BACKGROUND Gastrointestinal symptoms are common in patients with uremia undergoing hemodialysis,and these symptoms seriously affect patients'prognosis.AIM To assess the occurrence and factors influencing gastroint...BACKGROUND Gastrointestinal symptoms are common in patients with uremia undergoing hemodialysis,and these symptoms seriously affect patients'prognosis.AIM To assess the occurrence and factors influencing gastrointestinal symptoms in patients with uremia undergoing hemodialysis.METHODS We retrospectively selected 98 patients with uremia who underwent regular hemo-dialysis treatment in the blood purification center of our hospital from December 2022 to December 2023.The gastrointestinal symptoms and scores of each dimension were evaluated using the Gastrointestinal Symptom Grading Scale(GSRS).Patients were divided into gastrointestinal symptoms and no gastrointestinal symptom groups according to whether they had gastrointestinal symptoms.The factors that may affect gastrointestinal symptoms were identified by single-factor analysis.Multiple logistic regression analysis was performed to identify independent risk factors for gastrointestinal symptoms.RESULTS Gastrointestinal symptoms included indigestion,constipation,reflux,diarrhea,abdominal pain,and eating disorders,and the total average GSRS score was 1.35±0.47.This study showed that age,number of tablets,dialysis time,glucocorticoid,parathyroid hormone(PTH),combined diabetes mellitus and C-reactive protein(CRP)were independent risk factors for gastrointestinal symptoms in patients with uremia undergoing hemodialysis,whereas body mass index(BMI),hemoglobin(Hb),and urea clearance index were independent protective factors(P<0.05).CONCLUSION Gastrointestinal symptoms are mostly mild in patients with uremia undergoing hemodialysis,most commonly including dyspepsia,eating disorders,and gastroesophageal reflux.The independent influencing factors mainly include the BMI,age,number of pills taken,dialysis time,urea clearance index,Hb,use of glucocorticoids,and thyroid hormone level.PTH,CRP,and diabetes are clinically related factors influencing the occurrence of gastrointestinal symptoms,and targeted prevention can be performed.展开更多
Objective:This study aimed to compare the efficacy of anti-CD19 chimeric antigen receptor T cells(CAR-T cells)versus chemotherapy plus donor lymphocyte infusion(chemo-DLI)for treating relapsed CD 19-positive B-cell ac...Objective:This study aimed to compare the efficacy of anti-CD19 chimeric antigen receptor T cells(CAR-T cells)versus chemotherapy plus donor lymphocyte infusion(chemo-DLI)for treating relapsed CD 19-positive B-cell acute lymphoblastic leukemia(B-ALL)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods:Clinical data of 43 patients with B-ALL who relapsed after allo-HSCT were retrospectively analyzed.Twenty-two patients were treated with CAR-T cells(CAR-T group),and 21 with chemotherapy plus DLI(chemo-DLI group).The complete remission(CR)and minimal residual disease(MRD)-negative CR rates,leukemia-free survival(LFS)rate,overall survival(OS)rate,and incidence of acute graft-versus-host disease(aGVHD),cytokine release syndrome(CRS)and immune effector cell-associated neurotoxicity syndrome(ICANS)were compared between the two groups.Results:The CR and MRD-negative CR rates in the CAR-T group(77.3%and 61.5%)were significantly higher than those in the chemo-DLI group(38.1%and 23.8%)(P=0.008 and P=0.003).The 1-and 2-year LFS rates in the CAR-T group were superior to those in the chemo-DLI group:54.5%and 50.0%vs.9.5%and 4.8%(P=0.0001 and P=0.00004).The 1-and 2-year OS rates in the CAR-T versus chemo-DLI group were 59.1%and 54.5%vs.19%and 9.5%(P=0.011 and P=0.003).Six patients(28.6%)with grade 2-4 aGVHD were identified in the chemo-DLI group.Two patients(9.1%)in the CAR-T group developed grade 1-2 aGVHD.Nineteen patients(86.4%)developed CRS in the CAR-T group,comprising grade 1-2 CRS in 13 patients(59.1%)and grade 3 CRS in 6 patients(27.3%).Two patients(9.1%)developed grade 1-2 ICANS.Conclusion:Donor-derived anti-CD19 CAR-T-cell therapy may be better,safer,and more effective than chemo-DLI for B-ALL patients who relapse after allo-HSCT.展开更多
BACKGROUND Peripheral arterial disease(PAD)has become one of the leading causes of disability and death in diabetic patients.Restoring blood supply to the hindlimbs,especially by promoting arteriogenesis,is currently ...BACKGROUND Peripheral arterial disease(PAD)has become one of the leading causes of disability and death in diabetic patients.Restoring blood supply to the hindlimbs,especially by promoting arteriogenesis,is currently the most effective strategy,in which endothelial cells play an important role.Tongxinluo(TXL)has been widely used for the treatment of cardio-cerebrovascular diseases and extended for diabetes-related vascular disease.AIM To investigate the effect of TXL on diabetic PAD and its underlying mechanisms.METHODS An animal model of diabetic PAD was established by ligating the femoral artery of db/db mice.Laser Doppler imaging and micro-computed tomography(micro-CT)were performed to assess the recovery of blood flow and arteriogenesis.Endothelial cell function related to arteriogenesis and cellular pyroptosis was assessed using histopathology,Western blot analysis,enzyme-linked immunosorbent assay and real-time polymerase chain reaction assays.In vitro,human vascular endothelial cells(HUVECs)and human vascular smooth muscle cells(VSMCs)were pretreated with TXL for 4 h,followed by incubation in high glucose and hypoxia conditions to induce cell injury.Then,indicators of HUVEC pyroptosis and function,HUVECVSMC interactions and the migration of VSMCs were measured.RESULTS Laser Doppler imaging and micro-CT showed that TXL restored blood flow to the hindlimbs and enhanced arteriogenesis.TXL also inhibited endothelial cell pyroptosis via the reactive oxygen species/nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3/Caspase-1/GSDMD signaling pathway.In addition,TXL restored endothelial cell functions,including maintaining the balance of vasodilation,acting as a barrier to reduce inflammation,and enhancing endothelial-smooth muscle cell interactions through the Jagged-1/Notch-1/ephrin-B2 signaling pathway.Similar results were observed in vitro.CONCLUSION TXL has a pro-arteriogenic effect in the treatment of diabetic PAD,and the mechanism may be related to the inhibition of endothelial cell pyroptosis,restoration of endothelial cell function and promotion of endothelial cell-smooth muscle cell interactions.展开更多
AIM To assess the accuracy of Look-Locker on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(GdEOB-DTPA)-enhanced magnetic resonance imaging(MRI) for staging liver fibrosis in chronic hepatitis B/C(CHB/C)....AIM To assess the accuracy of Look-Locker on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(GdEOB-DTPA)-enhanced magnetic resonance imaging(MRI) for staging liver fibrosis in chronic hepatitis B/C(CHB/C).METHODS We prospectively included 109 patients with CHB or CHC who underwent a 3.0-Tesla MRI examination, including T1-weighted and Look-Locker sequences for T1 mapping. Hepatocyte fractions(He F) and relaxation time reduction rate(RE) were measured for staging liver fibrosis. A receiver operating characteristic analysis using the area under the receiver operating characteristic curve(AUC) was used to compare thediagnostic performance in predicting liver fibrosis between He F and RE.RESULTS A total of 73 patients had both pathological results and MRI information. The number of patients in each fibrosis stage was evaluated semiquantitatively according to the METAVIR scoring system: F0, n = 23(31.5%); F1, n = 19(26.0%); F2, n = 13(17.8%); F3, n = 6(8.2%), and F4, n = 12(16.4%). He F by EOB enhancement imaging was significantly correlated with fibrosis stage(r =-0.808, P < 0.05). AUC values for diagnosis of any(≥ F1), significant(≥ F2) or advanced(≥ F3) fibrosis, and cirrhosis(F4) using He F were 0.837(0.733-0.913), 0.890(0.795-0.951), 0.957(0.881-0.990), and 0.957(0.882-0.991), respectively. He F measurement was more accurate than use of RE in establishing liver fibrosis staging, suggesting that calculation of He F is a superior noninvasive liver fibrosis staging method.CONCLUSION A T1 mapping-based He F method is an efficient diagnostic tool for the staging of liver fibrosis.展开更多
BACKGROUND Hypotension after the induction of anesthesia is known to be associated with various adverse events.The involvement of a series of factors makes the prediction of hypotension during anesthesia quite challen...BACKGROUND Hypotension after the induction of anesthesia is known to be associated with various adverse events.The involvement of a series of factors makes the prediction of hypotension during anesthesia quite challenging.AIM To explore the ability and effectiveness of a random forest(RF)model in the prediction of post-induction hypotension(PIH)in patients undergoing cardiac surgery.METHODS Patient information was obtained from the electronic health records of the Second Affiliated Hospital of Hainan Medical University.The study included patients,≥18 years of age,who underwent cardiac surgery from December 2007 to January 2018.An RF algorithm,which is a supervised machine learning technique,was employed to predict PIH.Model performance was assessed by the area under the curve(AUC)of the receiver operating characteristic.Mean decrease in the Gini index was used to rank various features based on their importance.RESULTS Of the 3030 patients included in the study,1578(52.1%)experienced hypotension after the induction of anesthesia.The RF model performed effectively,with an AUC of 0.843(0.808-0.877)and identified mean blood pressure as the most important predictor of PIH after anesthesia.Age and body mass index also had a significant impact.CONCLUSION The generated RF model had high discrimination ability for the identification of individuals at high risk for a hypotensive event during cardiac surgery.The study results highlighted that machine learning tools confer unique advantages for the prediction of adverse post-anesthesia events.展开更多
We theoretically study the transport properties in the T-shaped double-quantum-dot structure,by considering the dot in the main channel to be coupled to the Majorana bound state(MBS)at one end of the topological super...We theoretically study the transport properties in the T-shaped double-quantum-dot structure,by considering the dot in the main channel to be coupled to the Majorana bound state(MBS)at one end of the topological superconducting nanowire.It is found that the side-coupled dot governs the effect of the MBS on the transport behavior.When its level is consistent with the energy zero point,the MBS contributes little to the conductance spectrum.Otherwise,the linear conductance exhibits notable changes according to the inter-MBS coupling manners.In the absence of inter-MBS coupling,the linear conductance value keeps equal to e^(2)/2 h when the level of the side-coupled dot departs from the energy zero point.However,the linear conductance is always analogous to the MBS-absent case once the inter-MBS coupling comes into play.These findings provide new information about the leakage effect of MBSs in quantum-dot structures.展开更多
Severe acute respiratory syndrome-coronavirus-2(SARS-CoV-2)infection can lead to a cytokine storm,unleashed in part by pyroptosis of virus-infected macrophages and monocytes.Interleukin-6(IL-6)has emerged as a key par...Severe acute respiratory syndrome-coronavirus-2(SARS-CoV-2)infection can lead to a cytokine storm,unleashed in part by pyroptosis of virus-infected macrophages and monocytes.Interleukin-6(IL-6)has emerged as a key participant in this ominous complication of coronavirus disease 2019(COVID-19).IL-6 antagonists have improved outcomes in patients with COVID-19 in some,but not all,studies.IL-6 signaling involves at least 3 distinct pathways,including classic-signaling,trans-signaling,and trans-presentation depending on the localization of IL-6 receptor and its binding partner glycoprotein gp130.IL-6 has become a therapeutic target in COVID-19,cardiovascular diseases,and other inflammatory conditions.However,the efficacy of inhibition of IL-6 signaling in metabolic diseases,such as obesity and diabetes,may depend in part on cell type-dependent actions of IL-6 in controlling lipid metabolism,glucose uptake,and insulin sensitivity owing to complexities that remain to be elucidated.The present review sought to summarize and discuss the current understanding of how and whether targeting IL-6 signaling ameliorates outcomes following SARS-CoV-2 infection and associated clinical complications,focusing predominantly on metabolic and cardiovascular diseases.展开更多
Background:Irritable bowel syndrome(IBS)is reported associated with the alteration of gut microbial composition termed as dysbiosis.However,the pathogenic mechanism of IBS remains unclear,while the studies of Chinese ...Background:Irritable bowel syndrome(IBS)is reported associated with the alteration of gut microbial composition termed as dysbiosis.However,the pathogenic mechanism of IBS remains unclear,while the studies of Chinese individuals are scarce.This study aimed to understand the concept of dysbiosis among patients with Chinese diarrhea-predominant IBS(IBS-D),as a degree of variance between the gut microbiomes of IBS-D population and that of a healthy population.Methods:The patients with IBS-D were recruited(assessed according to the Rome III criteria,by IBS symptom severity score)from the Outpatient Department of Gastroenterology of Peking University Third Hosp让al,and volunteers as healthy controls(HCs)were enrolled,during 2013.The 16S rRNA sequences were extracted from fecal samples.Ribosomal database project resources,basic local alignment search tool,and SparCC software were used to obtain the phylotype composition of samples and the internal interactions of the microbial community.Herein,the non-parametric test,Wilcoxon rank-sum test was carried out to find the statistical significance between HC and IBS-D groups.All the P values were adjusted to q values to decrease the error rate.Results:The study characterized the gut microbiomes of Chinese patients with IBS-D,and demonstrated that the dysbiosis could be characterized as directed alteration of the microbiome composition leading to greater disparity between relative abundance of two phyla,Bacteroidetes(Z=4.77,q=1.59×10^-5)and Firmicutes(Z=-3.87,q=5.83×10^-4).Moreover,it indicated that the IBS symptom features were associated with the dysbiosis of whole gut microbiome,instead of one or several certain genera even they were dominating.Two genera,Bacteroides and Lachnospiracea incertae sedis,were identified as the core genera,meanwhile,the non-core genera contribute to a larger pan-microbiome of the gut microbiome.Furthermore,the dysbiosis in patients with IBS-D was associated with a reduction of network complexity of the interacted microbial community(HC us.IBS-D:639 vs.154).The disordered metabolic functions of patients with IBS-D were identified as the potential influence of gut microbiome on the host(significant difference with q<0.01 between HC and IBS-D).Conclusions:This study supported the view of the potential influence of gut microbiome on the symptom of Chinese patients with IBS-D,and further characterized dysbiosis in Chinese patients with IBS-D,thus provided more pathological evidences for IBS-D with the further understanding of dysbiosis.展开更多
To the Editor: Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder that presents as abdominal pain with altered bowel habits. The pathophysiologic mechanism of IBS is not well understood...To the Editor: Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder that presents as abdominal pain with altered bowel habits. The pathophysiologic mechanism of IBS is not well understood, although many hypotheses have been proposed, including visceral hypersensitivity, gastrointestinal dysmotility, lowgrade inflammation of the intestinal mucosa, and dysfunction of the brain-gut interaction. Dysfunction of the braingut interaction is thought to be involved in IBS because a considerable proportion of patients with IBS have some form of psychologic comorbidity, such as depression or anxiety. In addition, mental and psychologic problems increase the risk for IBS and the symptom severity of IBS. Recently, changes in the gut microbiota have also been suggested to contribute to both IBS and depression. Our previous study demonstrated significant altered gut microbiota profiles in patients with diarrhea-predominant IBS (IBS-D) and depression.展开更多
Background：Magnetic resonance （MR） imaging provides a unique,noninvasive diagnostic platform to quantify the physiological and biochemical variables of skeletal muscle at rest.This study was to investigate the diff...Background：Magnetic resonance （MR） imaging provides a unique,noninvasive diagnostic platform to quantify the physiological and biochemical variables of skeletal muscle at rest.This study was to investigate the difference in thigh skeletal muscles between snowboarding halfpipe athletes and healthy volunteers via multiparametric MR imaging.Methods：A comparative study was conducted between 12 healthy volunteers and 14 snowboarding halfpipe athletes.MR scanning targeted the left leg at the level of the proximal thigh on a 3.0T MR system.The measured parameters compared between the two groups included T1,T2,T2＊ relaxation times,fat fraction （FF）,and cross-sectional area （CSA） of the quadriceps femoris and the hamstring muscles.Statistical analysis was carried out using independent sample t-test.Interrater reliability was also assessed with intraclass correlation coefficients （ICCs）.Results：It was statistically equivalent between two groups in age,body mass index,thigh circumference,calf circumference,systolic blood pressure,and resting heart rate （all P ＞ 0.05）.However,the T1 and T2 values of the hamstring muscles in the athlete group were found to be significantly shorter than those in control group （T1：1063.3 ± 24.1 ms vs.1112.0 ± 38.2 ms in biceps femoris,1050.4 ± 31.2 ms vs.1095.0 ± 39.5 ms in semitendinosus,1053.1 ± 31.7 ms vs.1118.4 ± 40.0 ms in semimembranosus,respectively;T2：33.4 ± 0.7 ms vs.36.1 ± 1.9 ms in biceps femoris,34.6 ± 2.0 ms vs.37.0 ± 1.9 ms in semitendinosus,36.9 ± 1.5 ms vs.38.9 ± 2.4 ms in semimembranosus,respectively;all P ＜ 0.05） although T2＊ relaxation time was detected with no significant difference.The FF of the hamstring muscles was obviously less than the control group （5.5 ± 1.9％ vs.10.7 ± 4.7％,P ＜ 0.001）.In addition,the quadriceps＇ CSA in the athlete group was substantially larger than the control group （8039.0 ± 1072.3 vs.6258.2 ± 852.0 mm2,P ＜ 0.001）.Interrater reliability was excellent （ICC：0.758-0.994）.Conclusion：Multiple MR imaging parameters indicated significant differences between snowboarding halfpipe athletes and healthy volunteers in the thigh skeletal muscles.展开更多
文摘BACKGROUND Gastrointestinal symptoms are common in patients with uremia undergoing hemodialysis,and these symptoms seriously affect patients'prognosis.AIM To assess the occurrence and factors influencing gastrointestinal symptoms in patients with uremia undergoing hemodialysis.METHODS We retrospectively selected 98 patients with uremia who underwent regular hemo-dialysis treatment in the blood purification center of our hospital from December 2022 to December 2023.The gastrointestinal symptoms and scores of each dimension were evaluated using the Gastrointestinal Symptom Grading Scale(GSRS).Patients were divided into gastrointestinal symptoms and no gastrointestinal symptom groups according to whether they had gastrointestinal symptoms.The factors that may affect gastrointestinal symptoms were identified by single-factor analysis.Multiple logistic regression analysis was performed to identify independent risk factors for gastrointestinal symptoms.RESULTS Gastrointestinal symptoms included indigestion,constipation,reflux,diarrhea,abdominal pain,and eating disorders,and the total average GSRS score was 1.35±0.47.This study showed that age,number of tablets,dialysis time,glucocorticoid,parathyroid hormone(PTH),combined diabetes mellitus and C-reactive protein(CRP)were independent risk factors for gastrointestinal symptoms in patients with uremia undergoing hemodialysis,whereas body mass index(BMI),hemoglobin(Hb),and urea clearance index were independent protective factors(P<0.05).CONCLUSION Gastrointestinal symptoms are mostly mild in patients with uremia undergoing hemodialysis,most commonly including dyspepsia,eating disorders,and gastroesophageal reflux.The independent influencing factors mainly include the BMI,age,number of pills taken,dialysis time,urea clearance index,Hb,use of glucocorticoids,and thyroid hormone level.PTH,CRP,and diabetes are clinically related factors influencing the occurrence of gastrointestinal symptoms,and targeted prevention can be performed.
基金supported by grants from the National Natural Science Foundation of China(No.82020108004)the Hospital-level Clinical Innovation Military-Civilian Special Project of Army Medical University(No.2018JSLC0020)+1 种基金Chongqing Science and Technology Innovation Leading Talent(No.CSTCCXLJRC201718)Natural Science Foundation of Chongqing Innovation Group Science Program(No.cstc2021jcyj-cxttX0001).
文摘Objective:This study aimed to compare the efficacy of anti-CD19 chimeric antigen receptor T cells(CAR-T cells)versus chemotherapy plus donor lymphocyte infusion(chemo-DLI)for treating relapsed CD 19-positive B-cell acute lymphoblastic leukemia(B-ALL)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods:Clinical data of 43 patients with B-ALL who relapsed after allo-HSCT were retrospectively analyzed.Twenty-two patients were treated with CAR-T cells(CAR-T group),and 21 with chemotherapy plus DLI(chemo-DLI group).The complete remission(CR)and minimal residual disease(MRD)-negative CR rates,leukemia-free survival(LFS)rate,overall survival(OS)rate,and incidence of acute graft-versus-host disease(aGVHD),cytokine release syndrome(CRS)and immune effector cell-associated neurotoxicity syndrome(ICANS)were compared between the two groups.Results:The CR and MRD-negative CR rates in the CAR-T group(77.3%and 61.5%)were significantly higher than those in the chemo-DLI group(38.1%and 23.8%)(P=0.008 and P=0.003).The 1-and 2-year LFS rates in the CAR-T group were superior to those in the chemo-DLI group:54.5%and 50.0%vs.9.5%and 4.8%(P=0.0001 and P=0.00004).The 1-and 2-year OS rates in the CAR-T versus chemo-DLI group were 59.1%and 54.5%vs.19%and 9.5%(P=0.011 and P=0.003).Six patients(28.6%)with grade 2-4 aGVHD were identified in the chemo-DLI group.Two patients(9.1%)in the CAR-T group developed grade 1-2 aGVHD.Nineteen patients(86.4%)developed CRS in the CAR-T group,comprising grade 1-2 CRS in 13 patients(59.1%)and grade 3 CRS in 6 patients(27.3%).Two patients(9.1%)developed grade 1-2 ICANS.Conclusion:Donor-derived anti-CD19 CAR-T-cell therapy may be better,safer,and more effective than chemo-DLI for B-ALL patients who relapse after allo-HSCT.
基金Supported by The Hebei Province Natural Science Foundation,No. H2019106062Key R&D Plan of Hebei Provincial Department of Science and Technology,No. 223777155DResearch Project of Hebei Provincial Administration of Traditional Chinese Medicine,No. 2023179
文摘BACKGROUND Peripheral arterial disease(PAD)has become one of the leading causes of disability and death in diabetic patients.Restoring blood supply to the hindlimbs,especially by promoting arteriogenesis,is currently the most effective strategy,in which endothelial cells play an important role.Tongxinluo(TXL)has been widely used for the treatment of cardio-cerebrovascular diseases and extended for diabetes-related vascular disease.AIM To investigate the effect of TXL on diabetic PAD and its underlying mechanisms.METHODS An animal model of diabetic PAD was established by ligating the femoral artery of db/db mice.Laser Doppler imaging and micro-computed tomography(micro-CT)were performed to assess the recovery of blood flow and arteriogenesis.Endothelial cell function related to arteriogenesis and cellular pyroptosis was assessed using histopathology,Western blot analysis,enzyme-linked immunosorbent assay and real-time polymerase chain reaction assays.In vitro,human vascular endothelial cells(HUVECs)and human vascular smooth muscle cells(VSMCs)were pretreated with TXL for 4 h,followed by incubation in high glucose and hypoxia conditions to induce cell injury.Then,indicators of HUVEC pyroptosis and function,HUVECVSMC interactions and the migration of VSMCs were measured.RESULTS Laser Doppler imaging and micro-CT showed that TXL restored blood flow to the hindlimbs and enhanced arteriogenesis.TXL also inhibited endothelial cell pyroptosis via the reactive oxygen species/nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3/Caspase-1/GSDMD signaling pathway.In addition,TXL restored endothelial cell functions,including maintaining the balance of vasodilation,acting as a barrier to reduce inflammation,and enhancing endothelial-smooth muscle cell interactions through the Jagged-1/Notch-1/ephrin-B2 signaling pathway.Similar results were observed in vitro.CONCLUSION TXL has a pro-arteriogenic effect in the treatment of diabetic PAD,and the mechanism may be related to the inhibition of endothelial cell pyroptosis,restoration of endothelial cell function and promotion of endothelial cell-smooth muscle cell interactions.
基金Supported by National Natural Science Foundation of China,No.81771893,No.81771802,No.81471718 and No.81401376Outstanding youth Foundation of China Medical University,No.yq20160005
文摘AIM To assess the accuracy of Look-Locker on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(GdEOB-DTPA)-enhanced magnetic resonance imaging(MRI) for staging liver fibrosis in chronic hepatitis B/C(CHB/C).METHODS We prospectively included 109 patients with CHB or CHC who underwent a 3.0-Tesla MRI examination, including T1-weighted and Look-Locker sequences for T1 mapping. Hepatocyte fractions(He F) and relaxation time reduction rate(RE) were measured for staging liver fibrosis. A receiver operating characteristic analysis using the area under the receiver operating characteristic curve(AUC) was used to compare thediagnostic performance in predicting liver fibrosis between He F and RE.RESULTS A total of 73 patients had both pathological results and MRI information. The number of patients in each fibrosis stage was evaluated semiquantitatively according to the METAVIR scoring system: F0, n = 23(31.5%); F1, n = 19(26.0%); F2, n = 13(17.8%); F3, n = 6(8.2%), and F4, n = 12(16.4%). He F by EOB enhancement imaging was significantly correlated with fibrosis stage(r =-0.808, P < 0.05). AUC values for diagnosis of any(≥ F1), significant(≥ F2) or advanced(≥ F3) fibrosis, and cirrhosis(F4) using He F were 0.837(0.733-0.913), 0.890(0.795-0.951), 0.957(0.881-0.990), and 0.957(0.882-0.991), respectively. He F measurement was more accurate than use of RE in establishing liver fibrosis staging, suggesting that calculation of He F is a superior noninvasive liver fibrosis staging method.CONCLUSION A T1 mapping-based He F method is an efficient diagnostic tool for the staging of liver fibrosis.
文摘BACKGROUND Hypotension after the induction of anesthesia is known to be associated with various adverse events.The involvement of a series of factors makes the prediction of hypotension during anesthesia quite challenging.AIM To explore the ability and effectiveness of a random forest(RF)model in the prediction of post-induction hypotension(PIH)in patients undergoing cardiac surgery.METHODS Patient information was obtained from the electronic health records of the Second Affiliated Hospital of Hainan Medical University.The study included patients,≥18 years of age,who underwent cardiac surgery from December 2007 to January 2018.An RF algorithm,which is a supervised machine learning technique,was employed to predict PIH.Model performance was assessed by the area under the curve(AUC)of the receiver operating characteristic.Mean decrease in the Gini index was used to rank various features based on their importance.RESULTS Of the 3030 patients included in the study,1578(52.1%)experienced hypotension after the induction of anesthesia.The RF model performed effectively,with an AUC of 0.843(0.808-0.877)and identified mean blood pressure as the most important predictor of PIH after anesthesia.Age and body mass index also had a significant impact.CONCLUSION The generated RF model had high discrimination ability for the identification of individuals at high risk for a hypotensive event during cardiac surgery.The study results highlighted that machine learning tools confer unique advantages for the prediction of adverse post-anesthesia events.
基金the Liao Ning Revitalization Talents Program(Grant No.XLYC1907033)the Fundamental Research Funds for the Central Universities,China(Grant No.N2002005)the National Natural Science Foundation of China(Grant No.11905027)。
文摘We theoretically study the transport properties in the T-shaped double-quantum-dot structure,by considering the dot in the main channel to be coupled to the Majorana bound state(MBS)at one end of the topological superconducting nanowire.It is found that the side-coupled dot governs the effect of the MBS on the transport behavior.When its level is consistent with the energy zero point,the MBS contributes little to the conductance spectrum.Otherwise,the linear conductance exhibits notable changes according to the inter-MBS coupling manners.In the absence of inter-MBS coupling,the linear conductance value keeps equal to e^(2)/2 h when the level of the side-coupled dot departs from the energy zero point.However,the linear conductance is always analogous to the MBS-absent case once the inter-MBS coupling comes into play.These findings provide new information about the leakage effect of MBSs in quantum-dot structures.
基金supported by the National Heart,Lung,and Blood Institute (HL151627 and HL157073 to Guo-Ping Shi,HL134892 and HL163099 to Peter Libby)the National Institute of Neurological Disorders and Stroke (AG063839 to Guo-Ping Shi).
文摘Severe acute respiratory syndrome-coronavirus-2(SARS-CoV-2)infection can lead to a cytokine storm,unleashed in part by pyroptosis of virus-infected macrophages and monocytes.Interleukin-6(IL-6)has emerged as a key participant in this ominous complication of coronavirus disease 2019(COVID-19).IL-6 antagonists have improved outcomes in patients with COVID-19 in some,but not all,studies.IL-6 signaling involves at least 3 distinct pathways,including classic-signaling,trans-signaling,and trans-presentation depending on the localization of IL-6 receptor and its binding partner glycoprotein gp130.IL-6 has become a therapeutic target in COVID-19,cardiovascular diseases,and other inflammatory conditions.However,the efficacy of inhibition of IL-6 signaling in metabolic diseases,such as obesity and diabetes,may depend in part on cell type-dependent actions of IL-6 in controlling lipid metabolism,glucose uptake,and insulin sensitivity owing to complexities that remain to be elucidated.The present review sought to summarize and discuss the current understanding of how and whether targeting IL-6 signaling ameliorates outcomes following SARS-CoV-2 infection and associated clinical complications,focusing predominantly on metabolic and cardiovascular diseases.
基金the National Key Research and Development Program of China(No.2017YFC1200205)the National Natural Science Foundation of China(No.31671366 and No.91231119)the Special Research Project of‘Clinical Medicine+X’by Peking University.
文摘Background:Irritable bowel syndrome(IBS)is reported associated with the alteration of gut microbial composition termed as dysbiosis.However,the pathogenic mechanism of IBS remains unclear,while the studies of Chinese individuals are scarce.This study aimed to understand the concept of dysbiosis among patients with Chinese diarrhea-predominant IBS(IBS-D),as a degree of variance between the gut microbiomes of IBS-D population and that of a healthy population.Methods:The patients with IBS-D were recruited(assessed according to the Rome III criteria,by IBS symptom severity score)from the Outpatient Department of Gastroenterology of Peking University Third Hosp让al,and volunteers as healthy controls(HCs)were enrolled,during 2013.The 16S rRNA sequences were extracted from fecal samples.Ribosomal database project resources,basic local alignment search tool,and SparCC software were used to obtain the phylotype composition of samples and the internal interactions of the microbial community.Herein,the non-parametric test,Wilcoxon rank-sum test was carried out to find the statistical significance between HC and IBS-D groups.All the P values were adjusted to q values to decrease the error rate.Results:The study characterized the gut microbiomes of Chinese patients with IBS-D,and demonstrated that the dysbiosis could be characterized as directed alteration of the microbiome composition leading to greater disparity between relative abundance of two phyla,Bacteroidetes(Z=4.77,q=1.59×10^-5)and Firmicutes(Z=-3.87,q=5.83×10^-4).Moreover,it indicated that the IBS symptom features were associated with the dysbiosis of whole gut microbiome,instead of one or several certain genera even they were dominating.Two genera,Bacteroides and Lachnospiracea incertae sedis,were identified as the core genera,meanwhile,the non-core genera contribute to a larger pan-microbiome of the gut microbiome.Furthermore,the dysbiosis in patients with IBS-D was associated with a reduction of network complexity of the interacted microbial community(HC us.IBS-D:639 vs.154).The disordered metabolic functions of patients with IBS-D were identified as the potential influence of gut microbiome on the host(significant difference with q<0.01 between HC and IBS-D).Conclusions:This study supported the view of the potential influence of gut microbiome on the symptom of Chinese patients with IBS-D,and further characterized dysbiosis in Chinese patients with IBS-D,thus provided more pathological evidences for IBS-D with the further understanding of dysbiosis.
基金the grants from the National Twelfth Five-Year Plan for Science and Technology of China (No.2012BAI06B02)the National Natural Science Foundation of China (No.81670491)The Capital Health Research and Development of Special (No.2016-2- 4093).
文摘To the Editor: Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder that presents as abdominal pain with altered bowel habits. The pathophysiologic mechanism of IBS is not well understood, although many hypotheses have been proposed, including visceral hypersensitivity, gastrointestinal dysmotility, lowgrade inflammation of the intestinal mucosa, and dysfunction of the brain-gut interaction. Dysfunction of the braingut interaction is thought to be involved in IBS because a considerable proportion of patients with IBS have some form of psychologic comorbidity, such as depression or anxiety. In addition, mental and psychologic problems increase the risk for IBS and the symptom severity of IBS. Recently, changes in the gut microbiota have also been suggested to contribute to both IBS and depression. Our previous study demonstrated significant altered gut microbiota profiles in patients with diarrhea-predominant IBS (IBS-D) and depression.
基金This work was supported by grants from the National Key Research and Development Program of China （No. 2016YFC0107102） and the National Natural Science Foundation of China （No. 30871211 and No. 81271538）.
文摘Background：Magnetic resonance （MR） imaging provides a unique,noninvasive diagnostic platform to quantify the physiological and biochemical variables of skeletal muscle at rest.This study was to investigate the difference in thigh skeletal muscles between snowboarding halfpipe athletes and healthy volunteers via multiparametric MR imaging.Methods：A comparative study was conducted between 12 healthy volunteers and 14 snowboarding halfpipe athletes.MR scanning targeted the left leg at the level of the proximal thigh on a 3.0T MR system.The measured parameters compared between the two groups included T1,T2,T2＊ relaxation times,fat fraction （FF）,and cross-sectional area （CSA） of the quadriceps femoris and the hamstring muscles.Statistical analysis was carried out using independent sample t-test.Interrater reliability was also assessed with intraclass correlation coefficients （ICCs）.Results：It was statistically equivalent between two groups in age,body mass index,thigh circumference,calf circumference,systolic blood pressure,and resting heart rate （all P ＞ 0.05）.However,the T1 and T2 values of the hamstring muscles in the athlete group were found to be significantly shorter than those in control group （T1：1063.3 ± 24.1 ms vs.1112.0 ± 38.2 ms in biceps femoris,1050.4 ± 31.2 ms vs.1095.0 ± 39.5 ms in semitendinosus,1053.1 ± 31.7 ms vs.1118.4 ± 40.0 ms in semimembranosus,respectively;T2：33.4 ± 0.7 ms vs.36.1 ± 1.9 ms in biceps femoris,34.6 ± 2.0 ms vs.37.0 ± 1.9 ms in semitendinosus,36.9 ± 1.5 ms vs.38.9 ± 2.4 ms in semimembranosus,respectively;all P ＜ 0.05） although T2＊ relaxation time was detected with no significant difference.The FF of the hamstring muscles was obviously less than the control group （5.5 ± 1.9％ vs.10.7 ± 4.7％,P ＜ 0.001）.In addition,the quadriceps＇ CSA in the athlete group was substantially larger than the control group （8039.0 ± 1072.3 vs.6258.2 ± 852.0 mm2,P ＜ 0.001）.Interrater reliability was excellent （ICC：0.758-0.994）.Conclusion：Multiple MR imaging parameters indicated significant differences between snowboarding halfpipe athletes and healthy volunteers in the thigh skeletal muscles.
