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Evidence has demonstrated that omega-3 fatty acids intake may be associated with age-related cognitive decline. However, randomized controlled trials (RCTs) have drawn inconsistent conclusions. We performed a meta-analysis to assess the association between omega-3 fatty acids and risk of cognitive decline in the elderly. A strategic literature search of PubMed, EMBASE, and Cochrane Library (updated to December 2014) was performed. We retrieved six randomized controlled studies as eligible for our meta-analysis. Among these six studies, the duration time ranged from 3 to 40 months. The dose of omega-3 fatty acids (DHA + EPA) ranged from 400 to 1800 mg. The result of our meta-analysis expressed that omega-3 fatty acids statistically decrease the rate of cognitive decline in MMSE score (WMD = 0.15, [0.05, 0.25]; p = 0.003). In conclusion, our meta-analysis indicated that omega-3 fatty acids may help to prevent cognitive decline in the elderly.

Background: Stroke is often regulated by a number of modifiable and nonmodifiable risk factors. Recently, studies suggested high gamma-glutamyltransferase (GGT) level may be associated with stroke, but drew inconsistent conclusions. So, we conducted a meta-analysis to evaluate the relationship between GGT level and risk of stroke., Methods: We systematically searched PubMed, Embase, and Cochrane Library (updated to January 2015) for prospective cohort studies. Then, relative risk (RR) with 95% confidence interval (CI) was used to assess the association. Regression analyses, subgroup analyses, and sensitivity analyses were also performed. The Begg test, Egger test, and the trim-and-fill method were used to assess potential publication bias., Results: A total of 5707 cases and 926,497 participants in 10 prospective studies were included. Overall, high GGT level has a positive association with increased risk of stroke (RR = 1.28; 95% CI, 1.16-1.43). In the subgroup analyses, a positive association was consistently observed in each subgroup except in the women subgroup (RR = 1.45; 95% CI, .9-2.34) and a large number of stroke events subgroups (≥ 500) (RR = 1.25; 95% CI, .85-1.84). Heterogeneity was significantly reduced in the subgroup analysis by population characteristics. In the publication bias test, the resulting adjusted RR remained significant (RR = 1.10; 95% CI, 1.00-1.21) after using the trim-and-fill method., Conclusions: Our meta-analysis provides evidence that a high level of GGT is significantly associated with increased risk of stroke independently of alcohol intake. Gender and ethnicity variations may exist in the relationship between high GGT level and risk of stroke., (Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.)

Objectives: The present study aimed to investigate the difference in major adverse cardiac events (MACE) at 3 years after double-kissing (DK) crush versus culotte stenting for unprotected left main distal bifurcation lesions (LMDBLs)., Background: The multicenter and randomized DKCRUSH-III (Comparison of double kissing crush versus culotte stenting for unprotected distal left main bifurcation lesions: results from a multicenter, randomized, prospective study) showed that DK crush stenting was associated with fewer MACE at 1-year follow-up in patients with LMDBLs compared with culotte stenting. Here, we report the 3-year clinical outcome of the DKCRUSH-III study., Methods: A total of 419 patients with LMDBLs who were randomly assigned to either the DK crush or culotte group in the DKCRUSH-III study were followed for 3 year. The primary endpoint was the occurrence of a MACE at 3 years. Stent thrombosis (ST) was the safety endpoint. Patients were classified by simple and complex LMDBLs according to the DEFINITION (Definition and Impact of Complex Bifurcation Lesions on Clinical Outcomes After Percutaneous Coronary Intervention Using Drug-Eluting Stents) study criteria., Results: At 3 years, MACE occurred in 49 patients the culotte group and in 17 patients in the DK crush group (cumulative event rates of 23.7% and 8.2%, respectively; p < 0.001), mainly driven by increased myocardial infarction (8.2% vs. 3.4%, respectively; p = 0.037) and target-vessel revascularization (18.8% vs. 5.8%, respectively; p < 0.001) between groups. Definite ST rate was 3.4% in the culotte group and 0% in the DK crush group (p = 0.007). Complex LMDBLs were associated with a higher rate of MACE (35.3%) at 3 years compared with a rate of 8.1% in patients with simple LMDBLs (p < 0.001), with an extremely higher rate in the culotte group (51.5% vs. 15.1%, p < 0.001)., Conclusions: Culotte stenting for LMDBLs was associated with significantly increased rates of MACE and ST. (Double Kissing [DK] Crush Versus Culotte Stenting for the Treatment of Unprotected Distal Left Main Bifurcation Lesions: DKCRUSH-III, a Multicenter Randomized Study Comparing Double-Stent Techniques; ChiCTR-TRC-11001877)., (Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

The aim of the present study was to investigate the characteristic microRNAs (miRNAs) expressed during the pre-invasive and invasive stages of cervical cancer. A gene expression profile (GSE7803) containing 21 invasive squamous cell cervical carcinoma samples, 10 normal squamous cervical epithelium samples and seven high-grade squamous intraepithelial cervical lesion samples, was obtained from the Gene Expression Omnibus. Differentially expressed genes (DEGs) were identified using significance analysis of microarray software, and a Gene Ontology (GO) enrichment analysis was conducted using the Database for Annotation, Visualization and Integrated Discovery. The miRNAs that interacted with the identified DEGs were selected, based on the TarBase v5.0 database. Regulatory networks were constructed from these selected miRNAs along with their corresponding target genes among the DEGs. The regulatory networks were visualized using Cytoscape. A total of 1,160 and 756 DEGs were identified in the pre-invasive and invasive stages of cervical cancer, respectively. The results of the GO enrichment demonstrated that the DEGs were predominantly involved in the immune response and the cell cycle, in the pre‑invasive and invasive stages, respectively. Furthermore, a total of 18 and 26 characteristic miRNAs were screened in the pre‑invasive and invasive stages, respectively. These miRNAs may be potential biomarkers and targets for the diagnosis and treatment of the different stages of cervical cancer.

Objectives: The present study aimed to investigate the association between periprocedural myocardial infarction (PMI), defined by creatine kinase (CK)-MB or troponin I (TNI) level elevations >5 times the 99 th percentile of the upper reference limit (URL) within 48 hr after implantation of a drug-eluting stent (DES), and one-year mortality in patients with coronary bifurcation., Background: PMI is reported to be associated with increased one-year mortality after DES implantation. However, the prevalence and association of PMI with mortality after stenting bifurcation lesions remains unclear., Methods: We prospectively followed 1,971 patients with true coronary bifurcations who underwent DES implantation as part of the multicenter DEFINITION study. These patients were grouped into categories based on PMI outcome: Non-PMI, CKMB-PMI, TNI-PMI, and CKMB/TNI-PMI. The primary endpoint was the rate of all-cause mortality at one year., Results: PMI occurred in 11.4% of patients by CKMB criteria and 41.3% of patients by TNI criteria. At one-year follow-up, the mortality rate was 2.3% in the entire patient population. However, mortality was significantly higher in the CKMB-PMI (6.4%) and CKMB/TNI-PMI (6.1%) groups compared to the Non-PMI (1.7%) and TNI-PMI (2.1%) groups (all P < 0.05). A 10-fold increase in TNI levels resulted in similar PMI rate (5.2%) and mortality risk (adjusted HR 2.7, 95% CI 3.0-5.2) as a fivefold increase in CKMB levels., Conclusions: PMI, as defined by CKMB elevations following coronary bifurcation lesion stenting, was associated with increased one-year mortality. Additionally, to attain an equal frequency of PMI, the elevation in TNI levels needed to be twice as high as the elevation in CKMB levels., (© 2015 Wiley Periodicals, Inc.)

Objectives: The present study established criteria to differentiate simple from complex bifurcation lesions and compared 1-year outcomes stratified by lesion complexity after provisional stenting (PS) and 2-stent techniques using drug-eluting stents., Background: Currently, no criterion can distinguish between simple and complex coronary bifurcation lesions. Comparisons of PS and 2-stent strategies stratified by lesion complexity have also not been reported previously., Methods: Criteria of bifurcation complexity in 1,500 patients were externally tested in another 3,660 true bifurcation lesions after placement of drug-eluting stents. The primary endpoint was the occurrence of a major adverse cardiac event (MACE) at 12 months. The secondary endpoint was the rate of stent thrombosis (ST)., Results: Complex (n = 1,108) bifurcation lesions were associated with a higher 1-year rate of MACE (16.8%) compared with simple (n = 2,552) bifurcation lesions (8.9%) (p < 0.001). The in-hospital ST and 1-year target lesion revascularization rates after 2-stent techniques in the simple group (1.0% and 5.6%, respectively) were significantly different from those after PS (0.2% [p = 0.007] and 3.2% [p = 0.009], respectively); however, 1-year MACE rates were not significantly different between the 2 groups. For complex bifurcation lesions, 2-stent techniques had lower rates of 1-year cardiac death (2.8%) and in-hospital MACE (5.0%) compared with PS (5.3%, p = 0.047; 8.4%, p = 0.031)., Conclusions: Complex bifurcation lesions had higher rates of 1-year MACE and ST. The 2-stent and PS techniques were overall equivalent in 1-year MACE. However, 2-stent techniques for complex lesions elicited a lower rate of cardiac death and in-hospital MACE but higher rates of in-hospital ST and revascularization at 1 year for simple lesions., (Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Objective: To assess the application of rotational atherectomy to improving the success rate and outcome of percutaneous recanalization of resistant chronic total occlusion (CTO), i.e. the guidewire could cross the lesion but it is impossible to advance any device over the wire through the occluded segment., Methods: From August 2008 to December 2012, 26 consecutive patients with 27 resistant CTO lesions were additionally treated by high-speed rotational atherectomy (rotational atherectomy group). The control group included 751 non-resistant CTO lesions. Drug-eluting stents were implanted in two groups after the balloon catheter crossed the CTO lesions. The successful rate of rotational atherectomy and in hospital major adverse cardiovascular events (including cardiac death, interventional treatment related myocardial infarction and target vessel revascularization) were observed., Results: The rate of heavily calcified coronary lesions was significantly higher in rotational atherectomy group than in the control group[63.0% (17/27) vs. 21.2% (159/751), P < 0.05] according to pre-procedural coronary angiography. Rotational atherectomy was successful in 25 out of 27 resistant CTO lesions (92.6 %). The rate of cardiac death [0 vs. 0.5% (4/751), P > 0.05], interventional treatment related myocardial infarction [38.5% (10/26) vs. 22.2% (167/751), P > 0.05] and target vessel revascularization [0 vs. 1.2% (9/751), P > 0.05] were similar between the rotational atherectomy group and the control group., Conclusion: Rotational atherectomy is a safe and helpful technique to overcome the inability of balloon catheter to cross a resistant CTO.

Background: The effects of intravascular ultrasound (IVUS)-guided complex approaches using drug-eluting stents (DES) for coronary bifurcation lesions on clinical outcomes has not yet been studied in detail., Objective: Our objective was to analyze the difference in 1-year outcomes following two-stent techniques involving implantation of DES for coronary bifurcation lesions between IVUS-guided and angiography-guided groups., Methods: From May 26, 2007 to March 24, 2010, 628 patients received two-stent techniques (324 in the IVUS-guided group and 304 angiography-guided) and were prospectively studied. We compared major adverse cardiac events (MACE, including cardiac death, stent thrombosis [ST], myocardial infarction [MI] and target lesion/vessel revascularization) at 12-months follow-up, before and after adjusting for propensity score matching., Results: At 12-months after the indexed procedure, patients in the angiography-guided group had significantly increased in-stent restenosis. Compared to the angiography-guided group, the IVUS-guided group had a significantly lower overall unadjusted ST rate (1.2% vs. 6.9%, P < 0.001), definite ST (0.6% vs. 5.3%, P < 0.001), late ST (0.6% vs. 4.3%, P = 0.003), MI (4.6% vs. 8.9%, P = 0.038) and cardiac death (0.9% vs. 3.3%, P = 0.049). By propensity score matching, 123 paired patients were matched. The late ST at 12-months follow-up was 0% in the IVUS-guided group versus 4.9% in the angiography-guided group (P = 0.029), resulting in significant differences in ST-elevation MI between the two groups (2.4% vs. 9.8%, P = 0.030)., Conclusions: The IVUS-guided two-stent technique was associated with significantly reduced late stent thrombosis, with a resultant reduction in ST-elevation MI. © 2012 Wiley Periodicals, Inc., (Copyright © 2012 Wiley Periodicals, Inc.)

Klotho was identified as the responsible gene in a mutant mouse line whose disruption results in a variety of premature aging-related phenotypes. Nonetheless, the related mechanisms were still unknown. Many studies report that dietary phosphate restriction and genetic ablation of vitamin D pathways indirectly reverse premature aging processes in these mice. Furthermore, transgenic overexpression of klotho in mice extends their life span through inhibition of insulin and IGF1 signaling. We found that intraperitoneal injection of recombinant soluble Klotho protein at dose of 0.02 mg/kg every other day effectively extends the life span of kl/kl mice by 17.4%. Soluble Klotho administration also ameliorated premature aging-related phenotype, such as growth retardation, premature thymus involution and vascular calcification, and effectively enhanced urinary phosphate excretion in kl/kl mice. Klotho treatment attenuated renal fibrosis through down-regulation of transforming growth factor-β signaling as well as reduced cellular senescence through down-regulation of p21-cip1 mRNA levels. In addition, soluble Klotho treatment significantly reduced both renal and aorta calcium deposits. In conclusion, our study shows the therapeutic potential of soluble Klotho protein to treat age-related disorders in mice., (Copyright © 2012 Elsevier B.V. All rights reserved.)

The present paper describes an effort for developing the total maximum daily load (TMDL) for phosphorus and a load reduction strategy for the Feitsui Reservoir in Northern Taiwan. BASINS model was employed to estimate watershed pollutant loads from nonpoint sources (NPS) in the Feitsui Reservoir watershed. The BASINS model was calibrated using field data collected during a 2-year sampling period and then used to compute watershed pollutant loadings into the Feitsui Reservoir. The simulated results indicate that the average annual total phosphorus (TP) loading into the reservoir is 18,910 kg/year, which consists of non-point source loading of 16,003 kg/year, and point source loading of 2,907 kg/year. The Vollenweider mass balance model was used next to determine the degree of eutrophication under current pollutant loading and the load reduction needed to keep the reservoir from being eutrophic. It was estimated that Feitsui Reservoir can becoming of the oligotrophic state if the average annual TP loading is reduced by 37% or more. The results provide the basis on which an integrated control action plan for both point and nonpoint sources of pollution in the watershed can be developed.

We have successfully cloned and expressed core-streptavidin in Escherichia coli. Core-streptavidin was expressed in shaker flask culture as a soluble protein, isolated by periplasmic extraction, purified by immobilized metal affinity chromatography column, and analyzed for its size, thermal stability, and biotin-binding activity. In Western blots using streptavidin-horseradish peroxidase (HRP) as a probe, we identified a contaminant that co-purified with core-streptavidin, identified as biotin carboxyl carrier protein (BCCP). Although BCCP cannot be detected on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, it appears as a prominent band in Western blot when probed with streptavidin peroxidase conjugate. Based on the results from in vitro gel digestion, mass spectrometry and Mascot database search results, we confirmed the presence of BCCP. It was found that BCCP can complex with core-streptavidin and can dissociate when heated above 80 degrees C. BCCP could be successfully removed and recovered by using core-streptavidin immobilized magnetic beads under mild conditions. In addition, the enriched fractions of core-streptavidin oligotetramers were separated, which may be the by-products of BCCP binding to core-streptavidin in various ratios. Finally, enzyme linked immunosorbent assay results have shown that the amount of biotin-HRP binding to core-streptavidin was higher compared to commercially available streptavidin.