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Impact of Insurance Status on the Prognosis of Acute Lower Limb Ischemia

World Journal of Cardiovascular Diseases 2016年第7期6卷 218-223页

作者： Shyamal Premaratne J. David Neel cynthia x. zhao Linda D. Doucet Tze-Woei Tan Wayne W. Zhang Hunter Holmes McGuire Veterans Administration Medical Center Richmond Virginia USA Department of Surgery Louisiana State University Health Sciences Center Shreveport Louisiana USA Department of Pathology Louisiana State University Health Sciences Center Shreveport Louisiana USA

The objective of this study was to investigate if the insurance status of patients impacted the treatment options and prognosis in acute limb ischemia (ALI). A retrospective chart review was performed at a single university tertiary care center using ICD-9 codes for the diagnosis and procedure for ALI from January 2000 to January 2011. A total of 96 patients were diagnosed with ALI, comprising of 66 males and 30 females with a mean age of 56 years (range was 19 - 80 years). Time to presentation and prognosis (rate and level of amputation) were analyzed using insurance status as the independent variable. Patients covered under commercial insurance were compared to patients with Medicare and Medicaid and to patients without any insurance coverage. Statistical analysis was performed using the proportion z test to evaluate differences among the groups investigated. A “p” value of ≤0.05 was considered significant. In this study, ALI occurred more commonly in African Americans (p = 0.0029) and in patients without insurance coverage regardless of race (p = 0.0034). Chronic obstructive pulmonary disease (COPD), hypertension (HTN), and acute renal failure (ARF) were significantly higher in the uninsured group, compared to the insured group (p = 0.0005, 0.0055, and 0.0034, respectively). The time to hospital admission was significantly longer in uninsured patients compared to the insured group (p = 0.0449). The rates of major amputation above the ankle were 46% in patients with commercial insurance, 62% in the government insurance (Medicare and Medicaid) group, and 51% in the uninsured group. There was no significant difference in major versus minor amputation in patients with commercial insurances. However, the rates of major amputation were significantly higher than the rates of minor amputation in both Medicare and Medicaid and uninsured patients (p = 0.005, and <0.0001, respectively). With respect to acute lower limb ischemia, African Americans presented more frequently a

关键词： Ischemia Lower Ex.remity Amputation Insurance

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Hepatic macrophages in drug-induced liver injury

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Liver Research 2019年第3期3卷 170-175页

作者： zhao Shan cynthia Ju Center for Life Sciences School of Life SciencesYunnan UniversityKunmingChina Department of Anesthesiology UTHealth McGovern Medical SchoolHoustonTXUSA

Drug-induced liver injury(DILI)is a major public health *** DILI,for ex.mple,acetaminophen overdose accounts for half of acute liver failure in the United ***,the most problematic type of DILI affecting drug development and health care is idiosyncratic DILI,which occurs unpredictably in a small population of patients taking the drug and the latency could be several weeks to *** knowledge on the pathogenesis of DILI suggest that hepatic macrophages play a central role in the initiation,progression and restoration stages of DILI,which make hepatic macrophages attractive as therapeutic *** macrophages consist of liver resident macrophages(also known as Kupffer cells,KCs)and infiltrating monocyte-derived macrophages(MoMF).There is a growing appreciation that hepatic macrophage is very plastic,and assumes diverse phenotypes and functions in response to micro-environmental *** this review,we will summarize studies on the role of hepatic macrophages in both intrinsic DILI and idiosyncratic DILI,followed by discussing the prognostic and therapeutic potentials of targeting hepatic macrophages and the obstacles in studying hepatic macrophages.

关键词： Hepatic macrophages Acetaminophen(APAP) Drug Liver injury Intrinsic drug-induced liver injury(DILI) Idiosyncratic DILI

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Global sources, emissions, transport and deposition of dust and sand and their effects on the climate and environment： a review

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Frontiers of Environmental Science & Engineering 2017年第1期11卷 35-43页

作者： Feng Wang x.eqiu zhao cynthia Gerlein-Safdi Yue Mu Dongfang Wang Qi Lu Institute of Desertification Studies Chinese Academy of Forestry Beijing 100091 China School of Resources and Environment Anhui Agricultural University Hefei 230036 China Department of Civil and Environmental Engineering Princeton University Princeton NJ 08544 USA

Dust and Sand Storms （DSS） originating in deserts in arid and semi-arid regions are events raising global public concern. An important component of atmospheric aerosols, dust aerosols play a key role in climatic and environmental changes at the regional and the global scale. Deserts and semi-deserts are the main source of dust and sand, but regions that undergo vegetation deterioration and desertification due to climate change and human activities also contribute significantly to DSS. Dust aerosols are mainly composed of dust particles with an average diameter of 2 ***, which can be transported over thousands of kilometers. Dust aerosols influence the radiation budget of the earth- atmosphere system by scattering solar short-wave radiation and absorbing surface long-wave radiation. They can also change albedo and rainfall patterns because they can act as cloud condensation nuclei （CCN） or ice nuclei （IN）. Dust deposition is an important source of both marine nutrients and contaminants. Dust aerosols that enter marine ecosystems after long-distance transport influence phytoplankton biomass in the oceans, and thus global climate by altering the amount of CO2 absorbed by phytoplankton. In addition, the carbonates carried by dust aerosols are an important source of carbon for the alkaline carbon pool, which can buffer atmospheric acidity and increase the alkalinity of seawater. DSS have both positive and negative impacts on human society： they can ex.rt adverse impacts on human＇s living environment, but can also contribute to the mitigation of global warming and the reduction of atmospheric acidity.

关键词： Dust and sand storm Climate effects Radiative forcing Cloud condensation nuclei Precipitation Iron fertilizer

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Agricultural cooperatives and the role of organisational models in new intelligent traceability systems and big data analysis

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International Journal of Agricultural and Biological Engineering 2017年第5期10卷 115-125页

作者： cynthia Giagnocavo Fernando Bienvenido Li Ming zhao Yurong Jorge Antonio Sanchez-Molina Yang x.nting Cátedra(Chair)Coex.hal-UAL of Horticulture Cooperative Studies and Sustainable DevelopmentUniversity of AlmeriaSpain Department of Informatics University of AlmeriaAlmeriaSpain Beijing Research Center for Information Technology in Agriculture/National Engineering Research Center for Information Technology in Agriculture/National Engineering Laboratory for Agri-product Quality Traceability/Key Laboratory for Information Technologies in Agriculture Ministry of AgricultureChina College of Economics and Management Shandong Agricultural UniversityChina

Traceability systems are key to assuring food safety,creating a benefit for food supply chain ***,the appearance of new technologies such as IoT and Big Data Analysis leads to a new generation of more functional,but complex.traceability *** models based on cooperation of multiple small/medium size agents,for ex.mple of small/family farming cooperatives,play an important role in high standard agricultural production and commercialization *** function as both social and economic networks,with high social and economic impact in the rural *** case of Almeria as an ex.mple of this model was used to analyze its cooperative *** actual traceability systems in the Almeria model were studied,taking account of the different networked agents and their *** study includes two main parts:a)analysis of the net-chains that constitute the food supply chains and their different relationships,and b)actual *** nex. step studied how the net-chain model,including many diverse agents,may be applied to develop a new generation of traceability systems based of IoT and Big *** implies ex.ending the special and functional scope of the actual systems and defining clear rules of ex.hange of the results of the Big Data Analysis,taking account of the adequate Privacy *** work analyses the current organisation as a base for a new generation of traceability systems considered in the European project IoF2020(Internet of the Food and Farm 2020).Some parallels between Almeria’s model and certain areas in China,mainly in the areas of Beijing-Tianjin-Hebei and Shandong were *** of the objectives of this work is to deepen the understanding of these similarities and analyze the possible adaptation of the results from Almeria to China.

关键词： food traceability system big data internet of things organisational structure business model agricultural cooperatives net-chains food supply chain

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Grading system modification and management of blunt aortic injury

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Chinese Medical Journal 2013年第3期126卷 442-445页

作者： Kaavya N Reddy Tim Matatov Linda D Doucet Maureen Heldmann cynthia x.zhao Wayne W Zhang Division of Vascular and Endovascular Surgery Louisiana State-University' Health Sciences Cemer Shreveport LA USA Department of Radiology Louisiana State University Health Sciences Center Shreveport LA USA Department of Pathology Louisiana State University Health Sciences Center Shreveport LA USA

Background The traditional approach to blunt aortic injury （BAI） has been emergent intervention. This study aimed to utilize a modified imaging grading system that may allow us to categorize these injuries as needing emergent, urgent, or non-operative management. Methods From January 2003 to December 2011, 28 patients with BAI were managed at our institution. Imaging and medical records were reviewed retrospectively. BAI was classified into 4 grades based on imaging studies. Grade la： intimal tear, Grade Ib： intramural hematoma; Grade Ⅱ： intimal injury with periaotic hematoma; Grade Ilia： aortic transection with pseudoaneurysm, Grade Illb： multiple aortic injuries; and Grade IV： free rupture. Progression and clinical outcomes of ABI were analyzed. Results Of the 28 patients, 22 were males and 6 were females with mean age of 38 （range, 7-69） years, Twenty-five （89.3%） had descending thoracic aortic injury, two （7.1%） had abdominal aortic injury and one （3.6%） presented with multiple aortic injuries. Three patients （10.7%） with Grade I, 1 （3.6%） Grade Ⅱ, 22 （78.6%） Grade Ⅲ, and 2 （7.1%） Grade IV injuries. Twenty-five patients underwent thoracic endovascular aortic repair and 3 were managed medically. Median time between injury and surgical intervention was （2±1） days. One （3.6%） patient developed paraplegia after thoracic endovascular aortic repair （TEVAR）. One Type 2 endoleak spontaneously sealed within 1 month, and another patient died from ruptured Type 1 endoleak 3 years later. Median follow-up time was 16 （range, 1-96） months. Perioperative 30-day mortality rate was 3.6%. Conclusions This study based on our modified BAI grading system indicated that Grade Ⅰ BAI can be managed conservatively. Grade Ⅱ injury requires close observation and repeated computerized tomography angiogram （CTA） within 48-72 hours. If injury appears worse on follow up imaging, surgery should be performed. Delayed repair of Grade Ⅲ BAI is acceptable if associated life threatenina traumatic i

关键词： blunt aortic injury imaging grading system endovascular management

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Fatal Skin and Soft Tissue Infection, Peritonitis and Bacteriemia Caused by Shewanella petrefaciens

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Forensic Medicine and Anatomy Research 2016年第2期4卷 29-32页

作者： cynthia zhao Long Jin Department of Pathology Louisiana State University Health Sciences Center Shreveport Shreveport LA USA

We report a case of skin and soft tissue infection, peritonitis and bacteriemia in a 51-year-old drug abuse male. His wife found him lifeless lying on the kitchen floor at his residence. At the time of autopsy, multiple skin ulcers with deep soft tissue infection and peritonitis were found on gross ex.mination. Cultures of postmortem blood and a swab of soft tissue were positive for Shewanella putrefaciens, a gram-negative bacterium that had been isolated from many foods, sewage and fresh and salt water. This is the first reported case in the United States of fatal skin and soft tissue infection, peritonitis and bacteremia caused by this micro-organism.

关键词： Shewanella putrefaciens Autopsy Drug Abuse Skin Ulcer Peritonitis

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Real world ex.erience with Pegylated Interferon and ribavirin in Hepatitis C Genotype 1 population with favourable IL28B polymorphism

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Gastroenterology Report 2017年第3期5卷 208-212,I0002页

作者： Victoria Ekstrom Rajneesh Kumar Yi zhao Mei Ling Yee cynthia Sung Dorothy Toh Poh Yen Loh Jessica Tan Eng Kiong Teo Wan Cheng Chow Department of Gastroenterology and Hepatology Singapore General HospitalSingapore Department of Clinical Translational Research Singapore General HospitalSingapore Department of Pharmacy Singapore General HospitalSingapore Health Products Regulation Group Health Sciences AuthoritySingapore Emerging Infectious Disease Programme Duke-NUS Medical SchoolSingapore Department of Gastroenterology and Hepatology Changi General HospitalSingapore

Background and aim:Conventional hepatitis C treatment using pegylated interferon(PEG-IFN)and ribavirin is associated with significant side ***28B polymorphism can predict response to treatment,with CC genotype having a better *** gene deficiency protects against clinically significant anaemia induced by *** purpose of this study was to determine IL28B polymorphismand ITPA variation among hepatitis C genotype 1 patients who have undergone therapy with PEG-IFN and ribavirin and their association with sustained viral response(SVR).Methods:All hepatitis C genotype 1 patients who had been treated with PEG-IFN and ribavirin over the past 10 years were identified by available medical records and were contacted by letter of invitation to participate in the *** samples for IL28B and ITPA genotyping were *** records were reviewed for verification of treatment response,development of anaemia and if treatment reduction was required during the ***:A total of 61 patients with hepatitis C genotype 1 were treated with PEG-IFN and ribavirin,of whom 42 agreed to participate in the *** age was 45.6±12.9 years at time of treatment,and 83.3%of patients ***-three(78.6%)had IL28B CC genotype,of whom 25(75.8%)obtained SVR compared with only 3 of 9(33.3%)non C/C genotype patients who achieved SVR(P=0.041).Eleven(26.1%)patients had ITPA AC genotype,and 30(71.4%)had CC *** was no statistically significant difference between ITPA AC and CC genotypes in predicting clinically significant anaemia(45.5%vs 63.3%,P=0.302).Even among patients who developed anaemia,70.8%stillmanaged to achieve *** reduction also had no impact on ***:Hepatitis C genotype 1 patients should be informed of the response rate for treatment with PEG-IFN and ribavirin in a population with favourable IL28B genotype before consideration of newer therapeutic options.

关键词： hepatitis C pegylated interferon IL28B polymorphism sustained viral response

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Identification of Fx.RLamide Family Neuropeptides from the Japanese Oak Silkworm,Antheraea yamamai Using Immunocytochemistry Methods

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Agricultural Sciences in China 2006年第12期5卷 944-951页

作者： WEI zhao-jun LAI Juan-hong zhao Yuan Department of Biotechnology Hefei University of Technology Hefei 230009 P.R.China The Sericultural Research Institute Chinese Academy of Agricultural Sciences Zhenjiang 212018 P.R.China

In the present study, zooblooting, ELISA, and whole-mount immunocytochemistry methods were used to identify the Fx.RLamide family neuropeptides from the Japanese oak silkworm, Antheraea yamamai. The results showed that the genomic DNA from A. yamamai showed positive bands after being hybridized with the fragment of DH-PBAN cDNA from Samia cynthia ricini, which was labeled with [α-32p]-dCTP. The SG showed highest Fx.RLamide peptides titer in neural organs. Using an antiserum against Helicoverpa armigera PBAN, PBAN-like immunoreactivity was detected in the SG and TG of A. yamamai by whole-mount immunocytochemistry, and there were three cluster cells in the SG which shows positive PBAN-like immunoreactivity. The titers of Fx.RLamide peptides immunoreactivity in the hemolymph were kept at a steady level. During pupation, the titer was increased promptly, but then decreased to a low level after the early pupal stage. The above-mentioned results demonstrate the ex.stence of Fx.RLamide family peptides in A. yamamai, but its function needs to be further investigated in the future.

关键词： Antheraea yamamai Fx.RLamide family neuropeptides immunocytochemistry identification

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Telemonitoring and hemodynamic monitoring to reduce hospitalization rates in heart failure： a systematic review and meta-analysis of randomized controlled trials and real-world studies

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Journal of Geriatric Cardiology 2018年第4期15卷 298-309页

作者： Gary Tse cynthia Chan Mengqi Gong Lei MENG Jian ZHANG x.ao-Ling SU Sadeq Ali-Hasan-Al-Saegh Abhishek C Sawant George Bazoukis Yun-Long x.A Ji-Chao zhao Alex.Pui Wai Lee Leonardo Roever Martin CS Wong Adrian Baranchuk Tong Liu Department of Medicine and Therapeutics Faculty of Medicine Chinese University of Hong Kong Hong Kong China Li Ka Shing Institute of Health Sciences Faculty of Medicine Chinese University of Hong Kong Hong Kong China Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease Department of Cardiology Tianjin Institute of Cardiology the Second Hospital of Tianjin Medical University Tianjin China State Key Laboratory of Cardiovascular Disease Heart Failure Center Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences Peking Union Medical College Beijing China Department of Cardiology Qinghai Provincial People's Hospital Xining China Cardiovascular Research Center Shahid Sadoughi University of Medical Sciences Yazd Iran Division of Cardiology State University of New York at Buffalo Buffalo NY USA The Second Department of Cardiology Laboratory of Cardiac Electrophystology Evangehsmos General Hospital of Athens Athens Greece Department of Cardiovascular Medicine the First Affiliated Hospital of Dalian Medical University Dalian China Auckland Bioengineering Institute the University of Auckland Auckland New Zealand Department of Clinical Research Federal University of Uberlandia Uberlandia MG Brazil JC School of Public Health and Primary Care Faculty of Medicine the Chinese University of Hong Kong Hong Kong China Division of Cardiology Kingston General Hospital Queen 's University Kingston Ontario Canada

Background Heart failure is a significant problem leading to repeated hospitalizations. Telemonitoring and hemodynamic monitoring have demonstrated success in reducing hospitalization rates, but not all studies reported significant effects. The aim of this systematic review and meta-analysis is to ex.mine the effectiveness of telemonitoring and wireless hemodynamic monitoring devices in reducing hospitalizations in heart failure. Methods ＆ Results PubMed and Cochrane Library were searched up to 1st May 2017 for articles that investigated the effects of telemonitoring or hemodynamic monitoring on hospitalization rates in heart failure. In 31,501 patients （mean age： 68 ± 12 years; 61% male; follow-up 11 ± 8 months）, telemonitoring reduced hospitalization rates with a HR of 0.73 （95% CI： 0.65-0.83; P 〈 0.0001） with significant heterogeneity （I2 = 94%）. These effects were observed in the short-term （≤ 6 months： HR = 0.77, 95% CI： 0.65-0.89; P 〈 0.01） and long-term （≥ 12 months： HR = 0.73, 95% CI： 0.62-0.87; P 〈 0.0001）. In 4831 patients （mean age 66 ± 18 years; 66% male; follow-up 13 ± 4 months）, wireless hemodynamic monitoring also reduced hospitalization rates with a HR of 0.60 （95% CI： 0.53-0.69; P 〈 0.001） with significant heterogeneity （I2 = 64%）.This reduction was observed both in the short-term （HR = 0.55, 95% CI： 0.45-0.68; P 〈 0.001; I2 = 72%） and long-term （HR = 0.64, 95% CI： 0.57-0.72; P 〈 0.001; I2 = 55%）. Conclusions Telemonitoring and hemodynamic monitoring reduce hospitalization in both short- and long-term in heart failure patients

关键词： Heart failure Hemodynamic monitoring Hospitalization Telemedicine Telemonitoring

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The gene ex.ression of adenosine receptors in the processes of contrast induced nephropathy in mouse kidney

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World Journal of Cardiovascular Diseases 2013年第9期3卷 561-568页

作者： Luyu Yao cynthia zhao x.n Gu Gopi K. Kolluru Christopher G. Kevil Wayne W. Zhang Department of Pathology Louisiana State University Health Sciences Center Shreveport USA Department of Surgery Louisiana State University Health Sciences Center Shreveport USA

Objective: Contrast induced nephropathy (CIN) is the third leading cause of hospital acquired renal failure. The mechanism of CIN is not fully understood. The objectives of this study were to investigate the ex.ression changes of the four subtypes of adenosine receptors (A1AR, A2AAR, A2BAR, and A3AR) following administration of contrast media in mice. Methods: C57BL/6J mice were randomized into treatment and control groups. Iodix.nol (IDx. was administered to two treatment groups through retroorbital injection at two different dosages, 0.75 gI/kg and 2.75 gI/kg. Phosphate buffered saline (PBS) was given to the control group. Mice kidneys were harvested at day 3 and day 7 after Iodix.nol administration. Kidney injuries and function were evaluated according to Hematox.lin and eosin stain, Ki67 protein ex.ression, and TUNEL assay of paraffin embedded kidney sections, and plasma creatinine assay. RNA and protein were ex.racted from the kidney specimens. A1AR, A2AAR, A2BAR, and A3AR RNA and protein level of the samples were assessed using qRT-PCR and Western blotting, with GAPDH as an endogenous control. Results: H&E staining showed no significant histopathology injuries after Iodix.nol administration. No evidence of kidney injury and functional impairment was found. However, there was an increased number of A1AR, A2AAR, A2BAR, and A3AR RNA transcripts detected in the kidney 3 days after Iodix.nol injection. The RNA levels in all the four subtypes of adenosine receptors were increased 2-3 fold in the day 3 specimens and back to normal at day 7. Western blot demonstrated that A1AR, A2AAR, and A3AR ex.ression increased 1.5 to 2 fold at day 3 and day 7 following Iodix.nol injection. A2BAR baseline ex.ression was low in normal physiological conditions and no significant change was detected by Western blot. Conclusions: Iodix.nol significantly increases adenosine receptors gene ex.ression in mice. This suggests that adenosine receptors may play a role in the development of CI

关键词： Contrast Induced Nephropathy Adenosine Receptor Iodix.nol

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