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Ruthenium complexes are one of the most promising anticancer drugs and ferroptosis is a novel form of regulated cell death, the study on the effect of Ru complexes on ferroptosis is helpful to find more effective antitumor drugs. Here, the synthesis and characterization of two Ru complexes containing 8-hydroxylquinoline and triphenylphosphine as ligands, [Ru(L 1 ) (PPh 3 ) 2 Cl 2 ] (Ru-1), [Ru(L 2 ) (PPh 3 ) 2 Cl 2 ] (Ru-2), were reported. Complexes Ru-1 ∼ Ru-2 showed good anticancer activity in Hep-G2 cells. Researches indicated that complexes Ru-1 ∼ Ru-2 could be enriched and appear as red fluorescence in the mitochondria, arouse dysfunction of mitochondria, induce the accumulation of reactive oxygen species (ROS) and lipid peroxidation (LPO), while the morphology of nuclei and cell apoptosis had no significant change. Further experiments proved that GPX4 and Ferritin were down-regulated, which eventually triggered ferroptosis in Hep-G2 cells. Remarkably, Ru-1 showed high inhibitory activity against xenograft tumor growth in vivo (TGIR = 49%). This study shows that the complex Ru-1 could act as a novel drug candidate by triggering cell ferroptosis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

This study investigated whether free prostate-specific antigen (fPSA) performs better than total PSA (tPSA) in predicting prostate volume (PV) in Chinese men with different PSA levels. A total of 5463 men with PSA levels of <10 ng ml -1 and without prostate cancer diagnosis were included in this study. Patients were classified into four groups: PSA <2.5 ng ml -1 , 2.5-3.9 ng ml -1 , 4.0-9.9 ng ml -1 , and 2.5-9.9 ng ml -1 . Pearson/Spearman's correlation coefficient (r) and receiver operating characteristic (ROC) curves were used to evaluate the ability of tPSA and fPSA to predict PV. The correlation coefficient between tPSA and PV in the PSA <2.5 ng ml -1 cohort (r = 0.422; P < 0.001) was markedly higher than those of the cohorts with PSA levels of 2.5-3.9 ng ml -1 , 4.0-9.9 ng ml -1 , and 2.5-9.9 ng ml -1 (r = 0.114, 0.167, and 0.264, respectively; all P ≤ 0.001), while fPSA levels did not differ significantly among different PSA groups. Area under ROC curve (AUC) analyses revealed that the performance of fPSA in predicting PV ≥40 ml (AUC: 0.694, 0.714, and 0.727) was better than that of tPSA (AUC = 0.545, 0.561, and 0.611) in men with PSA levels of 2.5-3.9 ng ml -1 , 4.0-9.9 ng ml -1 , and 2.5-9.9 ng ml -1 , respectively, but not at PSA levels of <2.5 ng ml -1 (AUC: 0.713 vs 0.720). These findings suggest that the relationship between tPSA and PV may vary with PSA level and that fPSA is more powerful at predicting PV only in the ''gray zone'' (PSA levels of 2.5-9.9 ng ml -1 ), but its performance was similar to that of tPSA at PSA levels of <2.5 ng ml -1 ., Competing Interests: None

Purpose: To investigate the feasibility of contrast agent and injection rate reduction for dual-layer spectral detector computed tomography (SDCT) imaging of the superior mesenteric artery (SMA) using virtual monochromatic image (VMI)., Methods: A total of 102 patients who underwent abdominal arterial phase-enhanced SDCT examination due to suspected abdominal diseases were prospectively selected and divided into control group, low concentration/dose groups (groups 370-0.7, 300-1.0, and 300-0.9) and low injection rate groups (groups 2-370 and 2-350). Compared with the control group, low concentration/dose groups and low injection rate groups lowered the concentration/dose or injection rate of the contrast agent to varying degrees. The raw data obtained in each group were reconstructed using hybrid-iterative reconstruction and projection spatial-spectral reconstruction algorithm. The image quality of the SMA in conventional images (CI) and in VMIs 40-140 kiloelectron volt (keV) (interval: 10 keV) during the arterial phase was analyzed. Multiplanar reformation images and volume rendering images of the SMA were reconstructed. Image quality objective evaluation indexes included the CT values, contrast-to-noise ratio, signal-to-noise ratio, and diameter of the SMA. The diameter of the SMA was determined by the CT values profile curve and its full width at half maximum. Two doctors independently evaluated the subjective image quality of multiplanar reformation coronal images and volume rendering images according to a 5-point scale. Repeated analysis of variance and Friedman test were used to compare the differences in the objective evaluation indexes and subjective scores between VMIs and CI in the same group. The Dunnett's t-test or Dunnett's T3 test and Kruskal-Wallis H-test were used to compare the differences in the objective evaluation indexes and subjective scores between the experimental and control groups., Results: VMIs of the SMA in each group had the best image quality at 60 keV, and VMI 60 keV in each group were better than their respective CI to varying degrees. Although the objective (CT values, contrast-to-noise ratio, and signal-to-noise ratio) and subjective (subjective scores) indexes of CI in the low concentration/dose groups and low injection rate groups were lower than those of CI in the control group to varying degrees, these indexes of VMI 60 keV in the low concentration/dose groups and group 2-370 were equal to or even better than the CI in the control group., Conclusions: VMI 60 keV using SDCT could effectively reduce the contrast agent load while providing equivalent or better SMA image quality compared with CI obtained using a conventional contrast agent protocol. When the injection rate was lowered to 2.0 ml/s for a high-concentration contrast agent (370 mgI/ml), the SMA image quality at VMI 60 keV was comparable with that of the CI in the control group., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Flipped classroom (FC) style Australian faculty development program Teaching on the Run (TOTR) was introduced into Chang Gung Memorial Hospital since 2014. However, its effectiveness in Taiwan has not been formally assessed. This work intended to examine the learning gain of TOTR and identify the moderators of FC outcome by using TOTR as a representative model of FC., Methods: A non-controlled before-after study was undertaken by retrospective analysis of learning data collected during TOTR workshop. Multiple choice questions were tested at baseline (pre-test), after pre-class learning (mid-test) and after classroom activity (post-test) to assess the learning gain. All available demographic and learning variables were included in the moderator analysis., Results: Stepwise and significant improvement in exam scores was noted from pre-test to mid-test and post-test (p < 0.001 for both). Univariate analysis showed pre-test scores, mid-test scores, class participation and session of TOTR were significantly associated with post-test scores. However, multivariate analysis by general linear model showed only mid-test scores and session of TOTR were significant predictor of post-test score. Generalized estimating equations analysis showed that class participation is a significant moderator that influence the scores change from mid-test to post-test., Conclusion: TOTR is effective in improving knowledge of teaching skills for clinical teachers in Taiwan. Achievement in pre-class learning, class participation and learner factor are potential moderators of the FC outcome. Thus, facilitators should try their best to promote a good achievement in pre-class learning and engagement in classroom activity in FC style learning., Competing Interests: Conflicts of Interest The authors declare no conflicts of interest., (Copyright © 2020 Chang Gung University. Published by Elsevier B.V. All rights reserved.)

Background: Non-vitamin K antagonist oral anticoagulants (NOACs) are as effective and safe as warfarin for thromboembolic prevention and treatment. The efficacy of NOACs lacks evidence from large and randomized studies in patients with inherited severe thrombophilia, including protein S deficiency. Further, some concerns still exist regarding the relative efficacy of edoxaban in preventing arterial thromboembolism in patients with normal to high creatinine clearance (CrCl). We present a case of a rare complication of lead thrombus under standard-dose edoxaban in a patient with protein S deficiency and supernormal renal function., Case Presentation: A 65-year-old man experienced persistent chest tightness and a high level of D-dimer. Chest computed tomography (CT) showed a lead thrombus at the superior vena cava. He had a medical history including, paroxysmal atrial fibrillation (PAf), sick sinus syndrome after permanent pacemaker implantation, and transient ischemic attack. He received standard-dose edoxaban (60 mg daily) after PAf was diagnosed. His estimated CrCl was 98.6-102.1 mL/min. However, protein S deficiency (22.8%; normal range: 55-130%) was diagnosed. After switching to dabigatran (150 mg twice daily) for 3 months, the chest CT showed lead thrombus resolution and no symptoms were seen during the follow-up period., Conclusions: This case was a rare complication of lead thrombus in a protein S deficient patient with normal renal function receiving standard-dose edoxaban. Edoxaban efficacy is uncertain in patients with protein S deficiency, and intracardiac devices also increase the risk of thromboembolic events., (© 2021. The Author(s).)

Objective: To study the characteristics of wideband tympanometry(WBT) and its application value in the diagnosis of otitis media with effusion(OME) in young children. Methods: We compared wideband acoustic energy absorbance(EA) under peak pressure in young children with OME(190 ears) and healthy control subjects(121 ears) from Ninth People's Hospital of Shanghai Jiaotong University School of Medicine between January 2018 and June 2020. Both groups were divided into three groups, 1-6 months, 7-36 months and 37-72 months. SPSS 20.0 statistical software was used to analyze and compare the EA parameters between OME children of different months and the control group. Receiver operating characteristic (ROC)curve was used to analyze the diagnostic value of WBT in young children with OME. Results: There were significant differences in EA among three OME groups from 500 Hz to 2 000 Hz( P <0.05).Compared with the control groups, EA of 1-6 m OME group decreased significantly below 4 000 Hz( P <0.05), EA of 7-36 m OME group decreased significantly at 545-1 600 Hz( P <0.05), EA of 37-72 m OME group decreased significantly above 545 Hz( P <0.05).ROC curve indicated that EA at 1 000 Hz had the greatest diagnostic value (AUC was 0.890), followed by 1 500 Hz and the range of 500-2 000 Hz (AUC was 0.883 and 0.881, respectively).EA at 1 000 Hz with a cutoff value of 0.55 had the best diagnostic sensitivity of 90.8%, which was higher than conventional tympanometry (85.8%). The maximum AUC (0.932) could be obtained by combining EA, peak pressure and admittance amplitude of 226 Hz tympanometry as predictors. Conclusions: EA is significantly decreased in young children with OME. Compared with the conventional single frequency tympanometry, WBT is more accurate in the diagnosis of OME in young children, and the prediction accuracy would be better if combined with 226 Hz tympanometry.

Objectives: Localizing non-palpable pulmonary nodules is challenging for thoracic surgeons. Here, we investigated the accuracy of three-dimensional (3D) printing technology combined with mixed reality (MR) for localizing ground glass opacity-dominant pulmonary nodules., Methods: In this single-arm study, we prospectively enrolled patients with small pulmonary nodules (<2 cm) that required accurate localization. A 3D-printing physical navigational template was designed based on the reconstruction of computed tomography images, and a 3D model was generated through the MR glasses. We set the deviation distance as the primary end point for efficacy evaluation. Clinicopathological and surgical data were obtained for further analysis., Results: Sixteen patients with 17 non-palpable pulmonary nodules were enrolled in this study. Sixteen nodules were localized successfully (16/17; 94.1%) using this novel approach with a median deviation of 9 mm. The mean time required for localization was 25 ± 5.2 min. For the nodules in the upper/middle and lower lobes, the median deviation was 6 mm (range, 0-12.0) and 16 mm (range, 15.0-20.0), respectively. The deviation difference between the groups was significant (Z = -2.957, P = 0.003). The pathological evaluation of resection margins was negative., Conclusions: The 3D printing navigational template combined with MR can be a feasible approach for localizing pulmonary nodules., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Introduction: Intrahepatic cholangiocarcinoma (ICC), which is difficult to diagnose and is usually fatal due to its late clinical presentation and a lack of effective treatment, has risen over the past decades but without much improvement in prognosis., Objective: The study aimed to investigate the role of apatinib that targets vascular endothelial growth factor receptor-2 (VEGFR2) in ICC., Methods: MTT assays, cell scratch assays, and tube formation assays were used to assess the effect of apatinib on human ICC cell line (HuCCT-1) and RBE cells proliferation, migration, and angiogenic capacity, respectively. Expression of vascular endothelial growth factor (VEGF), VEGFR2, signal transducer and activator of transcription factor 3 (STAT3), pSTAT3, and hypoxia inducible factor 1 subunit alpha (HIF-1α) pathway proteins was assessed using Western blotting and mRNA expression analysis in HuCCT-1 was performed using RT-qPCR assays. The pcDNA 3.1(-)-VEGFR2 and pcDNA 3.1(-)-HIF-1α were transfected into HuCCT-1 and RBE cells using Lipofectamine 2,000 to obtain overexpressed HuCCT-1 and RBE cells., Results: We found that apatinib-inhibited proliferation, migration, and angiogenesis of HuCCT-1 and RBE cells in vitro in a dose-dependent manner. We also proved that apatinib effectively inhibits angiogenesis in tumor cells by blocking the expression of VEGF and VEGFR2 in these cells. In addition, we demonstrated that apatinib regulates the expression of STAT3 phosphorylation by inhibiting VEGFR2. Finally, we showed that apatinib regulates ICC angiogenesis and HIF-1α/VEGF expression via STAT3., Conclusions: Based on the above findings, we conclude that apatinib inhibits HuCCT-1 and RBE cell proliferation, migration, and tumor angiogenesis by inhibiting the VEGFR2/STAT3/HIF-1α axis signaling pathway. Apatinib can be a promising drug for ICC-targeted molecular therapy., (© 2021 S. Karger AG, Basel.)

Objective: While liver biopsy is the golden standard for liver-fibrosis diagnosis, it is also invasive and has many limitations. Non-invasive techniques such as Magnetic Resonance Imaging (MRI) need to be further developed for liver fibrosis staging. This study aimed to evaluate the diagnostic accuracy of Gadolinium Ethoxybenzyl Diethylenetriamine Penta-acetic Acid (Gd-EOBDTPA)- enhanced MRI for liver fibrosis through systematic review and meta-analysis., Methods: This study comprehensively searched relevant article in PubMed, Embase, and the Cochrane Library published from 2004 to 2018 to find studies analyzing the diagnostic accuracy of Gd-EOB-DTPA-enhanced MRI for liver fibrosis. Two reviewers independently screened the retrieved articles, extracted the required data from the included studies, and evaluated the methodological quality of the studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and Summary Receiver Operating Characteristics (SROC) curve were assessed., Results: This study finally included 16 studies (n = 1,599) and selected a random-effects model based on the results of the I 2 statistic to combine them. The areas under the SROC curve for the detection of F1 or greater, F2 or greater, F3 or greater, or F4 liver fibrosis were 0.8669, 0.8399, 0.8481, and 0.8858, respectively., Conclusion: Gd-EOB-DTPA-enhanced MRI showed a good diagnostic performance for staging liver fibrosis, especially for F4 liver fibrosis., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Localization of small pulmonary nodules is an inevitable challenge for the thoracic surgeon. This study aimed to investigate the accuracy of three-dimensional (3D) printing technology for localizing small pulmonary nodules, especially ground-glass nodules (GGNs)., Methods: This study enrolled patients with peripheral small pulmonary nodules (≤ 2 cm) who required preoperative localization. In the comparison period, patients underwent both computed tomography-guided (CT-G) and 3D-printing template guided (3D-G) localization to compare the accuracies of the two methods. In the testing period, the 3D-printing technique was implemented alone. The 3D-printing physical navigational template was designed based on data from perioperative CT images. Clinical data, imaging data, surgical data, and evaluation index were collected for further analysis. The learning curve of the 3D-printing localization technique was assessed using cumulative sum (CUSUM) analysis and multiple linear regression analysis., Results: In the comparison period (n = 14), the success rates of CT-G and 3D-G were 100% and 92.9% (P = 0.31), respectively; in the testing period (n = 23), the success rate of 3D-G was 95.6%. The localization times of CT-G, 3D-G (comparison), and 3D-G (testing) were 23.6 ± 5.3, 19.3 ± 6.8, and 9.8 ± 4.6 minutes, respectively. The CUSUM learning curve was modeled using the equation: Y = 0.48X 2 - 0.013X - 0.454 (R 2 = 0.89). The learning curve was composed of two phases, phase 1 (the initial 20 patients) and phase 2 (the remaining 17 patients)., Conclusions: 3D printing localization has adequate accuracy and is a feasible and accessible strategy for use in localizing small pulmonary nodules, especially in right upper lobe. The use of this technique could facilitate lung nodule localization prior to surgery., (© 2020 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.)

Exciplex emitters have emerged as an important class of thermally activated delayed fluorescence (TADF) materials for highly efficient OLEDs. A TADF exciplex emitter requires an intermolecular donor/acceptor pair. We have synthesized a bipolar donor-type material, DPSTPA, which was used to pair with known acceptor materials (2CzPN, 4CzIPN, or CzDBA). The OLEDs based on the exciplex emitters, DPSTPA/X, where X = 2CzPN and CzDBA, give green and orange-red colors with record-high external quantum efficiencies (EQEs) of 19.0 ± 0.6 and 14.6 ± 0.4%, respectively. In contrast, the exciplex pair DPSTPA/4CzIPN gave a very low photoluminescence quantum yield (PLQY) and a very low EQE value of the device. The DFT calculations indicate that the intermolecular distance between the donor and the acceptor plays a key factor for the PLQY and EQE. The observed low PLQY and the poor device performance for the DPSTPA/4CzIPN pair are probably because of the relatively long distance between the DPSTPA and 4CzIPN in the thin film caused by the four congested carbazole (Cz) groups of 4CzIPN, which effectively block the interaction of the nitrile acceptor with the triphenylamino donor of DPSTPA.

Objective: To review the imaging features of coronary artery-to-pulmonary artery fistula (CPAF) on CT coronary angiography (CTCA) and evaluate its diagnostic performance compared with coronary catheter angiography (CCA) and transthoracic echocardiography (TTE)., Materials and Methods: We retrospectively reviewed with a diagnosis of CPAF from among 19855 consecutive CCTA performed with 256-slice MDCT scanner for suspected coronary artery disease. CT images were evaluated for - origin, number, size and course (tubular/worm-like dilation/significant aneurysm formation/wall attachment sign) of fistula vessels, drainage site, drainage site imaging features (pierced sign, isodensity sign, smoke sign, jet sign), and main pulmonary artery (MPA) enlargement. 25 patients of CPAF also underwent CCA and 47 patients underwent TTE., Results: There were 72 patients with CPAF (0.36%) in our study, of which 44 were men and 28 were women, with mean age of 55.8 ± 13.2 years (range 22-85 years). CPAF originated from conus artery, left anterior descending artery (LAD), combined conus artery and LAD in 55, 67, 50 cases, respectively. Tubular dilation, worm-like dilation and aneurysm was seen in 14, 58 and 35 cases, respectively. Wall attachment sign was noted in 69 cases. All the cases demonstrated only a single drainage site, with left lateral wall, left anterolateral, anterior, right lateral and right anterolateral walls of MPA in 44, 21, 5, 1 and 1 cases, respectively. The mean diameter of the fistula drainage site was 2.6 ± 1.3 mm. Pierced sign, jet sign, smoke sign, isodensity sign was seen in 72, 46, 41 and 24 cases, respectively. MPA enlargement was seen in 20 patients. CCA showed CPAF in only 20 cases among 25 patients; while TTE showed CPAF in only 9 patients among 47 patients., Conclusion: CTCA is competent in detecting and characterizing CPAF with an excellent diagnostic performance as the first imaging modality of choice, which is valuable for giving a distinct and intuitive explanation to patients and physicians and making an objective and exact assessment for further management., (Copyright © 2019 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.)

Purpose: To assess the value of susceptibility-weighted imaging (SWI) for staging of liver fibrosis (F), necroinflammatory activity (A), and steatosis (S) of chronic hepatitis., Methods: 100 Sprague-Dawley (SD) male rats were randomly divided into a chronic hepatitis model group (n = 88) and a control group (n = 12). The chronic hepatitis model rats were induced by intraperitoneal injection of 40% (v/v) of carbon tetrachloride (CCl 4 ) diluted in olive oil. All rats were examined by magnetic resonance imaging (MRI) and then killed immediately to detect pathologic staging as liver fibrosis (F), necroinflammatory activity (A), and steatosis (S). Liver-to-muscle signal intensity ratios (SIRs) of SWI were analyzed and associated with histopathologic findings., Results: There were ultimately 11 normal control rats and 60 chronic hepatitis model rats. Statistical data were as follows: F0 (n = 11), F1 (n = 18), F2 (n = 16), F3 (n = 13), F4 (n = 13); A0 (n = 11), A1 (n = 29), A2 (n = 21), A3 (n = 10); S0 (n = 11), S1 (n = 12), S2 (n = 12), S3 (n = 18), and S4 (n = 18). The liver-to-muscle SIR of the SWI was related to hepatic fibrosis (P < 0.05) and liver steatosis (P < 0.05) but not to necroinflammatory activity (P > 0.05). By partial correlation analysis, a significant negative correlation was shown between the liver-to-muscle SIR and staging of liver fibrosis (r = -0.68, P < 0.05) as well as a low correlation with liver steatosis (r = 0.30, P < 0.05). Except for F0-F1 and F1-F2, there were statistical differences between each of the stages of hepatic fibrosis (P < 0.05), with an area under the ROC of 0.87 for F3 or above and of 0.96 for F4., Conclusion: SWI can be a reliable method for staging hepatic fibrosis., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objective: To explore the effects of bimodal intervention on the development of auditory and speech ability in the infants with unilateral cochlear implantation(CI). Methods: Total 35 bilateral profound sensorineural hearing loss infants with unilateral CI, aged 0.7 to 2.8 years old, were selected. The subjects were divided into two groups: the group with unilateral CI(cochlear implant alone, n = 15), and the bimodal group with CI and contralateral fitting hearing aid( n = 20). Their auditory and speech abilities were estimated at the different time points after switch-on(the 0th, 0.5th, 1st, 3rd, 6th, 12th, 18th, and 24th month, respectively) using Infant Toddler-Meaningful Auditory Integration Scale(IT-MAIS), Meaningful Use of Speech Scale(MUSS), Categories of Auditory Performance(CAP), and Speech Intelligibility Rating(SIR) scores. Results: The IT-MAIS scores of bimodal group after switch-on were higher than unilateral CI group(the 0.5th, 1st, 3rd, 6th, 12th, and 18th month), the statistical significances were identified at the 0.5th, 1st, 3rd, 6th, and 12th month, respectively( P <0.05). The CAP scores of bimodal group before CI operation and after switch-on(the 0.5th, 1st, 3rd, 6th, 12th, 18th and 24th month)were higher than unilateral CI group, the statistical significances were seen at the 3rd, 6th, 12th, 18th and 24th month after switch-on( P <0.05). The MUSS scores of bimodal group after switch-on were higher than unilateral CI group(the 1st, 3rd, 6th, 12th, 18th and 24th month), the statistical significances were found at the 12th, 18th and 24th month, respectively( P <0.05). The SIR scores of bimodal group after switch-on were higher than unilateral CI group(the 3rd, 6th, 12th, 18th and 24th month), and significant differences appeared at the 12th, 18th and 24th month after switch-on( P <0.05). Conclusion: Bimodal intervention could be helpful to the development of auditory and speech ability of infants.

Aim: To evaluate the value of the aspartate aminotransferase-to-platelet ratio index (APRI) for hepatocellular carcinoma (HCC) patients who underwent transarterial chemoembolisation (TACE)., Materials and Methods: A total of 315 patients were enrolled, who were randomly divided into the training cohort (n=158) and the validation cohort (n=157). The optimal cut-off value of the APRI was determined using the X-tile software in the training cohort, and was validated in the validation cohort. Several serum-based markers, neutrophil-to-lymphocyte (N/L) and aspartate aminotransferase-to-alanine aminotransferase (AST/ALT) ratios were included to compare with the APRI. To predict individual survival rate, independent predictors were included to build a nomogram., Results: Using the X-tile, a cut-off value of the APRI as 0.40 was yielded to distinguish patients with distinct outcomes in the training cohort, but failed for the N/L and ALT/AST ratios. In the training cohort, 66 patients with high APRI had poorer survival (p<0.001) than did 92 patients with low APRI. Using the same cut-off value of APRI, 61 patients with high APRI had poorer survival (p<0.001) than did 96 patients with low APRI in the validation cohort. Furthermore, a nomogram, including the APRI, TACE cycles, tumour size, and tumour number, was built based on the training cohort, and validated well in the validation cohort (concordance index [C-index] 0.713)., Conclusion: The APRI is a promising marker to predict treatment response and outcome for HCC patients after TACE treatment., (Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)

A novel p-type charge generation material, DPAF, composed of a ferrocene core and a bis(biphenyl)amino group is designed and synthesized for application to tandem OLED devices. This molecular design not only enhances the thermal properties of ferrocene and the hole mobility, but also maintains its electrochemical stability. The red, green, and blue tandem OLEDs all give excellent device performance with low efficiency roll-off by using n-type C 60 and p-type DPAFs as charge generation layers.

In this work, Aspergillus aculeatus M105 was obtained to produce high extracellular fructooligosaccharide-producing enzyme activity. The maximum yields of fructooligosaccharides produced by its extracellular enzymes and immobilized cells were 67.54 and 65.47% (w/w), respectively. A fructosyltransferase (FTase), AaFT32A, was purified from M105. The optimal pH and temperature of AaFT32A were pH 5.0-6.0 and 65 °C, respectively. The Km, Vmax, and kcat values for the transfructosylating activity of AaFT32A were 2267 mM, 1347 μmol/min/mg protein, and 1550.2 s(-1), respectively, and those values for the hydrolytic activity of AaFT32A were 6.10 mM, 32.44 μmol/min/mg protein, and 37.3 s(-1), respectively. The sequence of AaFT32A deduced from the cloned gene shared 99.4% identity with a FTase from Aspergillus japonicus CB05 and a fructofuranosidase from Aspergillus niger and 96.5% identity with a FTase (Aspacl&#95;37092) from A. aculeatus ATCC 16872. The fungal strain and its FTase may have potential applications in the prebiotics industry.

An anomalous origin of the left coronary artery (LCA) is a relatively uncommon congenital heart defect that can lead to myocardial ischemia and sudden cardiac death. An LCA arising from the pulmonary artery and an LCA arising from the opposite sinus of Valsalva are the common types of anomalous origins of the LCA. Echocardiographic assessment of the coronary arteries is an important component of the routine cardiovascular evaluation, but echocardiographic "pseudo images" of LCA origination can be present in some patients. Detection of an anomalous origin of the LCA remains a challenge to sonographers.

Objective: To discuss the method as well as effect of hearing restoration for patients with acoustic neuroma (AN) in the only hearing ear., Methods: A retrospective study was conducted in three patients with AN in the only hearing ear. Ipsilateral cochlear implantation (CI) was performed in case 1 and contralateral CI was performed in case 2 without tumor resection. In case 3, CI was performed 6 months after tumor removal by the retrosigmoid approach. Dynamic changes in the audiological tests was recorded regularly., Results: In case 1 and case 2, no matter which side CI was performed, pure tone average (PTA) was improved clearly, and speech discrimination score (SDS) was slightly increased. In case 3, hearing loss was observed after tumor removal. Simultaneous bilateral CI after 12 months was performed in this case. PTA on both sides was largely lower than that before CI, and SDS was slightly improved. With bilateral CI, SDS was improved, especially in noise, compared with unilateral CI on either side., Conclusions: For patients with AN in the only hearing ear, CI can significantly improve PTA, and SDS can be slightly increased. Bilateral CI should improve the outcome of hearing restoration compared with unilateral CI.

Background: Iterative model reconstruction (IMR) is a newer generation iterative reconstruction method, but its value on coronary computed tomography (CT) angiography requires investigation., Purpose: To evaluate coronary image quality using IMR at a low-tube voltage of 80 kVp on coronary CT angiography in miniature pigs., Material and Methods: Five healthy miniature pigs underwent prospective electrocardiogram-gated coronary 256-slice CT angiography at 120 kVp and 80 kVp tube voltages, respectively. Filtered back projection (FBP) was used to reconstruct the 120 kVp standard-dose (SD) image sets (SD-FBP group), while iDose(4) and IMR were used to reconstruct the 80 kVp low-dose (LD) image sets (LD-iDose(4) and LD-IMR groups). Objective and subjective image qualities were compared among three groups., Results: There were no significant differences in mean CT values of the ascending aorta, left main coronary artery, and right coronary artery between the LD-IMR and LD-iDose(4) groups (P > 0.05), but the values were significantly lower in the SD-FBP group than in those two groups (P < 0.05). The image noise in the LD-IMR group (21.5 ± 3.9 HU) was significantly lower than in the LD-iDose(4) (63.7 ± 9.8 HU) and SD-FBP (50.6 ± 4.6 HU) groups (P < 0.05). The signal-to-noise and contrast-to-noise ratios were significantly higher in the LD-IMR group than in the LD-iDose(4) and SD-FBP groups, respectively (P < 0.05). Subjective scoring of image noise, streak artifacts, and overall image quality indicated that the LD-IMR group was consistently superior to the LD-iDose(4) and SD-FBP groups (P < 0.05)., Conclusion: IMR can significantly improve image quality at a low-tube voltage (80 kVp) with a 66% radiation dose reduction on coronary 256-slice CT angiography in miniature pigs., (© The Foundation Acta Radiologica 2015.)

Introduction: The incidence of multiple intracardiac mass is rare. The differential diagnosis of intracavitary mass lesions includes benign, malignant primary, secondary metastatic cardiac tumors, or thrombus., Case Presentation: We report the case of a 49-year-old Asian woman, who experienced a 2-week history of progressive exertional dyspnea, orthopnea, bilateral lower limb edema and palpitations. Transthoracic echocardiography showed one fixed round hyperechoic mass with central necrosis over the left ventricular apex, one oscillating hyperechoic nodule over the anterior mitral annulus and one irregularly heterogeneous mass bulging out from the lateral wall of the right atrium. The incidence of multiple myxomas is rare. Unfortunately, high tumor marker, serum lactic dehydrogenase and serum uric acid levels were also present. We could not differentiate between diagnoses of multiple myxomas with thrombi or multiple metastatic tumors., Conclusions: Primary intracardiac tumors are rare. Approximately 75% are benign, and approximately 50% are myxomas, which have an incidence of 0.0017% in the general population. Multiple intracardiac myxomas account for less than 5% of all cases of myxoma. Our case was an atypical picture of right atrial (RA) myxoma, as it was located in the RA lateral wall and extended to the RA auricle at the junction among the superior and inferior vena cava. Two masses in the left ventricle (LV) were thrombi and resolved after heparinization. Initially, elevated tumor markers and high serum uric acid and high serum lactic dehydrogenase levels were related to necrotic tumor-derived tissue, decompensated heart failure with pleural effusion and renal insufficiency. We share our experience of multiple intracardiac masses. Whether the intracardiac mass is benign or malignant, we recommend surgery due to the possibilities of systemic or pulmonary massive embolism, infection, arrhythmia and sudden death if the thrombus ruptures or the mass dislodges.

Purpose: To assess the impact of chest circumference (CC)-adjusted tube current and iterative reconstructions (iDose) on individualized radiation dose reduction and image quality (IQ) in ECG-triggered computed tomography coronary angiography (CTCA)., Materials and Methods: A total of 102 patients underwent retrospectively ECG-triggered CTCA utilizing CC-adapted tube current [mAs=1000×(0.051×CC-23.765)/900] and filtered back projection (FBP) reconstruction (group A). On the basis of the CC-adjusted tube current technique, 54 patients (group B) underwent retrospective ECG-triggered CTCA with a 20% mAs reduction compared with group A and 90 patients (group C) underwent prospective ECG-triggered CTCA with an 80% mAs reduction compared with group A; both groups B and C were reconstructed with FBP and iDose. Subjective IQ was assessed, and image noise, signal-to-noise, and contrast-to-noise ratios (SNR and CNR) were quantified., Results: Patients in group A had the highest radiation dose, followed by group B and group C. iDose provided decreased image noise and increased SNR and CNR, as did subjective IQ. The image noise was higher and SNR and CNR in group B were obviously lower than those in group A with FBP, but in group B, iDose4 increased the mean objective IQ. There was no difference between group B with iDose and group A with FBP, as was the case with subjective IQ., Conclusion: The combination of a CC-adapted technique, prospective triggering, and partial iterative reconstruction techniques reduces the radiation dose significantly, without significant degradation of IQ.

Inflammasomes are multi-protein complexes that regulate chronic inflammation-associated diseases by inducing interleukin-1 β (IL-1β) secretion. Numerous components involved in inflammasome activation have been identified, but the mechanisms of inflammasome-mediated IL-1β secretion have not yet been fully explored. Here, we demonstrate that end-binding protein 1 (EB1), which is required for activation of AIM2 inflammasome complex, links the AIM2 inflammasome to autophagy-dependent secretion. Imaging studies revealed that AIM2 inflammasomes colocalize with microtubule organizing centers and autophagosomes. Biochemical analyses showed that poly(dA-dT)-activated AIM2 inflammasomes induce autophagy and IL-1β secretion in an LC3-dependent fashion. Furthermore, depletion of EB1 decreases autophagic shedding and intracellular trafficking. Finally, we found that the 5'-AMP activated protein kinase may regulate this EB1-mediated autophagy-based inflammasome-induced secretion of IL-1β. These findings reveal a novel EB1-mediated pathway for the secretion of IL-1β., (© 2014 by The American Society for Biochemistry and Molecular Biology, Inc.)

Introduction: We aimed to determine a potentially optimal body size index for adjusting the tube current in retrospective ECG-triggered helical 256-slice CT coronary angiography (CTCA) for individualized radiation dose control., Methods: Consecutive patients (n=102) with suspected coronary artery disease underwent retrospective ECG-triggered CTCA with a 256-slice CT scanner. Body mass index (BMI), nipple level (NL) bust and six anthropometric body size indexes, including thoracic anteroposterior diameter at NL, chest circumference (CC) at NL, left main (LM) and right coronary artery (RCA) origin level, chest area (CAr) and chest attenuation (CAt) at RCA origin level were measured, and their correlation with image noise in the aorta was evaluated using linear regression. Pearson correlation analysis was performed respectively to determine the body size index that correlated best with the other body size indexes. An equation was derived to use the best correlated body size index for adjusting tube current., Results: Linear regression demonstrated that CCRCA had the best correlation with image noise. Pearson correlation analysis showed that CCNL, CCLM and CArRCA had the closest linear relationship with CCRCA. The equations connecting CCRCA and tube current for males and females were XmA = 662 × (0.055 × CCRCA - 28.594) / 302 and XmA = 662 × (0.049 × CCRCA - 21.584) / 302, respectively, for a fixed image noise value of 30 HU., Conclusions: Tube current selection is different for males and females, particularly in patients with a small chest circumference. CCRCA is an ideal body index for appropriately adjusting tube current in CTCA for individualized radiation dose control.

Objective: Chronic HBV infection can lead to "immune tolerance" in asymptomatic carriers (ACs), "immune injury" in active chronic hepatitis (ACH) patients or "immune abnormality" in cirrhosis (Cir) and hepatocellular carcinoma (HCC) patients. Previous investigations reported that chronic hepatitis presented abnormal expression of costimulatory molecules. We investigated the costimulation profile in the liver of ACs and patients with ACH, Cir and HCC., Methods: Patients with ACH, Cir and HCC, ACs and normal controls were recruited into the present study. The costimulation profiles and cytokines in the liver of patients were investigated by Western blotting, immunohistochemistry and real-time quantitative PCR. Correlations between serum alanime aminotransferase (ALT) levels, necroinflammation scores, cytokines and costimulatory proteins were assessed., Results: The ACs presented decreased inflammatory and increased inhibitory costimulation, which was negatively correlated with inflammatory costimulatory proteins and ALT, whereas the ACH patients exhibited increased inflammatory costimulation and decreased inhibitory costimulation, which was correlated with increased ALT. The Cir patients showed both increased inhibitory and inflammatory costimulation. The HCC patients exhibited both decreased inhibitory and inflammatory costimulation., Conclusion: Costimulation participates in intrahepatic immune responses, and plays important roles in immune tolerance, immune injury and immune abnormalities in patients with chronic HBV infection.

Objective: To explore the antitumor effects of 2-deoxyglucose (2-DG) plus docetaxel (Doc) on PC3 and DU145 cells and its mechanism., Methods: The proliferation of cells was detected by methyl thiazolyl tetrazolium (MTT) assay. Then propidium iodide (PI) staining measured apoptotic cells on flow cytometry. ATP assay kit was used to detect ATP content. The expressions of proteins ubiquitinated protein (Ub) and Hsp70 were measured by Western blot., Results: 2-DG could inhibit proliferation of PC3 and DU145 cells in a dose- and time-dependent manner. However, it could not induce apoptosis in PC3 or DU145. The inhibition rates for PC3 proliferation at 48 h by Doc with concentrations of 0.1, 0.5, 2.5 nmol/L were 10.71%, 25.32% and 56.46% respectively. The inhibition rates for DU145 cell proliferation at 48h by Doc with concentrations of 0.1, 0.5, 2.5 nmol/L were 12.28%, 23.94% and 63.43% respectively. The inhibition rates for PC3 cell proliferation by Doc plus 2-DG with a concentration of 1.0 g/L were 27.15%, 58.74% and 87.95% respectively and 29.53%, 59.41%, and 90.48% for DU145 respectively. 2-DG could enhance the effectiveness of inhibition to PC3 and DU145 proliferation by Doc with a synergistic manner (all q>1.15). The apoptotic rates for PC3 and DU145 induced by Doc 0.5 nmol/L plus 2-DG 1.0 g/L at 48 h were 46.49% and 53.64% respectively. The apoptotic rates were significantly higher than Doc 0.5 nmol/L alone (21.30% for PC3 and 18.92% for DU145 respectively) (P < 0.05). The ATP relative concentration for PC3 in 2-DG 1.0 g/L at 0, 12, 24, 48, and 72 h were 13.75, 11.23, 10.19, 9.81 and 9.02 and for DU145 15.00, 12.59, 11.38, 10.54 and 10.37 respectively. Simultaneously, Western blot showed that Ub and Hsp70 protein were expressed intensively., Conclusions: 2-DG can enhance the sensitivity of androgen-independent prostate cancer cells to docetaxel. Its mechanism may be associated with the decrease of proteasome function.

Background: In Taiwan, the prevalence of head and neck cancer is relatively high. Because radiation-associated carotid stenosis is a significant risk factor for stroke, carotid artery stenting (CAS), instead of carotid endarterectomy, is indicated in patients with radiation-associated carotid stenosis. We sought to evaluate the effect of neck radiotherapy (XRT) on the long-term outcome of patients undergoing CAS., Methods: From March 2001 to November 2011, 147 CAS procedures were performed on 129 patients (n = 43 for XRT, n = 86 for non-XRT). Mean follow-up was 42.7 ± 20.5 months (median: 52 months; range: 1-60 months). Duplex velocity criterion for > 50% restenosis after CAS was defined as peak systolic velocity > 175 cm/s. Endpoints included 5-year freedom from mortality, ipsilateral recurrent stroke, and major adverse cardiovascular events (MACE)., Results: The mean age of XRT patients was significantly lesser than that of non-XRT patients (61 ± 8 vs. 71 ± 8, p < 0.001). There was significantly less coronary artery disease and other cardiovascular co-morbidities in XRT patients. No significant differences were noted in the composite 30-day ipsilateral stroke/myocardial infarction/mortality (XRT: 8.6% vs. non-XRT: 6%, p > 0.05) and 5-year freedom from mortality, ipsilateral recurrent stroke, and MACE (p > 0.05) between the two groups. Intra-stent carotid restenosis > 50% was significantly higher in the XRT group on follow-up., Conclusion: Long-term outcomes of CAS for radiation-associated stenosis were not altered by a history of neck XRT, except for asymptomatic carotid restenosis.

Background: The perioperative aortic dissection (AD) rupture is a severe event after endovascular stent graft placement for treatment of type B AD. However, this life-threatening complication has not undergone systematic investigation. The aim of the study is to discuss the reasons of AD rupture after the procedure., Methods: The medical record data of 563 Stanford type B AD patients who received thoracic endovascular repair from 2004 to December 2011 at our institution were collected and analyzed. Double entry and consistency checking were performed with Epidata software., Results: Twelve patients died during the perioperation after thoracic endovascular repair, with an incidence of 2.1%, 66.6% were caused by aortic rupture and half of the aortic rupture deaths were caused by retrograde type A AD. In our study, 74% of the non-rupture surviving patients had the free-flow bare spring proximal stent implanted, compared with 100% of the aortic rupture patients (74% vs. 100%, P = 0.213). The aortic rupture patients are more likely to have ascending aortic diameters = 4 cm (62.5% vs. 9.0%, P = 0.032), involvement the aortic arch concavity (62% vs. 27%, P = 0.041) and have had multiple stents placed (P = 0.039)., Conclusions: Thoracic AD endovascular repair is a safe and effective treatment option for AD with relative low in-hospital mortality. AD rupture may be more common in arch stent-graft patients with an ascending aortic diameter = 4 cm and with severe dissection that needs multi-stent placement. Attention should be paid to a proximal bare spring stent that has a higher probability of inducing an AD rupture. Post balloon dilation should be performed with serious caution, particularly for the migration during dilation.

Purpose: To reduce radiation dose for retrospective ECG-triggered helical 256-slice CTCA by determining an optimal body size index to prospectively adjust tube current., Methods: 102 consecutive patients with suspected CAD underwent retrospective ECG-triggered CTCA using 256-slice CT scanner. Six body size indexes including BMI, nipple level (NL) bust, thoracic anteroposterior diameter at NL, chest circumference (CC) at NL, left main and right coronary artery (RCA) origin level were measured and their correlation with noise was evaluated using linear regression. An equation was developed to use this index to adjust tube current. Additional 102 consecutive patients were scanned with the index-based mAs adjustment. A t-test for independent samples was used to compare radiation dose levels with and without the index-based mAs selection method., Results: Linear regression indicated that CC RCA had the best correlation with noise (R2=0.603). Effective radiation dose was reduced from 16.6±0.9 to 9.8±2.7 mSv (p<0.01), i.e. 40.9% lower dose with the CC RCA-adapted tube current method. The image quality scores indicated no significant difference with and without the size-based mAs selection method., Conclusion: An accessible measure of body size, such as CC RCA, can be used to adapt tube current for individualized radiation dose control., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Objectives: To explore the feasibility of evaluating the aortopulmonary collateral flow (APCF) and pulmonary vascular growth of patients who underwent bidirectional Glenn shunting (BGS) using phase-contrast magnetic resonance imaging (PC-MRI) and contrast-enhanced magnetic resonance imaging (CE-MRI)., Methods: Blood flow measurements of the great vessels of the body were recorded in 22 post-BGS patients using 3.0 T PC-MRI. Right and left pulmonary blood flow (Q(P)), stroke volume (SV) of the ascending aorta (Q(S)), blood flow of descending aorta (Q(d)) and venous return of the superior and inferior venae cavae (Q(V)) per minute were calculated using the Report Card software. APCF was equal to the difference between Q(S) and Q(V). The parameters for pulmonary vascular growth were assessed using CE-MRI. The relationship between pulmonary vascular growth and APCF was evaluated using correlation analysis. A comparative analysis was conducted between the MRI results and the results of five cases who underwent cardiac catheterization and 10 cases who underwent angiography., Results: Estimated APCF ranged from 0.23 to 1.63 l/(min/m(2)), accounting for 5-44% of Q(S). Morphologic abnormalities such as pulmonary stenosis, dilatation and thrombosis were clearly visualized through CE-MRI. Significant differences in individual pulmonary artery growth were observed. A significant negative correlation was found between APCF and the pulmonary artery index (PAI; r = -0.461, P = 0.031) when the McGoon rate was 2.04 ± 0.59 and the PAI was 253.27 ± 85.86 mm(2)/m(2). Good consistency or relativity was found between cardiac catheterization, angiography and MRI., Conclusions: Assessing the APCF and parameters for pulmonary vascular growth in patients who underwent BGS is feasible using 3.0 T PC-MRI integrated with CE-MRI, which may play an important role in clinical and therapeutic decision-making and prognostic evaluation.

Introduction: Many tissues express thyroid hormone metabolizing deiodinases that both activate and inactivate thyroid hormones through conversion processes. Many believe that the primary role of thyroid hormone deiodinases is the activation of the prohormone thyroxine (T(4)) to the active hormone triiodothyronine because athyreotic humans can be treated with T(4) alone. In our hands a nonspecific deiodinase inhibitor (iopanoic acid [IOP]) decreased cutaneous cell proliferation in vitro, so we hypothesized that topical IOP would inhibit epidermal proliferation in vivo., Methods: IOP was applied topically to mice. Treatments were applied daily for 1 week. Skin biopsies were either stained for 5-bromo-2-deoxyuridine or flash-frozen to assay for deiodinase activity., Results: Topical IOP resulted in a dose-dependent increase in epidermal proliferation. Assay revealed significant inactivating type 3 deiodinase (Dio3) activity in the epidermis but little or no activating (Dio1 or Dio2) activity. Dio3 activity was decreased 44%±21% in epidermis from mice treated with low-dose IOP and 80%±4% in epidermis from mice treated with high-dose IOP (p<0.001)., Conclusion: We hypothesize that keratinocytes express Dio3 in vivo to maintain cutaneous health and prevent the skin from becoming hyperproliferative. Our data support the developing recognition that the primary role of thyroid hormone deiodinases in some tissues may be the degradation of thyroid hormone to protect the tissue against thyrotoxicosis.

Background: There are a limited number of reports on the technical and clinical feasibility of prospective electrocardiogram (ECG)-gated multi-detector computed tomography (MDCT) in infants with congenital heart disease (CHD)., Objective: To evaluate image quality and radiation dose at weight-based low-dose prospectively gated 256-slice MDCT angiography in infants with CHD., Materials and Methods: From November 2009 to February 2010, 64 consecutive infants with CHD referred for pre-operative or post-operative CT were included. All were scanned on a 256-slice MDCT system utilizing a low-dose protocol (80 kVp and 60-120 mAs depending on weight: 60 mAs for ≤ 3 kg, 80 mAs for 3.1-6 kg, 100 mAs for 6.1-10 kg, 120 mAs for 10.1-15 kg)., Results: No serious adverse events were recorded. A total of 174 cardiac deformities, confirmed by surgery or heart catheterization, were studied. The sensitivity of MDCT for cardiac deformities was 97.1%; specificity, 99.4%; accuracy, 95.9%. The mean heart rate during scan was 136.7 ± 14.9/min (range, 91-160) with a corresponding heart rate variability of 2.8 ± 2.2/min (range, 0-8). Mean scan length was 115.3 ± 11.7 mm (range, 93.6-143.3). Mean volume CT dose index, mean dose-length product and effective dose were 2.1 ± 0.4 mGy (range, 1.5-2.8), 24.7 ± 5.9 mGy·cm (range, 14.7-35.8) and 1.6 ± 0.3 mSv (range, 1.1-2.5), respectively. Diagnostic-quality images were achieved in all cases. Satisfactory diagnostic quality for visualization of all/proximal/distal coronary artery segments was achieved in 88.4/98.8/80.0% of the scans., Conclusion: Low-dose prospectively gated axial 256-slice CT angiography is a valuable tool in the routine clinical evaluation of infants with CHD, providing a comprehensive three-dimensional evaluation of the cardiac anatomy, including the coronary arteries.

At present, eszopiclone and zolpidem are the most commonly prescribed drugs for treating insomnia. Despite the established relationship between sleep disturbance and anxiety, it remains unknown whether targeted treatment for insomnia may affect acute anxiety. Therefore, the objective of this study was to examine the effects of three different doses (1, 3, and 10mg/kg) of eszopiclone and zolpidem on the states of sleep and wakefulness, levels of anxiety-like behavior, and long-term contextual memory in footshock-induced anxious rats. The results of this study demonstrated that the administration of eszopiclone and zolpidem both were equally effective in attenuating footshock stressor-induced suppression of slow-wave sleep (SWS). The administration of eszopiclone at 1mg/kg or zolpidem at 1 and 3mg/kg doses showed a tendency for attenuating stressor-induced suppression of REM sleep. However, the REM sleep attenuating effects of these drugs disappeared when they were administered at higher doses. The administration of eszopiclone at 3 and 10mg/kg doses and zolpidem at all three doses reduced the power of electroencephalographic theta band frequencies during wakefulness. In addition, the administration of eszopiclone at 1 and 3mg/kg doses suppressed stressor-induced anxiety-like behavior. The administration of zolpidem at 1, 3, or 10mg/kg doses was not effective in attenuating stressor-induced anxiety-like behavior. Contextual memory after administration of eszopiclone at 1mg/kg dose had no effects, but was reduced significantly with increased dosage. Contextual memory after administration of zolpidem, at all three doses, was severely disrupted. The results of this study suggest that eszopiclone at a low dose could be used effectively to control anxiety and anxiety-induced insomnia.

Objective: To assess the efficacy and safety of intravascular ultrasound (IVUS)-guided interventional therapy for borderline lesions in patients with acute coronary syndrome (ASC)., Methods: Thirty-one ASC patients with borderline lesions (coronary artery stenosis between 40%-70% confirmed by coronary arteriography [CAG]) and a minimal lumen area (MLA) of the infarction related artery(IRA) < or =4.0 mm(2) shown by IVUS underwent percutaneous coronary intervention (PCI). Another 31 PCI cases without IVUS were also enrolled as the control group. The minimal luminal diameter, cross section luminal area, total cross section, plaque area and area stenosis rate were measured before and after stent deployment at a conventional or higher pressure in the IVUS group. All the patients were followed up for 10-12 months and clinically evaluated 1, 3, 6 month and 12 months after the procedure to collect the data of angina recurrence, myocardial infarction and revascularization., Results: All the 31 cases were successfully stented with satisfied CAG results (with residual stenosis <0, TIMI flow grade III) and without dissection or any related complications. Among the 32 stents, 28 showed insufficient adherence or underexpansion (stent malapposition) to require 18-20 atm dilation or another high pressure balloon to attain the adequate IVUS results. CAG and IVUS were repeated in 22 patients (70.97%) of the IVUS group during the 10 to 12 months of follow up. No stent restenosis occurred with the in-stent diameter late loss >50%, nor was in-stent thrombus found by IVUS. Endomembrane proliferation was found but without any significant difference. Minimal stent lumen area were not significantly different from the immediate results after PCI (10.12-/+1.15 mm(2) vs 8.98-/+2.12 mm(2), P>0.05). The 31 patients in the control group were successfully stented with satisactory CAG results, but 3 suffered angina at 3-6 months who showed stent restenosis and insufficient stent adherence., Conclusion: IVUS can more effectively guide the interventional therapy for ACS borderline lesions and assess the immediate efficacy of therapy than CAG. Post-dilation with higher pressure (16-20 atm) guided by IVUS can further improve the procedural results. IVUS-guided PCI for ACS borderline lesions ensures high immediate and long-term success rate.

Previous studies have shown that two-way active avoidance (TWAA) memory processing involves a functional interaction between the pontine wave (P wave) generator and the CA3 region of the dorsal hippocampus (DH-CA3). The present experiments examined whether the interaction between P wave generator activity and the DH-CA3 involves the intracellular protein kinase A (PKA) signaling system. In the first series of experiments, rats were subjected to a session of TWAA training followed immediately by bilateral microinjection of either the PKA activation inhibitor (KT-5720) or vehicle control into the DH-CA3 and tested for TWAA memory 24 h later. The results indicated that immediate KT-5720 infusion impaired improvement of TWAA performance. Additional experiments showed that KT-5720 infusion also blocked TWAA training-induced BDNF expression in the DH-CA3. Together, these findings suggest that the PKA activation and BDNF expression in the DH-CA3 is essential for the improvement of TWAA memory.

Unlabelled: To evaluate the detection rate of myocardial bridging by 64-slice spiral CT coronary angiography., Methods: The data of 3011 patients with suspected coronary artery disease undergoing 64-slice spiral CT coronary angiography were collected and analyzed retrospectively., Results: A total of 174 cases (5.8%) with myocardial bridging were detected by 64-slice spiral CT coronary angiography, among which 168 (96.6%) had single foci of involvement and 6 (3.4%) had were multiple foci. Involvement of the left anterior descending coronary artery (LAD) was detected in 167 out of the 174 cases (96.0%). The length of the myocardial bridge varied between 5 and 120 mm (mean of 30.5 mm), and the depth of the tunneled artery ranged between 1.3 and 2.8 mm (mean 2.3 mm). Seventy-nine of the cases (45.4%) had uncomplicated myocardial bridging and 95 (54.6%) had myocardial bridging complicated by coronary atherosclerosis., Conclusion: Multi-slice spiral CT coronary angiography is a reliable and noninvasive modality for diagnosis of myocardial bridging to allow direct measurement of the length and depth of the myocardial bridge and detection of concurrent coronary and cardiac lesions.

Objective: To explore the geomorphological performance, the characteristics of volume, and the largest signal intension of blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI) in brain tumors located in or closed to the central area., Methods: We recruited 13 normal volunteers and 31(13 benign tumors and 18 malignant tumors) patients with brain tumor located in or closed to the central area, to examine both side hand motor and tactile function by BOLD-fMRI and obtained the activation map and its superposition image with T1 imaging, the volume, and the largest signal intension of the functional area by SPM software which manipulated the raw data in the off-line work station. The volume and the largest signal intension data of the functional area were statistically analyzed by SPSS 13.0., Results: The volume and the largest signal intension of the activation map in the normal functional area had hemisphere advantage. There was difference in the activated signal pixel number and the largest signal intension of the functional area between the benign brain tumors, malignant brain tumors, and the normal volunteers (P < 0.05). The shape, anatomic location, the volume, and the largest signal intension of the functional area were changed in the patients with brain tumors., Conclusion: BOLD-fMRI is a valid method to assess the pre-surgical risk of patients with brain tumors, which can get the volume, the largest signal intension, the basic shape,and the anatomic location of the functional area.