Abstract Objective This study was aimed to investigate an optimal therapeutic window for platelet reactivity (PR) to predict the lowest ischemic and bleeding events in patients underwent percutaneous coronary intervention (PCI) and treated with dual antiplatelet agents. Design A total of 1709 patients who had received coronary stent implantation and had taken aspirin 100 mg in combination with clopidogrel 75 mg daily for >5 days were consecutively recruited and their platelet reactivity was determined by light transmittance aggregometry (LTA). All patients were followed up for 12 months. The primary end-point was the net adverse clinical events (NACE) of cardiovascular death, nonfatal myocardial infarction (MI), target vessel revascularization (TVR) , stent thrombosis (ST) and any bleeding. Result By using the receiver-operating curve (ROC) analysis, the optimal cutoff values were found to be 37.5% and 25.5% respectively in predicting ischemic and bleeding events. Patients were classified into 2 groups according to PR: inside the window group (IW) [adenosine diphosphate (ADP) induced platelet aggregation (PL ADP ) 25.5%-37.4%)] and outside the window group (OW) (PL ADP <25.5% or ≥37.5%). The incidence of NACE was 16.8% and 23.1% respectively in the IW and OW group. The hazard ratio of NACE in IW-group was significantly lower [0.69 (95% CI: 0.54–0.89; P = 0.004)] than that in the OW-group during 12 month follow-up. Conclusion An optimal therapeutic window of 25.5%-37.4% for PL ADP predicts the lowest risk of NACE, which could be referred for tailored antiplatelet treatment while using LTA assay. Trial and clinical registry Trial registration number: ClinicalTrials.gov NCT01968499. Registered 18 October 2013 - Retrospectively registered.
Calorie restriction (CR) is a simple method for delaying aging process, extending lifespan, and preventing the onset of aging-related diseases, such as diabetes. However, the mechanism, by which CR influences β-cell functions during the aging process, still remains unclear. In this study, sixteen 8-week-old male Sprague-Dawley rats were randomized to control group with food intake ad libitum and CR group fed with 70% of food intake of the control group. Twenty-four weeks later, the body weights of the rats with CR were significantly lower with the smaller amounts of perirenal and epididymal fats, compared to those of control rats. The β-cell activity, as judged by the early insulin secretion in the intraperitoneal glucose tolerance test, was significantly higher in the CR group than that in control animals. Moreover, CR animals showed the increased β-cell mass and proliferation of β-cells in pancreas. The plasma level of malondialdehyde was lower in CR rats than that in control rats, while the activities of superoxide dismutase, catalase and glutathione peroxidase in plasma were higher in CR rats than control rats. These results indicate that aging is associated with the increases in oxidative stress, which was, however, alleviated by CR. In conclusion, CR from a young age preserves the principal β-cell function of early insulin secretion in rats probably by stimulating the β-cell proliferation. Our observations provide the evidence for clinical significance of CR in preventing β-cell dysfunction during the aging process, which may delay the onset of aging-related disease, including diabetes in humans.
Background The limitations in current medical imaging systems often result in poor visibility and insufficient detail. Such low-quality images hinder the decision-making of medical professionals. The weighted least squares (WLS) model provides a prevalent framework for detail and tone manipulation, but it is non-trivial to solve. Method We propose a fast solution to the WLS model. Instead of addressing a large linear system or approximating two-dimensional image processing with multiple one-dimensional procedures, we demonstrate that the model can be solved efficiently using an iterative algorithm. We leverage our method for the detail and tone enhancement of medical images. Results (1) For detail enhancement, on the three subsets of X-ray images, the spatial-spectral entropy-based quality (SSEQ) values are 21.15, 29.46, and 31.36; the convolutional neural networks image quality assessment (CIQA) values are 17.67, 25.60, and 26.01; on the computed tomography and magnetic resonance imaging images, the SSEQ and CIQA values are 14.01 and 16.93; it achieves peak signal-to-noise ratio (PSNR) ≥39.39 and structural similarity index (SSIM) ≥0.99; (2) for tone enhancement, the tone mapped image quality index, fidelity, and naturalness values are recorded at 0.7905, 0.9300, and 0.0090; it achieves PSNR ≥50.09 and SSIM ≥0.99. Notably, our method processes a 720P color image in 0.0725 seconds on a modern graphics processing unit. Conclusion The proposed method enhances the detail and tone of medical images. It addresses computational challenges inherent in traditional approaches. Its adaptability to diverse applications suggests a promising avenue for improving diagnostic accuracy and patient outcomes in clinical practice.
Objective Evidence from many studies suggests that dyslipidemia has a pathogenetic role in the development and progression of diabetic nephropathy. The objective of this study was to evaluate the relationships between serum lipid parameters and urinary albumin excretion in type 2 diabetic patients from Shanghai, China. Methods A total of 1094 type 2 diabetic patients were recruited. The urinary albumin to creatinine ratio (ACR), serum total cholesterol, triglyceride, high density lipoprotein cholesterol (HDL-C), apolipoprotein A I (ApoA I), apolipoprotein B (ApoB), apolipoprotein E (ApoE) and lipoprotein (a) [Lp(a)] were measured and low density lipoprotein cholesterol (LDL-C) was calculated according to the Friedewald formula. An ACR of ≥30 μg/mg was defined as albuminuria, and <30 μg/mg as normoalbuminuria. Results The levels of ApoE and triglyceride were significantly higher in albuminuric group compared with normoalbuminuric group (p<0.001 and p=0.003, respectively). Differences of ACR among the groups based on the tertile of ApoE and the tertile of triglyceride were significant (both p<0.001). In a multiple linear regression model, ApoE was independently associated with ACR (β=0.003, 95%CI 0.002-0.005, p<0.001). Conclusion Serum ApoE level was independently associated with urinary albumin excretion in type 2 diabetic patients from Shanghai, China.
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