Association of interleukin 17 / angiotensin II with refractory hypertension risk in hemodialysis patients.

Objective: The study was performed to investigate the association of interleukin 17 (IL 17) or angiotensin II (Ang II) with refractory hypertension risk in hemodialysis patients. Methods: Ninety hemodialysis patients were enrolled into this study, and those with hypertension were divided into two groups. The Easy-to-Control Hypertension group (ECHG) had fifty patients, while the refractory hypertension group (RHG) had forty patients. Twenty healthy individuals were recruited as the control group. IL17 and Ang II were determined using a human IL 17 / Ang II enzyme-linked immunosorbent assay kit. Serum IL 17 and Ang II concentrations in RHG patients were higher than those in ECHG patients. Results: Serum IL 17 and Ang II concentrations in both patient groups were higher than those in the control group. Linear regression analysis showed a positive correlation between IL 17 and Ang II. In multivariate regression analysis, we found that IL17 and Ang II were associated with refractory hypertension risk in hemodialysis patients. Conclusion: IL17 and Ang II were associated with refractory hypertension risk in hemodialysis patients. There was also a positive correlation between IL 17and Ang II

Integrating Strategies of Herbal Metabolomics, Network Pharmacology, and Experiment Validation to Investigate Frankincense Processing Effects

In-depth research on processing can promote the globalization of processed herbs. The purpose of this study is to propose an improved strategy for processing effect investigation. Frankincense and processed frankincense were used as research subjects. First, high-speed countercurrent chromatography (HSCCC) and preparation high-performance liquid chromatography (PHPLC) techniques were used for major compounds isolation and minor compounds concentration. Processed frankincense was subjected to two stepwise solvent systems, namely, n-hexane:ethanol:water (6:5:1) and n-hexane:methyl-acetate:acetonitrile:water (4:4:3:4), to yield 12 fractions, and 18 compounds were further separated. Second, a comprehensive metabolomic analysis conducted by ultrahigh-performance liquid-chromatography/electrospray-ionization mass spectrometry (UHPLC-Qtof-MS) coupled with multivariate statistics was performed to fully characterize the chemical components and discover the potential biomarkers between frankincense and processed frankincense. In total, 81 metabolites, including the 18 separated compounds, were selected as potential biomarkers between frankincense and processed frankincense among 153 detected compounds for their VIP values of greater than one. The tirucallane-type compounds and components with 9,11-dehydro structures clearly occurred at high levels in the processed frankincense, while lupine-type compounds and those with 11-keto structures were significantly higher in frankincense. Then, a network pharmacology model was constructed to decipher the potential mechanisms of processing. Intestinal absorption properties prediction indicated the possibility of processing-related absorption enhancement. A systematic analysis of the constructed networks showed that the C-T network was constructed with 18 potential biomarkers and 69 targets. TNF and IL-1β were among the top-ranked and were linked by 8 and 7 pathways, which were mainly involved in inflammation. The arachidonic acid metabolism pathway exhibited the highest number of target connections. Finally, the prediction was validated experimentally by an intestinal permeability and efficacy assay. The experiments provided convincing evidence that processed frankincense harbored stronger inhibition effects toward TNF-α-, IL-1β- and arachidonic acid-induced platelet aggregation. The processing procedure leads to changes of the chemical metabolites, which triggers the enhancement of absorption and cure efficiency. The global change of the metabolites, absorption and pharmacological effects of processing were depicted in a systematic manner

Automated Detection of High-Frequency Oscillations in Epilepsy Based on a Convolutional Neural Network

Epilepsy is one of the most common chronic neurological diseases. High-frequency oscillations (HFOs) have emerged as promising biomarkers for the epileptogenic zone. However, visual marking of HFOs is a time-consuming and laborious process. Several automated techniques have been proposed to detect HFOs, yet these are still far from being suitable for application in a clinical setting. Here, ripples and fast ripples from intracranial electroencephalograms were detected in six patients with intractable epilepsy using a convolutional neural network (CNN) method. This approach proved more accurate than using four other HFO detectors integrated in RIPPLELAB, providing a higher sensitivity (77.04% for ripples and 83.23% for fast ripples) and specificity (72.27% for ripples and 79.36% for fast ripples) for HFO detection. Furthermore, for one patient, the Cohen's kappa coefficients comparing automated detection and visual analysis results were 0.541 for ripples and 0.777 for fast ripples. Hence, our automated detector was capable of reliable estimates of ripples and fast ripples with higher sensitivity and specificity than four other HFO detectors. Our detector may be used to assist clinicians in locating epileptogenic zone in the future

Deletion of scavenger receptor A protects mice from progressive nephropathy independent of lipid control during diet-induced hyperlipidemia

Scavenger receptor A (SR-A) is a key transmembrane receptor in the endocytosis of lipids and contributes to the pathogenesis of atherosclerosis. To assess its role in hyperlipidemic chronic kidney disease, wild-type and SR-A-deficient (knockout) mice underwent uninephrectomy followed by either normal or high-fat diet. After 16 weeks of diet intervention, hyperlipidemic wild-type mice presented characteristic features of progressive nephropathy: albuminuria, renal fibrosis, and overexpression of transforming growth factor (TGF)-β1/Smad. These changes were markedly diminished in hyperlipidemic knockout mice and attributed to reduced renal lipid retention, oxidative stress, and CD11c+ cell infiltration. In vitro, overexpression of SR-A augmented monocyte chemoattractant protein-1 release and TGF-β1/Smad activation in HK-2 cells exposed to oxidized low-density lipoprotein. SR-A knockdown prevented lipid-induced cell injury. Moreover, wild-type to knockout bone marrow transplantation resulted in renal fibrosis in uninephrectomized mice following 16 weeks of the high-fat diet. In contrast, knockout to wild-type bone marrow transplantation led to markedly reduced albuminuria, CD11c+ cell infiltration, and renal fibrosis compared to wild-type to SR-A knockout or wild-type to wild-type bone marrow transplanted mice, without difference in plasma lipid levels. Thus, SR-A on circulating leukocytes rather than resident renal cells predominantly mediates lipid-induced kidney injury

Application of Angiotensin Receptor–Neprilysin Inhibitor in Chronic Kidney Disease Patients: Chinese Expert Consensus

Chronic kidney disease (CKD) is a global public health problem, and cardiovascular disease is the most common cause of death in patients with CKD. The incidence and prevalence of cardiovascular events during the early stages of CKD increases significantly with a decline in renal function. More than 50% of dialysis patients die from cardiovascular disease, including coronary heart disease, heart failure, arrhythmia, and sudden cardiac death. Therefore, developing effective methods to control risk factors and improve prognosis is the primary focus during the diagnosis and treatment of CKD. For example, the SPRINT study demonstrated that CKD drugs are effective in reducing cardiovascular and cerebrovascular events by controlling blood pressure. Uncontrolled blood pressure not only increases the risk of these events but also accelerates the progression of CKD. A co-crystal complex of sacubitril, which is a neprilysin inhibitor, and valsartan, which is an angiotensin receptor blockade, has the potential to be widely used against CKD. Sacubitril inhibits neprilysin, which further reduces the degradation of natriuretic peptides and enhances the beneficial effects of the natriuretic peptide system. In contrast, valsartan alone can block the angiotensin II-1 (AT1) receptor and therefore inhibit the renin–angiotensin–aldosterone system. These two components can act synergistically to relax blood vessels, prevent and reverse cardiovascular remodeling, and promote natriuresis. Recent studies have repeatedly confirmed that the first and so far the only angiotensin receptor–neprilysin inhibitor (ARNI) sacubitril/valsartan can reduce blood pressure more effectively than renin–angiotensin system inhibitors and improve the prognosis of heart failure in patients with CKD. Here, we propose clinical recommendations based on an expert consensus to guide ARNI-based therapeutics and reduce the occurrence of cardiovascular events in patients with CKD

Analysis of Thermal Comfort under Different Exercise Modes in Winter in Universities in Severe Cold Regions

In this study, we collected 927 cases of samples from students at the Harbin Institute of Technology, China and conducted a thermal comfort questionnaire survey on four outdoor exercise modes in winter. Additionally, we analyzed the thermal perception conditions of the campus population in winter, the association between exercise volume and TCV (Thermal Comfort Vote) and the correlation between PET (physiological equivalent temperature) and MTSV (Mean Thermal Sensation Vote). Furthermore, we identified different PET neutral temperatures under different exercise modes (skating 3 °C, running 6 °C, hiking 9 °C, standing 14 °C), the variability of different thermal comforts in the original residence and the trend of thermal comfort with outdoor activity time. Finally, we obtained the prediction model of thermal perception under different exercise modes, and it can used as a basis for assessing the cold outdoor thermal environment to provide some references for environmental designers

A Computer-aided Method for Improving the Reliability of Lenke Classification for Scoliosis

Classification of the spinal curve pattern is crucial for assessment and treatment of scoliosis. We developed a computer-aided system to improve the reliability of three components of the Lenke classification. The system semi-automatically measured the Cobb angles and identified the apical lumbar vertebra and its pedicles on digitized radiographs. The system then classified the curve type, lumbar modifier, and thoracic sagittal modifier of the Lenke classification based on the computerized measurements and identifications. The system was tested by five operators for 62 scoliotic cases. The kappa statistic was used to assess the reliability. With the aid of computer, the average intra- and interobserver kappa values were improved to 0.89 and 0.81 for the curve type, to 0.83 and 0.81 for the lumbar modifier, and to 0.94 and 0.92 for the sagittal modifier of the Lenke classification, respectively, relative to the classification by two of the operators without the aid of computer. Results indicate that the computerized system can improve reliability for all three components of the Lenke classification

First-Order Ocean Surface Cross Section for Shipborne Bistatic HFSWR: Derivation and Simulation

A bistatic high-frequency surface wave radar (HFSWR) with both receiving and transmitting stations placed on different ships (platforms) is a new radar system and referred to as shipborne bistatic HFSWR. In this paper, a first-order ocean surface cross section of shipborne bistatic HFSWR was derived. The first-order cross-section models for three different cases, i.e., ships moving with uniform, periodic, and hybrid motion states, respectively, are presented. The corresponding first-order Doppler spectra were simulated, and the spread width of the first-order spectrum was investigated. The simulation results show that the characteristics of the first-order spectrum are similar to those of a shore-based bistatic HFSWR when the transmitting and receiving platforms move in opposite directions. The first-order spectral spread width in the case of platforms with opposite directions is much smaller than that in the case of platforms with the same direction. This finding is useful for reducing HFSWR first-order spectrum spread due to platform motion, thus improving the target detection performance of the shipborne bistatic HFSWR. In addition, periodic oscillation motion of both platforms will cause complex motion-induced peaks in the first-order spectrum, which may be detrimental to target detection and ocean remote sensing. These results have important implications for the application of shipborne bistatic HFSWR

The value of the ACEF II score in Chinese patients with elective and non-elective cardiac surgery

Abstract Objective To evaluate the value of the ACEF II score in predicting postoperative hospital death and acute kidney injury requiring dialysis (AKI-D) in Chinese patients. Methods This retrospective study included adult patients who underwent cardiopulmonary bypass open heart surgery between January 2010 and December 2015 at Guangdong Provincial People’s Hospital. ACEF II was evaluated to predict in-hospital death and AKI-D using the Hosmer–Lemeshow goodness of fit test for calibration and area under the receiver operating characteristic (ROC) curve for discrimination in non-elective and elective cardiac surgery. Results A total of 9748 patients were included. Among them, 1080 underwent non-elective surgery, and 8615 underwent elective surgery. Mortality was 1.8% (177/9748). In elective surgery, the area under the ROC (AUC) of the ACEF II score was 0.704 (95% CI: 0.648–0.759), similar to the ACEF score of 0.709 (95% CI: 0.654–0.763). In non-elective surgery, the AUC of the ACEF II score was 0.725 (95% CI: 0.663–0.787), higher than the ACEF score (AUC = 0.625, 95% CI: 0.553–0.697). The incidence of AKI-D was 3.5% (345/9748). The AUC of the ACEF II score was 0.718 (95% CI: 0.687–0.749), higher than the ACEF score (AUC = 0.626, 95% CI: 0.594–0.658). Conclusion ACEF and ACEF II have poor discrimination ability in predicting AKI-D in non-elective surgery. The ACEF II and ACEF scores have the same ability to predict in-hospital death in elective cardiac surgery, and the ACEF II score is better in non-elective surgery. The ACEF II score can be used to assess the risk of AKI-D in elective surgery in Chinese adults