[A comparison of CAS risk model and CHA2DS2-VASc risk model in guiding anticoagulation treatment in Chinese patients with non-valvular atrial fibrillation].

Objective: To compare the differences between CAS risk model and CHA2DS2-VASc risk score in predicting all cause death, thromboembolic events, major bleeding events and composite endpoint in patients with nonvalvular atrial fibrillation. Methods: This is a retrospective cohort study. From the China Atrial Fibrillation Registry cohort study, the patients with atrial fibrillation who were>18 years old were randomly divided into CAS risk score group and CHA2DS2-VASc risk score group respectively. According to the anticoagulant status at baseline and follow-up, patients in the 2 groups who complied with the scoring specifications for anticoagulation were selected for inclusion in this study. Baseline information such as age and gender in the two groups were collected and compared. Follow-up was performed periodically to collect information on anticoagulant therapy and endpoints. The endpoints were all-cause death, thromboembolism events and major bleeding, the composite endpoint events were all-cause death and thromboembolism events. The incidence of endpoints in CAS group and CHA2DS2-VASc group was analyzed, and multivariate Cox proportional risk model was used to analyze whether the incidence of the endpoints was statistically different between the two groups. Results: A total of 5 206 patients with AF were enrolled, average aged (63.6±12.2) years, and 2092 (40.2%) women. There were 2 447 cases (47.0%) in CAS risk score group and 2 759 cases (53.0%) in CHA2DS2-VASc risk score group. In the clinical baseline data of the two groups, the proportion of left ventricular ejection fraction<55%, non-paroxysmal atrial fibrillation, oral warfarin and HAS BLED score in the CAS group were lower than those in the CHA2DS2-VASc group, while the proportion of previous diabetes history and history of antiplatelet drugs in the CAS group was higher than that in the CHA2DS2-VASc group, and there was no statistical difference in other baseline data. Patients were followed up for (82.8±40.8) months. In CAS risk score group, 225(9.2%) had all-cause death, 186 (7.6%) had thromboembolic events, 81(3.3%) had major bleeding, and 368 (15.0%) had composite endpoint. In CHA2DS2-VASc risk score group, 261(9.5%) had all-cause death 209(7.6%) had thromboembolic events, 112(4.1%) had major bleeding, and 424 (15.4%) had composite endpoint. There were no significant differences in the occurrence of all-cause death, thromboembolic events, major bleeding and composite endpoint between anticoagulation in CAS risk score group and anticoagulation in CHA2DS2-VASc risk score group (log-rank P =0.643, 0.904, 0.126, 0.599, respectively). Compared with CAS risk score, multivariable Cox proportional hazards regression models showed no significant differences for all-cause death, thromboembolic events, major bleeding and composite endpoint between the two groups with HR(95%CI) 0.95(0.80-1.14), 1.00(0.82-1.22), 0.83(0.62-1.10), 0.96(0.84-1.11), respectively. All P>0.05. Conclusions: There were no significant differences between CAS risk model and CHA2DS2-VASc risk score in predicting all-cause death, thromboembolic events, and major bleeding events in Chinese patients with non-valvular atrial fibrillation.

[Comparison of acute sports injury between recreational skiers and skiers].

OBJECTIVE: To compare and analyze the difference between the injuries of recreational skiers in public ski resorts and those of skiing athletes in official competitions, and to explore the suggestions of medical insurance for these two types of skiers. METHODS: The injury data of recreational skiers in Chongli District, Zhangjiakou City, Hebei Province during 2018-2019 and 2019-2020 snow seasons, and the injury data of skiers in two official international skiing competitions during 2019-2020 snow season and domestic test events in Chongli District of 2021 Winter Olympic Games were analyzed retrospectively, and the similarities and differences were compared. RESULTS: A total of 1 187 injuries occurred to recreational skiers in the two public ski resorts during the 2018-2019 snow season, with an injury rate of 0.3%.There were 1 277 injury sites in total, and the most frequent injury sites were head and neck (230 cases, 18.0%), followed by knee joint (204 cases, 16.0%) and lower extremity (131 cases, 10.3%). Thirty-one skiers were injured in the two official international skiing competitions in the 2019-2020 and 2020-2021 snow season, and in the domestic test competitions in the 2021 Winter Olympic Games, and the injury rates were 11.5%, 17.2% and 12.0%, respectively. There were 37 injury sites in total, among which 11 (29.7%) were in the head and neck, followed by 6 (16.2%) in the knee joint and 5 (13.6%) in the chest, rib and abdomen. CONCLUSION: In order to better guarantee the safety of skiers and timely provide corresponding medical help, safety facilities and technical guidance should be added to the snow resort for leisure skiing, and medical stations should be set up in the snow resort. As the formal ski racing for skiing athletes during the game has 30 to 80 times higher injury ratesthan recreational skiers, and compared with the recreational skiing, head and neck injury rate is higher, and the damage is much heavier, more complete first aid facilities and experienced medical workers are, needed so the field should be equipped with the circuit inside the quantities, track fixed outside the clinic, surrounding referral hospitals set up trauma centers to provide athletes with more timely medical care.

17 beta-estradiol affects proliferation and apoptosis of canine bone marrow mesenchymal stem cells in vitro.

Emerging researches in humans, pigs and mice, highlighted that estrogen plays a pivotal role in self-renewal and differentiation of bone marrow mesenchymal stem cells (BMSCs). The present study aimed at evaluating effects of 17 beta-estradiol (E2) on proliferation and apop-tosis of canine-derived bone marrow mesenchymal stem cells (cBMSCs) in vitro. The results showed that E2 supplementation at the concentration of 10-11 M promoted the proliferation of cBMSCs by CCK-8 assay and RT-qPCR analysis for the proliferation-related genes, with proliferating cell nuclear antigen (PCNA), cyclin-D1 (CCND1) being up-regulated and cyclin--dependent kinase inhibitor 1B (CDKN1B) being down-regulated. Contrarily, analysis of fluores-cence-activated cell sorting (FACS) and RT-qPCR demonstrated that E2 supplementation above 10-11 M had inhibitory effects on the proliferation of cBMSCs and induced apoptosis. Intriguingly,cBMSCs still possessed the capability to differentiate into osteoblasts and adipocytes with 10-11 M E2 addition. Taken together, this study determined the optimal culture condition of cBMSCs in vitro, and has important implications for further understanding the regulatory effect of E2 on the self-renewal of cBMSCs, which are helpful for the clinical application of BMSCs.

Effect of the Fusarium toxins, zearalenone and deoxynivalenol, on the mouse brain.

The aim of this study was to find effects of Fusarium toxins on brain injury in mice. We evaluated the individual and combined effect of the Fusarium toxins zearalenone and deoxynivalenol on the mouse brain. We examined brain weight, protein, antioxidant indicators, and apoptosis. After 3 and 5days of treatment, increased levels of nitric oxide, total nitric oxide synthase, hydroxyl radical scavenging, and malondialdehyde were observed in the treatment groups. This was accompanied by reduced levels of brain protein, superoxide dismutase (apart from the low-dose zearalenone groups), glutathione, glutathione peroxidase activity, and percentage of apoptotic cells. By day 12, most of these indicators had returned to control group levels. The effects of zearalenone and deoxynivalenol were dose-dependent, and were synergistic in combination. Our results suggest that brain function is affected by zearalenone and deoxynivalenol.

The Fusarium toxin zearalenone and deoxynivalenol affect murine splenic antioxidant functions, interferon levels, and T-cell subsets.

This study aimed to evaluate the effects of the Fusarium toxin zearalenone (ZEA) and deoxynivalenol (DON) on splenic antioxidant functions, IFN levels, and T-cell subsets in mice. Herein, 360 mice were assigned to nine groups for a 12-day study. Mice were administered an intraperitoneal injection for 4 consecutive days with different concentrations of ZEA alone, DON alone, or ZEA+DON. Spleen and blood samples were collected on days 0, 3, 5, 8, and 12. Mice in each of the experimental groups showed dysreglated splenic antioxidant functions, IFN levels, and T-cell subset frequencies, suggesting that the immune system had been affected. The ZEA+DON-treated groups, especially the group that received a higher concentration of ZEA+DON (Group D2Z2), showed more obvious effects on the dysregulation of splenic antioxidant functions, IFN levels, and T-cell subsets. This finding suggested that DON and ZEA exerted synergistic effects.

Effects of antibacterial peptide on cellular immunity in weaned piglets.

The aim of this study was to evaluate the effects of antibacterial peptide (ABP) sufficiency on cellular immune functions by determining the spleen cell cycle and apoptosis, peripheral blood T cell subsets, and T cell proliferation function in weaned piglets. A total of 90 piglets (Duroc × Landrace × Yorkshire) of both sexes were randomly allotted to 5 dietary treatments. Each treatment consisted of 3 replicates with 6 piglets per replicate. The dietary treatments consisted of the negative control (NC; basal diet), positive control (PC; basal diet supplemented with 400 mg/kg Astragalus polysaccharide), and ABP (basal diet mixed with 250, 500, and 1,000 mg/kg ABP). The experimental lasted for 28 d. Two piglets from each replicate were selected randomly for blood samples extraction from the jugular vein to obtain peripheral blood T cell subsets, and T cell proliferation function analysis was performed on d 32, 39, 46, and 53. Two piglets from each replicate were selected and euthanized to observe the spleen cell cycle and apoptosis on d 39 and 53. In ABP-sufficient piglets, the G0/G1 phase of the spleen cell cycle was much lower (P < 0.05) and the S and G2 + M phases and proliferation index (PI) were greater (P < 0.05) than in NC piglets. The percentage of apoptotic cells in the spleen significantly decreased under ABP sufficiency (P < 0.05). The proliferation function of peripheral blood T cells increased (P < 0.05) in ABP-sufficient piglets. Percentages of CD3 (+) and CD3 (+)CD4 (+) ratios (d 39, 46, and 53) and CD4 (+)CD8 (+) ratios (d 32, 39, 46, and 53) increased remarkably (P < 0.05) under ABP sufficiency compared with NC. These results suggest that ABP sufficiency could increase the T cell population and proliferation function of T cells and could induce decreased percentages of apoptotic cells. Overall, the cellular immune function was evidently improved in weaned piglets. We suggest optimal dosages of 500 mg/kg ABP for 4-wk addition and 1,000 mg/kg ABP for 2-wk addition.

Energy, amino acid, and phosphorus digestibility of phytase transgenic corn for growing pigs.

Three experiments were conducted to evaluate energy, AA, and P digestibility in a phytase transgenic corn (PTC) containing a phytase gene (phyA2) isolated from Aspergillus niger compared with a nontransgenic near-isoline conventional corn (CC) grown in the same environmental conditions for growing pigs. Experiment 1 was an energy balance experiment conducted to measure DE and ME in PTC and CC. Eighteen growing barrows (initial BW 25.8±0.3 kg) from 9 litters were allotted by BW and litter to 1 of 2 dietary treatments with 9 pigs per treatment in a randomized complete block design. Pigs were individually placed in metabolism cages and fed diets based on the 2 corns. The DE and ME in PTC (3,967 and 3,941 kcal/kg of DM, respectively) were greater (P<0.05) than those in CC (3,917 and 3,848 kcal/kg of DM, respectively). Experiment 2 was conducted to measure apparent ileal digestibility (AID) and standardized ileal digestibility (SID) values of CP and AA in the 2 corns. Eighteen growing barrows (initial BW 41.8±0.7 kg) were equipped with a T-cannula in the distal ileum. Pigs were placed in metabolism cages in a completely randomized design with 3 dietary treatments of 6 pigs each. An N-free diet was used to estimate basal endogenous losses of CP and AA. The AID and SID values for CP and all AA did not differ between the 2 corns. Experiment 3 was conducted to measure apparent total tract digestibility (ATTD) and standardized total tract digestibility (STTD) values of P in the 2 corns. Eighteen growing pigs (initial BW 30.5±0.5 kg) from 6 litters were placed in metabolism cages in a randomized complete block design with 3 dietary treatments of 6 pigs each based on BW and litter. Two diets were based on the 2 corns, and a P-free diet was used to measure endogenous P losses. The ATTD and STTD values of P were greater (P<0.05) in the PTC diet (71.4% and 76.9%, respectively) than those in the CC diet (27.6% and 33.4%, respectively). Pigs fed the PTC diet had a greater (P<0.05) P retention (70.7%) than those fed the CC diet (27.1%). It was concluded that PTC had a greater digestibility of energy and P than CC for growing pigs. As a consequence, if PTC replaces CC in a pig diet, the DE and ME in the diet will increase, and less inorganic P will need to be supplemented to the diet, and thus P excretion in manure will be decreased.

Effects of zearalenone on calcium homeostasis of splenic lymphocytes of chickens in vitro.

Zearalenone (ZEA) is an estrogenic mycotoxin. It is produced by several Fusarium species and can contaminate food and feed. To investigate the role of calcium homeostasis in ZEA-induced toxicity of poultry and elucidate its cytotoxic mechanism, splenic lymphocytes isolated from chickens were exposed to ZEA (0-25 µg/mL) for 48 h. The intracellular calcium concentration ([Ca2+]i), pH, calmodulin (CaM) mRNA levels, and Na+/K+-ATPase activities and Ca2+-ATPase activities were detected by the fluorescent dyes Fluo-3/AM and BCECF/AM, quantitative real-time PCR, and chromatometry. Supernatant CaM concentrations were simultaneously detected by ELISA. As the ZEA exposure concentration increased, the [Ca2+]i and CaM mRNA levels gradually increased, while intracellular pH, CaM concentrations of supernatants, and intracellular Na+,K+-ATPase and Ca2+-ATPase activities gradually decreased in a dose-dependent manner. There were significant differences (P<0.05 or P<0.01) between the treatment groups and the control group. These results indicate that ZEA cytotoxicity arises by causing an imbalance in calcium homeostasis and intracellular acidification in lymphocytes.

Effects of zearalenone on IL-2, IL-6, and IFN-γ mRNA levels in the splenic lymphocytes of chickens.

Zearalenone (ZEN) is an estrogenic mycotoxin produced by several Fusarium species, which can contaminate food and feed. These compounds elicit a wide spectrum of toxic effects, including the capacity to alter normal immune function. In this study, the in vitro effects of the treatment of ConA-stimulated splenic lymphocytes with ZEN (0-25 µg/mL) were examined. ZEN modulates the expression of IL-2, IL-6, and IFN-γ. The IL-2 levels were up to fourfold higher (P < 0.05) compared with the levels in the control at toxin concentrations of 25 µg/mL after 48 h of treatment. The IL-6 levels were critically suppressed at this concentration; these changes were very statistically significant (P < 0.05). At lower ZEN concentrations (0.1, 0.4 and 1.6 µg/mL), the IFN-γ levels changed slightly; however at 6.25 and 25 µg/mL, the IFN-γ results reached statistical significance compared with the control levels (P < 0.05). These data suggest that ZEN has potent effects on the expression of chicken splenic lymphocytes cytokines at the mRNA level.

MRI appearance of multiple eccrine spiradenoma.

Multiple eccrine spiradenoma is one of the rarest tumours of the sweat gland. We report a case of multiple eccrine spiradenoma that was distributed in several parts of the body. On MRI the lesions presented with multiple dispersive foci with clear circumferences in the cutis and the subcutaneous tissue. The lesions showed low signal intensity on T1 weighted images, and high signal intensity on short tau inversion recovery images. Although the signal intensities of the lesions were not characteristic in this patient, multiple eccrine spiradenoma should be included in the differential diagnosis of the lesions in the cutis and the subcutaneous tissue.

Cell transplantation with a catheter-based approach: an efficient method for the treatment of heart failure with multiple lesions.

Cell transplantation is emerging as a potential therapeutic approach for the treatment of heart failure. At present, popular methods of cell delivery may not be efficient in perfusing cells through the whole myocardium. We have developed a novel catheter-based method for global transplantation of cells. Heart failure was induced in rabbit by intravenous administration of doxorubicin. Autologous bone marrow mononuclear cells were transplanted into failing hearts via the root of the aorta. Bilateral sinus aortae and coronary arteries were visualized by angiography during the cell transplantation procedure; there was no intraprocedural death. Four weeks after cell transplantation, there was an improvement in the mean left ventricular ejection fraction from baseline 72.13% to 81.54% (P = 0.034). Transplanted cells were observed throughout the cardiac layers of left and right ventricles. In conclusion, cell transplantation through the root of the aorta is a useful approach to globally supply cells into the heart.

Studies on gastrin in duodenal ulcer.

By immunocytochemical method and radioimmunoassay, the gastrin secreting cells (G cells) and gastrin concentration in antral mucosa, gastric juice and serum in 20 patients with duodenal ulcer (DU) were studied. The number of G cells and gastrin concentration in antral mucosa showed no significant difference as compared with normal control. The number of G cells in patients with DU and antral atrophy was much higher than those with antral atrophy but with DU. It indicated that G cells were increased in number in DU, and the gastrin concentration in gastric juice (271.11 +/- 255.25 pg/ml) was much higher than in sera (74.71 +/- 43.07 pg/ml). G cells were distributed in different parts of pyloric glands, showing that gastrin in gastric juice should come directly from G cells. The disturbance of feedback mechanism in regulating gastric acidity might be an important role in hypersecretion of gastric acid in DU. The increase of gastrin concentration in gastric juice might be closely related to hyperplasia of parietal cells.

[Pericardial puncture under linear array real time ultrasound guidance].

This article reported 14 cases of pericardial puncture under ultrasound guidance with total success and without any complications. This technique is safer and more accurate than conventional method. The localization of puncture site and the technique were introduced. A common linear array transducer coupled with a self-made end-entering guide is the instrument needed which is simple and effective.