Comparison of bypass surgery and drug-eluting stenting in diabetic patients with left main and/or multivessel disease: A systematic review and meta-analysis of randomized and nonrandomized studies

Background: With advances in theinterventional field, the choice between coronary artery bypass grafting (CABG) and percutaneous coronary intervention with drug-eluting stents (PCI-DES) for the diabetic subset with left main (LM) and/or multivessel disease (MVD) remains consistently controversial. Methods and results: We conducted a systematic review of randomized controlled trials (RCTs) and observational controlled trials (OCTs) comparing the two strategies for the diabetic subset with LM and/or MVD. PubMed, EMBASE, CENTRAL databases, Google Scholar and SinoMed were systematically searched for eligible studies without language and publica­tion restrictions. We identified 19 trials (4 randomized and 15 nonrandomized), enrolling 5,805 patients in OCTs and 3,060 patients in RCTs, respectively. PCI-DES was associated with higher mortality compared with CABG (11.7% DES vs. 9.1% CABG, RR 1.23, 95% CI 1.00–1.53, p = 0.06). Patients after PCI-DES had higher prevalence of myocardial infarction (MI) when compared with CABG (8.5% DES vs. 4.6% CABG, RR 1.68, 95% CI 1.20–2.37, p = 0.003). PCI-DES patients were at substantially lower risk of stroke (2.0% DES vs. 3.9% CABG, RR 0.51, 95% CI 0.39–0.67, p < 0.00001), but at several-fold higher risk of repeat revascularization (19.0% DES vs. 6.3% CABG, RR 2.95, 95% CI 2.46–3.55, p < 0.00001). The OCT patients risked a lower mortality as compared to the RCT patients (9.6% OCTs vs. 11.9% RCTs, RR 0.81, 95% CI 0.71–0.92, p = 0.001). Conclusions: CABG for patients with diabetes mellitus and LM and/or MVD had advan­tages over PCI-DES in all-cause death, nonfatal MI, and repeat revascularization, but the substantial disadvantage in nonfatal stroke. The high-selected patients (RCTs) risked a higher mortality than the real-world patients (OCTs)

The yields of r-process elements and chemical evolution of the Galaxy

The supernova yields of r-process elements are obtained as a function of the mass of their progenitor stars from the abundance patterns of extremely metal-poor stars on the left-side [Ba/Mg]-[Mg/H] boundary with a procedure proposed by Tsujimoto and Shigeyama. The ejected masses of r-process elements associated with stars of progenitor mass $M_{ms}\leq18M_{\odot}$ are infertile sources and the SNe II with 20$M_{\odot}\leq M_{ms}\leq 40M_{\odot}$are the dominant source of r-process nucleosynthesis in the Galaxy. The ratio of these stars 20$M_{\odot}\leq M_{ms}\leq40M_{\odot}$ with compared to the all massive stars is about $\sim$18%. In this paper, we present a simple model that describes a star's [r/Fe] in terms of the nucleosynthesis yields of r-process elements and the number of SN II explosions. Combined the r-process yields obtained by our procedure with the scatter model of the Galactic halo, the observed abundance patterns of the metal-poor stars can be well reproducedComment: 7 pages, 6 figures, Accepted for publication in Astrophysics and Space Scienc

PEG-aspargase and DEP regimen combination therapy for refractory Epstein–Barr virus-associated hemophagocytic lymphohistiocytosis

Abstract Background Epstein–Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) is the most frequent subtype of secondary HLH triggered by infections. Previous studies have shown that ~30 % or more of patients with EBV-HLH do not respond to standard therapy. This study investigated the efficacy and safety profile of a modified DEP regimen in combination with PEG-aspargase (L-DEP) as a salvage therapy for refractory EBV-HLH. Methods In this study from October 2014 to October 2015, 28 patients with refractory EBV-HLH received a L-DEP regimen at the Beijing Friendship Hospital, Capital Medical University. Treatment efficacy and adverse events were evaluated at 2 and 4 weeks after L-DEP treatment. Results Median EBV-DNA concentrations before and 2 weeks after receiving the L-DEP regimen were 9.6 × 105 (1.5 × 104 − 1 × 109) copies/mL and 2.2 × 105 (3.8 × 102 − 1.2 × 107) copies/mL, respectively; the post-treatment values were significantly lower than that of the pretreatment (P = 0.048). Nine of the 28 study patients achieved complete response (CR) and 15 partial response (PR), resulting in an overall response rate of 85.7 % (CR+PR). Four patients who did not achieve response died within 4 weeks of receiving L-DEP. Thirteen of the 24 patients who achieved partial or complete response received subsequent allogenic hematopoietic stem cell transplantation (allo-HSCT). Ten of these 13 patients survived until 1 March 2016. The major adverse effects of the L-DEP regimen were high serum amylase concentrations, abnormal liver function, and coagulation disorders. Conclusions This study suggests that L-DEP is a safe and effective salvage therapy prior to allo-HSCT for refractory EBV-HLH and increases the possibility of such patients receiving allo-HSCT. A prospective multicenter large-scale clinical trial that aims to validate the L-DEP regimen for refractory EBV-HLH is currently underway (ClinicalTrails.gov Identifier: NCT02631109)

Antioxidant Effects of Resveratrol in Intervertebral Disk

Intervertebral disk (IVD) degeneration (IVDD) can cause various spinal degenerative diseases. Cumulative evidence has indicated that IVDD can result from inflammation, apoptosis, autophagy, biomechanical changes and other factors. Currently, lack of conservative treatment for degenerative spinal diseases leads to an urgent demand for clinically applicable medication to ameliorate the progression of IVDD. Resveratrol (3,5,4′-trihydroxy-trans-stilbene), a polyphenol compound extracted from red wine or grapes, has shown protective effects on IVD, alleviating the progression of IVDD. Resveratrol has been demonstrated as a scavenger of free radicals both in vivo and in vitro. The antioxidant effects of resveratrol are likely attributed to its regulation on mitochondrial dysfunction or the elimination of reactive oxygen species. This review will summarize the mechanisms of the reactive oxygen species production and elaborate the mechanisms of resveratrol in retarding IVDD progression, providing a comprehensive understanding of the antioxidant effects of resveratrol in IVD

Degradation Characteristics and Reliability Assessment of 1310 nm VCSEL for Microwave Photonic Link

The long-term reliability of the commercially available vertical-cavity surface-emitting laser (VCSEL) at 1310 nm wavelength is investigated. To do so, a high current accelerated life test is used to evaluate the 1310 nm VCSEL reliability. Variations of properties that depend on the operating condition are characterized by the light-current-voltage, leakage current and low-frequency noise. When the aging current is 6 mA, 8 mA and 10 mA, the maximum output power reduces by 5%, 6% and 15% of the initial value, respectively. It is demonstrated theoretically and experimentally that the leakage current increases and reverse bias breakdown voltage decreases after the accelerated current aging test. The current noise power spectral density increases after the device ages, and the noise increases with the augment of the electrical stress. When the bias current of VCSEL is below the threshold, the frequency index factor and noise amplitude gradually increase with the bias current increase. Further, lifetime fitting curves of the devices at an accelerating current of 6 mA, 8 mA and 10 mA are obtained, and the median lifetime of 67 years at the operating current is extrapolated

Degradation Characteristics and Reliability Assessment of 1310 nm VCSEL for Microwave Photonic Link

The long-term reliability of the commercially available vertical-cavity surface-emitting laser (VCSEL) at 1310 nm wavelength is investigated. To do so, a high current accelerated life test is used to evaluate the 1310 nm VCSEL reliability. Variations of properties that depend on the operating condition are characterized by the light-current-voltage, leakage current and low-frequency noise. When the aging current is 6 mA, 8 mA and 10 mA, the maximum output power reduces by 5%, 6% and 15% of the initial value, respectively. It is demonstrated theoretically and experimentally that the leakage current increases and reverse bias breakdown voltage decreases after the accelerated current aging test. The current noise power spectral density increases after the device ages, and the noise increases with the augment of the electrical stress. When the bias current of VCSEL is below the threshold, the frequency index factor and noise amplitude gradually increase with the bias current increase. Further, lifetime fitting curves of the devices at an accelerating current of 6 mA, 8 mA and 10 mA are obtained, and the median lifetime of 67 years at the operating current is extrapolated

Primary hemophagocytic lymphohistiocytosis in adults: the utility of family surveys in a single-center study from China

Abstract Background This study investigated the clinical characteristics of primary hemophagocytic lymphohistiocytosis (HLH) in adults, including immunological markers, pedigree findings, and conditions of allogeneic hematopoietic stem cell transplantation (Allo-HSCT). Methods The study included clinical data of 18 adult patients with primary HLH treated in our center from June 2010 to January 2017. Results Of these 18 cases, pathogenic variants were found in the following genes: PRF1 (n = 11), UNC13D (n = 5), SH2D1A (n = 2), RAB27a (n = 1), and LYST (n = 2). One patient had pathogenic variants in both PRF1 and UNC13D genes, one patient had pathogenic variants in both LYST and UNC13D genes and another patient had pathogenic variants in both PRF1 and SH2D1A genes. Additionally, 3 of the 18 cases involved homozygous pathogenic variants, while 2 cases involved hemizygous pathogenic variants. The remaining 13 cases involved compound heterozygous pathogenic variants. The natural killer (NK) cell activity test was conducted in all 18 cases where 14(77.8%)patients showed reduction in NK cell activity. Furthermore, this article presents 3 representative results of the pedigree findings from 12 patients who underwent family surveys. The 8 patients who underwent Allo-HSCT had a median survival of 27.2 months, as compared with the median survival of 7 months for the10 patients who did not undergo Allo-HSCT, a significant difference between the two groups of patients (p = 0.006). Conclusion PRF1 was one of the most commonly mutated gene in adult patients with primary HLH. Family surveys and immunological markers were important for the HLH diagnosis and the selection of an appropriate donor. Allo-HSCT was an effective therapy for adult primary HLH