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A type-I burst could influence the accretion process through radiation pressure and Comptonization both for the accretion disk and the corona/boundary layer of an X-ray binary, and vice versa. We investigate the temporal evolution of a bright photospheric radius expansion (PRE) burst of 4U 1608-52 detected by Insight-HXMT in 1-50 keV, with the aim of studying the interplay between the burst and persistent emission. Apart from the emission from the neutron star (NS) surface, we find the residuals both in the soft (10 keV) X-ray band. Time-resolved spectroscopy reveals that the excess can be attributed to an enhanced pre-burst/persistent emission or the Comptonization of the burst emission by the corona/boundary layer. The Comptonization model is a convolution thermal-Comptonization model (thcomp in XSPEC) and the Comptonization parameters are fixed at the values derived from the persistent emission. We find, during the PRE phase, after the enhanced pre-burst/persistent emission or the Comptonization of the burst emission is removed, the NS surface emission shows a plateau, and then a rise until the photosphere touches down to the NS surface, resulting in a flux peak at that moment. We speculate that the findings above correspond to that the obscured lower part of the NS surface by the disk is exposed to the line of sight due to the inner disk evaporation by the burst emission. The consistency between the fa model and convolution thermal-Comptonization model indicates the interplay between thermonuclear bursts and accretion environments. These phenomena did not usually show up by the conventional blackbody model fitting, which may be due to low count rate and narrow energy coverage in previous observations., ApJ in press. arXiv admin note: text overlap with arXiv:2208.12124, arXiv:1910.08220

After in quiescence for 49 years, 4U~1730--22 became active and had two outbursts in 2021 \& 2022; ten thermonuclear X-ray bursts were detected with Insight-HXMT. Among them, the faintest burst showed a double-peaked profile, placing the source as the 5th accreting neutron star (NS) exhibiting double/triple-peaked type-I X-ray bursts; the other bursts showed photospheric radius expansion (PRE). The properties of double-peaked non-PRE burst indicate that it could be related to a stalled burning front. For the five bright PRE bursts, apart from the emission from the neutron star (NS) surface, we find the residuals both in the soft ($$10 keV) X-ray band. Time-resolved spectroscopy reveals that the excess can be attributed to an enhanced pre-burst/persistent emission or the Comptonization of the burst emission by the corona/boundary-layer. We find, the burst emission shows a rise until the photosphere touches down to the NS surface rather than the theoretical predicted constant Eddington luminosity. The shortage of the burst emission in the early rising phase is beyond the occlusion by the disk. We speculate that the findings above correspond to that the obscured part (not only the lower part) of the NS surface is exposed to the line of sight due to the evaporation of the obscured material by the burst emission, or the burst emission is anisotropic ($ξ>1$) in the burst early phase. In addition, based on the average flux of PRE bursts at their touch-down time, we derive a distance estimation as 10.4 kpc., arXiv admin note: substantial text overlap with arXiv:2208.13556; text overlap with arXiv:2208.12124

PSR B1259-63 is a $\gamma$-ray binary system, where the compact object is a pulsar. The system has an orbital period of 1236.7 days and shows peculiar $\gamma$-ray flares (in 100\,MeV--300\,GeV) after its periastron time. We analyzed the \textit{Fermi}-LAT observation of PSR B1259-63 during its latest periastron passage, as well as its previous three periastrons. The bright GeV flares started about 60 days after the periastron epoch in 2021. This delay is larger than that around the 2017 periastron and much larger than earlier periastrons. The delay of the GeV flux peak time in each periastron passage is apparent in our results. We discussed the possible origin of this delay and made a prediction of the GeV flux peak time in next periastron passage, based on observation of the previous delays., Comment: accepted for publication in Universe

After 49 yr of quiescence, 4U 1730–22 became active and had two outbursts in 2021 and 2022; the onset and tail of the outbursts were observed by NICER, which give us a peerless opportunity to study the state transition and its underlying mechanism. In this work, we take both the neutron star (NS) surface and accretion disk emission as the seed photons of the Comptonization and derive their spectral evolution in a bolometric luminosity range of 1%–15% L Edd. In the high/soft state, the inferred inner disk radius and the NS radius are well consistent, which implies that the accretion disk is close to the NS surface. For the decay stage, we report a steep change of the accretion disk emission within 1 day, i.e., the soft-to-hard transition, which could be due to the propeller effect, and the corresponding NS surface magnetic field is 1.8–2.2 × 108 G. Moreover, the inner disk radius is truncated at the corotation radius, which is similar to the propeller effect detected from 4U 1608–52. The absence of the propeller effect in the hard-to-soft state transition implies that the transition between the magnetospheric accretion and the disk accretion is not the sole cause of the state transitions.

To assess the efficacy of Da Chaihu decoction combined with metformin tablets on patients with type 2 diabetes compared with metformin alone.This systematic review and meta-analysis is written based on 2020 PRISMA Extension for Chinese Herbal Medicines 2020 (PRISMA-CHM 2020) reporting guidelines. We reviewed all the relevant studies from a search of the following databases from inception to February 2022 without any language restriction: Excerpta Medica Database (EMBASE), Google Scholar, PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Information, Wanfang Data, and the Chinese Biomedical Literature Database(CBM). Data were extracted and the quality was independently evaluated by two reviewers, based on the inclusion and exclusion criteria. Data were analyzed using the Cochrane software RevMan 5.3.Six randomized controlled trials comprising 516 participants were included. The meta-analysis revealed the Da Chaihu decoction combined with metformin tablets group was significantly superior to the metformin tablets group in terms of fasting blood glucose(FPG) (-0.66 mmol/L; 95 % CI (confidence intervals) [- 1.28, - 0.04]), plasma glucose 2 h after meal (2-h PG) (-1.18 mmol/L; 95 % CI [-1.94, -0.42]) in six RCTs, body mass index (BMI) (-3.07 mmol/L; 95 % CI [-6.89, 0.75]) in three RCTs, glycosylated hemoglobin (HbAlc) (-0.36 mmol/L; 95 % CI [-1.04, 0.31]) in three RCTs, and triglycerides (TG) (-0.76 mmol/L; 95 % CI [-1.37, -0.15]) in two RCTs. In two RCTs, there were significant differences in terms of total cholesterol (TC) (-0.97 mmol/L; 95 % CI [-1.18, -0.76]).Very low-quality research shows that Da Chaihu decoction combined with metformin tablets exert a certain level of efficacy on patients with type 2 diabetes compared with metformin alone. However, random sequence generation methodology was reported in five studies leading to the low quality of the included studies. None of the six studies depicted the blinding method, allocation concealment, selective reporting, and assessed the purity and potency of the product. This observation requires verification through high-quality, multi-center, double-blinded randomized controlled trials, and assesses the purity and potency of the product.

MAXI J1816-195 is a newly discovered accreting millisecond pulsar with prolific thermonuclear bursts, detected during its outburst in 2022 June by Insight-HXMT and NICER. During the outburst, Insight-HXMT detected 73 bursts in its peak and decay phase, serving as a prolific burst system found in the accreting millisecond pulsars. By analyzing one burst which was simultaneously detected by Insight-HXMT and NICER, we find a mild deviation from the conventional blackbody model. By stacking the Insight-HXMT lightcurves of 66 bursts which have similar profiles and intensities, a hard X-ray shortage is detected with a significance of 15.7 sigma in 30-100 keV. The shortage is about 30% of the persistent flux, which is low compared with other bursters. The shortage fraction is energy-dependent: larger in a higher energy band. These findings make the newly discovered millisecond MAXI J1816-195 a rather peculiar system compared with other millisecond pulsars and atoll bursters. In addition, based on the brightest burst, we derive an upper limit of the distance as 6.3 kpc, and therefore estimate the upper limit of the inner disc radius of the accretion disc to be~ 40 km. Assuming the radius as the magnetospheric radius, the derived magnetic field strength is about 7.1*10^8 G., ApJL in press

Here we report the spectral-timing results of the black hole X-ray binary 4U 1630–47 during its 2021 outburst using observations from the Hard X-ray Modulation Telescope (Insight-HXMT). Type C quasi-periodic oscillations (QPOs) in ∼1.6–4.2 Hz and quasi-regular modulation (QRM) near 60 mHz are detected during the outburst. The mHz QRM has a fractional rms of ∼10%–16% in the 8–35 keV energy band with a Q factor (frequency/width) of ∼2–4. Benefiting from the broad energy band of Insight-HXMT, we study the energy dependence of the ∼60 mHz QRM in 1–100 keV for the first time. We find that the fractional rms of the mHz QRM increases with photon energy, while the time lags of the mHz QRM are soft and decrease with photon energy. Fast recurrence of the mHz QRM, in a timescale of less than 1 hr, has been observed during the outburst. During this period, the corresponding energy spectra moderately change when the source transitions from the QRM state to the non-QRM state. The QRM phenomenon also shows a dependence with the accretion rate. We suggest that the QRM could be caused by an unknown accretion instability aroused from the corona.

The detection of cyclotron resonance scattering features (CRSFs) is the only way to directly and reliably measure the magnetic field near the surface of a neutron star (NS). The broad energy coverage and large collection area of \emph{Insight}-HXMT in the hard X-ray band allowed us to detect the CRSF with the highest energy known to date, reaching about 146 keV during the 2017 outburst of the first galactic pulsing ultraluminous X-ray source (pULX) Swift J0243.6+6124. During this outburst, the CRSF was only prominent close to the peak luminosity $\sim 2\times10^{39}$ erg s$^{-1}$, the highest to date in any of the Galactic pulsars. The CRSF is most significant in the spin phase region corresponding to the main pulse of the pulse profile, and its centroid energy evolves with phase from 120 to 146 keV. We identify this feature as the fundamental CRSF, since no spectral feature exists at $60-70$ keV. This is the first unambiguous detection of an electron CRSF from an ULX. We also estimate a surface magnetic field $\sim1.6\times10^{13}$ G for Swift J0243.6+6124. Considering that the dipole magnetic field strengths, inferred from several independent estimates of magnetosphere radius, are at least an order of magnitude lower than our measurement, we argue that the detection of the highest energy CRSF reported here unambiguously proves the presence of multipole field components close to the surface of the neutron star. Such a scenario has previously been suggested for several pulsating ULXs, including Swift J0243.6+6124, and our result represents the first direct confirmation of this scenario., Accepted for publication in ApJL

We have performed phase-resolved spectral analysis of the accreting pulsar 1A 0535+262 based on observations of Insight-HXMT during the 2020 type II outburst of the source. We focus on the two-dimensional dependence of the cyclotron resonance scattering features (CRSFs) along the outburst time and at different phases. The fundamental CRSF line (f-CRSF) shows different time- and phase-dependent behaviors. At higher luminosity, the phase profile of the f-CRSF energy changes from a single peak to double peaks, with the transition occurring at MJD 59185. On the contrary, the first harmonic CRSF (first CRSF) at ∼100 keV is only detected within a narrow phase range (0.8−1.0) accompanied by a shallow f-CRSF line. Based on these results, we speculate that when the source enters the supercritical regime, the higher accretion column height can significantly enhance the harmonic line at a narrow phase through an “anti-pencil” beam at a higher energy band. At the same time, it will also affect the behavior of the fundamental line.

Obesity is a risk factor for both coronary artery disease (CAD) and chronic renal insufficiency (RI); patients with CAD are prone to obesity and RI. In this study, we try to analyze the effect of body composition on death in CAD patients with mild RI.Retrospective cohort study.A total of 1,591 consecutive CAD patients confirmed by coronary angiography were enrolled and met the mild RI criteria by estimated glomerular filtration rate: 60-90 mL/min.The influence of body composition on mortality of CAD was detected in different body compositions, including body mass index (BMI), body fat (BF), and lean mass index (LMI). The end points were all-cause mortality. Cox models were used to evaluate the relationship of quintiles of body compositions with all-cause mortality.A survival curve showed that the risk of death was higher in the low BMI group than in the high BMI group (log-rank for overall P = .002); LMI was inversely correlated with risk of death, such that a lower LMI was associated with a higher risk of death (log-rank for overall P .001). No significant correlation was observed between BF and risk of death. Multifactorial correction show that LMI was still inversely correlated with risk of death (quintile 1: reference; quintile 2: hazard ratio [HR]: 0.49, 95% confidence interval [CI]: 0.26-0.92; quintile 3: HR: 0.35, 95% CI: 0.17-0.70; quintile 4: HR: 0.41, 95% CI: 0.20-0.85; quintile 5: HR: 0.28, 95% CI: 0.12-0.67).For CAD patients with mild RI, BMI or BF was unrelated to risk of death, while LMI was inversely correlated with risk of death. A weak "obesity paradox" was observed in this study.

Fibrinogen (Fib) is considered to be a potential risk factor for the prognosis of patients with acute coronary syndrome (ACS), but it is unclear whether Fib level have synergistic effects to enhance the prognostic value of the GRACE score in patients with ACS. A retrospective analysis was conducted from a single registered database. 2253 consecutive patients with ACS confirmed by coronary angiography were enrolled and were grouped into 3 categories by the tertiles of admission plasma Fib levels. The end points were all-cause mortality and cardiac mortality. The mean follow-up time was 27.2 ± 13.1 months and death events occurred in 223 cases and cardiac death events occurred in 130 cases. Cumulative survival curves indicated that the risk of all-cause death increased with increasing Fib level (mortality rates for Tertile 1 vs. Tertile 2 vs. Tertile 3 = 6.6% vs. 10.8 %vs. 12.3%, p < 0.001). Cox multivariate regression analysis indicated that compared with other traditional risk factors, plasma Fib level is independently correlated with all-cause death (HR 1.33, 95% CI 1.04-1.70). However, incorporating elevated Fib level into the GRACE model did not significantly increase the predictive value of the GRACE score; for instance, AUC only increased from 0.703 to 0.713 (p = 0.765). In conclusion, Fib level at admission was independently associated with death risk among Chinese patients with ACS. However, the incorporation of Fib level at admission into the GRACE score did not improve this score's predictive value for death risk among these patients.

There is a controversy surrounding the correlation between fibrinogen (Fib) level and prognosis of coronary artery disease (CAD). We try to investigate the role of the subtypes of CAD in this controversy.A retrospective analysis was conducted from a single center CAD registered database. 3020 consecutive patients with CAD confirmed by coronary angiography were enrolled. The end points were all-cause mortality.The mean follow-up time was 27.2±13.1months and death events occurred in 258 cases. Mortality rates for patients with CAD and those in the stable coronary artery disease (SCAD) and unstable angina pectoris (UAP) groups exhibited an overall rising trend as Fib levels increased (log rank test, all p0.05). However, similar trends were not detected in patients with acute myocardial infarction (AMI). The results of a Cox proportional-hazards regression analysis showed that Fib level was independently correlated with the risk of death in patients with CAD as well as those in the SCAD and UAP groups (CAD, HR 1.40, CI 1.16-1.68; SCAD, HR 1.86, CI 1.24-2.79; UAP, HR 1.42, CI 1.06-1.90). In the AMI group, however, no independent correlation was observed between Fib level and mortality.The different proportions of subtypes of CAD affected the correlation between Fib level and the clinical prognosis of patients with CAD. This is maybe a clue to explain the controversy.

The monitoring of soil mite community is an important part of ecological restoration monitoring. Changes of community structure in soil mites could reflect effects of ecological restoration in degraded environment. In different seasons of 2014, we investigated soil mites in the moderate rocky desertification ecological restoration area of Chaoying small watershed in Bijie City, Guizhou Pro-vince. We compared the community structure of soil mites in native Quercus variabilis forest and moderate rocky desertification area. The results showed that soil mites in ecological restoration area of moderate rocky desertification belonged to three orders, 35 families, and 58 genera, with Haploze-tes and Vilhenabates being the dominant genera. Higher number of genera, abundance, and indivi-dual densities were found in upper soil layer. The community structure of predatory Gamasina mites was mainly r-selected, and that of Oribatida mites was mainly Poronota (P-type). In the moderate rocky desertification ecological restoration area, both the abundance and individual density of soil mites were higher than that in moderate rocky desertification area and Q. variabilis forest, while the number of genera, diversity index and richness index were higher than that in moderate rocky desertification area, but lower than that in Q. variabilis forest. On the basis of the control area, 32 genera of mites were recovered and added, accounting for 55.2% of the total number of mite genera in the restoration area. In the whole study area, the number of mite genera were significantly correlated with soil available potassium, richness index, and organic carbon content. The number of indivi-duals, individual density, diversity index, richness index separately had significant correlations with the content of available potassium. The richness index had significant correlation with the content of organic matter. Our results suggested that the vegetation restoration of rocky desertification was beneficial to the restoration of mite community and improvement of soil environment, and that the dominant groups, new groups, and restoration groups of soil mites could indicate environment changes. However, the relationships between soil mite community structure and vegetation, soil physical and chemical factors in the restoration area remained to be further studied.土壤螨类群落监测是生态恢复监测的重要内容之一,土壤螨类群落结构的变化可以反映退化环境生态恢复的效果.2014年按季节对贵州省毕节市朝营小流域中度石漠化生态修复区的土壤螨类进行调查,并与原生栓皮栎林和中度石漠化区的土壤螨类群落结构进行对比.结果表明: 中度石漠化生态修复区土壤螨类计有3目35科58属,以单翼甲螨属和威单翼甲螨属为优势属;土壤上层具有较高的属数、个体数量和个体密度;捕食性革螨群落以r对策者为主,甲螨群落结构以有翅孔背甲螨型(P型)为主.中度石漠化生态恢复区土壤螨类个体数量与个体密度分别高于中度石漠化区和栓皮栎林,属数、多样性指数和丰富度指数分别高于中度石漠化区,但低于栓皮栎林;该区在对照区基础上恢复和新增螨类共32属,占该区螨类总属数的55.2%.在研究区,螨类属数与土壤速效钾含量、丰富度指数与有机碳含量具有显著相关性,个体数量、个体密度、多样性指数、丰富度指数分别与速效钾含量以及丰富度指数与有机质含量具有显著相关性.表明石漠化的植被修复有利于土壤螨类群落结构的恢复和土壤环境的改善,且螨类优势类群、新增类群和恢复类群能对环境变化进行较好地指示,但土壤螨类群落结构与修复区植被和土壤理化因子变化的关系还有待进一步研究.

Currently, there are no studies addressing the influence of age on the prognostic information of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in Asian population with acute coronary syndrome (ACS). The purpose of this study was to investigate the prognostic performance of NT-proBNP in Chinese patients with ACS across different age groups. A total of 1512 ACS patients with venous blood NT-proBNP measured were enrolled. Patients were divided into tertiles based on their ages (

Background The benefit of therapeutic hypothermia (TH) to patients suffering out-of-hospital cardiac arrest (OHCA) has been well established. However, the effect of prehospital cooling remains unclear. We aimed to investigate the efficacy and safety of prehospital TH for OHCA patients by conducting a systematic review of randomised controlled trials (RCTs). Methods The MEDLINE, EMbase and CENTRAL databases were searched for publications from inception to April 2015. RCTs that compared cooling with no cooling in a prehospital setting among adults with OHCA were eligible for inclusion. Random- and fixed-effect models were used depending on inter-study heterogeneity. Results Eight trials that recruited 2379 participants met the inclusion criteria. Prehospital TH was significantly associated with a lower temperature at admission (mean difference (MD) −0.94; 95% confidence interval (CI) −1.06 to −0.82). However, survival upon admission (Risk ratio (RR) 1.01, 95%CI 0.98–1.04), survival at discharge (RR 1.02, 95%CI 0.91–1.14), in-hospital survival (RR 1.05, 95%CI 0.92–1.19) and good neurological function recovery (RR 1.06, 95% CI 0.91–1.23) did not differ between the TH-treated and non-treated groups. Prehospital cooling increased the incidence of recurrent arrest (RR 1.23, 95%CI 1.02–1.48) and decreased the PH at admission (MD −0.04, 95%CI −0.07 to −0.02). Pulmonary oedema did not differ between the arms (RR 1.02, 95%CI 0.67–1.57). None of the potentially controversial issues (cooling methods, time of inducing TH, the proportion of continuing cooling in hospital, actual prehospital infusion volume and primary cardiac rhythms) affected the efficacy. Conclusion Evidence does not support the administration of prehospital TH to patients with OHCA.

In cluster science, it is challenging to identify the ground state structures (GSS) of gold (Au) clusters. Among different search approaches, first-principles method based on density functional theory (DFT) is the most reliable one with high precision. However, as the cluster size increases, it requires more expensive computational cost and becomes impracticable. In this paper, we have developed an artificial neural network (ANN) potential for Au clusters, which is trained to the DFT binding energies and forces of 9000 Au N clusters (11 ≤ N ≤ 100). The root mean square errors of energy and force are 13.4 meV/atom and 0.4 eV/Å, respectively. We demonstrate that the ANN potential has the capacity to differentiate the energy level of Au clusters and their isomers and highlight the need to further improve the accuracy. Given its excellent transferability, we emphasis that ANN potential is a promising tool to breakthrough computational bottleneck of DFT method and effectively accelerate the pre-screening of Au clusters’ GSS.

Studies focusing on the relationship between calcified lesions and adverse outcomes in the drug-eluting stent (DES) era have presented inconsistent conclusions. The aim of this study was to assess the association between target lesion calcification and adverse outcomes in patients undergoing DES implantation.A systematic search was conducted on Medline (Ovid SP, 1946 to 28 February 2014), Embase (Ovid SP, 1974 to 28 February 2014), and the Chinese Biomedical Literature Database (CBM, 1978 to 28 February 2014). Abstracts from the 2012 and 2013 scientific meetings of the American College of Cardiology and American Heart Association were manually searched. Hazard ratios (HRs) were pooled using a fixed or random effects model in the context of heterogeneity.A total of 13 studies comprising 66,361 patients were included. Target lesion calcification was associated with an increased risk of all-cause mortality (HR = 1.41; 95 % CI = 1.27-1.56), cardiac death (HR = 1.97; 95 % CI = 1.68-2.31), myocardial infarction (HR = 1.33; 95 % CI = 1.13-1.57), target lesion revascularization (TLR; HR 1.47, 95 % CI 1.18-1.83), stent thrombosis (HR 1.63, 95 % CI 1.36-1.96), and major cardiovascular events (HR 1.37, 95 % CI 1.19-1.58). The results proved robust in subgroup analyses for TLR and stent thrombosis.Calcified target lesions are risk factors for adverse outcomes in the DES era. Further studies focusing on comprehensive therapy in patients with coronary calcification are urgently needed.

Background There is debate regarding the predictive value of interventricular septum (IVS) wall thickness for adverse events. Aims The study investigated the association between the severity of thickened IVS and all-cause death in Chinese patients with coronary artery disease (CAD). Methods A total of 2297 CAD patients verified by angiography was consecutively included. Patients were grouped according to the severity of thickened IVS. Cox regression analysis was conducted to determine the independent prognostic value of thickened IVS for all-cause death. Results During a median follow up of 25 months, 149 patients died. A gradient increase in the risk of death was observed across thickened IVS groups. Compared to patients with normal IVS thickness, the adjusted hazard ratio (HR) was 1.49 (95% confidence interval (CI) 1.00–2.23, P = 0.05) and 2.13 (95% CI 1.29–3.54, P = 0.003) for all-cause death in those with mildly and moderately/severely thickened IVS respectively. For one unit increase in IVS thickness, the risk of all-cause death was elevated by 14% (adjusted HR 1.14, 95% CI 1.05–1.24, P = 0.003). In patients with normal indexed left ventricular mass, thickened IVS was also demonstrated as an independent risk factor for all-cause death. Conclusion Thickened IVS can be served as a reliable marker for predicting all-cause death in Chinese patients with CAD, even in those with normal left ventricular mass.

Our aim was to compare the efficacy and safety of bivalirudin (Biv) versus heparin (Hep) with or without similar usage rate of glycoprotein IIb/IIIa inhibitors (GPIs) during percutaneous coronary intervention (PCI). The PubMed and EMbase were searched. Randomized trials comparing Biv versus Hep were eligible for inclusion. With imbalanced GPI use, Biv had significantly lower major bleeding (pooled risk ratio [RR], 0.67; 95% confidence interval [CI], 0.54-0.83) without difference in mortality (pooled RR, 0.95; 95% CI, 0.80-1.14). With comparable GPI use, no significant difference was observed in major bleeding (pooled RR, 0.95; 95% CI, 0.82-1.10) and mortality (pooled RR, 1.13; 95% CI, 0.85-1.50). With no GPI use, Biv was associated with numerically higher mortality (pooled RR, 1.17; 95% CI, 0.83-1.65) without significant difference in major bleeding (pooled RR, 0.81; 95% CI, 0.64-1.02). In conclusion, when comparing different anticoagulants during PCI, the effect of GPIs should not be underestimated. Heparin as such was found noninferior to Biv.

Background A new 4-tired classification of left ventricular hypertrophy (LVH) based on LV concentricity and dilation has been proposed; however, the association between the new categorization of LV geometry and outcomes in patients with coronary artery disease (CAD) is still unknown. Methods All the 2297 patients with CAD included underwent echocardiographic examination prior to discharge. Left ventricular mass (LVM) was calculated, and left ventricular end-diastolic volume (EDV) was indexed by body surface area (BSA). Study cohort was divided into five groups according to LV geometry: (i) eccentric nondilated LVH (normal LVM/EDV(2/3) and EDV/BSA) (n = 129); (ii) eccentric dilated LVH (normal LVM/EDV(2/3) with increased EDV/BSA) (n = 222); (iii) concentric nondilated LVH (increased LVM/EDV(2/3) with normal EDV/BSA) (n = 441); (iv) concentric dilated LVH (increased LVM/EDV(2/3) and EDV/BSA) (n = 118); and (v) normal LV mass (n = 1387). Results Dilated LVH was associated with a higher event rates of all-cause death (eccentric 13·1% vs. 3·1%; concentric 13·6% vs. 8·4%) and composite events (eccentric: 17·6% vs. 5·4%; concentric: 18·6% vs. 12·7%) compared with nondilated LVH. While eccentric nondilated LVH had comparable risk for adverse outcomes compared with normal LV mass (all-cause death: relative risk (RR) 0·68, 95% confidential interval (CI) 0·25–1·85; composite events: RR 0·75, 95% CI 0·36–1·58). Cox regression analyses showed that eccentric dilated LVH had the highest propensity to all-cause death (adjusted hazard ratio [aHR] 2·752 [95% CI 1·749–4·328], P

Fibrinogen (Fib) was considered to be a potential risk factor for the prognosis of patients with coronary artery disease (CAD), but there was lack of the evidence from Chinese contemporary population. 3020 consecutive patients with CAD confirmed by coronary angiography were enrolled and were grouped into 2 categories by the optimal Fib cut-off value (3.17 g/L) for all-cause mortality prediction. The end points were all-cause mortality and cardiac mortality. Cumulative survival curves showed that the risk of all-cause mortality was significantly higher in patients with Fib ≥3.17 g/L compared to those with Fib p p = 0.002). Subgroup analysis showed that elevated Fib levels were predictive for the risk of all-cause mortality in the subgroups according to age, medical history and diagnosis. COX multivariate regression analysis showed that plasma Fib levels remained independently associated with all-cause mortality after adjustment for multiple cardiovascular risk factors (all-cause mortality, HR 2.01, CI 1.51–2.68, p

Background: There is an absence of randomized controlled trials (RCTs) comparing types of revascularization in patients with coronary artery disease (CAD) in the presence of left ventricular systolic dysfunction (LVSD). Our aim was to compare the outcomes of percutaneous coronary intervention (PCI) versus coronary artery graft bypass (CABG) among patients with CAD and LVSD.Methods: The PubMed online database (from 1976 to November, 2014) and EMbase (from 1974 to November, 2014) were searched. Studies comparing the outcomes of PCI versus CABG among patients with left ventricular dysfunction (ejection fraction Results: Due to absence of RCTs on this topic, twelve observational studies including 5,494 patients were included. PCI was associated with a lower risk of short-term mortality (Risk ratio [RR], 0.51, 95% confidence interval [CI], 0.26-1.00) but a higher risk of long-term mortality (RR, 1.21, 95%CI, 1.05-1.40) and repeat revascularization (RR, 4.18, 95%CI, 1.92-9.12) compared with CABG. No significant difference in composite outcomes (RR, 1.26, 95%CI, 0.92-1.73), myocardial infarction (RR, 0.63, 95% CI, 0.17-2.41) and cerebrovascular accident ((RR, 0.61, 95%CI, 0.18-2.01) was observed between PCI vs. CABG.Conclusions: Due to the absence of any RCTs on this topic, a meta-analysis of observational studies was performed. It suggested PCI was associated with a better short-term prognosis but an increased risk of long-term mortality compared with CABG. Further well-designed RCT’s are needed to verify this conclusion.

Background Whether body composition is associated with the N-terminal pro-B-type natriuretic peptide (NT-proBNP) level and its prognostic performance in acute coronary syndrome (ACS) remains unknown. We aimed to investigate the influence of body composition on the NT-proBNP level and its prognostic performance among ACS patients. Methods In total, 1623 ACS patients with NT-proBNP data were enrolled. Percent body fat and lean mass index were estimated using the Clínica Universidad de Navarra—Body Adiposity Estimator equation. Patients were divided into three groups according to the tertiles of sex-specific body mass index, percent body fat, or lean mass index. The endpoints were death from any cause and cardiovascular death. Results Body mass index was inversely correlated with NT-proBNP levels (β = −0.036, P = 0.003). Lean mass index, but not percent body fat, was inversely associated with NT-proBNP levels (β of lean mass index = −0.692, P = 0.002). During a median follow-up of 23 months, 161 all-cause deaths occurred, and of these, 93 (57.8 %) were attributed to cardiovascular causes. Multivariate Cox analysis showed that the NT-proBNP level independently predicted all-cause mortality or cardiovascular death in the lower body mass index, lean mass index, and percent body fat groups. However, the prognostic performance of NT-proBNP was attenuated in patients with high body mass index, lean mass index, and percent body fat. In the subgroup of patients with diabetes, inverse associations between NT-proBNP levels and body mass index or body composition were not observed. In addition, the negative influence of high body mass index and body composition on the prognostic performance of the NT-proBNP level appeared to be attenuated. Conclusions Body mass index and lean mass index, but not percent body fat, are inversely associated with NT-proBNP levels. The prognostic performance of this biomarker may be compromised in patients with high body mass index, percent body fat, or lean mass index. Additionally, the influence of body composition on the NT-proBNP level and its prognostic performance might be attenuated in diabetic patients with ACS.

Our aim was to illustrate the effect of higher activated clotting time (ACT) values versus lower ACT values on thrombotic or hemorrhagic events in coronary atherosclerotic heart disease (CHD) patients undergoing percutaneous coronary intervention (PCI). PubMed, Embase, Web of Science, and Cochrane Library were searched. Observational studies assessing ACT related major adverse cardiac event (MACE) and major bleeding were included. Studies were allocated into three groups. Group 1 included studies with low percentage of participants prescribed with glycoprotein IIb/IIIa inhibitors ([GPI] ≤30%), Group 2 with high percentage of participants prescribed with GPI (>30%), and Group 3 with routine direct thrombin inhibitors (DTI) prescription. The cutoff is designed as 300s (290-310s) for Group 1, and 250s (240-260s) for Group 2. With regard to MACE and major bleeding in Group 1, there was no significant difference between higher ACT values and lower ACT values (risk ratio [RR] for MACE, 1.16, 95% confidence interval [CI], 0.65-2.05, p=0.62, I(2)=94%, RR for major bleeding, 0.96, 95% CI, 0.66-1.40, p=0.83, I(2)=0%). Likewise, no significant difference was found in Group 2 between higher ACT values and lower ACT values (RR for MACE, 1.15, 95% CI, 0.97-1.35, p=0.10, I(2)=0%, RR for major bleeding, 0.85, 95% CI, 0.45-1.60, p=0.61, I(2)=83%). In conclusion, ACT may not have a substantial effect on thrombotic or hemorrhagic complications. Under current clinical practice, target ACT may be higher than what is necessary to prevent thrombotic events. We may achieve a relative low ACT level to preserve efficacy and enhance safety.

In our previous study, the sequence of a matrix attachment region binding protein (MBP) cDNA was cloned from the unicellular green alga Dunaliella salina. However, the nucleotide sequence of this gene has not been reported so far. In this paper, the nucleotide sequence of MBP was cloned and characterized, and its gene copy number was determined. The MBP nucleotide sequence is 5641 bp long, and interrupted by 12 introns ranging from 132 to 562 bp. All the introns in the D. salina MBP gene have orthodox splice sites, exhibiting GT at the 5' end and AG at the 3' end. Southern blot analysis showed that MBP only has one copy in the D. salina genome.

Red soil may play an important role in nitrous oxide (N 2 O) emissions due to its recent land use change pattern. To predict the land use change effect on N 2 O emissions, we examined the relationship between soil N 2 O flux and environmental determinants in four different types of land uses in subtropical red soil. During two years of study (January 2005–January 2007), biweekly N 2 O fluxes were measured from 09:00 to 11:00 a.m. using static closed chamber method. Objectives were to estimate the seasonal and annual N 2 O flux differences from land use change and, reveal the controlling factors of soil N 2 O emission by studying the relationship of dissolved organic carbon (DOC), microbial biomass carbon (MBC), water filled pore space (WFPS) and soil temperature with soil N 2 O flux. Nitrous oxide fluxes were significantly higher in hot-humid season than in the cool-dry season. Significant differences in soil N 2 O fluxes were observed among four land uses; 2.9, 1.9 and 1.7 times increased N 2 O emissions were observed after conventional land use conversion from woodland to paddy, orchard and upland, respectively. The mean annual budgets of N 2 O emission were 0.71–2.21 kg N 2 O-N ha −1 year −1 from four land use types. The differences were partly attributed to increased fertilizer use in agriculture land uses. In all land uses, N 2 O fluxes were positively related to soil temperature and DOC accounting for 22–48% and 30–46% of the seasonal N 2 O flux variability, respectively. Nitrous oxide fluxes did significantly correlate with WFPS in orchard and upland only. Nitrous oxide fluxes responded positively to MBC in all land use types except orchard which had the lowest WFPS. We conclude that (1) land use conversion from woodland to agriculture land uses leads to increased soil N 2 O fluxes, partly due increased fertilizer use, and (2) irrespective of land use, soil N 2 O fluxes are under environmental controls, the main variables being soil temperature and DOC, both of which control the supply of nitrification and denitrification substrates.

Our aim was to investigate the gender disparity in the safety and efficacy of transradial percutaneous coronary intervention (PCI; TRI) and transfemoral PCI (TFI) by a meta-analysis. MEDLINE, Embase, and CENTRAL were searched to identify studies on vascular access with sex-specific events available or studies on sex difference with the events reported by vascular access. Fifteen studies involving 3 921 848 participants were included. Transradial PCI significantly reduced the risk of bleeding complications in both sexes (TRI-versus-TFI odds ratio [OR]: 0.37 in females vs 0.47 in males) and major adverse cardiac events (MACE) in females (OR: 0.70, P < .001) but not in males (OR: 0.83, P = .15) compared to TFI. Transradial PCI diminished the sex difference in the incidence of bleeding complications (female-versus-male OR: 1.82 with TRI vs 2.39 with TFI; interaction P = .01) and MACE (female-versus-male OR: 1.21 with TRI vs 1.41 with TFI; interaction P = .003) compared to TFI. Females were associated with higher crossover rate in the TRI subgroup but not in the TFI subgroup (interaction P = .05). In conclusion, TRI may improve the safety and efficacy of outcomes in both sexes and be an effective means to cut down the gender difference in prognosis.

The flight Performance of missile can be improved by adaptive morphing wing serving as main lift surface. A novel compounded morphing missile, a complicated nonlinear and non-analytical multivariable constrained optimization problem, is modeled to design adaptive program of the wing geometry versus flight states. Based on reformed optimal algorithms such as Monte Carlo and Particle Swarm Optimization (PSO), a set of integrated approach is developed to optimize the shape change program of wings by interactively reading and writing data files from missile DATCOM. The simulation results show that the proposed algorithms can be used to obtain an optimal missile configuration over large flight envelope, characterized by maximal lift-to-drag ratio and a required normal overload.

The aim of the present review was to investigate the association between the use of oral β-blockers and prognosis in patients with acute myocardial infarction (AMI) who underwent percutaneous coronary intervention (PCI) treatment. A systematic literature search was conducted in Pubmed (from inception to September 27, 2014) and Embase (Ovid SP, from 1974 to September 29, 2014) to identify studies that compared the outcome of patients with AMI taking oral β-blockers with that of patients not taking after PCI. Systematic review and meta-analysis were performed with random-effects model or fixed-effects model. Ten observational studies with a total of 40,873 patients were included. Use of β-blockers was associated with a reduced risk of all-cause death (unadjusted relative risk 0.58, 95% confidential interval 0.48 to 0.71; adjusted hazard ratio 0.76, 95% confidential interval 0.62 to 0.94). The potential benefit of β-blockers in preventing all-cause death was not similar in all population but was restricted to those with reduced ejection fraction, with low use proportion of other secondary prevention drugs or with non–ST-segment elevation myocardial infarction. The association between the use of β-blockers and improved survival rate was significant in ≤1-year follow-up duration. Rates of cardiac death, myocardial infarction, and heart failure readmission in patients using β-blockers were not significantly different from those in patients without β-blocker therapy. In conclusion, there is lack of evidence to support routine use of β-blockers in all patients with AMI who underwent PCI. Further trials are urgently needed to address the issue.

Although inappropriate left ventricular mass has been associated with clustered cardiac geometric and functional abnormalities, its predictive value in patients with coronary artery disease is still unknown. This study examined the association of inappropriate left ventricular mass with clinical outcomes in patients with angina pectoris and normal ejection fraction.Consecutive patients diagnosed with angina pectoris whose ejection fraction was normal were recruited from 2008 to 2012. Inappropriate left ventricular mass was determined when the ratio of actual left ventricular mass to the predicted one exceeded 150%. The primary endpoint was a composite of all-cause death, nonfatal myocardial infarction, and nonfatal stroke. Clinical outcomes between the inappropriate and appropriate left ventricular mass group were compared before and after propensity matching.Of the total of 1515 participants, 18.3% had inappropriate left ventricular mass. Patients with inappropriate left ventricular mass had a higher composite event rate compared with those with appropriate left ventricular mass (11.2 vs. 6.6%, P=0.010). Multivariate Cox regression analyses showed that inappropriate left ventricular mass was an independent risk factor for adverse events (adjusted hazard ratio, 1.59; 95% confidence interval, 1.03-2.45; P=0.035). The worse outcome in patients with inappropriate left ventricular mass was further validated in a propensity matching cohort and patients with the traditional definition of left ventricular hypertrophy.Inappropriate left ventricular mass was associated with an increased risk of adverse events in patients with angina pectoris and normal ejection fraction.

Background: "Obesity paradox" was not consistently observed in Asians with coronary artery disease (CAD). Aim: The study investigated the association between body composition and outcomes in Chinese patients with CAD. Design: Cohort study. Method: A total of 3280 patients with angiographically validated CAD were consecutively included. Body fat percentage and lean mass index (LMI) were evaluated using the Clinica Universidad de Navarra - Body Adiposity Estimator. The rate of mortality from any cause was compared across groups classified by the quartiles of LMI. Results: During a median period of 24 months, 288 (8.8%) participants died. There was a close association between increasing LMI and reducing mortality rate. However, univariate analyses did not find protective effect of body fat on survival. After adjusting for age, sex, diabetes, current smoking, systolic blood pressure, creatinine, white blood cell count, haemoglobin and medication, Cox regression analyses showed that the significant relation between higher quartiles (Q) of LMI and survival benefit (Q4, hazard ratio 0.58 (95% confidential interval 0.36-0.94) vs. Q3, 0.60 (0.39-0.91) vs. Q2, 0.60 (0.41-0.88) vs. Q1, reference) remained. Conclusion: Low lean mass index, but not body fat predicts all-cause mortality in Chinese patients with CAD.

On the basis of expatiating on the necessity of compensating failed innovation projects, summarizes and concludes the related literatures on innovation subsidies, then discusses many related factors which influence government compensating science and technology innovation failed projects, and further analyzes the relationships between various factors, builds the interpretation structural model for influencing factors of government compensating science and technology innovation failed projects. According to the results of classified model of interpretation structural model, points out clearly the hierarchy relationship of the influencing factors, analyzes the most direct and the most fundamental factors which influence government compensating science and technology innovation failed projects. It is found that the key factors include enterprise commercialization ability of innovations, total input of enterprise re-innovation, and the government compensation funding plans for science and technology innovation failure, the government compensation way, and competition with other enterprises for compensation funds. What is more, enterprise commercialization ability of innovation is the heart in the system of government compensating science and technology innovation failed projects. All of these provide the theoretical support for the design of government making scientific decision on compensating science and technology innovation failed projects, and offer reference for the related policy formulation and implementation.

This study was conducted in Jintuo watershed of Changsha City, Hunan Province, in the suburban agriculture regions, by selecting 8 sub-basins to examine the effect of land use on watershed runoff nitrogen output. The land use map of watershed was interpreted from Spot-5 image of 2009, and by using hydraulic analysis function and spatial analysis extensions of ArcGIS 9.3, the catchment areas were delineated from DEM. Water sampling was carried out from Dec. 2009 to Nov. 2010, and the relationships between different types of nitrogen export and land use were analyzed. The results showed that nitrogen pollution in the watershed was extremely serious. There was a distinct seasonal variation in the following order: WISPSU approximately = FA in the output concentration of total nitrogen and ammonium nitrogen which was not observed in the nitrate output. Moreover, land use was a dominant factor that determined the export of nitrogen, and especially a significant correlation was figured out between the nitrate output concentration and the land use structure. Forest and water body had a negative impact on nitrate output concentration while dry land, paddy field and habitation road had a positive effect. However, the effects varied with time. Dry land had the most significant important effect on nitrate output concentration in winter and fall, but in spring and summer was the forest land. The correlation between land use structure and the output concentration of total nitrogen and ammonium nitrogen was not found. The resident number, pig number and fertilization also had a major impact on nitrogen output quantity.

To evaluate the antitumor efficacy of Ad-TD-RFP for human nasopharyngeal carcinoma cells (C666-1) in vitro and in vivo.The oncolytic effects of Ad-TD-RFP and control virus dl11520 on C666-1 cells were determined by cytotoxicity assay (MTS assay). Viral replication of Ad-TD-RFP and dl11520 was detected at different time points (24 h, 48 h, 72 h and 96 h) by tissue culture infective dose (TCID(50)) in C666-1 cells implanted subcutaneously into the flank in each of BALB/c nude mice. The xenografts were injected intratumorally with Ad-TD-RFP or dl1520 to investigate their effects on tumor growth.The concentration for 50% of maximal effect (EC(50)) values of Ad-TD-RFP and dl1520 were (107.6 ± 3.2) pt/cell and (174.1 ± 4.0) pt/cell, respectively (t = 22.6, P0.001). The Ad-TD-RFP replication was 3-14 folds more than dl1520 replication at four time points (24 h, 48 h, 72 h and 96 h) in C666-1 cells (t values were 33.6, 23.4, 20.8 and 17.3, respectively, P0.001). The average tumor volumes of PBS group, dl1520 group and Ad-TD-RFP group were (1765.5 ± 713.9) mm(3), (1036.9 ± 623.8) mm(3), and (420.8 ± 238.7) mm(3), respectively (F = 12.0, P0.05) on day 67 after treatment.The antitumour efficacy of the novel oncolytic adenovirus Ad-TD-RFP for human nasopharyngeal carcinoma C666-1 cells is superior to that of dl1520 in vitro and in vivo. The outcome of this study provides an experimental basis for the treatment of human nasopharyngeal carcinoma by viral gene therapy.

Supplemental Digital Content is available in the text, Limited data exist regarding the outcomes of patients with nonobstructive coronary artery disease (CAD) detected by computed tomography coronary angiography (CTCA) or invasive coronary angiography (ICA). Our aim was to compare the prognosis of patients with nonobstructive coronary artery plaques with that of patients with entirely normal arteries. The MEDLINE, Cochrane Library, and Embase databases were searched. Studies comparing the prognosis of individuals with nonobstructive CAD versus normal coronary arteries detected by CTCA or ICA were included. The primary outcome was major adverse cardiac events (MACE) including cardiac death, nonfatal myocardial infarction, hospitalization due to unstable angina or revascularization. A fixed effects model was chosen to pool the estimates of odds ratios (ORs). Forty-eight studies with 64,905 individuals met the inclusion criteria. Patients in the nonobstructive CAD arm had a significantly higher risk of MACE compared to their counterparts in the normal artery arm (pooled OR, 3.17, 95% confidence interval, 2.77–3.63). When excluding revascularization as an endpoint, hard cardiac composite outcomes were also more frequent among patients with nonobstructive CAD (pooled OR, 2.10; 95%CI, 1.79–2.45). All subgroups (age, sex, follow-up duration, different outcomes, diagnostic modality, and CAD risk factor) consistently showed a poorer prognosis with nonobstructive CAD than with normal arteries. When dividing the studies into a CTCA and ICA group for further analysis based on the indications for diagnostic tests, we also found nonobstructive CAD to be associated with a higher risk of MACE in both stable and acute chest pain. Patients with nonobstructive CAD had a poorer prognosis compared with their counterparts with normal arteries.

The Cu atom in the title compound, [Cu2(C4H4O4)(NO3)2(C12H8N2)2(H2O)2], adopts an octahedral geometry that is distorted tetragonally, as seen in the copper–water [Cu—O 2.657 (4) A] and copper–nitrate [Cu—O 2.525 (4) A] bonds. The water mol­ecule bridges adjacent mol­ecules into a linear chain, and neighboring chains are linked by hydrogen bonds into a layer structure.

To evaluate the treatment responses of persistent allergic rhinitis with and without nasal discharge eosinophilia (EOS) to inhaled glucocorticosteroid (CS), and therefore to verify whether low nasal discharge eosinophils predict poor response to treatment with CS.Forty-two symptomatic allergic rhinitis patients, who had not received CS therapy in three months preceding the study, were examined before and 2 month,4 months and 6 months after treatment with CS. At each visit, all patients underwent symptom scoring and physical sign scoring. The level of eosinophil cationic protein (ECP) in the nasal discharge supernatants was measured by radioimmunoassay. The patients were divided into 2 groups according to nasal discharge EOS percentages, an EOS group (group A, EOSor = 0.03) and a non-EOS group (group B, EOS0.03). The response to CS therapy (as measured by symptom and physical sign scores) and the changes of nasal discharge measurements were compared between the 2 groups.In the group A, the baseline EOS [0.086 (0.065; 0.176)] and ECP level [(326 +/- 145) microg/L] were significantly higher than those of the group B [0.016 (0.005; 0.022)] and ECP level (154 +/- 58) microg/L], respectively, t = 4.40, 3.33, both, all P0.01. After 2 month and 6 months CS therapy, the nasal discharge EOS, ECP pred were 0.038 (0.006; 0.070), 0.019 (0.010; 0.060), (175 +/- 122) microg/L, (175 +/- 153) microg/L, respectively in the EOS group, which were significantly different as compared to baseline values (F = 6.73, 7.38, respectively, all P0.05). But in the non-EOS group, the nasal discharge EOS ECP pred were 0.014 (0.004; 0.032), 0.015 (0.000; 0.026), (118 +/- 60) microg/L, (112 +/- 60) microg/L, respectively at 2 and 6 months, which showed that the the nasal discharge EOS pred and the symptom and physical sign scores improved did not change (F = 0.82, P0.05), but the ECP level improved (F = 3.78, P0.05). and the average daily dose of CS wear not different between the two groups at any visits.In persistent allergic rhinitis with low nasal discharge EOS, CS therapy for 6 months failed to improve symptom and physical sign.

To investigate the effect of uvulopalatopharyngoplasty on changes of serum leptin levels in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).Sixty-one patients with OSAHS diagnosed by polysomnography were treated with uvulopalatopharyngoplasty. Pretreatment and post-uppp serum leptin concentrations in patients with OSAHS and in BMI-matched controls were measured by radioimmunoassay. Correlations between leptin concentrations and AHI, BMI were analyzed.The concentrations of leptin in patients with OSAHS were higher than that in controls (P0.05). Mean levels (x+/-s) of leptin were (9.8+/-2.1) microg/L, (14.2+/-6.7) microg/L, and (19.3+/-7.9) microg/L in patients with severe, mediate and mild obstructive sleep apnea, respectively. Serum leptin levels correlated positively with the degree of OSAHS as reflected by AHI (r = 0. 68, P0.01). The leptin concentration of 51 responders after 6 months were significantly decreased (P0.01) than that of pre-operation. However, the difference of leptin concentration between pre-operation and post operation was not significant in 9 nonresponders (P0.05).There are higher leptin concentrations in patients with OSAHS, which are significantly correlated to the severity of disease. Serum leptin levels in responders decreased significantly after uvulopalatopharyngoplasty. OSAHS may influence the leptin system, resulting in increased serum leptin level.

Objective We try to analyse the effect of renal functions on death in CAD patients with different body compositions. Methods A retrospective analysis was conducted in 2989 consecutive patients with CAD confirmed by coronary angiography were enrolled and were grouped into two categories: basically preserved renal function (PRF) (eGFR ≥60 ml/min) and obviously reduced renal function (RRF) (eGFR