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Ascending aortic perivascular adipose tissue (AA-PVAT) mainly comprises brown adipose tissue (BAT), originates from neural crest cells that derive from ectoderm, and plays important role in angiotensin II-induced vascular inflammation and remodeling in mice. However, the characterization and function of human AA-PVAT remains highly unclear.Patients with coronary artery disease (CAD) (n = 20) and aortic valve disease (AVD) (n = 23) who underwent cardiac surgery consented to take part in transcriptome and histological studies. Paired samples of AA-PVAT, epicardial adipose tissue (EAT), and subcutaneous adipose tissue (SAT) were obtained. RNA sequencing, histological analysis, quantitative reverse transcription polymerase chain reaction and western blot studies were performed on those samples.Human AA-PVAT exhibited smaller adipocyte morphology and high expression of brown adipocyte marker. Transcriptome analysis revealed that AA-PVAT showed unique transcriptome characteristics compared with EAT and SAT. While comparing CAD and AVD patients, AA-PVAT exhibited a decreasing brown phenotype and higher inflammatory response in AVD patients. Gene ontology enrichment and Kyoto Encyclopedia of Genes and Genomes pathway analysis suggested that the differentially expressed genes in AA-PVAT between CAD and AVD patients were involved mainly in the processes of inflammation and metabolism regulation.Human AA-PVAT is a BAT-like adipose tissue with unique transcriptome characteristics, and exhibits a weakened brown phenotype and an enhanced inflammation response in AVD patients.

Oxide-dispersion-strengthened (ODS) steels, which contain nano-scale Y-Ti-O particles, are being considered for high-temperature radiation environments of nuclear reactors. It is important to accurately characterize the structure of grain boundaries and understand the behavior of segregation at grain boundaries in ODS steels during irradiation. The effect of heavy ion irradiation at 700 °C on Nanostructured Ferritic Alloy 14YWT was investigated using Atom Probe Tomography. Enrichment of Cr occurs at the grain boundaries as well as at nano oxide particle surfaces in the unirradiated sample. The enrichment of Ti and Y at a grain boundary corresponds with Y-Ti-O nano oxide particles with larger size compared to those in the grain, and the Cr enrichment is particularly accentuated at these larger nano oxide particles. The segregation of W occurs at the grain boundaries that are without nano oxide particles. O is segregated at grain boundaries without oxide particles after irradiation. The segregation behavior of Cr, W, Ti, and Y at the grain boundary in the irradiated samples is similar to that in the unirradiated sample. The nano oxide particles embedded in the grain boundary are a primary reason for the increase in Cr segregation at the grain boundary.

Osteoarthritis (OA) is characterized by cartilage matrix degeneration and chondrocyte apoptosis. Prolonged endoplasmic reticulum (ER) stress participates in chondrocyte apoptosis and cartilage degeneration in OA progression. miR-486-5p could suppress the apoptosis of nucleus pulposus cells and cardiomyocyte, yet whether miR-486-5p modified exosomes could modulate ER stress and apoptosis of chondrocytes remain unknown. We validated the increased inflammation and ER stress in OA synovium and cartilage, and the inhibition of ER stress could attenuate the IL-1β induced chondrocyte apoptosis. Administration of exogenous miR-486-5p could inhibit the ER stress, alleviate chondrocytes apoptosis and promote matrix regeneration. In comparison with direct administration of miR-486-5p and miR-486-5p overexpressing ADSCs, miR-486-5p modified exosomes indicated a better effect in modulating chondrocyte homeostasis. MiR-486-5p containing exosomes could also regulate macrophage polarization. Our IVIS imaging data validated that intraarticular injection of miR-486-5p containing exosomes could sustain for at least 7 days. MiR-486-5p containing exosomes showed a better effect on alleviating rats OA compared with direct administration of miR-486-5p and miR-486-5p overexpressing ADSCs. Our data demonstrated that miR-486-5p modified exosomes have a better effect on alleviating chondrocyte apoptosis and osteoarthritis. This study provides evidence of this efficient strategy of exosomal miRNA delivery and the miRNA-based therapy for OA.

Poly(ether-ether-ketone) (PEEK) with good biocompatibility exhibits high mechanical strengths but bioinert. In addition, tantalum (Ta) possesses outstanding osteogenesis but high density and elastic modulus, and cost. In this study, by blending Ta nanoparticles with PEEK, Ta/PEEK composite (TP) was prepared, which was then treated by concentrated sulfuric acid to form a microporous surface containing Ta particles on TP (TPS). Moreover, genistein (GS) with antibacterial property was loaded into the microporous surface of TPS (TPSG). Compared with TP, the surface properties (e.g., surface roughness and hydrophilicity) of TPS was obviously improved because of the microporous surface including Ta nanoparticles. Moreover, TPS showed low antibacterial properties because of presence of sulfonic group while TPSG exhibited excellent antibacterial properties due to GS loaded into the microporous surface. Furthermore, compared with TP, TPS obviously promoted attachment and proliferation of MG63 cells, while TPSG with GS remarkably inducing osteogenic differentiation of the cells compared with TPS in vitro. Moreover, in comparison with TP, TPS with optimized surface properties promoted new bone regeneration and osseointegration, while TPSG loading GS further enhanced bone regeneration as well as osseointegration in vivo. In summary, the GS loaded into microporous surface including Ta nanoparticles of TPSG exhibited antibacterial and osteogenic activity, which would have great potential for bone tissue repair.

BackgroundAs one of the most common disabling diseases in the musculoskeletal system, osteoarthritis (OA) is characterized with cartilage matrix degeneration and chondrocyte apoptosis. Endoplasmic reticulum (ER) stress is well known for participate in chondrocyte apoptosis and cartilage degeneration in OA progression. microRNAs (miRNAs) could function in cartilage homeostasis, yet limited is known regarding whether miRNA could modulate ER stress in chondrocytes. Here, we reported that exosomal microRNA-486-5p from adipose derived stem cells (ADSCs) could alleviate chondrocyte apoptosis and osteoarthritis by attenuating ER stress MethodsER stress markers and inflammatory cytokines were analyzed in OA knee joint by immunohistochemistry and immunofluorescence staining. IL-1β induced apoptosis of chondrocytes was analyzed using flow cytometry. ER stress markers and inflammatory cytokines of IL-1β induced chondrocytes were analyzed by immunofluorescence staining, western blot and ELISA. miR-486-5p mimic overexpressed ADSCs and their exosomes were validated and used to treat IL-1β induced chondrocytes together with miR-486-5p mimic. Different administrative methods of miR-486-5p mimic were tracked both in vitro and in vivo, and further used to treat OA model mice. OA progression of mice was analyzed by H&E, safranin O/fast green, immunofluorescence and immunohistochemistry staining. ResultsWe validated the increased inflammation and ER stress in OA synovium and cartilage, and the IL-1β induced chondrocyte apoptosis was through the ER stress activation. Administration of exogenous miR-486-5p could not only inhibit the ER stress, but also alleviate chondrocytes apoptosis and promote matrix regeneration. In comparison with direct administration of miR-486-5p and miR-486-5p overexpressing ADSCs, exosomes seem to be a better delivery vehicle for miRNA in modulating chondrocyte homeostasis. Our immunofluorescence and IVIS imaging data further validated the better delivery ability of exosomes through tracking the uptake of miR486-5p in chondrocytes and the diffusion of miR-486-5p in the knee joint with different transportation methods. Exosomal microRNA-486-5p also showed a better effect on alleviating mice OA. ConclusionOur data demonstrated that exosomes are better delivery vehicle for miR-486-5p on alleviating chondrocyte apoptosis and osteoarthritis. This study provides evidence to this efficient strategy of exosomal miRNA delivery and to the miRNA-based therapy for OA.

OBJECTIVES Long-term effectiveness of coronary artery bypass grafting using radial artery (RA) or great saphenous vein (SVG) grafts as a second conduit was compared. METHODS Patients received simple elective off-pump coronary artery bypass involving both the left internal thoracic artery (LITA) and the left anterior descending artery between January 1999 and December 2005 at Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China. RA graft patients (n = 147 LITA + RA and n = 61 LITA + RA + SVG) were matched with SVG graft patients (n = 208 LITA + SVG). Mean follow-up was 86.5 months. RESULTS Baseline characteristics were comparable before and after surgery. Intraoperative hospital mortality was not significantly different. In all, 378 (90.9%) patients completed postoperative follow-up (197 in the RA and 181 in SVG). Overall survival was significantly better in the RA group (Log-rank, P = 0.017) with 88% 10-year survival in the RA group and 81% in the SVG group. All-cause mortality was significantly lower in the RA group (hazard ratio 0.42, 95% confidence interval 0.20-0.88, P = 0.020). Major adverse cardiovascular event-free survival was significantly better in the RA group than in the SVG group (Log-rank, P = 0.019). No significant difference in the length of postoperative angina relief was found. CONCLUSIONS Using the RA as the secondary graft for coronary artery bypass grafting improved long-term postoperative survival and reduced the incidence of postoperative major adverse cardiovascular events.

BACKGROUND This prospective study aimed to compare clinical effects of intramedullary nailing guided by digital and conventional technologies in treatment of tibial fractures. MATERIAL AND METHODS Thirty-two patients (mean age 43 years, 18 males and 14 females) who were treated for tibial fractures from October 2010 to October 2012 were enrolled. They were sequentially randomized to receive intramedullary nailing guided by either digital technology (digital group, n=16) or conventional technology (conventional group, n=16). The operation time, fluoroscopy times, fracture healing time, distance between the actual and planned insertion point, postoperative lower limb alignment, and functional recovery were recorded for all patients. RESULTS The mean operation time in the digital group was 43.1±6.2 min compared with 48.7±8.3 min for the conventional technology (P=0.039). The fluoroscopy times and distance between the actual and planned insertion point were significantly lower in the digital group than in the conventional group (both P

Background: Matrix metalloproteinase 9 (MMP9) has recently emerged as a risk predictor in patients with cardiovascular diseases. However, little is known about the significance of increased plasma MMP9 in patients with perioperative myocardial injury. We aimed to investigate the role of MMP9 in the occurrence of myocardial injury during off-pump coronary artery bypass grafting (OPCAB). Methods: A total of 34 consecutive patients with coronary artery diseases (CAD) were recruited in this prospective, observational study. All patients were operated for OPCAB surgery. Serial blood samples were collected preoperatively and 12 hours after surgery. MMP9, together with cardiac troponin I (cTnI), creatinine kinase myocardial b fraction (CK-MB), C-reactive protein (CRP), and N-terminal pro B-type natriuretic peptide (NT-proBNP) levels in plasma were measured at each time-point. Results: MMP9 levels increased significantly at 12 hours after surgery, attaining nearly 2 times the baseline levels (P=0.0001). There was a significant correlation between preoperative (pre-OP) circulating levels of MMP9 and the left ventricular ejection fraction (LVEF) (r=0.48; P=0.004) as well as European System for Cardiac Operative Risk Evaluation (EuroSCORE) II (r=0.43; P=0.012). Patients were in New York Heart Association (NYHA) functional class III or IV heart failure showed a significantly higher MMP9 levels (1,348.0±337.2 vs . 630.4±93.0 ng/L, P=0.012) as compared to the patients in NYHA functional class I and II. No significant correlation was observed between MMP9 and age (P=0.612), serum creatinine (P=0.185), CRP (P=0.207), NT-proBNP (P=0.058). A significant correlation was observed in these data between the post-OP MMP9 and cTnI (r=0.35; P=0.003). Conclusions: Our study first established a connection between MMP9 and OPCAB procedure, suggesting that MMP9 could be a novel biomarker for identifying perioperative myocardial injury in patients undergoing OPCAB.

Objective The aim of this study was to gain a better understanding of the molecular mechanisms and identify more critical genes associated with the pathogenesis of postmenopausal osteoporosis (PMOP). Materials and methods Microarray data of GSE13850 were download from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were identified either in B cells from postmenopausal female nonsmokers with high bone mineral density (BMD) compared with those with low BMD (defined as DEG1 group) or in B cells from postmenopausal female smokers with high BMD compared with postmenopausal female nonsmokers with high BMD (defined as DEG2 group). Gene ontology and immune-related functional enrichment analysis of DEGs were performed. Additionally, the protein-protein interaction network of all DEGs was constructed and subnetworks of the hub genes were extracted. Results A total of 51 DEGs were identified in the DEG1 group, including 30 up- and 21 downregulated genes. Besides, 86 DEGs were identified in the DEG2 group, of which 46 were upregulated and 40 were downregulated. Immune enrichment analysis showed DEGs were mainly enriched in functions of CD molecules and chemokines and receptor, and the upregulated gene interleukin 4 receptor (IL-4R) was significantly enriched. Moreover, guanine nucleotide-binding protein G (GNAI2), filamin A alpha (FLNA), and transforming growth factor-β1 (TGFB1) were hub proteins in the protein-protein interaction network. Conclusion IL-4R, GNAI2, FLNA, and TGFB1 may be potential target genes associated with the pathogenesis of PMOP. In particular, FLNA, and TGFB1 may be affected by smoking, a risk factor of PMOP.

Distribution systems are transforming from passive networks to active ones with the development and deployment of renewable energy sources, microgrids (MGs) and virtual plants. Accompanied by the emergence of multiple stakeholders owning personal distributed generators (DGs), energy storage systems and even MGs, the optimal dispatch problem in active distribution networks (ADNs) is challenged. Basing on three-level day-ahead optimal scheduling framework, an up-to-down interaction mechanism is proposed firstly for the optimization in ADNs considering multi-stakeholders. The optimization mechanism starts from DN-layer with minimizing total active power loss of the DN, and then it implements the optimizations of all MGs within the optimizations of all users in the corresponding MG. The optimizing information of connection nodes will be fed back to upper layers in turn and this three-level optimization will be repeatedly implemented until the maximal unbalance power generation returned from all MGs satisfying the convergence condition. Additionally, an elasticity coefficient-based demand response program using time-of-use (TOU) pricing is integrated into the optimizations of MG-layer and User-Layer to guide peak load cutting. Moreover, a power flow rebalancing strategy is also integrated into the MG-layer optimization to accelerate the convergence of the whole solution. Finally, an actual 47-bus distribution system is employed to verify this proposed three-level optimization and the results show the effectiveness and applicability of the proposed method.

Objectives There are concerns about effects of surgical revascularization on patients with ischaemic systolic dysfunction when no signs of myocardial viability have been detected by nuclear imaging preoperatively. We reviewed our data to determine the efficacy of coronary bypass graft in this special patient cohort. Methods A retrospective review with prospectively collected clinical data was conducted on 87 consecutive patients between 2000 and 2012 whose left ventricular ejection fraction was less than 40%. All patients received positron emission tomography examination before undergoing coronary artery bypass graft and showed no signs of myocardial viability. Improvements in ejection fraction, postoperative re-examination of myocardial viability by nuclear imaging and freedom from major cardiac events were observed. Survival was calculated using Kaplan-Meier analysis. Results The 30-day mortality rate was 7%. Ejection fraction improvement (defined as over 5%) was observed in 13 (16%) patients within 6 months postoperatively. Ejection fraction improvement was observed in 46 (58%) patients by the end of the first year and 50 (63%) patients by the second year. It was noted that 25 (32%) and 43 (54%) patients progressed to heart functional class I or II at 1 and 5 years, respectively. Positron emission tomography examination showed enhanced myocardial viability in the non-viable ventricular wall segment in 53 (67%) patients at 1 year. Freedom from major adverse cardiac events was observed in 56 (71%) patients at 1 year and 47 (60%) patients at 5 years. Survival rates were 82 and 66% at 1 and 5 years, respectively. Conclusions Coronary artery bypass graft proved to be a positive choice of treatment for patients with severe ischaemic systolic dysfunction when there was no viable myocardium detected through nuclear imaging.

Due to the advancement of the bidding time in the EPC mode, especially for the project owners who have tendered after the feasibility study or the design of the project can only propose the functional requirements of the project and cannot form a detailed bill of quantities, which is not conducive to the owners. The investment control has led to an increase in information asymmetry between the owner and the general contractor. To this end, this paper borrows the concept of “customer demand” in total quality management and the “QFD quality function development method” to identify the functional requirements of the owner and realize the transformation from the owner’s functional requirements to the function list to the engineering quantity list. The owner can convert the qualitative functional requirements into a list of functions corresponding to the bill of quantities in the bidding stage, thereby solving the information asymmetry between the owner and the general contractor.

Objectives Despite the increasing success and applicability of transcatheter aortic valve replacement, 2 critical issues remain: the durability of the valves, and the ideal imaging to aid implantation. This study was designed to investigate the transapical implantation of a device of known durability using real-time magnetic resonance imaging (MRI) guidance. Methods A sutureless aortic valve was used that employs a self-expanding nitinol stent and is amenable to transapical delivery. MRI (1.5-T) was used to identify the anatomic landmarks in 60-kg Yucatan swine. Prostheses were loaded into an MRI-compatible delivery device with an active guidewire to enhance visualization. A series of acute feasibility experiments were conducted (n = 10). Additional animals (n = 6) were allowed to survive and had follow-up MRI scans and echocardiography at 90 days postoperatively. Postmortem gross examination was performed. Results The valve was MRI compatible and created no significant MRI artifacts. The 3 commissural struts were visible on short-axis view; therefore, coronary ostia obstruction was easily avoided. The average implantation time was 65 seconds. Final results demonstrated stability of the implants with preservation of myocardial perfusion and function over 90 days: the ejection fraction was 48% ± 15%; the peak gradient was 17.3 ± 11.3 mm Hg; the mean gradient was 9.8 ± 7.2 mm Hg. Mild aortic regurgitation was seen in 4 cases, trace in 1 case, and a severe central jet in 1 case. Prosthesis positioning was evaluated during gross examination. Conclusions We demonstrated that a sutureless aortic valve can be safely and expeditiously implanted through a transapical approach under real-time MRI guidance. Postimplantation results showed a well-functioning prosthesis, with minimal regurgitation, and stability over time.

Articular cartilage has restricted self-regenerative capacity; therefore, treatment of cartilage lesions is a great challenge in the field of orthopedics. In the present study, we evaluate the enhancing effect of a transforming growth factor-beta 1 (TGF-β1)-immobilized scaffold, fabricated by incorporating TGF-β1-loaded gelatin microspheres into PLGA framework, on the differentiation of adipose-derived stem cells (ASCs) into chondrocytes. Significant increase in cell proliferation was observed in the TGF-β1-immobilized PLGA-gelatin scaffold, as compared with the ASC-seeded non-TGF-β1-immobilized PLGA-gelatin scaffold. When chondrogenic differentiation of ASCs was evaluated for both constructs, sulfated glycosaminoglycan (sGAG) content was significantly higher in the TGF-β1-immobilized scaffold. This study showed that ASCs containing the TGF-β1-immobilized scaffold better promoted cartilage regeneration in defective articular cartilage, which is assessed by histological observation. Based on the above results, we conclude that TGF-β1-immobilized PLGA-gelatin scaffold seeded with ASCs considerably enhances the quality of the tissue-engineered cartilage, therefore, advancing the field of cartilage tissue engineering.

Motivated by applications in food processing and semiconductor manufacturing industries, we consider the scheduling problem of a batching machine with jobs of multiple families. The machine has a limited capacity to accommodate jobs. The jobs are in arbitrary sizes and multiple families. Jobs from different families cannot be processed in a batch. We show the problems of minimizing makespan and total batch completion time are both NP-hard in the strong sense. We present a mixed integer programming model for the problems. Then we propose two polynomial time heuristics based on longest processing time first rule and first fit rule. For the special case where a larger job also has a longer processing time, the heuristic for minimizing makespan is optimal. For the general case, we show the performance guarantee of the methods for the two objectives respectively.

Genetic polymorphisms of CYP2C9 significantly influence the pharmacokinetics and pharmacodynamics of some drugs, which might result in adverse drug effects and therapeutic failure. Several studies have been performed on CYP2C9 genetic polymorphisms in Han Chinese populations. However, these studies only focused on two commonly investigated alleles, *2 and *3, in relatively small sample sizes. To scale up the gene-scanning region and determine relatively precise data on the genetic distribution pattern in Chinese populations, unrelated healthy Han Chinese volunteers from Zhejiang Province (n=1127) and Hebei (n=1000) Province were recruited as subjects for the direct sequencing of all exons of CYP2C9. As a result, 14 previously reported alleles were detected in this work, and 8 of these alleles (*14, *16, *19, *23, *27, *29, *33 and *34) were described for the first time in Chinese populations. In addition, 37 novel mutations were also detected, of which 22 variants were non-synonymous, and 21 new alleles, *36-*56, were designated by the Human CYP Allele Nomenclature Committee. In vitro functional analysis of these 22 novel CYP2C9 variants revealed that 17 mutations had a significant influence on the protein's catalytic activity. Our study provides the most accurate data on CYP2C9 polymorphisms in Han Chinese populations and detects the largest number of novel allelic variants existing to date. These new alleles will greatly enrich the current knowledge of naturally occurring CYP2C9 variants in Chinese populations.

OBJECTIVES The prognostic value of myocardial viability before coronary bypass grafting remains controversial. The present study evaluated the effects of off-pump coronary artery bypass (OPCAB) grafting on patients with coronary artery disease (CAD) with or without viable myocardium (VM) preoperatively detected via nuclear imaging. METHODS A total of 115 consecutive patients with 3-vessel disease and impaired left ventricular ejection fraction (LVEF ≤ 45%) who underwent OPCAB grafting were recruited in this prospective study. The patients were divided into 2 groups based on myocardial viability, the non-viable myocardium (NVM, 55 patients) and VM (60 patients) groups. Positron emission tomography and radionuclide imaging examination were applied to evaluate the myocardium viability. A Kaplan-Meier analysis was conducted to evaluate the 1-year survival rate. RESULTS The preoperative data were similar between groups. An improvement in the LVEF was observed in both groups 12 months after OPCAB grafting (P

Growth differentiation factor-15 (GDF-15) has recently emerged as a risk predictor in patients with cardiovascular diseases. We therefore aimed to investigate the role of GDF-15 in the occurrence of cardiac injury during off-pump coronary artery bypass grafting (OPCAB). 55 consecutive patients with coronary artery diseases were recruited in this prospective, observational study. All patients were operated for OPCAB surgery. Serial blood samples were collected preoperatively, 12 hours and 36 hours after surgery. GDF-15, together with C-reactive protein, cardiac troponin I, creatine kinase MB and N-terminal pro B-type natriuretic peptide levels in plasma were measured at each time-point. GDF-15 levels increased significantly at 12 hours after surgery, attaining nearly 2.5 times the baseline levels (p

Toll-like receptor 4 (TLR4) plays important roles in modulating innate immunity. Type 2 diabetes mellitus (T2DM) is a chronic and complex disease that is characterized by impaired insulin resistance and dysregulated immune response. In the current study, we investigated whether TLR4 polymorphisms were correlated with susceptibility to T2DM in the Chinese population. Four TLR4 polymorphisms (-2431T/C, Asp299Gly, Thr399Il3, and +3725G/C) were genotyped in 936 T2DM patients and 978 healthy controls. Results showed that the prevalence of TLR4 +3725GC and CC genotypes was significantly decreased in T2DM cases than those in controls [odds ratio (OR) = 0.68, 95% confidence interval (CI) = 0.55-0.84, p = 0.0003, and OR=0.46, 95% CI = 0.32-0.67, p = 3.71 × 10(-5) , respectively). Also, the frequency of TLR4 +3725C allele was significantly lower in T2DM patients (p = 2.50 × 10(-8) ). The -2431T/C did not reveal any significant differences between cases and controls. We did not detect Asp299Gly and Thr399Il3 polymorphisms in our study group. Stratification analysis of the clinical features in the patients demonstrated that frequency of +3725CC genotype was lower in patients older than 50 years old (p = 0.047). In conclusion, these results indicate that TLR4 +3725G/C polymorphism may be a novel protective factor against T2DM in the Chinese population.

The rapid development of urbanization in China brings convenience to people's lives, but it also faces the risk of water crisis. The effective resources such as rain, which is large in quality and easy to obtain, are wasted due to poor management and become cities. The potential safety threats, out of consideration of the above issues, China proposed the concept of building a "sponge city", promoted the exploration and practice of solving storm water problems in cities and building low-impact rainwater systems in various fields, and also constituted an opportunity and basis for this study. . This article is based on low-impact development concepts and practices as the basis for research, focusing on its system construction methods and specific facilities in China's "sponge city" construction. Therefore, the design principles, design methods, and post-assessment methods of rainwater landscape based on low-impact development were proposed, and the design contents, methods, advantages, and disadvantages of the sponge landscape design case in Qian'an City in China were studied and studied.

Background Preoperative planning and surgical navigation are two crucial aspects of a computer-assisted system for the success of minimally invasive cardiac surgery. Methods In the first part, port placement planning was mainly discussed. We proposed an algorithm based on four criteria to achieve optimized placement. In the second part, an optical tracker was used to locate the thoracoscope and surgical instruments accurately and to show the relative positions between the thoracoscope, surgical instruments and the patient's anatomical structures. An image-matching technique was employed to help the surgeon locate the target, using real-time thoracoscopic video images during the procedure. Results In order to verify our proposed algorithms, several clinical planning cases were performed to compare our port placement algorithm to the traditional method. Both phantom test and animal study experiments were also done to demonstrate the validity of the target tracking of the system. Both the phantom test and the animal study revealed that the fiducial registration error (FRE) was 1.08 ± 0.16 mm and system error was 5.05 ± 0.67 mm, respectively. Conclusion A novel computer-assisted system for minimally invasive cardiac surgery has been developed. This method has shown its capability to achieve the preoperative planning and real-time surgery navigation. Copyright © 2010 John Wiley & Sons, Ltd.

Minimal invasive direct coronary artery bypass grafting (MIDCAB) procedures are potentially advantageous over conventional open surgery, while one major limitation is the narrow view of the endoscope and the difficulty in detecting stenosis from the endoscopic view. In this paper, we propose a frame to align the endoscope view and the 3D-vessel model reconstructed from angiography. We register the endoscopic video frame with the 3D-vessel model by electro-magnetic sensor, and then we segment the vessel in the endoscopic video frame with HSV (hue, saturation, value) and hessian transformation, and refined the registration with the vessel model by Coherent Points Drifting. We have validated the proposed method on a static phantom heart model and a real patient's endoscope video. RMSE (root mean-square error) was employed to evaluate our method and the registration error for the phantom model were 1.1+−0.2mm, for the real patient was 3.1mm.

Postmenopausal osteoporosis is a common bone disease and characterized by low bone mineral density. This study aimed to reveal key genes associated with postmenopausal osteoporosis (PMO), and provide a theoretical basis for subsequent experiments. The dataset GSE7429 was obtained from Gene Expression Omnibus. A total of 20 B cell samples (ten ones, respectively from postmenopausal women with low or high bone mineral density (BMD) were included in this dataset. Following screening of differentially expressed genes (DEGs), coexpression analysis of all genes was performed, and key genes in the coexpression network were screened using the random walk algorithm. Afterwards, functional and pathway analyses were conducted. Additionally, protein–protein interactions (PPIs) between DEGs and key genes were analyzed. A set of 308 DEGs (170 up-regulated ones and 138 down-regulated ones) between low BMD and high BMD samples were identified, and 101 key genes in the coexpression network were screened out. In the coexpression network, some genes had a higher score and degree, such as CSTA. The key genes in the coexpression network were mainly enriched in GO terms of the defense response (e.g., SERPINA1 and CST3), immune response (e.g., IL32 and CLEC7A); while, the DEGs were mainly enriched in structural constituent of cytoskeleton (e.g., CYLC2 and TUBA1B) and membrane-enclosed lumen (e.g., CCNE1 and INTS5). In the PPI network, CCNE1 interacted with REL; and TUBA1B interacted with ESR1. A series of interactions, such as CSTA/TYROBP, CCNE1/REL and TUBA1B/ESR1 might play pivotal roles in the occurrence and development of PMO.