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Background: Hypercoagulability emerges as a central pathological feature and clinical complication in nephrotic syndrome. Increased platelet activation and aggregability are closely related to hypercoagulability in nephrotic syndrome. Monocyte-platelet aggregates (MPAs) have been proposed to represent a robust biomarker of platelet activation. The aim of this study was to investigate levels of the circulating MPAs and MPAs with the different monocyte subsets to evaluate the association of MPAs with hypercoagulability in nephrotic syndrome. Methods: Thirty-two patients with nephrotic syndrome were enrolled. In addition, thirty-two healthy age and sex matched adult volunteers served as healthy controls. MPAs were identified by CD14 monocytes positive for CD41a platelets. The classical (CD14 + + CD16-, CM), the intermediate (CD14 + + CD16+, IM) and the non-classical (CD14 + CD16++, NCM) monocytes, as well as subset specific MPAs, were measured by flow cytometry. Results: Patients with nephrotic syndrome showed a higher percentage of circulating MPAs as compared with healthy controls (p < 0.001). The percentages of MPAs with CM, IM, and NCM were higher than those of healthy controls (p = 0.012, p < 0.001 and p < 0.001, respectively). Circulating MPAs showed correlations with hypoalbuminemia (r=-0.85; p < 0.001), hypercholesterolemia (r = 0.54; p < 0.001), fibrinogen (r = 0.70; p < 0.001) and D-dimer (r = 0.37; p = 0.003), but not with hypertriglyceridemia in nephrotic syndrome. The AUC for the prediction of hypercoagulability in nephrotic syndrome using MPAs was 0.79 (95% CI 0.68–0.90, p < 0.001). The sensitivity of MPAs in predicting hypercoagulability was 0.71, and the specificity was 0.78. Conclusion: Increased MPAs were correlated with hypercoagulability in nephrotic syndrome. MPAs may serve as a potential biomarker for thrombophilic or hypercoagulable state and provide novel insight into the mechanisms of anticoagulation in nephrotic syndrome. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical and imaging differences between limb - girdle muscular dystrophy type 2B (LGMD2B) and immune - mediated necrotizing myopathy (IMNM). Methods Forty-five patients with LGMD2B and 45 patients with IMNM from January 2014 to December 2018 were included. Sex, age of onset, age of diagnosis and time of delay in admission were recorded, and serum creatine kinase (CK) level was measured. Cervical flexion, proximal and distal upper limbs, proximal and distal lower limbs were evaluated by Medical Research Council (MRC) Level 6 and muscle strength percentages were calculated. Skeletal muscle fatty infiltration and edema degree on both thighs were evaluated by MRI. Results The onset age (Z = -3.605, P = 0.000) and diagnosis age (Z = -2.757, P = 0.006) of LGMD2B patients were earlier than those of IMNM patients, while the delay time of admission was longer than that of IMNM patients (Z = -4.749, P = 0.000), the serum CK was higher than that of IMNM patients (Z = -2.247, P = 0.025). The muscle strength of neck flexion (Z = -6.320, P = 0.000) and percentage of muscle strength (t = -6.320, P = 0.000), the muscle strengh of proximal upper extremities (Z = -3.528, P = 0.000) and percentage of muscle strength (t = -3.762, P = 0.000) in IMNM patients were lower than those in LGMD2B patients, while the muscle strengh of distal lower extremity (Z = -3.256, P = 0.001) and percentage of muscle strength (t = -2.883, P = 0.004) in LGMD2B patients were lower than those in IMNM patients. LGMD2B patients had higher muscle fatty infiltration degree in anterior group (Z = -3.119, P = 0.002) and posterior group (Z = -2.534, P = 0.011) of thigh muscle than IMNM patients, but IMNM patients had highter thigh muscle edema degree in posterior group than LGMD2B patients (Z = -3.887, P = 0.000). Conclusions Compared with IMNM patients, LGMD2B patients had earlier onset age, longer delay in diagnosis time, worse muscle strength of distal lower extremities, higher serum CK and more obviously thigh muscle fatty infiltration. In IMNM patients, muscle weakness of neck flexion and proximal upper extremities, thigh muscle edema of posterior group were more obvious. These characteristics contribute to the clinical differentiation of the two diseases. [ABSTRACT FROM AUTHOR]

White matter hyperintensities (WMHs), mainly caused by cerebrovascular injury, may lead to cognitive impairment. In order to identify whether the volume of WMHs is associated with cognitive decline over years, this longitudinal study involved 818 individuals from the ADNI-2 dataset from August 2010 to May 2017. Cross-sectional and longitudinal associations of WMHs with 8 cognitive domains were explored, using Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Clinical Dementia Rating Sum of Boxes (CDRSB), Alzheimer Disease Assessment Scale-Cognitive (ADAS-Cog13), Rey Auditory Verbal Learning Test (RAVLT), Functional Assessment Questionnaire (FAQ), executive function (ADNI-EF), and memory function (ADNI-Mem). The association analyses were performed using multiple linear regression models, linear mixed models, Spearman rank correlation, and Kaplan-Meier survival curves. The volumes of WMHs were greater in patients with Alzheimer's disease (AD) dementia compared with controls (p < 0.001) and mild cognitive impairment (p = 0.006) patients at baseline. The bigger volumes of WMHs correlated with worse performances on ADAS-Cog13 and ADNI-EF (p = 0.029; p = 0.003) at baseline and MMSE, MoCA, CDRSB, ADAS-Cog13, FAQ, and ADNI-Mem (overall p < 0.05) longitudinally, after adjusting for age, sex, educational level, apolipoprotein E ɛ4 genotype, hypertension, hyperlipidemia, diabetes, smoking, infarction, and diagnosis. Additionally, the correlations between the change rate of WMHs and change rates of MMSE, MoCA, CDRSB, FAQ, ADNI-EF, and ADNI-Mem were statistically significant. Furthermore, patients with high WMH volumes showed an increased likelihood of dementia. The results of the study suggest that WMH volume is associated with cognitive decline, and it contributes to the conversion to AD. [ABSTRACT FROM AUTHOR]

Purpose: To compare the efficacy of thrombolysis with and without predilation of the inferior vena cava (IVC) for Budd–Chiari syndrome (BCS) with old IVC thrombosis. Methods: We divided 40 patients with BCS with old IVC thrombosis into 2 groups, group A (n ¼ 21), thrombolysis after dilation of the obstructed IVC and group B (n ¼ 19), thrombolysis without predilation of the obstructed IVC. Thrombolysis was performed via urokinase administration through the dorsal vein of the foot. Results: Color Doppler ultrasonography at 30 days showed complete resolution of the thrombus in 21 (100%) group A patients and 6 group B patients (31.6%; P < .001). Thrombolysis was achieved using a lower dose of urokinase and within a shorter time frame in group A than in group B (P < .001). Conclusions: Thrombolysis after dilation was superior to thrombolysis alone and was safe and efficacious in patients with BCS with old IVC thrombosis. [ABSTRACT FROM AUTHOR]

Abstract: Inoculation methods for rice blast fungus Magnaporthe oryzae to Brachypodium distachyon were developed to investigate the infection process and symptom development in comparison with those on rice (Oryza sativa) and barley (Hordeum vulgare). M. oryzae could infect leaves, sheathes, stems and panicles of B. distachyon and cause blast disease. Spraying conidial suspension on either intact seedlings or leaf segments induced typical symptoms on B. distachyon. During the intact seedling inoculation, the symptom developed on B. distachyon leaves closely resembled that on rice; but the lesions on B. distachyon had better uniformity in shapes and sizes than those on rice or barley. In the leaf segments inoculation, only initial and low-developed lesions could be found on rice, while normal symptoms on B. distachyon and barley. Inoculated with low-virulent mutants of M. oryzae, B. distachyon produced low-level symptoms. The symptom level of each mutant on B. distachyon corresponded well to that on rice. In addition, typical infection processes presented on B. distachyon leaves: forming melanized appressoria, penetrating into host epidermis and then forming hyphae in epidermal cells. According to these results, B. distachyon can be used as a candidate for studying fungus-plant interactions and as a probable source of disease resistance. [Copyright &y& Elsevier]

Ages at natural menarche and menopause are influenced by several genetic factors. This study aimed to investigate the possible relationship between the apolipoprotein E (ApoE) genotype and the age at menarche and natural menopause in Chinese females. In the current study, 398 (elderly group, aged 47-80 years) and 825 (young group, aged 15-25 years) Chinese females were enrolled under informed content. Ages at natural menarche and menopause were obtained by questionnaires. ApoE genotypes were identified by restriction fragment length polymorphism analysis. In the elderly group, the number of pregnancies and live births and breastfeeding were associated with the age at menopause ( P = 0.008, P = 0.002, and P = 0.023, respectively). One-way ANOVA analysis revealed that the ApoE genotype was significantly associated with age at natural menopause (ANM; P = 0.010). Compared with ApoE ε3/3 carriers, ApoE ε3/4 females showed a 1.8-year delay in ANM ( P = 0.002). Single ApoE allele-positive/allele-negative analysis also showed that the age at menopause of ApoE ε4 carriers was delayed compared with those who were not carriers ( P = 0.023). In the young group, no statistical difference was found in the age of menarche between the carriers of ApoE ε3/3 and ε3/4. Single ApoE allele-positive/allele-negative analysis showed that the age at menarche in ApoE ε4 carriers was slightly earlier than in those who were not carriers ( P = 0.048). Meanwhile, univariate association analysis revealed that the ApoE genotypes were not significantly associated with the age at menarche using age as a covariate in the pooled group (young + elderly) ( P = 0.143). We demonstrated that the ApoE genotype is significantly linked to the age at natural menopause. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To evaluate whether predilation approach yield intermediate-term results were better than those with stent filter approach. Materials and methods: 59 BCS patients with old IVC thrombosis were selected for the treatment with a stent filter (n =33, group A) or predilation (n =26, group B) before thrombolysis, and subsequently underwent color Doppler ultrasound follow-up at our hospital. Data relating to the technical success, color Doppler ultrasound results, cost, mortality, morbidity, and final clinical results were collected prospectively and follow-ups were performed 1, 3, 6, and 12 months after the procedures, and annually thereafter. Results: Sent filter placement, thrombolysis and predilation were technically successful in all patients, with no procedure-related complications. Stent migration upward occurred in two patients, and removal of the stent filter was technically successful in 32 of 33 patients in group A. Inferior vena cavagrams performed before dilation with a 30-mm balloon catheter demonstrated that the IVC thrombus had completely resolved in all patients without pulmonary embolism. Reobstruction of the IVC without thrombosis was observed in three patients. Short of higher overall complications and costs in group A when compared to group B, there were no other differences in the clinical and color Doppler ultrasound findings, and primary patency rate between the two groups. All patients are alive with no recurrence of thrombosis at the time of this report. Conclusions: BCS patients with old IVC thrombosis treatment with predilation approach yielded intermediate-term results that were better than those with the stent filter approach. [Copyright &y& Elsevier]