Serum Uric Acid and Long-term Prognosis in Patients with Acute Myocardial Infarction

BackgroundIt is still controversial whether or not serum uric acid, a key risk for coronary heart disease, is significantly associated with prognosis of acute myocardial infarction (AMI) . And there are rare large-scale and multicenter studies on serum uric acid and long prognosis of AMI in China.ObjectiveTo investigate the relationship between serum uric acid and long-term prognosis in AMI patients.MethodsOne thousand and ninety-eight AMI patients from 9 hospitals (Chengdu First People's Hospital, Chengdu Second People's Hospital, the Third People's Hospital of Chengdu, the First Affiliated Hospital of Chengdu Medical College, Dujiangyan Medical Center, Pidu District People's Hospital, Chengdu, Shuangliu District First People's Hospital, Jintang First People's Hospital, the People's Hospital of Pengzhou) in Chengdu during September 2016 to July 2019 were consecutively reSScruited. Baseline data were collected via the electronic medical record system of each hospital by trained professionals, including: (1) demographic data: age, gender, prevalence of smoking; (2) clinical complications and related information: hypertension, diabetes, blood pressure, heart rate, Killip class, AMI type (NSTEMI or STEMI) , prevalence of percutaneous coronary intervention (PCI) ; (3) laboratory parameters: serum SScreatinine (Scr) , uric acid (UA) , triglyceride (TG) , total cholesterol (TC) , low-density lipoprotein cholesterol (LDL-C) , high-density lipoprotein cholesterol (HDL-C) , estimated glomerular filtration rate (eGFR) ; (4) post-discharge medication: aspirin, clopidogrel/tigrelol, statins, Beta-blockers, ACEI/ARB, diuretics. Baseline data were compared between patients with and without major adverse cardiovascular and cerebrovascular events (MACCE) during post-discharge follow-up. Then, prognosis was compared aSScross UA tertile subgroups〔A: UA<420 μmol/L; B: 420 ≤UA<480 μmol/L; C: UA≥480 μmol/L〕 stratified by the diagnostic SScriteria for hyperuricemia in Guideline for the Diagnosis and Management of Hyperuricemia and Gout in China (2019) .ResultsThe median follow-up time for all participants was 14.5 (9.2, 20.7) months. Of all cases, 173 were found with MACCE, and 366 with hyperuricemia. Compared with those without MACCE, patients with MACCE had greater average age, Scr and UA, and heart rate, and higher female ratio, higher prevalence of hypertension, diabetes, use of diuretics, and Killip class≥3, but lower prevalence of PCI treatment (P<0.05) . Subgroup A had much lower incidence of MACCE, all-cause death and cardiac death than subgroup B or C (P<0.01) . Kaplan-Meier survival analysis indicated that the cumulative incidence of MACCE, all-cause death and cardiac death either in subgroup B or C was higher than that in subgroup A (P<0.01) . Cox regression analysis showed that Killip class ≥3〔HR=1.812, 95%CI (1.215, 2.700) 〕, older age〔HR=1.045, 95%CI (1.031, 1.059) 〕 and higher UA level〔 (≥420 μmol/L but<480 μmol/L: HR=1.614, 95%CI (1.062, 2.455) ; ≥480 μmol/L: HR=1.949, 95%CI (1.327, 2.862) 〕 were independent risk factors for long-term MACCE events in patients with AMI (P<0.05) . Serum UA had an AUC (95%CI) of 0.578 (0.548, 0.607) with 0.387 sensitivity, and 0.779 specificity in predicting long-term incidence of MACCE, an AUC (95%CI) of 0.645 (0.616, 0.674) with 0.598 sensitivity, and 0.670 specificity in predicting long-term incidence of all-cause death, and an AUC (95% CI) of 0.653 (0.624, 0.681) with 0.534 sensitivity, and 0.761 specificity in predicting long-term incidence of cardiac death.ConclusionElevated serum UA was associated with higher risk of long-term adverse events in AMI patients. Serum UA may be used as a predictor for long-term MACCE events in such patients

The impacts of sawmill processing variances on lumber target sizes and production revenue

Although the statistical quality control technique has been applied in the lumber manufacturing industry for more than two decades, many sawmills are still severely over-sizing their lumber due to the inefficiency of their lumber target size control programs in which only the sawing variation is controlled. The shrinkage variation and planing variation which may also contribute significantly to lumber target sizes in the current sawmills are usually not the controlled subjects. This study evaluated the traditional target size control programs and investigated the impacts of all the three processing variances (sawing, drying and planing) on lumber target size control and production net revenue. This was done by: 1) thorough examination of the system variances of an interior B. C. softwood sawmill, and 2) developing a target size estimation program which considers all the three processing variances. The results of empirical study indicated that the variation in drying shrinkage was even larger than total sawing variation and the planing variation of the test mill was more than half of the total sawing variation. The shrinkage variation caused by drying operations other than material itself was found significant. Therefore it was found to be essential to control the drying and planing processes along with controlling the sawing process. The evaluation of traditional target size estimation method showed that this method over-estimates lumber target sizes. The results also showed that the target sizes currently used in the test sawmill were much larger than the necessary target sizes. There is great opportunity for the mill to reduce its target sizes. If the variances of the three sub-processes are strictly controlled, the test mill could expect to realize about three million dollar net revenue per year without reducing current system variation level. The study of the impact of system variation on the target size reduction showed that the reduction in planing variation had greatest impact among the three processing variances. The impact of sawing and drying variation on the target size reduction were similar. In general, it was the variation which was larger in value had larger impact on target size reduction.Forestry, Faculty ofGraduat

Separate Calibration of Johnson–Cook Model for Static and Dynamic Compression of a DNAN-Based Melt-Cast Explosive

When describing the relation between the flow stress and plastic strain of a material under a wide range of strain rates and temperatures, the original Johnson–Cook model generally requires a complicated modification, resulting in a loss of simplicity and clear physical interpretation. In this paper, without modification, the original Johnson–Cook model was calibrated separately for the static and dynamic compression of a DNAN-based melt-cast explosive. The stress–strain curves for static and dynamic compression of this explosive were experimentally measured with a universal testing machine and a split-Hopkinson pressure bar, respectively. Based on the stress–strain curves, the flow stress vs. plastic strain data were extracted and used to calibrate the Johnson–Cook model. The calibration process is described. The parameters for the strain term, strain rate term, and temperature term were fitted sequentially. One set of model parameters was not able to fully describe the relationship between flow stress and plastic strain for both the static and dynamic compression of the DNAN-based melt-cast explosive. Two sets of model parameters were separately calibrated and compared for the static and dynamic compression of this explosive. The effects of the adiabatic temperature rise and the definition of the yield point on this calibration were also investigated

Decreased plasma IL-35 levels are related to the left ventricular ejection fraction in coronary artery diseases.

BACKGROUND: Accumulating evidence shows that the novel anti-inflammatory cytokine IL-35 can efficiently suppress effector T cell activity and alter the progression of inflammatory and autoimmune diseases. The two subunits of IL-35, EBI3 and p35, are strongly expressed in human advanced plaque, suggesting a potential role of IL-35 in atherosclerosis and coronary artery disease (CAD). However, the plasma levels of IL-35 in patients with CAD have yet to be investigated. METHODS: Plasma IL-35, IL-10, TGF-β1, IL-12 and IL-27 levels were measured using an ELISA in 43 stable angina pectoris (SAP) patients, 62 unstable angina pectoris (UAP) patients, 56 acute myocardial infarction (AMI) patients and 47 chest pain syndrome patients as a control group. RESULTS: The results showed that plasma IL-35 levels were significantly decreased in the SAP group (90.74±34.22 pg/ml), the UAP group (72.20±26.63 pg/ml), and the AMI group (50.21±24.69 pg/ml) compared with chest pain syndrome group (115.06±32.27 pg/ml). Similar results were also demonstrated with IL-10 and TGF-β1. Plasma IL-12 and IL-27 levels were significantly increased in the UAP group (349.72±85.22 pg/ml, 101.75±51.42 pg/ml, respectively) and the AMI group (318.05±86.82 pg/ml, 148.88±68.45 pg/ml, respectively) compared with chest pain syndrome group (138.68±34.37 pg/ml, 63.60±22.75 pg/ml, respectively) and the SAP group (153.84±53.86 pg/ml, 70.84±38.77 pg/ml, respectively). Furthermore, lower IL-35 levels were moderately positively correlated with left ventricular ejection fraction (LVEF) in CAD patients (R = 0.416, P<0.01), whereas higher IL-27 levels were weakly negatively correlated with LVEF in CAD patients(R = -0.205, P<0.01). CONCLUSIONS: The results of the present study show that circulating IL-35 is a potentially novel biomarker for coronary artery disease. Regulating the expression of IL-35 also provides a new possible target for the treatment of atherosclerosis and CAD

Circulating Sestrin Levels Are Increased in Hypertension Patients

Background. Sestrins (Sesns), a group of oxidative stress-related proteins, have been reported to be involved in various cardiovascular diseases, including aortic dissection and chronic heart failure. This study is aimed at investigating the level of circulating Sesn1, Sesn2, and Sesn3 in hypertension patients. Methods. Plasma levels of Sesn1, Sesn2, and Sesn3 in 400 hypertensive patients and 100 normotensive subjects were detected using enzyme-linked immunosorbent assay (ELISA) kits. The hypertension patients were divided into groups with grade I (n=140), grade II (n=180), and grade III (n=80) hypertension. Results. Compared with the normotensive subjects, Sesn1, Sesn2, and Sesn3 levels were increased in patients with hypertension, with a gradual increase between the groups with grade I, grade II, and grade III hypertension. Elevated Sesn1, Sesn2, and Sesn3 levels were positively correlated with both the systolic blood pressure (SBP) and diastolic blood pressure (DBP). Moreover, Sesn1, Sesn2, and Sesn3 levels were elevated in patients with dipper hypertension and further increased in patients with nondipper hypertension. In addition, smokers, as well as patients with higher levels of angiotensin II (Ang II) and carotid atherosclerotic plaque (CAP), exhibited increased Sesn1, Sesn2, and Sesn3 levels when compared with patients without these clinical characteristics. Furthermore, plasma levels of Sesn1, Sesn2, and Sesn3 were negatively correlated with the presence of CAP. Conclusions. Circulating Sesn levels are increased in patients with hypertension and may be a target for the prevention and treatment of clinical hypertension

The Predictive Value of Different Nutritional Indices Combined with the GRACE Score in Predicting the Risk of Long-Term Death in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Nutritional status is associated with prognosis in acute coronary syndrome (ACS) patients. Although the Global Registry of Acute Coronary Events (GRACE) risk score is regarded as a relevant risk predictor for the prognosis of ACS patients, nutritional variables are not included in the GRACE score. This study aimed to compare the prognostic ability of the Geriatric Nutritional Risk Index (GNRI) and Prognostic Nutritional Index (PNI) in predicting long-term all-cause death in ACS patients undergoing percutaneous coronary intervention (PCI) and to determine whether the GNRI or PNI could improve the predictive value of the GRACE score. A total of 799 patients with ACS who underwent PCI from May 2018 to December 2019 were included and regularly followed up. The performance of the PNI in predicting all-cause death was better than that of the GNRI [C-index, 0.677 vs. 0.638, p = 0.038]. The addition of the PNI significantly improved the predictive value of the GRACE score for all-cause death [increase in C-index from 0.722 to 0.740; IDI 0.006; NRI 0.095; p < 0.05]. The PNI was superior to the GNRI in predicting long-term all-cause death in ACS patients undergoing PCI. The addition of the PNI to the GRACE score could significantly improve the prediction of long-term all-cause death