The risks of major bleeding and intracranial hemorrhage (ICH) are higher in Asian patients with atrial fibrillation (AF) compared to non-Asians. We aimed to investigate risk factors for bleeding, and validate the predictive value of available bleeding risk scores (mOBRI, HEMORR2HAGES, Shireman, HAS-BLED, ATRIA and ORBIT) in a large cohort of Chinese inpatients with AF. Using hospital electronic medical databases, we identified 4824 AF patients (mean age 67 years; 34.9% female) from January 1, 1995 to May 30, 2015, with median (interquartile) in-hospital days of 10 (7–16) days. On multivariate analysis, prior bleeds, vascular disease, anemia, prior stroke, and liver dysfunction were independent risk factors of major bleeding (all p < 0.05). C-statistics (95%CI) of the HAS-BLED score were 0.72 (0.65–0.79) for major bleeding events and 0.83 (0.75–0.91) for ICH (all p < 0.001). Compared to other risk scores, the HAS-BLED score was significantly better in predicting major bleeding events (Delong test, all P < 0.05, apart from mOBRI, HEMORR2HAGES) and ICH (all p < 0.05), and additionally, resulted in a net reclassification improvement (NRI) of 17.1–65.5% in predicting major bleeding events and 29.5–67.3% in predicting ICH (all p < 0.05). We conclude that the HAS-BLED score had the best predictive and discriminatory ability for major bleeding and ICH in an Asian/Chinese AF population.
Background and Aim Aberrant activation of the TGF-β1/Smad pathway contributes to the activation of hepatic stellate cells (HSCs). MicroRNA-195 has been shown to regulate the activation of HSCs. The aim of this study was to investigate the role of miRNA-195 in HSCs activation. Methods A liver fibrotic rat model induced by diethylnitrosamine was established. Dual luciferase reporter assays were performed to verify that Smad7 was the target of miRNA-195. The expression levels of miR-195, Smad7, and α-SMA in HSC-T6 transfected, respectively, with miR-195 mimic, inhibitor, or control were measured by qRT-PCR. The protein expression of Smad7 was detected by Western blot analysis. Results Enhanced miR-195 and decreased Smad7 were observed in diethylnitrosamine-induced liver fibrotic rats (P < 0.05). Dual luciferase reporter assays showed that the miR-195 mimic significantly suppressed the luciferase activity of a reporter plasmid carrying the binding site of miR-195 on the 3′UTR of Smad7 (P < 0.05). The miR-195 mimics activated HSCs, further elevated miR-195 and α-SMA (P < 0.01), and reduced the Smad7 level (P < 0.05). The miR-195 inhibitors blocked the activation of HSCs, reduced the expression of miR-195 and α-SMA (P < 0.01), and upregulated the expression of Smad7 (P < 0.05). Conclusion Collectively, we demonstrated that miRNA-195 activated HSCs by targeting Smad7.
The distribution and solidified structure of alloying elements are important for the quality and the properties of alloys. In the present study, the solidification behavior of aluminum-rich alloys is studied under various high magnetic field conditions, and the influences of uniform and gradient magnetic fields with different intensity and direction on the distribution and the morphology of solute elements of Al-Cu and Al-Mg alloys are investigated. It is found that because of the differences of the electromagnetic force (Lorentz and magnetization forces) acting on Cu element and Mg element with different physical properties in the matrix, the regularities of distribution for Cu element and Mg element are opposite just in the intracrystalline and intergranular under high uniform magnetic field condition, and not only the content but the distributions of Cu and Mg elements are obviously different under high gradient magnetic field conditions as well. It can be concluded that high magnetic field has different effect on the solute distribution in alloys with different physical properties such as density, susceptibility, conductivity, etc. And the experimental results indicate that it is possible to control the terminal solubility and morphology of the solute elements in alloys by high magnetic fields.
Those materials with an one dimensional phase-aligned structure have a large amount of potentiality as engineering materials because of their exceptional optical, electrical and anisotropically mechanical properties. Many researchers are now working determinedly to explore the methods for fabricating this kind of material. Recently, high magnetic fields have been used to fabricate non-magnetic materials with textured structure where anisotropic magnetic energy should be strong enough to induce preferred crystal orientation. Based on this mechanism, we developed an in situ process for fabricating phase-aligned composites using high magnetic fields. In this work, hypoeutectic Mn-Sb and hypereutectic Al-Ni alloys were solidified in various magnetic fields. The primary MnSb dendrites in the solidified Mn-Sb alloys were found to be macrostructurally aligned along the field direction, while the primary Al3Ni phases in the Al-Ni alloys were found to be macrostructurally aligned perpendicular to the field direction. The X-ray diffraction (XRD) measurement results suggested that these two phases were also oriented by the magnetic field. It was believed that the above-mentioned alignment is based on the crystal orientation and relevant to the heat flux direction, the preferred growth direction and the concentration field around crystallized crystals.
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