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Aims

The prognostic values of left ventricular ejection fraction (LVEF) during heart failure (HF) with acute decompensation or after optimal treatment have not been extensively studied. We hypothesized that posttreatment LVEF has superior predictive value for long-term prognosis than LVEF at admission does.

Methods and Results

In Protocol 1, 428 acute decompensated HF (ADHF) patients with LVEF ≤35% in a tertiary medical center were enrolled and followed for a mean period of 34.7 ± 10.8 months. The primary and secondary end points were all-cause mortality and HF readmission, respectively. In total, 86 deaths and 240 HF readmissions were recorded. The predictive values of baseline LVEF at admission and LVEF 6 months posttreatment were analyzed and compared. The posttreatment LVEFs were predictive for future events (P = 0.01 for all-cause mortality, P < 0.001 for HF readmission), but the baseline LVEFs were not. In Protocol 2, the outcomes of patients with improved LVEF (change of LVEF: ≥+10%), unchanged LVEF (change of LVEF: –10% to +10%), and reduced LVEF (change of LVEF: ≤–10%) were analyzed and compared. Improved LVEF occurred in 171 patients and was associated with a superior long-term prognosis among all groups (P = 0.02 for all-cause mortality, P < 0.001 for HF readmission). In Protocol 3, independent predictors of improved LVEF were analyzed, and baseline LV end-diastolic dimension (LVEDD) was identified as a powerful predictor in ADHF patients (P < 0.001).

Conclusions

In patients with ADHF, posttreatment LVEF but not baseline LVEF had prognostic power. Improved LVEF was associated with superior long-term prognosis, and baseline LVEDD identified patients who were more likely to have improved LVEF. Therefore, baseline LVEF should not be considered a relevant prognosis factor in clinical practice for patients with ADHF.  相似文献   
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目的观察高表达RORα对二烯丙基二硫(DADS)抑制人胃癌MGC803细胞增殖、迁移与侵袭的影响。方法集落形成实验与流式细胞术检测细胞增殖与细胞周期;细胞划痕和Transwell实验分别检测细胞迁移与侵袭。RT-PCR与Western blot分别检测RORα、MMP-9和TIMP3 mRNA与蛋白表达水平。结果RT-PCR与Western blot检测显示,RORα高表达与DADS处理较对照组与空载体组RORαmRNA与蛋白表达明显上调,DADS+RORα高表达组上调更为显著(P<0.05)。与对照组和空载体组比较,RORα高表达与DADS处理组MMP-9表达下调,TIMP3表达上调,DADS+RORα高表达组改变最为显著。集落形成实验显示,RORα高表达与DADS处理组较对照组与空载体组的集落形成率明显降低。流式细胞术显示,与对照组和空载体组比较,RORα高表达与DADS处理组G2/M期细胞比率明显升高。细胞划痕和Transwell实验显示,RORα高表达与DADS处理组细胞迁移与侵袭能力明显降低。结论RORα高表达可通过上调TIMP3与下调MMP-9促进DADS阻滞MGC803细胞G2/M期和抑制增殖与迁移侵袭。  相似文献   
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Computed tomography (CT) has a revolutionized diagnostic radiology but involves large radiation doses that directly impact image quality. In this paper, we propose adaptive tensor-based principal component analysis (AT-PCA) algorithm for low-dose CT image denoising. Pixels in the image are presented by their nearby neighbors, and are modeled as a patch. Adaptive searching windows are calculated to find similar patches as training groups for further processing. Tensor-based PCA is used to obtain transformation matrices, and coefficients are sequentially shrunk by the linear minimum mean square error. Reconstructed patches are obtained, and a denoised image is finally achieved by aggregating all of these patches. The experimental results of the standard test image show that the best results are obtained with two denoising rounds according to six quantitative measures. For the experiment on the clinical images, the proposed AT-PCA method can suppress the noise, enhance the edge, and improve the image quality more effectively than NLM and KSVD denoising methods.  相似文献   
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Highly sensitive detection of hepatitis C virus (HCV) in serum is a key method for diagnosing and classifying the extent of HCV infection. In this study, a p‐phenol derivative, 4‐(1,2,4‐triazol‐1‐yl)phenol (4‐TRP), was employed as an efficient enhancer of the luminol–hydrogen peroxide (H2O2)–horseradish peroxidase (HRP) chemiluminescence (CL) system for detection of HCV. Compared with a traditional enhancer, 4‐TRP strongly enhanced CL intensity with the effect of prolonging and stabilizing light emission. The developed CL system was applied to detecting HCV core antigen (HCV‐cAg) using a sandwich structure inside microwells. Our experimental results showed that there was good linear relationship between CL intensity and HCV‐cAg concentration in the 0.6–3.6 pg/mL range (R = 0.99). The intra‐ and inter‐assay coefficients of variation were 4.5–5.8% and 5.0–7.3%, respectively. In addition, sensitive determination of HCV‐cAg in serum samples using the luminol–H2O2–HRP–4‐TRP CL system was also feasible in clinical settings. Copyright © 2015 John Wiley & Sons, Ltd.  相似文献   
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Abrupt drought–flood alternation (T1) is a meteorological disaster that frequently occurs during summer in southern China and the Yangtze river basin, often causing a significant loss of rice production. In this study, the response mechanism of yield decline under abrupt drought–flood alternation stress at the panicle differentiation stage was analyzed by looking at the metabolome, proteome as well as yield and physiological and biochemical indexes. The results showed that drought and flood stress caused a decrease in the yield of rice at the panicle differentiation stage, and abrupt drought–flood alternation stress created a synergistic effect for the reduction of yield. The main reason for the decrease of yield per plant under abrupt drought–flood alternation was the decrease of seed setting rate. Compared with CK0 (no drought and no flood), the net photosynthetic rate and soluble sugar content of T1 decreased significantly and its hydrogen peroxidase, superoxide dismutase, peroxidase activity increased significantly. The identified differential metabolites and differentially expressed proteins indicated that photosynthesis metabolism, energy metabolism pathway and reactive oxygen species response have changed strongly under abrupt drought–flood alteration stress, which are factors that leads to the rice grain yield reduction.  相似文献   
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