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Yue Cao, Yue-Yue Feng, Wei Du, Jing Li, Ya-Lan Fei, Hao Yang, Meng Wang, Shi-Jie Li, Xian-Jin Li, Bing Han Division of Cardiology, Xuzhou Central Hospital, Xuzhou, People’s Republic of ChinaCorrespondence: Bing Han, Division of Cardiology, Xuzhou Central Hospital, 199 South Jiefang Road, Xuzhou, 221009, People’s Republic of China, Tel +86-516-83985069, Fax +86-516-83956012, Email hbing777@hotmail.comPurpose: To investigate the reasons for elderly atrial fibrillation (AF) patients not continuing their oral anticoagulation (OAC) treatment and the factors that influence this behavior.Methods: Elderly AF patients (aged≥ 75 years) hospitalized from December 2019 to May 2022 were consecutively enrolled. Clinical, demographic, and concomitant medication data were collected. The endpoint was defined as OAC discontinuation for more than 30 days or a switch to an alternative therapy. Predictors of OAC non-persistence were investigated using a multivariable Cox regression model.Results: This study included 560 participants (51.1% men, mean age 80.9± 0.2 years). During a median follow-up of 20 months, medication persistence was observed in 322 patients (57.5%). Non-persistence was found to be significantly higher with warfarin than with NOAC (48.8% vs 33.6%, p = 0.006). In the multivariate analysis, OAC non-persistence was independently predicted by a history of permanent pacemaker implantation, the use of antiplatelet drugs, employee Medicare, living with children, college degree or above, and persistent AF (HR = 1.580, 1.586, 0.604, 0.668, 0.028, 0.769, p < 0.05, respectively). Treatment discontinuation within 3 months of discharge was observed in a large number of patients (81.8%). Medication discontinuation due to bleeding was more frequently observed in patients who continued for longer than 3 months (p < 0.001), while discontinuation due to patient preference was more frequent in those with shorter durations (≤ 3 months) (p = 0.049). Patient preference was the second leading cause of non-persistence in patients, regardless of whether they were taking warfarin or NOAC.Conclusion: OAC non-persistence remains high among elderly AF patients during long-term follow-up, with a significant proportion discontinuing shortly after discharge. This pattern of non-persistence is heavily influenced by demographic factors and patient preference. Further interventions should be developed based on the reasons and risk factors to improve persistence and initiated early in the treatment process.Keywords: atrial fibrillation, the elderly, oral anticoagulants, non-persistence

Ning Li,1 Jia Zhang,1,2 Si-Jia Li,1 Yang Du,1,2 Qi Zhou,2 Hong-Qiu Gu,2 Xing-Quan Zhao1– 3 1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China; 3Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, People’s Republic of ChinaCorrespondence: Xing-Quan Zhao, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, People’s Republic of China, Tel +86-13501031486, Email zxq@vip.163.comBackground: The presence of mild deficit is the most common reason for nonuse of intravenous alteplase in ischemic stroke. We analyzed within a national prospective cohort on whether patients with minor stroke can benefit from intravenous alteplase.Methods: This observational study included patients with acute ischemic stroke with a National Institutes of Health Stroke Scale (NIHSS) score 0 to 5 at admission. The short-term outcomes at discharge and 3-month were analyzed including the modified Rankin Scale score, gait speed, Montreal Cognitive Assessment, Patient Health Questionnaire-9, General Anxiety Disorder-7 and Stroke Impact Scale-16. Multivariate regression models were performed to evaluate the association between intravenous thrombolysis and clinical outcomes.Results: A total of 1876 consecutive patients were included in the current analyses with 102 patients (5.4%) received alteplase and 1774 patients (94.5%) were in non-alteplase group. We found that 10.9% patients presented unfavorable functional outcome with a mRS ≥ 2 at 3-month. Patients with alteplase treatment had a more favorable outcome in SIS-16 at discharge (OR, 5.45; 95% CI, 2.22– 8.68) and 3-month after stroke (OR, 2.34; 95% CI, 0.17– 4.50). There was an association of alteplase with better gait speed in the restricted sample of age > 60 (OR,0.14; 95% CI, 0.02– 0.25), while an unfavorable effect was found in anxiety (OR, 2.23; 95% CI, 2.23, 0.91– 3.55) and depression (OR, 1.54; 95% CI, 0.17– 2.91) in female.Conclusion: Alteplase showed a suggestive benefit in function and motor outcomes in patients with low NIHSS score of 0– 5. Meanwhile, female seemed more inclined to post-stroke emotional problems after alteplase treatment, which should be further explored in the future.Keywords: alteplase, minor stroke, ischemic, outcomes

Wen-Qi Wu,1– 3,&ast; Yu-Qi Zhang,1– 3,&ast; Jie Xu,1– 3,&ast; Zai-Xiang Tang,4 Shi-Jia Li,1– 3 Xi-Ya Wei,1– 3 Ling Li,1– 3 He-Qing Wu,1– 3 Xiao Ma,1– 3 Ji-Sheng Liu,1,5 De-Pei Wu,1– 3 Xiao-Jin Wu1– 3 1Department of Hematology, the First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China; 2National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou, People’s Republic of China; 3Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People’s Republic of China; 4Department of Epidemiology and Statistics, School of Public Health, Faculty of Medicine, Soochow University, Suzhou, People’s Republic of China; 5Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiao-Jin Wu; De-Pei Wu, Email wuxiaojin@suda.edu.cn; wudepei@suda.edu.cnPurpose: The current study assesses which are the main risk factors, clinical outcome and prognosis following the colonization of CRE in patients that underwent allo-HSCT.Patients and Methods: A total of 343 patients subjected to allo-HSCT in the period comprised between June 2021 and June 2022 were enrolled in this retrospective study. The CRE colonization was diagnosed by clinical history and routine microbial culture of perirectal swab. In this regard, a clinical prediction model was designed based on independent risk factors underlying the pre-transplantation CRE colonization using a backward stepwise logistic regression, followed by the evaluation of its discrimination and calibration efficacies, along with clinical usefulness. Furthermore, univariate and multivariate Cox regression analyses were then conducted to assess the risk factors for post-transplantation clinical outcomes.Results: Out of 343 patients enrolled in this study, 135 (39.3%) reported CRE colonization. The independent risk factor variables for CRE colonization were incorporated into the nomogram to build a prediction model, which showed an area under the curve of 0.767 (95% CI: 0.716– 0.818), and well-fitted calibration curves (χ 2 = 1.737, P = 0.9788). The patients with CRE colonization reported a significantly lower platelet engraftment rate with a higher risk of post-transplantation BSI when compared with the non-CRE colonization group (P = 0.02 and P < 0.001; respectively). The non-relapse mortality (NRM) value was higher in the CRE patients (P < 0.05), consistently with a survival probability that was thus significantly lower for the same timeframe (P < 0.05).Conclusion: A reliable clinical prediction model for pre-transplantation CRE colonization was developed that demonstrated that the CRE colonization negatively affects platelet engraftment and survival outcomes following allo-HSCT.Keywords: CRE, Enterobacteriaceae colonization, perirectal swab, allo-HSCT, risk factors, prognosis

Xiao-Yan Li,1,&ast; Shu-Min Zhu,2,&ast; Xin-Yuan Li,2,&ast; Rui-Sheng Dong,3 Ai-Ai Zhang,1 Shu-Jing Li,4 Yu-Lan Geng2 1Department of Laboratory Medicine, Shanxi Province Fenyang Hospital, Fenyang, 032200, People’s Republic of China; 2Department of Laboratory Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, People’s Republic of China; 3Department of Imaging Medicine, Shanxi Province Fenyang Hospital, Fenyang, 032200, People’s Republic of China; 4Department of Radiology, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiao-Yan Li, Department of Laboratory Medicine, Shanxi Province Fenyang Hospital, No. 186 of Shengli Road, Fenyang, Shanxi, 032200, People’s Republic of China, Tel +86 358 7222225, Fax +86 358 7222615, Email lixiaoyanlxy8@126.com Yu-Lan Geng, Department of Laboratory Medicine, The First Hospital of Hebei Medical University, No. 89 of Donggang Road, Shijiazhuang, Hebei, 050031, People’s Republic of China, Tel +86 311 87156567, Fax +86 311 85917029, Email gengyulangyl9@126.comBackground: Hemophagocytic lymphohistiocytosis (HLH), a syndrome of immune hyperactivation and abnormal regulation that causes life-threatening inflammation, is mainly characterized by fever, hepatosplenomegaly, cytopenia, and other symptoms. Reactive HLH (rHLH) is typically secondary to immune deregulation caused by underlying rheumatologic, infectious, or malignant conditions. Malignancy-associated HLH (M-HLH) continues to be a critical health problem worldwide. Most malignancies associated with HLH are hematologic tumors, and M-HLH in non-hematologic tumors very rarely occurs.Case Report: A 34-year-old Chinese woman had a history of persistent fever, acute dizziness, and bicytopenia. She was found to have developed bilateral ovarian cancer. Additional tests showed splenomegaly, hemophagocytes in the bone marrow, low natural killer activity, and hyperferritinemia, which met the diagnostic criteria put forth in the Histiocyte Society HLH-2004. The patient was treated with correcting anemia, increased platelets, and glucocorticoid therapy but showed no response. She progressively deteriorated and died 55 days later.Conclusion: Hemophagocytic lymphohistiocytosis related to a solid tumor is extremely rare. To the best of the authors’ knowledge, the present case was the first to report rHLH secondary to ovarian adenocarcinoma. It is very significant for a better understanding of the disease mechanisms of HLH and should attract the attention of hematologists and other clinicians as the condition progresses and the cost of treating it increases.Keywords: ovarian adenocarcinoma, reactive hemophagocytic lymphohistiocytosis, hyperferritinemia, cytopenia, high reticulocyte, natural killer activity

Jin-Min Wang,1,&ast; Kan-Di Yang,2,&ast; Song-Ying Wu,3 Xiang-Gu Zou,3 Yuan-Sheng Liao,1 Bin Yang,4 Bu-Ni Xie,1 Yan Huang,4 Shi-Ju Li,1 Hui-Jun Ma5 1Department of Internal Neurology, The Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, 350003, Fujian, People’s Republic of China; 2Department of Internal Neurology, Anxi County Hospital, Quanzhou, Fujian, 362400, People’s Republic of China; 3Institute of Clinical Research, Fujian Academy of Chinese Medical Sciences, Fuzhou, 350003, Fujian, People’s Republic of China; 4Department of Internal Neurology, Fuzhou Traditional Chinese Medicine Hospital, Fuzhou, 350001, Fujian, People’s Republic of China; 5Department of General, Qiaokou Han Jia Dun Street Community Health Service Center, Wuhan, 430000, Hubei, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jin-Min WangDepartment of Internal Neurology, The Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, No. 282 of Wusi Road, Gulou District, Fuzhou, 350003, Fujian, People’s Republic of ChinaTel +86-13960769905Fax +86-591-87825344Email drwang_wjm1298@163.comObjective: This study aims to investigate the correlation of platelet parameters and C-reactive protein (CRP) with depression.Methods: The clinical data of 61 patients with depression and 30 healthy control subjects were collected to compare the platelet parameters, CRP levels, and Hamilton Depression Rating Scale (HAMD) scores of the two groups for correlation analysis.Results: The results revealed that the body mass index (BMI) of patients with depression was lower (P < 0.05) than that of the healthy control subjects, and that this difference was more significant in women than in men. Patients with severe depression showed an increased mean platelet volume (MPV) (P < 0.05). In the patients with depression, MPV was positively correlated (P < 0.05) with HAMD scores for work and interest, gastrointestinal symptoms, hopelessness, the anxiety/somatization factor, and the hopelessness factor. Platelet count (PLT) was negatively correlated (P < 0.05) with HAMD scores for hypochondriasis, and plateletcrit (PCT) was negatively correlated (P < 0.05) with HAMD scores for middle insomnia and hypochondriasis. Platelet distribution width (PDW) was positively correlated (P < 0.05) with HAMD scores for gastrointestinal and systemic symptoms as well as hopelessness. Higher CRP levels (P < 0.05) were found in the patients with depression than in the healthy control subjects. Furthermore, in the patients with depression, CRP levels were positively correlated (P < 0.05) with HAMD scores for guilt and the cognitive impairment factor.Conclusion: Classical platelet parameters (PLT, MPV, PCT, PDW) and CRP were shown to be associated with specific depressive symptoms and cognitive impairment factors, including sleep, gastrointestinal symptoms, hypochondriasis, losing interest in work, and despair. These results suggest that both platelet parameters and CRP could be suitable biomarkers for predicting the occurrence and prognosis of depression, thus providing a new target for its treatment.Keywords: depression, platelet parameters, C-reactive protein, Hamilton Depression Rating Scale

Shi-Ji Li,&ast; Zhi-Wen Cai,&ast; Hong-Fu Yang,&ast; Xu-Dong Tang, Xiao Fang, Le Qiu, Fei Wang, Xu-Lin Chen Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xu-Lin ChenDepartment of Burns, The First Affiliated Hospital of Anhui Medical University, 120 Wanshui Road, Hefei, Anhui, 230088, People’s Republic of ChinaTel/Fax +86-551-65908495Email okcxl@126.comBackground: Plasma exosome-derived microRNA (miRNA) profiles following thermal injury and their relationship with gene expression derangements in burned skin remain unexplored. This study focused on the identification of key miRNA-mRNA axes in potential blood-to-tissue interactions at early burn stage.Methods: Plasma exosomes were obtained from 6 severe burn patients 4– 7 days post injury and 6 healthy volunteers. Next-generation sequencing (NGS) of exosomal small RNAs presented the differentially expressed miRNAs (DEMs). Target genes of the DEMs were predicted in the mirDIP database. Dataset GSE8056 was enrolled to acquire differentially expressed genes (DEGs) in burned skin compared to normal skin. Overlap between the DEGs and target genes of the DEMs were focus genes. The protein–protein interaction (PPI) network and enrichment analyses of the focus genes demonstrated hub genes and suggested underlying mechanisms and pathways. The hub genes and upstream DEMs were selected to construct key miRNA-mRNA axes.Results: The NGS of plasma exosome-derived small RNAs identified 85 DEMs (14 downregulated miRNAs and 71 upregulated miRNAs) with 12,901 predicted target genes. Dataset GSE8056 exhibited 1861 DEGs in partial-thickness burned skins 4– 7 days postburn. The overlap between DEGs and target genes of DEMs displayed 1058 focus genes. The top 9 hub genes (CDK1, CCNB1, CCNA2, BUB1B, PLK1, KIF11, AURKA, NUSAP1 and CDCA8) in the PPI network of the focus genes pointed to 16 upstream miRNAs in DEMs, including 4 downregulated miRNAs (hsa-miR-6848-3p, has-miR-4684-3p, has-miR-4786-5p and has-miR-365a-5p) and 12 upregulated miRNAs (hsa-miR-6751-3p, hsa-miR-718, hsa-miR-4754, hsa-miR-6754-3p, hsa-miR-4739, hsa-miR-6739-5p, hsa-miR-6884-3p, hsa-miR-1224-3p, hsa-miR-6878-3p, hsa-miR-6795-3p, hsa-miR-550a-3p, and hsa-miR-550b-3p). A key miRNA-mRNA network in potential blood-to-tissue interactions at early burn stage was therefore constructed.Conclusion: An NGS and bioinformatic analysis in the study identified key miRNA-mRNA axes in potential blood-to-tissue interactions at early burn stage, suggesting plasma exosome-derived miRNAs may impact on the alteration patterns of gene expressions in a burn wound.Keywords: burn, exosome, miRNA, next-generation sequencing, bioinformatics

Le Qiu,* Xu Jin,* Jun-Jie Wang,* Xu-Dong Tang,* Xiao Fang, Shi-Ji Li, Fei Wang, Xu-Lin Chen Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xu-Lin ChenDepartment of Burns, The First Affiliated Hospital of Anhui Medical University, 120 Wanshui Road, Hefei, Anhui, 230088, People’s Republic of ChinaTel +86-551-65908495 Email okcxl@126.comIntroduction: Neutrophil-to-lymphocyte ratio (NLR) is a marker of inflammation. This study aimed to evaluate the potential role of NLR to predict 90-day mortality.Methods: Data of 577 patients with burns over 30% of total body surface area were collected and retrospectively analyzed. The risk factors for 90-day mortality were evaluated using logistic regression analyses. Receiver operating characteristic (ROC) curve analysis of the 3rd day NLR was performed and the optimal cut-off value was calculated. The 90-day mortality rates were compared between high and low NLR groups using Kaplan-Meier analysis.Results: Age, mechanical ventilation, burn index, 3rd day NLR, and 7th day red blood cell and platelet (PLT) counts were found to be independent predictive values for 90-day mortality. In contrast, percentage of total body surface area burned, inhalation injury, 1st day white blood cell and neutrophil counts, the 3rd day lymphocytes and PLT counts, and 7th day hemoglobin level were not independently associated with 90-day mortality. The area under the ROC curve of the 3rd day NLR for severe burn–delayed death prediction was 0.665 (95% confidence interval, 0.591– 0.739), and the optimal cut-off value of the 3rd day NLR was 10.50. The 90-day mortality rates differed significantly between the NLR > 10.5 group and the NLR ≤ 10.5 group (17.03% vs 5.92%, respectively; P < 0.01).Conclusion: These results suggested that the 3rd day NLR was associated with an increased risk of death in severely burned patients; thus, it can provide useful information to predict 90-day mortality.Keywords: burns, neutrophil-to-lymphocyte ratio, 90-day mortality

Chong-Hou Lok, Dong Zhu, Jia Wang, Yu-Tang Ren, Xuan Jiang, Shu-Jun Li, Xiu-Ying Zhao Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People’s Republic of ChinaCorrespondence : Xiu-Ying ZhaoBeijing Tsinghua Changgung Hospital,School of Clinical Medicine, Tsinghua University, Beijing 10220, People’s Republic of ChinaEmail zxya00340@btch.edu.cnIntroduction: Understanding drug resistance is important in drug selection for Helicobacter pylori (H. pylori) eradication, and drug resistance data are lacking in Beijing.Purpose: This cross-sectional study aimed to isolate H. pylori from patients with gastroduodenal diseases and to analyze drug resistance to clarithromycin (CLA) and levofloxacin (LEV), which are used frequently in China.Patients and Methods: One hundred and seventy-six patients with gastroduodenal diseases undergoing gastroduodenoscopy were selected by convenient sampling. Gastric mucosa samples were cultured and sub-cultured using a new medium broth. Active H. pylori strains were confirmed by microscopy observation as Gram-negative curved bacilli with positive test results for urease, oxidase, and catalase, and H. pylori 16S rRNA amplification by polymerase chain reaction (PCR). CLA and LEV resistance was identified by minimum inhibitory concentration (MIC) tests and sequencing of 23S rRNA, gyrA, and gyrB genes.Results: From the 176 clinical samples, 112 (112/176, 63.6%) were confirmed with H. pylori infection and 65 (65/176, 36.9%) active H. pylori strains were obtained and further confirmed by MIC assay. Overall, the rates of CLA-resistant and LEV-resistant mutations in the 112 samples were 50.9% and 33.0%, respectively. Mutation related to CLA resistance was A2143G in the 23S rRNA gene and mutations associated with LEV resistance were N87K, D91G, and D91Y in the gyrA gene. Of 112 samples, 22 (19.6%) presented dual resistance to CLA and LEV. Resistance of the H. pylori strains to CLA (r=0.846, P< 0.001) and LEV (r=0.936, P< 0.001) had a strong correlation in phenotypic and genotypic level.Conclusion: The results indicated that resistance of CLA and LEV is severe among patients with gastroduodenitis. A good consistency could be found as to drug resistance between genotypic or phenotypic assay, suggested extending the detection of H. pylori drug resistance from the MIC method to a genotypic assay.Keywords: Helicobacter pylori, clarithromycin, levofloxacin, antibiotic resistance

Jing Huang,1 Dan Zhang,2 Shu-Jing Li,1 Ying Xi,1 Li-Yan Cui,1 Feng-Li Gao3 1Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Nephrology, Beijing, Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Department of Nursing, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China Objective: Prolonged maintenance of surgical position often results in postoperative pain and discomfort in patients. The present study aimed to investigate the effect of preoperative practice of surgical position on postoperative pain and general comfort in patients receiving kidney surgeries. Methods: For this nonrandomized pilot study, 74 patients receiving kidney surgeries were selected using the probability sampling method. Patients from ward 1 were assigned to the practice group (n=35), and those from ward 2 were assigned to the control group (n=39). The practice group were instructed to practice the surgical position for 3 days prior to the surgery. Postoperative pain and comfort were surveyed using two questionnaires for 3 days, respectively. The postoperative pain scores were compared using the Student’s t-test. Results: The two groups did not differ significantly in wound pain on postoperative days 1–3 (P > 0.05). However, the practice group showed significantly reduced low back pain and contralateral shoulder pain than the control group for 3 postoperative days (P < 0.05). The physical domain score was significantly higher in the practice group than in the control group (P < 0.01). Conclusion: Preoperative practice of surgical position can effectively reduce postoperative low back pain and contralateral shoulder pain in patients receiving kidney surgeries and improve the physical comfort. Keywords: surgical position, kidney surgery, postoperative pain, comfort, low back pain, physical comfort

Shijie Li,1 Daqi Zhang,1 Shihou Sheng,2 Hui Sun1 1Department of Thyroid Surgery, 2Department of Gastrointestinal Colorectal and Anal Surgery, China–Japan Union Hospital of Jilin University, Chang Chun, People’s Republic of China Abstract: Currently, therapy for thyroid cancer mainly involves surgery and radioiodine therapy. However, chemotherapy can be used in advanced and aggressive thyroid cancer that cannot be treated by other options. Nevertheless, a major obstacle to the successful treatment of thyroid cancer is the delivery of drugs to the thyroid gland. Here, we present an example of the construction of silicon dioxide nanoparticles with thyroid–stimulating-hormone receptor-targeting ligand that can specifically target the thyroid cancer. Doxorubicin nanoparticles can be triggered by acid to release the drug payload for cancer therapy. These nanoparticles shrink the tumor size in vivo with less toxic side effects. This research paves the way toward effective chemotherapy for thyroid cancer. Keywords: thyroid cancer, silicon dioxide nanoparticle, doxorubicin, acid-triggered release

Jun Wang,1,* Qun Li,2,* Shi-jing Li,1 De-zhao Wang,2 Bu-xing Chen2 1Department of Cardiology, Beijing Mentougou District Hospital, 2Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China *These authors contributed equally to this work Background: Eosinophils (EOS) have been associated with prognosis of patients with coronary artery disease, and those who showed plenitudinous coronary collateral circulation (CCC) often have good clinical consequences. However, the relationship between EOS and CCC was seldom reported. Objective: To investigate the relationship between EOS and CCC development in patients with unstable angina pectoris (UAP).Methods: The study population consisted of 502 consecutive patients with UAP who underwent coronary angiography and coronary stenosis ≥80%. CCC was graded according to the Rentrop grading system of 0–3. Rentrop grades of 0 and 1 indicated low-grade CCC group, whereas grades 2 and 3 indicated high-grade CCC group.Results: The EOS was significantly higher in the high-grade CCC group compared with the low-grade CCC group. In multiple logistic regression analysis, EOS (odds ratio: 1.969; 95% confidence interval [CI]: 1.210–3.3205; P=0.006) and neutrophil count (odds ratio: 0.757; 95% CI: 0.584–0.981; P=0.035) were predictors of high-grade CCC development. EOS of >0.12×109/L could independently predict high-grade CCC with 72.5% sensitivity and 58.4% specificity (area under the curve: 0.681; 95% CI: 0.632–0.729).Conclusion: EOS were associated with high-grade CCC in patients with UAP with coronary stenosis ≥80%. Increased EOS count may play an important role in the development of CCC in patients with UAP. Keywords: unstable angina pectoris, coronary collateral circulation, eosinophils, coronary artery disease

Yi-Dan Chen,1 Zhong-Yuan Liang,1 Yan-Yan Cen,1 He Zhang,2 Mei-Gui Han,2 Yun-Qiao Tian,2 Jie Zhang,2 Shu-Jun Li,2 Da-Sheng Yang2 1College of Pharmacy, The Third Military Medical University, Chongqing, 2Department of Pediatrics, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, People’s Republic of ChinaAbstract: The purpose of the present study was to develop oral dispersible tablets containing prednisolone (PDS)-loaded chitosan nanoparticles using microcrystalline cellulose (MCC 101), lactose, and croscarmellose sodium (CCS). The PDS-loaded chitosan nanoparticles were formulated by ionotropic external gelation technique in order to enhance the solubility of PDS in salivary pH. Prepared nanoparticles were used for the development of oral fast disintegrating tablets by direct compression method. The prepared tablets were evaluated for disintegration time (DT), in vitro drug release (DR), thickness, weight variation, drug content uniformity, friability, and hardness. The effect of concentrations of the dependent variables (MCC, lactose, CCS) on DT and in vitro DR was studied. Fast disintegrating tablets of PDS can be prepared by using MCC, CCS, and lactose with enhanced solubility of PDS. The minimum DT was found to be 15 seconds, and the maximum DR within 30 minutes was 98.50%. All independent variables selected for the study were statistically significant. Oral fast disintegrating tablets containing PDS nanoparticles could be the better choice for the pediatric patients that would result in better patient compliance. From this study, it can be concluded that fast disintegrating tablets could be a potential drug delivery technology for the management of asthma in pediatrics. Keywords: asthma, superdisintegrant, prednisolone, oral tablets, MCC, CCS, factorial design, ANOVA

Salim Bary Barywani,1 Shijun Li,1,2 Maria Lindh,1 Josefin Ekelund,1 Max Petzold,3 Per Albertsson,4 Lars H Lund,5,6 Michael LX Fu1 1Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Sahlgrenska University Hospital/Östra Hospital, Gothenburg, Sweden; 2Department of Geriatrical Cardiology, PLA General Hospitals, Beijing, People’s Republic of China; 3Centre for Applied Biostatistics, University of Gothenurg, Gothenburg, 4Department of Cardiology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, 5Department of Medicine, Karolinska Institute, 6Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden Aim: Evidence of improved survival after use of percutaneous coronary intervention (PCI) in elderly patients with acute coronary syndrome (ACS) is limited. We assessed the association between PCI and long-term mortality in octogenarians with ACS. Methods and results: We followed 353 consecutive patients aged ≥80 years hospitalized with ACS during 2006–2007. Among them, 182 were treated with PCI, whereas 171 were not. PCI-treated patients were younger and more often male, and had less stroke and dependency in activities of daily living, but there were no significant differences in occurrence of diabetes mellitus, chronic obstructive pulmonary disease, hypertension, and uncured malignancies between the two groups. The association between PCI and all-cause mortality was assessed in the overall cohort and a 1:1 matched cohort based on propensity score (PS). In overall cohort, 5-year all-cause mortality was 46.2% and 89.5% in the PCI and non-PCI groups, respectively. Cox regression analysis in overall cohort by adjustment for ten baseline variables showed statistically significant association between PCI and reduced long-term mortality (P

De-Zhao Wang,1 Wei Chen,1 Song Yang,2 Jun Wang,3 Qun Li,1 Qiang Fu,2 Shi-Jing Li,3 Bu-Xing Chen1 1Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, 2Department of Ultrasonography, Beijing Tiantan Hospital, Capital Medical University, 3Department of Cardiology, Beijing Mentougou District Hospital, Beijing, People’s Republic of China Objective: To explore the relationship between Helicobacter pylori (Hp) infection and atrial fibrillation (AF) in Chinese patients.Methods: A total of 285 hospitalized patients with AF and 300 patients from Health Screening Center who matched age and sex with AF group were enrolled. AF patients were divided into two groups: the short-standing AF category (less than a year) and the long-standing AF category (more than a year). All patients had laboratory testing of 13C urea breath test, high-sensitive C-reactive protein (hs-CRP) and left atrial diameter (LAD). We analyzed the difference of these factors in all groups and explored the correlation between Hp infection and AF using logistic regression analysis.Results: Both AF groups had more hypertension, diabetes, and Hp infection than the control group. The Hp value and the hs-CRP level in patients with long-standing AF were higher than those in the short-standing AF and the control groups (for Hp value: P5 mg/L, and LAD >36 mm were significantly related to long-standing AF.Conclusion: The values of Hp in patients with long-standing AF were significantly higher than those in short-standing AF and control groups. Hp δ value ≥4‰ is an independent predictor for long-standing AF. Keywords: high sensitivity C-reactive protein, left atrial diameter,13C urea breath testA Letter to the Editor has been received and published for this article.

Some relationships between the second-order contingent derivative of a set-valued map and its profile map are obtained. By virtue of the second-order contingent derivatives of set-valued maps, some results concerning sensitivity analysis are obtained in multiobjective optimization. Several examples are provided to show the results obtained.

Abstract A scalarization theorem and two Lagrange multiplier theorems are established for tightly proper efficiency in vector optimization involving nearly cone-subconvexlike set-valued maps. A dual is proposed, and some duality results are obtained in terms of tightly properly efficient solutions. A new type of saddle point, which is called tightly proper saddle point of an appropriate set-valued Lagrange map, is introduced and is used to characterize tightly proper efficiency.

We present a sufficient and necessary condition for weak -sharp minima in infinite-dimensional spaces. Moreover, we develop the characterization of weak -sharp minima by virtue of a nonlinear scalarization function.

By virtue of higher-order adjacent derivative of set-valued maps, relationships between higher-order adjacent derivative of a set-valued map and its profile map are discussed. Some results concerning stability analysis are obtained in parametrized vector optimization.

This paper investigates the upper semicontinuity of the solution map for a parametric weak vector variational inequality associated to a -hemicontinuous and weakly -pseudomonotone operator.

A new notion of higher-order weakly generalized adjacent epiderivative for a set-valued map is introduced. By virtue of the epiderivative and weak minimality, a higher-order Mond-Weir type dual problem and a higher-order Wolfe type dual problem are introduced for a constrained set-valued optimization problem, respectively. Then, corresponding weak duality, strong duality, and converse duality theorems are established.

Painleve-Kuratowski convergence of the solution sets is investigated for the perturbed set-valued weak vector variational inequalities with a sequence of mappings converging continuously. The closedness and Painleve-Kuratowski upper convergence of the solution sets are obtained. We also obtain Painleve-Kuratowski upper convergence when the sequence of mappings converges graphically. By virtue of a sequence of gap functions and a key assumption, Painleve-Kuratowski lower convergence of the solution sets is established. Some examples are given for the illustration of our results.

A high precision calibration of the nonlinearity in the energy response of the Daya Bay Reactor Neutrino Experiment's antineutrino detectors is presented in detail. The energy nonlinearity originates from the particle-dependent light yield of the scintillator and charge-dependent electronics response. The nonlinearity model is constrained by γ calibration points from deployed and naturally occurring radioactive sources, the β spectrum from 12B decays, and a direct measurement of the electronics nonlinearity with a new flash analog-to-digital converter readout system. Less than 0.5% uncertainty in the energy nonlinearity calibration is achieved for positrons of kinetic energies greater than 1 MeV.

This Letter reports the first extraction of individual antineutrino spectra from ^{235}U and ^{239}Pu fission and an improved measurement of the prompt energy spectrum of reactor antineutrinos at Daya Bay. The analysis uses 3.5×10^{6} inverse beta-decay candidates in four near antineutrino detectors in 1958 days. The individual antineutrino spectra of the two dominant isotopes, ^{235}U and ^{239}Pu, are extracted using the evolution of the prompt spectrum as a function of the isotope fission fractions. In the energy window of 4-6 MeV, a 7% (9%) excess of events is observed for the ^{235}U (^{239}Pu) spectrum compared with the normalized Huber-Mueller model prediction. The significance of discrepancy is 4.0σ for ^{235}U spectral shape compared with the Huber-Mueller model prediction. The shape of the measured inverse beta-decay prompt energy spectrum disagrees with the prediction of the Huber-Mueller model at 5.3σ. In the energy range of 4-6 MeV, a maximal local discrepancy of 6.3σ is observed.

This work reports a precise measurement of the reactor antineutrino flux using 2.2 million inverse beta decay (IBD) events collected with the Daya Bay near detectors in 1230 days. The dominant uncertainty on the neutron detection efficiency is reduced by 56% with respect to the previous measurement through a comprehensive neutron calibration and detailed data and simulation analysis. The new average IBD yield is determined to be (5.91±0.09)×10-43 cm2/fission with total uncertainty improved by 29%. The corresponding mean fission fractions from the four main fission isotopes U235, U238, Pu239, and Pu241 are 0.564, 0.076, 0.304, and 0.056, respectively. The ratio of measured to predicted antineutrino yield is found to be 0.952±0.014±0.023 (1.001±0.015±0.027) for the Huber-Mueller (ILL-Vogel) model, where the first and second uncertainty are experimental and theoretical model uncertainty, respectively. This measurement confirms the discrepancy between the world average of reactor antineutrino flux and the Huber-Mueller model.

This Letter reports the first extraction of individual antineutrino spectra from ^{235}U and ^{239}Pu fission and an improved measurement of the prompt energy spectrum of reactor antineutrinos at Daya Bay. The analysis uses 3.5×10^{6} inverse beta-decay candidates in four near antineutrino detectors in 1958 days. The individual antineutrino spectra of the two dominant isotopes, ^{235}U and ^{239}Pu, are extracted using the evolution of the prompt spectrum as a function of the isotope fission fractions. In the energy window of 4-6 MeV, a 7% (9%) excess of events is observed for the ^{235}U (^{239}Pu) spectrum compared with the normalized Huber-Mueller model prediction. The significance of discrepancy is 4.0σ for ^{235}U spectral shape compared with the Huber-Mueller model prediction. The shape of the measured inverse beta-decay prompt energy spectrum disagrees with the prediction of the Huber-Mueller model at 5.3σ. In the energy range of 4-6 MeV, a maximal local discrepancy of 6.3σ is observed.

The Daya Bay Collaboration responds to comments posted by S. Parke and R.Zukanovich Funchal regarding our use of Delta(m^2_ee).

We report a measurement of electron antineutrino oscillation from the Daya Bay Reactor Neutrino Experiment with nearly 4 million reactor ν[over ¯]_{e} inverse β decay candidates observed over 1958 days of data collection. The installation of a flash analog-to-digital converter readout system and a special calibration campaign using different source enclosures reduce uncertainties in the absolute energy calibration to less than 0.5% for visible energies larger than 2 MeV. The uncertainty in the cosmogenic ^{9}Li and ^{8}He background is reduced from 45% to 30% in the near detectors. A detailed investigation of the spent nuclear fuel history improves its uncertainty from 100% to 30%. Analysis of the relative ν[over ¯]_{e} rates and energy spectra among detectors yields sin^{2}2θ_{13}=0.0856±0.0029 and Δm_{32}^{2}=(2.471_{-0.070}^{+0.068})×10^{-3}  eV^{2} assuming the normal hierarchy, and Δm_{32}^{2}=-(2.575_{-0.070}^{+0.068})×10^{-3}  eV^{2} assuming the inverted hierarchy.

A search for a time-varying νe signal was performed with 621 days of data acquired by the Daya Bay Reactor Neutrino Experiment over 704 calendar days. The time spectrum of the measured νe flux normalized to its prediction was analyzed with a Lomb-Scargle periodogram, which yielded no significant signal for periods ranging from 2 hours to nearly 2 years. The normalized time spectrum was also fit for a sidereal modulation under the Standard Model Extension (SME) framework to search for Lorentz and CPT violation (LV-CPTV). Limits were obtained for all six flavor pairs ēμ,ēτ, μτ, ēē,μμ and ττ by fitting them one at a time, constituting the first experimental constraints on the latter three. Daya Bay's high statistics and unique layout of multiple directions from three pairs of reactors to three experimental halls allowed the simultaneous constraint of individual SME LV-CPTV coefficients without assuming others contribute negligibly, a first for a neutrino experiment.