Effects of Statin Therapy on Clinical Outcomes of Survivors of Acute Myocardial Infarction with Severe Systolic Heart Failure

Objective

Large randomized trials have failed to show a beneficial effect of statin treatment in chronic HF. The investigators tried to evaluate the long-term effects of statin therapy in patients with new onset heart failure (HF) following acute myocardial infarction (AMI).

Methods

Between January 2008 and December 2011, a total of 13,616 AMI patients were enrolled in the Korea Acute Myocardial Infarction Registry (KAMIR) which was a prospective, multi-center, nationwide, web-based database of AMI in Korea. From this database, we studied 1,055 patients with AMI who had newly developed severe acute HF [left ventricular ejection fraction ≤ 40%] and were discharged alive. The patients were divided into two groups, a statin group (n = 756) and a no-statin group (n = 299). We investigated the one-year major adverse cardiovascular events (MACEs), including all-cause mortality, MI, and any revascularization of each group. We then performed a propensity-score matched analysis.

Results

In the original cohort, one-year MACEs were similar between the two groups (16.5% vs. 14.7% in the statin or no-statin groups; p = 0.47). Propensity-score matching yielded 256 pairs, and in that population we observed comparable results in terms of MACEs (18.0% vs. 12.5% in the statin or no-statin groups, p = 0.11) and mortality (5.1% vs. 3.5% in the statin or no-statin groups, p = 0.51). Cox-regression analysis revealed that statin therapy was not an independent predictor for occurrence of a MACE [Hazard ratio (HR) 1.11, 95% CI 0.79–1.57, p = 0.54] or all-cause mortality (HR 1.42, 95% CI 0.75–2.70, p = 0.28).

Conclusion

Statin therapy was not associated with a reduction in the long-term occurrence of MACEs or mortality in survivors of AMI with severe acute HF in this retrospective cohort study.     

端粒酶的研究进展

端粒酶是由RNA模板和蛋白质催化亚基组成的核糖蛋白颗粒,它解决染色体的未端复制问题,归属于逆转录酶家族又和逆转录酶有一定的差别。端粒酶的缺失能在细胞和机体水平引起各种疾病的发生,且端粒的过度表达和细胞的永生化和癌变直接相关,其中端粒蛋白在此过程中可能起调控作用,端粒酶的结构和功能决定了它有广泛的应用前景。     

土壤中含EB病毒诱导物的检测

从广西壮族自治区梧州市、苍梧县、罗城县和北京市收集的土壤标本中发现有EB病毒诱导物。梧州市和苍梧县沿公路和江河两旁桐油树下的土壤标本,对EB病毒早期抗原诱导的阳性率为40～58％。在其他大戟科植物下的土壤标本中,也发现有EB病毒诱导物。对桐油树下土壤中EB病毒诱导物与鼻咽癌发生的可能关系进行了讨论。     

The effects of age on inflammatory and coagulation-fibrinolysis response in patients hospitalized for pneumonia

Objective

To determine whether inflammatory and hemostasis response in patients hospitalized for pneumonia varies by age and whether these differences explain higher mortality in the elderly.

Methods

In an observational cohort of subjects with community-acquired pneumonia (CAP) recruited from emergency departments (ED) in 28 hospitals, we divided subjects into 5 age groups (<50, 51–64, 65–74, 75–84, and ≥85). We measured circulating levels of inflammatory (TNF, IL-6, and IL-10), hemostasis (D-dimer, Factor IX, thrombin-antithrombin complex, antithrombin and plasminogen-activator inhibitor-1), and cell-surface markers (TLR-2, TLR-4, and HLA-DR) during the first week of hospitalization and at discharge and compared 90-day mortality. We used logistic regression to compare odds ratios (OR) for 90-day mortality between age groups, adjusting for differences in pre-infection factors alone and then additionally adjusting for immune markers.

Results

Of 2,183 subjects, 495, 444, 403, 583, and 258 subjects were <50, 51–64, 65–74, 75–84, and ≥85 years of age, respectively. Large age-related differences were observed in 90-day mortality (0.82% vs. 3.2% vs. 6.4% vs. 12.8% vs. 13.6%, p<0.01). No age-related differences in inflammatory and cell surface markers occurred during the first week. Older subjects had higher pro-coagulant markers on ED presentation and over first week (p≤0.03), but these differences were modest (1.0–1.7-fold differences). Odds of death for older adults changed minimally in models incorporating differences in hemostasis and inflammatory markers (for subjects ≥85 compared to those <50, OR = 4.36, when adjusted for pre-infection factors and OR = 3.49 when additionally adjusted for hemostasis markers). At discharge, despite clinical recovery as evidenced by normal vital signs in >85% subjects, older subjects had modestly increased hemostasis markers and IL-6 levels (p<0.01).

Conclusions

Modest age-related increases in coagulation response occur during hospitalization for CAP; however these differences do not explain the large differences in mortality. Despite clinical recovery, immune resolution may be delayed in older adults at discharge.     

不同坡向人工油松幼林下地表苔藓植物层片的物种多样性与结构特征

调查和分析了岷江上游大沟流域的 4个坡向 (偏东坡N -E80°、偏西坡N -W 85°、偏南坡S -E10°、偏北坡N-W2 0°)人工油松 (Pinustabuliformis)林下地表苔藓植物的物种多样性、组成和结构特征。在 4个坡向的油松林下共发现 13种苔藓 ,各林下苔藓物种组成数量在 6 - 13种之间 ,并且具有较高的相似性。冰川青藓 (Brachytheci um glacile)、大羽藓 (Thuidiumcymbifolium)、厚角绢藓 (Entodonconcinnus)、密叶美喙藓 (Eurhynchiumsavatieri)、小酸土藓 (Oxysteguscuspidatus)和光萼苔 (Porellapinnata)为这 4个坡向油松林下的共有种 ,其中冰川青藓、大羽藓为优势物种。 4个坡向人工油松幼林下地表苔藓植物出现频率分别为 10 0 % (偏西、偏北油松林 )和 96 .7% (偏东、偏南油松林 ) ,其平均盖度、平均密度、平均厚度分别在 5 .5 0 %± 0 .90 %至 2 5 .6 6 %± 2 .76 %、4 80 .6 7± 133.6 5至 2 72 4 .80± 4 19.72株 /m2 和 4 .73± 0 .31至 6 .83± 0 .73mm之间。无论是苔藓植物层片的多样性指数还是结构参数 ,均以偏东坡向的油松林下为最低 ;而偏西坡向的油松林下除厚度略低于偏南坡向外 ,其他指标均最高。综合研究结果表明 ,坡向是形成苔藓植物物种多样性组成和结构差异的重要环境因素 ,对苔藓植物的生存     

Effectiveness of a Government-Organized and Hospital-Initiated Treatment for Multidrug-Resistant Tuberculosis Patients-A Retrospective Cohort Study

Background

In contrast to the conventional model of hospital-treated and government directly observed treatment (DOT) for multidrug-resistant tuberculosis (MDR-TB) patient care, the Taiwan MDR-TB Consortium (TMTC) was launched in May 2007 with the collaboration of five medical care groups that have provided both care and DOT. This study aimed to determine whether the TMTC provided a better care model for MDR-TB patients than the conventional model.

Methods and Findings

A total of 651 pulmonary MDR-TB patients that were diagnosed nation-wide from January 2000-August 2008 were enrolled. Of those, 290 (45%) MDR-TB patients whose initial sputum sample was taken in January 2007 or later were classified as patients in the TMTC era. All others were classified as patients in the pre-TMTC era. The treatment success rate at 36 months was better in the TMTC era group (82%) than in the pre-TMTC era group (61%) (p<0.001). With multiple logistic regressions, diagnosis in the TMTC era (adjusted odds ratio (aOR) 2.8, 95% confidence interval (CI) 1.9–4.2) was an independent predictor of a higher treatment success rate at 36 months. With the time-dependent proportional hazards method, a higher treatment success rate was still observed in the TMTC era group compared to the pre-TMTC era group (adjusted hazard ratio 6.3, 95% CI 4.2–9.5).

Conclusion

The improved treatment success observed in the TMTC era compared to the pre-TMTC era is encouraging. The detailed TMTC components that contribute the most to the improved outcome will need confirmation in follow-up studies with large numbers of MDR-TB patients.     

Natalizumab Treatment Reduces Fatigue in Multiple Sclerosis. Results from the TYNERGY Trial; A Study in the Real Life Setting

Fatigue is a significant symptom in multiple sclerosis (MS) patients. First-generation disease modifying therapies (DMTs) are at best moderately effective to improve fatigue. Observations from small cohorts have indicated that natalizumab, an antibody targeting VLA-4, may reduce MS-related fatigue. The TYNERGY study aimed to further evaluate the effects of natalizumab treatment on MS-related fatigue. In this one-armed clinical trial including 195 MS patients, natalizumab was prescribed in a real-life setting, and a validated questionnaire, the Fatigue Scale for Motor and Cognitive functions (FSMC), was used both before and after 12 months of treatment to evaluate a possible change in the fatigue experienced by the patients. In the treated cohort all measured variables, that is, fatigue score, quality of life, sleepiness, depression, cognition, and disability progression were improved from baseline (all p values<0.0001). Walking speed as measured by the six-minute walk-test also increased at month 12 (p = 0.0016). All patients were aware of the nature of the treatment agent, and of the study outcomes.

Conclusion

Natalizumab, as used in a real-life setting, might improve MS-related fatigue based on the results from this one-armed un-controlled stud. Also other parameters related to patients'' quality of life seemed to improve with natalizumab treatment.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT00884481","term_id":"NCT00884481"}}NCT00884481     

SRIF及CSH对斜带石斑鱼脑垂体生长激素合成和分泌的调控

斜带石斑鱼 (Epinepheluscoioides)属于雌性先成熟、具有性转变的雌雄同体鱼类。生长激素释放抑制因子 (SRIF)是鱼类生长激素 (GH)分泌的主要抑制性调节剂 ,半胱胺 (CSH)可抑制SRIF的作用。本文采用静态孵育系统 ,应用RPA及RIA研究SRIF及CSH对斜带石斑鱼GHmRNA表达及GH分泌的调节。结果显示 ,SRIF能以剂量依存方式抑制斜带石斑鱼脑垂体释放GH ,时间越长作用越强。但SRIF作用 2 4h对GHmR NA水平的影响不显著 ,表明SRIF是斜带石斑鱼GH释放的抑制性调节剂 ,对GHmRNA的表达没有明显影响。较低剂量的CSH (10 -4- 10 -2 mol/L)使斜带石斑鱼的GH释放量增加 ,较高剂量 (10 -1mol/L)的CSH引起的GH增加趋势减缓 ,这种现象可能与较高剂量的CSH不仅抑制下丘脑SRIF的释放 ,同时影响GHRH的释放 ,使得GH的分泌量增幅下降有关 ;无论是较高剂量还是较低剂量的CSH都不能使GHmRNA的水平增加 ,表明CSH只能引起GH的释放量增加 ,不影响GH的合成。GnRH与CSH共同作用引起的GH释放量明显高于CSH单独作用的效应 ,其主要原因是由于GnRH促进GHmRNA的表达所致     

基于CSSL的水稻抽穗期QTL定位及遗传分析

抽穗期是水稻（Oryza sativa）品种的重要农艺性状之一,适宜的抽穗期是获得理想产量的前提。鉴定和定位水稻抽穗期基因/QTL,分析其遗传效应对改良水稻抽穗期至关重要。以籼稻品种9311（Oryzasativa ssp.indica‘Yangdao 6’）为受体,粳稻品种日本晴（Oryza sativa ssp.japonica‘Nipponbare’）为供体构建的94个染色体片段置换系群体为材料,以P≤0.01为阈值,对置换片段上的抽穗期QTL进行了鉴定。采用代换作图法共定位了4个控制水稻抽穗期的QTL,分别位于第3、第4、第5和第8染色体;QTL的加性效应值变化范围为–6.4––2.7,加性效应百分率变化范围为–6.4%––2.7%;qHD-3和qHD-8加性效应值较大,表现主效基因特征。为了进一步定位qHD-3和qHD-8,在目标区域加密16对SSR引物,qHD-3和qHD-8分别被界定在第3染色体RM3166–RM16206之间及第8染色体RM4085–RM8271之间,其遗传距离分别为13.9cM和6.4cM。研究结果为利用分子标记辅助选择改良水稻抽穗期奠定了基础。