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Abstract Limestone forests are an unusual habitat for primates, especially fragmented limestone habitats. However, while some research has been conducted on François' langurs (Trachypithecus francois) in these habitats, there is still a need to improve the understanding of their behavioral adaptations to the fragmented limestone habitat. We collected data on the diet of François' langurs in a fragmented limestone habitat in Encheng National Nature Reserve, southwestern Guangxi, China using instantaneous scanning sampling, and their feeding adaptations to the fragmented forest were examined. The results indicated that a total of 101 species of plants were consumed by the langurs. They also fed on two non‐plant components, including cliff minerals and at least one species of insect. The langurs ate a higher number of food species in Encheng when compared with the other geographic populations, and they maintained a high level of food diversity and ate more vines. Moreover, they were highly selective in their use of vegetation in their home range, and fewer plants provided a high‐quality food source. During the season when food resources were scarce, the consumption of fruits and young leaves decreased as their availability decreased. This led to the use of other food components, such as mature leaves and seeds. The findings support that François' langurs adjust their feeding behavior to cope with seasonal and micro‐variations in their dietary requirements and to adapt to their particular environment.

The multistate resistance states in the amorphous Fe75Si25/0.7Pb(Mg1/3Nb2/3)O3-0.3PbTiO3 (PMN − 0.3PT) (001) heterostructure were modulated by electric fields (E). Based on the in-plane nonvolatile stress changes associated with ferroelectric domain switching in PMN-0.3PT, the widening and narrowing of surface gaps, and the fact that magnetism generally tracks the strain variation in amorphous Fe75Si25 films, the distinct four-state and nonvolatile resistance tuning near the coercive E-field are observed. Then, combining the converse magnetoelectric coupling and magnetoresistive effect, we quantify the coaction effect and equivalence relation between the E-field and magnetic fields (H) on the resistance modification. Meanwhile, another four-state resistance is obtained under the coaction of the E-fields and H-fields. All eight resistive states exhibit excellent E-field switchable behavior and stability performance at room temperature. These results provide a promising approach for exploring and designing multistate and multifield controlled spintronic memory devices.

Abstract Background There is no consensus on whether triplet regimen is better than doublet regimen in the first‐line treatment of advanced gastric cancer (AGC). We aimed to compare the efficacy and safety of oxaliplatin plus capecitabine (XELOX) and epirubicin, oxaliplatin, plus capecitabine (EOX) regimens in treating AGC. Methods This phase III trial enrolled previously untreated patients with AGC who were randomly assigned to receive the XELOX or EOX regimen. The primary endpoint was non‐inferiority in progression‐free survival (PFS) for XELOX as compared with EOX on an intention‐to‐treat basis. Results Between April 10, 2015 and August 20, 2020, 448 AGC patients were randomized to receive XELOX (n = 222) or EOX (n = 226). The median PFS (mPFS) was 5.0 months (95% confidence interval [CI] = 4.5‐6.0 months) in the XELOX arm and 5.5 months (95% CI = 5.0‐6.0 months) in the EOX arm (hazard ratio [HR] = 0.989, 95% CI = 0.812‐1.203; Pnon‐inferiority = 0.003). There was no significant difference in median overall survival (mOS) (12.0 vs. 12.0 months, P = 0.384) or objective response rate (37.4% vs. 45.1%, P = 0.291) between the two groups. In patients with poorly differentiated adenocarcinoma and liver metastasis, the EOX arm had a significantly longer mOS (P = 0.021) and a trend of longer mPFS (P = 0.073) than the XELOX arm. The rate of grade 3/4 adverse events (AEs) was 42.2% (90/213) in the XELOX arm and 72.5% (156/215) in the EOX arm (P = 0.001). The global health‐related quality of life (QoL) score was significantly higher in the XELOX arm than in the EOX arm during chemotherapy. Conclusions This non‐inferiority trial demonstrated that the doublet regimen was as effective as the triplet regimen and had a better safety profile and QoL as a first‐line treatment for AGC patients. However, the triplet regimen might have a survival advantage in patients with poorly differentiated adenocarcinoma and liver metastasis.

AIM: To analyze the clinical application of calculated and gradient accommodative convergence/accommodation ratio(AC/A)in different eye positions.METHODS: A total of 127 myopes in ophthalmology were included. The calculated AC/A was obtained by near/distance phoria and the gradient AC/A was obtained by near addition +1.00D. The differences of eye positions of the calculated and gradient AC/A were compared. RESULTS:The calculated AC/A value was higher than the near +1.00D gradient AC/C(P0.05).CONCLUSION: The calculated AC/A is higher than the gradient AC/A, especially in patients with esophoria and emmetropia, it is easy to obtain high AC/A values by using the calculation method, resulting in erroneous diagnosis. The gradient method is more recommended.

This research found that the clinical outcomes (PFS, ORR, OS) of the non-platinum-based doublet regimen (docetaxel capecitabine combination) were similar to those of the platinum-based (oxaliplatin capecitabine combination) when used as first line therapy for MGC patients.BackgroundDocetaxel, platinum and fluorouracil are the three most important drugs in the treatment of MGC. This study was to compare clinical outcomes of the docetaxel capecitabine combination and the oxaliplatin capecitabine combination as first-line therapy in MGC patients.MethodsIn this phase II trial, MGC patients were randomly assigned and treated with either TX (capecitabine 1000 mg/m2/twice daily/1-14 days and docetaxel 60/75 mg/m2 on the 1st day) (because of toxicity, the dose of docetaxel was reduced to 60 mg/m2) or XELOX (capecitabine the same dose with TX and oxaliplatin 130 mg/m2 on the 1st day) as first-line therapy. After progression, patients were crossover to the other group as second-line treatment.ResultsTotal 134 MGC patients were randomized (69 in TX, 65 in XELOX). There was no significant difference between the PFS of the two groups (TX vs XELOX, 4.6 months vs 5.1 months, p=0.359), and the SFS (9.3 months vs 7.5 months, p=0.705), OS (13.1 months vs 9.6 months, p=0.261), and ORR (46.4% vs 46.2%) were also similar. Among patients with ascites, the TX group had significantly longer PFS and OS than the XELOX group. A total of 85 patients (48 in TX, 37 in XELOX) received second-line treatment, with overall survival of second-line chemotherapy (OS2) of 8.0 m and 5.3 m (p=0.046), respectively. Grade 3 to 4 treatment-related adverse events of first line treatment occurred more in TX group than that in XELOX group(60.6% vs 55.4%).ConclusionTX regimen is an alternative choice of first-line treatment for MGC patients. We still need to explore the large number of cohort to confirm this results.

Bi2FeCrO6 (BFCO) thin films were fabricated by sol-gel method. Digital and analog resistive switching behaviors were sequentially observed in Au/BFCO/FTO/Glass structure by applying a continuous cyclic voltage. By analyzing formation mechanism of the two types of the resistive switching behaviors, it is found that the digital resistive behavior conductance mechanism is a bulk-limited conduction, and the analog resistive switching behavior is accompanied with rectification effects and negative differential resistance behaviors, which are considered as interface-limited conductivity behaviors. So the change of digital and analog resistive switching behaviors may be result of the transformation of conductive mechanism. These research results will help us to design and manufacture digital and analog multifunctional resistive switching memory devices.

ObjectiveNeuroimaging meta-analysis identified abnormal neural activity alterations in patients with type 2 diabetes mellitus (T2DM), but there was no consistency or heterogeneity analysis between different brain imaging processing strategies. The aim of this meta-analysis was to determine consistent changes of regional brain functions in T2DM via the indicators obtained by using different post-processing methods.MethodsSince the indicators obtained using varied post-processing methods reflect different neurophysiological and pathological characteristics, we further conducted a coordinate-based meta-analysis (CBMA) of the two categories of neuroimaging literature, which were grouped according to similar data processing methods: one group included regional homogeneity (ReHo), independent component analysis (ICA), and degree centrality (DC) studies, while the other group summarized the literature on amplitude of low-frequency fluctuation (ALFF) and cerebral blood flow (CBF).ResultsThe final meta-analysis included 23 eligible trials with 27 data sets. Compared with the healthy control group, when neuroimaging studies were combined with ReHo, ICA, and DC measurements, the brain activity of the right Rolandic operculum, right supramarginal gyrus, and right superior temporal gyrus in T2DM patients decreased significantly. When neuroimaging studies were combined with ALFF and CBF measurements, there was no clear evidence of differences in the brain function between T2DM and HCs.ConclusionT2DM patients have a series of spontaneous abnormal brain activities, mainly involving brain regions related to learning, memory, and emotion, which provide early biomarkers for clarifying the mechanism of cognitive impairment and neuropsychiatric disorders in diabetes.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=247071, PROSPERO [CRD42021247071].

Objective To investigate the incidence of cervical anomalies (CA), including cervical intraspinal neural axis abnormalities (CIINAA) and/or cervical osseous abnormalities (COA), and the clinical relevance in severe spinal deformities (SSD) at a single center. Methods A retrospective study of SSD admitted for spinal surgery from January 2003 to January 2015 was conducted at a single center. Inclusion criteria: patients who present with coronal Cobb over 90° (and/or sagittal cobb ≥90°); and patients with complete imaging and clinical data preoperatively. Exclusion criteria: ankylosing spondylitis, adult onset scoliosis, scoliosis secondary to bone destruction. There were 108 SSD patients who fulfilled the criteria in this research (41 males and 67 females). The mean age of the patients was 18.1 ± 2.7 years (range, 10–45 years). The clinical and radiological data of these patients were reviewed to identify CA and to analyze the relationship between clinical and radiographic characteristics in the population of SSD. Results The major curves of scoliosis and segmental kyphosis were 109.1° ± 24.7° and 91.2° ± 29.1°. Cervical abnormalities were detected in 56 patients (51.85%) with 9 different CA, including 28 patients (25.9%) with 6 different COA, 21 patients (19.4%) with 3 different CIINAA, and 7 patients (6.5%) with a combination of COA and cervical intraspinal neural axis abnormalities (CINAA). Basilar invagination and Klippel–Feil syndrome were the most frequent COA. Syringomyelia was the most frequent CINAA. SSD with COA in upper vertebral levels (UVL) had a higher incidence of CINAA than those in subaxial vertebral levels (SVL) (P = 0.024) and SSD with multiple COA (mCOA) in UVL had a higher incidence of CINAA than those with single COA (sCOA) (P = 0.029). In the present study, 83.9% of the SSD with CA were asymptomatic. Conclusion The incidence of CA in SSD was 51.85%, with most presenting with intact neurologic status. As the diversity of COA increased, we found a higher incidence of CINAA, especially in UVL.

ObjectivesTo investigate the value of morphological feature and signal intensity ratio (SIR) derived from conventional magnetic resonance imaging (MRI) in distinguishing primary central nervous system lymphoma (PCNSL) from atypical glioblastoma (aGBM).MethodsPathology-confirmed PCNSLs (n = 93) or aGBMs (n = 48) from three institutions were retrospectively enrolled and divided into training cohort (n = 98) and test cohort (n = 43). Morphological features and SIRs were compared between PCNSL and aGBM. Using linear discriminant analysis, multiple models were constructed with SIRs and morphological features alone or jointly, and the diagnostic performances were evaluated via receiver operating characteristic (ROC) analysis. Areas under the curves (AUCs) and accuracies (ACCs) of the models were compared with the radiologists’ assessment.ResultsIncision sign, T2 pseudonecrosis sign, reef sign and peritumoral leukomalacia sign were associated with PCNSL (training and overall cohorts, P < 0.05). Increased T1 ratio, decreased T2 ratio and T2/T1 ratio were predictive of PCNSL (all P < 0.05). ROC analysis showed that combination of morphological features and SIRs achieved the best diagnostic performance for differentiation of PCNSL and aGBM with AUC/ACC of 0.899/0.929 for the training cohort, AUC/ACC of 0.794/0.837 for the test cohort and AUC/ACC of 0.869/0.901 for the overall cohort, respectively. Based on the overall cohort, two radiologists could distinguish PCNSL from aGBM with AUC/ACC of 0.732/0.724 for radiologist A and AUC/ACC of 0.811/0.829 for radiologist B.ConclusionMRI morphological features can help differentiate PCNSL from aGBM. When combined with SIRs, the diagnostic performance was better than that of radiologists’ assessment.

The study aimed to investigate the efficacy and safety of coronary intervention via distal transradial access (dTRA) in patients with low body mass index (BMI). A total of 67 patients with low BMI who underwent coronary intervention, comprising 29 patients via dTRA and 38 patients via conventional transradial access (cTRA), were retrospectively included. There was no significant difference in the puncture success rate between the two groups (dTRA 96.6%, cTRA 97.4%, P=0.846). Compared with the cTRA group, the success rate of one-needle puncture in the dTRA group was lower (51.7% vs. 81.6%, P=0.020). The compression haemostasis time in the dTRA group was shorter than that in the cTRA group (P

Resistive random-access memory (RRAM) is a promising candidate for next-generation non-volatile memory. However, due to the random formation and rupture of conductive filaments, RRMS still has disadvantages, such as small storage windows and poor stability. Therefore, the performance of RRAM can be improved by optimizing the formation and rupture of conductive filaments. In this study, a hafnium oxide-/aluminum-doped zinc oxide/hafnium oxide (HfO2/Al-ZnO/HfO2) tri-layer structure device was prepared using the sol–gel method. The oxygen-rich vacancy Al-ZnO layer was inserted into the HfO2 layers. The device had excellent RS properties, such as an excellent switch ratio of 104, retention of 104 s, and multi-level storage capability of six resistance states (one low-resistance state and five high-resistance states) and four resistance states (three low-resistance states and one high-resistance state) which were obtained by controlling stop voltage and compliance current, respectively. Mechanism analysis revealed that the device is dominated by ohmic conduction and space-charge-limited current (SCLC). We believe that the oxygen-rich vacancy concentration of the Al-ZnO insertion layer can improve the formation and rupture behaviors of conductive filaments, thereby enhancing the resistive switching (RS) performance of the device.

PurposeTo characterize clinical features and identify baseline prognostic factors for survival in young adults with advanced gastric cancer (YAAGC).Materials and MethodsA total of 220 young inpatients (age less than or equal to 40 years) with an initial diagnosis of advanced gastric cancer were retrospectively enrolled in this study.ResultsOf a consecutive cohort of 220 patients with YAAGC, the median overall survival (OS) time was 16.3 months. One-year survival rate was 43.6% (95% CI: 36.5 to 50.7). In this cohort, a female (71.4%, n = 157) predominance and a number of patients with poorly differentiated tumors (95.9%, n = 211) were observed. In the univariate analysis, OS was significantly associated with neutrophil–lymphocyte ratio (NLR) (≥3.12), hypoproteinemia (

Amorphous SrTiO3 thin films grown on fluorine-doped tin oxide (FTO) glass were fabricated via the sol-gel route and coating process. The composition and chemical state of the thin films were studied by X-ray photoelectron spectroscopy. A high switching ratio and good endurance were demonstrated in the Au/amorphous SrTiO3/FTO/glass memory cells, with an ability to achieve a ratio of high and low resistance (Roff/Ron) of 102. A stable switching voltage and uniform resistance states could be identified, moreover, using standard Weibull distribution. The results showed that Ohmic and space charge limited conduction mechanisms coexisted in the amorphous SrTiO3 thin films. Ohmic conduction dominated in the initial high- and low-resistance state, but the space charge limited conduction mechanism was dominant in the later high-resistance field. The resistance switching effect in the device was explained by the formation and rupture of oxygen vacancies interrelated with filaments. These amorphous SrTiO3 films have potential resistive memory applications.

HfO2 thin film is deposited on p-Si substrates by RF magnetron sputtering apparatus and annealed at 750 °C for 10 min with O2 atmosphere. Spectral analysis shows that HfO2 thin films have good transmittance to light, especially ultraviolet band. The HfO2 layers belong monoclinic phase and its thickness is about 50 nm. In the Au/HfO2/p-Si structure, photodiode characteristics were studied at room temperature and compared with the light current generated under white light, the response current generated under ultraviolet light is more prominent. The photocurrent reaches 80 μA and the repeatable response of device under 23.5 mW/cm2 ultraviolet illuminating is stable. It's found that the working mechanism of this photodiode could have three different states: the majority carrier stacking state of reverse bias, the majority carrier depletion state of forward bias with dark condition and the minority carrier inversion state of forward bias with ultraviolet illumination. The device also has a high damage threshold and its photocurrent is still not saturated at bias 8 V, indicating that it can be applied as a new type of UV detector. Keywords: HfO2 thin films, MOS device, Photodiode, Photocurrent, Free carriers

Rhodiola rosea L., a worldwide botanical adaptogen, has been confirmed to possess protective effects of inflammatory injury for many diseases, including cardiovascular diseases, neurodegenerative diseases, diabetes, sepsis, and cancer. This paper is to review the recent clinical and experimental researches about the anti-inflammatory effects and the related mechanisms of Rhodiola rosea L. extracts, preparations, and the active compounds. From the collected information reviewed, this paper will provide the theoretical basis for its clinical application, and provide the evidences or guidance for future studies and medicinal exploitations of Rhodiola rosea L.

Lead-free ferroelectric ceramics (1-x) BaTiO3–xBi(Mg1/2Ti1/2)O3 (x = 0.0–0.07) were synthesized by conventional solid state reaction method and the correlation of structure, dielectric, ferroelectric and impedance properties were investigated. It was found that Tm and εm showed decreasing trend with the increase of BMT content. The high-temperature dielectric relaxation behaviour was observed in all the samples. The activation energy calculated from impedance (Ea) and conductivity (Econd), which revealed that the relaxation behaviours were linked with the migration of OVs. The values of Ea were almost equivalent to Econd. It was concluded that the short-range hopping of oxygen vacancy contributed to the dielectric relaxation and long-distance movement of doubly ionized oxygen vacancies contributed to the conduction. On the other hand, with increasing BMT contents, it was found that P-E loops became slimmer and slimmer, which indicated the increase of relaxor behaviour. The temperature dependence of P-E loops for 0.98BT–0.02BMT ceramic clearly showed the transition process from ferroelectric to relaxed ferroelectrics. Keywords: BT–BMT ceramic, Dielectric, Ferroelectric, Impedance, Oxygen vacancies

Non-stoichiometric (Pb0.97La0.02)(Zr0.95Ti0.05)1+yO3 (y = −0.03, −0.01, 0.01 and 0.03) antiferroelectric ceramics were successfully prepared via a solid-state reaction route. X-ray diffraction analysis indicated that a perovskite structure was obtained for all compositions. The effects of non-stoichiomotery content and temperature on dielectric properties and energy storage performance of PLZT2/95/5 ceramics were systematically investigated. The ceramics with all non-stoichiometric additions undergo two phase transitions during heating from 140 to 240°C: anti-ferroelectric-ferroelectric and ferroelectric-paraelectric phase transitions. With the y values increasing, both dielectric constant and transition temperature of the ceramics gradually increased. A maximum recoverable energy-storage density of about 0.98 J/cm3 with efficiency of 82.1% was obtained in (Pb0.97La0.02)(Zr0.95Ti0.05)0.97O3 ceramics at 60 kV/cm, which is due to the excess A-site content induced by non-stoichiometric adjustment. All the corresponding energy efficiencies were no less than 80%. These results indicate that non-stoichiometric (Pb0.97La0.02)(Zr0.95Ti0.05)1+yO3 ceramics with a large recoverable energy-storage density could be a potential candidate for applications in high energy-storage density ceramic capacitors.

A negative electrocaloric effect (ECE) in B-site non-stoichiometric (Pb0.97La0.02)(Zr0.95Ti0.05)O3 antiferroelectric ceramics synthesized by the conventional solid-state reaction method is investigated via indirect and direct measurements. Temperature-dependent P-E hysteresis loops were measured. A giant negative electrocaloric temperature change of about 12.45 K was achieved. The results indicate that the antiferroelectric ceramics with non-stoichiometry modification could be a promising candidate for the applications in cooling devices. IMPACT STATEMENT Giant negative electrocaloric effect (NECE) was achieved in B-site non-stoichiometric PLZT2/95/5 ceramics, the NECE parameters are comparable or even larger than most of the reported bulk materials, making it attractive for cooling devices application.

0bjective: We compared the diagnostic accuracy of contrast-enhanced computed tomography (CT), fluorine 18-labeled–fludeoxyglucose (18F–FDG) positron emission tomography (PET)/CT and conventional magnetic resonance imaging (MRI) without and with diffusion-weighted imaging (DWI) for characterization of tubo-ovarian abscesses (TOAs) that mimic adnexal tumors. Materials and Methods: We evaluated (retrospectively) 43 patients who underwent contrast-enhanced CT, PET/CT, conventional MRI without and with DWI, and who were found to have TOAs and complex adnexal tumors. All images were evaluated independently by four radiologists using a two-point grading system. Results of contrast-enhanced CT, PET/CT, MRI without DWI, and MRI with DWI were compared for each patient using receiver operating characteristic curves. Sensitivity, specificity, and positive predictive value (PPV) were calculated and compared using the chi-square test. Results: Sensitivity of MRI with DWI (95%) was significantly higher than that of contrast-enhanced CT (78.6%), PET/CT (86.7%) and MRI without DWI (87.5%). Specificities of these modalities were not significantly different. The PPV of MRI with DWI (100%) was significantly higher than that of the other three modalities (CT, 72.4%; PET/CT 78.5%; MRI without DWI, 81.5%). Overall accuracy of MRI with DWI was significantly higher than that of the other three modalities (CT, 74.4%; PET/CT, 81.4%; MRI without DWI, 83.7%). Conclusion: MRI with DWI shows high accuracy for characterization of complex ovarian lesions, and is the most useful method for differentiation of TOAs from ovarian tumors.

Herein, Bi4Ti3O12 (BIT) ferroelectric thin films were fabricated into Au/BIT/LaNiO3/Si structures to demonstrate their memristor properties. Repeatable and stable bipolar resistive switching (RS) characteristics of the device are first reported in this work. The switching ratio of the device annealed in air reached approximately 102 at 0.1 and −0.1 V. The RS performance was not significantly degraded after 100 consecutive cycles of testing. We also explored the factors affecting the RS behavior of the device. By investigating the RS characteristics of the devices annealed in O2, and in combination with XPS analysis, we found that the RS properties were closely related to the presence of oxygen vacancies. The devices annealed in air exhibited a markedly improved RS effect over those annealed in O2. According to the slope fitting, the conduction mechanism of the device was the ohmic conduction and space charge limited current (SCLC). This study is the first to successfully apply BIT ferroelectric films to the RS layers of memristors. Additionally, a theory of conductive filaments is proposed to adequately explain the relationship between RS behavior and oxygen vacancies, providing meaningful inspiration for designing high-quality resistive random access memory devices.

SDN decoupled the control plane and data plane of traditional network,making the network programmable and simplifying the development of network applications.A comprehensive survey was made to current studies on SDN-based cloud security applications.Based on classification of the applications,the advantages and disadvantages of each application were studied and each category was summarized.What’s more,a service model of cloud security based on SDN was proposed,to overcome the inefficient of current works and integrate security with network service.Lastly,some suggestions about the future development of SDN-based cloud security applications were made.

The resistive switching (RS) characteristics of flexible films deposited on mica substrates have rarely been reported upon, especially flexible HfO2 films. A novel flexible Au/HfO2/Pt/mica resistive random access memory device was prepared by a sol-gel process, and a Au/HfO2/Pt/Ti/SiO2/Si (100) device was also prepared for comparison. The HfO2 thin films were grown into the monoclinic phase by the proper annealing process at 700 °C, demonstrated by grazing-incidence X-ray diffraction patterns. The ratio of high/low resistance (off/on) reached 1000 and 50 for the two devices, respectively, being relatively stable for the former but not for the latter. The great difference in ratios for the two devices may have been caused by different concentrations of the oxygen defect obtained by the X-ray photoelectron spectroscopy spectra indicating composition and chemical state of the HfO2 thin films. The conduction mechanism was dominated by Ohm’s law in the low resistance state, while in high resistance state, Ohmic conduction, space charge limited conduction (SCLC), and trap-filled SCLC conducted together.

AIM:Heart failure (HF) increases the risk of thromboembolic events (TE). Study in a Caucasian population has shown that the CHA2DS2-VASc score predicts TE among HF patients without atrial fibrillation. We sought to assess the usefulness of the CHA2DS2-VASc score in predicting TE in an Asian population and refine the scoring system to improve its predictability of TE among HF patients in sinus rhythm. METHODS:A total of 1,202 consecutive patients who were admitted to our institution for new-onset HF from 2005 to 2012 and without atrial fibrillation or anticoagulation were retrospectively reviewed. RESULTS:The mean age was 77.6 ± 12.2 years and 51.7% were female. After 36.2 ± 30.1 months, 113 (9.4%) developed TE. The annual incidence was 0.54%, 1.54%, 2.98% and 5.04% per year in those who had a CHA2DS2-VASc score of 1, 2-3, 4-5 and ≥6, respectively. In multivariate analysis, age ≥75 years [Hazard ratio (HR) 2.59, 95% confidence interval (CI) 1.23-5.46, p = 0.012), chronic ischemic heart disease (HR 1.54, 95% CI 1.02-2.31, p = 0.040) and chronic kidney disease (HR 1.66, 95% CI 1.09-2.53, p = 0.018) independently predicted TE. Incorporation of chronic ischemic heart disease and chronic kidney disease into the CHA2DS2-VASc score significantly increased the area under the Receiver Operating Curve from 0.57 (95% CI 0.54-0.59) to 0.61 (95% CI 0.55-0.66; p = 0.022). CONCLUSION:The CHA2DS2-VASc score is useful for stratification of the risk of TE among HF patients in sinus rhythm. Incorporation of chronic ischemic heart disease and chronic kidney disease into the score modestly improves its predictive value.

BACKGROUND: Interleukin-32 (IL-32) is a recently discovered proinflammatory cytokine involved in inflammatory diseases. We investigated the expression of IL-32 and its regulation mechanism in the inflammatory response of patients with Helicobacter pylori (H. pylori) infection. DESIGN AND METHODS: IL-32 mRNA and protein expression in gastric tissues was detected by quantitative real-time PCR and immunohistochemistry. The regulation of IL-32 in human gastric epithelia cell line AGS was investigated by different cytokine stimulation and different H. pylori strain infection. RESULTS: Gastric IL-32 mRNA and protein expression were elevated in patients with H. pylori infection and positively correlated with gastritis. In H. pylori-infected patients, the mRNA level of IL-32 was also correlated with that of proinflammatory cytokines IL-1β and TNF-α. In vitro IL-1β and TNF-α could upregulate IL-32 mRNA and protein level in AGS cells, which was dependent on NF-κB signal pathway. The regulation of IL-32 expression in response to H. pylori-infection could be weakened by using neutralizing antibodies to block IL-1β and TNF-α. Moreover, H. pylori-infected AGS cells also induced IL-32 mRNA and protein expression, which was dependent on CagA. CONCLUSIONS: IL-32 level is elevated in patients with H. pylori infection and its expression is regulated by proinflammatory stimuli, suggesting that IL-32 may play a role in the pathogenesis of H. pylori-related gastritis.