Background: There have been few studies done regarding young patients with ST-elevation myocardial infarction (STEMI). The purpose of this study was to investigate the clinical characteristics and coronary angiographic features in young patients with STEMI. Methods: We collected data on 849 consecutive patients with STEMI from 1992 to 2006. Baseline clinical characteristics, coronary anatomy, and outcome were compared in young (≤45 yrs) and older patients (>45 yrs). Results: Young patients presented 11.6% of all patients with STEMI. These patients were predominantly male (92.9% vs 80.3%, P < 0.001), more likely to smoke (75.8% vs 47.2%, P < 0.001), obese (48.2% vs 27.9%, P = 0.002), have higher triglyceride levels (176.9 ± 153.8 mg/dL vs 140.7 ± 112.7 mg/dL, P = 0.005), and lower high-density lipoprotein cholesterol (37.1 ± 7.9 mg/dL vs 42.8 ± 14.3 mg/dL, P = 0.005) than older patients. Also, younger patients had a shorter hospital stay (7.1 ± 4.9 d vs 8.5 ± 6.7 d, P = 0.04), less in-hospital morbidity (29.3% vs 39.7%, P = 0.02), and mortality (3.0% vs 12.3%, P = 0.002). Killip class III or IV could predict in-hospital morbidity and mortality in young patients. Both groups had similar rates of repeated percutaneous coronary intervention (PCI; 45.5% vs 41.5%, P = 0.23) and reinfarction (6.1% vs 3.2%, P = 0.32). Mortality rate during follow-up was significantly lower in younger patients (3.0% vs 19.6%, P < 0.001). Conclusion: Cigarette smoking, obesity, and dyslipidemia were the most important modifiable risk factors in young patients with STEMI. These patients had a better outcome than older patients without differences in repeated PCI and reinfarction between them. Only Killip class III or IV could predict in-hospital morbidity and mortality in young patients with STEMI.

Oxidative stress is mainly caused by intracellular reactive oxygen species (ROS) production, which is highly associated with normal physiological homeostasis and the pathogenesis of diseases, particularly ocular diseases. Autophagy is a self-clearance pathway that removes oxidized cellular components and regulates cellular ROS levels. ROS can modulate autophagy activity through transcriptional and posttranslational mechanisms. Autophagy further triggers transcription factor activation and degrades impaired organelles and proteins to eliminate excessive ROS in cells. Thus, autophagy may play an antioxidant role in protecting ocular cells from oxidative stress. Nevertheless, excessive autophagy may cause autophagic cell death. In this review, we summarize the mechanisms of interaction between ROS and autophagy and their roles in the pathogenesis of several ocular diseases, including glaucoma, age-related macular degeneration (AMD), diabetic retinopathy (DR), and optic nerve atrophy, which are major causes of blindness. The autophagy modulators used to treat ocular diseases are further discussed. The findings of the studies reviewed here might shed light on the development and use of autophagy modulators for the future treatment of ocular diseases.

Theranostic nanohybrids are promising for effective delivery of therapeutic drug or energy and for imaging-guided therapy of tumors, which is demanded in personalized medicine. Here, a size-changeable graphene quantum dot (GQD) nanoaircraft (SCNA) that serves as a hierarchical tumor-targeting agent with high cargo payload is developed to penetrate and deliver anticancer drug into deep tumors. The nanoaircraft is composed of ultrasmall GQDs (less than 5 nm) functionalized with a pH-sensitive polymer that demonstrates an aggregation transition at weak acidity of tumor environment but is stable at physiological pH with stealth function. A size conversion of the SCNA at the tumor site is further actuated by near-infrared irradiation, which disassembles 150 nm of SCNA into 5 nm of doxorubicin (DOX)/GQD like a bomb-loaded jet, facilitating the penetration into the deep tumor tissue. At the tumor, the penetrated DOX/GQD can infect neighboring cancer cells for repeated cell killing. Such a SCNA integrated with combinational therapy successfully suppresses xenograft tumors in 18 d without distal harm. The sophisticated strategy displays the hierarchically targeted and penetrated delivery of drugs and energy to deep tumor and shows potential for use in other tumor therapy.

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Third-harmonic-generation (THG) has been emerged as an important noninvasive intravital imaging modality of in vivo biological research [1][2][3][4] in recent years with the advantages including intrinsic optical sectioning capability due to the highorder nonlinearity nature and no energy release due to the virtual-state-transition characteristic, [5][6][7][8][9] thus allowing much improved cell viability [3,4] in contrast to current absorptionbased fluorescence technologies. Although THG nonlinearity exists in all bio-materials, the Gouy phase shift effect substantially limits THG to be observed in the vicinity of interfaces where the first order or third order susceptibility discontinues.[10] Therefore, THG is generally regarded as a morphological imaging tool due to its interface-sensitive nature, with limited capability for molecular imaging. It is thus highly desirable to develop exogenous THG contrast agents to trace the functions of a specific molecule, taking advantage of the noninvasive nature of the THG process. Recently, noble metal nanoparticles have been proved to be able to enhance various nonlinear optical signals through surface plasmon resonance. [11][12][13][14][15][16] It should be ideal to adopt nanoparticles as molecular contrast agents of THG microscopy. However, these previous experiments proposed to enhance nonlinear emissions by matching excitation energy with the plasmon resonance energy of metal nanoparticles, which could induce strong laser absorption in nanoparticles while the induced temperature increase might alter the behaviors of the targeted bio-molecules or even induce thermal damages in the studied biological specimens.In this letter, we demonstrate molecular THG microscopy by using silver nanoparticles as exogenous THG contrast agents. This demonstration was performed in cultured mouse bladder carcinoma cells (MBT2) and the matched cell line with knocked-down Her2/neu expression by RNAi. Through matching surface plasmon wavelength to THG wavelength, strong contrast can be provided by the silver nanoparticles under a THG microscope, while the laser wavelength is located in the biological penetration window and laser absorption in nanoparticles is also strongly reduced due to the huge spectral difference between the laser excitation wavelength and the plasmon resonance wavelength. By successfully conjugating anti-her2 antibodies with the citrated silver nanoparticles, Her2/neu in the cancerous cell membranes is successfully imaged with THG microscopy.With the help of surface plasmon-resonance, nanometersized noble metals can serve as a nanoscopic optical resonant cavity. Metal nanoparticles with the plasmon resonance at the third harmonic of optical excitation, in the macroscopic point of view, is analogous to an optical third-harmonic oscillator. [17,18] We chose silver nanoparticles for its blue-violet plasmon resonance wavelengths when soaked in water. For nonlinear biological in vivo imaging, near-infrared (NIR) femtosecond lasers are preferred as the THG excitation sources ...