Background:A non-invasive predictive model has not been established to identify the severity of coronary lesions in young adults with acute coronary syndrome(ACS).Methods:In this retrospective study,1088 young adults(...Background:A non-invasive predictive model has not been established to identify the severity of coronary lesions in young adults with acute coronary syndrome(ACS).Methods:In this retrospective study,1088 young adults(≤45 years of age)first diagnosed with ACS who underwent coronary angiography were enrolled and randomized 7:3 into training or testing datasets.To build the nomogram,we determined optimal predictors of coronary lesion severity with the Least Absolute Shrinkage and Selection Operator and Random Forest algorithm.The predictive accuracy of the nomogram was assessed with calibration plots,and performance was assessed with the receiver operating characteristic curve,decision curve analysis and the clinical impact curve.Results:Seven predictors were identified and integrated into the nomogram:age,hypertension,diabetes,body mass index,low-density lipoprotein cholesterol,mean platelet volume and C-reactive protein.Receiver operating characteristic analyses demonstrated the nomogram’s good discriminatory performance in predicting severe coronary artery disease in young patients with ACS in the training(area under the curve 0.683,95%confidence interval[0.645–0.721])and testing(area under the curve 0.670,95%confidence interval[0.611–0.729])datasets.The nomogram was also well-calibrated in both the training(P=0.961)and testing(P=0.302)datasets.Decision curve analysis and the clinical impact curve indicated the model’s good clinical utility.Conclusion:A simple and practical nomogram for predicting coronary artery disease severity in young adults≤45 years of age with ACS was established and validated.展开更多
Background:Biological age is a reliable indicator reflecting the real physiological state and aging status of individu-als.This study was aimed at exploring the association between biological age and contrast-associat...Background:Biological age is a reliable indicator reflecting the real physiological state and aging status of individu-als.This study was aimed at exploring the association between biological age and contrast-associated acute kidney injury(CA-AKI).Methods:This retrospective study was conducted on 4078 patients with coronary artery disease(CAD)undergoing coronary angiography(CAG).Biological age was calculated according to chronological age and blood biomarkers,and the“age gap,”reflecting retardation or acceleration of biological aging,was further determined.Logistic regres-sion analysis was used to examine the association of the biological age and age gap with CA-AKI.Receiver operating characteristic(ROC)analysis and subgroup analysis were also conducted.Results:Among the 4078 patients(68.00[61.00,74.00]years,2680(65.7%)men),725 CA-AKI cases were identi-fied.Older biological age(≥79.3 vs.<79.3 years,OR[95%CI]=3.319[2.714 to 4.059])and greater age gap(≥1.12 vs.<1.12,OR[95%CI]=2.700[2.240 to 3.256])were independent risk factors for CA-AKI(both P<0.001).ROC analysis indicated that biological age(AUC=0.672)and age gap(AUC=0.672)had better predictive ability for CA-AKI than chronological age(AUC=0.583).Subgroup analysis also indicated similar findings(all P<0.001).Conclusion:Biological age was found to be an independent risk factor for CA-AKI after CAG,with better predictive value than chronological age.展开更多
CRISPR-Cas(Clustered Regularly Interspaced Short Palindromic Repeats-CRISPR associated)has been extensively exploited as a genetic tool for genome editing.The RNA guided Cas nucleases generate DNA doublestrand break(D...CRISPR-Cas(Clustered Regularly Interspaced Short Palindromic Repeats-CRISPR associated)has been extensively exploited as a genetic tool for genome editing.The RNA guided Cas nucleases generate DNA doublestrand break(DSB),triggering cellular repair systems mainly Non-homologous end-joining(NHEJ,imprecise repair)or Homology-directed repair(HDR,precise repair).However,DSB typically leads to unexpected DNA changes and lethality in some organisms.The establishment of bacteria and plants into major bio-production platforms require efficient and precise editing tools.Hence,in this review,we focus on the non-DSB and template-free genome editing,i.e.,base editing(BE)and prime editing(PE)in bacteria and plants.We first highlight the development of base and prime editors and summarize their studies in bacteria and plants.We then discuss current and future applications of BE/PE in synthetic biology,crop improvement,evolutionary engineering,and metabolic engineering.Lastly,we critically consider the challenges and prospects of BE/PE in PAM specificity,editing efficiency,off-targeting,sequence specification,and editing window.展开更多
文摘Background:A non-invasive predictive model has not been established to identify the severity of coronary lesions in young adults with acute coronary syndrome(ACS).Methods:In this retrospective study,1088 young adults(≤45 years of age)first diagnosed with ACS who underwent coronary angiography were enrolled and randomized 7:3 into training or testing datasets.To build the nomogram,we determined optimal predictors of coronary lesion severity with the Least Absolute Shrinkage and Selection Operator and Random Forest algorithm.The predictive accuracy of the nomogram was assessed with calibration plots,and performance was assessed with the receiver operating characteristic curve,decision curve analysis and the clinical impact curve.Results:Seven predictors were identified and integrated into the nomogram:age,hypertension,diabetes,body mass index,low-density lipoprotein cholesterol,mean platelet volume and C-reactive protein.Receiver operating characteristic analyses demonstrated the nomogram’s good discriminatory performance in predicting severe coronary artery disease in young patients with ACS in the training(area under the curve 0.683,95%confidence interval[0.645–0.721])and testing(area under the curve 0.670,95%confidence interval[0.611–0.729])datasets.The nomogram was also well-calibrated in both the training(P=0.961)and testing(P=0.302)datasets.Decision curve analysis and the clinical impact curve indicated the model’s good clinical utility.Conclusion:A simple and practical nomogram for predicting coronary artery disease severity in young adults≤45 years of age with ACS was established and validated.
基金supported by grants from the Zhejiang Provincial Health Department(2018KY460)Traditional Chinese Medicine Science and Technology Project of Zhejiang Province(2021ZB172).
文摘Background:Biological age is a reliable indicator reflecting the real physiological state and aging status of individu-als.This study was aimed at exploring the association between biological age and contrast-associated acute kidney injury(CA-AKI).Methods:This retrospective study was conducted on 4078 patients with coronary artery disease(CAD)undergoing coronary angiography(CAG).Biological age was calculated according to chronological age and blood biomarkers,and the“age gap,”reflecting retardation or acceleration of biological aging,was further determined.Logistic regres-sion analysis was used to examine the association of the biological age and age gap with CA-AKI.Receiver operating characteristic(ROC)analysis and subgroup analysis were also conducted.Results:Among the 4078 patients(68.00[61.00,74.00]years,2680(65.7%)men),725 CA-AKI cases were identi-fied.Older biological age(≥79.3 vs.<79.3 years,OR[95%CI]=3.319[2.714 to 4.059])and greater age gap(≥1.12 vs.<1.12,OR[95%CI]=2.700[2.240 to 3.256])were independent risk factors for CA-AKI(both P<0.001).ROC analysis indicated that biological age(AUC=0.672)and age gap(AUC=0.672)had better predictive ability for CA-AKI than chronological age(AUC=0.583).Subgroup analysis also indicated similar findings(all P<0.001).Conclusion:Biological age was found to be an independent risk factor for CA-AKI after CAG,with better predictive value than chronological age.
基金This work was sponsored by National Key R&D Program of China(2018YFA0901200)Science and Technology Commission of Shanghai Municipality(18JC1413600)National Natural Science Foundation of China(31870071).
文摘CRISPR-Cas(Clustered Regularly Interspaced Short Palindromic Repeats-CRISPR associated)has been extensively exploited as a genetic tool for genome editing.The RNA guided Cas nucleases generate DNA doublestrand break(DSB),triggering cellular repair systems mainly Non-homologous end-joining(NHEJ,imprecise repair)or Homology-directed repair(HDR,precise repair).However,DSB typically leads to unexpected DNA changes and lethality in some organisms.The establishment of bacteria and plants into major bio-production platforms require efficient and precise editing tools.Hence,in this review,we focus on the non-DSB and template-free genome editing,i.e.,base editing(BE)and prime editing(PE)in bacteria and plants.We first highlight the development of base and prime editors and summarize their studies in bacteria and plants.We then discuss current and future applications of BE/PE in synthetic biology,crop improvement,evolutionary engineering,and metabolic engineering.Lastly,we critically consider the challenges and prospects of BE/PE in PAM specificity,editing efficiency,off-targeting,sequence specification,and editing window.
