This study aimed to investigate the association between new inflammatory indicators at admission and the occurrence of preoperative deep vein thrombosis (DVT) in patients with patella fractures.A retrospective analysis of the medical records of patients aged 18 years or older who underwent surgical treatment for unilateral closed patella fractures at our hospital between August 2016 and August 2020. The incidence of preoperative DVT was detected by Duplex ultrasound (DUS). Partial blood routine and biochemical indexes were collected at admission, and the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) of inflammatory indexes were also calculated. ROC was used to analyze the cut-off value NLR, MLR, and PLR for predicting preoperative DVT, and univariate and multivariate analyses of the risk factors for preoperative DVT of patella fractures, and to verify whether other risk factors affecting the relationship between validation indexes and preoperative DVT.P = 0.009).A total of 500 patients were included, of which 39 patients (7.8%) developed preoperative DVT. After univariate and multivariate analysis, preoperative time (in each day delay), male , D-dimer > 0.6 mg/L, total cholesterol (TC) > 5.6 mmol/L, and PLR > 189.8 were the risk factors for preoperative DVT in patients with patella fracture. Inflammation index PLR combined with the other four risk factors significantly improved the predictive efficacy of preoperative DVT compared with PLR  are combined. These data are useful for the clinical identification of patients at high risk of preoperative DVT in patella fractures. DVT is a common complication in patients with lower extremity fractures and carries a risk of fatal pulmonary embolism. DVT has been reported in patients with fractures at the time of admission . A patelUnderstanding the high-risk factors of DVT and early identification of high-risk patients are the key to preventing DVT. However, risk factors are inconsistent in different studies –9. RecenOur objective was to collect data from patients with surgically treated patella fractures in our hospital and analyze whether inflammatory indicators were risk factors for DVT. In addition, when inflammatory indicators are combined with other risk factors, whether the association between inflammatory indicators and DVT is affected.This study retrospectively collected the data of patients with surgically treated patella fracture admitted to our hospital from August 2016 to August 2020. This study was approved by the Ethics Committee of the Hebei Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine, focusing only on the examination results of patients. All patients enrolled signed informed consent forms. All data are obtained through our electronic medical records system. According to the empirical criteria, the sample size of logistic regression analysis should be 10 to 15 times the number of covariates. There were 36 covariates in this study, and the sample size should not be less than 36 × 10 = 360.Inclusion criteria were: patients' age to be 18 years old or older, unilateral patella fracture, and surgical treatment. Exclusion criteria: time >2 weeks from fracture, complicated fractures at other sites, open fractures, pathological fractures, severe autoimmune diseases, infectious diseases at the time of fracture, abnormal coagulation function, use of anticoagulants within 3 months of admission, incomplete medical records.The data collected mainly included the following aspects: demographic data, comorbidities, injuries, blood routine and biochemical test results, and routine DUS test results of DVT.The demographic data include sex, age, body mass index (BMI), current smoking, alcohol consumption, American Society of Anesthesiologists (ASA). The comorbidities included hypertension, diabetes, chronic heart disease, cerebrovascular disease, and allergies to any medications, all of which were self-reported by patients. Injury-related data included the following: time from injury to hospital admission, mechanism of injury (low or high energy), time from hospital admission to operation, and total length of stay. Low energy injury refers to a fall at a high level while the patient is standing. High energy injury refers to injury caused by traffic accident or position injury higher than their own height.γ-glutamyl transferase (GGT), hypersensitive C-reactive protein (HCRP), total bile acid (TBA), creatine kinase (CK), lactic dehydrogenases (LDH), total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL-C) level, low-density lipoprotein (LDL-C) level, very low-density lipoprotein (VLDL) level, glucose (GLU), uric acid (UA), white blood cell (WBC) count, neutrophile (NEUT) count, lymphocyte (LYM) count, monocytes (MON) count, red blood cell (RBC) count, hemoglobin (HGB) level, platelet (PLT) count, D-dimer level. Neutrophile-to-lymphocyte rate (NLR), monocytes-to-lymphocyte rate (MLR), platelet-to-lymphocyte rate (PLR) were calculated according to blood routine indexes.Venous blood was collected from the elbow veins on an empty stomach for the first time after admission.Vein blood samples were collected in vacuum tubes containing sodium citrate anticoagulant. Blood samples were sent to the laboratory of our hospital for blood analysis within 6 h after collection. Laboratory tests included measurements of levels of total protein (TP), albumin (ALB), alkaline phosphatase (ALP), total bilirubin (TBIL), The patient could not perform off-bed weightbearing exercises because of pain in the injured extremity, but lay in bed until surgery. After admission, all patients were given Low Molecular Weight Heparin Injection (LMWHI) subcutaneous  for anticoagulation . In addition to drug prophylaxis, the patient underwent physical prophylaxis for DVT with ankle pump exercise in bed . Drug anticoagulation was discontinued on the day of operation. Patients were screened for DVT by DUS on the first day after admission and every 3 days thereafter, up to the day of operation. If any symptoms of thrombosis  occur in the preoperative time, DUS should be performed immediately to confirm DVT. The occurrence of DVT in patients was detected by the same group of senior ultrasound doctors in our hospital. The “Guidelines for the Diagnosis and Treatment of Deep Vein Thrombosis (2016 3rd Edition)” issued by the Chinese Medical Association was used to diagnose and treat DVTs . The veiP < 0.10 were included in the model, and the correlation strength was expressed by odds ratio (OR) and 95% confidence interval (95% CI). Hosmer–Lemeshow test was employed to evaluate the fitting degree of the final model, and a P > 0.05 represented the acceptable result. The ability of inflammatory indicators combined with other independent risk factors to predict preoperative DVT was evaluated by ROC curve again. The combination of indicators and individual inflammatory indicators were compared to predict whether there was statistical difference in preoperative DVT. The significance level was set as P < 0.05.SPSS 25.0  and MedCalc 20.0  was used for statistical analysis. For biomarker NLR, PLR, MLR, and the plasma D-dimer level, we constructed receiver operating characteristic (ROC) to determine the optimal cutoff value for each variable. On basis of the cutoff values determined, each variable was divided in to two groups. Categorical variables were analyzed by chi-square or Fisher's exact test. Student T test or Mann-Whitney test was performed for continuous variables. Univariate analysis of differences between DVT group and non-DVT group. Multivariate logistic regression model and stepwise backward elimination method were used to investigate the independent risk factors that predicted the occurrence of DVT. The univariate analysis results of In the window period, a total of 612 cases of patella fracture patients. According to the exclusion criteria, fracture over 2 weeks; complicated fractures at other sites, open fractures, a total of 54 cases, pathological fracture, severe autoimmune diseases and infectious diseases at the time of fracture, use of anticoagulants within 3 months of admission, a total of 32 cases, 26 cases of incomplete medical records. A total of 500 patients were included.They were divided into two groups based on the presence or absence of preoperative DVT: 461 patients in non-DVT group and 39 patients in DVT group, respectively. In the DVT group, there were 32 (82.1%) males and 7 (17.9%) females, with an average age of 57.0 ± 15.3 years . In the non-DVT group, there were 273 (59.2%) males and 188 (40.8%) females, with an average age of 52.1 ± 14.9 years . There were 275 (55%) left patella fractures and 225 (45%) right patella fractures. The mean days from fracture to admission was 0.2 ± 0.4 days , the mean days from fracture to operation was 4.1 ± 2.1 days , and mean total hospital stay was 11.3 ± 3.8 days .Preoperative DVT was detected in 39 patients 7.8% (39/500). None of the patients had pulmonary embolism. 79.5% (31/39) occurred in the injured lower extremity and 20.5% (8/39) in the uninjuried lower extremity, as shown in According to the ROC curve , the optP < 0.05).As shown in Multivariate analysis predicted the independent risk factors for preoperative DVT and compared the differences after combination.P = 0.008), time from fracture to operation (in each day delay) (P < 0.001), D-dimer > 0.6 mg/L (P < 0.001), TC > 5.2 mmol/L (P = 0.005), and PLR > 189.8 (P < 0.001), as shown in P = 0.683; Nagelkerke R2 = 0.289). After PLR was combined with other 4 factors, it was found that AUC, sensitivity and specificity for predicting preoperative DVT were 0.833, 0.641 and 0.883 (P = 0.009).Multivariate logistic regression model analysis found five independent risk factors for preoperative DVT, which were male (nd 0.883 . Better P < 0.001), TC > 5.2 mmol/L (P = 0.005), and PLR > 189.8 were risks factor for preoperative DVT in patients with patella fracture. The AUC of preoperative DVT after patella fracture predicted by ROC analysis after PLR combined with other 4 risk factors was 0.833, the sensitivity was 0.883, and the specificity was 0.641.Patients with patella fracture were selected for a retrospective analysis of the occurrence of preoperative DVT and related risk factors, and the risk factors were linearized to predict the occurrence of DVT again. In this study, we found that the incidence of preoperative DVT was 7.8%, and identified male, time from fracture to operation (in each day delay), D-dimer > 0.6 mg/L . However, the sensitivity is not high, only 0.641. We analyzed that PLR may be affected by other factors, but this needs further confirmation.Yao et al.  found thThere are some limitations of this study: First, we did not collect anticoagulant and blood drawing time after admission and before fasting venous blood drawing. Second, the amount of intravenous fluids in different patients before surgery may not be completely consistent. Third, none of the patients moved out of bed before surgery. These causes may influence independent factor results or the incidence of DVT.P = 0.009). PLR is expected to be a predictor of DVT, especially when other risk factors are combined.By collecting data from patients with patella fractures, it was found that the incidence of preoperative DVT for patella fractures was 7.8%. Multivariate analysis showed that male, preoperative time (in each day delay), TC > 5.2 mmol/L, D-dimer > 0.6 mg/L, and PLR > 189.8 were independent risk factors for preoperative DVT of patella fracture. PLR combined with other risk factors improved the ability to predict preoperative DVT. Better than PLR alone (


Curcuma longa L. [Zingiberaceae] (CL)—an herbal plant used in east Asia to alleviate pain and inflammation. Thus far, the therapeutic effects of CURs for knee osteoarthritis (OA) uncovered by multiple reviews remained uncertain due to broadly involving trials with different agents-combined or CURs-free interventions. Therefore, we formed stringent selection criteria and assessment methods to summarize current evidence on the efficacy and safety of CURs alone in the treatment of knee OA.Curcuminoids (CURs) are the principal ingredients of A series of databases were searched for randomized controlled trials (RCTs) evaluating the efficacy and safety of CURs for knee OA. Clinical outcomes were evaluated using meta-analysis and the minimum clinically important difference (MCID) for both statistical and clinical significance.P = 0.899, I2 = 23.7%) and NSAIDs .Fifteen studies with 1670 patients were included. CURs were significantly more effective than placebo in the improvements of VAS for pain , WOMAC total score , WOMAC pain score , WOMAC function score , and WOMAC stiffness score . Meanwhile, CURs were not inferior to NSAIDs in the improvements of pain- and function-related outcomes. Additionally, CURs did not significantly increase the incidence of adverse events (AEs) compared with placebo ( RR: 1.03, 95% CI: 0.69 to 1.53, CURs alone can be expected to achieve considerable analgesic and functional promotion effects for patients with symptomatic knee OA in short term, without inducing an increase of adverse events. However, considering the low quality and substantial heterogeneity of present studies, a cautious and conservative recommendation for broader clinical use of CURs should still be made. Further high-quality studies are necessary to investigate the impact of different dosages, optimization techniques and administration approaches on long-term safety and efficacy of CURs, so as to strengthen clinical decision making for patients with symptomatic knee OA.The online version contains supplementary material available at 10.1186/s12906-022-03740-9. Knee osteoarthritis (OA) is one of the most general irreversible articulus diseases globally, and presents with features of incremental cartilage defect and articular space narrowing. Approximately 11.8% to 12.7% of the global population are affected by knee OA, according to World Health Organization . Intra-aAnalogues comprising curcumin, bisdemethoxycurcumin, demethoxycurcumin and cyclocurcumin are collectively referred to as curcuminoids (CURs) , which cSeveral animal studies have assessed the efficacy of CURs administered via nano-scale drug carriers for knee OA, demonstrating that CURs have potent anti-inflammatory and anti-arthritic activity, both with and without biological materials –23. AlthThe research was performed according to our pre-registered protocol  with some amendments in the selection and assessment of outcomes.We adopted the concept of the minimum clinically important difference (MCID)  to asseshttp://ClinicalTrials.gov) were searched for all published randomized controlled trials (RCTs) evaluating the efficacy and safety of CURs alone in treating knee OA, without time or language restriction. The retrieval strategy sample of PubMed and Embase is shown in Supplementary TableAn electronic literature retrieval was conducted on August 2022. The Cochrane Library, Medline via PubMed, Web of Science, Embase, CNKI , SinoMed , Wanfang and VIP databases, and ClinicalTrials.gov (Eligible RCTs were included in this study based on the following criteria: (1) participants: patients diagnosed with knee OA according to the criteria proposed by the American College of Rheumatology (ACR) ; (2) intTo select relevant studies for further assessment, two independent reviewers (F.X. and X.M.) removed duplicate publications using Endnote X9, and identified each citation as eligible, ineligible and uncertain by screening titles and abstracts. For eligible and uncertain records, full-texts were further assessed to confirm if the studies were RCTs comparing CURs alone versus conventional therapies or placebo in the treatment of knee OA.All data were extracted, and recorded in Excel spreadsheets prepared in advance by two reviewers (L.L.T and Z.L.). The following contents were extracted: (1) study characteristics; (2) patient demographics; and (3) outcomes data. Predefined primary outcomes included VAS for pain, WOMAC pain score, WOMAC function scores, and adverse events. Other outcomes were defined as secondary outcomes. When the data of two or more studies were originated from one clinical trial, only the latest studies providing requisite outcomes were included, and they will be regarded as one study. Attempts were made to obtain missing data by contacting the corresponding author, browsing supplementary files, or consulting relevant data from previous meta-analyses.Two reviewers (L.L.T and Z.L.) applied the recommended Cochran Risk of Bias Tool 1  to assesAll data were processed and analyzed by J.F. and Z.L. using the Stata 14  and RevMan 5.4 software . We performed meta-analysis to merge the treatment effects of CURs and control groups, using a random-effects model due to the existence of substantial variability within and between studies . ContinuThe quality of evidence was classified using the GRADE system  as high,The literature screening process is illustrated in Fig. The study characteristics are presented in Table The results of literature quality assessment based on the Cochran Risk of Bias Tool 1 are presented in Fig. P = 0.082, I2 = 6.3%, Fig. Eleven studies  870 patients) –70, 72 a patientsAn obvious decrease from 86.8% to 56.9% in heterogeneity for placebo-controlled group was observed after removing the study of Atabaki et al. , with thP < 0.001, I2 = 0.0%, Fig. P = 0.676, I2 = 80.6%, Fig. Seven study (795 patients) , 67, 71 When the data of Haroyan et al.  was omitP < 0.001, I2 = 79.2%, Fig. P = 0.505, I2 = 0.0%, Fig. Eight studies (956 patients) , 69, 71 The study of Srivastava et al.  was consP < 0.001, Fig. P = 0.657, I2 = 0.0%, Fig. Eight studies 956 patients) , 69, 71  patientsP < 0.001) reached up to the magnitude exceeding the threshold (6.62) for clinical significance. Sensitivity analysis did not ferret out one individual study that would affect the statistical robustness of the overall results.After excluding the study of Haroyan et al. , the intP = 0.031, I2 = 77.6%, Fig. P = 0.298, I2 = 0.0%, Fig. Eight studies (956 patients) , 69, 71 P = 0.018) was similar with the original analysis. Sensitivity analysis did not ferret out one individual study that would affect the statistical robustness of the overall results.By excluding the study of Panda et al. , a decreP = 0.745, I2 = 32.6%, Fig. P = 0.065, I2 = 55.8%, Fig. P = 0.026, I2 = 53.7%) when the data of Gupte et al. [Among the included fifteen studies, two , 71 repoe et al.  were omiTwo studies , 65 asseP = 0.903, I2 = 0.0%) or NSAIDs group  or NSAIDs group , however, asymmetry of funnel plots was observed by visual inspection, which indicating the existence of potential publication bias (Supplementary Fig. The Egger’s linear regression test for VAS for pain, WOMAC total score, WOMAC pain score, WOMAC function score, WOMAC stiffness score and AEs did not detect significant publication bias (The principal finding of our study was that CURs were associated with better effectiveness than placebo and not inferior to NSAIDs in terms of pain reduction and functional promotion for knee OA. The pooled analyses found that CURs were more effective than placebo in the improvement of VAS for pain, WOMAC total score, WOMAC pain score, WOMAC function score and WOMAC stiffness score, while there was no significant difference found between CURs and NSAIDs. We used the MCID as a threshold in this meta-analysis to assess the clinical significance of the difference between CURs and the control groups, instead of rely solely on the statistical significance. The MCID can be calculated by anchor-based and distribution-based methods, we applied the anchor-based method to set the threshold at 20% based on previous research , 33–36. Pain and dysfunction were the leading causes for medical care use and clinical decision making for knee OA . Novel dThe appropriate dosage of CURs for treating knee OA remains uncertain. Previous meta-analyses by Daily et al.  and OnakA recently published review by Zeng et al.  suggesteThe quality of our findings was evaluated using the GRADE system . All paiIn this study, we included the latest fifteen clinical trials focused on this topic. Meanwhile, trials with CURs-free or combined interventions were excluded to realize a more objective display of the therapeutic effect of CURs alone for knee OA. Besides, the clinical significance of CURs in alleviating pain and dysfunction for knee OA was also evaluated by the MCID of patient-reported outcomes. However, the limitations of our study should be considered when interpreting our findings. Firstly, the quality of the original studies was low, and substantial heterogeneity was detected among the included studies, and the exact sources of heterogeneity were hard to be found for which may stem from the multitudinous variations in dosages, follow-up durations, regions, preparation schemes of CURs, and baseline values. Secondly, obvious heterogeneity was still present after subgroup analyses, which indicated that the substantial heterogeneity was not entirely stem from the subgrouping variables. The quality of the included studies was uneven, the degree of bias was large and the numbers of studies in each subgroup was rather small, which could result in large differences in the results of statistical analysis. Thirdly, the durations of follow-ups in main outcomes were limited to within 6 months, as a result, the long-term clinical effectiveness of CURs remains equivocal. Although Egger's test did not indicate significant publication bias, the limited data volume of included studies made the linearity assessment quite uncertain and at risk of being overly influenced by single studies, and the asymmetry of funnel plots observed by visual inspection also indicated the existence of potential publication bias. Because the symmetry of funnel plots could be influence by various factors, such as publication bias, and/or small-study effects, it was difficult to figure out the cause of asymmetry, especially when the sample size of each comparison was less than ten . For theCURs alone can be expected to achieve considerable analgesic and functional promotion effects for patients with symptomatic knee OA in short-term, without inducing an increase of adverse events. However, considering the low quality and substantial heterogeneity of present studies, a cautious and conservative recommendation for broader clinical use of CURs should still be made. Further high-quality studies are necessary to investigate the impact of different dosages, optimization techniques and administration approaches on long-term safety and efficacy of CURs, so as to strengthen clinical decision making for patients with symptomatic knee OA.Additional file 1.Additional file 2.Additional file 3.Additional file 4.


Patients undergoing oral and maxillofacial surgeries under general anesthesia usually require nasotracheal intubation. When presented with patients with equally patent nostrils, selection of the nostril to use for intubation is an important decision for facilitating intubation. The objective of this trial is to determine whether choice of nostril impacts nasotracheal intubation when using a video rigid stylet in patients undergoing oral and maxillofacial surgery.n = 25) or the right nostril . Intubation was performed by experienced anesthesiologists using a video rigid stylet. The primary endpoint was time to successful intubation, which was defined as the duration from when the tip of the stylet-tube assembly entered the selected nostril to when the tube entered the trachea. Secondary outcomes included: length of time for device insertion; length of time for tube insertion; total success rate; first-attempt success rate; number of intubation attempts; requirement of airway assisted maneuvers; incidence and severity of epistaxis. Intubation-related adverse events were monitored for up to postoperative 24 h.Fifty patients scheduled for elective oral and maxillofacial surgery requiring nasotracheal intubation were randomly allocated into two groups to undergo nasotracheal intubation through the left nostril . Nasotracheal intubation was successful in all patients in both groups and the first-attempt success rates in both groups were similar (Group L: 96% (24/25); Group R: 96% (24/25); relative risk (RR) 1.0; 95% CI 0.9 to 1.1; P > 0.999). No significant difference of requirement of assisted maneuvers was noted between the two groups (Group L: 36% (9/25); Group R: 28% (7/25); RR 0.8; 95% CI 0.3–1.8; P = 0.544). Furthermore, all patients showed a high quality of visualization of the glottis (Cormack and Lehane Grade I). For safety outcomes, the incidence and severity of epistaxis during intubation was comparable between the two groups. There were no significant differences between the selection of nostrils and intubation-related adverse events up to 24 h after surgery.Median time (interquartile range) to tracheal intubation was 25.3 seconds (20.7 to 27.6) in Group L and 26.8 seconds (22.5 to 30.0) in Group R (median difference (MD) = 1.9; 95% confidence interval (CI) –1.8 to 5.7, When considering which nostril to use for intubation with video rigid stylet, either nostril can be used similarly.Clinicaltrials.gov. Identifier: NCT05218590. Airway management is a highly integral component of general anesthesia. Patients undergoing oral and maxillofacial surgeries under general anesthesia usually require nasotracheal intubation, which allows latitude for operative maneuvering in the face, teeth, mouth, tongue, oropharynx, and neck . LaryngoLaryngoscopic nasotracheal intubation is limited in patients with severely restricted mouth-opening, or microstomia, which is frequently present in oral and maxillofacial patients. Visible rigid stylet is not affected by confined mouth-opening. As such, the visible stylet can be an alternative to the laryngoscope for nasotracheal intubation. Previous studies have shown that optical and video stylets for nasotracheal intubation are safe and effective in patients with either normal anatomy or limited mouth opening , 8. MoreThe objective of the present study was to determine whether choice of nostril impacts nasotracheal intubation when using a video rigid stylet in adult patients undergoing oral and maxillofacial surgery.ClinicalTrials.gov on 02/01/2022 (NCT05218590). The study was conducted in the Peking University Hospital of Stomatology in accordance with CONSORT guidelines. Written informed consent was obtained from each participant. All methods were performed in accordance with the Helsinki Declaration and relevant clinical trial management regulations of China.This was a randomized, controlled trial. The study protocol was approved by the Ethics Committee of Peking University Hospital of Stomatology, Beijing, China on 01/29/2022 (No. PKUSSIRB-202272018) and registered with During a preoperative visit, we asked patients to occlude the contralateral nostril in the sitting position to self-assess nasal airflow. This method has been verified as useful and accurate for assessing nostril selection for nasotracheal intubation . PatientPatients were excluded for the following: (1) history of, or presented with, an anticipated difficult airway. We assessed the airway mainly according to the difficult airway management guidelines of Chinese Society of Anesthesiology , which iRandom numbers were produced by the SPSS 21.0 software package  in a 1:1 ratio by an independent biostatistician and sealed in opaque envelopes. The envelopes were sequentially numbered and opened just prior to anesthesia by an anesthesia nurse who did not participate in the rest of the study. Patients were assigned to nasal intubation through either the left or right nostril . In our study, all intubations were performed using a video rigid stylet , which was patented and approved for human use in 2016 , electrocardiogram, oxygen and end-tidal concentration of carbon dioxide, inhalational anesthetic concentration.No premedication was given in the general ward. Routine intraoperative monitoring included noninvasive blood pressure, pulse oxygen saturation  was applied in the selected nostril. Nasotracheal intubation was achieved using a preformed double-curved nasotracheal tube   the time for stylet-tube assembly insertion, defined as the time interval from when the tip of the stylet-tube assembly entered the selected nostril to when it accessed the glottis; (2) the time for tube insertion, defined as the time interval from when the stylet-tube assembly accessed the glottis to when the tube was confirmed inserted into the trachea; (3) total success rate; (4) first-attempt success rate; (5) number of intubation-attempts; (6) requirement of airway-assisted maneuvers; (7) incidence and severity of epistaxis. After confirming the location of the tube, an investigator used a fiberoptic bronchoscope to examine the shell of the tube and then examine the posterior pharyngeal wall through the other nostril. No epistaxis was defined as absence of blood on the external surface of the tube and the posterior pharyngeal wall; mild epistaxis was defined as blood observed on the exterior of the tube or posterior pharyngeal wall; moderate epistaxis was defined as pooling of blood on the posterior pharyngeal wall; severe epistaxis was defined as a large amount of blood in the pharynx impeding nasotracheal intubation and necessitating urgent orotracheal intubation .Intubation-related adverse events were monitored for up to postoperative 24 h.The primary hypothesis was that the length of time for nasotracheal intubation differs significantly between the two nostrils. A previous study of patients in our center showed the mean (standard deviation (SD)) duration for nasotracheal intubation using an optical rigid stylet was 27 (3) seconds . In thatData with or without normal distribution were expressed as mean ± SD or median and interquartile range (IQR). Categorical data were presented as a number (%).t-test or Mann-Whitney U test; qualitative data were compared with chi-square test with or without Yates correction, or Fisher’s exact test. Repeatedly measured variables (hemodynamic parameters and SpO2) were compared with the general linear model.For baseline and intraoperative data, quantitative data were compared with Our primary outcome, the total length of time of intubation, was compared with Mann-Whitney U test, with differences between groups expressed as median difference and 95% confidence interval (CI).t-test or Mann-Whitney U test. Qualitative data were compared with chi-square test with or without Yates correction, or Fisher’s exact test. The difference between groups was quantified as the risk ratio (RR), median difference, or mean difference and 95% CI. Safety outcomes were compared with chi-square test with or without Yates correction, or Fisher’s exact test.For secondary outcomes, quantitative data were compared with P < 0.05 was regarded as statistically significant. Statistical analysis was performed with the SPSS 21.0 software package .A two-tailed 2 during intubation, no significant differences were noted between the two groups at any time points  (Table Intubation time for Group L and Group R were 25.3 seconds (IQR 20.7 to 27.6) and 26.8 seconds (IQR 22.5 to 30.0), respectively. No significant difference was noted between the two groups . Two patients (1 in the Group L and 1 in the Group R) were intubated on the second attempt due to nasal secretion-stained lens that prevented adequate vision; intubation was successful after wiping the lens. Nine (36%) and 7 (28%) patients in Group L and Group R, respectively required chin lift to assist the intubation. No significant difference was noted between the two groups . Furthermore, all patients showed a high quality of visualization of the glottis (Cormack and Lehane grade I) ; Group R: 96% (24/25); RR 1.0; 95% CI 0.9 to 1.1; ns. Nine 6% and 7 P > 0.999). Incidences of mild and moderate epistaxis in Group L were 24.0% (6/25) and 4.0% (1/25), and in Group R were 24.0% (6/25) and 8.0% (2/25). No severe epistaxis was observed. There was no significant difference in the severity of epistaxis between the two groups (P > 0.999) (Table Frequencies of epistaxis during intubation were comparable in Group L and Group R (28.0% (7/25) vs. 32% (8/25), Incidences of intubation-related complications within 24 hours after surgery were not significantly different between the two groups. No severe airway injury or complications occurred  is the most common bleeding site . WoodrufThe primary endpoint of our study was the time for successful intubation. Which primary endpoint to use in studies on intubation techniques remains debatable. In clinical trials on techniques or devices for intubation in patients with difficult or normal airways, intubation time is the most used primary endpoint. The time required for intubation can reflect the efficacy and simplicity of the technique. Certainly, for comparing the efficacy of intubation technique, first-attempt or total success rate may also be logical primary endpoints. However, the use of the video rigid stylet for nasotracheal intubation is a feasible, efficient, and safe technique with a 100% success rate as revealed in published literature –9, 13. FThe present study has limitations that merit discussion. First, video rigid stylet-guided nasotracheal intubations were performed by experienced anesthesiologists. The procedure requires special training to be competent to use this device. Thus, results from less-experienced anesthesiologists or novice clinicians needs to be evaluated. Second, due to the nature of the intervention, it is impossible to blind the anesthesiologists who performed the nasotracheal intubations; therefore, this could have introduced potential bias. Third, the nasal anatomy of patients was not examined by endoscopy before recruitment. Although nasal endoscopy has many advantages, epistaxis and nasal pain are not rare complaints . This coThe video rigid stylet can be an option in selected cases. Results of our study demonstrated that either nostril is an option when considering which nostril to use for intubation with the video rigid stylet.


Tenofovir disoproxil fumarate (TDF), a widely prescribed component in antiretroviral regimens, has been associated with nephrotoxicity. Nebivolol is a third generation selective β-1 adrenergic receptor blocker and may protect renal structure and function through the suppression of oxidative stress and enhancement of nitric oxide (NO) synthesis. We aimed to investigate whether nebivolol could be an effective therapeutic strategy to mitigate tenofovir-induced nephrotoxicity.We allocated Wistar rats to four groups: control (C), received a standard diet for 30 days; NBV, received a standard diet for 30 days added with nebivolol (100 mg/kg food) in the last 15 days; TDF, received a standard diet added with tenofovir (300 mg/kg food) for 30 days; and TDF+NBV, received a standard diet added with tenofovir for 30 days and nebivolol in the last 15 days.Long-term exposure to tenofovir led to impaired renal function, induced hypertension, endothelial dysfunction and oxidative stress. Nebivolol treatment partially recovered glomerular filtration rate, improved renal injury, normalized blood pressure and attenuated renal vasoconstriction. Administration of nebivolol contributed to reductions in asymmetric dimethylarginine (ADMA) levels as well as increases in endothelial nitric oxide sintase (eNOS) accompanied by renin-angiotensin-aldosterone system downregulation and decreases in macrophage and T-cells infiltrate. Furthermore, nebivolol was responsible for the maintenance of the adequate balance of thiobarbituric acid reactive substances (TBARS) and glutathione (GSH) levels and it was associated with reductions in NADPH oxidase (NOX) subunits.Nebivolol holds multifaceted actions that promote an advantageous option to slow the progression of kidney injury in tenofovir-induced nephrotoxicity. Human immunodeficiency virus (HIV) continues to be a major global public health issue, having claimed millions of lives so far . The larNebivolol is a third generation selective β-1 adrenergic receptor blocker that also displays NO-mediated vasodilatory actions through β-3 receptor agonism . Due to Considering that nebivolol is effective in a wide range of kidney illnesses, the aim of this study was to investigate whether the therapeutic actions of nebivolol could also be advantageous to mitigate tenofovir-induced nephrotoxicity.Male Wistar rats weighing 180–200 g were obtained from the animal facilities of the University of São Paulo—Institute of Biomedical Sciences. During the 30-day protocol, we kept our animals at controlled temperature (23 ± 1°C) with a light/dark cycle of 12/12 h. Rats received a standard diet  added with tenofovir  and/or nebivolol  and had free access to tap water. Rats were allocated to the following groups: control, received a standard diet for 30 days; NBV, received a standard diet for 30 days added with nebivolol in the last 15 days; TDF, received a standard diet added with tenofovir for 30 days; and TDF+NBV, received a standard diet added with tenofovir for 30 days and nebivolol in the last 15 days. The chosen doses of tenofovir and nebivolol were based on previous experimental studies , 13, 15.ProtV, mg/day) by colorimetric system using a commercial kit .Before the clearance studies, all the rats were placed in individual metabolic cages. We collected 24-h urine to assess urinary output and then centrifuged the samples to remove suspended material. We evaluated urinary protein excretion  and then we cannulated the trachea with a PE-240 catheter for spontaneous breathing. The jugular vein was cannulated with PE-60 catheter for infusion of inulin and fluids. To monitor mean arterial pressure  and collect blood samples, the right femoral artery was catheterized with a PE-50 catheter. We assessed MAP with a data acquisition system . To collect urine samples, we cannulated the bladder with a PE-240 catheter by suprapubic incision. After the surgical procedure, a loading dose of inulin  was administered through the jugular vein. A constant infusion of inulin (10 mg/kg BW) was started and continued at 0.04 mL/min throughout the whole experiment. We collected three urine samples at 30-min intervals. Blood samples were obtained at the beginning and at the end of the experiment. Inulin clearance values represent the mean of three periods. Plasma and urinary inulin were determined by the anthrone method, and the glomerular filtration rate (GFR) data were expressed as mL/min/100g BW. To measure renal blood flow , we made a median incision and dissected the left renal pedicle for isolating the renal artery. An ultrasonic flow probe was placed around the exposed renal artery, and RBF was measured with an ultrasonic flow meter . We divided blood pressure by RBF to calculate renal vascular resistance .®, TX, USA). The detection system and the quantification followed the protocols described by the manufacturers.We determined plasma levels of phosphate . We froze the right kidneys in liquid nitrogen and stored at −80°C for western blotting and ELISA. The left kidneys were removed and a fragment of the renal tissue was fixed in methacarn solution  for 24 h and replaced by 70% alcohol thereafter. The kidney blocks were embedded in paraffin and cut into 4-μm sections for histological and immunohistochemical (IHC) studies.Kidney samples were homogenized in ice-cold isolation solution  containing a protease inhibitor cocktail  with a homogenizer . Homogenates were centrifuged at 4,000 × rpm for 30 min at 4°C to remove nuclei and cell debris. Supernatants were isolated and protein was quantified by Bradford assay .phox and anti-p67phox . The labeling was visualized with a horseradish peroxidase-conjugated secondary antibody  and enhanced chemiluminescence detection . Kidney protein levels were further analyzed with a gel documentation system  and the software Image J for Windows (Image J-NIH Image). We used densitometry to quantitatively analyze the protein levels, normalizing the bands to β-actin expression .For Western blot analysis, 100 μg of total kidney protein were separated on SDS-polyacrylamide minigels by electrophoresis . After t®, TX, USA). The detection system and quantification followed the protocols described by the manufacturer. The absorbances were obtained using the Epoch/2 device .We assessed AngII (pg/μg protein), Monocyte Chemotactic Protein 1 , Transforming Growth Factor Beta 1  and Collagen Type 3  in renal tissue by ELISA using commercial kits , <5% of the field showing tubular epithelial swelling, vacuolar degeneration, necrosis, and desquamation; (I), 5–25% of the field presenting renal lesions; (II), involvement of 25–50% with renal damage; (III), 50–75% of damaged area; and (IV), more than 75% of the grid field presenting renal lesions. To minimize bias during the morphometric examination, the observer was blinded to the treatment groups. The mean score for each rat and the mean score for each group were calculated (2) to evaluate the immunoreactions. The volume ratios of positive areas of renal tissue (%), determined by the color limit, were obtained by ZEN image analyzer software  on a computer coupled to a microscope (Carl Zeiss Axioskop 40) and a digital camera  and examined under light microscopy. For the evaluation of renal damage, 40–60 grid fields (× 400 magnification) measuring 0.245 mmlculated , 18. Forl camera , 20. To Plasma (nmol/mL), urinary (μmol/mg creatinine) and tissue (nmol/mg protein) levels of thiobarbituric acid reactive substances (TBARS) were assessed using TBARS Assay Kit . The detection system and quantification followed the protocols provided by the manufacturer. The absorbances were obtained using the Epoch/2 device . Glutathione (GSH) was determined in total blood by the method of Sedlak and Lindsay . Whole bp < 0.05 were considered statistically significant.All quantitative data were expressed as mean ± SEM. Differences among groups were analyzed with GraphPad Prism 5.0 software  by one-way analysis of variance followed by the Student–Newman–Keuls test. Values of Tenofovir-treated rats presented a significantly impaired renal function compared to C and NBV rats. TDF+NBV group showed a partial recovery of GFR compared to TDF group . In addiV groups . TDF groV groups .Hypertension was accompanied by alterations in the RAAS. Tenofovir-treated rats presented increased plasma level and renal tissue expression of AngII as well as plasma Aldo concentration compared to C and NBV rats. Administration of nebivolol restored both components of the RAAS in the TDF+NBV rats compared to the C and NBV rats . FollowiprotV in the TDF+NBV rats compared to the TDF rats , decreased NOX-dependent superoxide formation and increased the bioavailability of NO  and HO-1 . Our stu2 into H2O2 by the actions of SOD, such as Cu/Zn-SOD and MnSOD. We demonstrated that tenofovir-treated rats presented an increase in MnSOD renal expression, probably in response to a higher oxidative stress. Nebivolol treatment restored this enzyme expression in the TDF+NBV rats compared to the C and NBV rats. Tenofovir-induced nephrotoxicity has been related to structural mitochondria abnormalities including wide alterations in size and shape, resulting in disruption on mitochondrial DNA and development of oxidative stress  possibly in response to an imbalance between TBARS and GSH levels, suggesting that oxidative stress activated both mitochondrial enzymatic system and Nrf2/HO-1 signaling pathway. Nevertheless, experimental studies have shown that despite the presence of intense oxidative stress, both Nrf2 and its cytoprotective gene HO-1 activities were downregulated, indicating that the injured kidney paradoxically compromised the Nrf2/HO-1 signaling pathway activation , 48, 52.In summary, nebivolol was capable of attenuating tenofovir-induced nephrotoxicity through its involvement in the NO cascade modulation and RAAS activity maintenance. Moreover, nebivolol had an outstanding systemic and renal antioxidant effect, as well as notable anti-inflammatory and anti-fibrotic properties. Hence, our study indicates that administration of nebivolol may be a beneficial therapeutic strategy to slow the progression of renal disease in patients undergoing tenofovir treatment and may offer a better prognosis and an improvement in quality of life of individuals living with HIV/HBV.The original contributions presented in the study are included in the article, further inquiries can be directed to the corresponding author.The animal study was reviewed and approved by Comissão de Ética no Uso de Animais (CEUA) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo—protocol n. 1287/2019.Conceptualization: MN and DC. Data curation: MN, DB, MM, AB, RV, and DC. Investigation and validation: MN, AB, RV, and DC. Writing and reviewing the original drafting: MN, AB, RV, and DC. Editing: AS. All authors approved the submitted version.This work was supported by the Fundação de Amparo à Pesquisa do Estado de São Paulo - FAPESP; grant numbers 2018/04930-6 (ACB), 2018/12297-1 (RAV), 2019/20840-0 (DC).The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Radiooncological scores are used to stratify patients for radiation therapy. We assessed their ability to predict overall survival (OS) in patients undergoing surgery for metastatic brain disease.We performed a post-hoc single-center analysis of 175 patients, prospectively enrolled in the MetastaSys study data. Score index of radiosurgery (SIR), graded prognostic assessment (GPA), and recursive partitioning analysis (RPA) were assessed. All scores consider age, systemic disease, and performance status prior to surgery. Furthermore, GPA and SIR include the number of intracranial lesions while SIR additionally requires metastatic lesion volume. Predictive values for case fatality at 1 year after surgery were compared among scoring systems.p ≤ 0.003). Median survival was 21–24 weeks in patients scored in the unfavorable cohorts, respectively. In cohorts with favorable scores, median survival ranged from 42 to 60 weeks. Favorable SIR was associated with a hazard ratio (HR) of 0.44  for death within 1 year. For GPA, the HR amounted to 0.44 , while RPA had a HR of 0.30 . Overall test performance was highest for the SIR.All scores produced accurate reflections on OS after surgery (All scores proved useful in predicting OS. Considering our data, we recommend using the SIR for preoperative prognostic evaluation and counseling. Brain metastases are more frequent than primary brain tumors , 16. TheWe performed a monocentric analysis of patients, prospectively enrolled in the MetastaSys trial, who underwent microsurgical resection of at least one brain metastasis at the Göttingen University Hospital, Germany, from June 2013 to December 2016. Indication for resection was based on current guidelines and interdisciplinary tumor board conferences. The resection of a metastatic brain tumor was indicated in (1) space occupying lesions with pronounced perifocal edema, (2) occlusive hydrocephalus due to the metastatic brain tumor, (3) singular or solitary metastases, and (4) progressive neurologic deterioration based on the space occupying effect. This study was performed in accordance with the Ethics committee of the Georg-August University, Göttingen  and with the 1964 Helsinki Declaration and its amendments.Patients were included in the present analysis if (1) they were older than 18 years of age at the time of surgery, (2) preoperative cranial MR imaging (T1 sequences with contrast media) showed at least one metastatic lesion and medical indication for resection of one or more lesions was given. Exclusion criteria were (1) patient unable or unwilling to consent by themselves/an authorized legal representative, (2) incomplete data, and (3) no surgical treatment or incomplete tumor removal. For this study, survival was evaluated at regular neuro-oncological follow-up visits and recorded in weeks after surgery. In cases of unavailable follow-ups, patients were contacted by telephone.Baseline characteristics such as age, sex, and Karnofsky performance scale (KPS) were recorded prior surgery Table . DetailsSystemic disease burden was assessed by interdisciplinary consensus based on computed tomography (CT) scans of the thorax and abdomen with iodinated contrast medium.The scoring systems were evaluated based on the baseline characteristics and the already established categories were reviewed. These were, after confirmation of reliability, adopted unchanged for further analysis. In addition, possible extensions to the scores were calculated.Age KPS Systemic disease status 3 Largest lesion volume in cm.Number of cerebral lesions As established by Lorenzoni et al. , five faThe sum of the aforementioned categories reflects the SIR which is subdivided into four classes . Patients in class 4 are expected to have favorable, while a minimum of points and classification in class 1 likely reflects an unfavorable baseline :ClaClass 1 includes young patients with good functional status and controlled tumor disease, while class 3 encompasses patients with low KPS. Thus, a lower RPA category reflects a more favorable baseline status , 27.p-values are two-sided and, where considered statistically significant, at p ≤ 0.05/3 when testing the SIR, GPA, and RPA or at p ≤ 0.05/7 when testing seven additional putative predictors combined with the SIR.Data are presented using means and standard deviations (SD) where appropriate. For categorical data, prevalences using percentages are given. Overall survival was analyzed with Cox-proportional hazards models using R software version 4.0.1 . Reported n = 102; 58.3%), the operated lesion was supratentorial, while infratentorial lesions were less common . Eighty-six patients (49.1%) had a solitary brain lesion, whereas the remaining 89 (50.9%) suffered from a mean of 3.1 ± 3.8 lesions. Lung cancer was the predominant primary , with non small-cell lung cancer in 63 patients (36.0%) and small cell lung cancer in the remaining 20  were male with a mean age of 63.5 ± 10 years. In most cases  could be classified in class 1, 49 28.0%) in class 2, 62 (35.4%) in class 3, and 5 (2.8%) in class 4. Details are shown in Table 8.0% in cThe GPA was calculated according to the elaborated categories with 61 patients (34.9%) in class 1, 85 (48.6%) in class 2, 25 (14.3%) in class 3, and 4 (2.3%) in class 4  were classified in class 1, 25 (14.3%) class 3, and the remaining 136 patients (77.7%) did not match any of the aforementioned classes and were therefore categorized as class 2 (Table p = 0.00000005), the GPA (p = 0.00003), and the RPA . Within scoring systems, Fig. HR [95% CI]: 0.44 ), GPA class 3 , and RPA class 1 . Among scoring systems, the best model of overall survival was provided by the SIR as having the highest likelihood of correct prediction (p < 0.000001) with the established classes of the SIR (p = 0.016). Complementing the SIR with additional predictive factors was not supported for infratentorial origin of the resected lesion (p = 0.88), eloquent location (p = 0.84), patient gender (p = 0.29), surgical indication for resection (p = 0.29), postoperative chemotherapy (p = 0.20), nor for origin of the primary tumor (p = 0.055). However, it was beneficial to combine the SIR with the binary factor adjuvant radiation therapy (p = 0.00023). Adjuvant radiation therapy, administered to 151 patients (86%), prolonged survival . Especially the improved survival in patients who received adjuvant radiotherapy  were dead. Overall survival differed significantly between classes of the SIR ,All three radiooncological scores SIR, GPA, and RPA provided useful categories to predict long-term outcome prior to surgical resection of brain metastases. The four classes of the SIR were statistically most solid in setting apart survival of greater than 1 year after surgery. Compared to the GPA and RPA, the SIR encompassed more information and yielded more precise estimates of survival and more homogenously distributed sample sizes across classes.Resection of metastatic brain lesions allows histopathological analysis of tumor tissue, which helps in identifying the origin of the primary tumor. This is essential in patients with unknown primaries. Furthermore, neurological deficits resulting out of mass effect, caused by the lesion itself or surrounding edema, frequently require surgical removal of the brain metastasis .In patients with glioma, the extent of resection is correlated with improved survival, whereas the impact of resection on long-term survival in patients with metastatic brain lesions remains a matter of debate , 11, 20.In a recent multicenter study, an external validation model was developed to predict functional impairment after intracranial tumor surgery . IncludiWith five parameters, the SIR is the most complex of the studied rating systems and was praised for its strong predictive power . PatientComparing the results of our prospectively enrolled patient cohort with the retrospective analysis of the Norwegian Brain Tumor Registry from Winther et al., the same tumor entities are included . HoweverThe unadjusted regression analyses performed by Winther et al. identified male gender, increasing age, an elevated ECOG status, multiple brain metastases, the presence of comorbidities, and extracranial metastases as well as a progressive, synchronous, or unknown extracranial disease status to be associated with shorter OS.The GPA is analyzed with age, KPS, the number of intracranial metastases, and the presence of extracranial lesions. All of these factors are mentioned above and are identified by Winther et al. separately to be associated with shorter OS. Furthermore, the RPA applied in our study is predominantly based on the KPS, including age and systemic disease status. In this score, the identified risk factors for shorter OS are represented, accordingly.The most accurate score in our study, the SIR, subdivides the systemic disease status not only into present or absent metastases but also further into progressive disease, partial remission — stable disease and complete clinical remission. The number of brain metastases and patients age is subdivided accordingly to the GPA. The KPS is more strictly subdivided than in the GPA that above all, it is evident which patients are already suffering from a greater impairment preoperatively and therefore will not receive any further tumor therapy. The only category applied in the SIR and not evaluated by Winther and colleagues is the largest lesion volume. However, four out of five categories are identified in the regression analysis by Winther et al. in their analysis of 590 patients with comparable survival rates. Hereby, a cross-validation with their study cohort seems applicable in our point of view and strengthens the expressive power of our study .Regarding the results obtained in our analysis, the SIR, partitioned in its four established classes, was validated in patients with surgical resection of one or more brain metastases with/without consecutive radiotherapy. Tumor characteristics, such as eloquent location and infra-/supratentorial origin, were not influential enough to merit addition to the SIR. In contrast, postoperative radiation therapy was a strong additional predictor. However, this factor cannot be taken into account preoperatively since the decision on further tumor treatment can only be provided after but not prior surgery. Therefore, we advocate the preoperative use of the SIR to estimate postoperative long-term survival of patients with metastatic brain disease.Based on the Metastasys study data, the SIR provides the best estimate of OS in patients prior to surgery for metastatic brain disease. The use of this score can be recommended to assist radiation oncologists and surgeons alike in the pre-therapeutic decision-making process.


Background: This study aimed to investigate whether advanced interatrial block (IAB) is a predictor of recurrent atrial fibrillation (AF) and/or ischemic stroke in elderly patients with AF and hypertension.Methods and objectives: Five hundred and sixteen elderly inpatients  with concurrent paroxysmal AF and hypertension were enrolled in this retrospective observational study. Data on comorbidity, medication, digital electrocardiograms (ECG), and outcomes were obtained from the medical records and follow-up examinations. IAB was classified as partial IAB or advanced IAB according to 12-lead surface ECG analysis on admission. Advanced IAB was defined as a maximum P wave duration of >120 ms with biphasic (±) morphology in leads II, Ⅲ, and aVF by two blinded investigators. The endpoints were recurrent AF and ischemic stroke.Results: We enrolled 120 patients (23.26%) with partial IAB and 187 (36.24%) with advanced IAB. The mean follow-up duration was 19 months. A total of 320 patients (62.02%) developed AF recurrence, and 31 (6.01%) experienced ischemic stroke. Significant predictors of advanced IAB in multivariate analysis were older age (>80 years), increased left atrial diameter (>40 mm), and being overweight (body mass index >25 kg/m2). In the multivariable comprehensive Cox regression analyses, partial IAB was associated with AF recurrence. Advanced IAB was an independent predictor of increased risk of AF recurrence and ischemic stroke.Conclusion: Both partial and advanced IAB are associated with AF recurrence in elderly patients with hypertension. Furthermore, advanced IAB is an independent predictor of ischemic stroke. Atrial fibrillation (AF) is one of the most common types of cardiac arrhythmias in elderly patients with hypertension and is associated with significant ischemic stroke and cardiovascular mortalities. Interatrial block (IAB) often occurs when a conduction delay occurs over Bachmann’s bundle or between the activation of the atrium. IAB was initially classified by Bayes de Luna and has recently often been defined according to IAB severity . Partial2); 3) severe obstructive sleep apnea syndrome (apnea-hypopnea index of >10); 4) hyperthyroidism; 5) radiofrequency catheter ablation procedures for all types of atrial arrhythmia; 6) left atrial appendage occlusion procedures; and 7) cardiac pacemaker implantation. All participants provided written informed consent, and the study was approved by the institutional ethics committee.This was a retrospective observational study conducted at Chinese PLA general hospital in Beijing. All eligible patients were aged ≥65 years, of Chinese ethnicity, and diagnosed with hypertension and paroxysmal non-valvular atrial fibrillation between April 2014 and May 2016. Patients with the following conditions were excluded: 1) valvular AF such as post-mechanical valve replacement or moderate-to-severe rheumatic mitral valve stenosis; 2) severe renal insufficiency  was recorded for each study patient at baseline and subsequent follow-up examinations and measured with digital calipers using the Muse Cardiology Information System. We amplified the ECG images up to 10 times their original size to define the P-wave duration and PR interval. IAB was classified according to the baseline 12-lead ECG by two independent blinded investigators as follows: 1) partial IAB was defined as P-wave duration longer than 120 ms without biphasic morphology in leads II, III, and aVF; and 2) advanced IAB was defined as P-wave duration longer than 120 ms and presented biphasic morphology in leads II, III, and aVF  Figure .All patients underwent two-dimensional transthoracic echocardiographic evaluation on admission. Echocardiographic parameters, such as ventricular ejection fraction (LVEF) and left atrial volume (LAV), were derived from the echocardiographic data. LVEF and LAV were measured using Simpson’s method and the area-length method, respectively. The left atrial volume index (LAVI) was calculated as the left atrial volume divided by the body surface area of each patient.Baseline demographic characteristics, relevant medical histories, therapeutic procedures, cardiovascular events, and laboratory and imaging data were extracted from hospital electronic medical records. All patients were followed up at regular intervals or during all-cause hospitalization, with additional visits as required in the case of decompensation. The regular schedule of visits included a minimum of quarterly visits by the cardiovascular specialists. A 12-lead ECG was recorded at every visit or at any time when the patient had palpitations. A 24 h ECG monitor (Holter) was evaluated at least twice in patients with no recurrence, as necessary. Information on the endpoints was collected from the medical records and questionnaires answered by the patients. The primary endpoint was recurrent AF and was defined using ECGs or 24 h Holter electrocardiogram results. The secondary endpoint was AF-related ischemic stroke, which was defined as a sudden onset of neurological deficits or other relative symptoms lasting over 24 h and was associated with AF and confirmed using computed tomography or magnetic resonance imaging.p < 0.05.All statistical data were evaluated using IBM SPSS Statistics for Windows version 23.0 . Continuous variables are represented as mean ± standard deviation. Univariate analysis was performed using analysis of variance for continuous variables and the chi-square test for categorical variables. Kaplan–Meier estimates were used to compute the cumulative incidence of recurrent AF. Follow-up time was defined as the time between the baseline visit and recurrence of AF, time to loss to follow-up, death, or the end of the study period. We conducted multivariate logistic regression analyses to screen the independent risk factors for IAB. The Cox proportional hazard model was used to calculate the adjusted hazard ratio (HR) of risk factors for recurrent AF and ischemic stroke. Adjusted HRs with 95% confidence intervals (CIs) are reported separately. Statistical significance was set at p < 0.01). Participants with advanced IAB were more likely to have coronary artery disease, heart failure, or prior ischemic stroke than those with normal atrial conduction. They were also more likely to take diuretics and had higher values of PR intervals, P-wave duration, body mass index (BMI), left atrial diameter, and right atrial diameter. Participants with partial IAB were more likely to have a higher PR interval and P-wave duration than those with normal atrial conduction. Similarly, participants with advanced IAB were more likely to have anemia, P-wave prolongation, a larger left atrial diameter, a larger right atrial diameter, and a higher BMI than those with partial IAB. There was no significant difference in the use of antiarrhythmic drugs (including amiodarone and propafenone) and anticoagulants (recommended dose of rivaroxaban or dabigatran) among the three groups  and during follow-up.A total of 516 patients with paroxysmal AF and hypertension  were included in the study. During a mean follow-up of 19 months, 320 patients (62.02%) experienced AF recurrence, and 31 (6.01%) experienced ischemic stroke. The baseline characteristics of the patients, according to their IAB degree, are listed in p < 0.001), left atrial enlargement  , and BMI of >25 kg/m2 . Overall, this model explained 69.6% of the variability in the prevalence of advanced IAB.p >0.05).The annual incidence of recurrent AF in patients with advanced IAB and hypertension was approximately 57.71 per 1,000 person-years, which declined stepwise to 35.02 per 1,000 person-years, and 15.92 per 1,000 person-years in patients with partial IAB and those with normal atrial conduction. Moreover, the annual incidence of ischemic stroke was highest in patients with advanced IAB , intermediate in patients with partial IAB , and lowest in patients with normal atrial conduction  . There wp < 0.01)  .p < 0.001; and HR: 4.57, 95% CI: 1.76–11.89, p = 0.002, respectively) after adjusting for potential confounders and demographics. Similarly, using multivariate analysis, we observed that partial IAB was also an independent risk factor associated with AF recurrence  but not for ischemic stroke  after adjusting for other risk factors. We observed no significant correlation between anticoagulant use and the risk of ischemic stroke . Additionally, age of ≥80 years, heart failure, left atrial diameter of >40 mm, right atrial diameter of >40 mm, anemia, and NT-proBNP levels of >450 pg/ml were all independent risk factors for AF recurrence (p < 0.05)  levels, and clinical medications. During the observation period, the crude HRs for recurrence of AF and ischemic stroke in the elderly AF patients with advanced IAB were higher than those with normal atrial conduction and remained significant  .2; 2) advanced IAB was significantly associated with an increased risk of recurrent AF and ischemic stroke in elderly patients with paroxysmal AF and hypertension; 3) partial IAB was also an independent predictor of recurrent AF but not of ischemic stroke.In this single-center, respective observational study, the major findings were as follows: 1) the significant predictors of advanced IAB were age of >80 years, left atrial diameter of >40 mm, and BMI >25 kg/m2DS2-VASc  risk score.IAB is rarely considered an independent, routine, and important electrocardiographic diagnosis despite its high prevalence and ease of diagnosis. Previous studies have found that the prevalence of IAB increased with age and could increase from 26% to 44% in patients with cardiovascular risk factors, rising to 50% in octogenarians . In the 2, which supports and extends the results of previous studies. A study by Bryce Alexander et al. demonstrated BMI of >30 kg/m2, male sex, and increased age (per 10 years increase)  were significant predictors of IAB in patients with carotid and coronary artery disease  score, coronary artery disease, and increased left atrial diameter were independently associated with IAB development. The association between IAB and degenerative diseases due to aging has been extensively studied. The mechanisms of the higher prevalence of IAB in obese patients than in those with normal weight may partly be due to an unhealthy lifestyle, diffuse ischemia, obstructive sleep apnea, and sympathetic nervous activation status , and BMI of >25 kg/m disease . The Ath disease . Anothern status . Previoup < 0.001), which supports and extends the results from previous studies. The mechanisms underlying the higher risk for recurrence of AF among patients with advanced IAB may partly be attributed to atrial fibrosis and atrial remodeling, which are considered anatomical substrates of advanced IAB, and play important roles in determining heterogeneous electrophysiological changes in atrial cardiomyocytes (Several previous studies have found that IAB, especially advanced IAB, is strongly correlated with rapid atrial arrhythmias in different clinical scenarios and may predict ineffective cardioversion of atrial fibrillation . For examyocytes . IAB migmyocytes . Some stmyocytes . The P-wmyocytes .2 score, which was also a common independent predictor of IAB development and ischemic stroke (In this study, we observed a higher incidence of ischemic stroke in patients with advanced IAB than in those with normal atrial conduction. Advanced IAB, but not partial IAB, was an independent predictor of ischemic stroke after adjusting for potential confounders and demographics. Recent reports have shown that advanced IAB is associated with ischemic stroke. Evidence from prior studies has suggested that AF might serve as an intermediate event between advanced IAB and stroke. Subsequent rapid atrial arrhythmia may further lead to high risks of atrial cardiopathy, atrial dysfunction, and left atrial thrombosis . Patientc stroke . Furtherc stroke .2DS2-VASc risk scoring system. Finally, we acknowledge that residual confounding remains a possibility, similar to that in other epidemiologic studies. Large-scale, multicenter, prospective studies with longer follow-up periods are required to validate our findings.The current study has several limitations. First, the retrospective nature of this study and the relatively small sample size from a single center could have introduced selection bias. Second, recurrent AF was defined by ECGs and clinical examinations at every visit and 24-h Holter electrocardiograms in patients with no AF recurrence during follow-up. However, the recurrence rate of AF may have been underestimated, and more episodes of asymptomatic AF may be detected by longer rhythm monitoring. Third, IAB was classified according to the baseline 12-lead ECG, and changes in the performance of IAB during follow-up were not considered. Fourth, there is insufficient evidence to support our finding that advanced IAB could further improve the prediction efficiency of the CHAOur results support the hypothesis that IAB is prevalent in elderly patients with hypertension. Both partial and advanced IAB were associated with AF recurrence in elderly patients with paroxysmal AF and hypertension. Furthermore, advanced IAB is an independent predictor of ischemic stroke.


Rheumatoid arthritis (RA) is one of the most common chronic non-organ-specific autoimmune diseases; meanwhile, autoimmune thyroid disease (AITD) is the most common organ-specific autoimmune disease that can lead to hypo or hyperthyroidism. Although the etiology of both diseases is complex with a combination of genetic and environmental factors, there are overlaps in genes contributing to the pathogenesis of both diseases. Numerous studies found a correlation between thyroid abnormality and RA in different populations, yet some didn’t. This study is aimed to evaluate the prevalence of thyroid dysfunction, AITD, and anti-thyroid peroxidase (anti-TPO) positively in Iranian patients with RA.A total of 250 RA patients and 248 patients with non-inflammatory rheumatologic disease were included in this case–control study. All participants underwent complete clinical and laboratory assessments. Participants were also assessed for thyroid function testing, including anti-TPO antibodies.Thyroid dysfunction was twice as common in RA patients as in controls . Overt hypothyroidism was the most common thyroid dysfunction among RA patients (58 out of 84). Anti-TPO positivity was also significantly more common in RA compared with controls . The proportion of controls and RA patients with AITD were 9 and 21.5%, respectively. AITD was found 2.8 times more common in RA group than controls .It was demonstrated that RA was an independent factor associated with thyroid dysfunction and AITD.The online version contains supplementary material available at 10.1186/s41927-022-00293-9. Rheumatoid arthritis (RA) is a chronic autoimmune systemic inflammatory disease characterized by symmetrical involvement of the peripheral small joints. The overall prevalence of RA is 0.5–1% of general population and RA is twice or threefold more common among females compared to males. RA is a multifactorial disease which both genetic and environmental factors play an important role in disease’s pathogenesis , 3. AlthThyroid dysfunction is mainly divided into hypothyroidism (insufficiency of thyroid hormones) and hyperthyroidism (excess of thyroid hormones). Each of these can be further subdivided as overt and subclinical thyroid dysfunction . AutoimmSeveral studies determined various ranges of frequency of thyroid dysfunction, AITD, and anti-thyroid autoantibody like anti-thyroid peroxidase (anti-TPO) in RA patients in different places . AlthougThis observational, case–control study was conducted at Shahid Beheshti tertiary care center, Qom, Iran, from April to October 2021. The protocol was approved by the ethics committee of Qom University of Medical Sciences and informed consent, according to the Declaration of Helsinki, was taken from all participants before enrollment.Two hundred fifty RA patients who presented to the outpatient clinic of our center were consecutively included. All patients were aged between 18 and 85 and met the American College of Rheumatology and the European League against Rheumatism (ACR/EULAR) 2010 criteria for rheumatoid arthritis . PatientTwo hundred forty-eight individuals were consecutively selected from patients with non-inflammatory rheumatologic disease including osteoarthritis, neck or back pain, chondromalacia, spinal canal stenosis, periarthritis . None of them meet the exclusion criteria mentioned above. Our control group had almost the same demographic features as our patient group.Overt hypothyroidism: TSH > 3.6 and FT4 < 0.7Subclinical hypothyroidism: TSH > 3.6 with normal range of FT4Overt hyperthyroidism: TSH < 0.3 and FT4 > 1.8 or FT3 > 4.43Subclinical hyperthyroidism: TSH < 0.3 with normal range of FT4 and FT3Euthyroid: normal range of TSH and FT4The data was collected by reviewing medical records of patients, interviews, and physical examination. Participants’ demographic features were also taken into consideration. They were also evaluated for prior history of thyroid hormone disturbance or thyroid drug consumption to assess previous thyroid dysfunction. visual analog scale (VAS) and DAS-28-ESR were also assessed . LaboratAnti-TPO antibody was also determined using radioimmunoassay with an optimum cut-off level of 50 IU/mL. AITD was defined by positive anti-TPO and the presence or history of thyroid dysfunction .Analysis of data was carried out by IBM SPSS Statistics version 26. Before any analysis was done, normality was checked using the Kolmogorov–Smirnov test, Q–Q, and P-P plots in continuous variables. Quantitative data with normal distributions including age, TSH and FT3 were described as mean ± standard deviation (SD) and all other data with non-normal distributions were reported as median (25–75th percentile). The difference of variables between cases and controls was assessed by using the Mann–Whitney U test for non-normally distributed data or the Student’s T-test for normally distributed data. Qualitative variables like laboratory test positivity and the proportion of thyroid abnormality were described in number and percentage. The comparisons of categorical variables between cases and controls were also determined using the chi-square test and odds ratio. When the chi-square test was inappropriate, the Fisher exact test was applied. Multivariant logistic regression was used to determine independent factors associated with thyroid dysfunction and AITD. The odds ratio (OR), and 95% confidence interval (CI) were presented as well. In all tests, P-value < 0.05 was considered statistically significant and it was non-significant if the P-value was > 0.05.This study included 250 patients with RA disease as cases and 248 patients with a non-inflammatory rheumatological disease as controls. Fifty-three (21.4%) individuals of controls suffer from back or/and neck pain, 111 (44.8%) from osteoarthritis, 52 (21.0%) from periarthritis, 28 (11.3%) from chondromalacia, and 3 (1.2%) from spinal canal stenosis.The results of clinical characteristics of cases and controls were shown and compared in Table The number of controls and cases with thyroid dysfunction were 47 19.2%) and 84 (33.9%), respectively, in which 28 (11.3%) controls and 60 (24.2%) cases have prior history of thyroid dysfunction. A significant association was found between RA disease and thyroid dysfunction which thyroid dysfunction was twice as common in RA patients as in controls . As presented in Table % and 84 Anti-TPO was positive in 37 15.0%) controls, and 77 32.0%) cases and it was significantly more common in RA patients . The frequency of AITD was 22 (9.0%) and 52 (21.5%) in controls and cases, respectively, therefore it was found AITD was 2.77 times more common in RA patients than that in controls . The proportion of overt/subclinical hypothyroidism and hyperthyroidism, as well as AITD among controls and cases, is shown in Fig. 5.0% cont.0% casesAs it is shown in Table The relationship between RA and thyroid dysfunction has been taken into account since the 1960s when an association between RA and Hashimoto’s thyroiditis based on the common underlying role of autoimmunity was found , 16. TheSince in early research the control group was absent, some recent studies have investigated the association between thyroid hormone dysfunction and AITD in RA patients . AlthougMoreover, recent studies have paid more attention to the prevalence of anti-thyroid antibodies positivity and AITD in RA patients. Xi-Feng Pan et al., in a meta-analysis, estimated that the presence of anti-TPO is 2.3 times more common in RA patients compared with healthy individuals. Although anti-thyroid autoantibodies were positively associated with RA disease in Asian and African populations, no significant association was detected in most of the studies conducted in America and Europe. The reason for this contrast might lie in geographical genetic, and environmental differences or preliminary studies to find its real association . In thisThe association between AITD, an organ-specific autoimmune disease, and systematic autoimmune diseases like systemic lupus erythematous, primary Sjögren’s syndrome, and especially RA was shown in several studies which can be partly explained by the similar underlying autoimmune pathogenesis and possible genetic susceptibility . DespiteAlthough seronegative thyroiditis, which is characterized by thyroid dysfunction without positive tests for thyroid autoantibodies and a hypoechoic pattern of the thyroid parenchyma at ultrasound, was not included in this study, it does not seem to have a significant impact on our analysis because of low prevalence of this form of thyroiditis (~ 5%) . NonetheIn conclusion, this study demonstrated that RA disease was an independent covariant for thyroid dysfunction , presence of anti-TPO positivity, and AITD among the Iranian population like several other populations.Additional file 1. It consist of all data generated during this study, which includes age, gender, duration of RA, history of thyroid disease and its subtypes, tender and swollen joint count, VAS, History of medication used for RA treatment, lab studies such as TSH, FT3, FT4, anti-CCP, anti-MCV, anti-TPO, RF, ESR, CRP and DAS-28.


Brassica napus and Sinapis alba via distant hybridization were collected for genome-wide association analysis (GWAS) and quantitative trait loci (QTL) mapping of the SOC trait, respectively. The variable coefficient of the RIL and natural populations ranged from 7.43 to 10.43% and 8.40 to 10.91%. Then, a high-density linkage map was constructed based on whole genome re-sequencing (WGS); the map harbored 2,799 bin markers and covered a total distance of 1,835.21 cM, with an average marker interval of 0.66 cM. The QTLs for SOC on chromosome A07 were stably detected in both single and multiple environments. Finally, a novel locus qA07.SOC was identified as the major QTL for SOC based on the GWAS and RIL populations. In addition, the RNA-seq results showed that photosynthesis, lipid biosynthesis proteins, fatty acid metabolism, and unsaturated fatty acid biosynthesis were significantly different between the developed seeds of the two parents of the RIL population. By comparing the variation information and expression levels of the syntenic genes within qA07.SOC and its syntenic genomic regions, as well as through haplotype analysis via GWAS, BnaA07.STR18, BnaA07.NRT1, and BnaA07g12880D were predicted as candidate genes in the qA07.SOC interval. These stable QTLs containing candidate genes and haplotypes can potentially provide a reliable basis for marker-assisted selection in B. napus breeding for SOC.Rapeseed, an allotetraploid oil crop, provides vegetable oil for human consumption. The growing demand for oilseeds has necessitated the development of rapeseed varieties with improved quality. Therefore, a clear understanding of the genetic basis underlying the seed oil content (SOC) is required. In this study, a natural population comprising 204 diverse accessions and recombinant inbred lines (RILs) derived from  Brassica napus L., 2n = 38, AACC) belongs to the family Brassicaceae and is one of the major oilseed crops that provide vegetable oil for human consumption worldwide. With an increase in global human population, improving seed oil content (SOC) has become an important goal in oilseed rape breeding programs  mapping and genome-wide association analysis (GWAS) are effective strategies to dissect complicated genetic bases, and can help accelerate the breeding of rapeseed by marker-assisted selection. Several studies have reported multiple QTLs for the seed oil-related traits, distributed over all chromosomes in the rapeseed genome . Similarentified .B. napus is mainly controlled by maternal effects, embryo gene effects, pollen instinct, cytoplasmic effects, and the corresponding gene-environmental interaction effects, which conforms to the additive-dominant-epistatic genetic model and are based on additive and dominant inheritance with high generalized heritability  population of 158 individuals. We used this RIL population to construct a high-density genetic map of 2,799 bin markers, with a total coverage distance of 1,835.21 cM. We evaluated SOC traits across nine different environments for QTL mapping in the RIL population and 3 consecutive years for GWAS. A major QTL on chromosome A07 was detected. Combined dynamic transcriptome, synteny analysis, variant detection, and haplotype analysis were conducted in the major QTL region, and BnaA07g12790D, BnaA07g12830D, and BnaA07g12880D were predicted to be candidate genes. Our findings could contribute to improving the understanding of the genetic basis and breeding of the SOC trait in B. napus.In this study, we collected 204 accessions of Sinapis alba L. inbred line with a high 1,000-seed wight was selected as a male parent to cross with a B. napus L. inbred line “Darmor.” Well-grown F1 lines were obtained by in vitro culture of plant embryos for embryo rescue. Using the microspore culture method, GRG2462 was generated in F2:3 lines with low SOC as female parent. We selected another high-SOC B. napus inbred line GRD328 as the male parent, in which the high-oil-content hybrid rapeseed Youyan2020 was developed using GRD328. Finally, a B. napus RIL population (F2:11) consisting of 158 individuals was derived from the crossing of GRG2462 × GRD328, and used for QTL mapping study. A total of 204 B. napus inbred lines , Qinghe (QH), Changshun (CS), Tangtou (TT), Jinsha (JS), and Badong (BD).A ed lines  collecteAt maturity, the natural population, RIL population, and two parents (GRG2462 and GRD328) were evaluated for SOC in each environment. Foss NIR Systems 5000 Near-Infrared Reflectance Spectroscopy was performed to measure SOC . SPSS 22http://bio-bwa.sourceforge.net/) was used to align the clean reads against the B. napus “Darmor-bzh” reference genome . Genomic DNA was diluted to a final concentration of 20 ng/μl and used to construct a DNA library. The DNA library was subjected to whole-genome resequencing (WGS) using the Illumina NovaSeq 6000 system. Clean reads were obtained by removing adaptor sequences, contamination, and low-quality reads from the raw reads. A Burrows-Wheeler Aligner ; (3) chromosomes with a small density of bin marker, add some Bin markers with unfixed parameters in terms of length and partial separation. The bin markers that met the criteria were used to construct a high-density genetic map. As per general genetic coding rules, the model “aa × bb” was used to analyze the genotype bin markers in the 158 RILs  being less than 10 kb in length; (2) having severe partial separation  method  in Windomutation .http://www.isbreeding.net/; p < 0.05) with 1,000 permutations.Quantitative trait loci × environment interaction effects  were identified by the MET functionality and ICIM-ADD mapping method in the QTL IciMapping V4.1 software (r-project.org)) and lsmeans (k) was set as 1–10, and the probability value (Q) of each material in each subgroup was calculated. The optimal number of subgroups was determined according to the cross-validation error , and each material was classified into the subgroup to which it belonged according to the Q value. The TASSEL 5.0 software was used to calculate the genetic relatedness between two specific accessions and the relative value of genetic relatedness between any accessions, which determined the kinship of the B. napus accessions in the natural population . The quantile-quantile (Q-Q) plot was shown with the expected p value and −log10P of each SNP, and the Manhattan plot was demonstrated using the R package qqman.The SOC trait for three consecutive years  was measured, and the best linear unbiased prediction (BLUP) for each accession was obtained using an R script lme4 (CRAN-Package lme4 ( lsmeans . The ADM lsmeans . The subpulation . The Poppulation . The Effpulation . The sigB. napus “Darmor-bzh” reference genome2 (Fold Change) | > 1 and padj < 0.05  were collected for RNA extraction and RNA-seq. High-quality RNA was extracted using the RNA Prep Pure Plant Kit  and sequenced using the Illumina NovaSeq 6000 system. Clean reads were acquired, by filtering the raw reads, and then mapped to the j < 0.05 . The KyoBnaActin gene as an internal control, was performed in a CFX Connect Real-time PCR system  using ChamQ™ SYBR qPCR Master Mix . Relative gene expression levels were determined using the 2(-ΔΔCT) method  following the manufacturer’s instructions. Quantitative real-time PCR (qRT-PCR), with the ) method . The priB. napus reference genome. The two parents were deeply sequenced on the Illumina NovaSeq 6000 system, and the homozygous polymorphic SNP and InDel between the two parents was used for variant analysis in SnpEff 5.1.B. napus were selected to analyze the unique gene and syntenic gene, along with their variation information and expression levels, based on the deep WGS and RNA-seq data, respectively.The syntenic properties of the genomic regions were used to exclude genes while determining the candidates responsible for QTL-SOC . The posp < 0.01) was observed among environments and genotypes, with the SOC having high narrow sense heritability of 78.54%  > 0.05 in the association panel (r2 > 0.2), respectively (10(P) > 5.0 (10(P) > 5.0 in 2015_2016 CS  > 5.0 , which s_2016 CS .For linkage map construction, 158 RILs were performed for whole genome re-sequencing, and a total of 617,466 SNP markers were obtained to constitute 38,516 bin markers . SubsequBased on the effective SNPs and bin markers, the map harbored 2,799 mapped bin markers, spanning a total distance of 1,835.21 cM with an average distance of 0.66 cM between adjacent markers ; Table 4B. napus reference genome showed that the mapped bin markers were consistent with the B. napus genome  were not expressed in the developed seeds of the two parents  and BnaA07g12830D (BnaA07.NRT1), which encode a thiosulfate sulfurtransferase and major facilitator superfamily protein, respectively, as well as the unknown functional gene BnaA07g12880D were the candidate genes.According to the syntenic analysis, the syntenic blocks of some C04 . Based osome C04 . After csome C04 . In the 7g12880D . The syn7g12830D . As ther parents , as wellqA07.SOC, haplotype analysis in BLUP showed that the SOC phenotype with a significant difference was divided by haplotype I and haplotype II derived from SNP_11440137 to SNP_11440139, respectively , BnaA07g12810D, BnaA07g12830D, and BnaA07g12880D were selected  with accession numbers CNP0002896 and CNP0002897.The datasets presented in this study can be found in online repositories. The raw data generated in this study have been deposited into the CNGB Sequence Archive (CNSA) of China National GeneBank DataBase , Subsidy project from NSFC of Guizhou Academy of Agricultural Sciences [No. (2021)50], and the Agricultural Scientific and Technological Research Projects of Guizhou province [Nos. (2020)1Y106 and 1Y109].The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.