简介：AbstractTuberous sclerosis complex (TSC) is a rare disease that involves multiple organs, including the brain; approximately 80%-90% of TSC patients exhibit TSC-associated epilepsy. Independent temporal lobe epilepsy (TLE), TSC-unrelated epilepsy, is particularly rare in patients with TSC. Here, we describe three patients with TSC with independent TLEs that were confirmed by stereo-electroencephalography (EEG), postoperative pathological findings, and seizure outcome at follow-up. The patients were retrospectively enrolled at two centers; their ictal epileptiform discharge onsets were determined using electrode contacts in the hippocampus during stereo-EEG. The three patients underwent anterior temporal lobectomies and remained seizure-free at 1-5 years after surgery. Postoperative pathological examinations confirmed hippocampal sclerosis in all three patients. Furthermore, postoperative intelligence quotient improvement was evident in one patient, while the quality of life was improved in two patients at 12 months after surgery.

简介：Prestinisthemotorproteinofcochlearouterhaircells(OHCs).ItisabletoperformrapidandreciprocalelectromechanicalconversionthatunderliesOHCelectromotility.Duetotheinadequatesizeofasingleprestinmoleculetoformthe~12nmintramembraneousproteinparticles(IMPs)intheOHClateralmembrane(LM),thepossibilityofprestinoligomerizationhasbeenproposed.Ithasbeensuggestedthatprestinmoleculesformhighorderoligomers,mostlikelyasthetetramer,inheterologoussystems.InOHCs,however,theoligomericstructureofprestinremainsunclear.Herewecalculatedtheprestin-relatedchargedensityinbothgerbilandguineapigOHCsthroughmeasuringtheirnonlinearcapacitance(NLC)andLMsurfacearea,showingthattheaveragechargedensity(22,608μm-2ingerbils;19,460μm-2inguineapigs)isstatistically4timestheaveragedensityofIMPs(5,686μm-2ingerbils;5,000μm-2inguineapigs).ThissuggeststhateachIMPcontainsfourprestinmoleculesbaseduponthenotionthateachprestintransfersasingleelementarycharge,implyingthatprestinformstetramersinOHCs.Todeterminewhethertheprestintetramerfunctionsasamechanicalunit,wesubsequentlycomparedtheslopefactors(α)ofelectromotilityandNLCsimultaneouslymeasuredfromthesameOHC,showingthattheαvaluesofthetwoarestatisticallythesame.ThissuggeststhateachprestinmoleculeinthetetramerismechanicallyindependentandequallycontributestoOHCelectromotility.

简介：为多信道的脑电图(EEG)的独立来源分离(ISS)的一个神经网络方法在这份报纸被建议。用小浪的降噪的功能多尺度的分解，高周波的噪音从原版被移开(未加工)EEG。当加权的混合物和重量向量的表示被寻求第四顺序的cumulants的本地极值获得，然后，多信道的EEG被对待(即峭度系数)混合物。在这些进程步以后，加权的混合物被用作神经网络的输入，因此EEG的独立来源能一个一个地被分开。试验性的结果证明我们的方法为多信道的EEG的ISS是有效的。

简介：我们决定了在prostatic演算和更低的尿道之间的关联症状(LUTS)，以及prostatic演算的预先安排的因素。为LUTS在我们的诊所介绍了的1527个病人，802经历了完全的评估，包括transrectalultrasonography，voidedbladder-3标本和国际prostatic症状分数(IPSS)。有prostatic演算的335个病人和没有prostatic演算的467个病人的一个总数分别地被划分成演算和没有演算组。严重LUTS和prostatic演算的预兆的因素用uni/multivariate分析被决定。全面IPSS分数是15.7卤9.2在演算和没有演算组织的9.2和14.1卤，分别地(P=0.013)。最大的流动率是12.1卤6.9和14.2卤8.2mLs?1在演算和没有演算组织，分别地(P=0.003)。在为预言严重LUTS的因素的univariate分析上，在年龄的差别(P=0.042)，prostatic演算(P=0.048)并且前列腺炎(P=0.018)是统计上重要的。在multivariate分析上，然而，没有因素是重要的。在为预先安排的multivariate分析上prostatic演算的因素，在年龄的差别(P<0.001)并且前列腺体积(P=0.001)是重要的。到我们的知识，有prostatic演算的病人抱怨更严重的LUTS。然而，prostatic演算不是严重LUTS的一个独立预兆的因素。因此，不仅因为prostatic演算而且因为年龄和另外的因素，有prostatic演算的人有更严重的LUTS。另外，老年和大前列腺体积是为prostatic演算的独立人士预先安排因素。

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简介：AbstractBackgrounds:Physical activity (PA) and sedentary behavior (SB) have been associated with mortality, while the joint association with mortality is rarely reported among Chinese population. We aimed to examine the independent and joint association of PA and SB with all-cause mortality in southern China.Methods:A cohort of 12,608 China Hypertension Survey participants aged ≥35 years were enrolled in 2013 to 2014, with a followup period of 5.4 years. Baseline self-reported PA and SB were collected via the questionnaire. Kaplan-Meier curves (log-rank test) and Cox proportional hazards regression were performed to evaluate the associations of PA and SB on all-cause mortality.Results:A total of 11,744 eligible participants were included in the analysis. Over an average of 5.4 years of follow-up, 796 deaths occurred. The risk of all-cause mortality was lower among participants with high PA than those with low to moderate level (5.2% vs. 8.9%; hazards ratio [HR]: 0.75, 95% confidence interval [CI]: 0.61-0.87). Participants with SB ≥ 6 h had a higher risk of all-cause mortality than those with SB <6 h (7.8% vs. 6.0%; HR: 1.37, 95% CI: 1.17-1.61). Participants with prolonged SB (≥6 h) and inadequate PA (low to moderate) had a higher risk of all-cause mortality compared to those with SB < 6 h and high PA (11.2% vs. 4.9%; HR: 1.67, 95% CI: 1.35-2.06). Even in the participants with high PA, prolonged SB (≥6 h) was still associated with the higher risk of all-cause mortality compared with SB < 6 h (7.0% vs. 4.9%; HR: 1.33, 95% CI: 1.12-1.56).Conclusions:Among Chinese population, PA and SB have a joint association with the risk of all-cause mortality. Participants with inadequate PA and prolonged SB had the highest risk of all-cause mortality compared with others.

简介：AbstractBackground:The most common etiologies of Cushing's syndrome (CS) are adrenocorticotropic hormone (ACTH)-producing pituitary adenoma (pitCS) and primary adrenal gland disease (adrCS), both of which burden patients with metabolic disturbance. The aim of this study was to compare the metabolic features of pitCS and adrCS patients.Methods:A retrospective review including 114 patients (64 adrCS and 50 pitCS) diagnosed with CS in 2009-2019 was performed. Metabolic factors were then compared between pitCS and adrCS groups.Results:Regarding sex, females suffered both adrCs (92.2%) and pitCS (88.0%) more frequently than males. Regarding age, patients with pitCS were diagnosed at a younger age (35.40 ± 11.94 vs. 39.65 ± 11.37 years, p = 0.056) than those with adrCS, although the difference was not statistically significant. Moreover, pitCS patients had much higher ACTH levels and more serious occurrences of hypercortisolemia at all time points (8 AM, 4 PM, 12 AM) than that in adrCS patients. Conversely, indexes, including body weight, BMI, blood pressure, serum total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides, fasting plasma glucose, and uric acid, showed no differences between adrCS and pitCS patients. Furthermore, diabetes prevalence was higher in pitCS patients than in adrCS patients; however, there were no significant differences in hypertension or dyslipidemia prevalence between the two.Conclusions:Although adrCS and pitCS had different pathogenetic mechanisms, different severities of hypercortisolemia, and different diabetes prevalences, both etiologies had similar metabolic characteristics.

简介：Objective:Thepredictiveandprognosticroleofprognosticnutritionalindex(PNI)ingastriccancerpatientswithperitonealdisseminationremainsunclear.ThisstudyaimstoexploretheroleofthePNIinpredictingoutcomesofgastriccancerpatientswithperitonealdissemination.Methods:Atotalof660patientsdiagnosedwithgastricadenocarcinomawithperitonealmetastasisbetweenJanuary2000andApril2014atSunYat-senUniversityCancerCenterandtheSixthAffiliatedHospitalofSunYatsenUniversitywereretrospectivelyanalyzed.Theclinicopathologiccharacteristicsandclinicaloutcomesofpatientswithperitonealdisseminationwereanalyzed.Results:ComparedwithPNI-highgroup,PNI-lowgroupwascorrelatedwithadvancedage(P=0.036),worseperformancestatus(P<0.001),higherfrequencyofascites(P<0.001)andhigherfrequencyofmultisitedistantmetastasis(P<0.001).Kaplan-MeiersurvivalcurvesshowedthatPNI-highgrouphadasignificantlylongermedianoverallsurvivalthanPNI-lowgroup(13.13vs.9.03months,P<0.001).MultivariatesurvivalanalysisrevealedthatBorrmanntypeIV(P=0.014),presenceofascites(P=0.017)andlowerPNI(P=0.041)wereindependentpoorprognosticfactors,andpalliativesurgery(P<0.001)andfirst-linechemotherapy(P<0.001)weregoodprognosticfactors.Forpatientsreceivingpalliativesurgery,thepostoperativemorbidityratesinthePNI-lowgroupandPNIhighgroupwere9.1%and9.9%,respectively(P=0.797).ThepostoperativemortalityratewasnotsignificantlydifferentbetweenPNI-lowandPNI-highgroups(2.3%vs.0.9%,P=0.362).Conclusions:PNIisausefulandpracticaltoolforevaluatingthenutritionalstatusofgastriccancerpatientswithperitonealdissemination,andisanindependentprognosticfactorforthesepatients.

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简介：贡献体液调停allograft拒绝的分子的小径糟糕被定义。在这研究，我们估计了在调停抗体的allograft拒绝的上下文表明小径的herpesvirus入口mediator/B淋巴细胞和T淋巴细胞衰减器(HVEM/BTLA)的角色。一个试验性的背景被设计阐明HVEM/BTLA相互作用的封锁是否能调制感应的denovo在接枝拒绝的功课期间招待antidonor特定的抗体。测试这个假设，充分allogeneic专业histocompatibility错配建筑群的皮肤接枝被移植到与适应于不同地区生活的动物控制，anti-CD40L或发信号的HVEM/BTLA的调节抗体被对待的接受者老鼠的正确胁腹上小径。CD4的频率T小囊的助手(Tfh)房间(B220，CD4+CXCR5+PD-1high)，extrafollicular助手房间(B220，CD4+CXCR5PD-1+和PD-1)并且幼芽的中心(GC)B房间(B220+Fas+GL7+)被流动cytometry在在接枝拒绝的尖锐阶段期间在白天10柱子移植排干和非排干的淋巴节点分析。适应于不同地区生活的动物特定的体液的有免疫力的反应也是的主人antidonor估计了。而CD40/CD40L小径的封锁在阻止allogeneic是高度有效的体液的有免疫力的反应，HVEM/BTLA-interacting小径的调停抗体的封锁影响了Tfh房间的既不扩大也不GCB房间的扩大。因而，主机antidonor的功课调停抗体的反应通常继续了，没有损害开发的可检测的证据。在摘要，这些数据显示HVEM/BTLA相互作用为denovo主人antidonor的形成是非必需的在移植的适应于不同地区生活的动物特定的抗体。

简介：客观刺猬(HH)的激活小径包括hepatocellular癌(HCC)在人的恶意的发展被含有。然而，在HCC病人的HH激活的临床的影响仍然是不清楚的。这研究被进行证实HH小径部件的表示是否与HCC前进和临床的结果被联系。这研究是的方法一膨胀样品、延长列在后面在上面我们的以前的研究之一。它包括了从2002～2005经历了外科的治疗的46个HCC病人。声音的HH(嘘)的表示，patched-1(PTCH1)，smoothened(SMOH)和在肿瘤和邻近的正常纸巾的基因从病人提取了的联系glioma的oncogene-1(GLI1)被反向的transcriptionpolymerase链反应(RT-PCR)检验探索在这些基因和HCC的临床的预后之间的关系。表示在HCC纸巾嘘，PTCH1，SMOH和GLI1铺平的结果分别地是60.87%，50.00%，32.61%和54.35%。嘘相关的分子的表示层次在癌症织物是相对强烈的，但是不足道与肿瘤的任何clinicopathological因素相关。Transcriptional因素GLI1是在HCC病人之中与差的预后联系的唯一的分子。在肿瘤纸巾的GLI1基因的表示显著地与没有疾病的幸存(DFS)(P=0.042)和全面幸存(OS)(P=0.030)被联系。在肿瘤和邻近的正常的肝纸巾的GLI1的同时的表示与DFS相关(P<0.029)并且OS(P<0.025)。结论HH发信号激活是在人的HCC的发展的一个重要事件。在嘘小径的GLI1的表示可能涉及HCC前进，它可以是HCC的有用预示的指示物。

简介：AIM:ToinvestigatethetryptaseandhistaminereleaseabilityofhumancolonmastcellsuponIgEdependentorindependentactivationandthepotentialmechanisms.METHODS:Enzymaticallydispersedcellsfromhumancolonswerechallengedwithanti-IgEorcalciumionophoreA23187,andthecellsupernatantsafterchallengewerecollected.Bothconcentrationdependentandtimecoursestudieswithanti-IgEorcalciumionophoreA23187wereperformed.TryptasereleasewasdeterminedwithasandwichELISAprocedureandhistaminereleasewasmeasuredusingaglassfibre-basedfiuorometricassay.RESULTS:Bothanti-IgEandcalciumionophorewereabletoinducedosedependentreleaseofhistaminefromcolonmastcellswithuptoapproximately60%and25%nethistaminereleasebeingachievedwith1μg/mLcalciumionophoreand10μg/mLanti-IgE,respectively.Dosedependentreleaseoftryptasewasalsoobservedwithuptoapproximately19ng/mLand21ng/mLreleaseoftryptasebeingachievedwith10μg/mLanti-IgEand1μg/mLcalciumionophore,respectively.Timecoursestudyrevealedthatbothtryptaseandhistaminereleasefromcolonmastcellsstimulatedbyanti-IgEinitiatedwithin10secandreachedtheirmaximumreleaseat6minfollowingchallenge.Pretreatmentofcellswithmetabolicinhibitorsabolishedtheactionsofanti-IgEaswellascalciumionophore.Tryptaseandhistaminerelease,particularlythatinducedbycalciumionophorewasinhibitedbypretreatmentofcellswithpertussistoxin.CONCLUSION:Bothanti-IgEandcalciumionophoreareabletoinducesignificantreleaseoftryptaseandhistaminefromcolonmastcells,indicatingthatthiscelltypeislikelytocontributetothepathogenesisofcolitisandothermastcellassociatedintestinaldiseases.

简介：简明比喻，‘；免疫系统装载了gun'，被用来在能在需求上几乎立即被释放与侵略者作斗争的能分泌的小粒由于他们大量有势力支持inflammatory和抗菌剂调停人的存储描述桅杆房间(MC)的角色。在主人环境定位了边界并且与模式识别受体的一个军火库装备了，MC被注定是渗透endothelial和上皮的表面的病原体的快速的天生的传感器。尽管在抗菌剂和antiparasitic防卫的MC的重要性长被欣赏了，他们在对病毒的感染发出报警的角色仅仅最近被注意了。cytomegalovirus(CMV)上的工作在鼠科的模型的感染在在CMV的天生、适应的有免疫力的监视之间的新奇串音轴作为播放器揭示了MC在MC，它与MCdegranulation和chemokineCCL5的版本被联系的那感染，提高保护的CD8T房间的招募到病毒复制的血管外的地点，明确地到肺interstitium和牙槽的上皮。这里，我们由响应主人感染为MC激活和作为结果的degranulation调查条件阐述了这些研究。令人惊讶地，数据揭示了MC激活的二个时间地并且机械学地不同的波浪：取决于TLR3/TRIF发信号并且由没包含TLR3/TRIF发信号的MC的直接感染推迟了激活的几乎立刻的间接激活。产出有选择地从MC发源的表示eGFP记者病毒的房间类型特定的Cre再结合识别了是的MC一在vivo新，生产鼠科的CMV感染的第一点击的目标房间。

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简介：AIM:Toevaluatetheepidemiologyandoutcomesofculture-positivespontaneousbacterialperitonitis(SBP)andspontaneousbacteremia(SB)indecompensatedcirrhosis.METHODS:Weprospectivelycollectedclinical,laboratorycharacteristics,typeofadministeredantibiotic,susceptibilityandresistanceofbacteriatoantibioticsinonehundredthirtycases(68.5%males)withpositiveasciticfluidand/orbloodculturesduringtheperiodfromJanuary1,2012toMay30,2014.AllpatientswithSBPhadpolymorphonuclearcellcountinasciticfluid>250/mm3.InpatientswithSBathoroughstudydidnotrevealanyothercauseofbacteremia.Thepatientswerefollowed-upfora30-dperiodfollowingdiagnosisoftheinfection.Thefinaloutcomeofthepatientswasrecordedintheendoffollow-upandcomparisonamong3groupsofpatientsaccordingtothepatternofdrugresistancewasperformed.RESULTS:Gram-positive-cocci(GPC)werefoundinhalfofthecases.ThemostprevalentorganismsinadescendingorderwereEscherichiacoli(33),Enterococcusspp(30),Streptococcusspp(25),Klebsiellapneumonia(16),S.aureus(8),Pseudomanasaeruginosa(5),otherGram-negative-bacteria(GNB)(11)andanaerobes(2).Overall,20.8%ofisolatesweremultidrug-resistant(MDR)and10%extensivelydrugresistant(XDR).Health-care-associated(HCA)and/ornosocomialinfectionswerepresentin100%ofMDR/XDRandin65.5%ofnon-DRcases.MeropenemwastheempiricallyprescribedantibioticinHCA/nosocomialinfectionsshowingadrug-resistancerateof30.7%whilethirdgenerationcephalosporinsof43.8%.MeropenemwasineffectiveonbothXDRbacteriaandEnterococcusfaecium(E.faecium).AllbutoneXDRweresusceptibletocolistinwhileallGPC(includingE.faecium)andthe86%ofGNBtotigecycline.Overall30-dmortalitywas37.7%(69.2%forXDRand34.2%fortherestofthepatients)(logrank,P=0.015).Inmultivariateanalysis,factorsadverselyaffectingoutcomeincludedXDRinfection(HR=2.263,95%CI:1.005-5.095,P=0.049),creatinine(HR

简介：Objective:Multiplemechanismsunderlyingthedevelopmentofportalveintumorthrombus(PVTT)inhepatocellularcarcinoma(HCC)havebeenreportedrecently.However,theoriginsofPVTTremainunknown.Increasingmulti-omicsdataonPVTTsinHCCshavemadeitpossibletoinvestigatewhetherPVTTsoriginatefromthecorrespondingprimarytumors(Ts).Methods:TheclonalrelationshipbetweenPVTTsandtheircorrespondingprimaryTswasinvestigatedusingdatasetsdepositedinpublicdatabases.OneDNAcopynumbervariationsdatasetandthreegeneexpressiondatasetsweredownloadedfortheanalyses.ClonalityanalysiswasperformedtoinvestigatetheclonalrelationshipbetweenPVTTsandTsfromanindividualpatient.DifferentialgeneexpressionanalysiswasappliedtoinvestigatethegeneexpressionprofilesofPVTTsandTs.Results:Oneoutof19PVTTshadnoclonalrelationshipwithitscorrespondingT,whereastheothersdid.ThePVTTswithindependentclonaloriginshoweddifferentgeneexpressionandenrichmentinbiologicalprocessesfromtheprimaryTs.Basedontheuniquegeneexpressionprofiles,agenesignatureincluding24geneswasusedtoidentifypairsofPVTTsandprimaryTswithoutanyclonalrelationship.ValidationinthreedatasetsshowedthatthesetypesofpairsofPVTTsandTscanbeidentifiedbythe24-genesignature.Conclusions:OurfindingsshowadirectevidenceforPVTToriginandconsolidatetheheterogeneityofPVTTsobservedinclinic.TheresultssuggestthatPVTTinvestigationatamolecularlevelisclinicallynecessaryfordiagnosisandtreatment.

简介：TostudythemechanismofinfectionofEpstein-Barrvirus(EBV)ingastriccarcinomacells,theAkataandP3HR-1strainsofEBVwereusedastheteststrainsofviruses,andthesignetringcelllineHSC-39ofgastriccarcinomacellswasusedasthetargetcellsofinfection.Thevirus-infectedcellcloneswereisolatedbylimiteddilutionmethod.ItwasfoundthattheEBV-encodedsmallRNA(EBER)couldbedetectedintheinfectedcells.TheAkataandP3HR-1EBVinfectedparentalcellsandmostofclonesexpressedEBNA1,butnotEBNA2.Latentmembraneprotein(LMP-1)andLMP-2,andtheQpromoter(p),butnottheCp/WpforEBNAgenetranscriptionwasactiveintheinfectedparentalcellsaswellasalltheclones.UninfectedHSC-39cellsdidnotexpressCD21,however,AkatabutnotP3HR-1EBV-infectedclonesex-pressedlowlevelofCD21mRNA.TheseresultsdemonstratethatHSC-39cellsaresusceptibletobothEBVstrainsandEBVinfectsHSC-39cellsthroughtheCD21-independentpathway.ThisstudydefinesasignetringtypeofgastriccarcinomacellslineasauniquetargetcellsforthestudyofEBVinfectionmechanism.

简介：Event-relatedpotentials(ERP)isanimportanttypeofbraindynamicsinhumancognitionresearch.However,ERPisoftensubmergedbythespontaneousbrainactivityEEG,foritsrelativelytinyscale.Furthermore,thebrainactivitiescollectedfromscalpelectrodesareofteninevitablycontaminatedbyseveralkindsofartifacts,suchasblinks,eyemovements,musclenoiseandpowerlineinterference.Anewapproachtocorrectthesedisturbancesispresentedusingindependentcomponentanalysis(ICA).ThistechniquecaneffectivelydetectandextractERPcomponentsfromthemeasuredelectrodesrecordingseveniftheyareheavilycontaminated.Theresultscomparefavorablytothoseobtainedbyparametricmodeling.Besides,auto--adaptiveprojectionofdecomposedresultstoERPcomponentswasalsogiven.Throughexperiments,ICAprovestobehighlycapableofERPextractionandS/Nratioimproving.

简介：AbstractObjective:This study aimed to determine: (1) whether recurrent deliveries of a small for gestational age (SGA) neonate are associated with increased obstetrical or neonatal complications; (2) whether the risk factors that can predict small for gestational age (SGA) recurrence.Methods:This study was based on Soroka Medical Center' s Obstetrics electronic database. The database consisted of 109 022 women who had 320 932 deliveries between the year 1988-2014.The study cohort included 6.8% (7 368/109 022) of these patients who gave birth to a singleton SGA neonate on their first delivery and had more than one delivery. The study population was divided into two groups according to the outcome of the subsequent delivery: (1) women with sporadic SGA who delivered a non-SGA neonate (n= 5 416); (2) women with recurrent SGA (n = 1 952). SGA defined as birthweight <10th percentile. Maternal and neonatal complications were compared between the two groups. Logistic regression was used to determine independent risk factors for SGA recurrence.Results:The prevalence of birthweight <5th percentile was higher among the recurrent SGA group in the first delivery (P < 0.001). Bedouin ethnicity was more prevalent in the recurrent SGA group (P < 0.001). The rate of preterm delivery was higher in the first delivery of the recurrent SGA group (P = 0.015). The sporadic SGA group had a higher rate of perinatal mortality during the first pregnancy (P= 0.017). The rate of severe hypertension (P= 0.005), polyhydramnios, meconium-stained amniotic fluid, nonreassuring fetal heart rate and total perinatal mortality (P < 0.001) were higher in the second delivery of the recurrent SGA group. In a logistic regression model, preterm delivery and birthweight <5th percentile at the first delivery was found to be independent risk factors for recurrence of an SGA neonate in the subsequent birth (relative risks:1.530, confidence interval: 1.249-1.875; relative risks:1.826, confidence interval: 1.641-2.030, respectively).Conclusion:Women with recurrent SGA neonates have specific clinical characteristics. Among women who deliver an SGA neonate, preterm delivery, and birthweight <5th percentile are independent predictors for its recurrence.

简介：AbstractBackground:Acute heart failure (AHF) is the most common disease in emergency departments (EDs). However, clinical data exploring the outcomes of patients presenting AHF in EDs are limited, especially the long-term outcomes. The purposes of this study were to describe the long-term outcomes of patients with AHF in the EDs and further analyze their prognostic factors.Methods:This prospective, multicenter, cohort study consecutively enrolled 3335 patients with AHF who were admitted to EDs of 14 hospitals from Beijing between January 1, 2011 and September 23, 2012. Kaplan-Meier and Cox regression analysis were adopted to evaluate 5-year outcomes and associated predictors.Results:The 5-year mortality and cardiovascular death rates were 55.4% and 49.6%, respectively. The median overall survival was 34 months. Independent predictors of 5-year mortality were patient age (hazard ratio [HR]: 1.027, 95 confidence interval [CI]: 1.023-1.030), body mass index (BMI) (HR: 0.971, 95% CI: 0.958-0.983), fatigue (HR: 1.127, 95% CI: 1.009-1.258), ascites (HR: 1.190, 95% CI: 1.057-1.340), hepatic jugular reflux (HR: 1.339, 95% CI: 1.140-1.572), New York Heart Association (NYHA) class III to IV (HR: 1.511, 95% CI: 1.291-1.769), heart rate (HR: 1.003, 95% CI: 1.001-1.005), diastolic blood pressure (DBP) (HR: 0.996, 95% CI: 0.993-0.999), blood urea nitrogen (BUN) (HR: 1.014, 95% CI: 1.008-1.020), B-type natriuretic peptide (BNP)/N-terminal pro-B-type natriuretic peptide (NT-proBNP) level in the third (HR: 1.426, 95% CI: 1.220-1.668) or fourth quartile (HR: 1.437, 95% CI: 1.223-1.690), serum sodium (HR: 0.980, 95% CI: 0.972-0.988), serum albumin (HR: 0.981, 95% CI: 0.971-0.992), ischemic heart diseases (HR: 1.195, 95% CI: 1.073-1.331), primary cardiomyopathy (HR: 1.382, 95% CI: 1.183-1.614), diabetes (HR: 1.118, 95% CI: 1.010-1.237), stroke (HR: 1.252, 95% CI: 1.121-1.397), and the use of diuretics (HR: 0.714, 95% CI: 0.626-0.814), β-blockers (HR: 0.673, 95% CI: 0.588-0.769), angiotensin-converting enzyme inhibitors (ACEIs) (HR: 0.714, 95% CI: 0.604-0.845), angiotensin-II receptor blockers (ARBs) (HR: 0.790, 95% CI: 0.646-0.965), spironolactone (HR: 0.814, 95% CI: 0.663-0.999), calcium antagonists (HR: 0.624, 95% CI: 0.531-0.733), nitrates (HR: 0.715, 95% CI: 0.631-0.811), and digoxin (HR: 0.579, 95% CI: 0.465-0.721).Conclusions:The results of our study demonstrate poor 5-year outcomes of patients presenting to EDs with AHF. Age, BMI, fatigue, ascites, hepatic jugular reflux, NYHA class III to IV, heart rate, DBP, BUN, BNP/NT-proBNP level in the third or fourth quartile, serum sodium, serum albumin, ischemic heart diseases, primary cardiomyopathy, diabetes, stroke, and the use of diuretics, β-blockers, ACEIs, ARBs, spironolactone, calcium antagonists, nitrates, and digoxin were independently associated with 5-year all-cause mortality.