酶活性下降了12.05%~63.55%,有机茶园土壤脲酶显著提高了324.95%,种植模式并未改变土壤硝酸还原酶活性。总体而言,夏秋季节(5月和8月)土壤脲酶、多酚氧化酶、蔗糖酶和酸性磷酸酶活性明显高于冬春季节(11月和2月),土壤硝酸还原酶和过氧化氢酶活性在春季最高。置换多元方差分析结果显示,种植模式对土壤整体理化性质的影响远大于季节变化。冗余分析结果显示,土壤环境因子解释了土壤酶活性变异的77.03%,土壤有机质、全氮、铵态氮、全磷、有效磷、全钾、有效钾和pH对土壤酶活性有显著或极显著的影响。综上所述,林地转变为茶园对土壤理化性质和酶活性产生显著影响,常规种植导致茶园土壤速效磷钾积累,土壤酶活性降低,有机种植提高了土壤酶活性,增强了土壤碳氮养分供应能力,具有良好的生态环境效应。

急诊科护士突发公共卫生事件心理弹性培训方案的构建与初步应用研究

目的构建基于Kumpfer心理弹性框架理论与国际心理弹性研究计划项目组(the International Resilience Research Project,IRRP)心理弹性训练策略的心理弹性培训方案,探讨其在急诊科护士突发公共卫生事件下的应用效果。方法2022年1-6月,采用简单随机抽样法选择上海市某三级医院的急诊科护士为研究对象,按随机数字表分为对照组和观察组各30例,对照组采用常规培训和管理方法,观察组在对照组的基础上实施心理弹性培训方案。评价并比较两组护士干预前后心理弹性及应急能力的变化。结果干预后,观察组护士的心理弹性、应急能力得分均高于对照组(均P<0.05)。结论心理弹性培训方案在突发公共卫生事件下能有效提升急诊科护士的心理弹性水平,保障突发公共卫生事件应急处置工作有序开展。