Background: For decades, traditional open surgical techniques were used to treat lumbar disc herniation and lumbar canal stenosis (LCS). However, seeking for better outcomes for patients and avoiding extensive bony lo...Background: For decades, traditional open surgical techniques were used to treat lumbar disc herniation and lumbar canal stenosis (LCS). However, seeking for better outcomes for patients and avoiding extensive bony loss with its sequences had raised minimally invasive technique for treating these disorders as an alternative surgery. Methods: This is a retrospective study in which 54 patients of LCS were operated upon via unilateral minimally invasive technique to decompress the canal in a 360 degrees fashion through laminotomy, deroofing of opposite laminar side, sublaminar ligamintectomy, bilateral foraminotomies and discectomy. We used VAS scores and ODI to assess clinical outcomes with a period of one year follow-up. Results: Our results demonstrated that minimally invasive techniques for treating these disorders are effective procedures. Minimally invasive 360 degrees decompression for treating LCS had better outcomes regarding postoperative back pain, smaller incisions, less bony loss and early ambulation. Conclusion: Minimally invasive techniques for treating lumbar canal stenosis of different causes could be considered a better option instead of traditional full laminectomy with better outcomes as regards respecting the anatomical layers such as posterior spinal integrity and musculature, postoperative pain, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods.展开更多
BACKGROUND The recently introduced ultrasonic flow ratio(UFR),is a novel fast computational method to derive fractional flow reserve(FFR)from intravascular ultrasound(IVUS)images.In the present study,we evaluate the d...BACKGROUND The recently introduced ultrasonic flow ratio(UFR),is a novel fast computational method to derive fractional flow reserve(FFR)from intravascular ultrasound(IVUS)images.In the present study,we evaluate the diagnostic performance of UFR in patients with intermediate left main(LM)stenosis.METHODS This is a prospective,single center study enrolling consecutive patients with presence of intermediated LM lesions(diameter stenosis of 30%-80%by visual estimation)underwent IVUS and FFR measurement.An independent core laboratory assessed offline UFR and IVUS-derived minimal lumen area(MLA)in a blinded fashion.RESULTS Both UFR and FFR were successfully achieved in 41 LM patients(mean age,62.0±9.9 years,46.3%diabetes).An acceptable correlation between UFR and FFR was identified(r=0.688,P<0.0001),with an absolute numerical difference of 0.03(standard difference:0.01).The area under the curve(AUC)in diagnosis of physiologically significant coronary stenosis for UFR was 0.94(95%CI:0.87-1.01),which was significantly higher than angiographic identified stenosis>50%(AUC=0.66,P<0.001)and numerically higher than IVUS-derived MLA(AUC=0.82;P=0.09).Patient level diagnostic accuracy,sensitivity and specificity for UFR to identify FFR≤0.80 was 82.9%(95%CI:70.2-95.7),93.1%(95%CI:82.2-100.0),58.3%(95%CI:26.3-90.4),respectively.CONCLUSION In patients with intermediate LM diseases,UFR was proved to be associated with acceptable correlation and high accuracy with pressure wire-based FFR as standard reference.The present study supports the use of UFR for functional evaluation of intermediate LM stenosis.展开更多
Aortic stenosis(AS)stands out as the most prevalent individual valvular defect globally.The onset and progression of AS mirror an active process akin to atherosclerosis,and the traditional triad of symptoms includes c...Aortic stenosis(AS)stands out as the most prevalent individual valvular defect globally.The onset and progression of AS mirror an active process akin to atherosclerosis,and the traditional triad of symptoms includes chest pain,breathlessness,and loss of consciousness.Prognosis takes a significant downturn when symptoms manifest,with mortality reaching approximately 50%-85% within the subsequent 5 years after symptom onset.展开更多
Aging in oak barrels is widely used in enology which could bring flavor changes and aromatic complexity to wines.In the present study,the aroma compounds were analyzed from the‘Merlot’dry red wines,which were fermen...Aging in oak barrels is widely used in enology which could bring flavor changes and aromatic complexity to wines.In the present study,the aroma compounds were analyzed from the‘Merlot’dry red wines,which were fermented in two types of fermenters(stainless steel tank and rotated oak barrel)and aged in six types of oak barrels(three geographic origins×two toasting degrees)for different time(0,3,6 and 9 months,respectively).Results showed that 30 volatiles were associated with barrels and increased during oak aging.The fermenters could influence the intensities of the toast,leathery,smoky,fruity,floral and caramel aromas.The concentration of whisky lactone,eugenol,cis-isoeugenol,and the intensities of the toast and spicy aromas were highest in the wines aged in American oak and were lowest in the wines aged in French oak barrels.The concentrations of guaiacol,syringol,trans-isoeugenol,furfural alcohol,vanilla,cis-whisky lactone enabled the medium toasting barrels to be distinguished from the light toasting ones.The compounds originating from the barrels could be used to distinguish the types of different barrels,but the other general grape-derived and fermentation-derived volatiles could not.The fermenters,oak species and toasting degrees of the barrels all had significant effects on the aroma profiles of the aged‘Merlot’dry red wines,but the influence of the geographic origin was not obvious.展开更多
This study presents a proposed method for assessing the condition and predicting the future status of condensers operating in seawater over an extended period.The aim is to address the problems of scaling and corrosio...This study presents a proposed method for assessing the condition and predicting the future status of condensers operating in seawater over an extended period.The aim is to address the problems of scaling and corrosion,which lead to increased loss of cold resources.The method involves utilising a set of multivariate feature parameters associated with the condenser as input for evaluation and trend prediction.This methodology offers a precise means of determining the optimal timing for condenser cleaning,with the ultimate goal of improving its overall performance.The proposed approach involves the integration of the analytic network process with subjective expert experience and the entropy weightmethod with objective big data analysis to develop a fusion health degreemodel.The mathematical model is constructed quantitatively using the improved Mahalanobis distance.Furthermore,a comprehensive prediction model is developed by integrating the improved Informer model and Markov error correction.This model takes into account the health status of the equipment and several influencing factors,includingmultivariate feature characteristics.This model facilitates the objective examination and prediction of the progression of equipment deterioration trends.The present study involves the computation and verification of the field time series data,which serves to demonstrate the accuracy of the condenser health-related models proposed in this research.These models effectively depict the real condition and temporal variations of the equipment,thus offering a valuable method for determining the precise cleaning time required for the condenser.展开更多
The efficient development and exploitation of shale oil depends on long-distance horizontal wells. As the degreeof cleaning of the wellbore plays a key role in these processes, in this study, this problem is investiga...The efficient development and exploitation of shale oil depends on long-distance horizontal wells. As the degreeof cleaning of the wellbore plays a key role in these processes, in this study, this problem is investigated experimentallyby focusing on the dimensionless cuttings bed height. A method is proposed to calculate the horizontalwellhydraulic extension taking into account the influence of the wellbore cleaning degree on the wellborepressure distribution and assess the effect of a variety of factors such as the bottom hole pressure, the circulatingpressure drop, the drilling pump performance and the formation properties. The analysis shows that the hydraulicextension of horizontal wells decreases with an increase in the cuttings bed height, and the higher the displacementof drilling fluid, the faster the hydraulic extension declines. The annular pressure drop of the horizontalsection increases with the increase of the cuttings bed height, resulting in a higher bottom-hole pressure. Severalarguments are provided to guide the safe drilling of shale oil horizontal wells and overcome the limits of currenttechnological approaches.展开更多
BACKGROUND Ultrasound guide technology,which can provide real-time visualization of the needle tip and tissues and avoid many adverse events,is widely used in mini-mally invasive therapy.However,the studies on ultraso...BACKGROUND Ultrasound guide technology,which can provide real-time visualization of the needle tip and tissues and avoid many adverse events,is widely used in mini-mally invasive therapy.However,the studies on ultrasound-guided Lateral recess block(LRB)are limited,this is probably because there is no recognized standard method for ultrasound scanning.This study aimed to evaluate the effect of ultrasound-guided LRB in patients with lateral recess stenosis(LRS).CASE SUMMARY A 65-year-old patient complained of low back pain accompanied occasionally by pain and numbness in the left lower limb.Physical examination showed ten-derness on the spinous process and paraspinal muscles from L1 to S1,extensor hallucis longus and tibialis anterior weakness(muscle strength:4-),and a positive straight leg raising test in the left lower limb(60°).Magnetic resonance imaging showed L4–L5 disc degeneration with left LRS and nerve root entrapment.Subsequently,the patient was diagnosed with LRS.This patient was treated with a novel ultrasound-guided LRB approach.The patient’s symptoms significantly improved without any complications at 1 wk postoperatively and at the 3-month follow-up.CONCLUSION This is the first report on the LRS treatment with ultrasound-guided LRB from the contralateral spinous process along the inner side of the articular process by out-plane technique.Further studies are expected to investigate the efficacy and safety of ultrasound-guided LRB for patients with LRS.展开更多
BACKGROUND Percutaneous transhepatic stent placement has become a common strategy for the postoperative treatment of portal vein(PV)/superior mesenteric veins(SMV)stenosis/occlusion.It has been widely used after liver...BACKGROUND Percutaneous transhepatic stent placement has become a common strategy for the postoperative treatment of portal vein(PV)/superior mesenteric veins(SMV)stenosis/occlusion.It has been widely used after liver transplantation surgery;however,reports on stent placement for acute PV/SMV stenosis after pancreatic surgery within postoperative 3 d are rare.CASE SUMMARY Herein,we reported a case of intestinal edema and SMV stenosis 2 d after pancreatic surgery.The patient was successfully treated using stent grafts.Although the stenosis resolved after stent placement,complications,including bleeding,pancreatic fistula,bile leakage,and infection,made the treatment highly challenging.The use of anticoagulants was adjusted multiple times to prevent venous thromboembolism and the risk of bleeding.After careful treatment,the patient stabilized,and stent placement effectively managed postoperative PV/SMV stenosis.CONCLUSION Stent placement is effective and feasible for treating acute PV/SMV stenosis after pancreatic surgery even within postoperative 3 d.展开更多
Introduction: Endoscopic internal urethrotomy (EIU) is a method for stricture opening using transurethral incision by direct visualisation of the urethral channel, resulting in a widening of the urinary canal with the...Introduction: Endoscopic internal urethrotomy (EIU) is a method for stricture opening using transurethral incision by direct visualisation of the urethral channel, resulting in a widening of the urinary canal with the aim of improving the quality of bladder emptying. The aim of the study was to evaluate the indication and results of EIU in the treatment of stenosis of the male urethra in the Urology-Andrology Department of Kara Teaching Hospital. Methodology: This was a cross-sectional descriptive study with retrospective data collection in the Urology-Andrology department of Kara Teaching Hospital. It involved 21 records of patients with urethral stenosis treated by endoscopic internal urethrotomy (EIU) in the said department during the period from January 2021 to September 2023. The following variables were evaluated: age, circumstance of discovery, site, length, number, etiology of the urethral stenosis and evolution of the patients. Results: The mean age of the patients was 59.2 ± 11.7 years. Infectious etiology of stenosis was predominant with 10 patients (47.6%) followed by trauma with 5 cases (23.8%). The bulbar urethra was the most frequently observed site, with 11 cases (52.4%). The length was mostly less than 2 cm in 12 patients (57.1%). Stenosis was unique in 14 patients (66.7%). The mean postoperative follow-up time was 3.2 months. The result was immediately better in 11 patients (52.4%) and it was poor in 8 patients (38.1%) who required maintenance dilation sessions.展开更多
BACKGROUND At present,there is no unified and effective treatment for extreme corrosive esophageal stenosis(CES)with esophagotracheal fistula(ETF).This case had extreme and severe esophageal stenosis(ES)and ETF after ...BACKGROUND At present,there is no unified and effective treatment for extreme corrosive esophageal stenosis(CES)with esophagotracheal fistula(ETF).This case had extreme and severe esophageal stenosis(ES)and ETF after ingesting an enzyme-based chemical detergent,resulting in a serious pulmonary infection and severe malnutrition.Upper gastrointestinal imaging showed that he had an ETF,and endoscopy showed that he had extreme and severe esophageal stricture.This case was complex and difficult to treat.According to the domestic and foreign lite-rature,there is no universal treatment that is low-risk.CASE SUMMARY A patient came to our hospital with extreme ES,an ETF,and severe malnutrition complicated with pulmonary tuberculosis 1 mo after the consumption of an enzy-me-based detergent.The ES was serious,and the endoscope was unable to pass through the esophagus.We treated him by endoscopic incision method(EIM),esophageal stent placement(ESP),and endoscopic balloon dilation(EBD)by using the bronchoscope and gastroscope.This treatment not only closed the ETF,but also expanded the esophagus,with minimal trauma,greatly reducing the pain of the patient.According to the literature,there are no similar reported cases.CONCLUSION We report,for the first time,a patient with extreme CES complicated with ETF,where the endoscope could not be passed through his esophagus but he could be examined by bronchoscopy and treated by EIM,ESP,and EBD.展开更多
Non-uniform linear array(NULA)configurations are well renowned due to their structural ability for providing increased degrees of freedom(DOF)and wider array aperture than uniform linear arrays(ULAs).These characteris...Non-uniform linear array(NULA)configurations are well renowned due to their structural ability for providing increased degrees of freedom(DOF)and wider array aperture than uniform linear arrays(ULAs).These characteristics play a significant role in improving the direction-of-arrival(DOA)estimation accuracy.However,most of the existing NULA geometries are primarily applicable to circular sources(CSs),while they limitedly improve the DOF and continuous virtual aperture for noncircular sources(NCSs).Toward this purpose,we present a triaddisplaced ULAs(Tdis-ULAs)configuration for NCS.The TdisULAs structure generally consists of three ULAs,which are appropriately placed.The proposed antenna array approach fully exploits the non-circular characteristics of the sources.Given the same number of elements,the Tdis-ULAs design achieves more DOF and larger hole-free co-array aperture than its sparse array competitors.Advantageously,the number of uniform DOF,optimal distribution of elements among the ULAs,and precise element positions are uniquely determined by the closed-form expressions.Moreover,the proposed array also produces a filled resulting co-array.Numerical simulations are conducted to show the performance advantages of the proposed Tdis-ULAs configuration over its counterpart designs.展开更多
Degree of freedom(DOF)is a key indicator for spatial multiplexing layers of a wireless channel.Traditionally,the channel of a multiple-input multiple-output(MIMO)half-wavelength dipole array has a DOF that equals the ...Degree of freedom(DOF)is a key indicator for spatial multiplexing layers of a wireless channel.Traditionally,the channel of a multiple-input multiple-output(MIMO)half-wavelength dipole array has a DOF that equals the antenna number.However,recent studies suggest that the DOF could be less than the antenna number when strong mutual coupling is considered.We utilize a mutual-coupling-compliant channel model to investigate the DOF of the holographic MIMO(HMIMO)channel and give a upper bound of the DOF with strong mutual coupling.Our numerical simulations demonstrate that a dense array can support more DOF per unit aperture as compared with a half-wavelength MIMO system.展开更多
In order to reveal the complex network characteristics and evolution principle of China aviation network, the probability distribution and evolution trace of average degree of edge vertices of China aviation network w...In order to reveal the complex network characteristics and evolution principle of China aviation network, the probability distribution and evolution trace of average degree of edge vertices of China aviation network were studied based on the statistics data of China civil aviation network in 1988, 1994, 2001, 2008 and 2015. According to the theory and method of complex network, the network system was constructed with the city where the airport was located as the network node and the route between cities as the edge of the network. Based on the statistical data, the average degrees of edge vertices in China aviation network in 1988, 1994, 2001, 2008 and 2015 were calculated. Using the probability statistical analysis method and regression analysis approach, it was found that the average degree of edge vertices had the probability distribution of normal function and the position parameters and scale parameters of the probability distribution had linear evolution trace.展开更多
In order to reveal the complex network characteristics and evolution principle of China aviation network,the relationship between the node degree and the average path length of China aviation network in 1988,1994,2001...In order to reveal the complex network characteristics and evolution principle of China aviation network,the relationship between the node degree and the average path length of China aviation network in 1988,1994,2001,2008 and 2015 was studied.According to the theory and method of complex network,the network system was constructed with the city where the airport was located as the network node and the airline as the edge of the network.On the basis of the statistical data,the node average path length of China aviation network in 1988,1994,2001,2008 and 2015 was calculated.Through regression analysis,it was found that the node degree had a logarithmic relationship with the average length of node path,and the two parameters of the logarithmic relationship had linear evolutionary trace.Key word:China aviation network,complex network,node degree,average length of node path,logarithmic relationship,evolutionary trace.展开更多
Objective To evaluate the outcome of two methods for stabilization and fusion: posterolateral fusion and circumferential fusion involving posterior lumbar interbody fusion for lumbar stenosis with Grades 1 and 2 lumba...Objective To evaluate the outcome of two methods for stabilization and fusion: posterolateral fusion and circumferential fusion involving posterior lumbar interbody fusion for lumbar stenosis with Grades 1 and 2 lumbar spondylolisthesis.Methods From April 1998 to April 2003, 45 patients suffering from lumbar stenosis with low degree lumbar spondylolisthesis treated in our hospital were retrospectively reviewed and assigned to two groups.Among them, 24 patients (group A) were treated with instrumented posterolateral fusion and 21 patients (group B) with instrumented circumferential fusion.The two groups were compared for clinical and radiological outcomes.Results All patients were followed up for 12 to 72 months.In group A, results showed preoperative clinical symptoms disappeared completely in 12 of 24 patients, and pain relief was seen in 91.7% (22/24).Two cases suffered from residual symptoms.Twenty-two cases obtained complete reduction of olisthy vertebral bodies, and anatomical reduction rate was 91.7%.No infection or neurological complication occurred in this group.In group B, results showed preoperative clinical symptoms disappeared completely in 13 of 21 patients, and pain relief was seen in 90.5% (19/21).One case suffered from residual symptoms.Twenty cases obtained complete reduction of the olisthy vertebral bodies, and anatomical reduction rate was 95.2%.Four cases of infection or neurological complication occurred in this group.Both groups indicated no significant difference in clinical outcomes and anatomical reduction rate during follow-up.But group A had better intraoperative circumstances and postoperative outcome than group B, while group B had better postoperative parameters in X-ray of Angle of Slipping and Disc Index than group A.Conclusions The first choice of surgical method for lumbar stenosis with low degree lumbar spondylolisthesis is instrumented posterolateral fusion.Only when patients suffer from severe preoperative disc degeneration and low back pain or intervertebral instability should we consider indications for additional use of CAGE.展开更多
High degrees of freedom(DOF)for K^(+)movement in the electrolytes is desirable,because the resulting high ionic conductivity helps improve potassium-ion batteries,yet requiring support from highly free and flammable o...High degrees of freedom(DOF)for K^(+)movement in the electrolytes is desirable,because the resulting high ionic conductivity helps improve potassium-ion batteries,yet requiring support from highly free and flammable organic solvent molecules,seriously affecting battery safety.Here,we develop a K^(+)flux rectifier to trim K ion’s DOF to 1 and improve electrochemical properties.Although the ionic conductivity is compromised in the K^(+)flux rectifier,the overall electrochemical performance of PIBs was improved.An oxidation stability improvement from 4.0 to 5.9 V was realized,and the formation of dendrites and the dissolution of organic cathodes were inhibited.Consequently,the K||K cells continuously cycled over 3,700 h;K||Cu cells operated stably over 800 cycles with the Coulombic efficiency exceeding 99%;and K||graphite cells exhibited high-capacity retention over 74.7%after 1,500 cycles.Moreover,the 3,4,9,10-perylenetetracarboxylic diimide organic cathodes operated for more than 2,100 cycles and reached year-scale-cycling time.We fabricated a 2.18 Ah pouch cell with no significant capacity fading observed after 100 cycles.展开更多
The coronary arteries diseases are one of the most causes of mortality and morbidity worldwide, particularly in the developing countries. Coronary obstructions are generally described by location and severity of steno...The coronary arteries diseases are one of the most causes of mortality and morbidity worldwide, particularly in the developing countries. Coronary obstructions are generally described by location and severity of stenosis. Manual tracing and measurement of the stenosis vessel in comparison to reference location of stenosis can be helpful to classify whether a lesion is significant or not. The aim of this study is to identify the dominant type of circulation carried out in patients presented in heart institute and associated with degree of stenosis in RCA and LAD artery. Materials and Methods: This was a retrospective study carried out on patients reporting to Heart Institute from June 2013 to August 2013 (311 patients records as a total coverage were collected as sample) whose coronary artery angiography revealed pathology in coronary arteries. Result: The findings were 71.7% right dominant, 23.5% left dominant and 4.8% co-dominant;LAD tends to be stricture with right dominant circulation type. LAD artery tends to be stenosis at proximal and mid segment while in the RCA tends to be stenosis in mid and distal segments. The right dominant artery is popular type of circulation in Sudanese people reported in Sudan Heart Institute;there is no significance association between gender and arterial type of circulation and also degree stenosis in LAD degree of stenosis in RCA. I observed that the site of stenosis in LAD artery was proximal and mid (P value < 0.05 significance association). Conclusion: Patients present at the heart institute are right dominant mostly coming with proximal and middle LAD stenosis unlike RCA which commonly presents with distal and middle stenosis, so the middle segment of coronary artery is stenosis in both situations. There are wild variations in dominance artery in relation to reduction of diameter in deferent ethic group. There are no significant associations between the gender and dominant artery.展开更多
BACKGROUND:Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) can display the site of lumbar spinal stenosis and predict nervous compression at the morphological level; however,pure morphological changes ca...BACKGROUND:Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) can display the site of lumbar spinal stenosis and predict nervous compression at the morphological level; however,pure morphological changes cannot reflect functional alterations in a compressed nerve root. Dermatomal somatosensory evoked potential (DSEP) provides a means to assess the functional state of a nerve root. OBJECTIVE: To evaluate the clinical significance of DSEP,assessing the degree of nerve root injury following lumbar spinal stenosis. DESIGN,TIME AND SETTING: A case-control study was performed in the Department of Orthopaedic Surgery,Hainan People’s Hospital,China,between September 2004 and December 2007. PARTICIPANTS: Forty-seven patients diagnosed with lumbar spinal stenosis by CT or MRI were selected as the case group; fifty healthy subjects were collected as the control group. METHODS: A KEYPOINT myoelectric evoked potential apparatus (DANTEC Company,Denmark) was used to measure DSEP,and stimulative spots were determined in accordance with the skin key sensory spot standards established by The American Spinal Injury Association: L4 in the medial malleolus,L5 in the third metatarsophalangeal joint of the dorsum of foot and S1 in the lateral heel. The needle electrode used as the recording electrode was located at the Cz point of the cranium,and the reference electrode at the Fz point. MAIN OUTCOME MEASURES: Latency of the P40 peak of DSEP,P1-N1 amplitude,P40 waveform and differentiation and disappearance of various waves. RESULTS: The sensitivity and diagnostic concurrence with surgery of nerve root injury following lumbar spinal stenosis evaluated by DSEP was 95.7 %. P40 latencies at L4,L5 and S1 in the case group were significantly longer than in the control group (P<0.05),and the P1-N1 amplitude in the case group was significantly lower than the control group (P<0.05-0.01). Nerve root injury was categorized according to DSEP latency as follows: severe damage (disappearance of the P40 wave in 103 dermatomes),moderate damage (prolongation of the P40 peak latency ≥ 3.0 times the standard deviation of the normal mean in 60 dermatomes) and mild damage (prolongation of the P40 peak latency ≥ 2.5 times the standard deviation of the normal mean in 31 dermatomes). CONCLUSION: DSEP can be used to determine the severity of nerve root injury following lumbar spinal stenosis with high sensitivity and specificity.展开更多
Based on the biological heat transfer equation of Penne,the internal temperature distribution of the biological tissue was studied,taking into account the evolution of stenosis and hematocrit.The one-dimensional simpl...Based on the biological heat transfer equation of Penne,the internal temperature distribution of the biological tissue was studied,taking into account the evolution of stenosis and hematocrit.The one-dimensional simplifying cylindrical heat equation of the biological living tissues in permanent regime was solved by the FDM(finite difference method)and analytically,to assess the temperature change under the variation of stenosis,hematocrit,K(thermal conductivity),kinematic viscosity,generation of metabolic heat and the heat transfer coefficient.The main results show that the temperature increases as the stenosis and hematocrit increase in size;and the secondary results show that the heat transfer coefficient and the K lower the body temperature while metabolic heat generation increases body temperature.This is in accordance with the literature.展开更多
BACKGROUND Intracranial and extracranial artery stenosis is associated with cerebral infarction.Vascular calcification and atherosclerosis are the main causes of stenosis and major risk factors for cardiovascular and ...BACKGROUND Intracranial and extracranial artery stenosis is associated with cerebral infarction.Vascular calcification and atherosclerosis are the main causes of stenosis and major risk factors for cardiovascular and cerebrovascular events in patients with type 2 diabetes mellitus(T2DM).Bone turnover biomarkers(BTMs)are associated with vascular calcification,atherosclerosis,glucose,and lipid metabolism.AIM To investigate the association of circulating BTM levels with severe intracranial and extracranial artery stenosis in patients with T2DM.METHODS For this cross-sectional study including 257 T2DM patients,levels of the BTMs serum osteocalcin(OC),C-terminal cross-linked telopeptide of type I collagen(CTX),and procollagen type I N-peptide were measured by electrical chemiluminescent immunoassay,and artery stenosis was assessed by color Doppler and transcranial Doppler.Patients were grouped according to the existence and location(intracranial vs.extracranial)of artery stenosis.Correlations between BTM levels,previous stroke,stenosis location,and glucose and lipid metabolism were analyzed.RESULTS T2DM patients with severe artery stenosis had a higher frequency of previous stroke and levels of all three tested BTMs(all P<0.05)than patients without.Some differences in OC and CTX levels were observed according to the location of artery stenosis.Significant associations were also observed between BTM levels and some glucose and lipid homeostasis parameters.On multivariate logistic regression analysis,all BTMs were significant predictors of artery stenosis in T2DM patients with and without adjustment for confounding factors(all P<0.001),and receiver operating characteristic curve analysis demonstrated the ability of BTM levels to predict artery stenosis in T2DM patients.CONCLUSION BTM levels were found to be independent risk factors for severe intracranial and extracranial artery stenosis and were differentially associated with glucose and lipid metabolism in patients with T2DM.Therefore,BTMs may be promising biomarkers and potential therapeutic targets for artery stenosis.展开更多
文摘Background: For decades, traditional open surgical techniques were used to treat lumbar disc herniation and lumbar canal stenosis (LCS). However, seeking for better outcomes for patients and avoiding extensive bony loss with its sequences had raised minimally invasive technique for treating these disorders as an alternative surgery. Methods: This is a retrospective study in which 54 patients of LCS were operated upon via unilateral minimally invasive technique to decompress the canal in a 360 degrees fashion through laminotomy, deroofing of opposite laminar side, sublaminar ligamintectomy, bilateral foraminotomies and discectomy. We used VAS scores and ODI to assess clinical outcomes with a period of one year follow-up. Results: Our results demonstrated that minimally invasive techniques for treating these disorders are effective procedures. Minimally invasive 360 degrees decompression for treating LCS had better outcomes regarding postoperative back pain, smaller incisions, less bony loss and early ambulation. Conclusion: Minimally invasive techniques for treating lumbar canal stenosis of different causes could be considered a better option instead of traditional full laminectomy with better outcomes as regards respecting the anatomical layers such as posterior spinal integrity and musculature, postoperative pain, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods.
基金supported by CAMS Innovation Fund for Medical Sciences(CIFMS)(2022–12M-C&TB-043).
文摘BACKGROUND The recently introduced ultrasonic flow ratio(UFR),is a novel fast computational method to derive fractional flow reserve(FFR)from intravascular ultrasound(IVUS)images.In the present study,we evaluate the diagnostic performance of UFR in patients with intermediate left main(LM)stenosis.METHODS This is a prospective,single center study enrolling consecutive patients with presence of intermediated LM lesions(diameter stenosis of 30%-80%by visual estimation)underwent IVUS and FFR measurement.An independent core laboratory assessed offline UFR and IVUS-derived minimal lumen area(MLA)in a blinded fashion.RESULTS Both UFR and FFR were successfully achieved in 41 LM patients(mean age,62.0±9.9 years,46.3%diabetes).An acceptable correlation between UFR and FFR was identified(r=0.688,P<0.0001),with an absolute numerical difference of 0.03(standard difference:0.01).The area under the curve(AUC)in diagnosis of physiologically significant coronary stenosis for UFR was 0.94(95%CI:0.87-1.01),which was significantly higher than angiographic identified stenosis>50%(AUC=0.66,P<0.001)and numerically higher than IVUS-derived MLA(AUC=0.82;P=0.09).Patient level diagnostic accuracy,sensitivity and specificity for UFR to identify FFR≤0.80 was 82.9%(95%CI:70.2-95.7),93.1%(95%CI:82.2-100.0),58.3%(95%CI:26.3-90.4),respectively.CONCLUSION In patients with intermediate LM diseases,UFR was proved to be associated with acceptable correlation and high accuracy with pressure wire-based FFR as standard reference.The present study supports the use of UFR for functional evaluation of intermediate LM stenosis.
文摘Aortic stenosis(AS)stands out as the most prevalent individual valvular defect globally.The onset and progression of AS mirror an active process akin to atherosclerosis,and the traditional triad of symptoms includes chest pain,breathlessness,and loss of consciousness.Prognosis takes a significant downturn when symptoms manifest,with mortality reaching approximately 50%-85% within the subsequent 5 years after symptom onset.
基金the financial support received from The Key Project of R&D Program of Ningxia Hui Autonomous Region,China(2022BBF01003)China Agriculture Research System of MOF and MARA(CARS-29).
文摘Aging in oak barrels is widely used in enology which could bring flavor changes and aromatic complexity to wines.In the present study,the aroma compounds were analyzed from the‘Merlot’dry red wines,which were fermented in two types of fermenters(stainless steel tank and rotated oak barrel)and aged in six types of oak barrels(three geographic origins×two toasting degrees)for different time(0,3,6 and 9 months,respectively).Results showed that 30 volatiles were associated with barrels and increased during oak aging.The fermenters could influence the intensities of the toast,leathery,smoky,fruity,floral and caramel aromas.The concentration of whisky lactone,eugenol,cis-isoeugenol,and the intensities of the toast and spicy aromas were highest in the wines aged in American oak and were lowest in the wines aged in French oak barrels.The concentrations of guaiacol,syringol,trans-isoeugenol,furfural alcohol,vanilla,cis-whisky lactone enabled the medium toasting barrels to be distinguished from the light toasting ones.The compounds originating from the barrels could be used to distinguish the types of different barrels,but the other general grape-derived and fermentation-derived volatiles could not.The fermenters,oak species and toasting degrees of the barrels all had significant effects on the aroma profiles of the aged‘Merlot’dry red wines,but the influence of the geographic origin was not obvious.
基金supported by the National Natural Science Foundation of China (51906133).
文摘This study presents a proposed method for assessing the condition and predicting the future status of condensers operating in seawater over an extended period.The aim is to address the problems of scaling and corrosion,which lead to increased loss of cold resources.The method involves utilising a set of multivariate feature parameters associated with the condenser as input for evaluation and trend prediction.This methodology offers a precise means of determining the optimal timing for condenser cleaning,with the ultimate goal of improving its overall performance.The proposed approach involves the integration of the analytic network process with subjective expert experience and the entropy weightmethod with objective big data analysis to develop a fusion health degreemodel.The mathematical model is constructed quantitatively using the improved Mahalanobis distance.Furthermore,a comprehensive prediction model is developed by integrating the improved Informer model and Markov error correction.This model takes into account the health status of the equipment and several influencing factors,includingmultivariate feature characteristics.This model facilitates the objective examination and prediction of the progression of equipment deterioration trends.The present study involves the computation and verification of the field time series data,which serves to demonstrate the accuracy of the condenser health-related models proposed in this research.These models effectively depict the real condition and temporal variations of the equipment,thus offering a valuable method for determining the precise cleaning time required for the condenser.
基金supported by CNPC Key Core Technology Research Projects (2022ZG06)project funded by China Postdoctoral Science Foundation (2021M693508)Basic research and strategic reserve technology research fund project of institutes directly under CNPC.
文摘The efficient development and exploitation of shale oil depends on long-distance horizontal wells. As the degreeof cleaning of the wellbore plays a key role in these processes, in this study, this problem is investigated experimentallyby focusing on the dimensionless cuttings bed height. A method is proposed to calculate the horizontalwellhydraulic extension taking into account the influence of the wellbore cleaning degree on the wellborepressure distribution and assess the effect of a variety of factors such as the bottom hole pressure, the circulatingpressure drop, the drilling pump performance and the formation properties. The analysis shows that the hydraulicextension of horizontal wells decreases with an increase in the cuttings bed height, and the higher the displacementof drilling fluid, the faster the hydraulic extension declines. The annular pressure drop of the horizontalsection increases with the increase of the cuttings bed height, resulting in a higher bottom-hole pressure. Severalarguments are provided to guide the safe drilling of shale oil horizontal wells and overcome the limits of currenttechnological approaches.
基金Supported by the National Natural Science Foundation of China,No.82305380The Postdoctoral Research Program,West China Hospital,Sichuan University,No.2020HXBH018.
文摘BACKGROUND Ultrasound guide technology,which can provide real-time visualization of the needle tip and tissues and avoid many adverse events,is widely used in mini-mally invasive therapy.However,the studies on ultrasound-guided Lateral recess block(LRB)are limited,this is probably because there is no recognized standard method for ultrasound scanning.This study aimed to evaluate the effect of ultrasound-guided LRB in patients with lateral recess stenosis(LRS).CASE SUMMARY A 65-year-old patient complained of low back pain accompanied occasionally by pain and numbness in the left lower limb.Physical examination showed ten-derness on the spinous process and paraspinal muscles from L1 to S1,extensor hallucis longus and tibialis anterior weakness(muscle strength:4-),and a positive straight leg raising test in the left lower limb(60°).Magnetic resonance imaging showed L4–L5 disc degeneration with left LRS and nerve root entrapment.Subsequently,the patient was diagnosed with LRS.This patient was treated with a novel ultrasound-guided LRB approach.The patient’s symptoms significantly improved without any complications at 1 wk postoperatively and at the 3-month follow-up.CONCLUSION This is the first report on the LRS treatment with ultrasound-guided LRB from the contralateral spinous process along the inner side of the articular process by out-plane technique.Further studies are expected to investigate the efficacy and safety of ultrasound-guided LRB for patients with LRS.
基金Supported by the National Natural Science Foundation of China,No.82173074the Beijing Natural Science Foundation,No.7232127+3 种基金the National High Level Hospital Clinical Research Funding,No.2022-PUMCH-D-001 and No.2022-PUMCH-B-004the CAMS Innovation Fund for Medical Sciences,No.2021-I2M-1-002the Nonprofit Central Research Institute Fund of Chinese Academy of Medical Sciences,No.2018PT32014Fundamental Research Funds for the Central Universities,No.3332019025.
文摘BACKGROUND Percutaneous transhepatic stent placement has become a common strategy for the postoperative treatment of portal vein(PV)/superior mesenteric veins(SMV)stenosis/occlusion.It has been widely used after liver transplantation surgery;however,reports on stent placement for acute PV/SMV stenosis after pancreatic surgery within postoperative 3 d are rare.CASE SUMMARY Herein,we reported a case of intestinal edema and SMV stenosis 2 d after pancreatic surgery.The patient was successfully treated using stent grafts.Although the stenosis resolved after stent placement,complications,including bleeding,pancreatic fistula,bile leakage,and infection,made the treatment highly challenging.The use of anticoagulants was adjusted multiple times to prevent venous thromboembolism and the risk of bleeding.After careful treatment,the patient stabilized,and stent placement effectively managed postoperative PV/SMV stenosis.CONCLUSION Stent placement is effective and feasible for treating acute PV/SMV stenosis after pancreatic surgery even within postoperative 3 d.
文摘Introduction: Endoscopic internal urethrotomy (EIU) is a method for stricture opening using transurethral incision by direct visualisation of the urethral channel, resulting in a widening of the urinary canal with the aim of improving the quality of bladder emptying. The aim of the study was to evaluate the indication and results of EIU in the treatment of stenosis of the male urethra in the Urology-Andrology Department of Kara Teaching Hospital. Methodology: This was a cross-sectional descriptive study with retrospective data collection in the Urology-Andrology department of Kara Teaching Hospital. It involved 21 records of patients with urethral stenosis treated by endoscopic internal urethrotomy (EIU) in the said department during the period from January 2021 to September 2023. The following variables were evaluated: age, circumstance of discovery, site, length, number, etiology of the urethral stenosis and evolution of the patients. Results: The mean age of the patients was 59.2 ± 11.7 years. Infectious etiology of stenosis was predominant with 10 patients (47.6%) followed by trauma with 5 cases (23.8%). The bulbar urethra was the most frequently observed site, with 11 cases (52.4%). The length was mostly less than 2 cm in 12 patients (57.1%). Stenosis was unique in 14 patients (66.7%). The mean postoperative follow-up time was 3.2 months. The result was immediately better in 11 patients (52.4%) and it was poor in 8 patients (38.1%) who required maintenance dilation sessions.
文摘BACKGROUND At present,there is no unified and effective treatment for extreme corrosive esophageal stenosis(CES)with esophagotracheal fistula(ETF).This case had extreme and severe esophageal stenosis(ES)and ETF after ingesting an enzyme-based chemical detergent,resulting in a serious pulmonary infection and severe malnutrition.Upper gastrointestinal imaging showed that he had an ETF,and endoscopy showed that he had extreme and severe esophageal stricture.This case was complex and difficult to treat.According to the domestic and foreign lite-rature,there is no universal treatment that is low-risk.CASE SUMMARY A patient came to our hospital with extreme ES,an ETF,and severe malnutrition complicated with pulmonary tuberculosis 1 mo after the consumption of an enzy-me-based detergent.The ES was serious,and the endoscope was unable to pass through the esophagus.We treated him by endoscopic incision method(EIM),esophageal stent placement(ESP),and endoscopic balloon dilation(EBD)by using the bronchoscope and gastroscope.This treatment not only closed the ETF,but also expanded the esophagus,with minimal trauma,greatly reducing the pain of the patient.According to the literature,there are no similar reported cases.CONCLUSION We report,for the first time,a patient with extreme CES complicated with ETF,where the endoscope could not be passed through his esophagus but he could be examined by bronchoscopy and treated by EIM,ESP,and EBD.
基金supported by the National Natural Science Foundation of China(62031017,61971221)the Fundamental Research Funds for the Central Universities of China(NP2020104)。
文摘Non-uniform linear array(NULA)configurations are well renowned due to their structural ability for providing increased degrees of freedom(DOF)and wider array aperture than uniform linear arrays(ULAs).These characteristics play a significant role in improving the direction-of-arrival(DOA)estimation accuracy.However,most of the existing NULA geometries are primarily applicable to circular sources(CSs),while they limitedly improve the DOF and continuous virtual aperture for noncircular sources(NCSs).Toward this purpose,we present a triaddisplaced ULAs(Tdis-ULAs)configuration for NCS.The TdisULAs structure generally consists of three ULAs,which are appropriately placed.The proposed antenna array approach fully exploits the non-circular characteristics of the sources.Given the same number of elements,the Tdis-ULAs design achieves more DOF and larger hole-free co-array aperture than its sparse array competitors.Advantageously,the number of uniform DOF,optimal distribution of elements among the ULAs,and precise element positions are uniquely determined by the closed-form expressions.Moreover,the proposed array also produces a filled resulting co-array.Numerical simulations are conducted to show the performance advantages of the proposed Tdis-ULAs configuration over its counterpart designs.
基金supported in part by National Key Research and Develop⁃ment Program of China under Grant No.2020YFB1807600.
文摘Degree of freedom(DOF)is a key indicator for spatial multiplexing layers of a wireless channel.Traditionally,the channel of a multiple-input multiple-output(MIMO)half-wavelength dipole array has a DOF that equals the antenna number.However,recent studies suggest that the DOF could be less than the antenna number when strong mutual coupling is considered.We utilize a mutual-coupling-compliant channel model to investigate the DOF of the holographic MIMO(HMIMO)channel and give a upper bound of the DOF with strong mutual coupling.Our numerical simulations demonstrate that a dense array can support more DOF per unit aperture as compared with a half-wavelength MIMO system.
文摘In order to reveal the complex network characteristics and evolution principle of China aviation network, the probability distribution and evolution trace of average degree of edge vertices of China aviation network were studied based on the statistics data of China civil aviation network in 1988, 1994, 2001, 2008 and 2015. According to the theory and method of complex network, the network system was constructed with the city where the airport was located as the network node and the route between cities as the edge of the network. Based on the statistical data, the average degrees of edge vertices in China aviation network in 1988, 1994, 2001, 2008 and 2015 were calculated. Using the probability statistical analysis method and regression analysis approach, it was found that the average degree of edge vertices had the probability distribution of normal function and the position parameters and scale parameters of the probability distribution had linear evolution trace.
文摘In order to reveal the complex network characteristics and evolution principle of China aviation network,the relationship between the node degree and the average path length of China aviation network in 1988,1994,2001,2008 and 2015 was studied.According to the theory and method of complex network,the network system was constructed with the city where the airport was located as the network node and the airline as the edge of the network.On the basis of the statistical data,the node average path length of China aviation network in 1988,1994,2001,2008 and 2015 was calculated.Through regression analysis,it was found that the node degree had a logarithmic relationship with the average length of node path,and the two parameters of the logarithmic relationship had linear evolutionary trace.Key word:China aviation network,complex network,node degree,average length of node path,logarithmic relationship,evolutionary trace.
文摘Objective To evaluate the outcome of two methods for stabilization and fusion: posterolateral fusion and circumferential fusion involving posterior lumbar interbody fusion for lumbar stenosis with Grades 1 and 2 lumbar spondylolisthesis.Methods From April 1998 to April 2003, 45 patients suffering from lumbar stenosis with low degree lumbar spondylolisthesis treated in our hospital were retrospectively reviewed and assigned to two groups.Among them, 24 patients (group A) were treated with instrumented posterolateral fusion and 21 patients (group B) with instrumented circumferential fusion.The two groups were compared for clinical and radiological outcomes.Results All patients were followed up for 12 to 72 months.In group A, results showed preoperative clinical symptoms disappeared completely in 12 of 24 patients, and pain relief was seen in 91.7% (22/24).Two cases suffered from residual symptoms.Twenty-two cases obtained complete reduction of olisthy vertebral bodies, and anatomical reduction rate was 91.7%.No infection or neurological complication occurred in this group.In group B, results showed preoperative clinical symptoms disappeared completely in 13 of 21 patients, and pain relief was seen in 90.5% (19/21).One case suffered from residual symptoms.Twenty cases obtained complete reduction of the olisthy vertebral bodies, and anatomical reduction rate was 95.2%.Four cases of infection or neurological complication occurred in this group.Both groups indicated no significant difference in clinical outcomes and anatomical reduction rate during follow-up.But group A had better intraoperative circumstances and postoperative outcome than group B, while group B had better postoperative parameters in X-ray of Angle of Slipping and Disc Index than group A.Conclusions The first choice of surgical method for lumbar stenosis with low degree lumbar spondylolisthesis is instrumented posterolateral fusion.Only when patients suffer from severe preoperative disc degeneration and low back pain or intervertebral instability should we consider indications for additional use of CAGE.
基金supported by the National Natural Science Foundation of China(Nos.U20A20247 and 51922038).A.M.R.acknowledges the seed funding provided by the R.A.Bowen Endowed Professorship funds at Clemson University.
文摘High degrees of freedom(DOF)for K^(+)movement in the electrolytes is desirable,because the resulting high ionic conductivity helps improve potassium-ion batteries,yet requiring support from highly free and flammable organic solvent molecules,seriously affecting battery safety.Here,we develop a K^(+)flux rectifier to trim K ion’s DOF to 1 and improve electrochemical properties.Although the ionic conductivity is compromised in the K^(+)flux rectifier,the overall electrochemical performance of PIBs was improved.An oxidation stability improvement from 4.0 to 5.9 V was realized,and the formation of dendrites and the dissolution of organic cathodes were inhibited.Consequently,the K||K cells continuously cycled over 3,700 h;K||Cu cells operated stably over 800 cycles with the Coulombic efficiency exceeding 99%;and K||graphite cells exhibited high-capacity retention over 74.7%after 1,500 cycles.Moreover,the 3,4,9,10-perylenetetracarboxylic diimide organic cathodes operated for more than 2,100 cycles and reached year-scale-cycling time.We fabricated a 2.18 Ah pouch cell with no significant capacity fading observed after 100 cycles.
文摘The coronary arteries diseases are one of the most causes of mortality and morbidity worldwide, particularly in the developing countries. Coronary obstructions are generally described by location and severity of stenosis. Manual tracing and measurement of the stenosis vessel in comparison to reference location of stenosis can be helpful to classify whether a lesion is significant or not. The aim of this study is to identify the dominant type of circulation carried out in patients presented in heart institute and associated with degree of stenosis in RCA and LAD artery. Materials and Methods: This was a retrospective study carried out on patients reporting to Heart Institute from June 2013 to August 2013 (311 patients records as a total coverage were collected as sample) whose coronary artery angiography revealed pathology in coronary arteries. Result: The findings were 71.7% right dominant, 23.5% left dominant and 4.8% co-dominant;LAD tends to be stricture with right dominant circulation type. LAD artery tends to be stenosis at proximal and mid segment while in the RCA tends to be stenosis in mid and distal segments. The right dominant artery is popular type of circulation in Sudanese people reported in Sudan Heart Institute;there is no significance association between gender and arterial type of circulation and also degree stenosis in LAD degree of stenosis in RCA. I observed that the site of stenosis in LAD artery was proximal and mid (P value < 0.05 significance association). Conclusion: Patients present at the heart institute are right dominant mostly coming with proximal and middle LAD stenosis unlike RCA which commonly presents with distal and middle stenosis, so the middle segment of coronary artery is stenosis in both situations. There are wild variations in dominance artery in relation to reduction of diameter in deferent ethic group. There are no significant associations between the gender and dominant artery.
基金the National Natural Science Foundation of Hainan Province,No.30318
文摘BACKGROUND:Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) can display the site of lumbar spinal stenosis and predict nervous compression at the morphological level; however,pure morphological changes cannot reflect functional alterations in a compressed nerve root. Dermatomal somatosensory evoked potential (DSEP) provides a means to assess the functional state of a nerve root. OBJECTIVE: To evaluate the clinical significance of DSEP,assessing the degree of nerve root injury following lumbar spinal stenosis. DESIGN,TIME AND SETTING: A case-control study was performed in the Department of Orthopaedic Surgery,Hainan People’s Hospital,China,between September 2004 and December 2007. PARTICIPANTS: Forty-seven patients diagnosed with lumbar spinal stenosis by CT or MRI were selected as the case group; fifty healthy subjects were collected as the control group. METHODS: A KEYPOINT myoelectric evoked potential apparatus (DANTEC Company,Denmark) was used to measure DSEP,and stimulative spots were determined in accordance with the skin key sensory spot standards established by The American Spinal Injury Association: L4 in the medial malleolus,L5 in the third metatarsophalangeal joint of the dorsum of foot and S1 in the lateral heel. The needle electrode used as the recording electrode was located at the Cz point of the cranium,and the reference electrode at the Fz point. MAIN OUTCOME MEASURES: Latency of the P40 peak of DSEP,P1-N1 amplitude,P40 waveform and differentiation and disappearance of various waves. RESULTS: The sensitivity and diagnostic concurrence with surgery of nerve root injury following lumbar spinal stenosis evaluated by DSEP was 95.7 %. P40 latencies at L4,L5 and S1 in the case group were significantly longer than in the control group (P<0.05),and the P1-N1 amplitude in the case group was significantly lower than the control group (P<0.05-0.01). Nerve root injury was categorized according to DSEP latency as follows: severe damage (disappearance of the P40 wave in 103 dermatomes),moderate damage (prolongation of the P40 peak latency ≥ 3.0 times the standard deviation of the normal mean in 60 dermatomes) and mild damage (prolongation of the P40 peak latency ≥ 2.5 times the standard deviation of the normal mean in 31 dermatomes). CONCLUSION: DSEP can be used to determine the severity of nerve root injury following lumbar spinal stenosis with high sensitivity and specificity.
文摘Based on the biological heat transfer equation of Penne,the internal temperature distribution of the biological tissue was studied,taking into account the evolution of stenosis and hematocrit.The one-dimensional simplifying cylindrical heat equation of the biological living tissues in permanent regime was solved by the FDM(finite difference method)and analytically,to assess the temperature change under the variation of stenosis,hematocrit,K(thermal conductivity),kinematic viscosity,generation of metabolic heat and the heat transfer coefficient.The main results show that the temperature increases as the stenosis and hematocrit increase in size;and the secondary results show that the heat transfer coefficient and the K lower the body temperature while metabolic heat generation increases body temperature.This is in accordance with the literature.
基金Supported by Beijing Municipal Hospital Management Center“Cultivation Plan”,No.PX2022032.
文摘BACKGROUND Intracranial and extracranial artery stenosis is associated with cerebral infarction.Vascular calcification and atherosclerosis are the main causes of stenosis and major risk factors for cardiovascular and cerebrovascular events in patients with type 2 diabetes mellitus(T2DM).Bone turnover biomarkers(BTMs)are associated with vascular calcification,atherosclerosis,glucose,and lipid metabolism.AIM To investigate the association of circulating BTM levels with severe intracranial and extracranial artery stenosis in patients with T2DM.METHODS For this cross-sectional study including 257 T2DM patients,levels of the BTMs serum osteocalcin(OC),C-terminal cross-linked telopeptide of type I collagen(CTX),and procollagen type I N-peptide were measured by electrical chemiluminescent immunoassay,and artery stenosis was assessed by color Doppler and transcranial Doppler.Patients were grouped according to the existence and location(intracranial vs.extracranial)of artery stenosis.Correlations between BTM levels,previous stroke,stenosis location,and glucose and lipid metabolism were analyzed.RESULTS T2DM patients with severe artery stenosis had a higher frequency of previous stroke and levels of all three tested BTMs(all P<0.05)than patients without.Some differences in OC and CTX levels were observed according to the location of artery stenosis.Significant associations were also observed between BTM levels and some glucose and lipid homeostasis parameters.On multivariate logistic regression analysis,all BTMs were significant predictors of artery stenosis in T2DM patients with and without adjustment for confounding factors(all P<0.001),and receiver operating characteristic curve analysis demonstrated the ability of BTM levels to predict artery stenosis in T2DM patients.CONCLUSION BTM levels were found to be independent risk factors for severe intracranial and extracranial artery stenosis and were differentially associated with glucose and lipid metabolism in patients with T2DM.Therefore,BTMs may be promising biomarkers and potential therapeutic targets for artery stenosis.
