A retrospective review of sex differences of white matter hyperintensities in brain MRI of patients with migraine.

OBJECTIVES: The primary objective of this study was to evaluate the prevalence of white matter hyperintensities (WMHs) in patients who experience migraine and compare findings between adult male and female patients. Specific symptoms and comorbidities also were analyzed to determine whether they were associated with WMH prevalence or the sex of patients with migraine. We hypothesized that females would have a higher prevalence of WMHs, experience more frequent and more severe migraine headaches, and be more likely to have certain comorbidities associated with migraine than males. BACKGROUND: An increased prevalence of WMHs in patients with migraine has been proposed, although this relation is not well-supported by data from population-based MRI studies. The difference in brain morphology between males and females is of research interest, and females in the general population appear to have a higher prevalence of WMHs. Sex differences and various comorbidities in patients with migraine relative to the number of WMHs on brain imaging have not been fully investigated. METHODS: This was a cross-sectional study of 177 patients aged 18 years and older with a diagnosis of migraine who were seen in the Lehigh Valley Fleming Neuroscience Institute's Headache Center between January 1, 2000, and January 1, 2017. Patients' baseline characteristics were extracted from electronic medical records, including demographics, review of systems documentation, and brain imaging from MRI. Variables including headache severity, frequency of head pain, insomnia, and comorbidities (anxiety, depression, diabetes, hyperlipidemia, hypertension, and neck pain) also were analyzed for associations with the presence of WMHs. RESULTS: Females were found to have a significantly higher number of WMHs than males (median 3 [IQR: 0-7] vs. 0 [IQR: 0-3], p = 0.023). Patients with WMHs were significantly more likely than those without WMHs to have hypertension (39.8% of patients with WMHs vs. 20.3% without WMHs, p = 0.011), constipation (20.9% vs. 8.3%, p = 0.034), and sleep disorder (55.7% vs. 37.3%, p = 0.022). Females with migraine were significantly more likely to experience constipation than males (20.0% vs. 2.9%, p = 0.015). None of the migraine characteristics studied (frequency, severity, presence of aura) were different between sexes, nor were they significantly associated with the presence of WMHs. CONCLUSION: This study suggests that females with migraine may be more likely to have WMHs and experience constipation than males with migraine. Migraine frequency and severity were not different between sexes, nor were they significantly associated with the presence of WMHs. The findings of this study do not support a specific etiology of WMH development in individuals with migraine that differs from findings in the general population. Further studies are warranted.

Prevalence and factors associated with fertility desires among HIV-positive MSM.

The National surveillance data showed that homosexual transmission played a considerable role in new HIV infections in China. The emphasis on antiretroviral therapy and prevention of mother-to-child transmission provided chances for reproduction among people living with HIV/AIDS. Issues of fertility desire have a paucity of data among HIV-positive men who have sex with men (MSM). This cross-sectional study has assessed fertility attitudes and associated factors, as well as the reproductive knowledge among HIV-positive MSM. Analysis was mainly based on the multinomial regression model. The study included 129 participants, and almost all of the participants (96.1%) were between 18 and 30 years old and 82.2% of them were single. About 35.6% expressed a fertility desire. MSM without siblings tended to have fertility desire (OR = 0.236, 95%CI: 0.078∼0.712, p = 0.010). Surrogacy (36.4%) was the most desired method among the 86 respondents who had the desire or did not make a decision. While the accuracy of the reproductive knowledge was only 69.6%. In summary, we recommend that providers offer much more professional information and develop assisted reproductive technology to meet the reproductive aspirations of HIV-positive MSM.

Adult localized Langerhans cell histiocytosis: A case report.

BACKGROUND: Langerhans cell histiocytosis (LCH) is a rare clonal proliferative disease of Langerhans cells with unknown pathogenesis. An increasing number of clinicians recognize that LCH has a wide clinical spectrum and a highly varied course. Adults rarely develop LCH. Here, we report a case of adult localized LCH. CASE SUMMARY: A 32-year-old woman presented with plaques and ulcers on the vulva and crissum, accompanied by pain that persisted for more than one year. Physical examination revealed a red-infiltrating plaque with ulcerations and exudates in the vulva and crissum. Pathological examination revealed a diffuse infiltration of lymphocytes, eosinophilic granulocytes, and histiocytoid cells in the superficial dermis. Proliferative histiocytoid cells showed mild atypia, partly with kidney-shaped nuclei. Immunohistochemical examination showed that the histiocytoid cells were positive for S100 protein and CD1 and weakly positive for CD68 (20% +), with a Ki-67 index of 30%. Laboratory tests did not reveal any other systemic damage. The patient was diagnosed with adult localized LCH and was prescribed oral prednisone (20 mg) once daily. The skin lesions gradually improved and are still being followed-up. CONCLUSION: Adult localized LCH is rare and must be differentiated from other common conditions.

Experimental research on the evaluation of left ventricular systolic function by layered speckle tracking before and after berberine treatment in a cardiac hypertrophy rat model.

Background: To evaluate the effect of berberine (BBR) intervention on left ventricular hypertrophy and systolic function in rats by ultrasound layered strain imaging and cardiac hypertrophy model. Methods: Eighty healthy male Sprague-Dawley (SD) rats were randomly divided into four groups: group A (normal saline control group), group B [isoproterenol (ISO) induced model group], group C (BBR hydrochloride 5 mg/kg + ISO group) and group D (BBR hydrochloride 10 mg/kg + ISO group). Echocardiography was performed on days 1, 7 and 14, respectively. The myocardial tissue was taken for pathological examination. The key proteins of Rho/ROCK signaling pathway were quantified by immunohistochemical staining. Results: On day 7, compared with group A, peripheral strain values of the subendocardium and middle myocardium of rats in groups B, C and D were significantly decreased. The absolute value of circumferential strain (CS) in subendocardium and middle myocardium in group B was significantly lower than that in groups C and D (-24.21 vs. -26.68 vs. -27.69; -14.90 vs. -16.48 vs. -17.69). Pathological results showed that compared with the myocardial cells in control group A, the myocardial cells in group B had significantly increased cross-sectional area, and obvious myocardial interstitial fibrosis. Compared with group B, BBR intervention reduced the deposition of fibrosis in groups C and D, group D was more obvious. Immunohistochemical results showed that compared with group A, the protein expression levels of ROCK, RhoA and Bax in groups B, C and D were significantly increased, while the protein expression levels of Bcl-2 were significantly decreased. Conclusions: Ultrasound layered strain imaging could evaluate the early left ventricular systolic function in isoprenaline-induced hypertrophy rat model. BBR might inhibit oxidative stress through the Rho/ROCK signaling pathway and slow down the progression of myocardial fibrosis after the formation of cardiac hypertrophy. This provides reference and direction for clinical decision-making and further research.

Prediction of overall survival after radical gastrectomy using nomograms created by tumor markers.

Prediction of prognosis after radical resection of gastric cancer has not been well established. Therefore, we aimed to establish a prognostic model based on a new score system of patients with gastric cancer. A total of 1235 patients who underwent curative gastrectomy at our hospital from October 2015 to April 2017 were included in this study. Univariate and multivariate analyses were used to screen for prognostic risk factors. Construction of the nomogram was based on Cox proportional hazard regression models. The construction of the new score models was analyzed by the receiver operating characteristic curve (ROC curve), calibration curve, and decision curve. Multivariate analysis showed that tumor size, T, N, carcinoembryonic antigen, CA125, and CA19-9 were independent prognostic factors. The new score model had a greater AUC (The area under the ROC curve) than other systems, and the C-index of the nomogram was highly reliable for evaluating the survival of patients with gastric cancer. Based on the tumor markers and other clinical indicators, we developed a precise model to predict the prognosis of patients with gastric cancer after radical surgery. This score system can be helpful to both surgeons and patients.

Sub-Cluster Identification through Semi-Supervised Optimization of Rare-Cell Silhouettes (SCISSORS) in single-cell RNA-sequencing.

MOTIVATION: Single-cell RNA-sequencing (scRNA-seq) has enabled the molecular profiling of thousands to millions of cells simultaneously in biologically heterogenous samples. Currently, the common practice in scRNA-seq is to determine cell type labels through unsupervised clustering and the examination of cluster-specific genes. However, even small differences in analysis and parameter choosing can greatly alter clustering results and thus impose great influence on which cell types are identified. Existing methods largely focus on determining the optimal number of robust clusters, which can be problematic for identifying cells of extremely low abundance due to their subtle contributions toward overall patterns of gene expression. RESULTS: Here, we present a carefully designed framework, SCISSORS, which accurately profiles subclusters within broad cluster(s) for the identification of rare cell types in scRNA-seq data. SCISSORS employs silhouette scoring for the estimation of heterogeneity of clusters and reveals rare cells in heterogenous clusters by a multi-step semi-supervised reclustering process. Additionally, SCISSORS provides a method for the identification of marker genes of high specificity to the cell type. SCISSORS is wrapped around the popular Seurat R package and can be easily integrated into existing Seurat pipelines. AVAILABILITY AND IMPLEMENTATION: SCISSORS, including source code and vignettes, are freely available at https://github.com/jr-leary7/SCISSORS.

A novel proxy to examine interspecific phosphorus facilitation between plant species.

Resource complementarity can contribute to enhanced ecosystem functioning in diverse plant communities, but the role of facilitation in the enhanced complementarity is poorly understood. Here, we use leaf manganese concentration ([Mn]) as a proxy for rhizosheath carboxylate concentration to explore novel mechanisms of complementarity mediated by phosphorus (P) facilitation. In pot experiments, we showed that mixtures involving Carex korshinskyi, an efficient P-mobilizing species, exhibited greater biomass and relative complementarity effect than combinations without C. korshinskyi on P-deficient soils. Compared with monocultures, leaf [Mn] and [P] of species that are inefficient at P mobilization increased by 27% and 21% when grown with C. korshinskyi (i.e. interspecific P facilitation via carboxylates) rather than next to another inefficient P-mobilizing species. This experimental result was supported by a meta-analysis including a range of efficient P-mobilizing species. Phosphorus facilitation enhanced the relative complementarity effect in low-P environments, related to a greater change in several facilitated species of their root morphological traits relative to those in monoculture. Using leaf [Mn] as a proxy, we highlight a vital mechanism of interspecific P facilitation via belowground processes and provide evidence for the pivotal role of P facilitation mediated by the plasticity of root traits in biodiversity research.

Nomogram established using risk factors of early gastric cancer for predicting the lymph node metastasis.

BACKGROUND: For the prognosis of patients with early gastric cancer (EGC), lymph node metastasis (LNM) plays a crucial role. A thorough and precise evaluation of the patient for LNM is now required. AIM: To determine the factors influencing LNM and to construct a prediction model of LNM for EGC patients. METHODS: Clinical information and pathology data of 2217 EGC patients downloaded from the Surveillance, Epidemiology, and End Results database were collected and analyzed. Based on a 7:3 ratio, 1550 people were categorized into training sets and 667 people were assigned to testing sets, randomly. Based on the factors influencing LNM determined by the training sets, the nomogram was drawn and verified. RESULTS: Based on multivariate analysis, age at diagnosis, histology type, grade, T-stage, and size were risk factors of LNM for EGC. Besides, nomogram was drawn to predict the risk of LNM for EGC patients. Among the categorical variables, the effect of grade (well, moderate, and poor) was the most significant prognosis factor. For training sets and testing sets, respectively, area under the receiver-operating characteristic curve of nomograms were 0.751 [95% confidence interval (CI): 0.721-0.782] and 0.786 (95%CI: 0.742-0.830). In addition, the calibration curves showed that the prediction model of LNM had good consistency. CONCLUSION: Age at diagnosis, histology type, grade, T-stage, and tumor size were independent variables for LNM in EGC. Based on the above risk factors, prediction model may offer some guiding implications for the choice of subsequent therapeutic approaches for EGC.

Evaluation of the relationship between left atrial strain and exercise tolerance in patients with hypertrophic cardiomyopathy by treadmill stress echocardiography.

Objective: The aim of this study is to evaluate the left atrial strain (LAS) in patients with hypertrophic cardiomyopathy (HCM) by treadmill exercise stress echocardiography, combined with three-dimensional speckle tracking technology, for predicting exercise tolerance. Methods: A total of 97 patients with HCM who underwent treadmill exercise stress echocardiography were recruited in Sichuan Provincial People's Hospital between January 2018 and January 2021, and 30 control subjects were selected to be included in the normal group. HCM patients with their metabolic equivalents (METS) ≤ 6.0 were included in the HCM-1 group, while those with METS > 6.0 were included in the HCM-2 group. The LAS and exercise tolerance were analyzed. The ultrasound parameters that could predict a decrease in exercise tolerance were screened, and a predictive model was constructed. Results: It was found that METS, Rest-LASr, Rest-LAScd, and Rest-LASct were significantly lower in HCM patients than those in normal controls. There was a significant difference in age, Target_HR, LVMI, LAVI, E/e'-Rest, E/e'-Peak, Rest-LASr, Rest-LAScd, and Rest-LASct between the HCM-1 and the HCM-2 groups. LASr is an independent resting echocardiographic predictor of METS ≤ 6.0. LASr remained significant for predicting different subtypes (AHCM, asymmetric HCM, and obstructive HCM). Rest-LASr (AUC 0.990) was better at predicting METS ≤ 6.0 than Peak-E/e' (AUC 0.753). A multivariate model (LASr + Age + Target_HR) was established for METS prediction. Conclusion: Left atrial reservoir strain (LASr) has the strongest association with METS ≤ 6.0. The LASr is an independent resting predictor of METS ≤ 6.0 and has a good performance record in predicting different subtypes of HCM. Compared with the traditional parameters, Peak-E/e' and Rest-E/e', Rest-LASr is the best predictor. Rest-LASr can serve as a reliable method for HCM patients who are unable to undergo exercise testing but require an urgent evaluation of their METS, which provides a basis for clinical treatment decision-making and treatment effect evaluation.

A Treatable Cause of Pulsatile Tinnitus: A Case of Sigmoid Sinus Dehiscence.

Tinnitus is a symptom of an underlying condition that can be neurological, ontological, or infectious in origin. This case report describes a patient with pulsatile tinnitus caused by sigmoid sinus dehiscence, which was successfully treated by sigmoid sinus dehiscence repair. We recommend computed tomography angiography/magnetic resonance angiography or digital subtraction angiography to rule out vascular malformation, such as arteriovenous fistula, prior to surgical intervention. In addition, we recommend imaging of the brain and formal evaluation by an ophthalmologist and lumbar puncture prior to surgical intervention to rule out idiopathic intracranial hypertension if suspected.

Maize/peanut intercropping has greater synergistic effects and home-field advantages than maize/soybean on straw decomposition.

Introduction: The decomposition of plant litter mass is responsible for substantial carbon fluxes and remains a key process regulating nutrient cycling in natural and managed ecosystems. Litter decomposition has been addressed in agricultural monoculture systems, but not in intercropping systems, which produce species-diverse litter mass mixtures. The aim here is to quantify how straw type, the soil environment and their combined effects may influence straw decomposition in widely practiced maize/legume intercropping systems. Methods: Three decomposition experiments were conducted over 341 days within a long-term intercropping field experiment which included two nitrogen (N) addition levels (i.e. no-N and N-addition) and five cropping systems (maize, soybean and peanut monocultures and maize/soybean and maize/peanut intercropping). Experiment I was used to quantify litter quality effects on decomposition; five types of straw (maize, soybean, peanut, maize-soybean and maize-peanut) from two N treatments decomposed in the same maize plot. Experiment II addressed soil environment effects on root decomposition; soybean straw decomposed in different plots (five cropping systems and two N levels). Experiment III addressed 'home' decomposition effects whereby litter mass (straw) was remained to decompose in the plot of origin. The contribution of litter and soil effects to the home-field advantages was compared between experiment III ('home' plot) and I-II ('away' plot). Results and discussions: Straw type affected litter mass loss in the same soil environment (experiment I) and the mass loss values of maize, soybean, peanut, maize-soybean, and maize-peanut straw were 59, 77, 87, 76, and 78%, respectively. Straw type also affected decomposition in the 'home' plot environment (experiment III), with mass loss values of maize, soybean, peanut, maize-soybean and maize-peanut straw of 66, 74, 80, 72, and 76%, respectively. Cropping system did not affect the mass loss of soybean straw (experiment II). Nitrogen-addition significantly increased straw mass loss in experiment III. Decomposition of maize-peanut straw mixtures was enhanced more by 'home-field advantage' effects than that of maize-soybean straw mixtures. There was a synergistic mixing effect of maize-peanut and maize-soybean straw mixture decomposition in both 'home' (experiment III) and 'away' plots (experiment I). Maize-peanut showed greater synergistic effects than maize-soybean in straw mixture decomposition in their 'home' plot (experiment III). These findings are discussed in terms of their important implications for the management of species-diverse straw in food-production intercropping systems.

A case study of HIV/AIDS services from community-based organizations during COVID-19 lockdown in China.

INTRODUCTION: People living with HIV (PLHIV) relied on community-based organizations (CBOs) in accessing HIV care and support during the COVID-19 pandemic in China. However, little is known about the impact of, and challenges faced by Chinese CBOs supporting PLHIV during lockdowns. METHODS: A survey and interview study was conducted among 29 CBOs serving PLHIV in China between November 10 and November 23, 2020. Participants were asked to complete a 20-minute online survey on their routine operations, organizational capacity building, service provided, and challenges during the pandemic. A focus group interview was conducted with CBOs after the survey to gather CBOs' policy recommendations. Survey data analysis was conducted using STATA 17.0 while qualitative data was examined using thematic analysis. RESULTS: HIV-focused CBOs in China serve diverse clients including PLHIV, HIV high-risk groups, and the public. The scope of services provided is broad, ranging from HIV testing to peer support. All CBOs surveyed maintained their services during the pandemic, many by switching to online or hybrid mode. Many CBOs reported adding new clients and services, such as mailing medications. The top challenges faced by CBOs included service reduction due to staff shortage, lack of PPE for staff, and lack of operational funding during COVID-19 lockdowns in 2020. CBOs considered the ability to better network with other CBOs and other sectors (e.g., clinics, governments), a standard emergency response guideline, and ready strategies to help PLHIV build resilience to be critical for future emergency preparation. CONCLUSION: Chinese CBOs serving vulnerable populations affected by HIV/AIDS are instrumental in building resilience in their communities during the COVID-19 pandemic, and they can play significant roles in providing uninterrupted services during emergencies by mobilizing resources, creating new services and operation methods, and utilizing existing networks. Chinese CBOs' experiences, challenges, and their policy recommendations can inform policy makers on how to support future CBO capacity building to bridge service gaps during crises and reduce health inequalities in China and globally.

Effects of berberine hydrochloride on left ventricular structure and function in rats with myocardial hypertrophy.

BACKGROUND: Inhibition of Rho/ROCK signalling pathway related proteins can alleviate left ventricular hypertrophy. Berberine hydrochloride (BBR) can effectively inhibit left ventricular hypertrophy. The purpose of this study is to explore the relationship between BBR and Rho/ROCK signalling pathway. METHODS: Isoproterenol (ISO) was used to induce left ventricular hypertrophy in rats. Two-dimensional speckle tracking technique (2D-STE) was used to evaluate rats in each group (group A: normal control group; Group B: isoproterenol model group; Group C: ISO + 5mg/kg BBR group; Group D: ISO + 10mg/kg BBR group) Heart structure and systolic function. HE staining and Masson staining were used to observe the pathological changes in four groups of rats. The expression levels of RhoA, ROCK-1, TGF-ß1 and PTEN protein in myocardial tissues were detected by immunohistochemistry. RESULT: The interventricular septum (IVS) of rats in groups C and D was thinner than that in group B (4.05 ± 0.16 mm vs. 3.50 ± 0.29 mm vs. 4.41 ± 0.23 mm, respectively, p < 0.05), and the global radial strain (GRS) of rats in groups C and D was higher than that in group B, especially in group D (26.05 ± 1.41 vs. 30.64 ± 1.63 vs. 19.40 ± 1.05, respectively, p < 0.05). Compared with group B, the expression levels of RhoA, ROCK-1 and TGF-ß1 in groups C and D decreased, while the expression level of PTEN increased, especially in group D (all p < 0.05). CONCLUSION: BBR can improve the cardiac structure and systolic function of rats with left ventricular hypertrophy, and the improvement mechanism may be related to Rho/ROCK signalling pathway.

Prediction of tide level based on variable weight combination of LightGBM and CNN-BiGRU model.

Accurate tide level prediction is crucial to human activities in coastal areas. Many practical applications show that compared with traditional harmonic analysis, long short-term memory (LSTM), gated recurrent units (GRUs) and other neural networks, along with ensemble learning models, such as light gradient boosting machine (LightGBM) and eXtreme gradient boosting (XGBoost), can achieve extremely high prediction accuracy in relatively stationary time series. Therefore, this paper proposes a variable weight combination model based on LightGBM and CNN-BiGRU with relevant research. It uses the variable weight combination method to weight and synthesize the prediction results of the two base models so that the combination model has a stronger ability to capture time series features and fits the data well. The experimental results show that in contrast to the base model LightGBM, the RMSE value and MAE value of the combination model are reduced by 43.2% and 44.7%, respectively; in contrast to the base model CNN-BiGRU, the RMSE value and MAE value of the combination model are reduced by 35.3% and 39.1%, respectively. This means that the variable weight combination model can greatly improve the accuracy of tide level prediction. In addition, we use tidal data from different geographical environments to further verify the good universality of the model. This study provides a new idea and method for tide prediction.

Biaxial strain improving carrier mobility for inorganic perovskite:ab initioBoltzmann transport equation.

Inorganic halide perovskites have attracted interest due to their high efficiency and low cost. Considering the uncertainty of experimental measurements, it was important to predict the upper limit of carrier mobility. In this study, theab initioBoltzmann transport equation, including all electron-phonon interactions, was used to accurately predict the mobilities of CsPbI3, CsSnI3, CsPbBr3, and CsSnBr3. Using the iterative Boltzmann transport equation (IBTE), the calculated mobility for CsPbI3isµe= 512/µh= 379 cm2 V-1 s-1, and Sn-based perovskite exhibited high hole mobility. The longitudinal optical phonons associated with the stretching between halogen anions and divalent metal cations were revealed to be the dominant scattering source for the carriers. Furthermore, the effect of biaxial strain on mobility was investigated. We observed that biaxial compressive strain could improve the mobility of CsPbI3and CsPbBr3. Surprisingly, under a compressive strain of-2%, the mobilities of CsPbI3using IBTE approach were improved toµe= 1176/µh= 936 cm2 V-1 s-1. It was revealed that the compressive strain could decrease the effective mass of CsPbI3and CsPbBr3.

SQuAPP-simple quantitative analysis of proteins and PTMs.

SUMMARY: The comprehensive analysis of the proteome and its modulation by post-translational modification (PTM) is increasingly used in biological and biomedical studies. As a result, proteomics data analysis is ever more carried out by scientists with limited expertise in this type of data. While excellent software solutions for comprehensive and rigorous analysis of quantitative proteomic data exist, most are complex and not well suited for non-proteomics scientists. Integrative analysis of multi-level proteomics data on protein and diverse PTMs, like phosphorylation or proteolytic processing, remains particularly challenging and inaccessible to most biologists. To fill this void, we developed SQuAPP, an R-Shiny web-based analysis pipeline for the quantitative analysis of proteomic data. SQuAPP uses a streamlined workflow model to guide expert and novice users through quality control, data pre-processing, statistical analysis and visualization steps. Processing the protein, peptide and PTM datasets in parallel and their quantitative integration enable rapid identification of protein-level-independent modulation of protein modifications and intuitive interpretation of dynamic dependencies between different protein modifications. AVAILABILITY AND IMPLEMENTATION: SQuAPP is available at http://squapp.langelab.org/. The source code and local setup instructions can be accessed from https://github.com/LangeLab/SQuAPP.

Model established based on blood markers predicts overall survival in patients after radical resection of types II and III adenocarcinoma of the esophagogastric junction.

BACKGROUND: In recent years, the incidence of types II and III adenocarcinoma of the esophagogastric junction (AEG) has shown an obvious upward trend worldwide. The prognostic prediction after radical resection of AEG has not been well established. AIM: To establish a prognostic model for AEG (types II and III) based on routine markers. METHODS: A total of 355 patients who underwent curative AEG at The First Affiliated Hospital of Anhui Medical University from January 2014 to June 2015 were retrospectively included in this study. Univariate and multivariate analyses were performed to identify the independent risk factors. A nomogram was constructed based on Cox proportional hazards models. The new score models was analyzed by C index and calibration curves. The receiver operating characteristic (ROC) curve was used to compare the predictive accuracy of the scoring system and tumor-node-metastasis (TNM) stage. Overall survival was calculated using the Kaplan-Meier curve amongst different risk AEG patients. RESULTS: Multivariate analysis showed that TNM stage (hazard ratio [HR] = 2.286, P = 0.008), neutrophil-to-lymphocyte ratio (HR = 2.979, P = 0.001), and body mass index (HR = 0.626, P = 0.026) were independent prognostic factors. The new scoring system had a higher concordance index (0.697), and the calibration curves of the nomogram were reliable. The area under the ROC curve of the new score model (3-year: 0.725, 95% confidence interval [CI]: 0.676-0.777; 5-year: 0.758, 95%CI: 0.708-0.807) was larger than that of TNM staging (3-year: 0.630, 95%CI: 0.585-0.684; 5-year: 0.665, 95%CI: 0.616-0.715). CONCLUSION: Based on the serum markers and other clinical indicators, we have developed a precise model to predict the prognosis of patients with AEG (types II and III). The new prognostic nomogram could effectively enhance the predictive value of the TNM staging system. This scoring system can be advantageous and helpful for surgeons and patients.

Evaluation of Exercise Tolerance in Non-obstructive Hypertrophic Cardiomyopathy With Myocardial Work and Peak Strain Dispersion by Speckle-Tracking Echocardiography.

Background: The aim of this study was to evaluate exercise tolerance in non-obstructive hypertrophic cardiomyopathy (HCM) by investigating the value of myocardial work (MW) combined with strain peak dispersion. Methods: A total of 65 patients with non-obstructive HCM and normal left ventricular ejection fraction were enrolled and 60 healthy subjects were selected as controls. The automated function imaging (AFI)-two-dimensional ultrasonic speckle-tracking technology was used to obtain the values for peak global longitudinal strain (GLS), longitudinal strain peak time dispersion (PSD), 18-segment systolic longitudinal peak strain (LPS), 18-segment longitudinal strain peak time (TTPLS), global waste work (GWW), global constructive work (GCW), global work index (GWI), global work efficiency (GWE), and exercise metabolic equivalents (METS). Results: (1) Values for LV-GLS (-17.77 ± 0.20 vs. -21.66 ± 0.42%) were lower and PSD (95.10 ± 8.15 vs. 28.97 ± 1.50 ms) was prolonged in patients with HCM (p < 0.01). (2) An increasing trend was shown in the basal segment < intermediate segment < apical segment for both patients with HCM and controls, although each segment had lower values in the HCM group. (3) TTPLS was prolonged in the HCM group (p < 0.01). (4) GWE, GWI, and GCW were all lower (p < 0.01) and GWW was higher in patients with HCM (p < 0.01). (5) Values of GWE were less than 92.5%, GWI less than 1,200 mmHg, GCW less than 1,399 mmHg, these abnormal values are helpful for the diagnosis of impaired exercise tolerance and poor prognosis (6) The METS and LV-GLS of HCM in the asymmetric group were significantly lower than that in AHCM group, but the PSD was significantly greater than that in the AHCM group. Values of LPS-BL (-13.13% ± 2.51% vs -10.17% ± 2.20%) in the apical HCM group were better than in the asymmetric HCM group (p < 0.05). Conclusion: GCW, GWI, and GWE can be safely measured by resting echocardiography to evaluate exercise tolerance in patients with HCM who cannot perform an exercise-based examination. Such measurements provide a basis for clinical decisions regarding exercise and drug prescription.

[Automatic detection model of hypertrophic cardiomyopathy based on deep convolutional neural network].

The diagnosis of hypertrophic cardiomyopathy (HCM) is of great significance for the early risk classification of sudden cardiac death and the screening of family genetic diseases. This research proposed a HCM automatic detection method based on convolution neural network (CNN) model, using single-lead electrocardiogram (ECG) signal as the research object. Firstly, the R-wave peak locations of single-lead ECG signal were determined, followed by the ECG signal segmentation and resample in units of heart beats, then a CNN model was built to automatically extract the deep features in the ECG signal and perform automatic classification and HCM detection. The experimental data is derived from 108 ECG records extracted from three public databases provided by PhysioNet, the database established in this research consists of 14,459 heartbeats, and each heartbeat contains 128 sampling points. The results revealed that the optimized CNN model could effectively detect HCM, the accuracy, sensitivity and specificity were 95.98%, 98.03% and 95.79% respectively. In this research, the deep learning method was introduced for the analysis of single-lead ECG of HCM patients, which could not only overcome the technical limitations of conventional detection methods based on multi-lead ECG, but also has important application value for assisting doctor in fast and convenient large-scale HCM preliminary screening.