Sudden diffuse spasm of multiple coronary arteries: A case report.

RATIONALE: Diffuse multivessel coronary artery spasm (DMV-CAS) was defined as a severe and reversible diffuse spasm occurring in more than 2 major coronary arteries, which is rare in clinical practice. Due to a wide lesion scope, DMV-CAS often occurs in the form of complications. It is not easy to be clinically diagnosed because it is too brief to be caught. Here, we report a rare case of spontaneous subtotal occlusion of 3 major coronary arteries induced by Vasalva action, which was confirmed in real-time by CAG. PATIENT CONCERNS: A 68-year-old man had sudden chest pain after forced defecation during hospitalization. The electrocardiogram showed transient ST segment elevation of the inferior wall lead, inversion of the anterior wall, and lateral wall leads T waves. Emergency CAG revealed elongated vessel beds in 3 coronary arteries and multiple diffuse stenosis, but none of the coronary arteries were completely occlusive. DIAGNOSES: Diagnoses of DMV-CAS were made based on CAG findings and postmedication response. INTERVENTIONS: Nitroglycerin was administered in the coronary arteries. The anti-vasospasm, antiplatelet aggregation and lipid-regulating drugs were administered orally. OUTCOMES: The patient was discharged on the 7th day with complete resolution of symptoms and normalization of the electrocardiography findings. No ischemic events occurred during a follow-up for 5 months. LESSONS: This case highlights the identification of multivessel diffuse coronary spasm and acute myocardial infarction, and the prevention of CAS triggers, which requires the attention of clinicians.

In Situ Generation of H2O2 over MoOx Decorated on Cu2O@CuO Core-Shell Particle Nanoarchitectonics for Boosting Photocatalytic Oxidative Desulfurization.

Photocatalytic oxidation desulfurization (PODS) has emerged as a promising, ecofriendly alternative to traditional, energy-intensive fuel desulfurization methods. Nevertheless, its progress is still hindered due to the slow sulfide oxidation kinetics in the current catalytic systems. Herein, we present a MoOx decorated on a Cu2O@CuO core-shell catalyst, which enables a new, efficient PODS pathway by in situ generation of hydrogen peroxide (H2O2) with saturated moist air as the oxidant source. The photocatalyst delivers remarkable specific activity in oxidizing dibenzothiophene (DBT), achieving a superior rate of 7.8 mmol g-1 h-1, while maintaining a consistent performance across consecutive reuses. Experimental investigations reveal that H2O2 is produced through the two-electron oxygen reduction reaction (ORR), and both H2O2 and the hydroxyl radicals (•OH) generated from it act as the primary reactive species responsible for sulfide oxidation. Importantly, our catalyst accomplishes complete PODS of real diesel fuel, underscoring an appealing industrial prospect for our photocatalyst.

Graph Neural Network-Guided Contrastive Learning for Sequential Recommendation.

Sequential recommendation uses contrastive learning to randomly augment user sequences and alleviate the data sparsity problem. However, there is no guarantee that the augmented positive or negative views remain semantically similar. To address this issue, we propose graph neural network-guided contrastive learning for sequential recommendation (GC4SRec). The guided process employs graph neural networks to obtain user embeddings, an encoder to determine the importance score of each item, and various data augmentation methods to construct a contrast view based on the importance score. Experimental validation is conducted on three publicly available datasets, and the experimental results demonstrate that GC4SRec improves the hit rate and normalized discounted cumulative gain metrics by 1.4% and 1.7%, respectively. The model can enhance recommendation performance and mitigate the data sparsity problem.

Effects of heat shock protein 90 on complement activation in myocardial ischemia/reperfusion injury after pioglitazone preconditioning.

BACKGROUND: Heat shock protein 90 (HSP90) appears to have a pivotal function in ischemic preconditioning. Pioglitazone preconditioning (PioC) attenuates myocardial ischemia/reperfusion (I/R) injuries. OBJECTIVES: The current study aims to investigate the role of HSP90, complement C3 and C5a, and nuclear factor kappa-B (NF-κB) in PioC-induced cardioprotection. MATERIAL AND METHODS: A total of 80 rats were randomly categorized into 4 groups, as follows: sham, I/R, PioC, and PioC+HSP90 inhibitor geldanamycin (PioC+GA). The sham group rats had a thoracotomy, in which the ligature was passed by the heart with no ligation (150 min). The other 3 groups were exposed to ischemia (30 min) followed by reperfusion (2 h). In the PioC group, pioglitazone (3 mg/kg) was administered intravenously 24 h before ischemia. In the PioC+GA group, after being pretreated with pioglitazone, GA was administered (intraperitoneally, 1 mg/kg) 30 min before ischemia. Myocardial infarct sizes (ISs), apoptosis rates, creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), and cardiac troponin I (cTnI) serum levels were determined. The HSP90, C3, NF-κB, C5a, B-cell lymphoma-2 (Bcl-2), and Bax expression levels, as well as interleukin (IL)-1ß, IL-6, intercellular cell adhesion molecule-1 (ICAM-1), and tumor necrosis factor alpha (TNF-α) mRNA levels were measured. RESULTS: The myocardial ISs, serum CK-MB, cTnI and LDH levels, apoptosis rates, IL-1ß, IL-6, TNF-α, ICAM-1 release, as well as Bax, C5a, C3, and NF-κB protein expression were considerably lower in the PioC group than in the I/R group (p < 0.05). The Bcl-2 and HSP90 expression was higher in the PioC group than in the I/R group (p < 0.05). Geldanamycin inhibited the effects of PioC. These data strongly demonstrate that the PioC-induced is dependent upon HSP90 activity. CONCLUSIONS: The HSP90 is indispensable for PioC-mediated cardioprotection. The HSP90 attenuates I/R-induced ISs, apoptosis of cardiomyocytes and myocardial inflammation through C3, C5a and NF-κB activation inhibition.

Vibration Prediction of the Robotic Arm Based on Elastic Joint Dynamics Modeling.

The flexibility of the joint drive system of an industrial robot can cause vibration at the end part, which can lead to motion errors. A method to predict the vibration during the motion of the robot arm is proposed considering the robot joint flexibility. The method combines the internal transfer function of the drive system and the identification of parameters under external excitation. Firstly, the dynamics of the robot joint system are modeled by a double inertia elastic system. The joint system transfer function from the electromagnetic torque to the arm vibration is obtained according to the dynamics model. To solve the unknown parameters in the transfer function, a vibration dynamics model of the joint arm under the external forces on the arm is developed. According to this model, the equivalent stiffness, damping and load inertia of the joint can be obtained by the direct parametric method. Then, the vibration spectrum of the robot arm is derived from the motor electromagnetic torque and joint dynamics models were used to predict the vibration spectrum of the robot arm. The experiments were conducted on a single-joint robot testbed, and on an articulated industrial robot. In both experiments, the key parameters in the system were determined by impact experiments. Then, the vibration signal of the arm during the robot motion was obtained by electromagnetic torque prediction. The predicted vibration signals are analyzed in comparison with the actual vibration signals. The experimental results both show the validity of the vibration prediction.

Surface warming-induced global acceleration of upper ocean currents.

How the ocean circulation changes in a warming climate is an important but poorly understood problem. Using a global ocean model, we decompose the problem into distinct responses to changes in sea surface temperature, salinity, and wind. Our results show that the surface warming effect, a robust feature of anthropogenic climate change, dominates and accelerates the upper ocean currents in 77% of the global ocean. Specifically, the increased vertical stratification intensifies the upper subtropical gyres and equatorial currents by shoaling these systems, while the differential warming between the Southern Ocean upwelling zone and the region to the north accelerates surface zonal currents in the Southern Ocean. In comparison, the wind stress and surface salinity changes affect regional current systems. Our study points a way forward for investigating ocean circulation change and evaluating the uncertainty.

HSP90-Mediates Liraglutide Preconditioning-Induced Cardioprotection by Inhibiting C5a and NF-κB.

OBJECTIVE: We previously showed that HSP90 is involved in postconditioning cardioprotection by inhibiting complement C5a. Here, we investigated whether HSP90-mediated C5a/NF-κB inhibition is responsible for the cardioprotection conferred by liraglutide. METHODS: Rat hearts underwent a 30 min occlusion of the anterior descending coronary artery, after which reperfusion was performed for 2 h. A total of 100 rats were randomly assigned to the following groups: ischemia/reperfusion (I/R), sham, liraglutide preconditioning (LP, liraglutide, 0.18 mg/kg, intravenously, 12 h before ischemia), HSP90 inhibitor geldanamycin (GA, 1 mg/kg, intraperitoneally, 30 min before ischemia) plus LP, and C5a receptor antagonist PMX53 (1 mg/kg, intravenously, 30 min before ischemia) plus LP. Cardiac injury, C5a/NF-κB activation, and inflammation were investigated. RESULTS: LP significantly attenuated I/R-induced cardiomyocyte apoptosis, infarct size, and secretion of creatine kinase-MB, lactate dehydrogenase and cardiac troponin I. These effects were complemented by decreased C5a levels, nuclear factor (NF)-κB signaling, inflammatory cytokine expression, and increased HSP90 levels. GA, an HSP90 inhibitor, promotes C5a activation, NF-κB signaling, and inflammation and suppresses cardioprotection by LP. By contrast, PMX53, a C5a inhibitor, suppressed C5a activation, NF-κB signaling, and inflammation, and enhanced cardioprotection by LP. CONCLUSION: HSP90 markedly contributes to LP cardioprotection by inhibiting inflammatory responsesand C5a/NF-κB signaling , ultimately attenuating I/R-induced cardiomyocyte apoptosis by suppressing the proapoptotic factor Bax, and inducing the anti-apoptotic factor Bcl2.

A Support-Free Infill Structure Based on Layer Construction for 3D Printing.

The design of the light-weight infill structure is a hot research topic in additive manufacturing. In recent years, various infill structures have been proposed to reduce the amount of printing material. However, 3D models filled with them may have very different structural performances under different loading conditions. In addition, most of them are not self-supporting. To mitigate these issues, a novel light-weight infill structure based on the layer construction is proposed in this article. The layers of the proposed infill structure continuously and periodically transform between triangles and hexagons. The geometries of two adjacent layers are controlled to be self-supporting for different 3D printing technologies. The machine code (Gcode) of the filled 3D model is generated in the construction of the infill structure for 3D printers. That means 3D models filled with the proposed infill structure do not need an extra slicing process before printing, which is time consuming in some cases. Structural simulations and physical experiments demonstrate that our infill structure has comparable structural performance under different loading conditions. Furthermore, the relationship between the structural stiffness and the parameters of the infill structure is investigated, which will be helpful for non-professional users.

New targets of morphine postconditioning protection of the myocardium in ischemia/reperfusion injury: Involvement of HSP90/Akt and C5a/NF-κB.

BACKGROUND: Activation of the complement component 5a (C5a) and nuclear factor κB (NF-κB) signaling is an important feature of myocardial ischemia/reperfusion (I/R) injury and recent studies show that morphine postconditioning (MP) attenuates the myocardial injury. However, the mediating cardioprotective mechanisms remain unclear. The present study explores the role and interaction of heat shock protein 90 (HSP90), Akt, C5a, and NF-κB in MP-induced cardioprotection. METHODS: Male Sprague Dawley rats (n = 160) were randomized into eight groups (n = 20 per group). Rats in the sham group underwent thoracotomy, passing the ligature through the heart but without tying it (150 min), and the other seven groups were subjected to 30 min of anterior descending coronary artery occlusion followed by 2 h of reperfusion and the following treatments: I/R (30 min of ischemia and followed by 2 h of reperfusion); ischemic postconditioning (IPostC, 30 s of ischemia altered with 30 s of reperfusion, repeated for three cycles, and followed by reperfusion for 2 h); MP (0.3 mg/kg morphine administration 10 min before reperfusion); MP combined with the HSP90 inhibitor geldanamycin (GA, 1 mg/kg); MP combined with the Akt inhibitor GSK-690693 (GSK, 20 mg/kg); and MP combined with the C5a inhibitor PMX205 (PMX, 1 mg/kg/day, administration via drinking water for 28 days) and MP combined with the NF-κB inhibitor EVP4593 (QNZ, 1 mg/kg). All inhibitors were administered 10 min before morphine and followed by 2 h reperfusion. RESULTS: MP significantly reduced the I/R-induced infarct size, the apoptosis, and the release of cardiac troponin I, lactate dehydrogenase (LDH), and creatine kinase-MB. These beneficial effects were accompanied by increased expression of HSP90 and p-Akt, and decreased expression of C5a, NF-κB, tumor necrosis factor α, interleukin-1ß, and intercellular cell adhesion molecule 1. However, HSP90 inhibitor GA or Akt inhibitor GSK increased the expression of C5a and NF-κB and prevented MP-induced cardioprotection. Furthermore, GA inhibited the MP-induced upregulation of p-Akt, while GSK did not affect HSP90, indicating that p-Akt acts downstream of HSP90 in MP-induced cardioprotection. In addition, C5a inhibitor PMX enhanced the MP-induced downregulation of NF-κB, while NF-κB inhibitor QNZ had no effect on C5a, indicating that the C5a/NF-κB signaling pathway is involved in MP-induced cardioprotection. CONCLUSION: HSP90 is critical for MP-mediated cardioprotection possibly by promoting the phosphorylation of Akt and inhibiting the activation of C5a and NF-κB signaling and the subsequent myocardial inflammation, ultimately attenuating the infarct size and cardiomyocyte apoptosis.

Reconstruction of Periodic Band Limited Signals from Non-Uniform Samples with Sub-Nyquist Sampling Rate.

Important state parameters, such as torque and angle obtained from the servo control and drive system, can reflect the operating condition of the equipment. However, there are two problems with the information obtained through the network from the control and drive system: the low sampling rate, which does not meet the sampling theorem and the nonuniformity of the sampling points. By combing equivalent sampling and nonuniform signal reconstruction theory, this paper proposes a reconstruction method for signal obtained from servo system in periodic reciprocating motion. Equivalent sampling combines the low rate and nonuniform samples from multiple periods into one single period, so that the equivalent sampling rate is far increased. Then, the nonuniform samples with high density are further resampled to meet the reconstruction conditions. This step can avoid the amplitude error in the reconstructed signal and increase the possibility of successful reconstruction. Finally, the reconstruction formula derived from basis theory is applied to recover the signal. This method has been successfully verified by the simulation signal of the robot swing process and the actual current signal collected on the robot arm testbed.

Role of HSP90 in suppressing TLR4-mediated inflammation in ischemic postconditioning.

BACKGROUND: Myocardial inflammation mediated by toll-like receptor 4 (TLR4) plays an active role in myocardial ischemia/reperfusion (I/R) injury. Studies show that heat shock protein 90 (HSP90) is involved in ischemic postconditioning (IPostC) cardioprotection. This study investigates the roles of TLR4 and HSP90 in IPostC. METHODS: Rats were subjected to 30 min ischemia, then 2 h reperfusion. IPostC was applied by three cycles of 30 s reperfusion, then 30 s reocclusion at reperfusion onset. Sixty rats were randomly divided into four groups: sham, I/R, IPostC, and geldanamycin (GA, HSP90 inhibitor, 1 mg/kg) plus IPostC (IPostC + GA). RESULTS: IPostC significantly reduced I/R-induced infarct size (40.2±2.1% versus 28.4±2.4%; P < 0.05); the release of cardiac Troponin T, creatine kinase-MB, and lactate dehydrogenase (191.5±3.1 versus 140.6±3.3 pg/ml, 3394.6±132.7 versus 2880.7±125.5 pg/ml, 2686.2±98.6 versus 1848.8±90.1 pg/ml, respectively; P < 0.05); and cardiomyocyte apoptosis (40.3±2.2% versus 27.0±1.6%; P < 0.05). Further, local and circulating IL-1ß, IL-6, TNF-α, and ICAM-1 levels decreased; TLR4 expression and nuclear factor-KB (NF-κB) signaling decreased; and cardiac HSP90 expression increased. Blocking HSP90 function with GA inhibited IPostC protection and anti-inflammation, suggesting that IPostC has a HSP90-dependent anti-inflammatory effect. CONCLUSION: HSP90 may play a role in IPostC-mediated cardioprotection by inhibiting TLR4 activation, local and systemic inflammation, and NF-kB signaling.

Ischemic postconditioning attenuates the inflammatory response in ischemia/reperfusion myocardium by upregulating miR­499 and inhibiting TLR2 activation.

Toll-like receptor 2 (TLR2)-mediated myocardial inflammation serves an important role in promoting myocardial ischemic/reperfusion (I/R) injury. Previous studies have shown that miR­499 is critical for cardioprotection after ischemic postconditioning (IPostC). Therefore, the present study evaluated the protective effect of IPostC on the myocardium by inhibiting TLR2, and also assessed the involvement of microRNA (miR)­499. Rat hearts were subjected to 30 min of ischemia and 2 h of reperfusion. The IPostC was 3 cycles of 30 sec of reperfusion and 30 sec of re­occlusion prior to reperfusion. In total, 90 rats were randomly divided into six groups (n=15 per group): Sham; I/R; IPostC; miR­499 negative control adeno­associated virus (AAV) vectors + IPostC; miR­499 inhibitor AAV vectors + IPostC; and miR­499 mimic AAV vectors + IPostC. It was identified that IPostC significantly decreased the I/R­induced cardiomyocyte apoptotic index (29.4±2.03% in IPostC vs. 42.64±2.27% in I/R; P<0.05) and myocardial infarct size (48.53±2.49% in IPostC vs. 66.52±3.1% in I/R; P<0.05). Moreover, these beneficial effects were accompanied by increased miR­499 expression levels (as demonstrated by reverse transcription­quantitative PCR) in the myocardial tissue and decreased TLR2, protein kinase C (PKC), interleukin (IL)­1ß and IL­6 expression levels (as demonstrated by western blotting and ELISA) in the myocardium and serum. The results indicated that IPostC + miR­499 mimics significantly inhibited inflammation and the PKC signaling pathway and enhanced the anti­inflammatory and anti­apoptotic effects of IPostC. However, IPostC + miR­499 inhibitors had the opposite effect. Therefore, it was speculated that IPostC may have a miR­499­dependent cardioprotective effect. The present results suggested that miR­499 may be involved in IPostC­mediated ischemic cardioprotection, which may occur via local and systemic TLR2 inhibition, subsequent inhibition of the PKC signaling pathway and a decrease in inflammatory cytokine release, including IL­1ß and IL­6. Moreover, these effects will ultimately lead to a decrease in the myocardial apoptotic index and myocardial infarct size via the induction of the anti­apoptotic protein Bcl­2, and inhibition of the pro­apoptotic protein Bax in myocardium.

Involvement of HSP90 in ischemic postconditioning-induced cardioprotection by inhibition of the complement system, JNK and inflammation.

PURPOSE: To investigate whether heat shock protein 90 (HSP90) is involved in complement regulation in ischemic postconditioning (IPC). METHODS: The left coronary artery of rats underwent 30 min of occlusion, followed by 120 min of reperfusion and treatment with IPC via 3 cycles of 30s reperfusion and 30s occlusion. The rats were injected intraperitoneally with 1 mg/kg HSP90 inhibitor geldanamycin (GA) after anesthesia. Eighty rats were randomly divided into four groups: sham, ischemia-reperfusion (I/R), IPC and IPC + GA. Myocardial infarct size, apoptosis index and the expression of HSP90, C3, C5a, tumor necrosis factor (TNF)-alpha, interleukin (IL)-1ß and c-Jun N-terminal kinase (JNK) were assessed. RESULTS: Compared with the I/R injury, the IPC treatment significantly reduced infarct size, release of troponin T, creatine kinase-MB, and lactate dehydrogenase, and cardiomyocyte apoptosis. These beneficial effects were accompanied by a decrease in TNF-α, IL-1ß, C3, C5a and JNK expression levels. However, all these effects were abrogated by administration of the HSP90 inhibitor GA. CONCLUSION: HSP90 exerts a profound effect on IPC cardioprotection, and may be linked to the inhibition of the complement system and JNK, ultimately attenuating I/R-induced myocardial injury and apoptosis.

Development of a Computer-Assisted Adverse Drug Events Alarm and Assessment System for Hospital Inpatients in China.

BACKGROUND: Computerized detection is a promising method for monitoring adverse drug events (ADEs); however, this method is currently in its infancy and is a new area of exploration in China. This study aimed to develop a computerized ADE alarm and assessment system to help pharmacists effectively detect, assess, and analyze possible ADEs in patients in China. METHODS: Based on the clinical characteristics of these adverse drug events, we designed combined multiparameters as ADE alert rules to be assembled into detection configurations. We also developed system function modules by extracting data from the People's Liberation Army (PLA) general hospital information system (electronic medical records). Positive predictive values were calculated for the alert. RESULTS: Five function modules were created in this platform: automatic screening, assisted evaluation, risk characteristic analysis, report generation into SRS (spontaneous reporting system), and a dictionary database. Four ADE alert configurations were set in our ADE alarm and assessment system: drug-related thrombocytopenia, anemia, liver injury, and kidney injury. The positive predictive values of the 4 monitored ADEs were approximately 44.4% to 95.8%. CONCLUSIONS: An automatic ADE screening system was established for hospitalized patients in Chinese medical institutions. Compared with previous studies, combined drug-event alerts and a system-assisted assessment interface performed better than alerts based only on laboratory values. Furthermore, this platform's assisted-layered evaluation and risk factor analysis functions could save considerable time for professionals and improve early prevention of potentially serious ADEs. To date, this system has been applied in 10 large-scale medical institutions.

Assessment of persistent organic pollutants (POPs) in sediments of the Eastern Indian Ocean.

The concentrations of persistent organic pollutants (POPs) in sediments from the Eastern Indian Ocean were analyzed by GC-MS/MS to explore the status of contamination, distribution and their potential sources and risk. The average (±SD) concentrations of total polycyclic aromatic hydrocarbons (∑16PAHs), polybrominated diphenyl ethers (∑10PBDEs), dechlorane plus (∑2DP), organochlorine pesticides (∑22OCPs) and polychlorinated biphenyls (∑31PCBs) in sediments were 79,900 ± 31,400, 173 ± 62, 42 ± 24, 1051 ± 305 and 147 ± 24 pg g-1 dw (or 11,200 ± 7200, 28 ± 26, 6 ± 6, 168 ± 121 and 24 ± 17 ng g-1 organic carbon), respectively. The concentrations of POPs in sediments were generally at low to median levels compared to those recorded in other ocean sediments. Composition analyses suggest that PAHs originate from both petrogenic and pyrogenic sources, while dichlorodiphenyltrichloroethane (DDT) mainly comes from technical-DDT, hexachlorocyclohexane (HCH) from lindane, and chlordane from fresh inputs. The risk assessments show that the targeted chemicals except for chlordane and naphthalene in sediments do not pose potential biological effects to the organisms in the Eastern Indian Ocean. The present study contributes to the very rare data on PAHs, PBDEs, DP, OCPs and PCBs in the vast deep-ocean and will deepen our knowledge of the fate of POPs in ocean environments.

Identification of protein targets for the antidepressant effects of Kai-Xin-San in Chinese medicine using isobaric tags for relative and absolute quantitation.

Kai-Xin-San consists of Ginseng Radix, Polygalae Radix, Acori Tatarinowii Rhizoma, and Poria at a ratio of 3:3:2:2. Kai-Xin-San has been widely used for the treatment of emotional disorders in China. However, no studies have identified the key proteins implicated in response to Kai-Xin-San treatment. In this study, rat models of chronic mild stress were established using different stress methods over 28 days. After 14 days of stress stimulation, rats received daily intragastric administrations of 600 mg/kg Kai-Xin-San. The sucrose preference test was used to determine depression-like behavior in rats, while isobaric tags were used for relative and absolute quantitation-based proteomics to identify altered proteins following Kai-Xin-San treatment. Kai-Xin-San treatment for 2 weeks noticeably improved depression-like behaviors in rats with chronic mild stress. We identified 33 differentially expressed proteins: 7 were upregulated and 26 were downregulated. Functional analysis showed that these differentially expressed proteins participate in synaptic plasticity, neurodevelopment, and neurogenesis. Our results indicate that Kai-Xin-San has an important role in regulating the key node proteins in the synaptic signaling network, and are helpful to better understand the mechanism of the antidepressive effects of Kai-Xin-San and to provide objective theoretical support for its clinical application. The study was approved by the Ethics Committee for Animal Research from the Chinese PLA General Hospital (approval No. X5-2016-07) on March 5, 2016.

Involvement of HSP90 in ischemic postconditioning-induced cardioprotection by inhibition of the complement system, JNK and inflammation

Abstract Purpose To investigate whether heat shock protein 90 (HSP90) is involved in complement regulation in ischemic postconditioning (IPC). Methods The left coronary artery of rats underwent 30 min of occlusion, followed by 120 min of reperfusion and treatment with IPC via 3 cycles of 30s reperfusion and 30s occlusion. The rats were injected intraperitoneally with 1 mg/kg HSP90 inhibitor geldanamycin (GA) after anesthesia. Eighty rats were randomly divided into four groups: sham, ischemia-reperfusion (I/R), IPC and IPC + GA. Myocardial infarct size, apoptosis index and the expression of HSP90, C3, C5a, tumor necrosis factor (TNF)-alpha, interleukin (IL)-1β and c-Jun N-terminal kinase (JNK) were assessed. Results Compared with the I/R injury, the IPC treatment significantly reduced infarct size, release of troponin T, creatine kinase-MB, and lactate dehydrogenase, and cardiomyocyte apoptosis. These beneficial effects were accompanied by a decrease in TNF-α, IL-1β, C3, C5a and JNK expression levels. However, all these effects were abrogated by administration of the HSP90 inhibitor GA. Conclusion HSP90 exerts a profound effect on IPC cardioprotection, and may be linked to the inhibition of the complement system and JNK, ultimately attenuating I/R-induced myocardial injury and apoptosis.

Diagnostic value of fine-needle aspiration combined with ultrasound for thyroid cancer.

Diagnostic value of fine-needle aspiration (FNA) combined with ultrasound for thyroid cancer was evaluated. A retrospective analysis was performed on the preoperative FNA and ultrasound data of 165 thyroid nodule patients, were divided into group A (≤1 cm group) and group B (>1 cm group) based on the maximum diameter line of the thyroid nodule. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of FNA, ultrasound and FNA combined with ultrasound in the diagnosis of thyroid cancer were analyzed and compared. In group A (≤1 cm group), the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of FNA in the diagnosis of thyroid cancer were 93.33, 71.43, 91.04, 96.55 and 55.56%, respectively, those of ultrasound were 86.67, 28.57, 80.60, 91.23 and 20%, respectively, and those of FNA combined with ultrasound were 100, 28.57, 92.54, 92.6 and 100%, respectively, with statistically significant differences in the sensitivity, specificity, accuracy, positive predictive value and negative predictive value between FNA, ultrasound and FNA combined with ultrasound (P<0.05). In group B, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of FNA in the diagnosis of thyroid cancer were 100, 54.55, 94.90, 94.57 and 100%, respectively, those of ultrasound were 96.55, 72.73, 93.88, 96.55 and 72.73%, respectively, and those of FNA combined with ultrasound were 100, 63.64, 97.96, 95.92 and 100%, respectively, without statistically significant differences in the sensitivity, specificity, accuracy, positive predictive value and negative predictive value between FNA, ultrasound and FNA combined with ultrasound (P>0.05). FNA combined with ultrasound significantly improved the sensitivity and accuracy in the diagnosis of the thyroid nodule in group A, but it did not significantly improve the accuracy, sensitivity and specificity in the diagnosis of the thyroid nodule in group B.

The Prevalence of the Potential Drug-Drug Interactions Involving Anticancer Drugs in China: A Retrospective Study.

BACKGROUND: To survey the prevalence of potential drug-drug interactions (DDIs) between anticancer drugs and non-anticancer drugs and evaluate the risk factors associated with these drug-drug interactions in China. METHODS: All discharged patients in the Department of Oncology were collected from Jun to Dec in 2016 with the Hospital Information System of the Chinese people's Liberation Army General Hospital. Drugs were screened for interactions by Micromedex solutions database. Descriptive statistics were generated and logistic regression was used to identify the associated factors. RESULTS: Among 6578 eligible patients, 1979 potential drug interactions were found in 1830 patients (27.82%). The most common drug-drug interaction was cisplatin and furosemide. Erlotinib was most likely to interact with various non-anticancer drugs. Most interactions were classified as pharmacodynamics (71.60%), major severity (97.02%) and were supported by fair documentation evidence (86.21%). In multivariate analysis, increasing number of medications, lung cancer and patients with stage IV had a higher risk for potential drug-drug interactions. CONCLUSION: Potential drug-drug interactions between antineoplastic drugs and non-antineoplastic drugs occur frequently in cancer patients of Chinese hospitals. Doctors should fully consider potential risk associated with DDIs. Further research should be performed to evaluate real clinical significance of these drug-drug interactions.

Coupled ocean-atmosphere dynamics of the 2017 extreme coastal El Niño.

In March 2017, sea surface temperatures off Peru rose above 28 °C, causing torrential rains that affected the lives of millions of people. This coastal warming is highly unusual in that it took place with a weak La Niña state. Observations and ocean model experiments show that the downwelling Kelvin waves caused by strong westerly wind events over the equatorial Pacific, together with anomalous northerly coastal winds, are important. Atmospheric model experiments further show the anomalous coastal winds are forced by the coastal warming. Taken together, these results indicate a positive feedback off Peru between the coastal warming, atmospheric deep convection, and the coastal winds. These coupled processes provide predictability. Indeed, initialized on as early as 1 February 2017, seasonal prediction models captured the extreme rainfall event. Climate model projections indicate that the frequency of extreme coastal El Niño will increase under global warming.