Background: Many studies have shown that Glycated hemoglobin (HbA1c) is associated with Coronary Artery Disease (CAD). HbA1c was independently related to angiographic severity in Chinese patients with CAD after adjusting for other covariates. Some traditional cardiovascular drugs may have an impact on this relationship. Methods: This retrospective study enrolled a total of 572 CAD patients who underwent their coronary angiography and had their HbA1c levels measured at the Chinese Hospital. The complexity of the coronary artery lesions was evaluated using the Syntax score, and the subjects were divided into 4 inter quartiles according to HbA1c levels. Covariates included history of traditional cardiovascular drugs. Results: The average age of selected participants was 61.00 ± 9.15 years old，and about 54.72% of them was male. Result of fully-adjusted linear regression showed HbA1c was positively associated with Syntax score after adjusting confounders (β=1.09, 95%CI: 0.27, 1.91, P=0.0096). By interaction and stratified analyses, the interactions were observed based on our specification including: with the medication history of Statins and Angiotensin Receptor Blockers (ARBs) (P values for interaction <0.05). Conclusions: In this study, we found a positive correlation between the HbA1c levels and the SYNTAX score among CAD individuals, and oral Statins and ARBs medication could affect the correlation. Thus, HbA1c measurement could be used for the evaluation of the severity and complexity of coronary lesions among CAD patients.

Background:The aim of the present study was to compare the operative and early postoperative results of the use of del Nido Cardioplegia solution(dNCS) with traditional blood cardioplegia(BC) in adult aortic surgery. Methods: A retrospective single-center study was performed on 118 patients who underwent aortic surgery with cardiopulmonary bypass (CPB) between January 2016 and June 2020. Patients were divided in to two groups according to the type of cardioplegia solution used during the operation. Cardiac arrest was achieved in Group 1(n:65) with traditional BC and in Group 2(n=53) with dNCS. Operative and postoperative outcomes of the patients were compared between the two groups. Results: Patient demographic characteristics were similar between the two groups. dNCS group showed significantly lower aortic cross-clamp (ACC) time(87,5 vs 73,3 min; P=0.001), cardioplegia volume (P<0.001), defibril¬lation(P=0.006), drenaige amount(P=0.026) and inotropic support need (P=0.046).Also dNCS group had significantly lower high sensitive troponin I (hsTnI) values at 6th (P=<0.001) and 24th (P=0.017) hours. Hematocrit levels at hours 6 and 24 were significantly higher in dNCS (P=0.001).Time of intensive care unit stay, duration of extubation and length of hospital stay times were similar in both groups. There was no significant difference in terms of postoperative ejection fraction values(P=0.714). Conclusion: Compared with conventional BC, dNCS provided beter myocardial protection with significantly shorter ACC times, reduced need for intraoperative defibrillation, postoperative lower hsTnI levels and comparable early clinical outcomes for adult patients undergoing aortic surgery. dNCS is a safe and efficient alternative to the traditional BC solution in adult cardiac surgery.

The blades of intertidal red algae Pyropia haitanensis can lose 90% cellular water during low tides, thus is a good material for exploring mechanisms of tolerance to intertidal desiccation. Here, multi-omics responses of blades to a single stress of desiccation (SS) or triple stress containing desiccation, high-temperature and high-light (TS) were determined. Differentially expressed genes (DEGs) and proteins (DEPs), and accumulated metabolites (DAMs) were analyzed in pairs. The results showed that several DEGs/DEPs, DEGs/DAMs, and DEPs/DAMs participated in Glyoxylate and dicarboxylate metabolism (ko00630) and Carbon fixation in photosynthetic organisms (ko00710), and several DEGs/DAMs enriched significantly in Ether lipid metabolism (ko00565). DEGs/DAMs of ko00630 enriched significantly under both stress conditions, DEGs/DAMs and DEPs/DAMs of ko00710 enriched significantly under SS and TS, respectively. Therefore, we speculated that plasma membrane responded first to intertidal desiccation and activated stress signal transduction. Organic acids and amino acids involved in osmoregulation were then synthesized and accumulated, meanwhile, energy metabolism was reduced to prevent the accumulation of reactive oxygen species and cellular damage. These pathways worked together to protect blades of P. haitanensis from intertidal desiccation during low tides, which further provided new ideas for breeding cultivars with improved resistance to abiotic stress caused by global warming.

Objective: To understand the preferences of women living with HIV (WLHIV) for methods of multipurpose technology (MPT) for the co-administration of contraception and antiretroviral therapy (ART) and non-oral ART to guide their development and implementation. Design: A cross-sectional telephone survey as part of a study of pregnancy incidence among contraception and ART users Setting: Our study was performed in western Kenya Population: We included 1132 WLHIV of reproductive potential with prior experience using injectable and long-acting contraception Methods: We performed descriptive statistics and multinomial logistic regression Main Outcome Measures: Main outcomes were interest in MPT, important characteristics and preferred methods for MPT and non-oral ART, and predictors of interest in specific methods Results: Two-thirds (67%) reported interest in MPT, most commonly due to ease of using a single medication for both HIV treatment and pregnancy prevention (26%). Main reasons for lack of interest in MPT were need to stop/not use contraception while continuing ART (21%) and risk of side effects (16%). Preferred methods for MPT and non-oral ART were injectables (50%, 54%) and implants (32%, 31%). Prior use of a contraceptive implant or injectable predicted interest in similar methods for MPT and non-oral ART, and this did not vary by age. Conclusions: Many WLHIV in western Kenya are interested in MPT for contraception and ART. Prior experience with contraceptive implants and injectables predicts interest in similar methods of MPT and non-oral ART. Funding: NIH NIAID (K23AI120855) and the NIH NIAID, NICHD, NIDA, NCI, & NIMH for the EA-IeDEA Consortium (U01AI069911)

Background Ethnic variations in pathways to early intervention in psychosis (EIP) have been studied. However it is important to explore the ethnic variations in response to pharmacological treatment in EIP. Aims To look at ethnic variation in response to antipsychotics. Method Electronic patient records in December 2018 were perused for: 1. Sociodemographic details including ethnicity 2. Prescribed antipsychotic and dosage to which the patient had responded Results White, Black and Asian ethnic groups responded mostly to Olanzapine. The largest proportion of the mixed ethnic group responded to Aripiprazole. The White and Asian groups showed the best responses to Lurasidone at 74 mg. There was a slight response in the mixed and other ethnic group only at the higher dose of 111 mg. The medication has not been used with any benefit in the Black ethnic group. Conclusion The complex differences highlighted amongst ethnic responses to treatment make a case for multi-centric studies to further explore ethnic differences in early intervention treatments. This will help streamline offered treatments to maximise response in EIP.

A 70-year-old man affected by a metastatic lung adenocarcinoma developed an atrioventricular block. Due to an extensive thrombosis of the superior vena cava with invasion of the right atrium, a traditional transvenous pacemaker system (TTPS) implantation was not feasible. Despite the extensive development of the thrombosis in the right atrium, the patient successfully underwent Micra transcatheter pacing system (MTPS) implantation. This case report describes a quite rare condition in which a leadless pacemaker (LP) is the best option to treat an atrioventricular block and where the recent introduction of the groundbreaking AV MTPS would be the optimal therapy.

Introduction Pathological studies have demonstrated that the cavotricuspid isthmus (CTI) is often composed of discrete muscle bundles that correlate with high-voltage local electrograms. The main objective was to demonstrate that ablation of high-voltage muscle bundles in the cavotricuspid isthmus (CTI), identified using an intracardiac mapping system, reduces radiofrequency (RF) time compared to the conventional technique. Methods A retrospective analysis of patients who had undergone CTI ablation guided by a mapping system. The patients were divided into two groups according to operator experience and selected by propensity score-matched analysis: group A, RF delivery in high-voltage bundles and group B, RF delivery producing a contiguous line of ablation lesions along the entire CTI length. Results Thirty-eight patients [92.1% male, 64 yrs (57-70)] were selected, 19 in each group. There were no differences in baseline characteristics or clinical results: success (A: 94.7% vs B: 94.7%), complications (A: 5.3% vs B: 0%) and recurrence (A: 10.5% vs B: 5.3%). In the procedures in group A, fewer RF applications were delivered [14 (9–19) vs 20 (2–25); P < 0.05] with greater contact force [14.5 g (13–16.2) vs 12 g (9-14); P < 0.01] and greater lesion size index (LSI) [5.3 (4.9–6) vs 4.5 (4.1–4.7); P < 0.001]. The RF time was less (P < 0.001) in group A [310 s (211–479) vs 577 s (312–858)]. Conclusions Application of RF in CTI muscle bundles reduces RF time, compared to conventional linear ablation, with similar clinical results.

Aims The left atrial appendage (LAA) is one of the major sources of atrial tachycardias (ATs) in children. However, endocardial ablation in LAA may fail or even cause fatal tamponade; and epicardial ablation with subsequent surgical appendectomy (SAE) may be required. There is no relevant report in children. We aimed to evaluate the feasibility of epicardial ablation with SAE in children. Methods and results The epicardial ablation with SAE was performed in a 12-year-old girl with an incessant AT. Endocardial mapping demonstrated endocardial activation time of −112 msec and −105 msec (relative to the onset of the A wave at CS9-10) in the right ventricular outflow tract and LAA, respectively. But multiple ablation attempts at these sites did not terminate the AT. After the left-side pericardium opened, the earliest activation (−120 msec) during AT was found at the apex of upper lobe. At this site, ablation eliminated the tachycardia within 5 seconds of onset of energy. After ablation, the LAA was excited, followed by a continuous over and over suture to definitely close the resection line. The free of AT and a decrease in LAD and NT-proBNP were achieved during the 12-month follow-up. Conclusion The epicardial ablation with subsequent SAE was successfully performed in a child. The heart function of the patient improved after a 12-month follow-up. The excision of LAA may be an ideal strategy for children with incessant AT originating from epicardial LAA. However, the long-term safety and efficacy of SAE in children should be further estimated.

We report the clinical outcomes following implementation of initial COVID-19 treatment guidelines in Thailand. A composite poor outcome was defined as death, ICU admission, requiring intubation, or high-flow oxygen. 744 COVID-19 patients (48.8% male) were included, median (IQR) age was 37 (27-48) years [8.4% >60 years] and 21.4% had pneumonia at admission. Admission <4 days from symptom onset had a reduced risk of poor outcome. In a subgroup analysis, favipiravir use reduced the risk of a poor outcome for patients admitted <4 days from symptom onset (OR 0.320 (0.152-0.662), P=0.003). Thai guidelines now include favipiravir to treat all symptomatic COVID-19 patients.

SARS-CoV-2 has emerged as a life-threatening virus claiming number of lives and adversely affecting the physical, mental health and economic growth world-wide. There is an urgent need to treat this life threatening condition as it is adversely affecting the mankind. Because of the pandemic, the global economic rate has declined by several folds. Initially, FDA approved drugs for other diseases have been repurposed for treatment, but these therapeutic strategies do not provide targeted treatment to treat Covid-19. Broad spectrum antiviral drugs, their combinations and life supporting systems provide effective result to inhibit viral entry and replication. Other therapeutic options like Angiotensin converting enzyme-2 (ACE2) blockers and Transmembrane protease, serine 2 (TMPRSS2) inhibitors and plasma therapy have proven to have greater potential to target the virus. In this review, we have discussed a number of therapeutic interventions like use of antiviral drugs, drug combination therapy and other therapeutics that are currently exhibiting effective results and helping to lower the mortality rate significantly. Vaccine is the best option as it elicits immune response and provides long-term immunity to fight against such infections. This review also focuses on the current vaccine development scenario practiced worldwide.

Abstract Background The use of telehealth during the COVID-19 pandemic has emerged as both a necessary and significant tool in the provision of safe and timely healthcare in the field of otolaryngology. Increased access to specialist care in a regional setting is an additional benefit. Variation in diagnostic accuracy of telehealth consultations may affect diagnosis and management. Therefore, our aim is to determine the diagnostic accuracy of telemedicine for otolaryngology in an Australian regional setting. Methods Retrospective review was conducted for all patients who received an initial telemedicine appointment over a 7 month period during the COVID-19 pandemic in regional Victoria, Australia. Data was collected regarding initial diagnosis and management from telemedicine consultations, subsequent physical appointment findings and management and intraoperative findings. Statistical analysis was performed using Prism (version 8.0, GraphPad). Results Two hundred and fifty-nine patients were included. The most common conditions referred were for consideration of tonsillectomy with or without adenoidectomy (44.0%). Overall diagnostic accuracy of the initial referrer was 63.3% and for telephone appointments it was 81.9%. Concordance of recommended treatment plans between telephone and physical appointments was 96.9%. Conclusion There are significant benefits of phone only telemedicine within the context of a global pandemic which were compounded by a regional setting. Paediatric patients were found to be of highest benefit for telemedicine with high diagnostic accuracy and concordance of treatment plans.

Objective: To evaluate and compare hidden blood loss (HBL) in laparoendoscopic single-site myomectomy (LESS-M) and conventional laparoscopic myomectomy (CLM). Design: Retrospective cohort study. Setting and population: Patients underwent laparoscopic myomectomy from July 2019 to October 2020 at the Second Affiliated Hospital of Wenzhou Medical University Methods: We collected data and calculated the HBL according to the Nadler and Gross formula, and identified its risk factors by multiple linear regression analysis. Main outcome measures: Visible blood loss(VBL)，total blood loss(TBL), and HBL. Results: The VBL was 115.4±180.6 mL in the LESS-M group; however, the HBL was 364.3±252.6 mL, accounting for 74.4±22.4% of true TBL. The VBL in the CLM group was 187.9±198.5 mL, and the HBL was 306.8±304.7 mL, accounting for 58.9±30.2% of true TBL. The HBL as a % of true TBL in LESS-M group was more than CLM group (p=0.000). Conclusions: HBL accounted for a significant percentage of TBL in conventional laparoscopic myomectomy. Paying attention to perioperative blood changes and a full understanding of the HBL might promote postoperative recovery of patients. Funding：This study was financially supported by the Medical and Health Research Project of Zhejiang Province of China [grant No. 2018KY127], the Natural Science Foundation of Zhejiang Province [grant No. LY20H040005], the Public Welfare Science and Technology Project of Wenzhou City [grant No. Y2020087]. Keywords: Hidden blood loss, laparoendoscopic single-site myomectomy, conventional laparoscopic myomectomy, leiomyoma, risk factors.

Background: Neuropathic pain is a common chronic ailment that can be challenging to treat, because of the heterogeneity of its etiologies, symptoms, and underlying mechanisms. Drugs to treat neuropathic pain are highly prescribed; however, limited data exist on the rates and patterns of dispensing in Lebanon. Aim: This study was conducted to assess the patterns of dispensing neuropathic pain drugs in the Lebanese adult population. Methods: An observational study was conducted at 30 community pharmacies over a period of 10 months. Adults presenting to the community pharmacy diagnosed with a neuropathic pain disorder, and taking at least one pain medication were interviewed using a questionnaire that included socio-demographic characteristics of patients, comorbidities, neuropathic pain disorder type, physicians’ specialty, class, and number of medications prescribed. Results: A total of 360 patients diagnosed with painful neuropathy were enrolled in our study. The mean patients’ age was 50.2 years. Guideline-recommended first-line agents (serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, and gabapentinoids) were prescribed to 278 patients (77.2%) with pregabalin being the most used drug (60.5%), nonsteroidal anti‐inflammatory drugs (46.8%), opioids (15.8%), and topical agents (5.5%). Combination treatment for neuropathic pain was prescribed to 78.3% of patients. Conclusion: Our study revealed that the Lebanese community is following international guidelines in treating neuropathic pain disorders.

Helicobacter pylori is a successful pathogen, infecting approximately 60% of the world’s population (1). It causes numerous gastrointestinal conditions, and was named a class I carcinogen by the World Health Organisation (WHO) in 1994 (2). This paper reviews studies assessing the impact of H. pylori on pregnancy related disorders such as Hyperemesis Gravidarum, Iron deficiency anaemia and fetal growth restriction and examines the proposed pathogenic mechanisms by which H. pylori is thought to cause these pregnancy related disorders through the use of virulence factors and specialisms it possesses.

Introduction: Gastrointestinal cancer is the most prevalent form of cancer worldwide. Surgical treatment interferes with functioning and increases the length of hospital stay. However, studies have shown that early mobilization reduces the length of hospital stay. Objectives: Determine the cardiovascular safety and intensity of an adapted protocol for early mobilization in patients following surgery for the treatment of gastrointestinal cancer. Methods: An observational, cross-sectional study was conducted with 24 individuals: 15 in the case group (cancer patients in the post-operative period) and nine in the control group (hospitalized patients without cancer). All participants were submitted to a standardized early mobilization physiotherapeutic protocol. A portable heart rate monitor and accelerometer were used to obtain data on heart rate variability (HRV) and the intensity of physical activity (IPA) before and after the intervention. Results: No statistically significant differences in energy expenditure or IPA percentages were found between groups. Moreover, no significant difference in HRV occurred in the case group, whereas differences in RR, HR and pNN50 variables were found in the control group. Conclusion: Early mobilization for patients following surgery for the treatment of gastrointestinal cancer can be performed without increasing HRV and with energy expenditure and IPA similar to those found in patients without cancer.

Randomization is very important in clinical trials which can prevent selection bias and valid statistical inference. Block randomization is often considered to prevent treatment imbalance in comparative clinical trials, especially when the sample size is small, or subjects’ characteristics change overtime. In practice, however, treatment imbalance may still occur, especially in multi-center clinical trials. Breaching blindness in clinical trials is another serious problem leading to subjective judgement and observational bias. In this article, we consider two fixed block randomization design with block size of 4 and 2 when comparing a placebo or an active control and a test treatment under investigation. The probabilities of observing various degrees of imbalance and the probabilities of correctly guessing the treatment under three types of prior knowledge are investigated. The results show that smaller block size design is more likely to maintain treatment balance than larger block size; however, the difference of imbalance between the two designs decreases when the sample size gets larger. The number of subjects per site in multi-center trials also has impact on the degree of imbalance. Additionally, both block size and prior knowledge have impact on the probability of guessing the treatment right. Large sample size in conjunction with varying block size are suggested for keeping treatment balance and avoiding the chance of guessers to guess the treatment right.

Background: Complications in living liver donors are one of the main concerns about living donor liver transplantation and the most important of all are biliary complications. Objective: To present the diagnostic and therapeutic algorithm developed for the postoperative biliary complications in living liver donors (LLDs). Methods: Between September 2005 and October 2019, 2120 living liver donor candidates underwent living donor hepatectomy and postoperative biliary complications developed in 167 (7.87%). Management algorithm for various biliary complications and living liver donors who required hepaticojejunostomy were evaluated for this retrospective cohort study. Results: Fifty-one LLDs underwent 53 relaparotomy procedures due to biliary peritonitis. Endoscopic retrograde cholangiopancreatography (sphincterotomy± stenting) was performed in 104 donors but due to persistent bile duct stricture ± bile leaks, percutaneous transhepatic biliary tract drainage catheter was inserted in six donors following a failed endoscopic retrograde cholangiopancreatography assisted treatment. Ninety-seven LLDs underwent interventional radiologic procedure and twelve of them were percutaneous transhepatic biliary tract drainage. HJ was performed in 10 LLDs with right lobe LDH and 2 LLDs with left lobe LDH. Ten of the 12 LLDs underwent percutaneous transhepatic biliary tract drainage catheter assisted HJ in a median of 50 days after LDH. Following HJ, 11 LLDs did not have any complication along the median of 978 days (min-max: 139-3578) of follow-up. Conclusion: As living donor liver transplantation will continue to be performed in countries with low cadaveric organ supply and biliary complications will be encountered following LDH. Timing of management of the biliary complication is vital and HJ procedure is the ultimate treatment modality for biliary complications that cannot be solved by other minimally invasive methods especially percutaneous transhepatic biliary tract drainage.

In many -but not all- recalcitrant Quercus seeds, water loss during drying only occurs through scar. Consequently, embryo sitting on the opposite side of scar is well protected from desiccation. However, whether such mechanism is common throughout Fagaceae species is unexplored. Similarly, little is known about the desiccation response of other Fagaceae genera. Germination and desiccation tolerance of Castanopsis sclerophylla (Fagaceae) were studied by drying the seeds. Fresh seeds had a moisture content (MC) of 36% and germinated to 93% when incubated at 15/20°C. Drying seeds to 22.5 and 20.7% MC decreased germination to 27 and 0%, respectively; indicating seeds are recalcitrant. X-ray computed tomography and photomicrographs showed that embryo of C. sclerophylla sits just below scar. Regardless of drying occurring either through only scar or whole pericarp, embryo drying was deemed unavoidable. Nevertheless, germination percentage during drying showed exceptional similarities with the other Fagaceae species.

Agrochemical use is predicted to increase 2-5 fold by 2050 to meet food demand. Evidence suggests that agrochemical pollution could increase snails that transmit the disease schistosomiasis to 250 million people, but most agrochemicals remain unexamined. Here we quantify the relative effects of fertilizer, six insecticides, and six herbicides on snail genera responsible for 90% of global schistosomiasis cases. We identified fertilizers and 4 of 6 insecticides as high risk for increasing snail biomass by increasing snail habitat (aquatic vegetation) or food (periphyton) and reducing snail predators, respectively. Herbicides generally had negative effects on snails by reducing habitat, with two herbicides increasing snails in the absence of aquatic vegetation. Parasite production, which reflects human infection risk, scaled positively to snail biomass. Our findings suggest that fertilizers and insecticides present higher chances of increasing human schistosomiasis than herbicides, and revealed several low risk agrochemicals might help increase crop production without increasing schistosomiasis.

In this paper, we define the Horadam polynomials and hybrinomials with two variables x and y; called the bivariate Horadam polynomials and hybrinomials, respectively. Also, we obtain Binet formula, generating function and some properties for the bivariate Horadam hybrinomials. Moreover, we get Catalan, Cassini and d’Ocagne identities for these hybrinomials. Finally, the matrix representations of the bivariate Horadam hybrinomials were introduced.

Kaempferol, a flavonoid compound, has various biological functions. Acute liver failure (ALF) is a lethal clinical syndrome with severe liver function damage. In this study, we explored the mechanisms underlying the therapeutic effect of kaempferol in ALF. The ALF mouse model was established using D-galactosamine (D-GalN, 700 mg/kg)/lipopolysaccharide (LPS, 10 μg/kg). Two hours before the administration of D-GalN/LPS, different group of mice were pretreated according different doses of kaempferol, 6 hours after injection of D-GalN/LPS, and then killed. The survival rate, liver function and inflammatory cytokine levels were assessed. It was determined whether kaempferol pretreatment protected hepatocytes from ALF induced by D-GalN/LPS via autophagy pathway in vivo and in vitro. Pretreatment with a high dose of kaempferol significantly decreased the survival rate and increased severe liver damage; however, pretreatment with a low dose of kaempferol showed the opposite effect. Furthermore, pretreatment with a high dose of kaempferol augment the levels of proinflammatory cytokines and markers of the MAPK signaling pathway, while pretreatment with a low dose of kaempferol showed the opposite effect. Additionally, pretreatment with a high dose of kaempferol decreased autophagy, but pretreatment with a low dose of kaempferol increased autophagy in vivo and in vitro. It was also proved that pretreatment with 3-methyadenine (3- MA) or Atg7 siRNA to inhibit autophagy partially negated the hepatoprotective effect of kaempferol (5 mg/kg) pretreatment in ALF mice induced by D-GalN/LPS. Our findings demonstrate that effects of different doses of kaempferol on D-GalN/LPS-induced ALF is remarkably different by regulating the autophagy pathway.

Objective: To determine the impact and usefulness of the combination of structural and functional biomarkers in the diagnosis of acute renal injury (AKI) and short-term prognosis of patients undergoing cardiac surgery (CS). Material and Methods. Prospective cohort study (March 2018 to December 2019). 63 adults older than 18 years old, on the Intensive Care Unit (ICU) were included. Interventions: Patients had undergone CS with extracorporeal circulation (ECC). Surgery was elective in 80% of cases; it was urgent in 18% and emergent in 3%. Exclusion criteria included chronic kidney disease, contrast medium application ≤24 hour before surgery, cancer, infectious and autoimmune diseases. On admission to the ICU, serum creatinine, urinary creatinine, urinary sediment, urinary NGAL, urinary cystatin, microalbuminuria and serum cystatin were measured. Results. AKI was found 31 cases (49%). ECC without renal damage was found when time of extracorporeal circulation was of 85 ± 25 minutes and with renal damage when it lasted 114 ± 32 (p = 0.0001). Serum creatinine has a likelihood ratio (LR) + of 5.5, the combination of serum cystatin c (cystatin C) and normalized NGAL, showed a better LR. In patients with severe irreversible AKI, the combination of cystatin C + NGAL adjusted to urinary creatinine (NGAL/uCr) + microalbuminuria had a LR+ of 18.75 and LR - of 0.26. Conclusions: The combination of biomarkers predicts and identifies severity of AKI and Biomarkers combination in Cardiac Surgery

This case describes a female who had long lasting primary infertility, labelled with polycystic ovarian syndrome, who showed no response to the given related treatments. Hysterosalpingography, which was performed as part of the IVF preparation, showed Asherman syndrome and calcified lymph nodes. Subsequently, further evaluations confirmed tuberculosis. The case highlights the necessity and importance of the proper assessment of the patients presenting with infertility for early detection of genital TB, to prevent end-stage disease.

Objective epithelial ovarian cancer (EOC) in early stage is difficult to diagnose. Serum indicators for stage I-II of epithelial ovarian cancer which confined to pelvic cavity were found through retrospective analysis, possible early detection methods might be found. Methods 165 patients were diagnosed as epithelial ovarian cancer at stage I-II from January 1st, 2015 to December 31st, 2019. Data was collected including age, pathological type, serum D-dimer (D-D), neutrophil to lymphocyte ratio (N/L), the platelet to lymphocyte ratio (P/L), cancer antigen 125 (CA125), human epididymis protein 4 (HE4) and diameter of the ovarian mass by ultrasound. Result D-D, CA125, HE4, ROMA, diameter, pathological type and age were significantly different in the different stage, age showed independent effect after logistical regression (P < 0.05). D-D, CA125, HE4, ROMA, diameter, age and stage were significantly different in the different pathological type, and diameter showed significant independent influence on different pathological type after binary logistic regression (P < 0.05). Conclusion CA125, HE4, ROMA, diameter of tumor, D-dimer and age were found significantly different between stage I and stage II, with age shows good effect on the diagnosis for stage II and diameter of tumor shows diagnostic value for non-serous ovarian cancer. Combined diagnosis may improve the diagnosis rate of early ovarian cancer.