Comparative evaluation of amino acid profiles, fatty acid compositions, and nutritional value of two varieties of head water Porphyra yezoensis: "Jianghaida No. 1" and "Sutong No.1"

Comparative nutritional analysis of Porphyra yezoensis strains "Jianghai No. 1" and "Sutong No.1" revealed significant differences in crude protein, crude fat, crude fiber, crude ash, and total sugar. Both strains contained 16 amino acids, with alanine as the highest and histidine the lowest content. Methionine was determined to be the first limiting amino acid for both strains in both amino acid score and chemical score assessment. They also featured 24 fatty acids, differing notably in four saturated fatty acids and five unsaturated fatty acids. All 12 mineral elements were present, notably differing in sodium, magnesium, potassium, calcium, iron, and zinc. The "Jianghai No. 1" strain stands out with its nutrient-rich profile, featuring high protein content, low fat, and abundant minerals, which could potentially command higher market prices and generate greater economic benefits due to its superior nutritional, and set a strong foundation for its future large-scale promotion and cultivation.

Comprehensive investigation of differentially expressed ncRNAs, mRNAs, and their ceRNA networks in the regulation of shell color formation in clam, Cyclina sinensis

Noncoding RNAs (ncRNAs) have gained significant attention in recent years due to their crucial roles in various biological processes. However, our understanding of the expression and functions of ncRNAs in Cyclina sinensis, an economically important marine bivalve, remains limited. This study aimed to address this knowledge gap by systematically identifying ncRNAs in the mantles of C. sinensis with purple and white shells. Through our analysis, we identified a differential expression of 1244 mRNAs, 196 lncRNAs, 49 circRNAs, and 23 miRNAs between purple- and white-shell clams. Functional enrichment analysis revealed the involvement of these differentially expressed ncRNAs in biomineralization and pigmentation processes. To gain further insights into the regulatory mechanisms underlying shell color formation, we established competitive endogenous RNA (ceRNA) networks. These networks allowed us to identify targeted differentially expressed miRNAs (DEMis) and genes associated with shell color formation. Based on the ceRNA networks, we obtained an up-down-up lncRNA-miRNA-mRNA network consisting of 13 upregulated lncRNAs and a circRNA-miRNA-mRNA network comprising three upregulated circRNAs (novel_circ_0004787, novel_circ_0001165, novel_circ_0000245). Through these networks, we identified and selected an upregulated novel gene (evm.TU.Hic_asm_7.988) and a downregulated sponge miRNA (hru-miR-1985) as potential contributors to shell color regulation. In summary, the present investigation offers a comprehensive analysis of ncRNA catalogs expressed in the clam mantle of C. sinensis. The findings enhance our comprehension of the molecular mechanisms governing shell coloration and offer new perspectives for selective breeding of C. sinensis in the future.

The genetic landscape of histologically transformed marginal zone lymphomas

BACKGROUND

Marginal zone lymphomas (MZLs) comprise a diverse group of indolent lymphoproliferative disorders; however, some patients develop histologic transformation (HT) with rapid progression to aggressive lymphoma.

METHODS

Forty-three MZLs with HT (HT-MZLs), 535 MZLs, and 174 de novo diffuse large B-cell lymphomas (DLBCLs) without rearrangements of MYC, BCL2, and BCL6 were collected. Among these, 22 HT-MZLs, 39 MZLs, and 174 DLBCLs were subjected to 148-gene targeted exome sequencing. The clinicopathologic features of patients who had HT-MZL and their genetic alterations were compared with those of patients who had MZLs and DLBCLs.

RESULTS

All 43 HT-MZLs corresponded to DLBCLs. No HT-MZLs harbored BCL2 and MYC and/or BCL6 rearrangements. Bone marrow involvement and higher levels of lactate dehydrogenase were significantly more common in HT-MZLs than in MZLs. Furthermore, upregulated BCL6, MUM1, C-MYC, and Ki-67 expression was observed more frequently in HT-MZLs than in MZLs. TBL1XR1 was the most frequently altered gene (63.6%) in HT-MZLs, followed by CCND3 (31.8%), CARD11, ID3, and TP53 (22.7%). A trend toward worse progression-free survival in patients with TBL1XR1 mutations was observed. Compared with MZLs and non-germinal center B-cell (GCB) type DLBCLs, significantly higher frequencies of TBL1XR1 and ID3 mutations were identified in HT-MZLs. PIM1 mutations frequently occurred in DLBCLs and were significantly associated with TBL1XR1 mutations but were mutated less in HT-MZLs that had TBL1XR1 mutations.

CONCLUSIONS

The current findings reveal the clinicopathologic and genetic features of HT-MZLs, suggesting that these tumors might constitute a group distinct from MZL and de novo non-GCB type DLBCL. TBL1XR1 mutations may be considered a predictor of HT in MZL.

Maternal androgen excess inhibits fetal cardiomyocytes proliferation through RB-mediated cell cycle arrest and induces cardiac hypertrophy in adulthood

PURPOSE

Maternal hyperandrogenism during pregnancy is associated with adverse gestational outcomes and chronic non-communicable diseases in offspring. However, few studies are reported to demonstrate the association between maternal androgen excess and cardiac health in offspring. This study aimed to explore the relation between androgen exposure in utero and cardiac health of offspring in fetal and adult period. Its underlying mechanism is also illustrated in this research.

METHODS

Pregnant mice were injected with dihydrotestosterone (DHT) from gestational day (GD) 16.5 to GD18.5. On GD18.5, fetal heart tissue was collected for metabolite and morphological analysis. The hearts from adult offspring were also collected for morphological and qPCR analysis. H9c2 cells were treated with 75 μM androsterone. Immunofluorescence, flow cytometry, qPCR, and western blot were performed to observe cell proliferation and explore the underlying mechanism.

RESULTS

Intrauterine exposure to excessive androgen led to thinner ventricular wall, decreased number of cardiomyocytes in fetal offspring and caused cardiac hypertrophy, compromised cardiac function in adult offspring. The analysis of steroid hormone metabolites in fetal heart tissue by ultra performance liquid chromatography and tandem mass spectrometry showed that the content of androgen metabolite androsterone was significantly increased. Mechanistically, H9c2 cells treated with androsterone led to a significant decrease in phosphorylated retinoblastoma protein (pRB) and cell cycle-related protein including cyclin-dependent kinase 2 (CDK2), cyclin-dependent kinase 4 (CDK4), and cyclin D1 (CCND1) in cardiomyocytes. This resulted in cell cycle arrest at G1-S phase, which in turn inhibited cardiomyocyte proliferation.

CONCLUSION

Taken together, our results indicate that in utero exposure to DHT, its metabolite androsterone could directly decrease cardiomyocytes proliferation through cell cycle arrest, which has a life-long-lasting effect on cardiac health. Our study highlights the importance of monitoring sex hormones in women during pregnancy and the follow-up of cardiac function in offspring with high risk of intrauterine androgen exposure.

Impact of the COVID-19 pandemic on the prevalence of respiratory viral pathogens in patients with acute respiratory infection in Shanghai, China

Objective

This study aimed to evaluate the impact of nonpharmaceutical interventions (NPIs) taken to combat COVID-19 on the prevalence of respiratory viruses (RVs) of acute respiratory infections (ARIs) in Shanghai.

Methods

Samples from ARI patients were collected and screened for 17 respiratory viral pathogens using TagMan low density microfluidic chip technology in Shanghai from January 2019 to December 2020. Pathogen data were analyzed to assess changes in acute respiratory infections between 2019 and 2020.

Results

A total of 2,744 patients were enrolled, including 1,710 and 1,034 in 2019 and 2020, respectively. The total detection rate of RVs decreased by 149.74% in 2020. However, detection rates for human respiratory syncytial virus B (RSVB), human coronavirus 229E (HCoV229E), human coronavirus NL63 (HCoVNL63), and human parainfluenza virus 3 (HPIV3) increased by 91.89, 58.33, 44.68 and 24.29%, in 2020. The increased positive rates of RSVB, HPIV3, resulted in more outpatients in 2020 than in 2019. IFV detection rates declined dramatically across gender, age groups, and seasons in 2020.

Conclusion

NPIs taken to eliminate COVID-19 had an impact on the prevalence of respiratory viral pathogens, especially the IFVs in the early phases of the pandemic. Partial respiratory viruses resurged with the lifting of NPIs, leading to an increase in ARIs infection.

Calibration method of the right-angle error of a hollow corner-cube retroreflector based on an independent autocollimator

Hollow corner-cube retroreflectors (HCCRs) are an essential reflection component of next-generation lunar laser-ranging technology. The verticality among the three reflectors, known as the right-angle error, is a critical parameter that affects the emission performance, and thus, should be correctly measured and calibrated. However, conventional methods measure the three right-angle errors separately, which can induce error superposition during the measurement process. A one-time measurement method was developed for the three right-angle errors of the HCCR using a single autocollimator (AC). The method establishes a mathematical relationship between the right-angle error of the HCCR and the angle offset of the reflected beam, and it considers the observation coordinates of the AC simultaneously to perform the coordinate transformation of the relationship parameters. The corresponding measurement equation was derived to extract the three-plane right-angle error of the HCCR using the measured readings of a single AC. In addition, a HCCR was designed to freely adjust the angle of the two reflective surfaces and used to simulate the different states of the three right-angle errors in practice. The measurement results show that the root-mean-square error of the proposed method in all right-angle error states is smaller than 16 ' ' .

iAMP-Attenpred: a novel antimicrobial peptide predictor based on BERT feature extraction method and CNN-BiLSTM-Attention combination model

As a kind of small molecule protein that can fight against various microorganisms in nature, antimicrobial peptides (AMPs) play an indispensable role in maintaining the health of organisms and fortifying defenses against diseases. Nevertheless, experimental approaches for AMP identification still demand substantial allocation of human resources and material inputs. Alternatively, computing approaches can assist researchers effectively and promptly predict AMPs. In this study, we present a novel AMP predictor called iAMP-Attenpred. As far as we know, this is the first work that not only employs the popular BERT model in the field of natural language processing (NLP) for AMPs feature encoding, but also utilizes the idea of combining multiple models to discover AMPs. Firstly, we treat each amino acid from preprocessed AMPs and non-AMP sequences as a word, and then input it into BERT pre-training model for feature extraction. Moreover, the features obtained from BERT method are fed to a composite model composed of one-dimensional CNN, BiLSTM and attention mechanism for better discriminating features. Finally, a flatten layer and various fully connected layers are utilized for the final classification of AMPs. Experimental results reveal that, compared with the existing predictors, our iAMP-Attenpred predictor achieves better performance indicators, such as accuracy, precision and so on. This further demonstrates that using the BERT approach to capture effective feature information of peptide sequences and combining multiple deep learning models are effective and meaningful for predicting AMPs.

Case report: Curing a rare, unstable hemoglobin variant Hb Bristol-Alesha using haploidentical hematopoietic stem cell transplantation

Unstable hemoglobinopathies are a rare, heterogeneous group of diseases that disrupt the stability of hemoglobin (Hb), leading to chronic hemolysis and anemia. Patients with severe phenotypes often require regular blood transfusions and iron chelation therapy. Although rare, studies have reported that hematopoietic stem cell transplantation (HSCT) seems to be an available curative approach in transfusion-dependent patients with unstable hemoglobinopathies. Here, we describe successful haploidentical HSCT for the treatment of an unstable Hb variant, Hb Bristol-Alesha, in a 6-year-old boy with severe anemia since early childhood. Two years after transplantation, he had a nearly normal hemoglobin level without evidence of hemolysis. DNA analysis showed complete chimerism of the donor cell origin, confirming full engraftment with normal erythropoiesis.

Toxicities associated with immune checkpoint inhibitors: a systematic study

BACKGROUND

Available evidence shows that the incidence of toxicities associated with cancer immunotherapy, such as programmed cell death 1 (PD-1) and programmed cell death 1 ligand 1 (PD-L1)-related toxicities, is estimated to be between 0.3 and 1.3%.

OBJECTIVE

This systematic review aimed to investigate cancer patients' susceptibility to toxicities associated with PD-1/PD-L1 inhibitors and establish a clinically relevant landscape of side effects of PD-1/PD-L1 inhibitors.

DATA SOURCES

Relevant publications from PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI) between 2014 and 2019.

STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS

We searched randomized controlled trials (RCTs) reporting treatment-related toxicities associated with PD-1 and PD-L1 inhibitors in the treatment of cancers. The primary endpoint was to assess the difference in the incidences of toxicities between cancer patients who did and did not receive PD-1/PD-L1 inhibitors. A total of 29 RCTs, incorporating 8576 patients, met the eligibility criteria.

STUDY APPRAISAL AND SYNTHESIS METHODS

We calculated the pooled relative risks and corresponding 95% CIs using a random-effects model and assessed the heterogeneity between different groups. The subgroup analyses were conducted based on cancer type, toxicity grade (severity), system and organ, treatment regimens in the intervention arm and the control arm, PD-1/PD-L1 inhibitor drug type, and cancer type.

RESULTS

A total of 11 categories (e.g. endocrine toxicity), and 39 toxicity types (e.g. hyperthyroidism) were identified. For toxicities at any grade, those treated with PD-1/PD-L1 inhibitors were at lower risks for gastrointestinal toxicity, hematologic toxicity, and treatment event leading to discontinuation; and were at higher risks for respiratory toxicity (all P <0.05). Those treated with PD-1/PD-L1 inhibitors were at lower risks for fatigue, asthenia, and peripheral edema and were at higher risks for pyrexia, cough, dyspnea, pneumonitis, and pruritus.

LIMITATIONS

The present research is a meta-analysis at the study level rather than at the patient level; insights on risk factors associated with the development of toxicities cannot be found in our study. There was a possible overlap in Common Terminology Criteria for Adverse Events (CTCAE) definitions which prevents understanding the true rates of specific toxicities.

CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS

For most toxicity types based on system and organ, the incidence proportions for patients in the intervention arm were lower than those in the control arm, which suggested the general safety of PD-1/PD-L1 inhibitors against conventional chemotherapy and cytotoxic t-lymphocyte-associated protein 4 (CTLA-4) inhibitors. Future research should focus on taking effective targeted measures to decrease the risks of different toxicities for different patient populations.

SYSTEMATIC REVIEW REGISTRATION NUMBER

We registered the research protocol with PROSPERO (registration number CRD42019135113).

[LINC00926 promotes pyroptosis of hypoxia-induced human umbilical vein vascular endothelial cells by recruiting ELAVL1]

OBJECTIVE

To investigate the regulatory role of the long non-coding RNA LINC00926 in pyroptosis of hypoxia-induced human umbilical vein vascular endothelial cells (HUVECs) and explore the molecular mechanism.

METHODS

HUVECs were transfected with a LINC00926-overexpressing plasmid (OE-LINC00926), a siRNA targeting ELAVL1, or both, followed by exposure to hypoxia (5% O2) or normoxia. The expression of LINC00926 and ELAVL1 in hypoxia-treated HUVECs was detected using real-time quantitative PCR (RT-qPCR) and Western blotting. Cell proliferation was detected using Cell Counting Kit-8 (CCK-8), and the levels of IL-1β in the cell cultures was determined with ELISA. The protein expression levels of pyroptosis-related proteins (caspase-1, cleaved caspase-1 and NLRP3) in the treated cells were analyzed using Western blotting, and the binding between LINC00926 and ELAVL1 was verified with RNA immunoprecipitation (RIP) assay.

RESULTS

Exposure to hypoxia obviously up-regulated the mRNA expression of LINC00926 and the protein expression of ELAVL1 in HUVECs, but did not affect the mRNA expression of ELAVL1. LINC00926 overexpression in the cells significantly inhibited cell proliferation, increased IL-1β level and enhanced the expressions of pyroptosis-related proteins (all P < 0.05). LINC00926 overexpression further up-regulated the protein expression of ELAVL1 in hypoxia-exposed HUVECs. The results of RIP assay confirmed the binding between LINC00926 and ELAVL1. ELAVL1 knockdown significantly decreased IL-1β level and the expressions of pyroptosis-related proteins in hypoxia-exposed HUVECs (P < 0.05), while LINC00926 overexpression partially reversed the effects of ELAVL1 knockdown.

CONCLUSION

LINC00926 promotes pyroptosis of hypoxia-induced HUVECs by recruiting ELAVL1.

Gastric cancer-derived exosomes facilitate pulmonary metastasis by activating ERK-mediated immunosuppressive macrophage polarization

Gastric cancer (GC) with pulmonary metastasis is one of the deadliest diseases in the world; however, the underlying pathological mechanisms and potential therapeutic targets remain to be elucidated. As exosomes play indispensable roles in the formation of premetastatic niches (PMN) and cancer metastasis. Therefore, investigating the underlying mechanisms of exosome-mediated pulmonary metastasis of GC may shed new light on identifying novel therapeutic targets for GC treatment. GC-derived exosomes were isolated from the conditioned medium of mouse forestomach carcinoma (MFC) cell line. The effects of MFC-derived exosomes on pulmonary macrophage polarization were analyzed by reverse- transcription polymerase chain reaction and flow cytometry. Expression of PD-L1 and other proteins was evaluated by Western blot. Exosomal microRNAs (miRNAs) were analyzed by microarray. GC-derived exosomes (GC-exo) accumulated in high numbers in the lungs and were ingested by macrophages. The extracellular-signal-regulated kinase (ERK) signaling pathway was activated by GC-exo, inducing macrophage immunosuppressive-phenotype differentiation and increased PD-L1 expression. miRNA-sequencing identified 130 enriched miRNAs in GC-exo. Among the enriched miRNAs, miR-92a-3p plays a major role in activating ERK signaling via inhibition of PTEN expression. In addition, inhibiting ERK signaling with PD98059 significantly reduced the expression of PD-L1 in macrophages and, therefore, reversed the immunosuppressive PMN and inhibited the colonization of GC cells in the lungs. This study identified a novel mechanism of GC-exo mediated PD-L1 expression in lung macrophages that facilitates lung PMN formation and GC pulmonary metastasis, which also provided a potential therapeutic target for GC with pulmonary metastasis treatment.

Changes in integrins αv and α5 with Nogo-A in the rat retina after optic nerve injury

OBJECTIVE

  The purpose of this study was to investigate whether integrin levels are associated with axon regeneration after central nervous system (CNS) injury.

MATERIALS AND METHODS

By using immunohistochemistry, we performed a detailed investigation of the changes in and colocalization of integrins αv and α5, with Nogo-A in the retina after optic nerve injury.

RESULTS

We confirmed that integrins αv and α5 were expressed in the rat retina and colocalized with Nogo-A. After optic nerve transection, we found that integrin α5 levels increased over 7 days, but integrin αv levels remained unchanged, while Nogo-A levels increased.

CONCLUSIONS

It seems that the inhibition of axonal regeneration by the Amino-Nogo-integrin signaling pathway may not occur via changes in integrin levels.

[Susceptibility and mechanism of sodium salicylate-induced tinnitus model in low estrogen rats]

Objective: The susceptibility of tinnitus rats with low estrogen level induced by sodium salicylate and the changes of tumor necrosis factor α (TNF-α) in serum were observed to investigate the relationship between tinnitus occurrence and estrogen level. Methods: Forty-two healthy female Wistar rats were randomly divided into control group(n=6), normal group(n=6), sham operation group(n=6) and ovariectomized group(n=24). Control group was intraperitoneally injected with normal saline 200 mg/kg for 14 consecutive days. Normal group, sham operation group and ovariectomized group were intraperitoneally injected with sodium salicylate 200 mg/kg for 14 consecutive days. Before and after sodium salicylate induction, the tinnitus behavior of rats in each group was detected by prepulse inhibition (PPI) and gap pre-pulse inhibition of the acoustic startle (GPIAS) test. Before and after sodium salicylate induction, blood samples were collected from eyeballs of rats in each group, and serum levels of estradiol and TNF-α were detected by ELISA. SPSS 25.0 software was used to analyze the data. Results: (1) Following 14 days of sodium salicylate intervention, there was no significant difference in PPI inhibition rate between groups or within groups(all P>0.05). (2)There was no significant difference in the inhibition rate of GPIAS in the four groups before sodium salicylate injection(F=0.217, P>0.05). With sodium salicylate injected for 14 days, the inhibition rate of GPIAS in ovariectomized group (30.88%±15.40%) was significantly lower than that in the other three groups (44.11%±21.06%, 38.27%±10.92%, 51.59%±11.34%), and the difference was statistically significant(F=3.533, P<0.05). The inhibition rate of GPIAS in ovariectomized group with sodium salicylate injected for 14 days was significantly lower than that before injection, and the difference was statistically significant(t=2.977, P<0.05).There was no significant difference in GPIAS inhibition rate between the other three groups before and after sodium salicylate injection(P>0.05). (3)The level of TNF-α in ovariectomized rats was significantly higher than that in the other three groups, the difference was statistically significant(all P<0.05). With sodium salicylate injection for 14 days, TNF-α level in the ovariectomized group increased more significantly than that in the other three groups, the difference was statistically significant(F=8.045, P<0.05). TNF-α levels increased following salicylate injection in normal group, sham operation group and ovariectomized group, and the differences were statistically significant(t value was -4.843, -4.932 and -5.965 respectively, each P<0.05). There was no significant difference in TNF-α levels before and after normal saline injection in control group(all P>0.05). Conclusion: Low estrogen levels increase susceptibility to sodium salicylate-induced tinnitus. Decreased estrogen levels may increase susceptibility to tinnitus through the increased expression of pro-inflammatory factor TNF-α.

Experimental and Quantum Chemical Study on the Inhibition Characteristics of Glutathione to Coal Oxidation at Low Temperature

In response to the frequent occurrence of coal spontaneous combustion accidents, this paper proposes to use glutathione (GSH) as an inhibitor to inhibit the coal oxidation at low temperature. Based on the gas production of oxidation, thermogravimetric analysis, electron spin resonance, and in situ Fourier infrared transform spectroscopy experiments, it is known that GSH has a good inhibiting effect on lignite, long-flame coal, and fatty coal. The optimal action temperature of GSH is 60-150 °C, which can effectively slow down the weight loss and exothermic process and reduce the gas production of CO and CO₂. Compared with the raw coal, the GSH-treated coal samples possess higher crossing point temperature and lower reactive group content. Subsequently, quantum chemical calculations are performed using density functional theory. The results demonstrate that the inhibiting mechanism of GSH is inerting the reactive radicals in coal and converting them into more stable compounds. Meanwhile, the activation energy of the reaction between GSH and each reactive radical is small, and all of them can occur at room temperature and pressure. This study lays the groundwork for future development of inhibitors.

Grading detection of “Red Fuji” apple in Luochuan based on machine vision and near-infrared spectroscopy

A quality detection system for the “Red Fuji” apple in Luochuan was designed for automatic grading. According to the Chinese national standard, the grading principles of apple appearance quality and Brix detection were determined. Based on machine vision and image processing, the classifier models of apple defect, contour, and size were constructed. And then, the grading thresholds were set to detect the defective pixel ratio t, aspect ratio λ, and the cross-sectional diameter Wp in the image of the apple. Spectral information of apples in the wavelength range of 400 nm~1000 nm was collected and the multiple scattering correction (MSC) and standard normal variable (SNV) transformation methods were used to preprocess spectral reflectance data. The competitive adaptive reweighted sampling (CARS) algorithm and the successive projections algorithm (SPA) were used to extract characteristic wavelength points containing Brix information, and the CARS-PLS (partial least squares) algorithm was used to establish a Brix prediction model. Apple defect, contour, size, and Brix were combined as grading indicators. The apple quality online grading detection platform was built, and apple’s comprehensive grading detection algorithm and upper computer software were designed. The experiments showed that the average accuracy of apple defect, contour, and size grading detection was 96.67%, 95.00%, and 94.67% respectively, and the correlation coefficient Rp of the Brix prediction set was 0.9469. The total accuracy of apple defect, contour, size, and Brix grading was 96.67%, indicating that the detection system designed in this paper is feasible to classify “Red Fuji” apple in Luochuan.

Study of Butylated Hydroxytoluene Inhibiting the Coal Oxidation at Low Temperature: Combining Experiments and Quantum Chemical Calculations

In order to cut off the chain reaction in the process of coal oxidation at low temperature (COLT), butylated hydroxytoluene (BHT) was used as an inhibitor to explore its inhibition effect and mechanism. In this paper, in situ Fourier transform infrared spectroscopy, electron paramagnetic resonance, and gas production of COLT experiments were conducted to compare the inhibited coal sample (BHT-Coal) with the raw coal. The results showed that BHT can effectively inhibit the formation of active free radicals, reduce the content of active alkoxy, carbonyl, and hydroxyl groups, increase the production temperature of CO, CO₂, and C₂H₄, and reduce the concentration. The crossing point temperature increased from 132.3 to 157.4 °C, indicating that BHT can reduce the spontaneous combustion tendency of the raw coal. To explore the inhibition mechanism of BHT on COLT, five typical active free-radical models were established, and their active sites, active bonds, and thermodynamic parameters were calculated according to the density functional theory. The results showed that the highly active H atoms of the phenolic hydroxyl group in BHT can combine with active free radicals to generate stable compounds, and the activation energy of each reaction is small, which can occur under normal temperature and pressure. The inhibition mechanism of BHT is to reduce the concentration of the free radicals, so as to weaken the chain reaction strength during the COLT. This study provides a reference for the development and utilization of inhibitors.

Integrated Genomic and Transcriptomic Analyses of Diffuse Large B-Cell Lymphoma With Multiple Abnormal Immunologic Markers

Background

Diffuse large B-cell lymphoma (DLBCL) is a highly aggressive subtype of lymphoma and related to autoimmune diseases (AIDs). Primary B-cell receptor-mediated AIDs are associated with poor clinical outcome of DLBCL. To further determine the role of immunological alterations on disease progression, our study integrated genomic and transcriptomic analyses on DLBCL with multiple abnormal immunologic markers.

Methods

The clinical data of 1,792 patients with newly diagnosed DLBCL were collected, with DNA- and RNA-sequencing conducted for 164 and 127 patients, respectively. Frequent gene mutations and the involved dysregulated pathways, along with gene expression pattern and tumor microenvironment alternations, were analyzed and compared based on the immune status of the patients.

Results

DLBCL with multiple abnormal immunologic markers demonstrated a variety of characteristics including elevated serum lactic dehydrogenase level, inferior prognosis, and dysregulated cell cycle and immune response, as well as activated oxidative phosphorylation pathway and increased Th1/Th2 and Th17/Treg ratios, which were highly similar as those that occur in AIDs.

Conclusions

We piloted the description of the clinical and genetic features of DLBCL with multiple abnormal immunologic markers, illustrated possible mechanisms of disease progression, and provided a clinical rationale of mechanism-based targeted therapy in this subset of DLBCL.

Study on the Formation Mechanism of the Pyrolysis Products of Lignite at Different Temperatures Based on ReaxFF-MD

The internal part of coal that is not in contact with oxygen will undergo pyrolysis reaction due to heat conduction, and the active groups generated can reverse-aggravate the degree of coal spontaneous combustion. At present, a few studies have been conducted on the pyrolysis mechanism of coal at different temperatures by using mutually validated experimental and simulation methods, resulting in the mismatch between the microscopic mechanism and macroscopic characteristics. In this paper, DH lignite is taken as the research object, and its macromolecular model is established. The pyrolysis reaction of lignite is studied by the experimental methods of coal pyrolysis index gas collection and detection experimental and thermogravimetric analyses and the simulation method of ReaxFF-MD. The influence of temperature on lignite pyrolysis is explored by analyzing the distribution of products at different temperatures and the formation mechanism of typical products, so as revealing the microscopic mechanism of lignite pyrolysis. The results show that 110-500 K of experimental temperature corresponds to 1400-2400 K of simulation temperature. CO₂ and C₂H₄ are the main gas products during pyrolysis simulation. Carboxyl and ester groups are the main source of CO₂, which gradually increases with the rise of temperature. Since CO₂ can be reduced to produce CO, H₂O, and C₂H₂O at high temperatures, the yield decreases when the temperature is higher than 2000 K. C₂H₄ is derived from the decomposition of long-chain aliphatic hydrocarbons, and its yield fluctuation rises with the rise of temperature. The formation of H₂O and H₂ mainly occurs in the secondary pyrolysis stage. When 1400 K < T < 2100 K, the primary pyrolysis is the main reaction, where the weak bridge bonds and macromolecular structure undergo cleavage to form gas products and tar free radical fragments. When T > 2100 K, the secondary pyrolysis reactions were significant. Tar free radicals and char undergo decomposition, hydrogenation, and polymerization reaction, gas products and tar free radicals increase, and the char yield decreases compared with the primary pyrolysis stage, so 2100 K is the key temperature of the pyrolysis reaction. The research is of great importance in improving the accurate control of coal spontaneous combustion.

Quantum Chemistry Calculation Study on Chain Reaction Mechanisms and Thermodynamic Characteristics of Coal Spontaneous Combustion at Low Temperatures

The coal spontaneous combustion phenomenon seriously affects the safety production of coal mines. Aiming at the problem of complex coal molecular structure and incomplete reaction sequences at present, the mechanisms and thermodynamic parameters of coal spontaneous combustion chain reactions were explored by combining experimental detections and molecular simulations. First, the active groups on the surface of coal were obtained by Fourier transform infrared spectroscopy (FTIR), mainly including methyl (-CH₃), methylene (-CH₂), methyne (-CH), phenolic hydroxyl (-ArOH), alcohol hydroxyl (-ROH), carboxyl (-COOH), aldehyde (-CHO), and ether (-O-), and the coal molecular models containing functional groups and radicals were established. According to the charge density, electrostatic potential, and frontier orbital theories, the active sites and active bonds were obtained, and a series of reactions were given. The thermodynamic and structural parameters of each reaction were explored. In the chain initiation reaction stage, O₂ chemisorption and the self-reaction of radicals play a leading role. In this stage, heat gradually accumulates and various radicals begin to generate, where the intramolecular hydrogen transfer reaction of a peroxide radical (-C-O-O·) can produce the key hydroxyl radical (-O·). In the chain propagation reaction stage, O₂ and -O· continuously consume active sites to accelerate the reaction sequences and increase the temperature of coal, and index gases such as CO and CO₂ generate, causing the chain cycle reactions to gradually form. The chain termination reaction stage is the formation of stable compounds such as ethers, esters, and quinones, which can inhibit the development of chain reactions. The results can further explain the reaction mechanism of coal spontaneous combustion and provide references for the development and utilization of chemical inhibitors.

The GABAB receptor mediates neuroprotection by coupling to G13

[Figure: see text].

Prognostic value of a novel index: computational pressure-flow dynamics derived fractional flow reserve in patients with stable coronary artery disease treated with optimal medical therapy alone

Background

The use of fractional flow reserve (FFR) is limited due to the need of invasive pressure wire and hyperaemic stimulus. Computational pressure-flow dynamics derived fractional flow reserve (caFFR) is a novel non-invasive index to determine the FFR in patients with stable coronary artery disease (CAD).

Purpose

The clinical value of caFFR remains uncertain. The aim of the study is to evaluate the prognostic role of caFFR in patients with stable CAD who were treated by optimal medical therapy alone.

Methods

A total of 558 stable CAD patients (mean age=64.5±11.2, 59.0% male) with ≥1 coronary lesion detected during conventional coronary angiogram were included. All of them did not undergo percutaneous coronary intervention and were treated with optimal medical therapy alone. Patients were then classified into 4 groups according to their caFFR value; caFFR ≤0.70 (n=40), caFFR = 0.71–0.80 (n=28), caFFR = 0.81–0.90 (n=292), caFFR = 0.91–1.00 (n=198), with a lower caFFR indicating a greater magnitude of myocardial ischemia. The primary endpoint was 3-year major adverse cardiac events (MACE), defined as a composite of all-cause mortality, myocardial infarction or any unplanned revascularization.

Results

During a median follow-up of 36 months, a total of 49 composite events occurred, including 27 all-cause mortality, 4 myocardial infarction and 18 unplanned revascularization.

After multivariate adjustment, caFFR was an independent predictor of MACE (adjusted hazard ratio [HR] = 0.97 per 0.01 increase in caFFR; 95% confidence interval [Cl], 0.95–0.99; P&lt;0.01), all-cause mortality (adjusted HR = 0.96 per 0.01 increase in caFFR; 95% Cl, 0.94–0.99; P&lt;0.01), and stroke (adjusted HR = 0.95 per 0.01 increase in caFFR; 95% Cl, 0.90–0.99; P=0.03).

The area under the curve (AUC) by receiver-operating characteristic curve analysis (ROC) is 0.70 (95% Cl, 0.62–0.78; P&lt;0.01). The optimal cut-off of caFFR defined by ROC analysis for predicting MACE is 0.80, concluding that patients with caFFR ≤0.80 have significantly higher adverse event rate, which is consistent with the cut-off from wire-based FFR.

Using caFFR = 0.91–1.00 as reference, the risk of MACE was highest in patients with caFFR ≤0.70 (adjusted HR = 4.65; 95% Cl, 1.81–11.94; P&lt;0.01), followed by caFFR = 0.71–0.80 (adjusted HR = 3.67; 95% Cl, 1.12–11.33; P=0.02). The risk of MACE was nonetheless similar among patients with caFFR &gt;0.8 (adjusted HR = 1.39; 95% Cl, 0.61–3.19, P=0.44).

Conclusion

In patients with stable CAD who were treated with optimal medical therapy alone, those with more significant myocardial ischemia, indicated by lower caFFR, had higher risks of adverse outcomes. The finding thus supports the use of this non invasive index to quantify the severity of myocardial ischemia, improve risk-stratification, and predict adverse outcomes in patients with stable CAD.

Funding Acknowledgement

Type of funding sources: Public hospital(s). Main funding source(s): The University of Hong Kong, Queen Mary Hospital

Association between non-wire based computational angiography fractional flow reserve treatment threshold and major adverse cardiac events in patients with stable coronary artery disease

Introduction

Despite class IA guideline recommendations, the use of fractional flow reserve (FFR) in guiding percutaneous coronary intervention (PCI) in stable coronary artery disease (CAD) patients remains low due to limitations including the need of guidewire placement and hyperaemic stimulus. A novel non-invasive index, computational pressure-flow dynamics derived FFR (caFFR), was developed for measuring functional myocardial ischemia and overcoming the limitations of FFR. However, the clinical relevance of caFFR remains to be investigated. In the present study, we aim at evaluating the prognostic value of caFFR among stable CAD patients.

Methods

We retrospectively included patients with stable CAD who underwent coronary angiography during 2014–2016 at our center. Based on the caFFR value, patients were considered to be ischemic (caFFR ≤0.8) and non-ischemic (caFFR &gt;0.8). Further, we recombined the patients to form the adherence cohort, where patients were defined as adherent-to-caFFR if they were ischemic with PCI or non-ischemic without PCI, and nonadherent-to-caFFR if they were ischemic without PCI or non-ischemic with PCI. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of all-cause mortality, non-fatal myocardial infarction, and any revascularization. Inverse probability of treatment weighting was used to account for treatment selection bias (PCI vs without PCI, or adherent vs non-adherent), and Cox proportional hazard model was used to evaluate the association with MACE.

Results

A total of 1322 patients, 782 patients in the ischemic cohort and 540 patients in the non-ischemic cohort respectively, were included in our analysis. PCI was associated with a lower risk of MACE in the ischemic cohort (hazard ratio [HR] 0.52; 95% confidence interval [CI], 0.34–0.80; P=0.002), but was not associated with MACE in the non-ischemic cohort. In the adherence cohort, adherent-to-caFFR group (n=803) had a lower risk of MACE compared with nonadherent-to-caFFR group (n=566) (HR, 0.61; 95% CI, 0.44–0.85; P=0.003).

Conclusion

Our study is the first to demonstrate the prognostic value of caFFR, a non-wire based assessment of myocardial ischemia, in patients with stable CAD undergoing PCI. These findings support the use of caFFR that bears the potential of a wider adoption compared with wire-based FFR through a reduction in procedure time, risk and costs.

Funding Acknowledgement

Type of funding sources: None. Weighted Kaplan-Meier curvesWeighted Cox proportional hazards model

Prognostic value of per-vessel treatment adherence in stable coronary artery disease based on novel computational pressure-flow dynamics derived fractional flow reserve

Background

Computational pressure-flow dynamics derived fractional flow reserve (caFFR) is a novel index developed to evaluate the extent of myocardial ischemia in patients with coronary artery disease (CAD), which eliminates the need of invasive pressure guidewire and hyperaemic stimulus in conventional fractional flow reserve (FFR) measurement. Studies have shown improved clinical outcomes associated with adherence to functional myocardial ischemia assessment when deciding to perform percutaneous coronary intervention (PCI) at a per-patient level. However, the clinical significance of such treatment adherence at a per-vessel level remains uncertain.

Methods

A total of 928 patients (mean age 66.2±10.5, male 72.7%) with stable CAD were included in this study. The caFFR of all three major coronary vessels were obtained for every patient, and the FFR threshold of 0.8 was adopted as the threshold for caFFR to indicate functionally significant artery stenosis which warrants PCI, and vice versa. Based on the caFFR of each major coronary vessel and whether PCI was performed to the respective vessel, patients were stratified into 0–1 vessel with treatment adherence group (group 1) (n=105), 2 vessels with treatment adherence group (group 2) (n=338), and 3 vessels with treatment adherence group (group 3) (n=485). The primary endpoint was major adverse cardiac events (MACE), defined as a composite of all-cause mortality, non-fatal myocardial infarction and any subsequent revascularization.

Results

The severity of CAD based on SYNTAX score assessment was 18.6±10.2 in group 1, 14.6±8.9 in group 2, and 11.5±9.9 in group 3 (P&lt;0.001). The rates of MACE at 3 years were significantly different across groups 1, 2 and 3 (17.1% vs. 12.1% vs. 7.4%; P=0.004). With reference to group 3, the risk of MACE at 3 years was increased in group 2 (adjusted hazard ratio [HR]=1.597; 95% confidence interval [CI]=1.020–2.501; P=0.041), and further increased in group 1 (adjusted HR=1.933; 95% CI=1.081–3.457; P=0.026).

Conclusion

In stable CAD patients, the risk of MACE is incremental when fewer major coronary vessels are treated with adherence to caFFR threshold of 0.8. Per-vessel treatment adherence significantly affects clinical outcomes in terms of MACE.

Funding Acknowledgement

Type of funding sources: None.

Long-term prognostic implications of PCI in ACS patients without ischemia on the basis of computational pressure-flow dynamics derived fractional flow reserve

Background

A substantial proportion of patients with acute coronary syndrome (ACS) may have intermediate lesion that are non-ischemic during emergency coronary angiography. The prognosis of such patients, compared to those with stable ischemic heart disease (SIHD) without ischemic lesion is however uncertain. Recently, a novel index, computational pressure-flow dynamics derived fractional flow reserve (caFFR), has been developed to assess myocardial ischemia, without the need of invasive pressure wire and hyperaemic stimulus as required in conventional fractional flow reserve (FFR). By utilizing caFFR to assess for ischaemic status during coronary angiography, the aim of our study is first to assess the prognostic difference between ACS and SIHD with non-ischaemia intermediate lesions. Second, we ascertain whether PCI in patients with ACS with non-ischaemia intermediate lesions provides survival benefit in addition to medical therapy.

Methods

We retrospectively recruited 551 patients (mean age 64.4 years; male 59.9%) with absence of myocardial ischaemia, defined as caFFR ≥0.80 in all vessels, from our Hospital. Patients were stratified into those with index presentation of ACS (n=132) and those with SIHD (n=491). Among the ACS cohort, patients were further divided into those with PCI (n=83) and with medical therapy alone (n=49). The SIHD cohort (n=491), all of whom were treated with medical therapy alone, was considered as referent group. The primary end point was major adverse cardiovascular events (MACE) at 3 years, which was defined as a composite of all-cause mortality, non-fatal myocardial infarction (MI), and any unplanned revascularization.

Results

During a median follow-up of 36 months, 54 composite events occurred, including 38 all-cause mortality, 5 MI, and 14 unplanned revascularization. Compared to those with SIHD, patients with ACS was independently associated with MACE even in the absence of myocardial ischaemia (adjusted Hazard Ratios=2.531; 95% confidence interval=1.397–4.586; P=0.002). The 3-year incidence rate of MACE was the highest in ACS patients with medical therapy alone, followed by ACS patients with immediate PCI; the SIHD cohort had the lowest incidence rates (30.6% vs 12.0% vs 5.9%, P&lt;0.001). This was mainly driven by the rate of all-cause death (26.5% vs 12.0% vs 3.1%; P&lt;0.001). Similar findings were observed for hospitalisation due to heart failure (14.3% vs 6.0% vs 3.1%, P=0.031) and cardiac death (8.2% vs 4.8% vs 0.4%, P&lt;0.001) at 3 years.

Conclusion

In patients with intermediate lesion without myocardial ischaemia (defined as caFFR ≥0.8), those presented with ACS had a higher risk of MACE at 3 years compared to SIHD. Among ACS patients with intermediate lesion without myocardial ischaemia, PCI significantly reduces the rate of MACE. In patients with ACS, our finding suggests that PCI should be advocated to intermediate lesion even without myocardial ischaemia.

Funding Acknowledgement

Type of funding sources: None. Kaplan-Meier curve for MACECumulative Events at 3 Years

Quantum Chemical Calculation of the Effects of H2O on Oxygen Functional Groups during Coal Spontaneous Combustion

The effects of H₂O on the low-temperature oxidation characteristics of coal have always been one of the keys in the research of coal spontaneous combustion, but most studies rely on experiments for macroscopic derivation, and theoretical researches at the microlevel are rarely mentioned. In this paper, phenylacetaldehyde, phenylethyl alcohol, phenylacetic acid, and ethylbenzene hydroperoxide were used as modeling compounds of coal molecules containing aldehyde (-CHO), alcohol hydroxyl (-OH), carboxyl (-COOH), and peroxide (-C-O-OH). The surface electrostatic potential (ESP), electron density of atoms in molecules (AIM), and reduced density gradient (RDG) of coal molecules were calculated by density functional theory (DFT), and the thermokinetic parameters of low-temperature oxidation of coal molecules with or without H₂O were analyzed. The results show that the extreme positive and negative ESPs are located at the H and O atoms of oxygen functional groups (OFGs), respectively, which are the active sites for H₂O adsorption. The AIM and RDG show that the phenylacetaldehyde···H₂O complexes have two kinds of adsorption configurations with two and three hydrogen bonds, and that the phenylethyl alcohol···H₂O complexes also have two kinds of adsorption configurations with one and three hydrogen bonds, and that both phenylacetic acid···H₂O and ethylbenzene hydroperoxide···H₂O only have one adsorption configuration, forming two and three hydrogen bonds, respectively. According to electron density ρ(r) and potential energy density V(r), the adsorption strength of H₂O by four kinds of oxygen functional groups is ranked as -C-O-OH > -COOH > -OH > -CHO. The thermokinetic parameters show that H₂O can increase the activation energy (ΔE) of the oxidation reactions of phenylacetaldehyde and phenylethyl alcohol, which can inhibit the reaction and decrease the activation energy (ΔE) of the oxidation reaction of phenylacetic acid and ethylbenzene hydroperoxide, which can promote the reactions.

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.

Identification of Ophiopogonis Radix from different producing areas by headspace-gas chromatography-ion mobility spectrometry analysis

Ophiopogonis Radix can be divided into Zhemaidong (ZMD) and Chuanmaidong (CMD). The main planting areas of ZMD are Cixi City and Sanmen county. The quality and price of Ophiopogonis Radix from different producing areas are different. In this study, the headspace-gas chromatography-ion mobility spectrometry (HS-GC-IMS) method is used to rapidly identify ZMD and CMD. The method is also used to identify ZMD from Cixi and Sanmen by analyzing volatile organic compounds (VOCs). A total of 58 VOCs was obtained from ZMD samples with more abundant signals of which 41 were identified. The peak intensities of all VOCs in ZMD and CMD, Cixi and Sanmen data were averaged and then those VOCs whose peak intensities were distributed outside of mean ± 2 standard deviation (μ ± 2σ) were selected as characteristic markers. We selected 14 characteristic markers to establish the characteristic fingerprint of ZMD and CMD, among the 14 VOCs, ZMD contained more eucalyptus oil compounds than CMD, CMD contained more volatile aldehydes than ZMD. We selected 12 characteristic markers for the establishment of the characteristic fingerprint of ZMD from Cixi and Sanmen. The principal component analysis (PCA) results indicated that both ZMD and CMD or ZMD from Cixi and Sanmen could be effectively divided. The ZMD and CMD as well as ZMD from Cixi and Sanmen were evaluated by partial least squares regression-discriminants analysis (PLS-DA) resulting to be excellent chemical descriptors for sample discrimination. One hundred percent classification rates for both PLS-DA calibration and prediction models were obtained. These results provided a reference for the traceability of species and origin and market standard of Ophiopogonis Radix. PRACTICAL APPLICATIONS: Ophiopogonis Radix can be divided into Zhejiang Ophiopogonis Radix (ZMD) and Sichuan Ophiopogonis Radix (CMD). As far as ZMD is concerned, its producing areas mainly include the traditional planting areas (Cixi City) and new growth areas (Sanmen county). In this paper, the HS-GC-IMS method was adopted to analyze VOCs in Ophiopogonis Radix from different producing areas and then we screen out the respective characteristic VOCs of ZMD and CMD as well as ZMD from Cixi and Sanmen. These characteristic VOCs can effectively identify ZMD and CMD as well as ZMD from Cixi City and Sanmen country to provide a scientific basis for the origin identification of Ophiopogonis Radix.

Molecular model construction of Danhou lignite and study on adsorption of CH4 by oxygen functional groups

In view of the frequent occurrence of gas accidents in coal mines, the mechanism of oxygen-containing functional groups (OCFGs) in Danhou lignite adsorbing gas was studied by experiment and simulation. Elemental analysis, X-ray photoelectron spectroscopy (XPS), solid-state 13C nuclear magnetic resonance spectroscopy (13C-NMR), and adsorption experiment of CH4 were applied to establish the macromolecular model of Danhou lignite. Then, molecular mechanics (MM) and molecular dynamics (MD) were utilized to optimize the coal macromolecular model, and the density of coal was determined via adding periodic boundary conditions. The mechanism of gas adsorption by OCFGs was studied by grand canonical Monte Carlo (GCMC) and density functional theory (DFT). The results showed that the aromatic structures mostly exist in the form of pyrenes; the structure of aliphatic carbons are mostly methylene and methine groups; the alkanes are mostly long chains; oxygen atoms are mainly in the form of hydroxyl groups and ether groups; nitrogen atoms are mainly in the form of pyridines; and the density of Danhou lignite is 1.25 g/cm3. The isotherm adsorption curve and Langmuir adsorption curve have a good fit, a single coal molecule reaches saturation after absorbing four CH4 molecules, and the error between experiment and simulation is small. The results of DFT calculation showed that the adsorption of CH4 by OCFGs is affected by the adsorption positions and adsorption directions. Due to CH4 molecules are affected by different electrostatic forces, the adsorption capacities of OCFGs are different, and the order is carbonyl groups > ether bonds > hydroxyl groups > carboxyl groups. The results can be used for reference in the prevention and control of coal and gas outburst.

Better precision of a new robotically assisted system for total knee arthroplasty compared to conventional techniques: A sawbone model study

BACKGROUND

The purpose of this study was to compare the accuracy of this new HURWA robotic-assisted total knee arthroplasty (TKA) technique to the accuracy of the conventional technique in a sawbone model.

METHODS

The HURWA robotic-assisted TKA system was applied in the robotic group. After bone resection, all of these sawbones were scanned by the use of a structured light scanning system. Measurements of bone resections, femoral coronal and sagittal measurements, and tibial coronal and sagittal measurements were recorded.

RESULTS

Compared to the conventional technique, the HURWA robotic-assisted system significantly improved the accuracy of the bone resection levels and angles. In the robotic group, the accuracy of all of the bone resection levels was below 0.6 mm (with standard deviation [SD] below 0.6 mm), and all of the bone resection angles were below 0.6° (with SD below 0.4°).

CONCLUSION

Our data suggest that this novel HURWA robotic-assisted system can significantly improve the accuracy of bone resection levels and angles.

A new robotically assisted system for total knee arthroplasty: A sheep model study

BACKGROUND

We investigated the accuracy and safety of a new HURWA robotic-assisted total knee arthroplasty (TKA) system in a sheep model.

METHODS

Ten male small-tailed Han sheep were used in this study. Sheep were imaged by computed tomography scan before and after bone resection and the cutting errors between actual bone preparation and preoperative planning of the femur and tibia in three dimensions were measured.

RESULTS

The overall accuracies after surgery compared with that from preoperative surgical planning of the left and right femurs were 1.93 ± 1.02° and 1.93 ± 1.23°, respectively. Additionally, similarly high overall accuracies for the left and right tibia of 1.26 ± 1.04 and 1.68 ± 0.92°, respectively, were obtained. The gap distances of the distal cut, anterior chamfer, anterior cut, posterior chamfer and posterior cut on the medial side were 0.47 ± 0.35 mm, 0.41 ± 0.37 mm, 0.12 ± 0.26 mm, 0.41 ± 0.44 mm and 0.12 ± 0.23 mm, respectively. No intraoperative complications, such as intraoperative fracture, massive bleeding or death, occurred.

CONCLUSION

This new HURWA robotic-assisted TKA system is an accurate and safe tool for TKA surgery based on the sheep model.

Early results for iCMR in atrial flutter

Funding Acknowledgements

Type of funding sources: None.

Background

 As a standard of care, ablation of typical atrial flutter involves performing cardiac catheterization under x-ray fluoroscopy. The unique ability of magnetic resonance (MR) to provide real-time functional imaging in multiple views without ionizing radiation exposure has the potential to be a powerful tool for diagnostic and interventional procedures. Real-time MR imaging-guided radiofrequency (RF) ablation has been used as a part of clinical trials.

Objective

 To implement the MR imaging-guided RF ablation of typical atrial flutter in the clinical routine.

Methods

 From January to July 2020, 15 consecutive patients with typical atrial flutter have been referred for ablation. Patient preparation, conscious sedation and groin puncture took place inside the 1.5 Tesla MR scanner as a part of an MR-only workflow. The catheter advancement as well as the RF ablation procedure have been performed under direct visualisation of catheters with integrated micro-coils using an interactive sequence with active tip tracking and automatic slice positioning in the plane where the catheter tip has been detected. During catheter advancement a single frontal plane has been used to visualize the passage of the catheter through femoral veins and inferior vena cava. With both diagnostic and ablation catheters in the right atrium, an axial stack of balanced steady-state free precession acquisitions has been acquired and used to reconstruct planes in the short- and long cardiac axis. These have been used to provide a "left- and right anterior oblique" view familiar to an interventional electrophysiologist. The subsequent catheter placement and ablation have been performed under direct visualisation in these two planes (see figure).

Results

 The ablation was successful in 14 patients, one patient had to undergo a conventional procedure on the following day. The mean time to reach right atrium and coronary sinus was 4 [3,5] and 7 [6,10] minutes, respectively. The mean total ablation duration and procedure time was 18 [12,26] and 43 [33,58] minutes, respectively. There were no adverse events.

Conclusion

 The implementation of the MR imaging-guided RF ablation of typical atrial flutter in the clinical routine is feasible and leads to similar success rates and procedure times as the conventional fluoroscopy-based ablation.

Abstract Figure.

The pressure relief protection effect of different strip widths, dip angles and pillar widths of an underside protective seam

To design underside protective seam strip layout. Similarity model experiments, numerical simulations and theoretical calculations are used to quantitatively study the pressure relief protection effect of different strip widths, dip angles and coal pillar widths of a thin underside protective seam under deeply buried conditions. The optimal strip width range is obtained according to the change law of strain during the mining process of the underside protective seam in a similar model experiment. The change law of the expansion of the protected coal seam is obtained and the fitting surfaces among the dip angle and strip width of the coal seam with the protection distance and pressure relief angle along the strike and dip of the protected coal seam are established according to the numerical simulation results of underside protective seam mining. It is concluded that the best pressure relief effect can be achieved when the dip angle is 16.7° and the strip width is 70 m. According to the stability threshold of coal pillars considered in strip mining theory, the coal pillar width is calculated to be 50 m. Similarity model experiments and numerical simulations of protected coal seam mining verify the pressure relief effect of the designed protective seam strip width and pillar width. A calculation method of the protective seam strip width, position and pillar width required by the specific width of the protected seam is proposed.

A Study on the Effect of Coal Metamorphism on the Adsorption Characteristics of a Binary Component System: CO2 and N2

At present, there is little research on the multicomponent gas adsorption characteristics of coal with different metamorphisms. In this study, DH (low metamorphism), FGZ (medium metamorphism), and DSC (high metamorphism) coal samples were selected as the microscopic research objects, and the molecular models of them were constructed by means of elemental analysis, ¹³C NMR, and X-ray. The adsorption characteristics of coal with different metamorphisms under the binary component system (CO₂ and N₂) were explored by experiments and simulations at 298 K and 1000 kPa. The results showed that in the binary component system gas environment, the adsorption strength of CO₂ is stronger than that of N₂. DH has the highest isosteric heat of adsorption, and the adsorption strengths of CO₂ and N₂ is stronger than that for FGZ and DSC. The adsorption amounts of CO₂ and N₂ by three coal molecules are ranked as DH > FGZ > DSC. The sequence of adsorption selectivity of CO₂/N₂ is DH > FGZ > DSC > 1, which demonstrates the stronger competitiveness of CO₂ than N₂. The adsorption selectivity of CO₂/N₂ for DH is stronger than that for DSC. However, with the increase of the CO₂ component, the adsorption selectivity of CO₂/N₂ for DH has a great influence, while DSC is relatively stable. The simulation results display a good agreement with the experimental results. The research can improve the accuracy and efficiency of inert injection measures and has guiding significance for the prevention and control of coal spontaneous combustion accidents by inert injection.

Systemic Inflammatory Response Syndrome Combined with Pre- and Postoperative White Blood Cell Ratio Is a Better Criterion to Identify Septic Shock Patients After Flexible Ureteroscopic Lithotripsy

Objective: To find out a better criterion to identify septic shock patients after flexible ureteroscopic lithotripsy (FUL). Materials and Methods: In total, 2364 patients who underwent the FUL procedure were enrolled in the study. The demographics and preoperative results of laboratory tests of the patients were collected. The postoperative white blood cell (WBC), systemic inflammatory response syndrome (SIRS), and quick sequential (sepsis-related) organ failure assessment score (qSOFA) were assessed 2 hours after FUL. The predictive efficacy was measured by sensitivity, specificity, positive and negative predictive value, and area under the receiver's operating characteristic curve (AUROC). Results: A total of 15 (0.63%) patients developed septic shock. There were 86 (3.64%) patients who were SIRS positive and 69 (2.92%) patients who were qSOFA positive. The pre- and postoperative WBC ratios in septic shock patients and normal patients were 2.50 ± 1.55 and 0.69 ± 0.24, respectively (p < 0.001). For sensitivity and negative predictive value, all reached 100%. For specificity, qSOFA was 97.70%, SIRS was 96.98%, and SIRS combining pre- and postoperative WBC ratio (the new criterion) was 99.79%. The new criterion had statistically significant higher specificity than SIRS or qSOFA (p < 0.001 for both), but when comparing SIRS and qSOFA, it had statistically insignificant specificity (p = 0.142). For positive predictive value, qSOFA was 21.73%, SIRS was 17.44%, and the new criterion was 75%. qSOFA and SIRS had similar AUROC (0.989 for qSOFA and 0.985 for SIRS), both lower than the new criterion (AUROC: 0.999). Conclusions: SIRS combined with pre- and postoperative WBC ratio has a much better specificity and positive predictive value than SIRS or qSOFA alone. It has 99.79% specificity and 75% positive predictive value, and as high as 100% sensitivity and negative predictive value.

Ultrasonic evaluation of systemic and renal perfusion in sepsis patients before and after fluid resuscitation

OBJECTIVE

This study aimed to explore the significance of renal Doppler ultrasound in evaluating systemic and renal perfusion in sepsis patients before and after fluid resuscitation.

PATIENTS AND METHODS

Forty sepsis patients admitted to the Department of Intensive Medicine and intensive care unit (ICU) of the Fourth Hospital of Hebei Medical University from June 2014 to December 2014 were enrolled in this study, and 35 patients were included in the final analysis. These patients were divided into positive and negative fluid responsiveness groups. They were also divided into an acute kidney injury (AKI) group and a non-AKI group according to changes in creatinine and urine volume. The correlations of the changes in hemodynamics before and after fluid resuscitation in each group with the changes in renal resistance index (RRI) and renal blood flow (RBF) grades were evaluated.

RESULTS

Before and after fluid resuscitation, the heart rate (HR), blood creatinine (Cre), and lactate (Lac) levels of all patients, including the patients in the positive fluid responsiveness group decreased, and the stroke volume (SV) and central venous pressure (CVP) increased. Only HR decreased in the negative fluid responsiveness group. In the AKI group, HR, Cre, and Lac decreased, while in the non-AKI group, HR decreased, but CVP and SV increased. There were differences between HR, Lac, and change rate of Lac (Lac%) after fluid resuscitation for the positive and negative fluid responsiveness groups. There was no statistical difference between the RRI values of each group before and after fluid resuscitation. The RRI values of the AKI group were higher than those of the non-AKI group, while the AKI group's RBF grades were lower than those of the non-AKI group. The change rate of RRI (RRI%) was higher in the AKI group than in the non-AKI group. Except for the negative fluid responsiveness group, the RBF grade of each group increased.

CONCLUSIONS

The approach of RBF classification based on Doppler ultrasound can be used to evaluate the systemic and renal perfusion of patients with severe sepsis before and after fluid resuscitation, while the RRI value cannot be used for evaluation. However, the RRI value can be used as a dynamic index for the evaluation of renal perfusion in patients with AKI.

Molecular Simulation Study on Adsorption and Diffusion Behaviors of CO2/N2 in Lignite

Understanding the adsorption and diffusion of CO₂ and N₂ in lignite at high temperature is of great significance for fire prevention and control. Considering the influence of temperature on coal structure, molecular structure models of lignite at 298.15, 323.15, 423.15, and 523.15 K were constructed by molecular mechanics and dynamics, and grand canonical Monte Carlo molecular simulation was conducted for single-component and two-component systems under different temperatures, pressures, and gas ratios. The adsorption capacity was positively correlated with the pressure and molar ratio of CO₂ but negatively correlated with the temperature. The adsorption amount of CO₂ (1.060 mmol/g) was generally larger than that of N₂ (0.069 mmol/g), showing a greater selectivity. However, CO₂ was more sensitive to temperature, and the adsorption amount decreased faster with the increase in temperature. At high temperature, the adsorption amount of CO₂ and N₂ is basically equal, both of which are at a low level. The CO₂ isosteric heat of adsorption (7.46-8.84 kcal/mol) varies significantly with temperature. The interaction energy is consistent with the change trend of adsorption quantity, and van der Waals energy plays a dominant role in adsorption. Injecting CO₂ and N₂ at the high temperature stage has a poor extinguishing effect, which can only dilute oxygen content and exchange heat, and the advantage of CO₂ will be lost. It may be more effective using liquid nitrogen which has the properties of low temperature and high specific heat capacity. The results are of great significance to improve the efficiency of fire prevention and suppression in underground coal mines.

Tafolecimab, a novel potential long-acting PCSK9 monoclonal antibody: efficacy and safety in healthy and hypercholesterolemia subjects

Background

LDL cholesterol (LDL-C) is a well-established risk factor for cardiovascular disease. PCSK9 binds LDL receptors, targeting them for degradation. The dosing intervals for currently available PCSK9 monoclonal antibodies are once every 2 or 4 weeks. Tafolecimab, a novel recombinant human PCSK9 monoclonal antibody, was found to have higher affinity with PCSK9 and show longer LDL-C reduction compared to evolocumab in preclinical studies.

Purposes

The objectives for the SAD and MAD studies were to investigate the safety and efficacy of tafolecimab and explore the optimal dosing schedule.

Methods

The phase 1 study was a randomized, placebo-controlled, double-blind, single-ascending dose study (SAD) in Chinese healthy subjects, who were randomized 3:1 to tafolecimab and placebo (n=58). SAD subjects received tafolecimab subcutaneously at 25/75/150/300/450/600mg, or intravenously at 75/450mg, monitored up to day 84. The phase 2 study was a randomized, double-blind, placebo-controlled, repeated-dosing, multiple ascending dose (MAD) study in patients with hypercholesterolemia, who were randomized 4:1 to tafolecimab and placebo (n=60). MAD subjects received tafolecimab subcutaneously at 75/140mg every 2 weeks, 300/420mg every 4weeks, 450/600mg every 6 weeks up to day 84 or 98 with 3 months follow-up.

Results

In the SAD, the maximum mean reduction in LDL-C ranged from 52.2% to 72.1% and was achieved as early as 5 days (figure 1a). The duration of LDL-C reduction was tafolecimab dose dependent. In the MAD, the mean LDL-C concentrations were reduced by tafolecimab for each dose at 12 weeks relative to baseline (ranging from 54.30% to 72.26%; p&lt;0.001). Particularly, a 56.52% (−72.50%, −40.54%) reduction of LDL-C was observed in the cohort of 600mg Q6W. The effect sustained till week 14 (8 weeks after the last dose) where there was still a 43.46% (−60.96%, −25.96%) reduction from baseline (figure 1b). The mean reduction of Lp(a) at week 12 ranged from 24.04% to 50.59% relative to baseline. Tafolecimab reduced the other lipids when comparing with placebo. The pharmacokinetics/pharmadynamics (LDL-C) profiles of tafolecimab were well characterised and support the potential dosing interval of 6–8 weeks subcutaneously.

Both healthy and hypercholesterolemia subjects are generally tolerable to tafolecimab. Reported treatment-emergent adverse events (TEAEs) were: tafolecimab 23 (52.3%) vs. placebo 8 (57.1%); tafolecimab 34 (70.8%) vs. placebo 9 (75.0%) in the SAD and MAD respectively. There were no serious TEAEs or events leading to death or treatment discontinuation in both SAD and MAD.

Conclusions

Tafolecimab was well tolerated in both healthy and hypercholesterolemia in Chinese subjects, and improved lipid profile including LDL-C, Lp(a) and other lipids. The sustained effects on LDL-C suggests the potential of tafolecimab as a long-lasting PCSK9 inhibitor with dosing interval of 6–8 weeks or beyond.

Figure 1. LDL-C: Percent change from baseline

Funding Acknowledgement

Type of funding source: Private company. Main funding source(s): Innovent Biologics (Suzhou), China

Effect of the baseline pulse wave velocity on short term and long term blood pressure control in primary hypertension

OBJECTIVES

Arterial stiffness may affect antihypertensive response to antihypertensive treatment. However, sufficient clinical evidence is lacking. This longitudinal study aimed to evaluate the effect of baseline arterial stiffness measured by the brachial-ankle pulse wave velocity (baPWV) on response to short-term and long-term enalapril-based treatment in 3310 hypertensive adults from the China Stroke Primary Prevention Trial (CSPPT).

METHODS AND RESULTS

Blood pressure (BP) measured at three months (short-term) in 2780 subjects, and the time-average on-treatment BP in 3310 subjects during a median of 4.5-year follow-ups (long-term) were analyzed in the study. After short-term antihypertensive treatment, every 1 m/s increase in baPWV denoted a 7% and 6% decreased chance of achieving systolic BP (SBP) control (odds ratio (OR), 0.93; 95% CI 0.90, 0.96; P < 0.001) and BP control (OR, 0.94; 95% CI 0.91, 0.97; P < 0.001), respectively, after adjustment for age, gender and other variables. After long-term treatment, every 1 m/s increase in baPWV posed an 7% and 6% greater risk of failing to attain SBP control (OR, 0.93; 95% CI 0.90, 0.95; P < 0.001) and BP control (OR, 0.94; 95% CI, 0.92, 0.96; P < 0.001), respectively, not regarding for DBP control after both short- and long-term treatment. Higher baseline baPWV significantly decreased SBP reduction both after three months and the median 4.5-year treatment, while increased DBP reduction after the median 4.5-year treatment.

CONCLUSIONS

Elevated baseline baPWV significantly decreased BP response to short-and long-term treatment in adults with primary hypertensive. Arterial stiffness improvement may be an essential target to achieve adequate BP control.

Gender and age differences in the association between sleep characteristics and fasting glucose levels in Chinese adults

AIM

The present study examined the associations between night-time sleep duration, midday napping duration and bedtime, and fasting glucose levels, and whether or not such associations are dependent on gender and age.

METHODS

This study was a cross-sectional analysis of 172,901 adults aged≥40 years living in mainland China. Sleep duration was obtained by self-reports of bedtime at night, waking-up time the next morning and average napping duration at midday. Fasting plasma glucose (FPG)≥7.0mmol/L was defined as hyperglycaemia. Independent associations between night-time sleep duration, midday naptime duration and bedtime with hyperglycaemia were evaluated using regression models.

RESULTS

Compared with night-time sleep durations of 6-7.9h, both short (<6h) and long (≥8h) night-time sleep durations were significantly associated with an increased risk of hyperglycaemia in women [odds ratio (OR): 1.12, 95% confidence interval (CI): 1.01-1.29 and OR: 1.14, 95% CI: 1.08-1.21, respectively], and revealed a U-shaped distribution of risk in women and no significant association in men. Long midday nap durations (≥1h) were significantly but weakly associated with hyperglycaemia (OR: 1.04, 95% CI: 1.01-1.09) compared with no napping without interactions from gender or age, whereas the association between bedtime and fasting glucose levels did vary according to gender and age.

CONCLUSION

Night-time sleep duration, midday napping duration and bedtime were all independently associated with the risk of hyperglycaemia, and some of the associations between these sleep characteristics and hyperglycaemia were gender- and age-dependent.

P457Incidence of LA fibrosis and substrate-based AF ablation success rates in HF patients

Funding Acknowledgements

The author(s) received no specific funding for this work.

Background

In heart failure (HF) patients, sinus rhythm maintenance after catheter ablation for atrial fibrillation (AF) is mandatory to achieve better long-term outcome. Presence of left atrial (LA) fibrosis significantly attenuates ablation success rates. Incidence of LA fibrosis and the effect of an individualized substrate-based ablation concept on rhythm outcome in HF patients with AF is unclear.

Methods

This study investigated 103 patients (64 years, 69% men) with persistent AF (79%) and left ventricular (LV) dysfunction (EF 33% IQR [25; 38]) undergoing first time AF ablation. Identification of LA fibrosis and selection of ablation strategy were based on sinus rhythm voltage mapping. All patients received pulmonary vein isolation (PVI). LA fibrosis ablation was individualized by (i) homogenization of small areas, (ii) linear lesions connecting fibrosis and anatomical obstacles and (iii) linear lesions isolating large fibrotic areas. Rhythm outcome was measured by continuous device monitoring (AF detection ≥ 6 min) or Holter-ECG. A total post-procedural AF burden &lt; 0.1% was defined as successful rhythm control.

Results

LA fibrosis in the overall cohort, in paroxysmal and persistent AF patients was detected in 39/103 (38%), 6/22 (27%) and 33/81 (41%), respectively. After 11 ± 5 months and 1.2 procedures/patient, freedom from AF recurrence was similar between patients with and without LA fibrosis (33/39 (84%) vs. 54/64 (84%); p = 0.485). With continuous monitoring, 73/87 (84%) patients recorded a total AF burden &lt; 0.1%. There was no significant difference in AF burden outcome between patients with and without LA fibrosis (3.1% SD ±17.4 vs. 2.2% SD ±8.1; p = 0.4). No correlation between presence or extent of LA fibrosis and AF burden was found; p = 0.299.

Conclusion

A substantial number of HF patients with AF have no evidence of LA fibrosis. Among HF patients with LA fibrosis, individualized substrate-based AF ablation beyond PVI was able to achieve similar ablation success.