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.

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.

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.

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.

DCE-MRI对肉芽肿性乳腺炎与非肿块样强化乳腺癌鉴别诊断价值

目的 分析肉芽肿性乳腺炎(GM)和非肿块样强化(NMLE)乳腺癌在磁共振动态增强(DCE-MRI)影像特征,以提高GM和乳腺癌的鉴别诊断。方法 回顾性分析60例在DCE-MRI表现为非肿块样强化(NMLE)病变,分析N MLE病变的弥散加权成像(DWI)信号特点、强化分布及强化方式,采用Pearson卡方检验对环状强化的分布、不同期相环壁强化程度。结果NMLE中GM组25例,强化分布(局灶3例、区域8例、多区域性5例、线样或导管样0例、段性6例、弥漫性3例),强化方式(不均匀2例、大小不等环23例),病灶实性区时间信号曲线(TIC)Ⅰ型9例,Ⅲ型16例,Ⅲ型曲线0例;NMLE中乳腺癌组35例,强化分布(局灶性5例、区域性15例、多区域性5例、线样或导管样3例、段性4例、弥漫性4例),强化方式(均匀强化3例、不均匀强化6例、集簇/簇环状26例),病灶实性区TIC曲线Ⅰ型7例,Ⅱ型12例及Ⅲ例16例, NMLE中GM组与乳腺癌在病灶环壁及环内容物DWI高信号(P=0.00、 P=0.00),大小不等环形强化(P=0.02),集簇/簇环状强化(P=0.01),病灶环壁晚期显著强化程度(P=0.01)有统计学意义,病灶环壁早期显著强化(P=0.07)无统计学意义。结论以线样、段样强化分布及以小簇环状强化的NMLE病变多提示恶性肿瘤;以区域或弥漫性强化分布伴大小不等环状强化的非肿块样强化,且随时间延迟渐进性均匀强化的病变多提示GM。

我国体育产业高质量发展的组态路径——基于TOE框架的fsQCA分析

选取22个省市为案例,依托“技术创新-组织运行-环境支持”(TOE)分析框架,综合运用组态比较思维和QCA方法,在明晰体育产业高质量发展各要素之间交互式关系基础上,系统探究体育产业高质量发展各因素之间的因果机制、组合效应和组态路径。研究认为:体育产业高质量发展并非单一条件驱动下的“线性发展”,而是呈现“殊途同归”为特点“多重并发”的复合式发展;体育产业的发展表征出非对称性,体现为“高质量”和“非高质量”两种组态。其中,驱动体育产业高质量发展存在“双核型”与“多维型”两类组态路径。据此提出如下建议:新质生产力赋能,创新驱动发展,强化“以新提质”;政策拉动,营造良好政策环境,夯实体育产业根基;消费推动,创新体育消费新模式,搭建体育消费新载体。

基于回归或机器学习方法的个体预后或诊断的多变量预测模型透明报告(TRIPOD+AI)解读

随着人工智能(AI)和机器学习方法在预测模型开发中的广泛应用,个体预后或诊断的多变量预测模型的透明报告(TRIPOD)2015指南已无法全面适应当下研究需求。本文旨在介绍和解析新版报告规范基于回归或机器学习方法的TRIPOD(TRIPOD+AI),通过详尽剖析27项清单条目,帮助研究者在比较TRIPOD 2015与TRIPOD+AI的基础上,更好地理解和应用这一更新的指南,以提高预测模型研究的报告质量、透明性和可重复性。