AC Group Research Articles

A Comparative Study of Amide Proton Transfer Weighted Imaging and Intravoxel Incoherent Motion MRI Techniques Versus (18) F-FDG PET to Distinguish Solitary Pulmonary Lesions and Their Subtypes.

Amide proton transfer weighted imaging (APTw), intravoxel incoherent motion (IVIM), and positron emission tomography (PET) imaging all have the potential to characterize solitary pulmonary lesions (SPLs). To compare APTw and IVIM with PET imaging for distinguishing between benign and malignant SPLs and their subtypes. Prospective. Ninety-five patients, 78 with malignant SPLs (including 48 with adenocarcinoma [AC] and 17 with squamous cell carcinoma [SCC]), and 17 with benign SPLs. Fast spin-echo (FSE) T2WI, FSE APTw and echo-planar imaging IVIM, MR-base attenuation correction (MRAC), and PET imaging on a 3-T whole-body PET/MR system. The magnetization transfer ratio asymmetry (MTRasym) at 3.5 ppm, diffusion coefficient (D), pseudo diffusion coefficient (D*), perfusion fraction (f), and the maximum standardized uptake value (SUVmax) were analyzed. Individual sample t-test, Delong test, Pearson's correlation analysis, and area under the receiver operating characteristic curve (AUC). P < 0.05 indicated statistical significance. The MTRasym and SUVmax were significantly higher, and D was significantly lower in the malignant group (3.3 ± 2.6 [%], 7.8 ± 5, and 1.2 ± 0.3 [×10-3 mm2 /second]) compared to the benign group (-0.3 ± 1.6 [%], 3.1 ± 3.8, and 1.6 ± 0.3 [×10-3 mm2 /second]). The MTRasym and D were significantly lower, and SUVmax was significantly higher in the SCC group (0.8 ± 1.0 [%], 1.0 ± 0.2 [×10-3 mm2 /second] than in the AC group (4.1 ± 2.6 [%], 1.3 ± 0.3 [×10-3 mm2 /second], 6.7 ± 4.6). Besides, the combination (AUC=0.964) of these three methods showed higher diagnostic efficacy than any individual method (AUC=0.917, 0.851, 0.82, respectively) in identifying malignant and benign SPLs. However, APTw showed better diagnostic efficacy than the combination of three methods or PET imaging alone in distinguishing SCC and AC groups (AUC=0.934, 0.781, 0.725, respectively). APTw, IVIM, and PET imaging are all effective methods to distinguish benign and malignant SPLs and their subtypes. APTw is potentially more capable than PET imaging of distinguishing lung SCC from AC. 2 TECHNICAL EFFICACY: Stage 2.

Analysis of the Reactivity of Aspirin and Clopidogrel and Its Influencing Factors in Patients with Coronary Heart Disease at High Altitude.

Objective To evaluate the efficacy of dual-antiplatelet treatment (DAPT) in patients with coronary heart disease (CHD) at high altitude by using thrombelastogram (TEG) and to analyze the related biochemical factors affecting drug reactivity. Methods Totally 118 CHD patients who admitted to the Qinghai People's Hospital from September 2019 to September 2020 were enrolled in the group. Those people have lived in Qinghai for a long time. Seven days after DAPT, venous blood was collected on an empty stomach in the early morning of the next day; blood routine, coagulation function, and biochemical items were tested. Thrombelastogram (TEG) was used to draw curves to calculate platelet, coagulation and fibrinolysis functions, and drug inhibition rate. Patients were divided into the aspirin resistance (AR) group, clopidogrel resistance (CR) group, dual-antiplatelet drug resistance (DAR) group, and drug-sensitive group according to different inhibition rates. The drug efficacy was analyzed, and the clinical data, biochemical indexes, and TEG parameters of each group were compared to identify the risk factors of drug resistance. Results Those 118 CHD patients at high altitude were incorporated into the study, ranging from 38 to 84 years of age, including 81 males (68.64%) and 37 females (31.36%). The platelet function and coagulation-fibrinolysis function were detected by TEG, and MATHROMBI, MAADP, and MAAA were higher than the reference range. There were 82 cases (69.49%) of drug resistance, 36 cases (32.53%) of drug sensitivity, 17 cases (14.41%) of AR alone, and 16 cases (12.71%) of CR alone. There was no significant difference in age, gender, BMI, oxygen saturation, TG, GFR, and history of diabetes and hypertension between ACS and CCS groups (P > 0.05). PLT and FIB in the ACS group were higher than those in the CCS group, and the difference was statistically significant (P < 0.05). In addition, MATHROMBIN, MAFIBRIN, E, A, A30, and coagulation composite index were also higher than those in the CCS group, with a statistically significant difference (P < 0.05). Univariate analysis and logistic regression analysis suggested that age, HbA1c, FBG, and diabetes were the main factors of drug resistance. Conclusion Antiplatelet drugs aspirin and clopidogrel resistance are associated with increased age, elevated HbA1c and FBG, and diabetes. Therefore, it is necessary to take reasonable treatment measures based on the actual situation of patients.

Antioxidative and immunological response of shrimp Litopenaeus vannamei to combined stress of acute cold exposure and waterless duration: Implications for live transport

High mortality is a common phenomenon for live transport of shrimp Litopenaeus vannamei, and the biochemical mechanism underlying mortality remains incompletely known. This investigation explored the effect of combined stress of acute cold exposure (AC) and waterless duration (WD) on survivability, oxidative stress, antioxidative and immunity defence responses, and histological impairments. The survival profiles showed no significant difference between normal control (NC) and AC groups. The shrimps exposed to AC + WD stress, however, exhibited significantly higher mortality (p < 0.05) since 6 h afterwards, and the median survival probability was observed at 10.46 h. Overall, both the homeostasis of antioxidative and immunological response were disturbed in a duration time-dependent manner, and the impairment on hepatopancreas was observed. Significantly, the indicators of total haemocyte count (THC), viable haemocyte count (VHC) and peroxidase (POD) decreased while the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), total antioxidant capacity (T-AOC), phenol oxidase (PO), alanine transaminase (ALT) and aspartate transaminase (AST) increased (p < 0.05). Together, correlation analyses indicated that high mortality of L. vannamei was resulted from the disorder of antioxidative and immunological response. This study deepens our understanding into mortality of L. vannamei during waterless live transport.

Instantaneous wave-free ratio for the assessment of nonculprit lesions in patients with acute coronary syndrome

Abstract Background A physiological assessment with the fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR) is strongly recommended by the European Guidelines of Revascularization to guide percutaneous coronary intervention (PCI) decision making in intermediate coronary stenosis. However, data supporting its use in the pro-inflammatory setting of ACS is weak. Purpose To analyze the usefulness of a physiological coronary evaluation with iFR of nonculprit lesions in patients with ACS. Methods Retrospective multicenter study including patients with ACS and underwent successful revascularization of the culprit vessel and had other nonculpritlesions physiologically evaluated with the iFR between January 2017 and December 2019. The primary endpoint was a composite of cardiac death, nonfatal myocardial infarction, stent thrombosis and new revascularization (MACEs). Results A total of 356 patients with 472 nonculprit lesions were included. The mean age was 66±11 years. The clinical presentation was non-ST-segment elevation myocardial infarction (NSTEMI) in 235 patients and ST-segment elevation myocardial infarction (STEMI) in 121 patients. After a mean follow-up period of 22±10 months, the primary endpoint occurred in 32 patients (9%). There were no differences in outcomes regarding iFR induced treatment strategy (patients with all lesions revascularized vs. patients with at least one lesion deferred for revascularization, 10.5 vs 8.4%, p=0.476). Conclusion The use of the iFR to guide percutaneous coronary intervention decision making in nonculprit lesions seems to be safe, with an acceptable percentage of MACEs at the mid-term follow-up. Funding Acknowledgement Type of funding sources: None. FlowchartSurvival curves by iFR and ACS group

Adoption of a new automated optical coherence tomography software to obtain a lipid plaque spread-out plot

Abstract Background Near infrared spectroscopy – intravascular ultrasound (NIRS-IVUS) imaging can provide a fully automated estimation of lipid burden, providing a two-dimensional spread-out plot, the Lipid Core Burden Index (LCBI), which has been associated with higher incidence of cardiac events. Optical coherence tomography (OCT) can identify lipid component with high accuracy and it is therefore potentially capable of measuring its longitudinal extension in a dedicated two-dimensional LCBI spread-out plot. Purpose The present study has been designed to validate a novel automated approach to assess OCT images, able of providing a dedicated LCBI spread-out plot plus other features of plaque vulnerability. Methods We compared the results obtained with a novel automated OCT alghorithm, developed utilising a convolutional neural network, with those obtained with conventional (manual) OCT and with NIRS-IVUS in a consecutive series of 40 patients with coronary artery disease. We tested and validated our new OCT algorithm to calculate the lipid core longitudinal extension in a dedicated two-dimensional LCBI spread-out plot. In each coronary plaque, the following measurements were obtained with NIRS-IVUS: 1) minimum lumen area (MLA), 2) vessel area at MLA site, 3) plaque burden (%) at MLA site, 4) NIRS-defined lipid pool arch and 5) maximum LCBI measurement within a 4 mm length. The following OCT features were obtained: 1) the MLA cross section, 2) the minimum fibrous cap thickness (FCT) in presence of lipid components and measured as the average of three measurements obtained in the same cross-section and 3) maximum LCBI within a 4 mm length. Results Three lesions groups were identified according to the studied lesions: 1) culprit lesions in patients with acute coronary syndrome (ACS, n=16), 2) non-culprit lesions in patients with ACS (n=12) and 3) lesions in patients with stable angina (n=12). OCT conventional assessment showed for the culprit ACS plaques a trend for a larger lipid arc and a significant thinner FCT (p=0.028). Consistently, NIRS-IVUS showed for culprit ACS plaques a more complex anatomy. A strong trend for increased maximum LPBI in 4mm segments was found in the culprit ACS group, regardless of the adopted imaging modality, either NIRS-IVUS or automated OCT (p=0.184 and p=0.066, respectively, figure 1). A fair correlation was obtained for the maximum 4 mm LCBI measured by NIRS-IVUS and automated OCT (r=0.75). The sensitivity and specificity of automated OCT to detect significant LCBI, applying a validated 400 cut off were 90.5 and 84.2 respectively. Conclusions We developed an automated approach, comparable to NIRS, to assess OCT images that can provide a dedicated lipid plaque spread-out plot to address plaque vulnerability. The automated OCT software can promote and improve OCT clinical applications for the identification of patients at risk of hard events. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): CLI - Centro Lotta all'Infarto Spread-out plot by IVUS-NIRS and OCT

The Dynamic Effect of Non-CYP3A4-Metabolized and CYP3A4-Metabolized Statins on Clopidogrel Resistance in Patients With Cerebral Infarction.

Objective: To explore the treatment effect of statins used together with clopidogrel on cerebral infarction (CI). Methods: One hundred and thirty non-clopidogrel resistant patients were divided into a dynamic clopidogrel resistant (DCR) group and a continuous Non clopidogrel resistance (NCR) group. Patients were randomly assigned to AC group (atorvastatin 40 mg/d + clopidogrel, 51 patients) and RC group (rosuvastatin 20 mg/d + clopidogrel, 47 patients). The patient’s platelet aggregation rate (PAR) was measured on visit 0 (baseline), visit 1 (1 week after clopidogrel alone treatment), and visits 2 to 4 (one, three, and 6 months after clopidogrel plus statins treatment). The platelet reactivity index (PRI) was assessed on visits 0, 2, and 4, and clopidogrel thiol metabolite (H4) levels was measured on visits 2 and 4. DNA sequencing was used to determine CYP3A4, CYP2C9, and CYP2C19 genotypes in all patients. Results: PAR, PRI, and H4 levels, DCR ratio, and the genotype frequencies of CYP2C9*3εC, CYP2C19*2εA, and CYP2C19*3εA of both groups were similar (p > 0.05). CYP2C19εA *2 and *3 were independent risk factors for DCR (p < 0.05). Conclusion: Clopidogrel combined with atorvastatin does not affect platelet inhibition and does not increase the incidence of DCR. The incidence of DCR in the Chinese population is high and is related to CYP2C19εA.

S686 Gastrointestinal Bleeding Risk and Endoscopy Utilization in COVID-19 Patients on Therapeutic Anticoagulation: A Multicentric Study

Introduction: Patients affected with coronavirus disease 2019 (COVID-19) can lead to severe hypercoagulability. Many of these patients receive therapeutic anticoagulation because of a very high risk of thromboembolism. However, data about the risk of gastrointestinal bleeding (GIB) in these patients on therapeutic anticoagulation is scarce. Additionally, endoscopy utilization among these GIB patients need further studies. This study aims to evaluate the rates of GIB bleeding in COVID-19 patients and the endoscopy utilization for the same from a national research network database. Methods: We used a federated cloud-based network database named TriNetX, comprising of 50 healthcare organizations (HCOs) across the US to identify all adults patients who were on therapeutic anticoagulation (warfarin, therapeutic dose-heparin [enoxaparin, unfractionated heparin], direct thrombin inhibitors, direct-acting factor Xa inhibitors 3-months prior to COVID-19 diagnosis. Patients with the use of anticoagulants for thromboprophylaxis were excluded. Patients with the above characteristics were studied from January 1, 2020, to June 15, 2021, were divided into the anticoagulation (COVID with AC) and without anticoagulation (COVID w/o AC) groups. The primary outcomes were rates of GIB (melena/hematemesis), inpatient hospitalizations, endoscopy (EGD/colonoscopy) utilization, number of packed red blood cell (PRBC) transfusions, and 30-day all-cause mortality. The outcomes were measured after 1:1 propensity matching of the groups based on the baseline demographics and comorbidities. Results: A total of 104,946 patients in COVID with AC and 591,273 patients in COVID w/o AC groups were compared. The patient comorbidities at presentation, laboratory findings, and clinical outcomes are noted in Table 1. After matching, COVID with AC patients had a higher risk of GIB (risk ratio [RR]- 1.62 (CI- 1.45 - 1.82)), inpatient hospitalization rates (RR- 4.53 (CI- 4.42 - 4.65)), PRBC transfusions (RR 3.67 (CI-3.35 - 4.02)), overall mortality (RR 3.93 (3.75 - 4.12)). Despite the increased presence of GIB, endoscopy utilization was lower (RR- 0.85 (0.78 - 0.93)). Conclusion: Rates of GIB, inpatient hospitalization, and overall mortality increased in COVID-19 patients on therapeutic anticoagulation. However, endoscopy utilization remained low, probably due to fear of infection transmission. If the increased mortality is related to the underlying severity of COVID-19 or unidentified comorbidities need to be further evaluated.Table 1.: Mortality in MDS patients with GI bleed (OR).Figure 1.: Risk of UGIB with and without SSRI Use Footnote: Forest Plot depicting OR of having UGIB with and without SSRI use in patients on NSAIDs.

Antenatal corticosteroids and neurodevelopmental outcomes in late preterm births

ObjectivesAntenatal corticosteroids (ACS) decrease neonatal mortality and morbidity among preterm neonates, yet there has been concern regarding their long-term safety. We hypothesised that potential long-term adverse effects of ACS may...

Clinical effect of peripheral capsule preservation in eyes with silicone oil tamponade.

BACKGROUNDAt present, silicone oil has been widely used in vitrectomy to deal with complex fundus diseases. Usually, cataract extraction is combined with vitrectomy. However, reducing the complications of silicone oil tamponade and facilitating the secondary implantation of intraocular lens (IOL) are still an urgent problem.AIMTo evaluate the clinical effect of vitrectomy combined with peripheral capsule preservation (PCP) in eyes with silicone oil tamponade.METHODSThis single-center retrospective analysis included 70 patients (73 eyes) who underwent vitrectomy and silicone oil tamponade combined with cataract surgery (stage I) between January 2015 and July 2019. All patients underwent selective reoperation for silicone oil extraction and IOL implantation (stage II) more than 3 mo after stage I. These patients were divided into three groups according to the different lens capsule preservation methods: 28 patients (31 eyes) in a whole capsule preserved (WCP) group, 17 (17 eyes) in a capsule absent (CA) group, and 25 (25 eyes) in a peripheral capsule preserved (PCP) group. Intraocular pressure (IOP), best-corrected visual acuity, surgery time, and other complications were recorded at each time point (1 d, 1 wk, and 1 mo after stages I and II).RESULTSThe IOP values were 14.9 ± 8.2 mmHg in the WCP group, 20.3 ± 13.0 mmHg in the CA group, and 14.2 ± 9.7 mmHg in the PCP group (P < 0.05) at 1 mo after stage I operation. Five eyes had IOP higher than 30 mmHg, and one eye in the WCP group appeared to have silicone oil entering the anterior chamber. There was no significant difference in IOP among the three groups at any other time point (P > 0.05). With IOL implantation, visual acuity improved significantly compared to stage I. The incidence rate of posterior capsule opacity was higher in the WCP group than in the other groups (P < 0.001). In the CA group, IOL deviation due to suture relaxation occurred in one case. There was no significant difference in the surgery time among the three groups in stage I (P = 0.618). In stage II, the surgery time of the PCP group and WCP group was significantly shorter than that of the AC group (P = 0.031).CONCLUSIONPreservation of the peripheral capsule in vitrectomy combined with lens removal is a better option. This method has significant advantages in reducing intraoperative and postoperative complications.

Atractylodes chinensis Water Extract Ameliorates Obesity via Promotion of the SIRT1/AMPK Expression in High-Fat Diet-Induced Obese Mice.

Obesity remains a continuing global health concern, as it is associated with an increased risk of many chronic diseases. Atractylodes chinensis Koidz. (Ac) is traditionally used in the treatment of inflammatory diseases, such as arthritis, hepatitis, and gastric ulcers. Despite the diverse pharmacological activities of Ac, scientific evidence for the use of Ac in obesity is still limited. Therefore, the present study aimed to determine the anti-obesity effects of Ac. C57BL/6N mice were divided into five groups as follows: chow diet group (CON), 45% HFD group, HFD + oral administration of orlistat group, and HFD + oral administration of Ac groups. RT-PCR and western blotting were used to examine the expression of molecules relating to obesity progression. Ac-administered mice showed dramatically decreased body weight and weight gain compared to the high-fat diet (HFD)-fed mice. In addition, Ac administration attenuated the protein expression levels of adipogenic transcription factors in the white adipose tissue (WAT) and livers of HFD-fed mice. Furthermore, Ac administration declined the expression levels of lipogenic genes, while enhancing those of the fatty acid oxidation genes in the WAT of HFD-fed mice. Importantly, Ac administration highly upregulated the AMP-activated kinase (AMPK) and sirtuin 1 (SIRT1) expression levels in WAT of the HFD-induced obese mouse model. Our results provide evidence that Ac can effectively ameliorate weight gain and adipose tissue expansion.

Adult spinal deformity surgery: posterior three-column osteotomies vs anterior lordotic cages with posterior fusion. Complications, clinical and radiological results. A systematic review of the literature.

The aim of our study is to analyse mid- to long-term severe adult spinal deformity (ASD) surgery outcomes by comparing three-column osteotomies (3CO) and multiple anterior interbody fusion cages (AC). The PRISMA flowchart was used to systematically review the literature. Only articles with a minimum 24-month follow-up were examined, and 11 articles were included. The following radiological parameters were observed: pelvic incidence (PI), pelvic tilt(PT), lumbar lordosis (LL), sagittal vertical axis(SVA), Cobb angle and T1-sacrum plumbline. Clinical outcome was assessed using the visual analogue scale(VAS) and Oswestry disability index (ODI)scores. The main complications were analysed, and the two groups were compared. Except for age, the two populations were homogeneous. Both techniques had the same number of posterior instrumented levels (7.4 ± 1.7). The AC group had a mean 3 ± 1.4 interbody fusions per patient. In the PSO group, all patients had 1 3CO and 89.8% of the osteotomies were performed at L2 or L3 vertebrae. No difference was observed between the two groups in terms of clinical outcomes. Both techniques were effective in sagittal parameters restoration with a final PI-LL mismatch = 4.4°. The PSO group had a statistically higher rate of intraoperative blood loss (p = 0.036), major complications, pseudoarthrosis and dural tears (p < 0.001). Both PSO and multiple AC are effective in treating ASD. Multiple AC seems more suitable when treating older patients because of a lower intraoperative blood loss, lower rate of major complications and fewer number of revision surgeries.

Mechanism and Selectivity of Cyclopropanation of 3-Alkenyl-oxindoles with Sulfoxonium Ylides Catalyzed by a Chiral N,N'-Dioxide-Mg(II) Complex.

The mechanism and stereoselectivity of an asymmetric cyclopropanation reaction between 3-alkenyl-oxindole and sulfoxonium ylide catalyzed by a chiral N,N'-dioxide-Mg(II) complex were explored using the B3LYP-D3(BJ) functional and the def2-TZVP basis set. The noncatalytic reaction occurred via a stepwise mechanism, with activation barriers of 21.6-23.5 kcal mol-1. The C2-Cα bond formed followed by the carbanion SN2 substitution, constructing a three-membered ring in spiro-cyclopropyl oxindoles, accompanied by the release of dimethylsulfoxide. The electron-withdrawing N-protecting t-butyloxy carbonyl (Boc) and acetyl (Ac) groups in isatin enhanced the local electrophilicity of the C2 atom and the repulsion between the two COPh groups in the reactants, contributing to high reactivity as well as good diastereoselectivity results. The N-Boc-3-phenacylideneoxindole coordinated to the chiral ligand (L-PiPr2) in a bidentate fashion, forming a hexacoordinate-Mg(II) complex as the reactive species. The origin of enantioselectivity was from the shielding effect of 2,6-diisopropylphenyl groups in the ligand toward the si-face of oxindole. The repulsion between the SO(CH3)2 and COPh groups in 3-alkenyl-oxindole and the neighboring ortho-iPr group in the ligand directed the re-face of ylide to attack the re-face of oxindole preferably, contributing to the high diastereoselectivity of the product. A metal-ion-ligand matching relationship was important for a good asymmetric induction effect of the chiral N,N'-dioxide-metal catalyst. A large chiral cavity in the Zn(II) catalyst weakened the shielding effect of 2,6-diisopropylphenyl groups in the ligand toward the prochiral face of oxindole, leading to inferior enantioselectivity observed in the experiment.

The Effects Of Long-term Treadmill Running Exercise On Nek7 Expression In Hippocampus Of AD Model Mouse

PURPOSE: The effects of treadmill running for 20 weeks intervention on the memory abilities and the expression of NEK7, IL-1β and IL-10 in hippocampus of Alzheimer's disease (AD) model mouse. METHODS: Twenty male APP/PS1 (three months old) mouse (C57BL/6JNju) were randomly divided into two groups: AD control group (AC, n = 10) and AD exercise group (AE, n = 10). Following acclimation to laboratory conditions for one week. The AE group was intervened by treadmill exercise for 20 weeks (12 m/min, 30 min/day, 5 days/week), the AC group was normally fed for 20 weeks. The Morris water maze experiment lasted for one week at week 20, to evaluate the spatial learning and memory function of the mice. Then brain tissue was taken, immunofluorescence was used to detect IL-1β and IL-10 deposition, and Western Blot were used to detect NEK7 deposition in hippocampus of mouse. The experimental data was reported as mean ± SE, and processed with one-way ANOVA, level of significance was set at α = 0.05. RESULTS: (1) Water maze navigation trial showed that the average escape latency of each group showed a downward trend. Compared with AC group, the decreasing trend of AE group was more significant. In the space exploration experiment, the average frequency of crossing the platform in AC group were significantly less than those in AE group (P < 0.01, AC = 1.48 ± 0.89, AE = 3.89 ± 1.20). (2) Immunofluorescence showed that the expression level of IL-1β of AE group was significantly lower than that of AC group(P < 0.01), but IL-10 of AE group was significantly higher than that of AC group (P < 0.01) in the hippocampus. (3) Western blot results showed that NEK7 expression level in AE group was significantly lower than that in AC group (P < 0.01, AC = 0.45 ± 0.02, AE = 0.19 ± 0.03). CONCLUSION: Long-term treadmill running exercise can improve the spatial learning and memory function of AD model mice. The mechanism may be due to inhibition Nek7 protein, thus inhibition IL-1β, promotion the expression of IL-10. These results indicate that long-term treadmill running exercise alleviation brain inflammation and prevent the impairment of spatial learning and memory function of AD.

Combined stress of acute cold exposure and waterless duration at low temperature induces mortality of shrimp Litopenaeus vannamei through injuring antioxidative and immunological response in hepatopancreas tissue.

High mortality is a frequent occurrence during live transport of shrimp species and the biochemical mechanism remains unknown. This study aimed to explore the influence of combined stress of acute cold exposure (AC) and waterless duration (WD) on survivability and biochemical response of shrimp L. vannamei during live transport. The shrimps in NC and AC groups remained the total survivability throughout the experiment while the shrimps exposed to AC+WD stress exhibited significantly higher mortality since 6h afterwards (P<0.05) and the median survival time was calculated at 10.46h. Moreover, the typical combined stress points at AC+WD3h, AC+WD6h and AC+WD9h were assigned for exploring the immunological and antioxidative responses. For immunity response, the total hemocyte counts (THC) decreased with the prolongation of duration time and the activities of non-specific immunity enzymes such as phenol oxidase (PO), acid phosphatase (ACP), alkaline phosphatase (AKP), aspartate aminotransferase (AST) and alanine transaminase (ALT) were significantly elevated in AC+WD9h groups (P<0.05). Moreover, compared with that in NC group, the significant accumulation of reactive oxygen species (ROS) was observed in AC group and then reduced in combined stress groups (P<0.05), with the highest level of malonaldehyde (MDA) in AC and AC+WD3h groups. Overall, the significant elevation of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and total antioxidant capacity (T-AOC) was detected in AC+WD9h group (P<0.05). Furthermore, the accumulative pathological impairment on hepatopancreas tissue revealed the cytoskeleton degradation. In addition, correlation analyses visualized the correlation between oxidative stress and biochemical response. This study not only deepens our understanding on the biochemical mechanism of shrimp mortality induced by combined stress, but also provides a potential strategy for improving the management of L. vannamei during live transport.

Adoption of a new automated optical coherence tomography software to obtain a lipid plaque spread-out plot.

Near infrared spectroscopy-Intravascular ultrasound (NIRS-IVUS) provide a fully automated Lipid Core Burden Index (LCBI). Optical coherence tomography (OCT) is potentially capable of measuring lipid longitudinal extension in a dedicated two-dimensional LCBI spread-out plot. The present study has been designed to validate an automated approach to assess OCT images, able of providing a dedicated LCBI spread-out plot. We compared results obtained with conventional (manual) OCT, with those obtained with a novel automated OCT algorithm and with NIRS-IVUS in consecutive 40 patients. Our goal was to calculate the lipid core longitudinal extension in a dedicated two-dimensional LCBI spread-out plot. Three groups were identified according to the studied lesions: (1) culprit lesions in ACS patients (n = 16), (2) non-culprit lesions in ACS patients (n = 12) and (3) lesions in stable patients (n = 12). OCT (either manual and automated) and NIRS-IVUS assessment showed for culprit ACS plaques a more complex anatomy. A strong trend for increased LCBI was found in the culprit ACS group, regardless of the adopted imaging modality (either NIRS-IVUS or automated OCT). A fair correlation was obtained for the maximum 4mm LCBI measured by NIRS-IVUS and automated OCT (r = 0.75). The sensitivity and specificity of automated OCT to detect significant LCBI (> 400) were 90.5 and 84.2 respectively. We developed an OCT automated approach that can provide a dedicated lipid plaque spread-out plot to address plaque vulnerability. The automated OCT software can promote and improve OCT clinical applications for the identification of patients at risk of hard events.

Black Chokeberry (Aronia melanocarpa) Functional Beverages Increase HDL-Cholesterol Levels in Aging Rats.

Plant-based foods rich in phenolic phytochemicals are among the promising strategies to counteract age-related changes in lipid profile. Aronia melanocarpa (AM) fruits are a rich source of phenolic compounds possessing lipid-modulating effects. The present study investigated the effect of 3-month supplementation of AM-based functional beverages on the lipid profile of healthy aging rats. Male Wistar rats (n = 40) were separated into five groups: (YC) young controls (2-month-old); (AC) adult controls (13-month-old); (A) adult animals supplemented with pure AM extract; (A + P) adult animals supplemented with pectin-enriched (1%) AM extract; (A + H) adult animals supplemented with AM extract enriched with a herbal mixture. Total cholesterol (TC), triglycerides (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C) and atherogenic indices were investigated at the end of the study. Adult controls demonstrated age-related dyslipidemia resulting in decreased HDL-C, and increased TG and TC/HDL index. The supplemented groups showed a significant increase in HDL-C levels: A + P (1.49 mmol/L) and A + H (1.61 mmol/L), respectively, vs. AC (1.09 mmol/L), p < 0.05. The TC/HDL-C and LDL-C/HDL-C indices were decreased in the A + P and A + H groups in comparison to the AC group (p < 0.05). These results indicate that supplementation with polyphenol-rich AM beverages can successfully alter HDL-C levels and this effect is further potentiated by pectin and herbs.

Do anti-platelet drugs improve duration of continuous renal replacement therapy? A retrospective cohort study in cardiac ICU patients.

The objective of this study was to investigate the impact of anti-platelet drug/s on duration of continuous renal replacement therapy (CRRT) in those patients where anti-coagulants were not used due to certain contraindications and in cases where patients were on anti-platelet drugs and were given anti-coagulant during CRRT. This single-center, retrospective cohort study was conducted using the medical records patients treated with CRRT in the cardiac ICU of the inpatient urban facility, located in North India. Data was collected from only those patients who received CRRT for the duration of at least 12 h. Patient's in NAC group were not on any anti-platelet/s and did not receive anti-coagulant during CRRT. AC and AP group patients received anti-coagulant alone or were already on anti-platelet/s and did not receive anti-coagulant respectively while ACAP group patients were on anti-platelet drug/s and also received anti-coagulant during CRRT. Patients in AC, AP, or ACAP group showed significantly (p < 0.001) higher CRRT filter life compared to NAC group. The median CRRT filter life was significantly higher in the ACAP group compared to AC (p < 0.05) and AP (p < 0.001) groups. This study indicates that systemic anti-platelet therapy can provide additional support in critical patients undergoing CRRT even with or without anti-coagulant therapy. However, the increase in CRRT filter life was more profound in patients who were on anti-platelet/s and also received anti-coagulant drug/s during CRRT.

Effects of cooling systems on physiological responses and intestinal microflora in early gestating sows exposed to high-temperature stress.

This study was conducted to investigate the effect of cooling systems on reproductive performance, body temperature, blood metabolites, and the intestinal microbiome in early gestating sows exposed to high ambient temperature. In total, 39 pregnant sows (Landrace × Yorkshire; 2 parities) were randomly assigned to and maintained in the following three treatment groups (13 sows per group) over days 0 to 35 of pregnancy: (i) air cooling (AC; 26.87 ± 1.23°C), (ii) water-drip cooling (WC; 28.81 ± 0.91°C), and (iii) a lack of cooling with heat stress (HS; 30.72 ± 0.70°C). Backfat thickness was measured before and after HS. Feces were collected on day 0 and 35 d of the trial for microbiome analysis, whereas blood was taken at day 35 of pregnancy and analyzed. Reproductive performance and physiological responses were identified at day 35. Respiration rate along with rectal and skin temperatures were lower (p < 0.05) in the AC group than in the HS and WC groups. Serum blood urea nitrogen values were increased (p < 0.05) in the WC group compared with those measured in the AC and HS groups. Triiodothyronine was found at greater levels (p < 0.05) in the AC than in the HS group. Reproductive performance was not affected by the cooling systems. At the phylum level, fecal pathogenic Spirochaete and Euryarchaeota were found in higher numbers (p < 0.05) in all groups after HS. Similarly, at the genus level, the amount of Treponema was greater (p < 0.05) in all groups after HS. In conclusion, our results suggest that AC or WC can ameliorate or mitigate the adverse effects of HS on the physiological parameters of pregnant sows reared under high temperatures.

Do Sequential Compression Devices Prevent Venous Thromboembolism in Hospital Inpatients?

IntroductionAnticoagulants (AC) are commonly used for primary prevention of venous thromboembolism (VTE) in hospitalized patients. Mechanical methods of VTE prevention such as sequential compression devices (SCD) are used mostly in combination with AC or in patients with high risk of bleeding.ObjectiveTo determine if the use of SCD prevents VTE in medically ill hospitalized patients.MethodsAll Sparrow Main Hospital admissions from 04/01/2015 to 03/31/2016 were included and categorized according to the methods used for prevention of VTE- SCD only (SCD), anticoagulants only (AC), SCD & anticoagulants (BOTH), and none (NONE). We excluded patients less than 18 years of age and those with VTE on admission. Bivariate and multivariate regression analyses were conducted. To control for the selection bias of patients to SCD, AC or BOTH group, we performed propensity score matching. First, the propensity scores for SCD, AC, and BOTH were estimated using logistic regression. The 1-1 optimal matching method was used to find matched controls from patients without treatment. The matched samples are expected to mimic the randomized controlled trial.ResultsWe identified a total of 39,265 eligible patients for our study- 20,220 of them were on SCD for VTE prophylaxis, 2,397 had AC, 5,719 had BOTH, and 10,929 had NONE of the measures (Table 1). Out of them, 0.6% (n=246) developed VTE during their hospital stay- 50 patients in SCD group, 40 in AC, 126 in BOTH, and 20 in NONE group. Among patients in the SCD group, 0.2% developed VTE; 0.1% developed VTE in NONE group. VTE developed in 1.6% of cases in the AC group and 2.2% in BOTH group (Table 1).Among patients without VTE, mean age was 56 years (SD±20.3), 58% were females, and 55% were active/former smokers. Similarly, patients with VTE had mean age of 62.7 (SD± 16.4); 44.5% were females and 52.5% were smokers. Mean length of hospital stay was 4.3 days (SD±5.5) in patients without VTE compared to 11.5 days (SD±12.82).Before propensity score matching, analysis showed that the risk of VTE was not decreased in SCD group compared to NONE group (OR 1.22, 95% CI 0.65-2.29). However, propensity matching analysis actually showed that the odds of developing VTE decreased with SCD compared to NONE (OR 0.26; 95% CI 0.18-0.38).Multivariate analysis showed various cancer types were associated with higher odds of VTE while comparing SCD vs NONE (Table 2). Hodgkin lymphoma had the highest risk among them (OR 11.60; 95% CI 1.45-92.56), followed by esophageal cancer (OR 10.27; 95% CI 1.31-80.18), bladder cancer (OR 8.45; 95% CI 1.94-36.67), colon cancer (OR 5.93; 95% CI 1.36-25.70), myeloma (OR 5.85; 95% CI 1.27-26.86), and leukemia (OR 5.14; 95% CI 1.52-17.41). Increased length of stay also led to increased VTE (OR 1.90; 95% CI 1.64-2.19).ConclusionUse of SCD prevents VTE during hospital stay. However, other confounding factors may also play a significant role. More studies to define role of SCD in VTE prevention are needed. Regardless of the method used for prevention, increased length of stay is associated with increased risk of VTE. [Display omitted] DisclosuresDhakal:Graduation Medical Education, Inc., Michigan State University: Research Funding. Rayamajhi:Michigan State University, College of Education: Research Funding; Sparrow/MSU Center for Innovation and Research: Research Funding.

Clinical implication of bactibilia in moderate to severe acute cholecystitis undergone cholecystostomy following cholecystectomy

There is little evidence of clinical outcome in using antibiotics during the perioperative phase of acute cholecystitis with bactibilia. The aim of current study is to examine the effect of bactibilia on patients with acute cholecystitis and their perioperative clinical outcome. We performed a retrospective cohort analysis of 128 patients who underwent cholecystectomy for acute cholecystitis with moderate and severe grade. Patients who were positive for bactibilia were compared to bactibilia-negative group in following categories: morbidity, duration of antimicrobial agent use, in-hospital course, and readmission rate. There was no difference in morbidity when patients with bactibilia (n = 70) were compared to those without (n = 58) after cholecystectomy. The duration of antibiotics use and clinical course were also similar in both groups. In severe grade AC group (n = 18), patients used antibiotics and were hospitalized for a significantly longer period of time than those in the moderate grade AC group. The morbidity including surgical site infection, and readmission rates were not significantly different in moderate and severe grade AC groups. In moderate and severe AC groups, bactibilia itself did not predict more complication and worse clinical course. Antibiotics may be safely discontinued within few days after cholecystectomy irrespective of bactibilia when cholecystectomy is successful.