Measurements of All-Particle Energy Spectrum and Mean Logarithmic Mass of Cosmic Rays from 0.3 to 30 PeV with LHAASO-KM2A

We present the measurements of all-particle energy spectrum and mean logarithmic mass of cosmic rays in the energy range of 0.3-30 PeV using data collected from LHAASO-KM2A between September 2021 and December 2022, which is based on a nearly composition-independent energy reconstruction method, achieving unprecedented accuracy. Our analysis reveals the position of the knee at 3.67±0.05±0.15  PeV. Below the knee, the spectral index is found to be -2.7413±0.0004±0.0050, while above the knee, it is -3.128±0.005±0.027, with the sharpness of the transition measured with a statistical error of 2%. The mean logarithmic mass of cosmic rays is almost heavier than helium in the whole measured energy range. It decreases from 1.7 at 0.3 PeV to 1.3 at 3 PeV, representing a 24% decline following a power law with an index of -0.1200±0.0003±0.0341. This is equivalent to an increase in abundance of light components. Above the knee, the mean logarithmic mass exhibits a power law trend towards heavier components, which is reversal to the behavior observed in the all-particle energy spectrum. Additionally, the knee position and the change in power-law index are approximately the same. These findings suggest that the knee observed in the all-particle spectrum corresponds to the knee of the light component, rather than the medium-heavy components.

CT whole lung radiomic nomogram: a potential biomarker for lung function evaluation and identification of COPD

BACKGROUND

Computed tomography (CT) plays a great role in characterizing and quantifying changes in lung structure and function of chronic obstructive pulmonary disease (COPD). This study aimed to explore the performance of CT-based whole lung radiomic in discriminating COPD patients and non-COPD patients.

METHODS

This retrospective study was performed on 2785 patients who underwent pulmonary function examination in 5 hospitals and were divided into non-COPD group and COPD group. The radiomic features of the whole lung volume were extracted. Least absolute shrinkage and selection operator (LASSO) logistic regression was applied for feature selection and radiomic signature construction. A radiomic nomogram was established by combining the radiomic score and clinical factors. Receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA) were used to evaluate the predictive performance of the radiomic nomogram in the training, internal validation, and independent external validation cohorts.

RESULTS

Eighteen radiomic features were collected from the whole lung volume to construct a radiomic model. The area under the curve (AUC) of the radiomic model in the training, internal, and independent external validation cohorts were 0.888 [95% confidence interval (CI) 0.869-0.906], 0.874 (95%CI 0.844-0.904) and 0.846 (95%CI 0.822-0.870), respectively. All were higher than the clinical model (AUC were 0.732, 0.714, and 0.777, respectively, P < 0.001). DCA demonstrated that the nomogram constructed by combining radiomic score, age, sex, height, and smoking status was superior to the clinical factor model.

CONCLUSIONS

The intuitive nomogram constructed by CT-based whole-lung radiomic has shown good performance and high accuracy in identifying COPD in this multicenter study.

The Proton of Alcohols as Hydrogen Source in Diboron-Mediated Nickel-Catalyzed Asymmetric Transfer Hydrogenation of Cyclic N-Sulfonyl Imines

The proton of alcohols as the sole hydrogen source in diboron-mediated nickel-catalyzed asymmetric transfer hydrogenation of cyclic N-sulfonyl imines has been developed, providing the chiral cyclic sulfamidates in excellent enantioselectivities. The mechanistic investigations suggested that the proton of alcohols could be activated by tetrahydroxydiboron to form active nickel hydride species.

CT-Based Radiomic Nomogram for the Prediction of Chronic Obstructive Pulmonary Disease in Patients with Lung cancer

RATIONALE AND OBJECTIVES

To develop and validate a model for predicting chronic obstructive pulmonary disease (COPD) in patients with lung cancer based on computed tomography (CT) radiomic signatures and clinical and imaging features.

MATERIALS AND METHODS

We retrospectively enrolled 443 patients with lung cancer who underwent pulmonary function test as the primary cohort. They were randomly assigned to the training (n = 311) or validation (n = 132) set in a 7:3 ratio. Additionally, an independent external cohort of 54 patients was evaluated. The radiomic lung nodule signature was constructed using the least absolute shrinkage and selection operator algorithm, while key variables were selected using logistic regression to develop the clinical and combined models presented as a nomogram.

RESULTS

COPD was significantly related to the radiomics signature in both cohorts. Moreover, the signature served as an independent predictor of COPD in the multivariate regression analysis. For the training, internal, and external cohorts, the area under the receiver operating characteristic curve (ROC, AUC) values of our radiomics signature for COPD prediction were 0.85, 0.85, and 0.76, respectively. Additionally, the AUC values of the radiomic nomogram for COPD prediction were 0.927, 0.879, and 0.762 for the three cohorts, respectively, which outperformed the other two models.

CONCLUSION

The present study presents a nomogram that incorporates radiomics signatures and clinical and radiological features, which could be used to predict the risk of COPD in patients with lung cancer with one-stop chest CT scanning.

[Animal study on left bundle branch current of injury and anatomic location of leads in His-purkinje conduction system pacing]

Objective: Explore the relationship between tip of the left bundle branch pacing lead and anatomic location of left bundle branch as well as the mechanism of left bundle branch current of injury. To clarify the clinical value of left bundle branch current of injury during operation. Methods: The pacing leads were implanted in the hearts of two living swines. Intraoperative electrophysiological study confirmed that the left bundle branch or only the deep left ventricular septum was captured at low output. Immediately after operation, the gross specimen of swine hearts was stained with iodine to observe the gross distribution of His-purkinje conduction system on the left ventricular endocardium and its relationship with the leads. Subsequently, the swine hearts were fixed with formalin solution, and the pacing leads were removed after the positions were marked. The swine hearts were then sectioned and stained with Masson and Goldner trichrome, and the relationship between the anatomic location of the conduction system and the tip of the lead was observed under a light microscope. Results: After iodine staining of the specimen, the His-purkinje conduction system was observed with the naked eye in a net-like distribution, and the lead tip was screwed deeply and fixed in the left bundle branch area of the left ventricular subendocardium in the ventricular septum. Masson and Goldner trichrome staining showed that left bundle branch pacing lead directly passed through the left bundle branch when there was left bundle branch potential with left bundle branch current of injury, while it was not directly contact the left bundle branch when there was left bundle branch potential without left bundle branch current of injury. Conclusion: The left bundle branch current of injury observed on intracardiac electrocardiogram during His-purkinje conduction system pacing suggests that the pacing lead directly contacted the conduction bundle or its branches, therefore, the captured threshold was relatively low. Left bundle branch current of injury can be used as an important anatomic and electrophysiological evidence of left bundle branch capture.

Palladium-catalyzed stereoselective construction of chiral allenes bearing nonadjacent axial and two central chirality

It is challenging to enantioselectively construct molecules bearing multiple nonadjacent stereocenters, in contrast to those bearing a single stereocenter or adjacent stereocenters. Herein, we report an enantio- and diastereoselective synthesis of substituted chiral allenes with nonadjacent axial and two central chiral centers through a combination of retro-oxa-Michael addition and palladium-catalyzed asymmetric allenylic alkylation. This methodology exhibits good functional-group compatibility, and the corresponding allenylic alkylated compounds, including flavonoid frameworks, are obtained with good yields and diastereoselectivities and excellent enantioselectivities (all >95% ee). Furthermore, the scalability of the current synthetic protocol was proven by performing a gram-scale reaction.

Measurement of Ultra-High-Energy Diffuse Gamma-Ray Emission of the Galactic Plane from 10 TeV to 1 PeV with LHAASO-KM2A

The diffuse Galactic γ-ray emission, mainly produced via interactions between cosmic rays and the interstellar medium and/or radiation field, is a very important probe of the distribution, propagation, and interaction of cosmic rays in the Milky Way. In this Letter, we report the measurements of diffuse γ rays from the Galactic plane between 10 TeV and 1 PeV energies, with the square kilometer array of the Large High Altitude Air Shower Observatory (LHAASO). Diffuse emissions from the inner (15°10  TeV). The energy spectrum in the inner Galaxy regions can be described by a power-law function with an index of -2.99±0.04, which is different from the curved spectrum as expected from hadronic interactions between locally measured cosmic rays and the line-of-sight integrated gas content. Furthermore, the measured flux is higher by a factor of ∼3 than the prediction. A similar spectrum with an index of -2.99±0.07 is found in the outer Galaxy region, and the absolute flux for 10≲E≲60  TeV is again higher than the prediction for hadronic cosmic ray interactions. The latitude distributions of the diffuse emission are consistent with the gas distribution, while the longitude distributions show clear deviation from the gas distribution. The LHAASO measurements imply that either additional emission sources exist or cosmic ray intensities have spatial variations.

[A randomized controlled study on the long-term efficacy of intra-cervical lymphatic immunotherapy for adult allergic rhinitis]

Objective: To determine the long-term efficacy and safety of intra-cervical lymphatic immunotherapy (ICLIT) for adult allergic rhinitis (AR) by comparing it with subcutaneous immunotherapy (SCIT). Methods: A total of 100 adult AR patients with dust mite allergy in Department of Otorhinolaryngology, First People's Hospital of Foshan from Feb 2018 to Dec 2019 were randomly divided into two groups, 50 in SCIT group [including 42 males and 8 females, aging (32.55±9.72) years] and 50 in ICLIT group [including 45 males and 5 females, aging (31.33±9.84) years]. The changes in total symptom score (total system score, TSS), nasal symptom score (total nasal symptom score, TNSS), eye symptom score (total ocular scoring system, TOSS), drug score (total medication score, TMS), and quality of life score of the two groups of patients were evaluated before and after treatment, and the adverse reactions of all patients during the treatment period were recorded. The changes in the level of dust mite specific IgE (sIgE) in the serum were evaluated. GraphPad Prism 9.0 software was used for statistical analysis. Results: In the SCIT group, 38 patients completed treatment and follow-up, with a dropout rate of 24%. In the ICLIT group, 48 patients completed treatment and follow-up, with a dropout rate of only 4%. The scores of TSS, TNSS, TOSS, TMS, and quality of life in the ICLIT group before treatment were 32.1±3.0, 27.3±3.1, 4.8±2.8, 2.3±0.9, and 68.1±28.7, respectively; After 36 months of treatment, the scores were 21.8±11.4, 18.1±9.4, 3.7±2.9, 1.3±1.1, and 36.0±26.7, respectively, which were significantly lower than those before treatment (all P<0.001). After 36 months of treatment, the TSS of the ICLIT group improved by 10.3±11.2 compared to before, while the TSS of the SCIT group improved significantly by 21.9±11.0 compared to before, with statistically significant differences between the groups (P<0.001). No serious systemic adverse reactions occurred in both groups of patients. Conclusions: ICLIT treatment for adult AR has long-term efficacy, high safety, and high compliance, but its long-term efficacy is not as good as SCIT. ICLIT can be considered as a new complementary option for AR immunotherapy.

A review and analysis of the business model innovation literature

Business model innovation (BMI) is an emerging field that has attracted much attention from scholars and practitioners. However, the literature on BMI is fragmented and inconsistent, lacking a comprehensive and systematic framework. This study aims to fill this gap by conducting a literature review of 272 peer-reviewed articles on BMI published between 2010 and 2022. We analyze the articles based on six dimensions: antecedents, processes, types, barriers, outcomes, and moderators/mediators of BMI. We synthesize the findings and propose an integrated theoretical model that captures the complex relationships among these dimensions. We also identify several research gaps and directions for future studies. This study contributes to the BMI literature by providing a clearer understanding of this phenomenon and offering practical guidance for various types of businesses.

A tera-electron volt afterglow from a narrow jet in an extremely bright gamma-ray burst

Some gamma-ray bursts (GRBs) have a tera-electron volt (TeV) afterglow, but the early onset of this has not been observed. We report observations with the Large High Altitude Air Shower Observatory of the bright GRB 221009A, which serendipitously occurred within the instrument field of view. More than 64,000 photons >0.2 TeV were detected within the first 3000 seconds. The TeV flux began several minutes after the GRB trigger, then rose to a peak about 10 seconds later. This was followed by a decay phase, which became more rapid ~650 seconds after the peak. We interpret the emission using a model of a relativistic jet with half-opening angle ~0.8°. This is consistent with the core of a structured jet and could explain the high isotropic energy of this GRB.

Mass Measurement of Upper fp-Shell N=Z-2 and N=Z-1 Nuclei and the Importance of Three-Nucleon Force along the N=Z Line

Using a novel method of isochronous mass spectrometry, the masses of ^{62}Ge, ^{64}As, ^{66}Se, and ^{70}Kr are measured for the first time, and the masses of ^{58}Zn, ^{61}Ga, ^{63}Ge, ^{65}As, ^{67}Se, ^{71}Kr, and ^{75}Sr are redetermined with improved accuracy. The new masses allow us to derive residual proton-neutron interactions (δV_{pn}) in the N=Z nuclei, which are found to decrease (increase) with increasing mass A for even-even (odd-odd) nuclei beyond Z=28. This bifurcation of δV_{pn} cannot be reproduced by the available mass models, nor is it consistent with expectations of a pseudo-SU(4) symmetry restoration in the fp shell. We performed ab initio calculations with a chiral three-nucleon force (3NF) included, which indicate the enhancement of the T=1 pn pairing over the T=0 pn pairing in this mass region, leading to the opposite evolving trends of δV_{pn} in even-even and odd-odd nuclei.

Brønsted acid-catalyzed C6 functionalization of 2,3-disubstituted indoles for construction of cyano-substituted all-carbon quaternary centers

We report a Brønsted acid-catalyzed C6 functionalization of 2,3-disubstituted indoles with 2,2-diarylacetonitriles for efficient construction of cyano-substituted all-carbon quaternary centers with excellent yields. The synthetic utility was demonstrated by the conversion of the cyano-group which enables the divergent preparation of aldehydes, primary amines and amides. Control experiments suggested that this process involves C-H oxidation of 2,2-diarylacetonitriles to in situ generate δ,δ-disubstituted p-quinone methide intermediates. This protocol provides an efficient method for C6 functionalization of 2,3-disubstituted indoles to construct all-carbon quaternary centers.

Trends in general and abdominal obesity in US adults: Evidence from the National Health and Nutrition Examination Survey (2001-2018)

Aim

This study investigates the trend in general obesity and abdominal obesity in US adults from 2001 to 2018.

Methods

We included 44,184 adults from the nine cycles of the continuous NHANES (2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018). The age-adjusted mean body mass index and waist circumference were calculated, and the sex-specific annual change was estimated by the survey cycle. We used the weighted sex-specific logistic regression models to analyze the prevalence of general obesity and abdominal obesity from 2001 to 2018. The weighted adjusted odds ratio (OR) with a 95% confidence interval (CI) was calculated.

Results

Our study showed that general obesity and abdominal obesity account for about 35.48 and 53.13% of the US population. From 2001-2002 to 2017-2018, the age-adjusted prevalence of general obesity increased from 33.09 to 41.36% in females and from 26.88 to 42.43% in males. During 2001-2018, the age-adjusted prevalence of abdominal obesity increased from 57.58 to 67.33% in females and from 39.07 to 49.73% in males. A significant time-dependent increase was observed in the prevalence of general obesity (adjusted OR, 1.007; 95% CI 1.005-1.009, P < 0.001) and abdominal obesity (adjusted OR, 1.006; 95% CI, 1.004-1.008; P < 0.001).

Conclusion

General obesity and abdominal obesity are a heavy health burden among US adults, and the increasing trend remains in both males and females from 2001 to 2018.

Chiral-Phosphoric-Acid-Catalyzed C6-Selective Pictet-Spengler Reactions for Construction of Polycyclic Indoles Containing Spiro Quaternary Stereocenters

Compared with the well-established asymmetric Pictet-Spengler reactions on the pyrrole ring of indoles, the catalytic asymmetric Pictet-Spengler reaction on the benzene ring of indoles has been rarely studied. Herein the C6-selective Pictet-Spengler reactions of indoles have been realized by employing 2-(1H-indol-7-yl)anilines and isatins in the presence of chiral phosphoric acid, affording novel polycyclic indole derivatives bearing spiro quaternary stereocenters in excellent yields with excellent enantioselectivities. This reaction could be conducted on the gram scale without any loss of activity or enantioselectivity.

A Magnetic Resonance Angiography-Based Study Comparing Machine Learning and Clinical Evaluation: Screening Intracranial Regions Associated with the Hemorrhagic Stroke of Adult Moyamoya Disease

OBJECTIVES

Moyamoya disease patients with hemorrhagic stroke usually have a poor prognosis. This study aimed to determine whether hemorrhagic moyamoya disease could be distinguished from MRA images using transfer deep learning and to screen potential regions that contain rich distinguishing information from MRA images in moyamoya disease.

MATERIALS AND METHODS

A total of 116 adult patients with bilateral moyamoya diseases suffering from hemorrhagic or ischemia complications were retrospectively screened. Based on original MRA images at the level of the basal cistern, basal ganglia, and centrum semiovale, we adopted the pretrained ResNet18 to build three models for differentiating hemorrhagic moyamoya disease. Grad-CAM was applied to visualize the regions of interest.

RESULTS

For the test set, the accuracies of model differentiation in the basal cistern, basal ganglia, and centrum semiovale were 93.3%, 91.5%, and 86.4%, respectively. Visualization of the regions of interest demonstrated that the models focused on the deep and periventricular white matter and abnormal collateral vessels in hemorrhagic moyamoya disease.

CONCLUSION

A transfer learning model based on MRA images of the basal cistern and basal ganglia showed a good ability to differentiate between patients with hemorrhagic moyamoya disease and those with ischemic moyamoya disease. The deep and periventricular white matter and collateral vessels at the level of the basal cistern and basal ganglia may contain rich distinguishing information.

[Immunogenicity and safety of a booster vaccination with an inactivated severe acute respiratory syndrome coronavirus 2 vaccine in adults aged 18 to 59 years]

Objective: To assess the immunogenicity and safety of a booster vaccination with an inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. Methods: The phase Ⅱ trial of an inactivated SARS-CoV-2 vaccine was conducted by Jiangsu Provincial Center for Disease Control and Prevention (CDC) since October 2020. The subjects were healthy adults aged 18-59 years, excluding pregnant, and not breastfeeding women. The primary vaccination schedule groups were 0-14 d 5 μg, 0-14 d 10 μg, 0-28 d 5 μg and 0-28 d 10 μg, respectively. And 50 participants in each group, a total of 200, who have received 2-doses primary vaccination were selected in ascending order of the study number and vaccinated with a booster dose (same dosage as primary vaccination) at the 6th months after post the primary vaccination (30-day window period). Blood samples were collected before and after boosting and tested for the geometric mean titers (GMT) and seroconversion of live virus neutralizing antibody, pseudovirus neutralizing antibody and receptor-binding-domain (RBD) IgG antibody. Adverse events (AE) were collected and assessed within 28 days after boosting. Results: The ages of subjects in group 0-14 d 5 μg, 0-14 d 10 μg, 0-28 d 5 μg and 0-28 d 10 μg were (43.98±9.58), (43.46±9.34), (42.56±9.08) and (43.94±11.05) years old, respectively (P=0.877). Sex ratios were balanced among the 4 groups (P=0.331). The live virus neutralizing antibody GMT (95%CI) in group 0-14 d 5 μg, 0-14 d 10 μg, 0-28 d 5 μg and 0-28 d 10 μg increased from 4.07 (3.30-5.04), 3.75 (3.08-4.55), 8.33 (7.01-11.11) and 7.69 (6.19-9.57) before the booster vaccination to 284.84 (215.28-376.86), 233.05 (178.61-304.08), 274.81 (223.64-337.68) and 280.77 (234.59-336.04) in 28 days after the booster vaccination, respectively. The rates of live virus neutralizing antibody seroconversion were all 100% in the 4 groups. The AE incidences following booster vaccination were 18.0% (9 cases), 4.0% (2 cases), 12% (6 cases), and 12% (6 cases) in the 4 groups(P=0.182). No AE was graded as level 3 or worse. No serious AE was reported. Conclusion: One booster vaccination of an inactivated SARS-CoV-2 vaccine administered 6 months after primary vaccination showed good immunogenicity and safety.

Penicisteckins A-F, Isochroman-Derived Atropisomeric Dimers from Penicillium steckii HNNU-5B18

Penicisteckins A-D (1-4), two pairs of atropodiastereomeric biaryl-type hetero- and homodimeric bis-isochromans with 7,5'- and 7,7'-linkages and a pair of atropodiastereomeric 2-(isochroman-5-yl)-1,4-benzoquinone derivatives [penicisteckins E (5) and F (6)], were isolated from the Penicillium steckii HNNU-5B18. Their structures including the absolute configuration were determined by extensive spectroscopic and single-crystal X-ray diffraction analysis and TDDFT-ECD calculations. Both the bis-isochromans and the isochroman/1,4-benzoquinone conjugates represent novel biaryl scaffolds containing both central and axial chirality elements. The monomer anserinone B (8) exhibited potent antibacterial activities against Staphylococcus aureus ATCC 29213 and methicillin-resistant Staphylococcus aureus with minimal inhibition concentration values ranging from 2 to 8 μg mL^-1. Plausible biosynthetic pathways of 1-6 are proposed, which suggest how the absolute configurations of the isolates were established during the biosynthetic scheme.

Direct Q-Value Determination of the β^{-} Decay of ^{187}Re

The cyclotron frequency ratio of ^{187}Os^{29+} to ^{187}Re^{29+} ions was measured with the Penning-trap mass spectrometer PENTATRAP. The achieved result of R=1.000 000 013 882(5) is to date the most precise such measurement performed on ions. Furthermore, the total binding-energy difference of the 29 missing electrons in Re and Os was calculated by relativistic multiconfiguration methods, yielding the value of ΔE=53.5(10)  eV. Finally, using the achieved results, the mass difference between neutral ^{187}Re and ^{187}Os, i.e., the Q value of the β^{-} decay of ^{187}Re, is determined to be 2470.9(13) eV.

Chiral Phosphoric Acid-Catalyzed C6 Functionalization of 2,3-Disubstituted Indoles for Synthesis of Heterotriarylmethanes

The direct regio- and enantioselective C6 functionalization of 2,3-disubstituted indoles with azadienes has been developed using chiral phosphoric acid as catalyst, providing a convenient approach to synthesize the optically active heterotriarylmethanes with excellent yields, broad substrate scope, and up to 98% ee. Mechanistic studies revealed that N-alkylation of 2,3-disubstituted indoles with azadienes would be reversible, and enantioselective C6 functionalization could be enabled.

[Survey of Oncomelania hupensis in national schistosomiasis surveillance sites of Guangxi Zhuang Autonomous Region from 2015 to 2019]

OBJECTIVE

To investigate the distribution characteristics of Oncomelania hupensis in Guangxi Zhuang Autonomous Region, so as to provide insights into the assessment of the risk of schistosomiasis transmission and the scientific formulation of the schistosomiasis surveillance strategy.

METHODS

From 2015 to 2019, a total of 19 national schistosomiasis surveillance sites were assigned in Guangxi Zhuang Autonomous Region, including 4 fixed sites and 15 mobile sites. Snail survey was performed by means of systematic sampling in combination with environmental sampling, and the infection of Schistosoma japonicum was detected by the crushing method combined with loop-mediated isothermal amplification (LAMP) assay.

RESULTS

From 2015 to 2019, snail habitats were detected at areas of 17 040 to 39 527 m², including 6 214 m² emerging snail habitats and 16 563 m² re-emerging snail habitats. The overall mean density of living snails was 0.019 2 snails/0.1 m² and the occurrence of frames with snails was 1.11% in the national schistosomiasis surveillance sites; however, no S. japonicum infection was identified in snails. The area of snail habitats increased by 121.46% in the national surveillance sites in 2019 as compared to that in 2015; however, 50.34% (Z = -0.422, P > 0.05) and 42.85% (χ² = 130.41, P < 0.01) reductions were seen in the overall means density of living snails and the occurrence of frames with snails. All snail habitats were distributed in the 4 fixed surveillance sites, and were mainly found in ditches, paddy fields and dry lands, with weeds as the primary vegetation type.

CONCLUSIONS

There are still risk factors leading to re-emergent transmission of schistosomiasis in Guangxi Zhuang Autonomous Region, such as local snail spread, and the monitoring of schistosomiasis remains to be reinforced to further consolidate the achievements of schistosomiasis elimination in the region.

[Evaluation and embolization strategy by ASITN/SIR grade for injured internal carotid artery of nasopharyngeal carcinoma]

Objective: To study the strategy of endovascular treatment for patients with the risks of internal carotid artery (ICA) rupture and bleeding during the treatment of nasopharyngeal carcinoma (NPC) based on American Society of Intervention and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) grade of collateral circulation. Methods: A total of 56 patients (45 males and 11 females, aged from 28 to 76 years old) diagnosed with nasopharyngeal carcinoma and admitted to the Department of Neurosurgery, the Third Affiliated Hospital of Southern Medical University from July 2018 to January 2020 were retrospectively analyzed. There were 15 cases of ASITN/SIR grade 4, 24 cases of ASITN/SIR grade 3, 5 cases of ASITN/SIR grade 2, 5 cases of ASITN/SIR grade 1, and 7 cases of ASITN/SIR grade 0. The events of stroke and death were analyzed statistically. Results: ALL patients with ASITN/SIR grade 4 or 3 and some of patients with ASITN/SIR grades 2-0 passed balloon occlusion test and electrophysiological monitoring. ICA pseudoaneurysm was found in 35 patients, and one-stage ICA embolization was performed in 29 patients after evaluation. Among them, 8 cases of ASITN/SIR grade 4 and 10 cases of ASITN/SIR grade 3 with obvious posterior circulation compensation obtained successful one-stage ICA embolization without cerebral ischemia; cerebral ischemic events occurred in 5 (55.6%) of 9 patients with ASITN/SIR grade 3 and in 1(50.0%) of 2 patients with ASITN/SIR grade 2. The total incidence of ischemic events was 20.7% (6/29) and 1 case was disabled (1/29, 3.4%). Among patients with ASITN/SIR 3, there were statistically significant differences in stroke event rate between patients with obvious posterior circulation compensation and patients with slight or without posterior circulation compensation (0/10 vs. 5/9, χ(2)=4.95, P=0.026). Follow-up time was 10.1±7.8 months, and 46 patients were survival (46/56, 82.1%) and 10 patients died (10/56, 17.9%) with a mean survival time of 2.6±1.4 months. Conclusions: For NPC patients with ICA invasion, ASITN/SIR based on DSA can simplify the assessment process of cerebral blood flow compensation. ICA can be embolized directly in patients with ASITN/SIR 4 or 3 with obvious posterior communicating compensation.

Mass-Difference Measurements on Heavy Nuclides with an eV/c^{2} Accuracy in the PENTATRAP Spectrometer

First ever measurements of the ratios of free cyclotron frequencies of heavy, highly charged ions with Z>50 with relative uncertainties close to 10^{-11} are presented. Such accurate measurements have become realistic due to the construction of the novel cryogenic multi-Penning-trap mass spectrometer PENTATRAP. Based on the measured frequency ratios, the mass differences of five pairs of stable xenon isotopes, ranging from ^{126}Xe to ^{134}Xe, have been determined. Moreover, the first direct measurement of an electron binding energy in a heavy highly charged ion, namely of the 37th atomic electron in xenon, with an uncertainty of a few eV is demonstrated. The obtained value agrees with the calculated one using two independent, different implementations of the multiconfiguration Dirac-Hartree-Fock method. PENTATRAP opens the door to future measurements of electron binding energies in highly charged heavy ions for more stringent tests of bound-state quantum electrodynamics in strong electromagnetic fields and for an investigation of the manifestation of light dark matter in isotopic chains of certain chemical elements.

First Glimpse of the N=82 Shell Closure below Z=50 from Masses of Neutron-Rich Cadmium Isotopes and Isomers

We probe the N=82 nuclear shell closure by mass measurements of neutron-rich cadmium isotopes with the ISOLTRAP spectrometer at ISOLDE-CERN. The new mass of ^{132}Cd offers the first value of the N=82, two-neutron shell gap below Z=50 and confirms the phenomenon of mutually enhanced magicity at ^{132}Sn. Using the recently implemented phase-imaging ion-cyclotron-resonance method, the ordering of the low-lying isomers in ^{129}Cd and their energies are determined. The new experimental findings are used to test large-scale shell-model, mean-field, and beyond-mean-field calculations, as well as the ab initio valence-space in-medium similarity renormalization group.

[Clinical characteristics of myelin oligodendrocyte glycoprotein antibody associated myelitis]

Objective: To evaluate the clinical characteristics of myelin oligodendrocyte glycoprotein antibody (MOG-IgG) associated myelitis in a cohort of Chinese Han adults. Methods: From January 2016 to December 2017, 70 patients with MOG-IgG associated disorders (MOGAD) and 120 patients with aquaporin 4 antibody (AQP4-IgG) positive neuromyelitis optica spectrum disorders (NMOSD) visited the NMO/MS clinic or the neurology ward of Huashan Hospital, and the neurophthalmology clinic of Eye and ENT hospital, Shanghai Medical College, Fudan University were enrolled. The clinical and paraclinical data of the patients were retrospectively reviewed. The characteristics of MOG-IgG associated myelitis were further clarified. Results: Sixteen of the 70 patients with MOGAD had ever experienced myelitis. The frequency of myelitis was 18.6% at the first attack and 22.9% throughout the disease duration. The onset age of MOG-IgG associated myelitis was 9-57(30±11) years, and the female to male ratio was 0.6∶1. Compared with AQP4-IgG positive myelitis attacks, MOG-IgG associated myelitis attacks were more common to be accompanied by feverish prodromal symptom (30.8%) while less common to exhibit painful tonic (12.5%). Longitudinally extensive myelitis (>3 vertebral segments) was less frequent (56.3%), and short-segment myelitis and multiple short-segment myelitis could also be seen. MRI showed that MOGAD patients had more lower spinal cord lesions (20%), fewer cervical cord lesions (40%) and less transverse lesions (52%). Axial H sign was a distinct feature (36%). MOG-IgG associated myelitis attack also demonstrated a lower EDSS score after treatment. Conclusion: MOG-IgG associated myelitis should be recognized as an important clinical component of MOGAD.

[Evaluation of medium to long term efficacy of balloon dilation in the treatment of aural fullness as chief complaint]

Objective: To discuss the characteristics of symptoms improvement based on the follow-up evaluation of Eustachian tube balloon dilation medium to long-term efficacy in patients with symptomatic Eustachian tube dysfunction (SETD). Methods: Patients from 2015 to 2017 were followed up after Eustachian tube balloon dilation (with the sense of aural fullness, or tinnitus and hearing ambiguity). All participants had been done ETDQ-7 before surgery and were re-evaluated with ETDQ-7 in follow-up. The improvement of overall and individual symptoms scores in ETDQ-7, the effects of gender and the difference of scores at different stages (12-18 months, 18-24 months and 24-30 months) after the operation were analyzed. Results: There were 29 patients, including 16 males and 13 females, whose age ranged from 20 to 62 years old. The medium to long-term score of ETDQ-7 significantly declined after surgery (27.0±7.9 vs. 14.1±7.5, P<0.05). Among all symptoms, symptoms like "blockage feeling in ear or being like under the water, constriction feeling" , "sound of blisters or explosions in the ear" decreased obviously (P<0.05). Comparing different stages after surgery, the scores of ETDQ-7 existed no difference (P>0.05). And the difference of gender showed no significant influence on surgery effects. Conclusion: The subjective symptoms of patients with Eustachian tube dysfunction diagnosed with SETD can be significantly improved in the medium to long-term follow-up after Eustachian tube balloon dilation, and the degree of improvement is not linearly related to the postoperative time.

Two novel nornemoralisin-type diterpenoids from Aphanamixis polystachya (Wall.) R. Parker

Two novel heptanornemoralisin-type diterpenoids nornemoralisins A (1) and B (2), together with two known compounds nemoralisin (3) and nemoralisin A (4), were isolated from the stem bark and leaves of Aphanamixis polystachya (Wall.) R. Parker. Their structures were established through comprehensive analyses of NMR spectroscopic data and high resolution mass spectrometric (HR-ESI-MS) data. The absolute configurations of carbon stereocenters were elucidated by circular dichroism (CD) analyses. The four compounds were tested for their potential cytotoxic effects against ACHN, HeLa, SMMC-7721, and MCF-7 cell lines. Nornemoralisins A (1) and B (2) exhibited significant cytotoxicity on ACHN with an IC₅₀ value of 13.9 ± 0.8 and 10.3 ± 0.4 μM, respectively, and other compounds failed to reveal obvious cytotoxicity on the tested cell lines, compared to positive control vinblastine (IC₅₀, 28.0 ± 0.9 μM).

P4528Feasibility and safety of left bundle branch area pacing by transvenous approach through the interventricular septum in patients with left bundle branch block

Background

His bundle pacing (HBP) has been shown to correct left bundle branch block (LBBB), however it often requires high pacing output and the success rate is variable.

Objective

To assess the feasibility and safety of left bundle branch area pacing (LBBAP) in patients with LBBB.

Methods

From Apr 2014 to Aug 2018, patients with LBBB from multicenters indicated for CRT or pacing therapy were included. LBBAP was performed by advancing the MDT 3830 lead deep into the septum about 1 cm distal to the His bundle region (Figure 1F). Pacing characteristics, success rate, threshold and R-wave amplitude were assessed.

Results

A total of 94 patients aged 68.3±10.7 y with the native QRS duration of 167.2±17.2 ms were included. In 92 patients, LBBAP was successfully achieved and demonstrated RBBB pattern during unipolar tip pacing (UTP), with the paced QRS duration of 116.4±12.6ms (Figure 1C). Fusion of LBBAP and native conduction via the RBB eliminated RBBB and resulted in an average QRS duration of 103.2±10.1 ms (Figure 1D). LBB potential could be recorded from the LBB lead during correction of LBBB by HBP in 21 patients who used two leads method (His lead and LBB lead, Figure 1B). Output dependent selective and non-selective LBBAP were demonstrated in 48 patients (Figure 1C, D). The LBB capture threshold by UTP was 0.53±0.18V/0.5ms at acute and 0.62±0.17V/0.5ms at 6 months and 0.65±0.2V/0.5ms at 1 year. The R-wave amplitude were 11.4±5.2mV, 12.4±5.8mV and 12.0±5.8mV at acute, 6 month and 1 year. During follow-up, only one patient had an increase in LBB capture threshold to 2.5V/0.5ms at 3 months and there were no other complications such as dislodgment, infections, embolism or stroke associated with the implantation.

Conclusion

Permanent LBBAP is feasible and safe in patients with LBBB.

P6548Left bundle branch area pacing in patients with atrioventricular block

Background

The application of His bundle pacing (HBP) on patients with distal AV block should be of concern.Left bundle branch Aera pacing (LBBA pacing), pacing immediately beyond the site of block will be considered.

Purpose

To access the clinical benefits and safety of LBBA pacing in patients with atrioventricular (AV) block.

Methods

One hundred and thiry nine patients diagnosed with AVB were included. The Select Secure lead (model 3830; Medtronic) was used. Characteristics of LBB capture are summarized as following: 1) The paced QRS morphology of RBBB pattern during unipolar tip pacing; 2) Usually, LBB potential could be recorded; 3) If higher output pacing shortened the times abruptly and the times remain constant. Pacing parameters (threshold, R-wave amplitude and impedance) and Echocardiographic measurements were assessed during follow-up.

Results

All patients were success achieved LBBA pacing. The detailed baseline characteristic and follow-up were shown in the Table. Threshold, R-wave amplitude and impedance remained stable during follow -up. Echocardiographic measurements showed that LBB pacing did not affect the cardiac function. There was no LV septum penetration and dislodgment.

Conclusion

LBBA pacing had ideal pacing parameters and preserve cardiac function and may be an excellent alternative to HBP or RVP.

Acknowledgement/Funding

Key R&D Program of Zhejiang (2019C03012), Major Project of the Science and Technology of Wenzhou (ZS2017010)

[Advances in the application of cloud platform in diagnosis and treatment of OSA]

Obstructive sleep apnea(OSA) has been a major public health problem due to a surge in the number of patients with OSA, which can create a heavy socio-economic burden. How to effectively carry out mass screening and prevention is an important link in China's health management and chronic disease prevention.The development of cloud computing and Internet of things technology has brought new directions and new solutions.For the sake of diagnosis and treatment of disease involving multiple disciplines, cross cooperation problems, we can use the Internet of things, a cloud platform and the database as the core architecture to establish the network which contains family-primary hospitals-tertiary hospitals-specialized subject and sleep medicine laboratory.With the help of handsets, we are able to realize the effectiveness and convenience of remote cooperation and eventually form the cloud platform diagnosis and treatment system of sleep-related breathing disease based on the large sample data.

[A customized method for information extraction from unstructured text data in the electronic medical records]

OBJECTIVE

There is a huge amount of diagnostic or treatment information in electronic medical record (EMR), which is a concrete manifestation of clinicians actual diagnosis and treatment details. Plenty of episodes in EMRs, such as complaints, present illness, past history, differential diagnosis, diagnostic imaging, surgical records, reflecting details of diagnosis and treatment in clinical process, adopt Chinese description of natural language. How to extract effective information from these Chinese narrative text data, and organize it into a form of tabular for analysis of medical research, for the practical utilization of clinical data in the real world, is a difficult problem in Chinese medical data processing.

METHODS

Based on the EMRs narrative text data in a tertiary hospital in China, a customized information extracting rules learning, and rule based information extraction methods is proposed. The overall method consists of three steps, which includes: (1) Step 1, a random sample of 600 copies (including the history of present illness, past history, personal history, family history, etc.) of the electronic medical record data, was extracted as raw corpora. With our developed Chinese clinical narrative text annotation platform, the trained clinician and nurses marked the tokens and phrases in the corpora which would be extracted (with a history of diabetes as an example). (2) Step 2, based on the annotated corpora clinical text data, some extraction templates were summarized and induced firstly. Then these templates were rewritten using regular expressions of Perl programming language, as extraction rules. Using these extraction rules as basic knowledge base, we developed extraction packages in Perl, for extracting data from the EMRs text data. In the end, the extracted data items were organized in tabular data format, for later usage in clinical research or hospital surveillance purposes. (3) As the final step of the method, the evaluation and validation of the proposed methods were implemented in the National Clinical Service Data Integration Platform, and we checked the extraction results using artificial verification and automated verification combined, proved the effectiveness of the method.

RESULTS

For all the patients with diabetes as diagnosed disease in the Department of Endocrine in the hospital, the medical history episode of these patients showed that, altogether 1 436 patients were dismissed in 2015, and a history of diabetes medical records extraction results showed that the recall rate was 87.6%, the accuracy rate was 99.5%, and F-Score was 0.93. For all the 10% patients (totally 1 223 patients) with diabetes by the dismissed dates of August 2017 in the same department, the extracted diabetes history extraction results showed that the recall rate was 89.2%, the accuracy rate was 99.2%, F-Score was 0.94.

CONCLUSION

This study mainly adopts the combination of natural language processing and rule-based information extraction, and designs and implements an algorithm for extracting customized information from unstructured Chinese electronic medical record text data. It has better results than existing work.

Propofol attenuates H2O2-induced oxidative stress and apoptosis via the mitochondria- and ER-medicated pathways in neonatal rat cardiomyocytes

Previous studies have shown that propofol, an intravenous anesthetic commonly used in clinical practice, protects the myocardium from injury. Mitochondria- and endoplasmic reticulum (ER)-mediated oxidative stress and apoptosis are two important signaling pathways involved in myocardial injury and protection. The present study aimed to test the hypothesis that propofol could exert a cardio-protective effect via the above two pathways. Cultured neonatal rat cardiomyocytes were treated with culture medium (control group), H₂O₂ at 500 μM (H₂O₂ group), propofol at 50 μM (propofol group), and H₂O₂ plus propofol (H₂O₂ + propofol group), respectively. The oxidative stress, mitochondrial membrane potential (ΔΨm) and apoptosis of the cardiomyocytes were evaluated by a series of assays including ELISA, flow cytometry, immunofluorescence microscopy and Western blotting. Propofol significantly suppressed the H₂O₂-induced elevations in the activities of caspases 3, 8, 9 and 12, the ratio of Bax/Bcl-2, and cell apoptosis. Propofol also inhibited the H₂O₂-induced reactive oxygen species (ROS) generation, lactic dehydrogenase (LDH) release and mitochondrial transmembrane potential (ΔΨm) depolarization, and restored the H₂O₂-induced reductions of glutathione (GSH) and superoxide dismutase (SOD). In addition, propofol decreased the expressions of glucose-regulated protein 78 kDa (Grp78) and inositol-requiring enzyme 1α (IRE1α), two important signaling molecules in the ER-mediated apoptosis pathway. Propofol protects cardiomyocytes from H₂O₂-induced injury by inhibiting the mitochondria- and ER-mediated apoptosis signaling pathways.

Atlantoaxial Joint Interlocking Following Type II Odontoid Fracture Associated with Posterolateral Atlantoaxial Dislocation: a Case Report and Review of Published Reports

A rare case of atlantoaxial lateral mass joint interlocking secondary to traumatic posterolateral C1,2 complete dislocation associated with type II odontoid fracture is herein reported and the impact of atlantoaxial joint interlocking on fracture reduction discussed. A 72-year-old man presented with traumatic atlantoaxial lateral mass joint interlocking without spinal cord signal change, the diagnosis being confirmed by radiography and 3-D reconstruction digital anatomy. Posterior internal fixation was performed after failure to achieve closed reduction by skull traction. After many surgical attempts at setting had failed because of interlocking of the lateral mass joints, reduction was achieved by compressing the posterior parts of the atlantal and axial screws. Odontoid bone union and C1,2 posterior bone graft fusion were eventually obtained by the 12-month follow-up. The patient had a complete neurological recovery with no residual neck pain or radiculopathy.

Induction of cell death by pyropheophorbide-α methyl ester-mediated photodynamic therapy in lung cancer A549 cells

Pyropheophorbide‐α methyl ester (MPPa) was a promising photosensitizer with stable chemical structure, strong absorption, higher tissue selectivity and longer activation wavelengths. The present study investigated the effect of MPPa‐mediated photodynamic treatment on lung cancer A549 cells as well as the underlying mechanisms. Cell Counting Kit‐8 was employed for cell viability assessment. Reactive oxygen species levels were determined by fluorescence microscopy and flow cytometry. Cell morphology was evaluated by Hoechst staining and transmission electron microscopy. Mitochondrial membrane potential, cellular apoptosis and cell cycle distribution were evaluated flow‐cytometrically. The protein levels of apoptotic effectors were examined by Western blot. We found that the photocytotoxicity of MPPa showed both drug‐ and light‐ dose dependent characteristics in A549 cells. Additionally, MPPa‐PDT caused cell apoptosis by reducing mitochondrial membrane potential, increasing reactive oxygen species (ROS) production, inducing caspase‐9/caspase‐3 signaling activation as well as cell cycle arrest at G₀/G₁ phase. These results suggested that MPPa‐PDT mainly kills cells by apoptotic mechanisms, with overt curative effects, indicating that MPPa should be considered a potent photosensitizer for lung carcinoma treatment.

Interleukin-6 -572G/C polymorphism and prostate cancer susceptibility

Strong evidence suggests that cancer-associated inflammation promotes tumor growth and progression, and interleukin-6 (IL6) is an important modulator of inflammation. However, the roles of IL6 and mutations of its corresponding gene in prostate cancer have not been clearly documented. We retrieved data from the Oncomine database concerning IL6 expression in prostate cancer and its role in prostate-specific antigen (PSA) recurrence. We also performed a case-control study of the IL6 -572G/C polymorphism (rs1800796) in 236 sporadic prostate cancer patients and 256 healthy controls from a southern Han Chinese population. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated to assess the association between rs1800796 and prostate cancer susceptibility. A dual-luciferase reporter assay was used to test the transcriptional activity of the IL6 promoter G and C alleles. IL6 was overexpressed in prostate cancer tissues compared to normal tissues, especially in those with higher Gleason scores. Moreover, elevated IL6 expression was associated with high PSA recurrence rate in Oncomine data. Our case-control study demonstrated that compared with the -572C allele, the -572G allele conferred a borderline increased risk of prostate cancer (OR = 1.31, 95%CI = 0.99-1.74, P = 0.061). This was more pronounced in the subgroup of individuals having never smoked (OR = 1.85, 95%CI = 1.07-3.22). Moreover, the G allele showed increased activity relative to the C allele in the dual-luciferase reporter assay. Our results suggest that the -572G/C polymorphism may be associated with IL6 expression, which in turn plays a role in prostate cancer development.

Therapeutic effect of Pleurotus eryngii cellulose on experimental fatty liver in rats

The aim of this study was to explore the therapeutic effect of Pleurotus eryngii cellulose on experimental fatty liver in rats. Rats were fed high-fat fodder to establish a rat fatty liver model, and were then fed different concentrations of Pleurotus eryngii cellulose for six weeks. Lipitor was used as a positive control. Measured levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), and total triglyceride (TG); the activity of malondialdehyde (MDA), superoxide dismutase (SOD), hepatic lipase (HL), and lipoprotein lipase; and liver histopathological changes. Successfully established rat fatty liver model after feeding high-fat fodder for one week. A diet of P. eryngii cellulose for six weeks significantly reduced ALT, AST, TC, and TG levels in rat serum (P < 0.01); TC and AST levels in P. eryngii cellulose high-dose group and Lipitor group were not significantly different from those of the control (P > 0.05). SOD activity increased significantly, while MDA and HL activity decreased (P < 0.05); fatty degeneration and fat accumulation both decreased in hepatic tissue. Hepatic protection of P. eryngii cellulose showed dose-related effect. P. eryngii cellulose can affect lipid metabolism, having therapeutic effects on fatty liver in rats.

Genistein induces activation of the mitochondrial apoptosis pathway by inhibiting phosphorylation of Akt in colorectal cancer cells

CONTEXT

Genistein inhibits the proliferation and induces apoptosis of colorectal cancer cells; however, the underling molecular mechanisms remain to be determined.

AIM

The aim of this study was to investigate whether genistein reduces cell viability by suppressing the phosphorylation of AKT and activating the mitochondrial apoptosis pathway in colorectal cancer cells.

MATERIALS AND METHODS

The anti-proliferative effects of genistein (0, 25, 50, and 100 μM) on HCT-116 and LoVo cells were assessed using MTT assay. Genistein-induced apoptosis was measured by Hoechst 33258 staining and flow cytometry. The mRNA level of Bax was detected by real-time PCR. The protein levels of Bax, total Akt, and phosphorylated Akt were assessed by western blot.

RESULTS

The IC50 values of genistein were 690, 135, and 61 μM in HCT-116 cells and 204, 135, and 93 μM in LoVo cells after treatment for 24, 48, and 72 h, respectively. After treatment with different concentrations of genistein (0, 25, 50, and 100 μM) for 48 h, the early apoptotic cells in HCT-116 increased from 1.99% ± 0.55% to 6.78% ± 2.12%, 23.16% ± 3.87%, and 36.99% ± 3.76%, respectively. The same concentrations of genistein increased the early apoptotic cells in LoVo from 2.56% ± 1.42% to 3.21% ± 1.52%, 18.22% ± 3.56%, and 23.56% ± 3.02%, respectively. Moreover, genistein increased the mRNA and protein levels of Bax, while it inhibited the phosphorylation of Akt in HCT-116 cells.

CONCLUSION

Genistein inhibited cell proliferation and induced apoptosis of colorectal cancer cells. Genistein induced the mitochondrial pathway of apoptosis in HCT-116 cells by inhibiting phosphorylation of Akt.

Terpenoids from Euphorbia pekinensis

Euphorpekone A (1) and euphorpekone B (2), two new diterpenoids, 3β-hydroxy-25-methyloxylanosta-8,23-diene, a new triterpenoid (3), together with a known triterpenoid, 3β,25-dihydroxylanosta-8,23-diene (4), were isolated from Euphorbia pekinensis Rupr. Their structures were elucidated on the basis of UV, IR, 1D ((1)H, (13)C, NOE) and 2D ((1)H-(1)H COSY, HSQC, HMBC) NMR, HR-ESI-MS, X-ray diffraction analysis, and CD method.

Efficacy of the low-dose Saccharum iron treatment of idiopathic restless legs syndrome

AIM

The aim of the study was to determine the efficacy of low-dose and high-dose Saccharum iron injected intravenously in patients with idiopathic restless legs syndrome (RLS) by detecting levels of serum ferritin (SF) and international RLS Severity Scale.

METHODS

For this purpose, 38 patients with idiopathic RLS were randomly divided into the following two groups: low-dose group (18 cases) and high-dose group (20 cases). Low-dose group received Saccharum iron intravenously (200 mg/dose); once a week for 5 weeks with a total dose of 1000 mg. High-dose group received Saccharum iron intravenously (500 mg/dose); once every two weeks for 4 weeks with a total dose of 1000 mg. The pre- and post-treatment (at 2, 4, and 6 weeks) level of SF and RLS scores were determined and the differences were compared between two groups.

RESULTS

Post-therapeutic SF levels increased significantly in both groups as compared with before treatment (P<0.05). At 6-week post-therapy, SF levels in low-dose group were significantly higher than those in high-dose group (P<0.05). The clinical symptoms were improved and RLS scores were lower than pretreatment ratings in both groups (P<0.05). After 6 weeks of treatment, RLS scores of low-dose group were lower than those of high-dose group (P<0.05).

CONCLUSION

Both the low-dose and high-dose Saccharum iron treatments increased the SF levels and improved clinical symptoms in patients with idiopathic RLS; however, the low-dose iron treatment was found to be more effective and had fewer side effects.

Relaxin inhibits cardiac fibrosis and endothelial-mesenchymal transition via the Notch pathway

BACKGROUND

Relaxin (RLX) can prevent cardiac fibrosis. We aimed to investigate the possible mechanism and signal transduction pathway of RLX inhibiting cardiac fibrosis.

METHODS

Isoproterenol (5 mg·kg(-1)·d(-1)) was used to establish the cardiac fibrosis model in rats, which were administered RLX. The cardiac function, related targets of cardiac fibrosis, and endothelial-mesenchymal transition (EndMT) were measured. Transforming growth factor β (TGF-β) was used to induce EndMT in human umbilical vein endothelial cells, which were pretreated with RLX, 200 ng·mL(-1), then with the inhibitor of Notch. Transwell cell migration was used to evaluate cell migration. CD31 and vimentin content was determined by immunofluorescence staining and Western blot analysis. Notch protein level was examined by Western blot analysis.

RESULTS

RLX improved cardiac function in rats with cardiac fibrosis; it reduced the content of collagen I and III, increased the microvascular density of the myocardium, and suppressed the EndMT in heart tissue. In vitro, RLX decreased the mobility of human umbilical vein endothelial cells induced by TGF-β, increased the expression of endothelial CD31, and decreased vimentin content. Compared to TGF-β and RLX co-culture alone, TGF-β + RLX + Notch inhibitor increased cell mobility and the EndMT, but decreased the levels of Notch-1, HES-1, and Jagged-1 proteins.

CONCLUSION

RLX may inhibit the cardiac fibrosis via EndMT by Notch-mediated signaling.