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AIM Sarcopenia is a robust prognostic indicator of outcomes after surgery for colorectal cancer (CRC). However, there are no serum markers routinely available for estimating skeletal muscle mass (SMM). The present study aimed to describe a new sarcopenia index (SI), serum creatinine (Scr) × cystatin C-based glomerular filtration rate, and investigate its association with short-term complications after curative resection of CRC. METHOD Consecutive patients who underwent curative resection of CRC from December 2011 to January 2017 were retrospectively identified. Skeletal muscle cross-sectional area was analysed on L3 computed tomographic images. Receiver operating characteristic curve analysis showed that the cutoff points of SI for sarcopenia were below 56.1 in men and below 43.7 in women. Patients were classified into low and high SI groups in accordance with these cutoff values. The association between SI and body composition and the impact of preoperative SI on postoperative outcomes were analysed. RESULTS Among 417 patients, SI showed a stronger correlation with skeletal muscle area (SMA) (r = 0.537, P

Aim Azathioprine can prevent postoperative recurrences in Crohn's disease. We compared the efficacy of azathioprine in preventing surgical recurrence to explore whether immediate prophylaxis after surgery is better than azathioprine started after endoscopic or clinical recurrence. Method Data of patients with intestinal resection and ileocolic anastomosis for Crohn's disease between 2006 and 2015 were retrieved from a prospectively maintained database. Patients were grouped according to the strategies of postoperative therapy with azathioprine. Univariate and multivariate proportional hazard Cox regression analyses were conducted to identify independent predictive factors for surgical recurrence. Results Only age equal to or less than 16 years at diagnosis was an independent risk factor for surgical recurrence in all 166 patients (P = 0.005). In patients with high risk of recurrence (27 in the symptom-driven group, 39 in the endoscopy-driven group and 69 in the immediate prophylaxis group), both immediate and endoscopy-driven azathioprine delayed and reduced surgical recurrence compared with symptom-driven azathioprine (P = 0.035, 0.019). Their efficacy in reducing surgical recurrence was confirmed by Cox regression analyses (hazard ratio 0.465, P = 0.045; hazard ratio 0.352, P = 0.028). Surgical recurrence was similar between the immediate and endoscopy-driven groups. In addition, age ≤ 16 at diagnosis was still an independent risk factor for surgical recurrence in this subgroup. Conclusions In patients with high risk of recurrence, both immediate prophylactic azathioprine after surgery and azathioprine started after endoscopic recurrence can delay and reduce surgical recurrence compared with azathioprine started after clinical recurrence. In addition, azathioprine started immediately after surgery was not superior to azathioprine started after discovery of endoscopic recurrence.

Background Fractional flow reserve (FFR)-guided revascularization strategy is popular in coronary intervention. However, the feasibility of assessing stenotic severity in intracranial large arteries using pressure gradient measurements still remains unclear. Methods Between March 2013 and May 2014, 12 consecutive patients with intracranial large artery stenosis (including intracranial internal carotid artery, middle cerebral M1 segment, intracranial vertebral artery, and basilar artery) were enrolled in this study. The trans-stenotic pressure gradient was measured before and/or after percutaneous transluminal angioplasty and stenting (PTAS), and was then compared with percent diameter stenosis. A Pd/Pa cut-off of ≤0.70 was used to guide stenting of hemodynamically significant stenoses. The device-related and procedure-related serious adverse events and recurrent cerebral ischemic events were recorded. Results The target vessel could be reached in all cases. No technical complications occurred due to the specific study protocol. Excellent pressure signals were obtained in all patients. For seven patients who performed PTAS, the mean pre-procedural pressure gradient decreased from 59.0 ± 17.2 to 13.3 ± 13.6 mm Hg after the procedure (P

Background and purpose A recent genome-wide association study identified two genetic variants (rs12425791 and rs11833579) on chromosome 12p13 that confer risk of ischaemic stroke. The purpose of this study was to examine whether these two polymorphisms are associated with stroke onset and prognosis in a Chinese population. Methods rs12425791 and rs11833579 were genotyped using the improved multiple ligase detection reaction in 913 patients with ischaemic stroke. Analyses of genotype association with onset and prognosis outcomes were evaluated by the Kaplan–Meier method, the log-rank test and Cox proportional hazards models. Results rs12425791 and rs11833579 were not associated with age of stroke onset (P = 0.786 and 0.340, respectively). However, these two polymorphisms were significantly associated with risk of stroke recurrence, especially for the large-artery atherosclerosis (LAA) subtype, in recessive models [hazard ratio (HR) 2.52; 95% confidence interval (CI) 1.04–6.12 for rs12425791; HR 2.13; 95% CI 1.03–4.40 for rs11833579]. The combined genotype of these two single-nucleotide polymorphisms showed a locus-dosage effect on recurrence of LAA subtype and was an independent prognostic factor for LAA subtype in the final multivariate Cox regression model. Conclusions These findings indicated that rs12425791 and rs11833579 on chromosome 12p13 may be useful biomarkers for predicting the prognosis of patients with the LAA subtype of ischaemic stroke.

BACKGROUND AND PURPOSE There are some controversial results on the relationship between cerebral atherosclerosis and leukoaraiosis in the published papers, where cerebral atherosclerosis was often evaluated by ultrasonography, CTA or MRA. We analyzed data in which patients underwent both MRI and DSA to explore the above relationship in the aged people. METHODS Three hundred and thirty-three patients were enrolled in the study from the Nanjing Stroke Registry. They underwent both cerebral DSA and MRI. Age, sex, and vascular risk factors were collected. Atherosclerosis was scored from grade 0 to 4. Leukoaraiosis was scored from grade 0 to 3. RESULTS Cerebral artery stenosis was not correlated with the presence of leukoaraiosis. There were no correlations between the number of cerebral moderately or more severely stenotic arteries and the severity of leukoaraiosis in periventricular, deep, or whole white matter (P = .747, .268, and .608, respectively). Old age (odds ratio = 1.103, P = .027) and hypertension (odds ratio = 2.748, P = .003) were correlated with leukoaraiosis in the periventricular white matter. Old age (odds ratio = 1.073, P = .031) and prior stroke (odds ratio = 2.678, P = .002) were correlated with leukoaraiosis in the deep white matter. CONCLUSIONS No apparent correlation exists between cerebral artery stenosis and the presence and severity of leukoaraiosis.

The efficacy of a danshen (Salvia miltiorrhiza) dripping pill (DDP) for secondary stroke prevention was evaluated in patients with ischemic cerebrovascular disease. The preparation also contained Panax notoginseng (sanqi) and Dryobalanops camphor. Patients who had suffered from ischemic stroke or a transient ischemic attack (TIA) within the previous 20 days were managed according to established guidelines, and were divided into groups to receive either DDP or non-DDP treatment according to their time of enrolment. Mortality, cerebrovascular events and any suspected adverse reactions during the 1-year follow-up were recorded and analysed. Hematological and hemorheological parameters were measured at the start of the study (baseline) and the end of the follow-up period. A total of 106 patients with ischemic stroke/TIA were enrolled, of which 52 were allocated to take DDP and 54 were in the control group. Recurrent stroke/TIA was observed in five patients (9.6%) with DDP and in 13 patients (24.1%) without DDP during the follow-up. Recurrence in the patient group taking DDP was lower than that in the control group (p 0.05). Blood C reactive protein decreased significantly in patients with DDP compared with patients without DDP. These results indicate that DDP treatment may reduce the risk for stroke/TIA recurrence, and this reduction of risk may be associated with its antiinflammatory effects.

This article reviews the procedures for attaining laser optimal control fields to manipulate the dynamics of quantum systems. Optimal control theory, whether implemented as a computational technique or directly in the laboratory, is the most general means to achieve precise control of quantum systems. In the case of theoretical control design, a class of monotonically convergent iteration algorithms are presented, which can reduce the computational effort involved. Implementation of optimal control field design can provide physical insight into the feasibility and mechanism of control, even for quantum systems whose Hamiltonian might contain some degree of uncertainty. Moreover, optimal quantum control fields may be directly determined in the laboratory by an analogous procedure with the molecule subject to manipulation acting as an analog computer to guide the discovery of successful controls. To facilitate this process closed-loop iteration is set up with the loop consisting of the laser, the molecular sample, and a learning algorithm to recognize patterns in the control fields giving rise to successful experimental outcomes. Theoretical design and laboratory learning can act in tandem with each other to achieve the best control and reveal information on how the control process occurs. © 2003 Wiley Periodicals, Inc. Int J Quantum Chem, 2003