AB0933 Development and Validation of a Nomogram for Prediction of Nonalcoholic Fatty Liver Disease in Psoriatic arthritis

Background

Psoriatic arthritis (PsA) has been linked to an increased risk of metabolic syndrome (MetS). Non-alcoholic fatty liver disease (NAFLD), the hepatic manifestation of MetS, is now the commonest liver disease worldwide. About 65% of PsA patients suffer from NAFLD, and chronic systemic inflammation may be an important predisposing factor.

Objectives

The purpose of this study was to establish and validate a diagnostic model nomogram for predicting the occurrence of NAFLD in patients with PsA.

Methods

A total of 127 PsA patients (46 had NAFLD and 81 had no NAFLD) were enrolled in this study. Retrospectively collected clinical and serological parameters of these patients. The percentage and absolute number of lymphocytes and CD4+T cells were determined by Flow cytometry. The independent risk factors for NAFLD were screened in the PsA patients using univariate and multivariate binary logistic regression analyses and were used for construction of the nomogram prediction model. The AUROC (C index) was used to verify the model discrimination; the calibration curve and Hosmer-Lemeshow test were used to verify the model calibration; and the DCA curve was used to verify the clinical validity of the model.

Results

Univariate and multivariate logistic regression analyses showed that Body Mass Index (BMI) (OR=1.25, P=0.001), serum triglyceride (TG) (OR=3.51，P=0.015) and peripheral blood Th1 cell percentage (OR=1.12, P < 0.001) is an independent risk factor for NAFLD in PsA patients, and an individualized nomogram prediction model was successfully established. The prediction model had a good discrimination power with AUROC (C-index) of 0.83 (95% CI: 0.76-0.90); the P value in the Hosmer-Lemeshow test was 0.683, suggesting a high reliability of the predicted probability by the model; the DCA curve indicating a good clinical efficiency of the model.

Conclusion

Our study shows that the establishment of a nomogram prediction model of PsA complicated with NAFLD patients is helpful for early clinical screening and identification of such high-risk patients.

Figure 1.

A. Example of prediction nomogram for risk of PsA complicated with NAFLD patients; B. The ROC curve of the prediction model; C. The calibration curve of the prediction model; D. The decision curve analysis of the prediction model.

Disclosure of Interests

None declared

AB0506 PRELIMINARY STUDY ON IMBALANCE BETWEEN Th17 AND REGULATORY T CELLS IN ANTIPHOSPHOLIPID SYNDROME

Background

Antiphospholipid syndrome (APS) is a typical autoimmune disease, which can be classified into primary antiphospholipid syndrome (PAPS) and secondary antiphospholipid syndrome (SAPS) based on the presence or not of other autoimmune diseases. Disorders of peripheral blood lymphocyte and CD4+T cell subsets, especially Th17 and Treg cell subsets, may be involved in the pathogenesis of APS.

Objectives

To investigate the differences of peripheral blood lymphocyte and CD4+T cell subsets between patients with primary and secondary antiphospholipid syndrome and healthy controls, and to evaluate the correlation of antiphospholipid antibody titers and Th17/Treg values in PAPS and SAPS groups, as well as the correlation of cytokines and clinical characteristics in APS patients.

Methods

A total of 67 APS patients (12 PAPS patients, 55 SAPS patients) and 40 healthy controls were enrolled in this study. Retrospectively collected clinical and laboratory data of these patients. The absolute numbers of peripheral blood lymphocyte subsets and CD4+ T cell subsets were detected by flow cytometry, and serum cytokine levels were detected by flow cytometry bead array.

Results

Compared with healthy control group, the absolute values of T [689.26 vs. 1239.00, p＜0.001], B (104.69 vs. 177.50, p＜0.001), NK (98.97 vs. 300.00, p＜0.001) and CD4+T (330.16 vs. 628.50, p＜0.001) cells in SAPS group were decreased. While only the NK cells (151.30 vs. 300.00, p＝0.002) in the PAPS group were lower than that in healthy control group. However, the absolute values of T (1295.41 vs. 689.26, p＝0.001), B (184.44 vs. 104.69, p＝0.012), NK (151.30 vs. 98.97, p＝0.023) and CD4+T cells (698.34 vs. 330.16, p＝0.002) in PAPS group were significantly higher than those in SAPS group. For CD4+T cell subsets, PAPS patients and SAPS patients showed the same trend compared with healthy controls, showing increased Th1(111.50 vs. 23.47, p=0.002 and 71.43 vs. 23.47, p=0.001, respectively), decreased Th2(6.97vs.12.43, p=0.037 and 2.49 vs. 12.43, p＜0.001, respectively) and, more importantly, decreased Treg (18.77 vs. 29.53, p=0.031 and 12.01 vs. 29.53, p＜0.001, respectively), with increased Th17/Treg ratio (0.39 vs. 0.17, p=0.001 and 0.42 vs. 0.17, p＜0.001, respectively). Meanwhile, Th2(6.97 vs. 2.46, p＝0.006), Th17 (8.42 vs. 4.00, p＝0.042) and Treg (18.77 vs. 12.01, p＝0.020) cells in PAPS group were higher than those in SAPS group. As for the correlation study, we concluded that both aCL (r=0.6061, p=0.0405) and aβ2GPI (r=0.6900, p=0.0158) were positively correlated to Th17/Treg ratio in PAPS group. In addition, for APS patients, IL-2 (r=-0.420, p=0.010), IL-4 (r=-0.392, p=0.016), IL-10 (r=-0.331, p=-0.046), IL-17 (r=-0.479, p=0.006), and IFN-γ (r=-0.339, p=0.040) were negatively correlated with titers of aCL. And IL-6 is also associated with ESR (r=0.469, p=0.004) and CRP (r=0.670, p＜0.001).

Conclusion

Whether PAPS or SAPS patients, detection and balancing of lymphocyte and CD4+T subsets, especially Th17 and Treg subsets, may help correct immune disorders. Of course, the immune function of primary and secondary APS patients is not completely consistent, at least in terms of immune cells. Also, the role of cytokines in the pathogenesis of APS should not be ignored.

Figure 1.

Comparison of lymphocyte absolute values and CD4+ T cell subsets in PAPS group, SAPS group and healthy control group.

Figure 2.

The correlation analysis between the value of Th17/Treg and the titer of aCL and aβ2GPI in PAPS group and SAPS group, respectively.

Figure 3.

Heatmap of correlation of the serum cytokine levels of a variety of cytokines with clinical and laboratory characteristics of APS patients.

Disclosure of Interests

None declared

AB1073 HIGH INCIDENCE OF VIRUSES INFECTION IN CONNECTIVE TISSUE DISEASES PATIENTS

Background

Connective tissue diseases (CTDs) are a group of diseases with a variety of clinical manifestations. The main drug was glucocorticoids and immunosuppressive drugs, but the results are not satisfactory and the side effects are obvious, increased the incidence of infection, especially opportunistic infections. Infections becomes important causes of morbidity and mortality in CTD patients.

Objectives

To evaluate the incidence of infection in CTD patients who were clinically considered for co-infection by a combination of metagenomic next-generation sequencing (mNGS) and conventional diagnostic testing methods.

Methods

We analyzed 126 connective tissue diseases (CTD)patients with suspected infections admitted to The Second Hospital of Shanxi Medical University. All patients with CTD were diagnosed according to relevant diagnostic criteria, including 34 systemic lupus erythematosus (SLE), 24 dermatomyositis and polymyositis (DM/PM), 19 rheumatoid arthritis (RA), 10 undifferentiated connective tissue disease(UCTD),16 Sjogren syndrome (SS), 5 mixed connective tissue disease (MCTD), 5 ANCA associated systemtc vasculitis (AAV), 5 adult onset Stillystemtc isease disease(tic criteria, including 34nfections admitted to The Second Hospital of Shanxi (TA), 1 systemic sclerosis (SSC), 1retroperitoneal fibrosis (RPF). All enrolled patients were tested for conventional diagnostic testing methods(CDT) and mNGS.

Results

Among the 126 patients with CTD who were clinically considered for co-infection, 31 patients were negative for mNGS, and pathogens were detected in 99 of them. In our results, the mNGS and CDT were both positive for pathogens detection in 28 individuals.Of both positive individuals, 2 cases were perfect matches,12 cases were partly matched, 14 cases were totally mismatched. A total of 23 cases were negative for both mNGS and CDT. 70 cases were positive for mNGS only.There were only 5 cases positive for pathogens detection by CDT only. In addition, the results of mNGS showed that 131 patients were virus-positive(54%), 78 patients were prokaryotes-positive (37%) inculding bacteria, mycoplasma and 14 patients were eukaryotes-positive (9%). Of course, someones have mixed infections among these patinets some of these patients, with two or more pathogens. In the mixed infection, 5 cases have no viruses infection, 38 cases with virus infection, including 20 cases of bacteria and viruses infection, 4 cases of bacteria,fungi and viruses infection, 9 cases of viruses mixed infection, 1 case of bacteria,viruses,fungi and mycoplasma infection, 1 case of bacteria,viruses and mycoplasma infection, 1 case of viruses and mycoplasma infection, 1 case of viruses and fungi infection. According to the results, viruses were the most common pathogens identified, followed by prokaryotes and eukaryotes. It is noteworthy that the incidence of Human gammaherpesvirus 4(EBV), Human betaherpesvirus 5(CMV) and Human alphaherpesvirus 1 are more common in virus-positive. The most frequently detected prokaryotes were Acinetobacter baumannii, Mycobacterium tuberculosis complex, followed by Staphylococcus aureus, Prevotella melaninogenica,Staphylococcus homini and Helicobacter pylori. The major pathogens were Pneumocystis jirovecii and Candida albicans among eukaryotes-positive individuals.

Conclusion

As a complementary approach to conventional methods, mNGS could help improving the identification of infection in CTD patients.The incidence of viral infection is high in patients with connective tissue disease and close attention should be paid to it in clinical works.

Figure 1.

A. Comparison of test results between mNGS and conventional diagnostic testing methods(CDT) in CTD patients. B. The classification of mixed infections with or without viruses infection detected by mNGS and conventional diagnostic testing methods(CDT).

Figure 2.

Distribution of pathogens detected by mNGS. A. Type distribution of pathogens identified by mNGS. Species distribution of viruses of B.viruses, C.Prokayote, D. Eucayon detected by mNGS.

Disclosure of Interests

None declared

Fermented soybean meal increases nutrient digestibility via the improvement of intestinal function, anti-oxidative capacity and immune function of weaned pigs

The nutritional components of fermented soybean meal (FSBM) vary because of the complex process of microbial fermentation. The objective of this study was to investigate the nutritional value of FSBM from two sources and explore the mode of actions of FSBM on the improvement of nutrient digestibility with the measurements of digestive enzymes and serum biomarkers. Eight weaned barrows (initial BW: 14.12 ± 0.24 kg) equipped with T-cannula in the distal ileum were allotted to a duplicated 4 × 4 Latin-square design with four experimental diets and four periods. Four experimental diets included a soybean meal control diet, two FSBM diets, and a nitrogen-free diet. The two sources of FSBM increased the contents of CP, amino acid and lactic acid, while decreased the levels of anti-nutritional factors, including glycinin, β-conglycinin and trypsin inhibitors. Compared to soybean meal control diet, both FSBM diets significantly increased the apparent and standardised ileal digestibility of CP and amino acids (P < 0.05), increased the activities of lipase, maltase and invertase in digesta (P < 0.05), increased total antioxidant capacity, activities of glutathione peroxidase and superoxide dismutase, the levels of interleukin-4, IgA, IgG and IgM in serum (P < 0.05), while decreased the levels of diamine oxidase, malondialdehyde, interleukin-6, and interleukin-2 in serum (P < 0.05). Additionally, the standardised ileal digestibility of amino acids were highly correlated with the aforementioned digestive enzymes and health-related serum biomarkers. In summary, FSBM diets showed an improved nutritional value evidenced by the higher nutrient digestibility, which may be partially derived from its beneficial effects on intestinal integrity, anti-oxidative capacity and immune function.

Joint iterative reconstruction and 3D rigid alignment for X-ray tomography

X-ray tomography is widely used for three-dimensional structure determination in many areas of science, from the millimeter to the nanometer scale. The resolution and quality of the 3D reconstruction is limited by the availability of alignment parameters that correct for the mechanical shifts of the sample or sample stage for the images that constitute a scan. In this paper we describe an algorithm for marker-free, fully automated and accurately aligned and reconstructed X-ray tomography data. Our approach solves the tomographic reconstruction jointly with projection data alignment based on a rigid-body deformation model. We demonstrate the robustness of our method on both synthetic phantom and experimental data and show that our method is highly efficient in recovering relatively large alignment errors without prior knowledge of a low resolution approximation of the 3D structure or a reasonable estimate of alignment parameters.

Metastable dynamics of neural circuits and networks

Cortical neurons emit seemingly erratic trains of action potentials or "spikes," and neural network dynamics emerge from the coordinated spiking activity within neural circuits. These rich dynamics manifest themselves in a variety of patterns, which emerge spontaneously or in response to incoming activity produced by sensory inputs. In this Review, we focus on neural dynamics that is best understood as a sequence of repeated activations of a number of discrete hidden states. These transiently occupied states are termed "metastable" and have been linked to important sensory and cognitive functions. In the rodent gustatory cortex, for instance, metastable dynamics have been associated with stimulus coding, with states of expectation, and with decision making. In frontal, parietal, and motor areas of macaques, metastable activity has been related to behavioral performance, choice behavior, task difficulty, and attention. In this article, we review the experimental evidence for neural metastable dynamics together with theoretical approaches to the study of metastable activity in neural circuits. These approaches include (i) a theoretical framework based on non-equilibrium statistical physics for network dynamics; (ii) statistical approaches to extract information about metastable states from a variety of neural signals; and (iii) recent neural network approaches, informed by experimental results, to model the emergence of metastable dynamics. By discussing these topics, we aim to provide a cohesive view of how transitions between different states of activity may provide the neural underpinnings for essential functions such as perception, memory, expectation, or decision making, and more generally, how the study of metastable neural activity may advance our understanding of neural circuit function in health and disease.

[Associations between adverse childhood experiences and adulthood substance use among lesbians]

Objective: To investigate the associations between adverse childhood experiences (ACE) and substance use behaviors among lesbians to provide a scientific basis for high-risk population identification and formulation of targeted intervention measures. Methods: Lesbians who participated in routine AIDS voluntary counseling, testing services, activities, and peer recommendations were recruited from July to December 2018, with the help of LesPark in Beijing. Convenient sampling method was used. Demographic characteristics, ACE, and substance use behaviors of subjects were investigated using an online platform powered by www.wjx.cn. Subsequently, the associations between ACE and adulthood substance use behaviors were evaluated using the logistic regression model. The SPSS 22.0 was used for statistical analysis. Results: A total of 294 lesbians were recruited in the study, 81.3% (239/294) of them were lesbians, and 18.7% (55/294) were bisexuals. Besides, 55.8% (164/294) of subjects reported they had had ACE, with proportions of lesbians experiencing abuse, neglect, and family dysfunction as 33.3% (98/294), 24.5% (72/294), and 32.7% (96/294), respectively. 55.1% (162/294) of the lesbians reported they had smoked in the past 30 days, 11.2% (33/294) reported having drug-use behavior in the past three months, and 22.8% (67/294) claimed drinking alcohol weekly. Multivariate logistic regression analysis showed that lesbians with ACE were at high risks to smoke (OR=1.87, 95%CI: 1.13-3.08), drink (OR=2.13, 95%CI: 1.18-3.84), and use drugs (OR=3.33, 95%CI: 1.29-8.61) in adulthood. Moreover, lesbians with childhood family dysfunction were at higher risk of smoking cigarettes (OR=2.60, 95%CI: 1.46-4.62) and drinking alcohol (OR=2.65, 95%CI: 1.44-4.87). At the same time, those with abuse experience were at higher risk of drug use (OR=3.17, 95%CI: 1.26-7.96). Conclusions: Substance use behaviors, including cigarette smoking, drinking alcohol, and drugs use, were common among lesbians. Positive associations were found between ACE and adulthood substance use behaviors.

RNA demethylase ALKBH5 in cancer: from mechanisms to therapeutic potential

RNA demethylase ALKBH5 takes part in the modulation of N⁶-methyladenosine (m⁶A) modification and controls various cell processes. ALKBH5-mediated m⁶A demethylation regulates gene expression by affecting multiple events in RNA metabolism, e.g., pre-mRNA processing, mRNA decay and translation. Mounting evidence shows that ALKBH5 plays critical roles in a variety of human malignancies, mostly via post-transcriptional regulation of oncogenes or tumor suppressors in an m⁶A-dependent manner. Meanwhile, increasing non-coding RNAs are recognized as functional targets of ALKBH5 in cancers. Here we reviewed up-to-date findings about the pathological roles of ALKBH5 in cancer, the molecular mechanisms by which it exerts its functions, as well as the underlying mechanism of its dysregulation. We also discussed the therapeutic implications of targeting ALKBH5 in cancer and potential ALKBH5-targeting strategies.

Treatment patterns and long-term persistence with osteoporosis therapies in women with Medicare fee-for-service (FFS) coverage

Osteoporosis, a chronic disease, requires long-term therapy. In Medicare-insured women, denosumab persistence was higher than oral bisphosphonate persistence over up to 3 years of follow-up. Longer-term persistence was higher among women who persisted in the first year of therapy.

INTRODUCTION

Osteoporosis, a chronic, progressive disease, requires long-term therapy; this study assessed long-term persistence with anti-resorptive therapies in postmenopausal women.

METHODS

This retrospective cohort study used administrative claims for women with data in the 100% Medicare osteoporosis sample who initiated (index date) denosumab, oral/intravenous (IV) bisphosphonate, or raloxifene between 2011 and 2014 and who had ≥ 1 year (zoledronic acid: 14 months) of pre-initiation medical/pharmacy coverage (baseline). Persistence was assessed from index date through end of continuous coverage, post-index evidence of censoring events (e.g., incident cancer), death, or end of study (December 31, 2015).

RESULTS

The study included 318,419 oral bisphosphonate users (78% alendronate), 145,056 denosumab users, 48,066 IV bisphosphonate users, and 31,400 raloxifene users; mean age ranged from 75.5 years (raloxifene) to 78.5 years (denosumab). In women with at least 36 months of follow-up (denosumab N = 25,107; oral bisphosphonates N = 79,710), more denosumab than oral bisphosphonate initiators were persistent at 1 year (73% vs. 39%), 2 years (50% vs. 25%), and 3 years (38% vs. 17%). Persistence decreased over time for all treatment groups, with denosumab users having the highest persistence in every follow-up time interval at or after 18 months. Women using denosumab, oral bisphosphonates, or raloxifene who persisted in a given year were more likely to remain persistent through the subsequent year.

CONCLUSIONS

Denosumab users persisted longer with therapy than women using other anti-resorptive medications, including oral bisphosphonates. Early persistence may predict long-term persistence. Overall persistence with osteoporosis medications is suboptimal and may impact fracture risk. Efforts to improve first year persistence are needed.

[A design of anti-reflux gastric lavage tube with built-in airbag]

At present, the gastric lavage tube used in clinical practice only has a few liquid orifices at the distal end of the lumen, and its structure has defects such as residual liquid reflux and aspiration in clinical practice. This article aims to solve the shortcomings of the existing technology and design a gastric lavage tube with built-in airbag with reasonable structure and high safety, in order to optimize the design and apply it to the actual clinical work, and further reduce the complications caused by the gastric lavage tube.

Nomogram to predict survival of patients with advanced and metastatic pancreatic Cancer

BACKGROUND

Nomograms are rarely employed to estimate the survival of patients with advanced and metastatic pancreatic cancer (PC). Herein, we developed a comprehensive approach to using a nomogram to predict survival probability in patients with advanced and metastatic PC.

METHODS

A total of 323 patients with advanced and metastatic PC were identified from the Chinese People's Liberation Army (PLA) General Hospital. A baseline nomogram was constructed using baseline variables of 323 patients. Additionally, 233 patients, whose tumors showed initial responses to first-line chemotherapy, were enrolled in the chemotherapy response-based model. 128 patients and 108 patients with advanced and metastatic PC from January 2019 to April 2021 were selected for external validating baseline model and chemotherapy response-based model. The 1-year and 2-year survival probability was evaluated using multivariate COX regression models. The discrimination and calibration capacity of the nomograms were assessed using C-statistic and calibration plots. The predictive accuracy and net benefit of the nomograms were evaluated using ROC curve and DCA, respectively.

RESULTS

In the baseline model, six variables (gender, KPS, baseline TB, baseline N, baseline WBC and baseline CA19-9) were used in the final model. In the chemotherapy response-based model, nine variables (KPS, gender, ascites, baseline N, baseline CA 19-9, baseline CEA, change in CA 19-9 level at week, change in CEA level at week and initial response to chemotherapy) were included in the final model. The C-statistics of the baseline nomogram and the chemotherapy response-based nomogram were 0.67 (95% CI, 0.62-0.71) and 0.74 (95% CI, 0.69-0.77), respectively.

CONCLUSION

These nomograms were constructed to predict the survival probability of patients of advanced and metastatic PC. The baseline model and chemotherapy response-based model performed well in survival prediction.

[Etiology and clinical characteristics of acquired ptosis]

Objective: To evaluate the demographics, etiology composition, clinical characteristics and surgical outcomes of acquired ptosis patients. Methods: Retrospective case-series study. The clinical records of 176 consecutive patients (312 eyes) with acquired ptosis were reviewed from January 2009 to December 2018 in the Ophthalmology Department of Tianjin Medical University General Hospital. The demographics, etiology composition, clinical characteristics, surgical strategies and outcomes were analyzed. Results: There were 59 male (33.5%) and 117 female (66.5%) patients suffering acquired ptosis, with an average age of (64±7) years. The disease was bilateral in 136 cases and unilateral in 40 cases. There were four etiological components of acquired ptosis: 145 cases (82.4%) of aponeurotic ptosis, 17 cases (9.6%) of neurogenic ptosis, 10 cases (5.7%) of myogenic ptosis and 4 cases (2.3%) of traumatic ptosis. The clinical characteristics of acquired ptosis varied significantly depending on etiology. Ptosis surgeries were performed on 152 cases (279 eyes), and the success rate was 92.1% (140/152). Surgical procedures included levator aponeurosis surgeries on 148 cases (275 eyes), frontal muscle suspensions on 2 cases (2 eyes) and conjunctival-Müller's ectomies on 2 cases (2 eyes). Conclusions: Acquired ptosis is more likely to occur in senile and female populations with bilateral eyelids involved mostly. Aponeurotic ptosis is the predominant type of acquired ptosis. The treatment is performed according to the clear etiological diagnosis based on clinical features, and operations are efficient for most patients with acquired ptosis. (Chin J Ophthalmol, 2021, 57: 844-849).

[Metabolism of New Psychoactive Substances 4F-MDMB-BUTINACA in Zebrafish]

Abstract

Objective To study the metabolic transformation pathways of 4F-MDMB-BUTINACA in vivo by establishing zebrafish models. Methods Six adult zebrafish were randomly divided into blank control group and experimental group, with three fish in each group. After the zebrafish in the experimental group were exposed to 1 μg/mL 4F-MDMB-BUTINACA for 24 h, they were transferred to clean water and cleaned three times, then pretreated for instrumental analysis. The zebrafish in blank control group were not exposed to 4F-MDMB-BUTINACA. Mass spectrometry and structural analysis of 4F-MDMB-BUTINACA and its metabolites were conducted by liquid chromatography-high resolution mass spectrometry and Mass Frontier software. Results A total of twenty-six metabolites of 4F-MDMB-BUTINACA were identified in zebrafish, including eighteen phase Ⅰ metabolites and eight phase Ⅱ metabolites. The main metabolic pathways of phase Ⅰ metabolites of 4F-MDMB-BUTINACA in zebrafish were ester hydrolysis, N-dealkylation, oxidative defluorination and hydroxylation, while the main metabolic pathway of phase Ⅱ metabolites was glucuronidation. Conclusion Metabolite Md24 （ester hydrolysis） and Md25 （ester hydrolysis combined with dehydrogenation） would be recommended to be potentially good biomarkers for abuse of 4F-MDMB-BUTINACA.

[Research Progress on Metabolite Identification of Synthetic Cannabinoid New Psychoactive Substances]

Abstract

Synthetic cannabinoids are currently a class of new psychoactive substances with the largest variety and most abused. Metabolite identification research can provide basic data for monitoring synthetic cannabinoids abuse, which is the current research hotspot. The main trend of structural modification of synthetic cannabinoid is to replace the fluorine atom on pentyl indole or indazole cyclopentyl with hydrogen atom, which greatly improves the biological activity of the compound. The main metabolic reactions include hydroxylation, fluoropentyl oxidative, ester hydrolyze, amide hydrolysis. Liquid chromatography-high resolution mass spectrometry has become the preferred choice for the structural identification of metabolites. This review mainly summarizes research on metabolism software prediction and human hepatocyte model, human liver microsomes model, rat in vivo model, zebrafish model and fungus C. elegans model in metabolite identification based on the structure and classification of synthetic cannabinoids.

Prevalence and impact of metabolic syndrome in patients with multivessel coronary artery disease and acute coronary syndrome

Background

Metabolic syndrome is associated with increased incidence of diabetes and cardiovascular diseases in patients initially free from these diseases. However, its prognostic value in patients with established coronary artery diseases remains controversial.

Purpose

Therefore, we aimed to illustrate the prevalence and investigate the impact of metabolic syndrome in patients with multivessel coronary artery disease and acute coronary syndrome.

Methods

We conducted a large registry of consecutive patients with acute coronary syndrome referred to primary percutaneous coronary intervention and those with multivessel diseases were eligible for this analysis. Metabolic syndrome was defined using modified criteria based on the Adult Treatment Panel III definition from the National Cholesterol Education Program. The primary outcome was major adverse cardiovascular events (MACE), a composite of all-cause death, myocardial infarction, and stroke.

Results

A total of 2532 patients were included in current analysis and 993 (39.2%) of them had metabolic syndrome while 1539 (60.8%) did not. The prevalence of metabolic syndrome increased over the study period (p for trend = 0.005). There was a significant decline of metabolic syndrome prevalence in patients over 60 years old (p for trend = 0.002) and females had a higher prevalence than their male counterparts (61.5% verse 32.9%, p&lt;0.001). Over a median follow-up of 2.3 years, metabolic syndrome was not significantly associated with MACE (adjusted 95% CI 0.92 to 1.54). In addition, there was no significant difference observed between two groups in other individual outcomes, namely all-cause death, cardiac death, stroke, myocardial infarction, and any revascularization.

Conclusions

Metabolic syndrome was frequently observed in patients with multivessel coronary artery disease and acute coronary syndrome. Patients with metabolic syndrome were more likely to be young and female. However, it was not an independent predictor for MACE after primary percutaneous coronary intervention in those patients.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences Metabolic syndrome distribution in MVDOutcome according to metabolic syndrome

Effect of xylanase and live yeast supplementation on growth performance, nutrient digestibility, and gut microbiome diversity of pigs

Effect of xylanase (Xyl) and live yeast (LY) supplementation on gut microbiome composition, growth performance, and nutrient digestibility of weanling pigs was determined. A total of 180 weanling pigs were assigned to five treatments from weaning to market. Treatments were designated based on whether Xyl, LY, or their combination were fed in the first 2 wk postweaning or thereafter until finishing at day 141 postweaning. Treatments were (days 1–15; days 15–141): control–control, control–Xyl, Xyl–Xyl, LY–Xyl, Xyl + LY–Xyl. Xylanase was added at 16 000 BXU·kg−1 and LY at 1 kg·t−1. Pigs fed with LY and LY + Xyl from days 0–15 had greater body weight and average daily gain at day 15 compared with control (P < 0.05). Glucose transporter 2 mRNA was higher in LY and LY + Xyl groups on day 15 compared with control (P < 0.05). Xylanase supplementation from week 2 postweaning increased apparent total tract nutrient digestibility of gross energy, nitrogen, and phosphorus on day 43. Live yeast with or without Xyl improved growth performance in the first 2 wk after weaning; Xyl + LY–Xyl and control–Xyl groups had improved overall feed efficiency. In conclusion, LY and Xyl supplementation improved performance of weanling pigs in the first 2 wk after weaning with no effects on long-term growth performance.

Treatment delay and reperfusion management of acute ST-segment elevation myocardial infarction: analysis of the China STEMI Care Project Phase 1

BACKGROUND

The China ST-segment elevation myocardial infarction (STEMI) Care Project (CSCAP) was launched in 2011 to address the problems of insufficient reperfusion and long treatment delay in STEMI care in China.

AIM

To describe the baseline status of STEMI emergency care in Tertiary PCI Hospitals using Phase 1 (CSCAP-1) data.

DESIGN

CSCAP-1 is a prospective multi-center STEMI registry.

METHODS AND RESULTS

A total of 4191 patients with symptom onset within 12 or 12-36 h requiring primary percutaneous coronary intervention (PCI), were enrolled from 53 tertiary PCI hospitals in 14 provinces, municipalities, and autonomous regions of China in CSCAP-1. Among them, 49.0% were self-transported to the hospital, 26.5% were transferred to the hospital by calling the emergency medical services directly, and 24.5% were transferred from other hospitals. In patients with symptom onset within 12 h, 83.2% received primary PCI, 5.9% received thrombolysis and 10.9% received conservative medications. The median door-to-balloon time was 115 (85-170) min and the median door-to-needle time for in-hospital thrombolysis was 80 (50-135) min. The overall in-hospital all-cause mortality was 2.4%, while it was 5.3% in the non-reperfusion group and 2.1% in the reperfusion group (P < 0.001).

CONCLUSION

Although a long treatment delay and a high proportion of patients transporting themselves to the hospital were observed, trends were positive with greater adoption of primary PCI and lower in-hospital mortality in tertiary hospitals in China. Our results provided important information for further integrated STEMI network construction in China.