A Chinese scoring system for predicting successful retrograde collateral traverse in patients with chronic total coronary occlusion.

BACKGROUND: Retrograde approach technique has been challenging in percutaneous coronary interventional treatment of chronic total occlusion (CTO) coronary disease. The present study endeavors to determine a novel Chinese scoring system for predicting successful collateral channels traverse via retrograde approach. METHODS: The demographic characteristics and angiographic characteristics of 309 CTO patient were analyzed by univariable and multivariable analysis for selecting potential predictors. And the nomogram was used to establish the scoring system. Then it was evaluated by the internal and external validation. RESULTS: The predictors of Age, Connections between collateral channels and recipient vessels, and Channel Tortuosity (ACT) were identified with univariable and multivariable analysis and employed to the ACT score system. With acceptable calibrations, the area under curve of the scoring system and the external validation were 0.826 and 0.816 respectively. Based on score, the predictors were divided into three risk categories and it showed a consistent prediction power in the validation cohort. CONCLUSIONS: The novel Chinese ACT score is a reliable tool for predicting successful retrograde collateral traverse.

[Horizontal Variation Characteristics of Alpine Grassland Soil Function and Vertical Changes Along Soil Genetic Horizons in the Three-River Headwaters Region].

The Three-River Headwaters region is a hotspot for studying the response of soil function to climate change. To study the horizontal variation characteristics of alpine grassland soil function and vertical changes along soil genetic horizons, soil functional indicators (including respiration, nitrogen conversion rate, and enzymatic activity) of different genetic horizons in alpine grassland soil profiles and their correlations with environmental factors were analyzed. The results showed that there were no significant differences in soil functional characteristics between alpine meadows and steppes, and topsoil had higher respiration rates, nitrogen conversion rates, and enzymatic activities than those of subsoil. Total nitrogen was a key driver of soil functional characteristics in different genetic horizons, explaining 18.3%, 21.4%, and 27.5% of the horizontal variation in functional characteristics, respectively. Climate and vegetation factors mainly affected soil function indirectly by changing soil physicochemical properties in topsoil, but atmospheric nitrogen deposition still affected soil function in subsoil. These results indicate the significant nitrogen limitation of alpine grassland soil in the Three-River Headwaters region, and the findings provide a new insight into the maintenance of soil functional diversity and the response to climate change in the context of global climate change.

A high triglyceride-glucose index associated with adverse cardiovascular events in patients with type 2 diabetes mellitus and chronic total occlusion after percutaneous coronary intervention.

Triglyceride-glucose index (TyG index) is a reliable surrogate marker of insulin resistance, associated with morbidity and prognosis of cardiovascular disease. However, its predictive value for cardiovascular events in patients with type 2 diabetes mellitus (T2DM) and chronic total occlusion (CTO) after percutaneous coronary intervention (PCI) has not been studied. Here, we retrospectively enrolled 681 patients with T2DM and CTO after PCI. Patients were divided into two groups based on a median TyG index of 9.02. The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The primary observational end point was the composite of overall death, nonfatal myocardial infarction, and unplanned revascularization. The Multivariate Cox hazards regression analysis showed that the TyG index was significantly correlated with the primary end point (hazard ratio = 1.699, 95% confidence interval 1.254-2.303, p = 0.001). The addition of TyG to a baseline risk model had an incremental effect on the predictive value for the primary end point (area under the curve: TyG index vs baseline model, 0.693 vs 0.663, comparison p = 0.040; integrated discrimination improvement = 0.049, p = 0.020). The TyG index might be a predictor of adverse cardiovascular events. Moreover, adding the TyG index into a baseline risk model had a cumulative effect on the predictive potential for the primary end point.

[Coupling Relationship Between Soil Functions and Environmental Factors Along an Altitudinal Gradient: A Case Study of the Meili Mountain].

Soil respiration and extracellular enzyme activity are important components of the material cycle of mountain ecosystems and play key roles in maintaining ecosystem functions. To explore the coupling relationship between soil functions and environmental factors, the soil functional indicators, environmental factors, and effects of altitude on the soil function of 36 soil samples from 12 altitudes of the Meili Mountain were analyzed. The results showed that there were significant differences in soil respirations and enzyme activities among altitudes of Meili Mountain, and high-altitude areas had higher soil functions. Soil functions increased with altitudinal difference. PCA analysis showed that the first three axes explained 56.7%, 17.4%, and 8.7% of the variance in soil functional elevation change, respectively, indicating that the functional changes related to carbon and phosphorus were higher than those related to nitrogen. There were significant correlations between environmental factors and soil functional indicators; soil function indicators had stronger correlations with soil physicochemical properties than with climatic factors. Altitude mainly affected soil function indirectly by affecting soil physicochemical properties and climatic factors. These results have great scientific significance for improving the understanding of the material cycle and ecological function of the Meili Mountain ecosystem and provide an important reference for in-depth study of the altitude distribution pattern and evolution characteristics of the soil function of the mountain ecosystem.

Paraneoplastic neurological syndrome caused by cystitis glandularis: A case report and literature review.

BACKGROUND: Paraneoplastic neurological syndrome (PNS) is an unusual event. PNS caused by cystitis glandularis (CG) or a bladder tumor is extremely rare; hence, missed diagnosis or misdiagnosis can easily occur. To date, approximately 21 cases have been reported in PubMed. CASE SUMMARY: We report a case of PNS caused by CG and describe the clinical and imaging features. The main clinical feature was advanced cognitive impairment, and early clinical features were memory impairment, decreased computational ability, and abnormal behavior. Later clinical features were dementia, vomiting, inability to eat and walk, urinary incontinence, and hematuria. Imaging features on cranial magnetic resonance imaging were diffuse white matter lesions. Paraneoplastic tumor markers were normal. A total abdominal computed tomography scan showed multiple thickened areas on the bladder wall with local prominence. Cystoscopy revealed a volcanic protuberance on the posterior wall of the bladder with a diameter of 6 cm and no pedicle. The postoperative pathological diagnosis was CG. The patient recovered well following resection of CG. PNS cases caused by previous bladder tumors can be retrieved from PubMed to describe the clinical signs and prognosis of PNS. CONCLUSION: The main clinical feature of PNS caused by CG was dementia, and the imaging features were diffuse cerebral white matter lesions. Resection of CG lesions is the fundamental treatment for PNS induced by CG. This case highlights the importance of etiological treatment.

Serum glycated albumin is associated with in-stent restenosis in patients with acute coronary syndrome after percutaneous coronary intervention with drug-eluting stents: An observational study.

Background: Previous studies have confirmed the predicted value of serum glycated albumin (GA) in atherosclerotic cardiovascular disease. However, the relationship between GA and the development of in-stent restenosis (ISR) after drug-eluting stent (DES) implantation has not been verified in patients with acute coronary syndrome (ACS). Materials and methods: In this study, 797 patients diagnosed with ACS who underwent re-coronary angiography more than 6 months after the first successful DES-based percutaneous coronary intervention (PCI) were eventually included. Patients were categorized into two groups based on the median GA levels of 14.94%. Moreover, multivariate logistic regression analysis models and the net reclassification improvement and integrated differentiation improvement risk models were constructed to assess the relationship between the GA and DES-ISR in patients with ACS. Results: The GA was significantly associated with an increased risk of DES-ISR, upon adjusting for confounding factors (as nominal variate: OR 1.868, 95% CI 1.191-2.932, P = 0.007; as continuous variate: OR 1.109, 95% CI 1.040-1.183, P = 0.002). The addition of GA to a baseline risk model had an incremental effect on the predictive value for DES-ISR (AUC: GA vs. baseline model, 0.714 vs. 0.692, comparison P = 0.017; category-free net reclassification improvement (NRI) 0.080, P = 0.035; integrated discrimination improvement (IDI) 0.023, P < 0.001). Conclusion: GA level was significantly associated with a high risk of DES-ISR in patients with ACS treated with PCI. Moreover, the addition of the GA to a baseline risk model has an incremental effect on the predictive potential for DES-ISR.

Admission high-sensitivity C-reactive protein levels improve the Grace risk score prediction on in-hospital outcomes in acute myocardial infarction patients.

BACKGROUND: Acute myocardial infarction (AMI) is the main cause of death and disability in cardiovascular and cerebrovascular diseases. Both the Global Registry of Acute Coronary Events (Grace) score and high-sensitivity C-reactive protein (hs-CRP) were associated with prognosis in patients with AMI. However, whether the addition of the hs-CRP to Grace risk score could improve the predictive power of Grace risk score on the prognosis of patients with AMI is unclear. HYPOTHESIS: We hypothesized that the inclusion of hs-CRP in the Grace risk score could improve the ability to correctly distinguish the occurrence of in-hospital outcomes. METHODS: We retrospectively enrolled 1804 patients with AMI in the final analysis. Patients were divided into four groups by hs-CRP quartiles. The relation between hs-CRP and Grace risk score was analyzed by Spearman rank correlation. Logistic regression was used to identify independent risk factors. The predictive value of hs-CRP add to Grace risk score was evaluated by C-statistic, net reclassification improvement (NRI), integrated differentiation improvement (IDI), calibration plot, and decision curve analysis. RESULTS: The hs-CRP and Grace risk score had a significantly positive correlation (r = .191, p < .001). hs-CRP combined with Grace risk score could improve the ability of Grace risk score alone to correctly redistinguish the occurrence of in-hospital outcome (C-statistic = 0.819, p < .001; NRI = 0.05956, p = .007; IDI = 0.0757, p < .001). CONCLUSION: Admission hs-CRP level was a significant independent risk factor for in-hospital outcomes in patients with AMI. The inclusion of hs-CRP in the Grace risk score could improve the ability to correctly distinguish the occurrence of in-hospital outcomes.

Tumor Microenvironment-Activated Theranostics Nanozymes for Fluorescence Imaging and Enhanced Chemo-Chemodynamic Therapy of Tumors.

Chemodynamic therapy (CDT) is widely explored for tumor-specific therapy by converting endogenous H2O2 to lethal ·OH to destroy cancer cells. However, ·OH scavenging by glutathione (GSH) and insufficient intratumoral H2O2 levels seriously hinder the application of CDT. Herein, we reported the fabrication of copper ion-doped ZIF-8 loaded with gold nanozymes and doxorubicin hydrochloride (DOX) for the chemotherapy and CDT synergistic treatment of tumors with the assistance of tumor microenvironment (TME)-activated fluorescence imaging. The Cu2+-doped ZIF-8 shell was gradually degraded to release DOX and gold nanoclusters responding to the acidic TME. The fluorescence signal of the tumor region was acquired after the quenched fluorescence of the gold nanoclusters by Cu2+ and DOX by aggregation-induced quenching was turned on because of the interaction of GSH with Cu2+ and the release of free DOX. The Cu2+ ions could deplete the GSH via redox reactions and the generated Cu+ could convert internal H2O2 to ·OH for tumor CDT. The chemotherapeutic effect of DOX was strengthened through drug efflux inhibition and drug sensitivity increase due to the consumption of GSH and ·OH burst. Moreover, DOX could raise the level of H2O2 and augment the effect of CDT. In addition, the fluorescent gold nanoclusters not only served as a peroxidase to convert H2O2 to ·OH but also employed as an oxidase to consume GSH, resulting in the amplification of chemotherapy and CDT. This work presents an approach to construct tumor microenvironment-activated theranostic probes without external stimuli and to achieve the tumor elimination through cascade reactions and synergistic treatment.

De novo transcriptome sequencing and anthocyanin metabolite analysis reveals leaf color of Acer pseudosieboldianum in autumn.

BACKGROUND: Leaf color is an important ornamental trait of colored-leaf plants. The change of leaf color is closely related to the synthesis and accumulation of anthocyanins in leaves. Acer pseudosieboldianum is a colored-leaf tree native to Northeastern China, however, there was less knowledge in Acer about anthocyanins biosynthesis and many steps of the pathway remain unknown to date. RESULTS: Anthocyanins metabolite and transcript profiling were conducted using HPLC and ESI-MS/MS system and high-throughput RNA sequencing respectively. The results demonstrated that five anthocyanins were detected in this experiment. It is worth mentioning that Peonidin O-hexoside and Cyanidin 3, 5-O-diglucoside were abundant, especially Cyanidin 3, 5-O-diglucoside displayed significant differences in content change at two periods, meaning it may be play an important role for the final color. Transcriptome identification showed that a total of 67.47 Gb of clean data were obtained from our sequencing results. Functional annotation of unigenes, including comparison with COG and GO databases, yielded 35,316 unigene annotations. 16,521 differentially expressed genes were identified from a statistical analysis of differentially gene expression. The genes related to leaf color formation including PAL, ANS, DFR, F3H were selected. Also, we screened out the regulatory genes such as MYB, bHLH and WD40. Combined with the detection of metabolites, the gene pathways related to anthocyanin synthesis were analyzed. CONCLUSIONS: Cyanidin 3, 5-O-diglucoside played an important role for the final color. The genes related to leaf color formation including PAL, ANS, DFR, F3H and regulatory genes such as MYB, bHLH and WD40 were selected. This study enriched the available transcriptome information for A. pseudosieboldianum and identified a series of differentially expressed genes related to leaf color, which provides valuable information for further study on the genetic mechanism of leaf color expression in A. pseudosieboldianum.

Injectable polypeptide-engineered hydrogel depot for amplifying the anti-tumor immune effect induced by chemo-photothermal therapy.

The immunosuppressive tumor microenvironment has caused great obstacles to tumor immunotherapy, especially where less tumor-associated antigens are released from tumor sites. Herein, a Ag2S QD/DOX/Bestatin@PC10ARGD genetically engineered polypeptide hydrogel PC10ARGD as a sustained-release material was developed for mammary carcinoma treatment. A near-infrared silver sulfide (Ag2S) QD as a photosensitizer was encapsulated into the hydrophobic cavity formed by the self-assembly of the polypeptide nanogel (PC10ARGD) for photothermal therapy. The water-soluble drug DOX and Bestatin were integrated into the PC10ARGD hydrogel. The photothermal effect could trigger the sustained release of the DOX, which could be applied to initiate in situ vaccination. Bestatin as an immune-adjuvant drug could amplify the body's immune function. The results of in vivo therapy tests exhibited that the Ag2S QD/DOX/Bestatin@PC10ARGD hydrogel with laser irradiation could activate anti-tumor immune effects that inhibit the growth of primary tumors and distal lung metastatic nodules. Meanwhile, a safer lower-temperature with multiple laser irradiation treatment strategy exhibited more effective tumor-killing performance (84.4% tumor inhibition rate) and promoted the penetration of immune cells into the tumor tissue. The CD8+ and CD4+ cytotoxic T cells ratio was increased by 5.3 and 10 times, respectively, thus exhibiting a good prognostic signal. The multifunctional polypeptide hydrogel as a green manufacturing and engineering material is promising to serve as a cancer vaccine for anticancer applications.

An in situ synthesis of silver nanoparticle-loaded genetically engineered polypeptide nanogels for antibacterial and wound healing applications.

The fact that the wounds infected by bacteria are difficult to heal is a major health issue. Herein, we synthesized silver nanoparticle-loaded polypeptide nanogels via an in situ method using UV irradiation, which is a relatively green and simple method. The size of the nanogel and silver nanoparticles could be regulated by changing the concentrations of the polypeptide and silver ions, respectively. Because the polypeptide PC10ARGD was histidine-rich and biodegradable, the as-synthesized silver nanogels exhibited low toxicity and good biocompatibility. The in vitro antibacterial experiments showed that the silver nanogels presented excellent antibacterial activity against both Gram-negative and Gram-positive bacteria. Moreover, silver nanogels had a good effect as an antibacterial and wound healing agent in vivo. These findings provide a new strategy and theoretical basis for the synthesis and application of silver nanoparticles.

A capillary electrophoresis strategy to sensitively detect dynamic properties of coiled coil polypeptides.

The self-assembly behavior of polypeptides plays an essential role to form biological and functional macromolecules, which have attracted a lot of attention due to their excellent characters. Understanding the polypeptide self-assembly systems and dynamic behaviors is fundamental to improve the potential of biomedical applications. In this work, coiled coil polypeptides PC10 and PC10 P were designed and biosynthesized. PC10 and PC10 P could form nanogels when the concentration of polypeptides was less than 2% (m/v). The dynamic behaviors of PC10 and PC10 P were measured by Förster resonance energy transfer method based on a capillary electrophoresis system. The Förster resonance energy transfer efficiency of this system was 60.4%, and the distance of self-assembled domains in the polypeptides was calculated as 6.14 nm, demonstrating that the exchange behavior occurred between two different polypeptides containing the same coiled coil region.

Realizing an Omega-Shaped Gate MoS2 Field-Effect Transistor Based on a SiO2/MoS2 Core-Shell Heterostructure.

Substantial progress has been made in the experimental synthesis of large-area two-dimensional transition metal dichalcogenide (TMD) thin films in recent years. This has provided a solid basis to build non-planar structures to implement the unique electrical and mechanical properties of TMDs in various nanoelectronic and mechano-electric devices, which, however, has not yet been fully explored. In this work, we demonstrate the fabrication and characterization of MoS2 field-effect transistors (FETs) with an omega (Ω)-shaped gate. The FET is built based on the SiO2/MoS2 core-shell heterostructure integrated using atomic layer deposition (ALD) technique. The MoS2 thin film has been uniformly deposited by ALD as wrapping the SiO2 nanowire forming the channel region, which is further surrounded by the gate dielectric and the Ω-gate. The device has exhibited n-type behavior with effective switching comparable to the reference device with a planar MoS2 channel built on a SiO2/Si substrate. Our work opens up an attractive avenue to realize novel device structures utilizing synthetic TMDs, thereby broadening their potential application in future advanced nanoelectronics.

Myocardial bridge-related coronary heart disease: Independent influencing factors and their predicting value.

BACKGROUND: Myocardial bridge (MB) will compress the mural coronary artery (MCA) during the systole and cause myocardial ischemia. In the diagnosis of coronary heart disease (CHD), because the structure of MB is difficult to be observed by coronary angiography (CAG), the clinical study of the influence of MB on CHD is lacking. With the advancement of computed tomography coronary angiography technology, detailed observations of the MB anatomy have realized. AIM: To explore the main influencing factors of MB-related CHD and to find potential indicators for predicting MB-related CHD. METHODS: A total of 1718 patients with suspected CHD due to the symptoms of myocardial ischemia were enrolled as subjects. Patients diagnosed with CHD were included in a CHD group, and patients with no significant abnormalities were included in a control group. In the CHD group, patients were divided into an MB-CHD subgroup if MB-related CHD was found. In the control group, patients were divided into a simple MB subgroup if MB was found. The patient's clinical data and MB-related indicators, including the branch of MB, MB type (superficial/deep type), MB length, MB thickness, systolic and diastolic compression of the MCA, and MCA systolic stenosis rate were recorded and compared. Logistic regression analysis was used to explore the independent influencing factors of MD-related CHD. ROC curve was used to analyze the diagnostic efficacy of potential indicators for MB-related CHD. RESULTS: There were 1060 cases in the CHD group and 658 cases in the control group, and there were 236 cases in the MB-CHD subgroup and 52 cases in the simple MB subgroup. Multivariate logistic regression analysis showed that the combined MB had a significant effect on the occurrence of CHD (P < 0.05). MB thickness, systolic compression, diastolic compression, and MCA systolic stenosis rate had significant effects on the occurrence of MB-related CHD (P < 0.05). The area under the curve (AUC) of the combination of these influencing factors for the diagnosis of MB-related CHD was 0.959, which was significantly higher than the AUCs of the four indicators separately (P < 0.05). The sensitivity was 97.06% and the specificity was 87.63%. CONCLUSION: MB thickness, systolic compression, diastolic compression, and MCA systolic stenosis are independent influencing factors for MB-related CHD. The combination of these factors has potential diagnostic value for MB-related CHD.

In situ aqueous synthesis of genetically engineered polypeptide-capped Ag2S quantum dots for second near-infrared fluorescence/photoacoustic imaging and photothermal therapy.

Ag2S quantum dots have received extensive attention as theranostic agents for second near-infrared (NIR-II) fluorescence and photoacoustic dual-mode imaging, and photothermal therapy. However, it is still greatly challenging to synthesize Ag2S quantum dots using aqueous synthesis. In this study, genetically engineered polypeptide-capped Ag2S quantum dots were successfully synthesized. Three cysteines were integrated to the C-terminal and N-terminal of RGDPC10A to enhance the stability and brightness of the synthesized Ag2S quantum dots. The RGDPC10A-capped Ag2S quantum dots exhibited excellent stability, outstanding resistance to photobleaching, and a superior quantum yield of up to 3.78% in the NIR-II biological window. The in vitro and in vivo results showed that the RGDPC10A-capped Ag2S quantum dots possessed typical NIR-II fluorescence, photoacoustic imaging, and photothermal therapeutic effectiveness against tumors. Moreover, the results of toxicity assays suggested that the RGDPC10A-capped Ag2S quantum dots have negligible long-term toxicity. These findings open up the possibility for synthesizing theranostic agents by using this aqueous method.

High quantum yield Ag2S quantum dot@polypeptide-engineered hybrid nanogels for targeted second near-infrared fluorescence/photoacoustic imaging and photothermal therapy.

A high quantum yield (4.3%) hybrid nanogel system based on engineered polypeptides and Ag2S quantum dots has been developed as a multifunctional diagnostic and therapeutic agent for targeted second near-infrared fluorescence, photoacoustic imaging, and photothermal therapy.

Impact of Metal Contacts on the Performance of Multilayer HfS2 Field-Effect Transistors.

HfS2 is one of the emerging transition metal dichalcogenides and is very promising for low-power nanoelectronics and high-sensitivity optoelectronic device applications. We studied the band structures of 1T-HfS2 with different thicknesses by first principles simulation, and the impact of different metal contacts to the HfS2 device performance has been experimentally studied. Back-gate and top-gate HfS2 field-effect transistors (FETs) were fabricated, and better electrical characteristics have been achieved with the FETs with the Ti/Au contact as compared with the Pt-contacted FETs. Thin layers of Pt and Ti/Au films were deposited on HfS2 flakes to investigate the metal/HfS2 interface by using scanning electron microscopy, atomic force microscopy, and Raman spectroscopy. A smoother Ti/Au film was formed on HfS2, resulting in higher carrier injection and transport efficiency. The phonon behavior being dominated by the interface chemical bonding at the Ti/Au contact region has been confirmed with the more sensitive A1g phonon mode from the bilayer HfS2.

Correlates of Condom-use Self-efficacy on the EPPM-based Integrated Model among Chinese College Students.

OBJECTIVE: To explore the predictors of condom-use self-efficacy in Chinese college students according to the extended parallel process model (EPPM)-based integrated model. METHODS: A total of 3,081 college students were anonymously surveyed through self-administered questionnaires in Guangzhou and Harbin, China. A structural equation model was applied to assess the integrated model. RESULTS: Among the participants, 1,387 (46.7%) were male, 1,586 (53.3%) were female, and the average age was 18.6 years. The final integrated model was acceptable. Apart from the direct effect (r = 0.23), perceived severity had two indirect effects on condom-use self-efficacy through the attitude to HIV education (r = 0.40) and intention to engage in premarital sex (r = -0.16), respectively. However, the perceived susceptibility mediated through the intention to engage in premarital sex (intent-to-premarital-sex) had a poor indirect impact on condom-use self-efficacy (total effect was -0.06). Furthermore, attitude toward HIV health education (r = 0.49) and intent-to-premarital-sex (r = -0.31) had a strong direct effect on condom-use self-efficacy. In addition, male students perceived higher susceptibility, stronger intent-to-premarital-sex, and lower condom-use self-efficacy than female students. CONCLUSION: The integrated model may be used to assess the determinants of condom-use self-efficacy among Chinese college students. Future research should focus on raising the severity perception, HIV-risk-reduction motivation, and the premarital abstinence intention among college students. Furthermore, considering the gender differences observed in the present survey, single-sex HIV education is required in school-based HIV/sex intervention.

Polypeptide-Engineered Hydrogel Coated Gold Nanorods for Targeted Drug Delivery and Chemo-photothermal Therapy.

A new hybrid nanogel system using polypetide-engineered coated gold nanorods has been developed for targeted drug delivery and tumor chemo-photothermal therapy. A triblock engineered polypeptide PC10A(RGD) was immobilized on the surface of gold nanorods by the electrostatic adsorption. The immobilized PC10A(RGD) formed hydrogel by self-assembly to load doxorubicin for chemotherapy. Coating polypeptide-engineering hydrogel on gold nanorods enhanced the stability in high-salt media and significantly reduced the cytotoxicity. An arginine-glycine-aspartic acid motif was introduced into the polypeptide on the surface of hybrid nanogels to promote cellular uptake through receptor-mediated endocytosis in αvß3 overexpressing HeLa cells. In addition, compared with single chemotherapy and near-infrared photothermal therapy, the combination therapy has a synergistic effect on the cancer cells. Thus, the chemo-photothermal therapy based on polypeptide-engineered hydrogel coated gold nanorods and doxorubicin is expected to have great potential impact on cancer therapy.

Randomized Comparison of the Crush Versus the Culotte Stenting for Coronary Artery Bifurcation Lesions.

BACKGROUND: The crush and the culotte stenting were both reported to be effective for complex bifurcation lesion treatment. However, their comparative performance remains elusive. METHODS: A total of 300 patients with coronary bifurcation lesions were randomly assigned to crush (n = 150) and culotte (n = 150) treatment. The primary endpoint was the occurrence of major adverse cardiac events (MACEs) at 12 months including cardiac death, myocardial infarction, stent thrombosis, and target vessel revascularization. Index lesion restenosis at 12 months was a secondary endpoint. The surface integrals of time-averaged wall shear stress at bifurcation sites were also be quantified. RESULTS: There were no significant differences in MACE rates between the two groups at 12-month follow-up: Crush 6.7%, culotte 5.3% (P = 0.48). The rates of index lesion restenosis were 12.7% versus 6.0% (P = 0.047) in the crush and the culotte groups, respectively. At 12-month follow-up, the surface integrals of time-averaged wall shear stress at bifurcation sites in the crush group were significantly lower than the culotte group ([5.01 ± 0.95] × 10-4 Newton and [6.08 ± 1.16] × 10-4 Newton, respectively; P = 0.003). CONCLUSIONS: Both the crush and the culotte bifurcation stenting techniques showed satisfying clinical and angiographic results at 12-month follow-up. Bifurcation lesions treated with the culotte technique tended to have lower restenosis rates and more favorable flow patterns.