Epidemiology and demographic patterns of cardiovascular diseases and neoplasms deaths in Western Europe: a 1990-2019 analysis

OBJECTIVES

Cardiovascular diseases (CVDs) and neoplasms have been considered as public health concerns worldwide. This study aimed to estimate the epidemiological patterns of death burden on CVDs and neoplasms and its attributable risk factors in Western Europe from 1990 to 2019 to discuss the potential causes of the disparities.

STUDY DESIGN AND METHODS

We collected data on CVDs and neoplasms deaths in 24 Western European countries from the Global Burden of Disease Study. We analyzed patterns by age, sex, country, and associated risk factors. The results include percentages of total deaths, age-standardized death rates per 100,000 population, and uncertainty intervals (UIs). Time trends were assessed using annual percent change.

RESULTS

In 2019, CVDs and neoplasms accounted for 33.54% and 30.15% of Western Europe's total deaths, with age-standardized death rates of 128.05 (95% UI: 135.37, 113.02) and 137.51 (95% UI: 142.54, 128.01) per 100,000. Over 1990-2019, CVDs rates decreased by 54.97%, and neoplasms rates decreased by 19.54%. Top CVDs subtypes were ischemic heart disease and stroke; top cancers for neoplasms were lung and colorectal. Highest CVD death burdens were in Finland, Greece, Austria; neoplasm burdens in Monaco, San Marino, Andorra. The major risk factors were metabolic (CVDs) and behavioral (neoplasms). Gender differences revealed higher CVDs death burden in males, while neoplasms burden varied by risk factors and age groups.

CONCLUSION

In 2019, CVDs and neoplasms posed significant health risks in Western Europe, with variations in death burdens and risk factors across genders, age groups, and countries. Future interventions should target vulnerable groups to lessen the impact of CVDs and neoplasms in the region.

[Staged and segmented two hybrid surgeries for total repair of Debakey type Ⅰ aortic dissection: a series of 10 cases]

Objective: To examine the efficacy and experience of staged and segmented two hybrid surgeries for total repair of Debakey type Ⅰ aortic dissection (TIAD). Methods: This study was a retrospective case series. The clinic data of 10 patients with acute TIAD who were admitted to the Department of Cardiac Surgery, Second Hospital of Lanzhou University or the First People's Hospital of Lanzhou, between January 2016 and August 2022, were retrospectively studied. Ten patients underwent hybrid surgeries in two hospitalizations (stages), including 7 males and 3 females with an age of (60±7) years (range: 49 to 71 years). In stage 1, the first type Ⅱ hybrid arch repair was performed to treat the ascending, total arch, and descending thoracic aorta for acute TIAD without circulatory arrest. In stage 2, the second hybrid surgery including infrarenal abdominal aorta replacement, visceral arteries bypass and endovascular thoracoabdominal aortic repair was performed to treat residual thoracoabdominal aortic dissection after the first hybrid operation (segmented). Basic data, preoperative concomitant diseases, high-risk factors, surgical approaches and postoperative complications of all important organs, as well as CT imaging were analyzed. Results: There was no death in the 20 hybrid surgical procedures. In stage 1 type Ⅱ hybrid surgery, 4 cases underwent reconstruction of the aortic sinutubular junction, while Bentall and David surgery was performed for 3 cases, respectively. A patient received coronary artery bypass grafting. Then all patients were sequentially treated with arch debranching and thoracic aortic endovascular repair. Postoperative complications included renal insufficiency (4/10), hemofiltration (1/10), hypoxemia (4/10), neurologic event (1/10) and type Ⅱ endoleak (1/10). Complete false lumen thrombosis occurred in 9/10 of the patients. All complications recovered successfully at discharge and the average hospital stay was (21±4) days (range: 16 to 28 days) in the first hospitalization. At stage 2, the second hybrid surgery was successfully performed in all patients. No paraplegia, hepatic or renal insufficiency, or endoleak occurred. However, branch graft embolism of the left renal artery was found in one patient 3 days after laparotomy, as well as of superior mesenteric artery in another. Superior mesenteric artery occlusion was successfully treated by endovascular recanalization. Complete false lumen thrombosis occurred in all patients. Although all patients had different degrees of intestinal dysfunction, they were gradually relieved at discharge, and the average hospital stay was (19±2)days (range:16 to 21 days) in the second hospitalization. During follow-up, CT angiography showed aortic remodeling in all patients. Conclusion: Staged and segmented two hybrid surgeries are safe and feasible for total repair of Debakey type Ⅰ aortic dissection and are associated with acceptable early and midterm outcomes.

Study of association between corneal shape parameters and axial length elongation during orthokeratology using image-pro plus software

BACKGROUND

The aim was to validate the correlation between corneal shape parameters and axial length growth (ALG) during orthokeratology using Image-Pro Plus (IPP) 6.0 software.

METHODS

This retrospective study used medical records of myopic children aged 8-13 years (n = 104) undergoing orthokeratology. Their corneal topography and axial length were measured at baseline and subsequent follow-ups after lens wear. Corneal shape parameters, including the treatment zone (TZ) area, TZ diameter, TZ fractal dimension, TZ radius ratio, eccentric distance, pupil area, and pupillary peripheral steepened zone(PSZ) area, were measured using IPP software. The impact of corneal shape parameters at 3 months post-orthokeratology visit on 1.5-year ALG was evaluated using multivariate linear regression analysis.

RESULTS

ALG exhibited significant associations with age, TZ area, TZ diameter, TZ fractal dimension, and eccentric distance on univariate linear regression analysis. Multivariate regression analysis identified age, TZ area, and eccentric distance as significantly correlated with ALG (all P < 0.01), with eccentric distance showing the strongest correlation (β = -0.370). The regressive equation was y = 1.870 - 0.235a + 0.276b - 0.370c, where y represents ALG, a represents age, b represents TZ area, and c represents eccentric distance; R2 = 0.27). No significant relationships were observed between the TZ radius ratio, pupillary PSZ area, and ALG.

CONCLUSIONS

IPP software proves effective in capturing precise corneal shape parameters after orthokeratology. Eccentric distance, rather than age or the TZ area, significantly influences ALG retardation.

UiO-66/AgNPs Coating for Dental Implants in Preventing Bacterial Infections

Titanium (Ti)-based biomaterials lack inherent antimicrobial activities, and the dental plaque formed on the implant surface is one of the main risk factors for implant infections. Construction of an antibacterial surface can effectively prevent implant infections and enhance implant success. Silver nanoparticles (AgNPs) exhibit broad antibacterial activity and a low tendency to induce drug resistance, but AgNPs easily self-aggregate in the aqueous environment, which significantly impairs their antibacterial activity. In this study, UiO-66/AgNP (U/A) nanocomposite was prepared, where zirconium metal-organic frameworks (UiO-66) were employed as the confinement matrix to control the particle size and prevent aggregation of AgNPs. The bactericidal activity of U/A against methicillin-resistant Staphylococcus aureus and Escherichia coli increased nearly 75.51 and 484.50 times compared with individually synthesized Ag. The antibacterial mechanism can be attributed to the enhanced membrane rupture caused by the ultrafine AgNPs on UiO-66, leading to protein leakage and generation of intracellular reactive oxygen species. Then, U/A was loaded onto Ti substrates (Ti-U/A) by using self-assembly deposition methods to construct an antibacterial surface coating. Ti-U/A exhibited excellent antibacterial activities and desired biocompatibility both in vitro and in vivo. The U/A nanocomposite coating technique is thus expected to be used as a promising surface modification strategy for Ti-based dental implants for preventing dental implant infections.

Fibrinogen/albumin ratio and carotid artery plaques in coronary heart disease patients with different glucose metabolic states: a RCSCD-TCM study

AIM

The relationship between fibrinogen/albumin ratio (FAR) and carotid artery plaques (CAPs) was investigated in patients with coronary heart disease (CHD).

METHODS

A total of 11,624 patients with CHD were enrolled and divided into quartiles based on the FAR (Q1: FAR index ≤ 0.0663; Q2: 0.0664 ≤ FAR index ≤ 0.0790; Q3: 0.0791 ≤ FAR index ≤ 0.0944; Q4: FAR index > 0.0944). Patients were classified into three groups according to their blood glucose levels: normal glucose regulation (NGR), prediabetes mellitus (pre-DM), and diabetes mellitus (DM) groups. Carotid ultrasonography was performed to detect CAPs. The relationship between FAR and CAPs was evaluated using logistic and subgroup analyses.

RESULTS

Among 11,624 participants, 8738 (75.14%) had CAPs. Compared with Q1, the odds ratio (OR) of Q4 in patients with CHD was 2.00 (95% confidence interval [CI]: 1.71-2.34) after multivariate adjustment. Taking Q1 as a reference, a higher OR was observed in Q4 of FAR for CAPs in men [OR: 2.26; 95% CI: 1.73-2.95] in the multi-adjusted models. Moreover, multivariate adjustment indicated that the highest OR was observed in patients with CHD and DM (OR: 2.36; 95% CI: 1.80-3.10).

CONCLUSIONS

A significant association between FAR and CAPs was observed in patients with CHD, regardless of sex or blood glucose levels. Therefore, FAR may be used as an effective indicator to identify patients at a high risk of CAPs among patients with CHD.

Study of High-Transverse-Momentum Higgs Boson Production in Association with a Vector Boson in the qqbb Final State with the ATLAS Detector

This Letter presents the first study of Higgs boson production in association with a vector boson (V=W or Z) in the fully hadronic qqbb final state using data recorded by the ATLAS detector at the LHC in proton-proton collisions at sqrt[s]=13  TeV and corresponding to an integrated luminosity of 137  fb^{-1}. The vector bosons and Higgs bosons are each reconstructed as large-radius jets and tagged using jet substructure techniques. Dedicated tagging algorithms exploiting b-tagging properties are used to identify jets consistent with Higgs bosons decaying into bb[over ¯]. Dominant backgrounds from multijet production are determined directly from the data, and a likelihood fit to the jet mass distribution of Higgs boson candidates is used to extract the number of signal events. The VH production cross section is measured inclusively and differentially in several ranges of Higgs boson transverse momentum: 250-450, 450-650, and greater than 650 GeV. The inclusive signal yield relative to the standard model expectation is observed to be μ=1.4_{-0.9}^{+1.0} and the corresponding cross section is 3.1±1.3(stat)_{-1.4}^{+1.8}(syst)  pb.

Measurement of the Centrality Dependence of the Dijet Yield in p+Pb Collisions at sqrt[s_{NN}]=8.16 TeV with the ATLAS Detector

ATLAS measured the centrality dependence of the dijet yield using 165  nb^{-1} of p+Pb data collected at sqrt[s_{NN}]=8.16  TeV in 2016. The event centrality, which reflects the p+Pb impact parameter, is characterized by the total transverse energy registered in the Pb-going side of the forward calorimeter. The central-to-peripheral ratio of the scaled dijet yields, R_{CP}, is evaluated, and the results are presented as a function of variables that reflect the kinematics of the initial hard parton scattering process. The R_{CP} shows a scaling with the Bjorken x of the parton originating from the proton, x_{p}, while no such trend is observed as a function of x_{Pb}. This analysis provides unique input to understanding the role of small proton spatial configurations in p+Pb collisions by covering parton momentum fractions from the valence region down to x_{p}∼10^{-3} and x_{Pb}∼4×10^{-4}.

Relationship Between Serum Uric Acid and Carotid Plaque in Patients With Coronary Artery Disease by Sex and Blood Pressure Status

The purpose of this study was to explore the sex difference and effects of blood pressure (BP) on the relationship between serum uric acid (SUA) and carotid plaque in patients with coronary heart disease (CHD). This large multicenter retrospective study included 12099 patients with CHD (aged 35-75 years) between January 1, 2014 and September 30, 2020. Patients were divided into three groups according to systolic BP (SBP) and diastolic BP (DBP), and the SUA levels in males and females were converted into three groups. Logistic regression was used to analyze the influence of sex and BP on the relationship between SUA levels and carotid plaque in patients with CHD. In the model of male BP subgroups, using the BP of group A (normal with SBP <120 mmHg and DBP <80 mmHg) as a reference, SUA levels were significantly correlated with the occurrence of carotid plaque under different BP states (P < .001). In contrast, in the model of female BP subgroups, most of these correlations were not statistically significant. Our study showed that SUA levels were significantly associated with carotid plaque occurrence in males with CHD, which remained significant across different BP states.

Age effect on the shared etiology of glycemic traits and serum lipids: evidence from a Chinese twin study

PURPOSE

Diabetes and dyslipidemia are among the most common chronic diseases with increasing global disease burdens, and they frequently occur together. The study aimed to investigate differences in the heritability of glycemic traits and serum lipid indicators and differences in overlapping genetic and environmental influences between them across age groups.

METHODS

This study included 1189 twin pairs from the Chinese National Twin Registry and divided them into three groups: aged ≤ 40, 41-50, and > 50 years old. Univariate and bivariate structural equation models (SEMs) were conducted on glycemic indicators and serum lipid indicators, including blood glucose (GLU), glycated hemoglobin A1c (HbA1c), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), in the total sample and three age groups.

RESULTS

All phenotypes showed moderate to high heritability (0.37-0.64). The heritability of HbA1c demonstrated a downward trend with age (HbA1c: 0.50-0.79), while others remained relatively stable (GLU: 0.55-0.62, TC: 0.58-0.66, TG: 0.50-0.63, LDL-C: 0.24-0.58, HDL-C: 0.31-0.57). The bivariate SEMs demonstrated that GLU and HbA1c were correlated with each serum lipid indicator (0.10-0.17), except HDL-C. Except for HbA1c and LDL-C, as well as HbA1c and HDL-C, differences in genetic correlations underlying glycemic traits and serum lipids between age groups were observed, with the youngest group showing a significantly higher genetic correlation than the oldest group.

CONCLUSION

Across the whole adulthood, genetic influences were consistently important for GLU, TC, TG, LDL-C and HDL-C, and age may affect the shared genetic influences between glycemic traits and serum lipids. Further studies are needed to elucidate the role of age in the interactions of genes related to glycemic traits and serum lipids.

[Introduction to carcinogenesis of nickel compounds in ILO criteria for Diagnosis and Exposure Standard for Occupational Diseases]

International Agency for Research on Cancer (IARC) classifies nickel compounds as Class Ⅰ carcinogens. International Labour Organization (ILO) also lists nickel compounds as carcinogenic factors of occupational cancer. At present, China is revising the Classification and Catalogue of Occupational Diseases, and cancer caused by nickel compounds may also be included in the statutory occupational diseases. The Diagnostic and Exposure Standards for Occupational Diseases published by ILO in 2022 discussed the pathogenic characteristics, occupational exposure, main health effects, diagnostic criteria and key preventive measures of nickel compounds in detail. This article mainly introduces its contents, in order to provid a basis for the formulation of relevant standards in China.

Association of thyroid hormone sensitivity index with stroke in patients with coronary artery disease

BACKGROUND AND AIMS

Thyroid hormones (THs) will affect the occurrence and prognosis of stroke, and the research on THs sensitivity index and stroke in patients with coronary heart disease (CHD) is scarce. The goal of this study is to look into the relationship between central and peripheral THs sensitivity index and stroke in patients with CHD.

METHODS

Between January 1, 2014, and September 30, 2020, 30,160 patients with CHD were enrolled in this study. By computing the thyroid feedback quantile index (TFQI), thyroid stimulating hormone index (TSHI), and thyrotropin thyroxine resistance index (TT4RI), the central sensitivity indexes to THs was assessed, and the ratio of serum free triiodothyronine (FT3) to serum free thyroxine (FT4) was used to assess peripheral THs sensitivity. The relationship between central and peripheral THs sensitivity index and stroke was investigated using logistic regression, especially in different types of stroke, ages, sexes, and blood glucose levels.

RESULTS

Stroke risk is positive associated with TSHI, TFQI, and PTFQI. In subgroup analysis, the OR values of these relationships are higher in people younger than 65 years old, male, and diagnosed with diabetes. In addition, stroke risk was negatively associated with FT3/FT4, and the OR values of these relationships were lower in people older than 65 years, female, and diagnosed with prediabetes.

CONCLUSIONS

This study demonstrates that the increase in the central THs sensitivity index and the decrease in the peripheral THs sensitivity index are associated with a higher risk of stroke in CHD patients, and provides new ideas for the assessment of stroke in patients with CHD.

Association Between Anemia Status and the Risk of Different Types of Heart Failure: A RCSCD-TCM Study in China

We investigated the association between anemia status and the risk of heart failure (HF) in patients with coronary heart disease (CHD) based on a multi-center, large-sample and retrospective cross-sectional study including 89,207 patients. Heart failure was categorized as HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), and HF with mid-range ejection fraction (HFmrEF). In multi-adjusted models, compared with patients without anemia, mild anemia (odds ratio [OR] 1.71; 95% confidence interval [CI] 1.53-1.91; P < .001), moderate anemia (OR 3.68; 95% CI, 3.25-4.17; P < .001), and severe anemia (OR 8.02; 95% CI, 6.50-9.88; P < .001) were associated with the risk of HF among CHD patients. Men aged <65 years were more likely to develop HF. In subgroup analyses, the multi-adjusted ORs and 95% CI of HFpEF, HFrEF, and HFmrEF related to anemia were 3.24 (95% CI 1.43-7.33), 2.22 (95% CI 1.28-3.84), and 2.55 (95% CI 2.24-2.89), respectively. These findings suggest that anemia might be associated with increased risk of different types of HF, especially HFpEF.

[Tracking evaluation on the implementation of Survey of oncomelanid snails (WS/T 563-2017) in Sichuan and Anhui provinces]

To evaluate the implementation of Survey of oncomelanid snails (WS/T 563-2017) in schistosomiasis-endemic foci, two schistosomiasis-endemic counties were selected from two provinces of Sichuan and Anhui. Professional staff working in province-, city-, county- and township-level disease control and prevention institutions, parasitic disease control institutions or medical institutions were recruited, and the understanding, use and implementation of Survey of oncomelanid snails (WS/T 563-2017) were investigated using questionnaires and interviews. The awareness, use, proportion of propagation and implementation and correct rate of answering questions pertaining to Survey of oncomelanid snails (WS/T 563-2017) were analyzed. A total of 270 questionnaires were allocated, and 269 were recovered, including 254 valid questionnaires. The overall awareness of Survey of oncomelanid snails (WS/T 563-2017) was 84.64% (215/254), and propagation and implementation of Survey of oncomelanid snails (WS/T 563-2017) was not performed in 23.28% (17/73) of the survey institutions following implementation of Survey of oncomelanid snails (WS/T 563-2017), with meeting training and allocation of propagation materials as the main type of propagation and implementation. Among 254 respondents, 77.16% (196/254) were familiar with the standard, 66.14% (168/254) understood the conditions for use of the standard during snail surveys, and 96.85% (246/254) had the approach for identifying snails. In addition, there were 41.73% (106/254), 50.78% (129/254) and 7.48% (19/254) of respondents that considered the operability of Survey of oncomelanid snails (WS/T 563-2017) was very good, good and general, respectively. The findings demonstrate that the issue and implementation of Survey of oncomelanid snails (WS/T 563-2017) has filled the gap for the standardization of snail control techniques, and which plays an importang guiding role in the national schistosomiasis control program.

Impaired sensitivity to thyroid hormones is associated with different grades of hypertension: A multicenter cross-sectional study

BACKGROUND AND AIM

Accumulating evidence suggests a potential link between thyroid function with hypertension. However, the research results are limited, and there is no research to explore the relationship between central and peripheral thyroid hormones (THs) sensitivity and different grades of hypertension in patients with coronary heart disease (CHD). This study aims to prove the complex interaction between thyroid system and blood pressure, and provides new ideas for the assessment of hypertension in patients with CHD.

METHODS AND RESULTS

Calculate parameters representing central and peripheral sensitivity to THs. Logistic regression analysis was used to analyze the relationship between central and peripheral THs sensitivity of CHD patients and different grades of hypertension, especially in different ages, sexes, blood glucose levels, smoking, and drinking statuses. Among the 34,310 participants, 19,610 (57.16 %) were diagnosed with hypertension. The risk of hypertension and TSHI (OR: 0.88; 95 % CI: 0.87-0.90; P < 0.001), TT4RI (OR: 0.998; 95 % CI: 0.998-0.999; P < 0.001), TFQI (OR: 0.63; 95 % CI: 0.60-0.67; P < 0.001), PTFQI (OR: 0.63; 95 % CI: 0.59-0.67; P < 0.001) was negatively associated. The risk of hypertension was positively associated with FT3/FT4 (OR: 1.20; 95 % CI: 1.17-1.22; P < 0.001). After stratified analysis, these associations remained significant at different ages, sexes, blood glucose levels, grades of hypertension, smoking, and drinking statuses (P < 0.001).

CONCLUSIONS

This study shows that the decrease in central THs sensitivity index and the increase in peripheral THs sensitivity index are associated with a higher risk of hypertension in CHD patients.

Combined Measurement of the Higgs Boson Mass from the H→γγ and H→ZZ^{*}→4ℓ Decay Channels with the ATLAS Detector Using sqrt[s]=7, 8, and 13 TeV pp Collision Data

A measurement of the mass of the Higgs boson combining the H→ZZ^{*}→4ℓ and H→γγ decay channels is presented. The result is based on 140  fb^{-1} of proton-proton collision data collected by the ATLAS detector during LHC run 2 at a center-of-mass energy of 13 TeV combined with the run 1 ATLAS mass measurement, performed at center-of-mass energies of 7 and 8 TeV, yielding a Higgs boson mass of 125.11±0.09(stat)±0.06(syst)=125.11±0.11  GeV. This corresponds to a 0.09% precision achieved on this fundamental parameter of the Standard Model of particle physics.

[Progress and application of liver organoids in the study of liver cancer]

The incidence rate of liver cancer has been rising in recent years. Traditional cell line culture and human patient-derived tumor xenograft models, which are commonly used tools to simulate the occurrence of human liver cancer, have deepened the understanding of tumor occurrence, development, and drug resistance mechanisms. However, they cannot reflect the accurate state of cancer cells, the tumor microenvironment, or spatial structural characteristics. Recently, more in vitro-produced physiological liver organoids have been applied in the study of liver cancer. Liver organoid models have made breakthroughs in the occurrence and development mechanisms of liver cancer, personalized drug screening and biomarker identification, immunotherapy, and regenerative medicine applications. This paper mainly summarizes the progress and application of liver organoids processed in the study of liver cancer.

Danlou Recipe promotes cholesterol efflux in macrophages RAW264.7 and reverses cholesterol transport in mice with hyperlipidemia induced by P407

INTRODUCTION

Liver X Receptor (LXR) agonists could attenuate the development of atherosclerosis but bring excess lipid accumulation in the liver. Danlou Recipe was believed to be a benefit for improving the lipid profile. Thus, it is unclear whether Danlou Recipe could attenuate hyperlipidemia without excess lipid accumulated in the liver of mice. This study aimed to clarify if Danlou Recipe could alleviate the progression of hyperlipidemia in mice without extra lipids accumulated in the liver.

METHODS

Male murine macrophage RAW264.7 cells and murine peritoneal macrophages were used for the in vitro experiments. Cellular cholesterol efflux was determined using the fluorescent cholesterol labeling method. Those genes involved in lipid metabolism were evaluated by qRT-PCR and western blotting respectively. In vivo, a mouse model of hyperlipidemia induced by P407 was used to figure out the effect of Danlou Recipe on reverse cholesterol transport (RCT) and hyperlipidemia. Ethanol extract of Danlou tablet (EEDL) was prepared by extracting the whole powder of Danlou Prescription from ethanol, and the chemical composition was analyzed by ultra-performance liquid chromatography (UPLC).

RESULTS

EEDL inhibits the formation of RAW264.7 macrophage-derived foam cells, and promotes ABCA1/apoA1 conducted cholesterol efflux in RAW264.7 macrophages and mouse peritoneal macrophages. In the P407-induced hyperlipidemia mouse model, oral administration of EEDL can promote RCT in vivo and improve fatty liver induced by a high-fat diet. Consistent with the findings in vitro, EEDL promotes RCT by upregulating the LXR activities.

CONCLUSION

Our results demonstrate that EEDL has the potential for targeting RCT/LXR in the treatment of lipid metabolism disorders to be developed as a safe and effective therapy.

Temporal trends in sleep pattern among Chinese adults between 2010 and 2018: findings from five consecutive nationally representative surveys

OBJECTIVES

This study aimed to comprehensively analyze the time trends in average sleep duration and prevalence of short sleep, poor sleep quality, and high sleep debt among Chinese adults.

STUDY DESIGN

This was a cross-sectional study.

METHODS

The study used nationally representative data from Chinese Family Panel Survey (CFPS) among adults aged ≥18 years. Linear regression and logistic regression were used to calculate P-values for trends across waves, and absolute difference in prevalences were calculated by linear regression. Poisson regression analysis was used to calculate the prevalence ratios of sleep-related problems.

RESULTS

In 2018, the estimated average sleep duration in adults was 7.6 h/d. A shorter sleep duration, higher proportion of short sleep, and poor sleep quality were observed in people aged ≥65 years, women, people with primary school education or below, and residents in Liaoning province. The average sleep duration slightly decreased from 8.2 h/d in 2010 to 7.6 h/d in 2016, and then remained stable from 2016 to 2018. The prevalence of short sleep duration has markedly increased from 11.8% in 2010 to 24.1% in 2016, and then there was a decline in prevalence from 2016 to 2018, although this decrease was not significant. The prevalence of high sleep debt among employed people increased from 6.2% in 2010 to 8.6% in 2018 (absolute difference, 2.4 p.p; P trend = 0.063). In addition, the prevalence of poor sleep quality increased from 15.6% in 2012 to 21.3% in 2018 (absolute difference of 5.7 p.p; P trend<0.001). For all the sleep-related variables, the degree of changes varied by sociodemographic subgroups.

CONCLUSIONS

In this nationally representative survey of the Chinese population, the average sleep duration slightly decreased from 2010 to 2016, and then remained stable from 2016 to 2018. Poor sleep quality, and high sleep debt increased among most of the sociodemographic subgroups. Future studies are needed to understand the drivers of changes in sleep health among Chinese adults.

Fibrinogen-to-Albumin Ratio and Glucose Metabolic States in Patients With Coronary Heart Disease

This study investigated the relationship between fibrinogen-to-albumin ratio (FAR) and glucose metabolic state in patients with coronary heart disease (CHD). A total of 52,062 patients were enrolled in this study. Patients were classified according to FAR tertiles (T1: FAR < 0.0073; T2: 0.0073 ≤ FAR ≤ 0.0886; T3: FAR ≥ 0.0887). Patients were also classified into the normal glucose regulation (NGR) and elevated blood glucose (EBG) groups. The relationship between FAR and EBG was analyzed using logistic regression, and the association was evaluated according to sex and age. Among the participants, 32,471 (62.4%) had EBG, which was positively associated with FAR (odds ratio [OR], 1.19; 95% confidence interval [CI] 1.15-1.23). The OR of the FAR for EBG in males was higher than that in females (1.25; 95% CI 1.18-1.33 vs 1.15; 95% CI 1.10-1.20). Moreover, the OR of FAR for EBG was greater in patients aged 60 or younger (OR: 1.25; 95% CI 1.18-1.33) than in the elderly patients (over 60 years of age) (OR: 1.15; 95% CI 1.10-1.20). The results indicated a significant relationship between FAR and EBG and this association was higher in males and middle-aged patients.

Relationship between the circulating N-terminal pro B-type natriuretic peptide and the risk of carotid artery plaque in different glucose metabolic states in patients with coronary heart disease: a CSCD-TCM plus study in China

OBJECTIVE

Circulating N-terminal pro B-type natriuretic peptide (NT-proBNP) is a marker for heart failure in patients with coronary heart disease (CHD) and associated with glycemic abnormalities. Studies on the association and diagnostic value of NT-proBNP in carotid plaques (CAP) in patients with CHD are limited.

METHODS

The relationships between NT-proBNP and the risk of CAP in different glucose metabolic states, sexes, and age categories were also examined using 5,093 patients diagnosed with CHD. The NT-proBNP tertiles were used to divide patients into three groups in which the NT-proBNP levels, blood glucose levels, the occurrence of CAP, and the number and nature of CAP were measured using normoglycemic (NG), prediabetes (Pre-DM), and diabetes mellitus (DM) glucose metabolic statuses. Logistic regression analyses were used to compare the relationship between NT-proBNP and the risk of CAP occurrence and the number and nature of CAP. The diagnostic value of NT-proBNP for CAP risk was measured using receiver operating characteristic (ROC) curves.

RESULTS

We found a 37% relative increase in the correlation between changes in NT-proBNP per standard deviation (SD) and the incidence of CAP. After adjusting for potential confounders, NT-proBNP at the T3 level was found to be associated with an increased CAP odds ratio (OR) when T1 was used as the reference. This relationship was also present in males, patients aged > 60 years, or both pre-DM and DM states. NT-proBNP was more likely to present as hypoechoic plaques at T1 and as mixed plaques at T3. We also measured the diagnostic accuracy of CAP for NT-proBNP in patients with CHD, with an AUC value of 0.627(95% CI 0.592-0.631), sensitivity of 50.7%, and specificity of 68.0%.

CONCLUSION

An increase in NT-proBNP was significantly associated with the risk of CAP in patients with CHD, especially in males and patients aged > 60 years, and exhibited specific characteristics under different glucose metabolism states. Trial registration The study was approved by the Ethics Committee of Tianjin University of Traditional Chinese Medicine (Approval number TJUTCM-EC20210007) and certified by the Chinese Clinical Trials Registry on April 4, 2022 (Registration number ChiCTR2200058296) and March 25, 2022 by ClinicalTrials.gov (registration number NCT05309343).

An evolutionary epigenetic clock in plants

Molecular clocks are the basis for dating the divergence between lineages over macroevolutionary timescales (~105 to 108 years). However, classical DNA-based clocks tick too slowly to inform us about the recent past. Here, we demonstrate that stochastic DNA methylation changes at a subset of cytosines in plant genomes display a clocklike behavior. This "epimutation clock" is orders of magnitude faster than DNA-based clocks and enables phylogenetic explorations on a scale of years to centuries. We show experimentally that epimutation clocks recapitulate known topologies and branching times of intraspecies phylogenetic trees in the self-fertilizing plant Arabidopsis thaliana and the clonal seagrass Zostera marina, which represent two major modes of plant reproduction. This discovery will open new possibilities for high-resolution temporal studies of plant biodiversity.

[Progress of researches on Blastocystis hominis infection among patients with inflammatory bowel disease and irritable bowel syndrome]

Blastocystis is a common unicellular intestinal protozoa in humans and animals, and the most common clinical manifestations of infections include abdominal pain and diarrhea. Based on the sequence of the small-subunit ribosomal RNA (SSU rRNA) gene, 28 subtypes of B. hominis (ST1 to ST17, ST21 and ST23 to ST32) have been characterized. Previous studies have demonstrated that B. hominis infection is strongly associated with inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and other intestinal diseases, which threatens the health and quality of life among patients with B. hominis infection and is considered as an important public health problem. This review summarizes the progress of researches on B. hominis infection among IBD and IBS patients during the past 20 years, so as to provide insights into management of blastocystosis in China.

Associations Between Atherosclerosis and Elevated Serum Alkaline Phosphatase in Patients With Coronary Artery Disease in an Inflammatory State

BACKGROUND AND AIM

Serum alkaline phosphatase (ALP) has been shown to be associated with cardiovascular disease (CVD) risk. Inflammation is the initiator of atherosclerosis, throughout the life of atherosclerosis. This study investigated the relationship between serum ALP and atherosclerosis in patients with coronary artery disease (CAD) in an inflammatory state.

METHODS

This was a multicentre retrospective study including 22,989 patients with CAD. Serum alkaline phosphatase was converted into the quartiles. C-reactive protein (CRP) was assayed as a marker of systemic inflammation. The atherosclerosis index (AI) was used to assess the degree of atherosclerosis. Binary logistic regression was used to analyse the relationship between ALP and AI. Stratified analysis was performed according to sex and age.

RESULTS

Elevated serum ALP was associated with the risk of atherosclerosis in patients with CAD, and after quartiling ALP, the OR for Q4 was 1.17 (95% CI 1.08-1.26; p<0.001) when using Q1 as reference. The odds ratio (OR) for ALP and risk of atherosclerosis was higher in patients aged ≤60 years (OR 1.33, 95% CI 1.15-1.53; p<0.001) than in patients aged >60 years (OR 1.11, 95% CI 1.01-1.23; p<0.05), and higher in males (OR 1.21, 95% CI 1.09-1.35; p<0.001) than in females (OR 1.16, 95% CI 1.03-1.31; p<0.05). Q4 (ALP >83.00 U/L) was significantly associated with increased risk of atherosclerosis in the inflammatory state (OR 1.48, 95% CI 1.18-1.86; p<0.001), and it remained after stratified analysis according to sex and age.

CONCLUSIONS

The risk of atherosclerosis tended to increase with increasing ALP levels and the correlation between ALP and the degree of atherosclerosis was significantly stronger when ALP was >83.00 U/L. This relationship was more pronounced in inflammatory states, and there were sex and age differences.

REGISTRATION

URL: https://www.

CLINICALTRIALS

gov; Unique identifier: NCT04026724.

The Association Between Hemoglobin Glycation Index and Carotid Artery Plaque in Patients With Coronary Heart Disease

This study aimed to examine the association between the hemoglobin glycation index (HGI) and carotid artery plaque (CAP) in patients with coronary heart disease (CHD). We conducted a cross-sectional analysis of 10,778 patients with CHD. The participants were divided into three groups by HGI tertiles (T1 HGI<-0.44, T2 -0.44 ≤ HGI ≤ 0.15, T3 HGI>0.15). The presence of CAP was used to diagnose by carotid ultrasonography. Logistic regression analysis was used to analyze the association between the HGI and CAP. The association between HGI and CAP was also assessed according to sex, age, smoking status, and drinking status. We further assessed the association between HGI and the ultrasound characteristics of CAP. The baseline analysis showed substantial differences in relevant parameters between the three groups of patients with CHD according to the tertiles of the HGI. Multivariate logistic regression analysis showed that HGI was significantly associated with CAP (odds ratio [OR] 1.32; 95% confidence interval [CI] 1.26-1.39). The association between HGI and CAP exists among different sex, age, smoking, and drinking status. Furthermore, there was a significant and positive association between HGI and all four different echogenicities of the CAP.

Associations Between GGT/ALT Ratio and Carotid Plaque in Inpatients With Coronary Artery Disease: A RCSCD-TCM Study

This study investigated the relationship between gamma-glutamyltransferase/alanine aminotransferase (GGT/ALT) ratio and carotid plaques in patients with coronary artery disease (CAD). This multicenter retrospective study included 8,255 patients with CAD who were divided according to GGT/ALT quartiles: Q1 (GGT/ALT ≤ 1.00), Q2 (1.00 < GGT/ALT ≤ 1.41), Q3 (1.41 < GGT/ALT ≤ 2.05), and Q4 (GGT/ALT > 2.05). Logistic regression was used to analyze the relationship between GGT/ALT, carotid plaques, and carotid plaque echogenicity. GGT/ALT ratio (odds ratio [OR]: 1.16; 95% confidence interval [CI]: 1.11-1.21; P < .001) was significantly associated with carotid plaque risk. The degree of relevance was higher in men (OR: 1.71; 95% CI: 1.35-2.15; P < .001) than in women (OR: 1.56; 95% CI: 1.28-1.91; P < .001). The ORs value of carotid plaque risk was higher in middle-aged patients (OR: 2.23; 95% CI: 1.78-2.80; P < .001) than in older patients (OR: 1.77; 95% CI: 1.44-2.18; P < .001). The GGT/ALT ratio was significantly associated with different carotid plaque echogenicity, and the highest OR values were for isoechoic plaques (OR: 1.18; 95% CI: 1.12-1.24; P < .001). These findings suggest that the GGT/ALT ratio might be associated with a high risk of developing carotid plaques and different types of plaque echoes and was more significantly associated with isoechoic plaques.

Seismic evidence for global basalt accumulation in the mantle transition zone

The mantle's compositional structure reflects the thermochemical evolution of Earth. Yet, even the radial average composition of the mantle remains debated. Here, we analyze a global dataset of shear and compressional waves reflecting off the 410- and 660-km discontinuities that is 10 times larger than any previous studies. Our array analysis retrieves globally averaged amplitude-distance trends in SS and PP precursor reflectivity from which we infer relative wavespeed and density contrasts and associated mantle composition. Our results are best matched by a basalt-enriched mantle transition zone, with higher basalt fractions near 660 (~40%) than 410 (~18-31%). These are consistent with mantle-convection/plate-recycling simulations, which predict that basaltic crust accumulates in the mantle transition zone, with basalt fractions peaking near the 660. Basalt segregation in the mantle transition zone also implies that the overall mantle is more silica enriched than the often-assumed pyrolitic mantle reference composition.

Association between the atherogenic index of plasma and carotid artery plaques in patients with coronary heart disease in different glucose metabolism states: an RCSCD-TCM study in Tianjin, China

BACKGROUND

The atherogenic index of plasma (AIP) is considered a powerful biomarker of dyslipidemia and atherosclerosis (AS). However, limited evidence is available regarding the relationship between the AIP and carotid artery plaques (CAPs) in patients with coronary heart disease (CHD).

METHODS

This retrospective study included 9281 patients with CHD who underwent carotid ultrasound. Participants were divided according to the AIP tertiles: T1, AIP < 1.02; T2, 1.02 ≤ AIP < 1.25; and T3, AIP ≥ 1.25. The presence or absence of CAPs was assessed using carotid ultrasound. Logistic regression was used to analyze the relationship between the AIP and CAPs in patients with CHD. The relationship between the AIP and CAPs was assessed according to sex, age, and glucose metabolic status.

RESULTS

The baseline characteristics revealed significant differences in related parameters among patients with CHD after stratification into the three groups according to the AIP tertiles. Compared with T1, the odds ratio (OR) of T3 in patients with CHD was 1.53 (95% confidence interval [CI]:1.35-1.74). The association between AIP and CAPs was higher in females (OR: 1.63; 95% CI: 1.38-1.92) than in males (OR: 1.38; 95% CI: 1.12-1.70). The OR for patients aged ≤60 years (OR: 1.40; 95% CI: 1.14-1.71) was lower than that for patients aged >60 years (OR: 1.49; 95% CI: 1.26-1.76). AIP was significantly associated with the risk of CAPs formation in different glucose metabolic states, with diabetes having the highest OR value (OR: 1.31; 95% CI: 1.19-1.43).

CONCLUSION

The AIP and CAPs were significantly associated in patients with CHD, and the association was higher in female than in male patients. The association was lower in patients aged ≤60 years than in patients aged >60 years. Under different glucose metabolism statuses, the association between the AIP and the CAPs among patients with CHD was highest in patients with diabetes.

Effect of Dan-Lou tablets on coronary heart disease revealed by microarray analysis integrated with molecular mechanism studies

Dan-Lou tablets (DLT) effectively treat coronary heart disease (CHD). However, its pharmacological mechanism in CHD treatment requires further investigation. This study aimed to elucidate the underlying pharmacological mechanisms of DLT in the treatment of CHD through clinical trials, microarray research, bioinformatics analysis, and molecular mechanism research. In this study, DLT improved coagulation function, endothelial injury, and levels of lipids, metalloproteases, adhesion molecules, inflammatory mediators, and homocysteine. The results of molecular biology research demonstrated that DLT can increase the gene and protein expressions of meningioma expressed antigen 5 (MGEA5) and mouse doubleminute 2 (MDM2) and inhibited the gene and protein expressions of signal transcription and transcription activator 5 B (STAT5B), tropomyosin-1 (TPM1), and aromatic hydrocarbon receptor nuclear transpose (ARNT). The results indicate that DLT reduced the extent of vascular endothelial damage in CHD rats by reducing the expressions of STAT5B, TPM1, and MDM2; inhibiting the inflammatory reaction; and increasing the expressions of ARNT and MGEA5.

[Lysosomal membrane protein Sidt2 knockout induces apoptosis of human hepatocytes in vitro independent of the autophagy-lysosomal pathway]

OBJECTIVE

To explore the regulatory mechanism of human hepatocyte apoptosis induced by lysosomal membrane protein Sidt2 knockout.

METHODS

The Sidt2 knockout (Sidt2^-/-) cell model was constructed in human hepatocyte HL7702 cells using Crispr-Cas9 technology.The protein levels of Sidt2 and key autophagy proteins LC3-II/I and P62 in the cell model were detected using Western blotting, and the formation of autophagosomes was observed with MDC staining.EdU incorporation assay and flow cytometry were performed to observe the effect of Sidt2 knockout on cell proliferation and apoptosis.The effect of chloroquine at the saturating concentration on autophagic flux, proliferation and apoptosis of Sidt2 knockout cells were observed.

RESULTS

Sidt2^-/- HL7702 cells were successfully constructed.Sidt2 knockout significantly inhibited the proliferation and increased apoptosis of the cells, causing also increased protein expressions of LC3-II/I and P62(P < 0.05) and increased number of autophagosomes.Autophagy of the cells reached a saturated state following treatment with 50 μmol/L chloroquine, and at this concentration, chloroquine significantly increased the expressions of LC3B and P62 in Sidt2^-/- HL7702 cells.

CONCLUSION

Sidt2 gene knockout causes dysregulation of the autophagy pathway and induces apoptosis of HL7702 cells, and the latter effect is not mediated by inhibiting the autophagy-lysosomal pathway.

An evolutionary epigenetic clock in plants

Molecular clocks are the basis for dating the divergence between lineages over macro-evolutionary timescales (~10 5 -10 8 years). However, classical DNA-based clocks tick too slowly to inform us about the recent past. Here, we demonstrate that stochastic DNA methylation changes at a subset of cytosines in plant genomes possess a clock-like behavior. This 'epimutation-clock' is orders of magnitude faster than DNA-based clocks and enables phylogenetic explorations on a scale of years to centuries. We show experimentally that epimutation-clocks recapitulate known topologies and branching times of intra-species phylogenetic trees in the selfing plant A. thaliana and the clonal seagrass Z. marina , which represent two major modes of plant reproduction. This discovery will open new possibilities for high-resolution temporal studies of plant biodiversity.

Chronological and Replicative Aging of CD51+/PDGFR-α+ Pulp Stromal Cells

As a crucial source of mesenchymal stromal cells, CD51⁺/PDGFR-α⁺ human dental pulp stromal cells (hDPSCs) are promising seeding cells for regenerative medicine. Cellular senescence hinders the translational application of hDPSCs. However, it remains unclear whether chronological and replicative senescence results in distinct outcomes for hDPSCs. To investigate the influence of senescence on DPSCs, we used transgenic lineage tracking, immunofluorescence, flow cytometry, and various molecular experiments to depict the dynamic pattern of hDPSCs in mice and humans during chronological and replicative senescence. The data demonstrated that CD51⁺/PDGFR-α⁺ cells were decreased in chronological senescence. Impaired self-renewal and higher ossificatory differentiation were observed in chronologically senescent hDPSCs. Regarding replicative senescence, a decreased CD51⁺ but upregulated PDGFR-α⁺ population was observed in culture. Furthermore, weakened self-renewal and osteogenic differentiation were observed in replicatively senescent hDPSCs. In summary, CD51⁺/PDGFR-α⁺ hDPSCs decrease in chronologically aged pulp, with self-renewal that is impaired without impaired osteogenic differentiation. However, replicative senescence has a different impact: self-renewal and ossific differentiation are impaired and CD51 expression is reduced, but PDGFR-α expression remains. These findings demonstrate the different outcomes of chronological and replicative senescence in CD51⁺/PDGFR-α⁺ hDPSCs. Furthermore, we revealed that impaired self-renewal is the core dysfunction for both types of cellular aging and that osteogenic differentiation capability differs between them. This study provides insights into the influence of chronological and replicative senescence on the characteristics and capabilities of hDPSCs. These advances provide fundamental knowledge to alleviate cellular aging of CD51⁺/PDGFR-α⁺ hDPSCs and promote their translational applications.

Analysis of the reports of low-concentration atropine in controlling myopia in children

PURPOSE

To evaluate the efficacy of 0.01% atropine to slow the progression of myopia in children.

METHODS

We searched PubMed, Embase, ClinicalTrials.gov, CNKI, Cqvip and Wan fang databases from inception to January 2022, including RCTs (randomized controlled trials) and non-RCTs (non-randomized controlled trials). The search strategy was 'myopia' OR 'refractive error' and 'atropine.' Two researchers independently reviewed the articles, and stata12.0 was used for meta-analysis. The Jadad score was used to assess the quality of RCT, and the Newcastle-Ottawa scale was used for non-RCTs.

RESULTS

Five RCTs and two non-RCTs (1 prospective non-randomized controlled study, 1 retrospective cohort study) were identified (including 1000 eyes). Results of the meta-analysis showed statistical heterogeneity among the 7 included studies (P=0. 026, I2 =47.1%). According to different durations of atropine use - 4 months, 6 months and greater than 8 months, subgroup analysis results showed that the axial elongation of all experimental groups relative to control groups were respectively -0.03mm (95% [CI], (confidence interval), -0.07 to 0.01), -0.07mm (95% [CI], -0.10 to -0.05), -0.09mm (95% [CI], -0.12 to -0.06). Each P was greater than 0.05, which indicated that there is little heterogeneity among the subgroups.

CONCLUSIONS

In this meta-analysis of the short-term efficacy of atropine in myopia patients, it was found that there was little heterogeneity when grouped by usage time. It is suggested that the use of atropine in the treatment of myopia is not only related to its concentration but also related to the duration of use.

Association between sensitivity to thyroid hormones and dyslipidemia in patients with coronary heart disease

BACKGROUND

Thyroid hormones affect lipid metabolism via central and peripheral regulation. However, there have been few studies on the association between thyroid hormone sensitivity and dyslipidemia. We aimed to investigate the association between thyroid hormone sensitivity and dyslipidemia in patients with coronary heart disease (CHD).

METHODS

A total of 31,678 patients with CHD were included in this large multicenter retrospective study. Central thyroid hormone sensitivity was evaluated using the thyroid feedback quantile-based index (TFQI), parametric thyroid feedback quantile-based index (PTFQI), thyroid-stimulating hormone index (TSHI), and thyrotropin thyroxine resistance index (TT4RI); peripheral thyroid hormone sensitivity was assessed by the ratio of free triiodothyronine (FT3)/free thyroxine (FT4). Logistic regression analysis was used to analyze the association between thyroid hormone sensitivity and dyslipidemia.

RESULTS

Among 31,678 participants, 21,648 (68.34%) had dyslipidemia. In the multi-adjusted models, the risk of dyslipidemia was positively correlated with TFQI (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.03-1.05), PTFQI (OR: 1.09; 95% CI: 1.06-1.12), TSHI (OR: 1.08; 95% CI: 1.06-1.11), and TT4RI (OR: 1.08; 95% CI: 1.05-1.11). Conversely, the risk of dyslipidemia was negatively correlated with FT3/FT4 (OR: 0.94; 95% CI: 0.92-0.97). In stratified analyses, the association between thyroid hormone sensitivity and dyslipidemia was statistically significant for different sexes, glucose levels, and blood pressure states.

CONCLUSION

There is a significant association between sensitivity to thyroid hormones and dyslipidemia, regardless of sex, glucose level, or blood pressure. Graphical abstract.

[Microvascular perfusion and cardiac function after revascularization assessed by myocardial contrast echocardiography in patients with acute ST-segment elevation myocardial infarction]

Objectives: To evaluate microvascular perfusion and left ventricular function in patients with acute ST-segment elevation myocardial infarction after revascularization using myocardial contrast echocardiography (MCE), and to explore clinical influencing factors of abnormal microvascular perfusion in these patients. Methods: This is a cross-sectional study. The analysis was performed among patients admitted to Peking University People's Hospital for acute ST-segment elevation myocardial infarction (STEMI) from June 2018 to July 2021. All patients underwent percutaneous coronary intervention (PCI) and completed MCE within 48 hours after PCI. Patients were divided into normal myocardial perfusion group and abnormal perfusion group according to the myocardial perfusion score. The echocardiographic indexes within 48 hours after PCI, including peak mitral valve flow velocity (E), mean value of early diastolic velocity of left ventricular septum and lateral mitral annulus (Em), left ventricular global longitudinal strain (GLS) and so on, were analyzed and compared between the two groups. Multivariate logistic regression analysis was used to evaluate the influencing factors of myocardial perfusion abnormalities. Results: A total of 123 STEMI patients, aged 59±13 years with 93 (75.6%) males, were enrolled. There were 50 cases in the normal myocardial perfusion group, and 73 cases in the abnormal myocardial perfusion group. The incidence of abnormal myocardial perfusion was 59.3% (73/123). The left ventricular volume index ((62.3±18.4)ml/m² vs. (55.1±15.2)ml/m², P=0.018), wall motion score index (WMSI) (1.59 (1.44, 2.00) vs. 1.24(1.00, 1.47), P<0.001) and mitral E/Em (17.8(12.0, 24.3) vs. 12.2(9.2, 15.7), P<0.001) were significantly higher whereas left ventricular global longitudinal strain (GLS) ((-10.8±3.4)% vs. (-13.8±3.5)%, P<0.001) was significantly lower in the abnormal myocardial perfusion group than those in the normal myocardial perfusion group. Multivariate logistic regression analysis showed that left anterior descending (LAD) as culprit vessel (OR=3.733, 95%CI 1.282-10.873, P=0.016), intraoperative no/low-reflow (OR=6.125, 95%CI 1.299-28.872, P=0.022), and peak troponin I (TnI) (OR=1.018, 95%CI 1.008-1.029, P=0.001) were independent risk factors of abnormal myocardial perfusion. As for ultrasonic indexes, deceleration time of mitral E wave (OR=0.979, 95%CI 0.965-0.993, P=0.003), mitral E/Em (OR=1.100, 95%CI 1.014-1.194, P=0.022) and WMSI (OR=7.470, 95%CI 2.630-21.222, P<0.001) were independently related to abnormal myocardial perfusion. Conclusions: The incidence of abnormal myocardial perfusion after PCI is high in patients with acute STEMI. Abnormal myocardial perfusion is related to worse left ventricular systolic and diastolic function. LAD as culprit vessel, intraoperative no/low-reflow and peak TnI are independent risk factors of abnormal myocardial perfusion.

Relationship between red cell distribution width/albumin ratio and carotid plaque in different glucose metabolic states in patients with coronary heart disease: a RCSCD-TCM study in China

BACKGROUND

Red cell distribution width/albumin ratio (RAR) is thought to be associated with the prognosis of a variety of diseases, including diabetes and heart failure. To date, no studies have focused on the relationship between RAR and carotid plaque in patients with coronary heart disease (CHD).

METHODS

A total of 10,267 patients with CHD were divided according to RAR quartiles (Q1: RAR ≤ 2.960; Q2: 2.960 < RAR ≤ 3.185; Q3: 3.185 < RAR < 3.441; Q4: RAR ≥ 3.441). Logistic regression was used to analyze the relationship between RAR and carotid plaques in CHD patients. The relationship between RAR and carotid plaques in according to sex, age and glucose regulation state groups were also assessed.

RESULTS

Among the 10,267 participants, 75.43% had carotid plaques. After adjusting for confounding factors, RAR was found to be associated with carotid plaque formation (OR: 1.23; 95% CI 1.08-1.39). The risk of carotid plaque formation in the Q4 group was 1.24 times higher than that in the Q1 group. After multivariate adjustment, RAR was associated with the risk of carotid plaque in female (OR: 1.29; 95% CI 1.09-1.52). And the relationship between RAR and carotid plaques in patients younger than 60 years old (OR: 1.43; 95% CI 1.16-1.75) was stronger than that in those older than 60 years old (OR: 1.29; 95% CI 1.10-1.51). Under different glucose metabolism states, RAR had the highest correlation with the risk of carotid plaques in diabetes patients (OR: 1.28; 95% CI 1.04-1.58).

CONCLUSIONS

RAR was significantly related to carotid plaques in patients with CHD. In addition, the correlation between RAR and the incidence of carotid plaque in patients with CHD was higher in women and middle-aged and elderly patients. In patients with CHD and diabetes, the correlation between RAR and carotid plaque was higher.

Association between sensitivity to thyroid hormones and risk of arrhythmia in patients with coronary heart disease: a RCSCD-TCM study in China

BACKGROUND

Thyroid dysfunction is closely related to arrhythmia. However, the relationship between sensitivity to thyroid hormone and risk of arrhythmia remains unknown. This study aimed to investigate the association between the thyroid system complex index and risk of arrhythmia in patients with coronary heart disease (CHD).

METHODS

This large, multicenter study included 28,413 patients with CHD. Central sensitivity to thyroid hormone was assessed by calculating the thyroid feedback quantile-based index (TFQI). Logistic regression was used to analyze the relationship between sensitivity to thyroid hormone and risk of arrhythmia. This study also assessed the relationship between sensitivity to thyroid hormone and risk of arrhythmia in different sexes, ages, and glucose regulation and blood lipid states.

RESULTS

Of the 28,413 participants, 8935 (31.4%) patients with CHD had arrhythmia. There was a remarkable association between TFQI and risk of arrhythmia (odds ratio [OR]: 0.783; 95% confidence interval [CI], 0.735-0.836). Furthermore, the association between the TFQI and risk of arrhythmia in women (OR: 0.731; 95% CI: 0.667-0.802) was stronger than that in men (OR: 0.894; 95% CI: 0.816-0.910), as well as higher in elder (OR: 0.779; 95% CI: 0.721-0.843) than middle-aged (OR: 0.789; 95% CI: 0.703-0.886) patients. Furthermore, the association was strong in the state of diabetes (OR: 0.635; 95% 0.569-0.709) and dyslipidemia (OR: 0.706; 95% CI: 0.644-0.774).

CONCLUSION

There is a remarkable association between sensitivity to thyroid hormone and risk of arrhythmia in patients with CHD, which is more pronounced among women and the elderly. The association is also stronger in CHD patients with dyslipidemia or diabetes.

An approach combining bioinformatics and machine learning to identify eight autophagy-related biomarkers and construct molecular mechanisms underlying COVID-19 and major depressive disorders

OBJECTIVE

A lack of objective biomarkers is preventing the screening and diagnosis of COVID-19 combined with major depression disorder (COVID-19-MDD). The purpose of this study was to identify diagnostic biomarkers and gene regulatory mechanisms associated with autophagy; a crucial process significantly involved in the pathogenesis of COVID-19-MDD.

MATERIALS AND METHODS

In this study, differentially expressed genes (DEGs) were screened using GSE98793 from the GEO2R analysis (GEO) database, and intersected with the COVID-19-related gene (CRGs) and autophagy-related genes (ARGs) to obtain common genes involved in. Then, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses of these common genes were performed. Subsequently, the transcription factor (TF)-gene regulatory network and comorbidity network were constructed. In addition, 10 drug candidates were screened using the DSigDB database. To identify diagnostic markers, we used LASSO regression.

RESULTS

In total, 13 common genes were screened, which were primarily enriched in lysosomes, endoplasmic reticulum membranes, and other endomembrane systems also associated with autophagy. Additionally, these genes were involved in neurological cell signaling and have a functional role in pathways related to vascular endothelial growth factor, tyrosine kinase, autophagy, inflammation, immunity, and carcinogenesis. Tumors and psychiatric disorders were the most highly linked diseases to COVID-19. Finally, ten drug candidates and eight diagnostic markers (STX17, NRG1, RRAGD, XPO1, HERC1, HSP90AB1, EPHB2, and S1PR3) were screened.

CONCLUSIONS

This is the first study to screen eight diagnostic markers and construct a gene regulatory network for COVID-19-MDD from the perspective of autophagy. The findings of our study provide novel insights into the diagnosis and treatment of COVID-19-MDD.

Left atrial appendage mechanical dispersion assessed by speckle-tracking echocardiography as a determinant of left atrial appendage stasis in patients with non-valvular atrial fibrillation

Background

We sought to investigate the relationship of left atrial appendage (LAA) mechanical dispersion (MD) with LAA dense spontaneous echo contrast (SEC) or thrombus, and to compare its usefulness in the identification of thrombogenesis with left atrial (LA) MD or LA/LAA strain parameters in patients with nonvalvular atrial fibrillation (AF).

Methods

We conducted a cross-sectional study of 493 consecutive patients with AF (median age 65, male 66.9%) who underwent echocardiography prior to catheter ablation. We measured the LAA and LA global longitudinal strain (GLS) using speckle-tracking echocardiography (STE). LAA MD and LA MD was defined as the standard deviation (SD) of time to peak positive strain corrected by the R-R interval.

Results

Patients with LAA dense SEC/thrombus (n=70) had significantly higher LAA MD than controls (n=423) (median 14.20% vs 9.35%). Areas under the receiver-operating curve for CHA2DS2-VASc score plus LAA MD, LAA GLS or LA GLS were comparable (0.830, 0.843 and 0.809) and superior to that combined with LA MD (0.762, all p&lt;0.01). Multivariable analysis showed that LAA MD was an independent determinant of LAA dense SEC/thrombus in four different models (Odds ratio, 1.23–1.24; P&lt;0.001), and provided additional diagnostic value over clinical and standard echocardiographic parameters. Whereas LA MD was not independently associated with LAA dense SEC/thrombus and had no incremental predictive value.

Conclusion

LAA mechanical dispersion provided incremental information over conventional risk factors in the identification of LAA dense SEC or thrombus in AF patients and is superior to LA mechanical dispersion.

Funding Acknowledgement

Type of funding sources: None.

Cardiac magnetic resonance relaxometry compared to left ventricular ejection fraction in the identification of anthracycline related cardiac changes: a systematic review and meta-analysis

Background

Anthracyclines are associated with cancer therapeutics related cardiac dysfunction (CTRCD). The identification of CTRCD currently uses a change in left ventricular ejection fraction (LVEF). Myocardial damage associated with anthracyclines include myocardial inflammation and oedema. This can be assessed using cardiac magnetic resonance (CMR) relaxometry techniques; T1 and T2 mapping and extracellular volume (ECV) fraction.

Purpose

In this meta-analysis, we compared the magnitude of the changes in LVEF and CMR relaxometry techniques wihtin a month of anthracycline therapy completion.

Methods

We performed a structured literature review as per the PRISMA guidelines across three databases (EMBASE, MEDLINE, and SCOPUS) for studies evaluating CMR relaxometry parameter at baseline and soon after completion of anthracycline therapy (3–5 months post baseline). CMR parameters pre and post anthracycline-based chemotherapy were abstracted. A random effects model was used to pool mean difference (MD) in LVEF and ECV given standardisation in imaging acquisition techniques. A random effects model was used to pool standardized mean difference (SMD) in LVEF, T1, T2 and ECV after anthracycline to adjust for variations in imaging techniques and comparison between techniques.

Results

A total of 174 patients were included from seven studies. 91% were female with a mean age of 55.6 years. The pooled MD in LVEF and ECV was −3.15% [95% CI −4.99, −1.31] and 1.61% [0.90, 2.32], respectively. The pooled SMD in LVEF, T1, T2 and ECV was −0.61 [−0.96, −0.25] 0.34 [0.04, 0.63], 0.67 [0.12,1.21], 0.6 [0.31, 0.89], respectively (Table 1).

Conclusions

T2 mapping, ECV and LVEF can identify early myocardial changes better than T1 mapping. These changes suggest there is marked oedema in the myocardial injury from anthracycline therapy. Whilst these findings support the role of CMR relaxometry in identifying CTRCD, further studies are required.

Funding Acknowledgement

Type of funding sources: None.

Cardioprotection against cardiac dysfunction from breast cancer chemotherapy: a bayesian and frequentist network meta-analysis of randomised controlled trials

Background

Anthracyclines (ANT) are the cornerstone of multiple chemotherapy regimens but at the risk of potential cardiotoxicity. Previous RCTs have tested the prophylactic effects of multiple cardioprotective agents to prevent ANT-related cardiotoxicity. Unfortunately, attempts to combine RCT findings in previous meta-analyses have been heterogeneous, creating further uncertainty. There remains an unmet need to determine the role of cardio-protective agents in breast cancer.

Purpose

To assess the comparative efficacy of cardioprotective drugs in patients with breast cancer using both Bayesian and frequentist analyses of randomised controlled trials

Methods

We performed a systematic review using four databases (CENTRAL, Cochrane Reviews, MEDLINE, SCOPUS), to find RCTs evaluating cardio protective drugs in breast cancer patients without prior ANT exposure. The population included was anthracycline naïve, and trials were excluded if cardio-protective agents were commenced post anthracycline treatment. The primary outcome was a mean change in LVEF pre and post ANT dosing. Results were pooled with both Bayesian and frequentist approaches using random effects models in R statistical software.

Results

We identified 12 RCTs from 2807 search results (n=1126, Age 51 years, ANT dose 412m/m2, baseline LVEF 62.6%) with comparisons including beta-blockers (BB) (n=9), Angiotensin Converting Enzyme inhibitors (ACEi)/Angiotensin Receptor Blockers (ARB) (n=3), combination BB + AA (n=2), spironolactone (n=1) and statins (n=1). All included trials had either intermediate or high risk of bias, with marked heterogeneity in ANT dosing and LVEF monitoring. Overall, our Bayesian network meta-analysis showed no statistically significant difference in mean LVEF preservation between AA (1.3%, 95% credible interval [−0.20, 2.9]), BB (0.77, [−0.21, 1.8]), AABB (0.84 [−1.1, 2.8]), SPR (0.72, [−2.3, 3.7]) or statin (0.60, [−2.4, 3.6]) when compared against placebo. After ranking for efficacy, ACEi/ARBs achieved the most protection against LVEF decline of 1.3% [95% CI: −0.2, 2.9] although still not significant. Conversely, frequentist analysis showed benefit in using AA (Standardised Mean Difference (SMD) 1.32% [0.32, 2.33]) and BB (SMD 0.76% [0.12, 1.4]).

Conclusion

Bayesian analysis demonstrated no difference in LVEF with cardio-protective agents. In contrast, frequentist analysis showed that AA and BB may provide significant cardio-protection. The quality of RCT data to date is limited by a high risk of bias and significant heterogeneity between RCA reporting. Larger trials with clear population definition are required to determine whether any drug class provides benefit in this setting.

Funding Acknowledgement

Type of funding sources: None.

Remnant cholesterol for the detection of glucose metabolic states in patients with coronary heart disease angina pectoris

BACKGROUND

This study aimed to evaluate the relationship between remnant cholesterol (RC) and glucose metabolic states in coronary heart disease (CHD) patients with angina pectoris.

METHODS

This study collected data from 11,557 CHD patients with angina pectoris aged 35-75 years in Tianjin, China. Participants were divided into normal glucose regulation (NGR), prediabetes (Pre-DM) and diabetes mellitus (DM) groups according to glucose metabolic states. Linear regression analysis was used to explore the relationship between glucose metabolism [fasting blood glucose (FBG) and glycated hemoglobin (HbA1c)] and RC levels. Logistic regression was performed to analyze the relationship between RC levels and glucose metabolic states.

RESULTS

Among all participants, 5883 (50.9%) had a DM state and 4034 (34.9%) had a Pre-DM state. FBG levels and HbA1c levels were positively related with RC in all patients (P < 0.001). NGR was used as a reference, multi-adjusted model showing that RC level was significantly associated with Pre-DM [Odds ratio (OR): 1.37; 95% confidence interval (CI) 1.19-1.56; P < 0.001] and DM state (OR:1.47; 95% CI 1.29-1.67; P < 0.001). When considering RC as categorical variables (tertiles), using T1 as a reference, T3 had the strongest relationship between RC levels and Pre-DM and DM state in univariate model and multivariate model. In the stratified analyses, the association between RC levels and pre-DM and DM in women was higher than that in men, and the elderly patients was higher than in the middle-aged patients.

CONCLUSION

The study demonstrated a significant association between RC levels and pre-DM and DM state among CHD patients with angina pectoris, and the relationship was stronger in women and elderly patients.

Relationship Between Monocyte-to-Lymphocyte Ratio as Well as Other Leukocyte-Derived Ratios and Carotid Plaques in Patients with Coronary Heart Disease: A RCSCD-TCM Study

Purpose

This study explored the relationship between monocyte-to-lymphocyte ratio (MLR) as well as other leukocyte-derived ratios and carotid plaques in patients with coronary heart disease (CHD).

Patients and Methods

A total of 12,093 patients with CHD were selected as research participants. Leukocyte-derived ratios assessed in this study included neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), MLR, platelet-to-lymphocyte ratio (PLR), white blood cell-to-mean platelet volume ratio (WMR), lymphocyte×neutrophil/10⁴ ratio (MNM), systemic immune inflammation index (SII), and systemic inflammation response index (SIRI). Leukocyte-derived ratios were divided into four groups according to quarters. Logistic regression analysis was performed to evaluate the relationship between leukocyte-derived ratios and the incidence, number, and echo characteristics of carotid plaques in patients with CHD. Further analysis was performed after adjusting for confounding factors.

Results

Among the 12,093 participants, 71.7% had carotid plaques. After adjusting for confounding factors, MLR, NLR, dNLR, PLR, SII, SIRI, and WMR were found to be associated with carotid plaque formation. Among them, MLR had the strongest association with the incidence of carotid plaques (odd ratio[OR]:1.889; 95% confidence interval[CI]:1.406–2.539) and hyperechoic plaques (OR:2.024; 95% CI:1.481–2.767). When MLR was viewed as a categorical variable, the risk of carotid plaque formation in Q4 was 1.4 times higher than that in Q1. The relationship between MLR and carotid plaques in females (OR:2.250; 95% CI:1.458–3.473) was stronger than that in males (OR: 1.638; 95% CI:1.102–-2.436). The relationship between MLR and carotid plaques in patients younger than 65 years (OR:3.597; 95% CI:2.379–5.439) was stronger than that in those older than 65 years (OR:1.577; 95% CI:1.046–2.378).

Conclusion

Leukocyte-derived ratios were related to the incidence, number, and echo characteristics of carotid plaques. In particular, MLR, an inflammatory biomarker that encompasses innate and adaptive immunity, may be of great value in revealing the incidence and echo characteristics of plaques.

Association of Serum γ-Glutamyltransferase With C-Reactive Protein Levels in Patients With Coronary Heart Disease

Serum γ-glutamyltransferase (GGT) levels have been shown to be associated with C-reactive protein (CRP) levels. Nevertheless, studies on this relationship in coronary heart disease (CHD) populations are limited. This study retrospectively assessed 17 523 patients with CHD undergoing GGT and CRP testing. They were divided into 3 groups according to GGT tertiles. The critical points for high CRP levels was 10.0 mg/L, which corresponded to the 75th percentile. Logistic regression analysis was used to analyze the association between GGT and CRP levels in CHD patients. The baseline analysis showed significant differences in related parameters among patients with CHD. Compared with GGT tertile 1 (T1), the odds ratio (OR) of T3 for GGT in CHD patients was 2.15 (95% confidence interval [CI]: 1.96-2.36). The association between GGT and CRP was higher in males (OR: 2.23; 95% CI: 1.98-2.52) than in females (OR: 2.18; 95% CI: 1.89-2.51). This study showed an association between serum GGT and CRP levels in patients with CHD. GGT may be an inflammatory marker and an additional measure for assessing cardiovascular risk.

P11.75.B Survival benefit of radiotherapy and surgery in patients with lung cancer brain metastases with poor prognosis factors

Background

Radiotherapy and surgery are the standard treatments for lung cancer brain metastases (BMs). However, limitted studies focused on the treatments for patients with lung cancer BMs with poor prognosis factors. The purpose of this study was to investigate the effects of radiotherapy and surgery in patients with lung cancer BMs with poor prognosis factors, providing reference for clinical strategies.

Material and Methods

We analyzed retrospectively 714 patients with lung cancer BMs. A 1:1 propensity score matching (PSM) was performed to balance potential confounders. Analyses of overall survival (OS) and risk factors for OS were assessed by log-rank test and Cox proportional hazard model.

Results

Age ≥65 years, Karnofsky Performance Scale (KPS) score ≤70, anaplastic large-cell lymphoma kinase (ALK)/epidermal growth factor receptor (EGFR) wild type, extracranial metastases, non-surgery and non-radiotherapy led to poor prognosis. Patients were stratified according to these factors. Radiotherapy and surgery showed no survival benefit in patients with aged ≥65 years or pretreatment KPS score ≤70 before and after PSM. Before PSM, whole brain radiotherapy (WBRT) improved the OS and predicted good prognosis in patients with ALK/EGFR wild type or extracranial metastases. WBRT also predicted good prognosis in patients with non-surgery. Stereotactic radiosurgery (SRS) improved the OS and predicted good prognosis in patients with ALK/EGFR wild type or non-surgery. WBRT plus SRS improved the OS and predicted good prognosis in patients with extracranial metastases or non-surgery. WBRT plus SRS also predicted good prognosis in patients with ALK/EGFR wild type. Surgery improved the OS and predicted good prognosis in patients with non-radiotherapy. After PSM, SRS improved the OS and predicted good prognosis in patients with non-surgery. WBRT plus SRS improved the OS and predicted good prognosis in patients with non-surgery or extracranial metastases. WBRT plus SRS also predicted good prognosis in patients with ALK/EGFR wild type. Surgery improved the OS of patients with non-radiotherapy. We defined that the treatment would provide significant survival benefit if it both prolonged the OS and predicted good prognosis. Meanwhile, the results after PSM were more convincing than the results before PSM.

Conclusion

Radiotherapy has significant survival benefit in patients with lung cancer BMs with poor prognosis factors, including patients with ALK/EGFR wild type or extracranial metastases or non-surgery. Surgery only has significant survival benefit in patients with non-radiotherapy.