[Clinical features and surgical treatment of right cardiac system tumors]

A total of 25 patients with right cardiac system tumors in the Department of Cardiac Surgery, Beijing Anzhen Hospital from January 2012 to October 2022 were retrospectively included in the study. The preoperative data, and information of surgical treatment and perioperative management on these patients were analyzed and summarized. One patient developed pulmonary embolism and died before surgery, and the other 24 patients (16 males and 8 females) received surgical treatment, with an average age of (44.7±10.2) years (24-74 years). Nine patients were diagnosed with malignant tumors. Among the 24 patients who received surgical treatment, two patients died during the perioperative period, in-situ tumor recurrence was seen in three patients within about 1 year after surgery (two patients died without surgery, and one patient died 3 months after surgery), two patients had distant metastasis, and 17 patients had a good prognosis. Right cardiac system tumors are rare, with a high malignant rate, and the clinical manifestations vary greatly. Active surgical intervention is found to be effective, and the prognosis is closely related to the pathological type and extent of tumor invasion.

[Advances in warfarin's anticoagulation therapy in Chinese population after mechanical valve replacement]

Warfarin is an irreplaceable oral anticoagulant for patients with mechanical heart valves, the stable pharmacogenetic-based warfarin dose prediction algorithms have improved the effectiveness and safety of warfarin anticoagulation therapy. Genetic factors are the main factors affecting the stable dose of warfarin. Single nucleotide polymorphisms such as VKORC1 and CYP2C9 affect the anticoagulation effect of warfarin through pharmacodynamic or pharmacokinetic pathways. Age, body surface area, combined use of drugs, and other nongenetic factors also affect the stable dose of warfarin. Previously published algorithms for warfarin dose prediction included mainly the white race, and most algorithms were constructed using traditional multiple linear regression. However, domestic studies have used machine learning methods to construct warfarin dose prediction algorithms based on the Chinese Han post-mechanical valve replacement population and have achieved better prediction efficiency. This article reviews the advances of warfarin anticoagulation influencing factors and the clinical application of stable dose prediction algorithms.

Coronary Sinus Metabolite 12,13-diHOME Is a Novel Biomarker for Left Atrial Remodeling in Patients With Atrial Fibrillation

BACKGROUND

12,13-dihydroxy-9Z-octadecenoic acid (12,13-diHOME) has shown potential in protecting against heart disease, but its relationship with atrial fibrillation (AF) remains unknown.

METHODS

Coronary sinus (CS) and femoral vein blood samplings were synchronously collected from AF and non-AF subjects (paroxysmal supraventricular tachycardia or idiopathic premature ventricular complexes) who underwent catheter ablation. First, untargeted metabolomic profiling was performed in a discovery cohort (including 12 AF and 12 non-AF subjects) to identify the most promising CS or femoral vein metabolite. Then, the selected metabolite was further measured in a validation cohort (including 119 AF and 103 non-AF subjects) to confirm its relationship with left atrium remodeling and 1-year postablation recurrence of AF. Finally, the biological function of the selected metabolite was validated in a rapid-paced cultured HL-1 atrial cardiomyocytes model.

RESULTS

Metabolomic analysis identified CS 12,13-diHOME as the most pronounced change metabolite correlated with left atrium remodeling in the discovery cohort. In the validation cohort, CS 12,13-diHOME was significantly lower in patients with AF than non-AF controls (84.32±20.13 versus 96.24±23.56 pg/mL; P<0.01), and associated with worse structural, functional, and electrical remodeling of left atrium. Multivariable regression analyses further demonstrated that decreased CS 12,13-diHOME was an independent predictor of 1-year postablation recurrence of AF (odds ratio, 0.754 [95% CI, 0.648-0.920]; P=0.005). Biological function validations showed that 12,13-diHOME treatment significantly protect the cell viability, improved the expression of MHC (myosin heavy chain) and L-type calcium channel α1c, and attenuated mitochondrial damage in the rapid-paced cultured HL-1 cardiomyocytes model.

CONCLUSIONS

CS metabolite 12,13-diHOME is decreased in patients with AF and can serve as a novel biomarker for left atrium remodeling.

Modulation of the microRNA-6089/E2F transcription factor2 axis by querceting: implications for osteoblast viability, proliferation, migration, and osteogenic differentiation in fracture healing

Quercetin is widely distributed in plants as a flavonol compound with multiple biological activities. It has been found that quercetin can regulate bone homeostasis through multiple pathways and targets. This study investigated the role and specific molecular mechanisms of quercetin in regulating osteoblast viability, proliferation, migration and osteogenic differentiation. A mouse model of traumatic fracture was established and then 100 mg/kg quercetin corn oil suspension was gavaged at the same time every day for 28 days. miR-6089 and E2F transcription factor 2 (E2F2) expression levels in mice were measured. Fracture healing in mice was observed. MC3T3-E1 cells were transfected with plasmids targeting miR-6089 and E2F2, and cell viability, proliferation, migration, apoptosis, and osteogenic differentiation were determined. The targeting relationship between miR-6089 and E2F2 was verified. In vivo experiments showed that quercetin significantly increased osteocalcin (OCN) expression (P<0.05) and promoted fracture healing in traumatic fracture (TF) mice. miR-6089 expression was down-regulated (P<0.05) and E2F2 expression was up-regulated (P<0.05) in TF mice. Quercetin promoted miR-6089 expression and inhibited E2F2 expression (both P<0.05). In vitro results showed that quercetin promoted miR-6089 expression and inhibited E2F2 expression in a dose-dependent manner (both P<0.05). Quercetin dose-dependently promoted MC3T3-E1 cell viability, proliferation, migration, and osteogenic differentiation, and inhibited MC3T3-E1 cell apoptosis (all P<0.05). Up-regulating miR-6089 further promoted MC3T3-E1 cell viability, proliferation, migration and osteogenic differentiation, and inhibited MC3T3-E1 cell apoptosis (all P<0.05). miR-6089 targeted and regulated E2F2 expression. Up-regulating E2F2 attenuated the promoting effect of up-regulated miR-6089 on MC3T3-E1 cell viability, proliferation, migration, osteogenic differentiation, and inhibition of apoptosis (all P<0.05). We conclude that quercetin enhances osteoblast viability, proliferation, migration, and osteogenic differentiation by modulating the miR-6089/E2F2 axis, thereby promoting fracture healing.

Electrocardiogram Parameters Associated With the Diagnosis of Pulmonary Hypertension in High-Altitude Tibetan Populations: A Retrospective Single-Centre Study

BACKGROUND

Electrocardiogram (ECG) is a commonly used diagnostic method for pulmonary hypertension (PH) in Tibetan areas, but its sensitivity and specificity are not good enough. This study aimed to investigate the ECG parameters associated with the diagnosis of PH in Tibetan areas.

METHODS

Ninety-four PH patients of Tibetan ethnicity who were treated at the hospital between March 2019 and October 2020, and 52 Tibetan individuals as controls, were included. The ECG parameters were compared between groups. Multivariate logistic analysis was performed to identify the ECG parameters that can be used for the diagnosis of PH. The univariate significances of ECG parameters were included in the multivariate analyses, whereas those exhibiting opposite trends between different PH subtypes were excluded.

RESULTS

Two ECG parameters were significant in multivariate analysis. The final model included S wave amplitude in lead V3 (OR 5.81; 95% CI 2.79-12.11; p<0.001) and a negative T wave in leads V1-V3 (OR 0.05; 95% CI 0.01-0.41; p=0.005). The ROC curve analysis on the final model yielded an AUC of 0.830 (95% CI 0.766-0.894; p<0.001), indicating good diagnostic performance. A nomogram for diagnosis of PH was also established using S wave amplitude in lead V3 and a negative T wave in leads V1-V3.

CONCLUSION

The ECG parameters S wave amplitude in lead V3 and a negative T wave in leads V1-V3 were independent factors associated with the diagnosis of PH in high-altitude Tibetan populations.

Apolipoprotein B is associated with CT-angiographic progression beyond low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol in patients with coronary artery disease

BACKGROUND

Accumulating evidence indicated that apolipoprotein B (apoB) was the principal lipid determinant of coronary artery disease (CAD). Nevertheless, the connection between apoB and angiographic progression of CAD remained undetermined.

METHODS

Five hundred and forty-four CAD patients with twice coronary computed tomography angiography experiences were enrolled. The Gensini scoring system was used to assess angiographic progression. Incident angiographic progression was defined as an annual change rate of the Gensini score of > 1 point. The predictive efficacy of baseline apoB levels for angiographic progression was assessed using a receiver operating characteristic (ROC) curve. For comparative purposes, patients were categorized into three groups according to their baseline apoB tertiles. Furthermore, discordance analyses defined by the median were performed to assess the superiority of apoB over lipoprotein cholesterol in predicting angiographic progression of CAD.

RESULTS

Angiographic progression was observed in 184 patients (33.8%) during a follow-up period of 2.2-year. The area under the ROC curve was 0.565 (0.522-0.607, P = 0.013). The incidence of angiographic progression was elevated with increasing apoB tertile after adjusting for confounding factors [odds ratio (OR) for the medium apoB tertile: 1.92, 95% confidence interval (CI): 1.15-3.19, P = 0.012; OR for the high apoB tertile: 2.05, 95%CI:1.17-3.60, P = 0.013]. Additionally, discordance analyses showed that the higher apoB group had a significantly higher risk of CAD progression in the fully adjusted model (all P < 0.05).

CONCLUSIONS

ApoB could be used as an accurate and comprehensive indicator of angiographic progression in patients with CAD.

[Clinical features and management analysis of 11 cases of laryngocele]

Objective: To summarize clinical features and our experience of the diagnosis and treatment of laryngocele. Methods: Clinical data of 11 laryngocele patients in department of Otorhinolaryngology Head and Neck Surgery of the Second Affiliated Hospital of Shanxi Medical University from January 2012 to December 2021 were retrospectively reviewed, including 9 men and 2 women, aged from 12 to 75 years, with median age of 56 years. Electronic laryngoscope was performed in 10 of all patients, laryngeal CT in 10 and cervical color ultrasound in 5 before operation.All the operations were performed under general anesthesia, and the external cervical approach was used for external and combined laryngocele. The internal laryngocele was resected by low temperature plasma through transoral endoscopy. Patients were followed up regularly after operation to evaluate the effect. Clinical feature, types of lesions, imaging findings, surgical approaches and follow-up results were analyzed through descriptive statistical method. Results: Eleven laryngocele patients were divided into mixed type (n=6), internal type (n=4) and external type (n=1).Nine patients presented with hoarseness or dysphonia, 7 with cervical mass and 1 with airway obstruction. Surgical resections were done through external cervical approach (n=7)or transoral endoscopic approach (n=4). All the operations were successful and no complication occurred. All cases were followed up from 17 to 110 months. No recurrence was encountered. Conclusions: Laryngocele is a rare lesion with atypical clinical presentation. Preoperative imaging including CT scan and electronic laryngoscope is essential to evaluate the location, and extent of the lesion, and to make the surgical plan.Complete surgical excision is required. Surgical resection is the only effective method for the treatment of laryngocele.

[Predictive value of the proportion of hibernating myocardium in total perfusion defect on reverse remodeling in patients with HFrEF underwent coronary artery bypass graft]

Objective: To evaluate the predictive value of the proportion of hibernating myocardium (HM) in total perfusion defect (TPD) on reverse left ventricle remodeling (RR) after coronary artery bypass graft (CABG) in patients with heart failure with reduced ejection fraction (HFrEF) by ^99mTc-methoxyisobutylisonitrile (MIBI) single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) combined with ¹⁸F-flurodeoxyglucose (FDG) gated myocardial imaging positron emission computed tomography (PET). Methods: Inpatients diagnosed with HFrEF at the Cardiac Surgery Center, Anzhen Hospital of Capital Medical University from January 2016 to January 2022 were prospectively recruited. MPI combined with ¹⁸F-FDG gated PET was performed before surgery for viability assessment and the patients received follow-up MPI and ¹⁸F-FDG gated PET at different stages (3-12 months) after surgery. Δ indicated changes (post-pre). Left ventricular end-systolic volume (ESV) reduced at least 10% was defined as RR, patients were divided into reverse remodeling (RR+) group and the non-reverse group (RR-). Binary logistic regression analysis was used to identify predictors of RR. Receiver operating characteristic (ROC) curve analysis was performed and the area under the curve (AUC) was calculated to assess the cut-off value for predicting RR. Additionally, we retrospectively enrolled inpatients with HFrEF at the Cardiac Surgery Center, Anzhen Hospital of Capital Medical University from January 2021 to January 2022 as the validation group, who underwent MPI and ¹⁸F-FDG gated PET before surgery. Echocardiography was performed before CABG and after CABG (3-12 months). In the validation group, the reliability of obtaining the cut-off value for the ROC curve was verified. Results: A total of 28 patients with HFrEF (26 males; age (56.9±8.7) years) were included in the prospective cohort. HM/TPD was significantly higher in the RR+ group than in the RR- group ((51.8%±17.9%) vs. (35.7%±13.9%), P=0.016). Binary logistic regression analysis revealed that HM/TPD was an independent predictor of RR (Odds ratio=1.073, 95% Confidence interval: 1.005-1.145, P=0.035). ROC curve analysis revealed that HM/TPD=38.3% yielded the highest sensitivity, specificity, and accuracy (all 75%) for predicting RR and the AUC was 0.786 (P=0.011). Meanwhile, a total of 100 patients with HFrEF (90 males; age (59.7±9.6) years) were included in the validation group. In the validation group, HM/TPD=38.3% predicted RR in HFrEF patients after CABG with the highest sensitivity, specificity and accuracy (82%, 60% and 73% respectively). Compared with the HFrEF patients in the HM/TPD<38.3% group (n=36), RR and cardiac function improved more significantly in the HM/TPD≥38.3% group (n=64) (all P<0.05). Conclusions: Preoperative HM/TPD ratio is an independent factor for predicting RR in patients with HFrEF after CABG, and HM/TPD≥38.3% can accurately predict RR and the improvement of cardiac function after CABG.

Recent advancement in conjugated polymers based photocatalytic technology for air pollutants abatement: Cases of CO2, NOx, and VOCs

According to World Health Organization (WHO) survey, air pollution has become the major reason of several fatal diseases, which had led to the death of 7 million peoples around the globe. The 9 people out of 10 breathe air, which exceeds WHO recommendations. Several strategies are in practice to reduce the emission of pollutants into the air, and also strict industrial, scientific, and health recommendations to use sustainable green technologies to reduce the emission of contaminants into the air. Photocatalysis technology recently has been raised as a green technology to be in practice towards the removal of air pollutants. The scientific community has passed a long pathway to develop such technology from the material, and reactor points of view. Many classes of photoactive materials have been suggested to achieve such a target. In this context, the contribution of conjugated polymers (CPs), and their modification with some common inorganic semiconductors as novel photocatalysts, has never been addressed in literature till now for said application, and is critically evaluated in this review. As we know that CPs have unique characteristics compared to inorganic semiconductors, because of their conductivity, excellent light response, good sorption ability, better redox charge generation, and separation along with a delocalized π-electrons system. The advances in photocatalytic removal/reduction of three primary air-polluting compounds such as CO₂, NO_X, and VOCs using CPs based photocatalysts are discussed in detail. Furthermore, the synergetic effects, obtained in CPs after combining with inorganic semiconductors are also comprehensively summarized in this review. However, such a combined system, on to better charges generation and separation, may make the Adsorb & Shuttle process into action, wherein, CPs may play the sorbing area. And, we hope that, the critical discussion on the further enhancement of photoactivity and future recommendations will open the doors for up-to-date technology transfer in modern research.

[Comparison of off-pump coronary artery bypass grafting alone or combined with mitral valve plasty for coronary heart disease with moderate ischemic mitral insufficiency]

Objective: To compare the efficacy of off-pump coronary artery bypass grafting (CABG) or CABG plus mitral valve plasty (MVP) in patients with coronary heart disease complicated with moderate ischemic mitral insufficiency. Methods: The clinical data of 1 050 patients with coronary heart disease complicated with moderate ischemic mitral insufficiency who underwent surgical procedures from January 2009 to December 2020 were analyzed retrospectively. There were 733 males and 317 females, aging (63.3±9.0) years (range: 31 to 83 years). Patients were divided into CABG+MVP group and CABG group according to surgical methods, and the two groups of patients were matched for 1∶4 by the propensity score matching method. There were 107 patients in the CABG+MVP group and 406 patients in the CABG group after matching. The t test, Mann-Whitney U test, χ2 test, Fisher's exact probability method and repeated measures anova were used to compare the surgical outcomes and overall survival in the two groups. Results: There were no significant differences in perioperative death and postoperative complications between the two groups (all P>0.05). Compared with CABG group, CABG+MVP group had longer operation time ((5.6±1.2) hours vs. (4.2±1.0) hours, t=11.528, P<0.01), ICU stay(M(IQR))(43.0(47.3) hours vs. 25.0(33.6) hours, Z=2.483, P=0.013), and postoperative hospital stay (8(4) days vs. 7(5) days, Z=2.143, P=0.032). The amount of erythrocyte and platelet used in CABG+MVP group was significantly increased (2.0(6.5) U vs. 0(2.0) U, Z=7.084, P<0.01; 0(0.5) U vs. 0(0) U, Z=5.210, P<0.01). A total of 463 cases (93.9%) were followed up. Median follow-up was 32(31) months (range: 3 to 105 months). There was no significant difference in overall survival and no major adverse cardic and cerebrovascular events survival between CABG group and CABG+MVP group (P=0.196,P=0.305). Echocardiography showed that there was no significant difference in ejection fraction left ventricular end-diastolic diameter between the two groups (F=0.322, P=0.571; F=0.681, P=0.410). However, CABG+MVP improved mitral regurgitation better than CABG (F=160.222, P<0.01). Conclusions: For patients with coronary heart disease with moderate ischemic mitral insufficiency, the rates of all-cause mortality and major adverse cardiac and cerebrovascular events are similar between the two surgeries. Although CABG+MVP improves mitral regurgitation better than CABG, it increases the duration of surgery, ICU stay, postoperative hospital stay, and blood transfusion requirement.

Basic Amino Acids Modulated Neutral-pH PEDOT:PSS for Stable Blue Perovskite Light-Emitting Diodes

State-of-the-art external quantum efficiencies (EQEs) have exceeded 20% for near-infrared, red, and green perovskite light-emitting diodes (PeLEDs) so far. Nevertheless, the cutting-edge blue counterparts demonstrate an inferior device performance, which impedes the commercialization and industrialization of PeLEDs in ultrahigh-definition displays. As the most popular hole transport layer, poly(3,4-ethylenedioxythiophene):polystyrenesulfonate (PEDOT:PSS) bears the acidic and hygroscopic drawbacks, which deteriorates the device efficiency and long-term stability of blue PeLEDs. In this work, the basic amino acids with zwitterionic characteristics are proposed to modulate the pH of PEDOT:PSS, which are arginine, lysine, and histidine. It is found that they play a triple function to the blue perovskite films: modulating the acidity of PEDOT:PSS, controlling the crystalline process, and passivating the defects at the PEDOT:PSS/perovskite interface. As a result, the utilization of neutral PEDOT:PSS leads to a significant enhancement in stability and photoluminescence quantum yield. Eventually, the pure-blue PeLEDs achieve a record EQE of 5.6% with the emission peak at 467 nm. This research proves that the interfacial engineering of hole transport layers is a reliable strategy to enhance the device efficiency and operation stability of blue PeLEDs.

[Death-related risk factors analysis of surgical treatment of myocardial infarction combined with ventricular septal rupture]

Objective: To in vestigate the death-related risk factors of surgical treatment of myocardial infarction (MI) combined with ventricular septal rupture (VSR). Methods: The clinical data of patients (68 cases) with ventricular septal rupture after myocardial infarction (PI-VSR) from January 2008 to December 2020 in Beijing Anzhen Hospital were retrospectively selected and analyzed. We followed up the surviving patients and divided them into the survival group and the death group according to the perioperative and follow-up results. The univariate analysis was performed on various indicators, and the Cox regression analysis was used to analyze the risk factors related to postoperative death. Results: A total of 68 patients (42 were male and 26 were female, with age 44-82 (64.3±8.2) years after surgical treatment of myocardial infarction combined with ventricular septal rupture were enrolled, 9 patients died during the perioperative period, 59 surviving patients were followed up for 0.1-10.5 years(mean, 4 years), and 7 deaths during follow-up. Based on this, 52 patients were selected as the survival group while 16 patients as the death group. The results of univariate analysis showed that age, VSR to operation time less than 7 days, killip grade ≥ grade 3, cardiogenic shock, preoperative use of IABP, emergent surgery were related to postoperative death. The factors with P<0.2 factors in univariate analysis were selected into the multivariate Cox regression analysis. Age ([OR=1.110(1.012-1.217), P=0.026], platelet count [OR=0.990(0.981-0.999), P=0.031], D dimer (OR=1.002[1.001-1.003], P=0.003), cardiogenic shock (OR=6.084[1.729-21.405], P=0.005) were independent risk factors for postoperative death. All patients were followed up, the survival rate of 2-year, 4-year, 6-year, 8-year, and 10-year was 77.5%, 77.5%, 71.0%, 71.0%, and 71.0%, respectively. Conclusions: Age, platelet count, D-dimer, and cardiogenic shock are risk factors for death after surgical treatment of myocardial infarction combined with ventricular septal rupture. Surgery is an effective method for the treatment of myocardial infarction combined with ventricular septal rupture. Long-term prognosis of the surviving patients during perioperative are relatively better.

[m7G-lncRNAs are potential biomarkers for prognosis and tumor microenvironment in patients with colon cancer]

OBJECTIVE

To assess the value of m⁷G-lncRNAs in predicting the prognosis and microenvironment of colorectal cancer (CRC).

METHODS

We screened m⁷G-lncRNAs from TCGA to construct an m⁷G-lncRNAs risk model using multivariate Cox analysis, which was validated using ROC and C-index curves. Calibration and nomogram were used to predict the prognosis of CRC patients. Point-bar charts and K-M survival curves were used to assess the correlation of risk scores with the patients' clinical staging and prognosis. CIBERSORT and ESTIMATE were used to explore the association between the tumor microenvironment and immune cell infiltration in patients in high and low risk groups and the correlation of risk scores with microsatellite instability, stem cell index and immune checkpoint expression. A protein-protein interaction network was constructed, and the key targets regulated by m⁷G-lncRNAs were identified and validated in paired samples of CRC and adjacent tissues by immunoblotting.

RESULTS

We identified a total of 1722 m⁷G-lncRNAs from TCGA database, from which 12 lncRNAs were screened to construct the risk model. The AUCs of the risk model for predicting survival outcomes at 1, 3 and 5 years were 0.727, 0.747 and 0.794, respectively. The AUC of the nomogram for predicting prognosis was 0.794, and the predicted results were consistent with actual survival outcomes of the patients. The patients in the high-risk group showed more advanced tumor stages and a greater likelihood of high microsatellite instability than those in the low-risk group (P < 0.05). The tumor stemness index was negatively correlated with the risk score (r=-0.19; P=7.3e-05). Patients in the high-risk group had higher stromal cell scores (P=0.0028) and higher total scores (P=0.007) with lowered expressions of activated mast cells (r=-0.11; P=0.045) and resting CD4+ T cells (r=-0.14; P=0.01) and increased expressions of most immune checkpoints (P < 0.05). ATXN2 (P= 0.006) and G3BP1 (P=0.007) were identified as the key targets regulated by m⁷G-lncRNAs, and their expressions were both higher in CRC than in adjacent tissues.

CONCLUSION

The risk model based on 12 m⁷G-lncRNAs has important prognostic value for CRC and can reflect the microenvironment and the efficacy of immunotherapy in the patients.

Association of serum sclerostin and osteoprotegerin levels with the presence, severity and prognosis in patients with acute myocardial infarction

Background

Bone-related proteins (such as sclerostin and osteoprotegerin [OPG]) are involved in the development of atherosclerosis. However, the relationship between bone-related proteins and acute myocardial infarction (AMI) has not been extensively evaluated. The purpose of this study was to assess the association of serum sclerostin and OPG with the presence, severity and prognosis in patients with AMI.

Methods

This study prospectively enrolled 152 patients attacked by acute chest pain. Serum sclerostin and OPG were detected within the first 24 h after AMI diagnosis by ELISA kits. The AMI predictive efficacy of sclerostin and OPG were analyzed by receiver operating characteristics (ROC) curve. Univariable and multivariable linear regression analyses were performed to determine the association between bone-related proteins and scores indicating the severity of coronary artery occlusion. Moreover, prognostic values were assessed by Kaplan–Meier curves and Cox regression analysis.

Results

There were 92 patients in AMI group, 60 in non-AMI group. Serum levels of sclerostin and OPG were significantly higher in AMI group than in non-AMI group (all p < 0.001), which showed predictive value for the presence of AMI (all p < 0.001). The area under the ROC curve values of sclerostin and OPG were 0.744 and 0.897, respectively. A multivariable linear regression analysis demonstrated that Ln-transformed sclerostin (β = 0.288, p = 0.009) and Ln-transformed OPG (Ln-OPG: β = 0.295, p = 0.019) levels were associated with GENISINI score, independently of conventional clinical parameters. In addition, Ln-OPG levels were still positively associated with GRACE score after adjustments (β = 0.320, p = 0.001). During a 1-year follow-up, patients above the median of sclerostin levels had higher incidence of major adverse cardiac events (MACE) than those below the median (p = 0.028). It was also observed that the MACE rates were higher in patients above the median of OPG levels, though no statistic importance (p = 0.060). After adjusting conventional risk factors by multivariate Cox regression, Ln-OPG was associated with incident MACE (hazard ratio = 2.188 [95% confidence intervals 1.102–4.344], p = 0.025).

Conclusions

Bone-related proteins could exert a potential role in early risk stratification and prognosis assessment in patients with AMI.

Stable and Efficient Red Perovskite Light-Emitting Diodes Based on Ca2+-Doped CsPbI3 Nanocrystals

α-CsPbI₃ nanocrystals (NCs) with poor stability prevent their wide applications in optoelectronic fields. Ca²⁺ (1.00 Å) as a new B-site doping ion can successfully boost CsPbI₃ NC performance with both improved phase stability and optoelectronic properties. With a Ca²⁺/Pb²⁺ ratio of 0.40%, both phase and photoluminescence (PL) stability could be greatly enhanced. Facilitated by increased tolerance factor, the cubic phase of its solid film could be maintained after 58 days in ambient condition or 4 h accelerated aging process at 120°C. The PL stability of its solution could be preserved to 83% after 147 days in ambient condition. Even using UV light to accelerate aging, the T₅₀ of PL could boost 1.8-folds as compared to CsPbI₃ NCs. Because Ca²⁺ doping can dramatically decrease defect densities of films and reduce hole injection barriers, the red light-emitting diodes (LEDs) exhibited about triple enhancement for maximum the external quantum efficiency (EQE) up to 7.8% and 2.2 times enhancement for half-lifetime of LED up to 85 min. We believe it is promising to further explore high-quality CsPbI₃ NC LEDs via a Ca²⁺-doping strategy.

[Interpretation of the American Association for Thoracic Surgery expert consensus document: coronary artery bypass grafting in patients with ischemic cardiomyopathy and heart failure in 2021]

An expert consensus on coronary artery bypass grafting (CABG) in patients with ischemic cardiomyopathy (ICM) was released by the American Association for Thoracic Surgery in May 2021, which contains a vast array of perioperative recommendations. During preoperative period, a comprehensive assessment on ICM including myocardial viability and valve function by a multi-disciplinary team (MDT) approach should be performed. In terms of intraoperative period, multiple arterial conduits and on-pump CABG using cold blood cardioplegia should be considered, meanwhile, other aspects involving concomitant management of mitral valve regurgitation and arrythmia, as well as active use of mechanical cardiac assist devices (e.g., intra-aortic balloon pump) should also be achieved. Finally, a range of postoperative interventions which includes standardized MDT management in intensive care unit (ICU), continuous use of cardiac assist devices, cardiac pacing, close follow-up within 90 days and drug treatment strictly guided by the guidelines after discharge from hospital should be conducted. The above-mentioned perioperative bundled care might reduce perioperative complications and operative mortality, and thus improve the prognosis of the patients with ICM.

Vibration modes of a transportable optical cavity

Many factors still need to be evaluated to fully understand the physical mechanisms determining optical cavity vibration, which are crucial for designing and constructing a transportable ultra-stable laser. Herein, a detailed dynamic analysis is used to characterize the vibration modes of a transportable optical cavity. The first five resonance modes are identified in the presence of a cavity support, and the guidelines to achieve a high first-order resonance frequency are proposed; thereby, high robustness is described using a 50 mm length optical cavity. The results demonstrate that the first-order resonance of up to 681 Hz with a gross weight of 2.51 kg can be achieved using an optimization strategy for given cavity support. The theoretical results are consistent with simulation and experiment. With the optimal group, a 1.34 Hz linewidth transportable ultra-stable laser at 1550 nm is established, and a linewidth of 1.5 Hz and frequency instability of 9.5×10^-15@1s are obtained after the test including 100 km actual road transportation and 34 min continuous vibration. The test condition is equivalent to ∼ 1000 km road transportation. Our method can be readily extended to other transportable optical cavities, providing a powerful tool for improving the robustness of vibration, particularly important for transportable environments.

Inhibition of microRNA-346 inhibits myocardial inflammation and apoptosis after myocardial infarction via targeting NFIB

OBJECTIVE

Acute myocardial infarction (AMI) is a sudden cardiovascular event that endangers human life. MicroRNA is considered to be an important participant in the pathophysiology of myocardial infarction (MI). This article aim was to study the function and mechanisms of microRNA-346 (miR-346) on myocardium after MI.

MATERIALS AND METHODS

To study the role of miR-346 in MI, we established H2O2-induced H9c2 cell injury model and rat MI model. Real-time polymerase chain reaction (RT-PCR) was used to detect miR-346 expression. Western blot was utilized to measure the expression of Bcl-2, Bax, TNF-α, IL-6 and NFIB. Apoptosis of H9c2 cells was detected by TUNEL staining and flow cytometry. Enzyme-linked immunosorbent assay (ELISA) assay was utilized to measure the levels of TNF-α and IL-6 in supernatant. Assessment of left ventricular function in rats was performed using echocardiography.

RESULTS

MiR-346 was significantly upregulated in H2O2-treated H9c2 cells and ischemic myocardium. In the H9c2 cell injury model, the expressions of Bax, TNF-α, and IL-6 were greatly increased while Bcl-2 expression was decreased, and the number of TUNEL-positive cells and apoptosis rate were also significantly increased. At the same time, the levels of TNF-α and IL-6 in the cell supernatant were markedly increased. However, after miR-346 expression was suppressed, these results were reversed. The expression of Bcl-2 increased, while the expression of Bax, TNF-α, and IL-6 decreased. The contents of TNF-α and IL-6 in the cell supernatant also decreased significantly. Both the number of TUNEL-positive cells and the apoptosis rate were markedly reduced. After injecting antagomir-346 into the myocardium of rats to silence miR-346, the cardiac function of MI rats was remarkably improved, and the LDH content in the serum of rats also decreased significantly. Using computational predictions tools, Western blotting and Luciferase activity assay, we found that nuclear factor I/B (NFIB) was targeted by miR-346.

CONCLUSIONS

The expression of miR-346 was increased in H9c2 cells and ischemic myocardium of MI rats. Silencing miR-346 can significantly inhibit the inflammatory response and the apoptosis of cardiomyocytes by targeting NFIB.

Phosphomolybdic Acid-Modified Monolayer Graphene Anode for Efficient Organic and Perovskite Light-Emitting Diodes

Graphene is a promising flexible transparent electrode, and significant progress in graphene-based optoelectronic devices has been accomplished by reducing the sheet resistance and tuning the work function. Herein, phosphomolybdic acid (PMA) is proposed as a novel p-type chemical dopant for graphene, and the optical and electrical properties of graphene are investigated systematically. As a result, the monolayer graphene electrode with lower sheet resistance and work function are obtained while maintaining a high transmittance. The Raman spectrum proves the p-type doping effect of PMA on graphene, and the X-ray photoelectron spectroscopy results reveal the mechanism, which is that the electrons transfer from graphene to PMA through the Mo-O-C bond. Furthermore, using the PMA-doped graphene anode, organic and perovskite light-emitting diodes obtained the maximum efficiencies of 129.3 and 15.6 cd/A with an increase of 50.8 and 36.8% compared with the pristine counterparts, respectively. This work confirms that PMA is a potential p-type chemical dopant to achieve an ideal graphene electrode and demonstrates the feasibility of PMA-doped graphene in the practical application of next-generation displays and solid-state lighting.

MiR-449 improves cardiac function by regulating HDAC1 and cTnI

OBJECTIVE

To investigate the effect of microRNA-449 (miRNA-449) on cTnI and cardiac function and reveal the mechanism of Histone deacetylase 1 (HDAC1)-mediated histone deacetylation in cardiomyocytes.

MATERIALS AND METHODS

First, we used biochemical analysis and Dual-Luciferase reporter gene assay to confirm that HDAC1 and miR-449 having the binding site. Then, the effect of miR-449 inhibited HDAC1 on cTnI gene transcription was observed. In vivo, the effect of histone acetylation on cTnI expression and cardiac function in heart was observed in elderly mice with low expression of cTnI through miR-449 agomiR intervention.

RESULTS

This study revealed miR-449 can sponge with HDAC1. HDAC1-mediated histone deacetylation was involved in the regulation of cTnI gene expression by HDAC1-mediated acetylation of H3K4 and H3K9 in cTnI promoter regions. In addition, HDAC1-mediated histone deacetylation regulated the binding of the transcription factor GATA4 to the GATA element in the cTnI promoter region and improved cardiac function in elderly mice with low expression of cTnI CONCLUSIONS: MiR-449 can regulate the acetylation of the histones H3K4 and H3K9 of the GATA element in the cTnI promoter region, thereby recruiting the transcription factor GATA4 to the cTnI promoter region, upregulating the cTnI gene expression, and improving cardiac function in elderly mice with low expression of cTnI.

Renin-Angiotensin System Inhibitors for the Prevention of Atrial Fibrillation Recurrence After Ablation - A Meta-Analysis

BACKGROUND

Atrial fibrillation (AF) recurrence remains a tricky problem in patients undergoing ablation. This meta-analysis aimed to summarize the current literature to clarify whether renin-angiotensin system inhibitors (RASIs) prevent AF recurrence after ablation.Methods and Results:Relevant studies were searched on Pubmed and EMBASE through December 2019. Pooled relative risk (RR) of AF recurrence was calculated. Subgroup analyses according to study design, race, and follow-up duration were further performed. A total of 15 studies examining 4,300 patients were included, with 3 randomized controlled trials and 12 cohort studies. Overall analysis showed that RASIs significantly reduced AF recurrence after ablation (RR=0.83; 95% confidence interval (CI) 0.70-0.98, P=0.028; I²=68.9%). Subgroup analysis further indicated that positive results were found in randomized controlled trials (RR=0.51, 95% CI 0.37-0.70, P<0.001; I²=4%), studies conducted in Asia (RR=0.59, 95% CI 0.46-0.76, P<0.001; I²=30.7%), and studies with follow-up duration ≥1 year (RR=0.82, 95% CI 0.70-0.95, P=0.01; I²=59.1%); negative results were found in cohort studies, studies conducted in Europe or the USA, and studies with follow-up duration <1 year.

CONCLUSIONS

RASIs can potentially prevent AF recurrence after ablation under selected conditions. However, more studies are required to confirm this finding due to the variation in current evidence.

[Long-term outcome comparison of ostial/shaft lesions in unprotected left main coronary artery treated by PCI or CABG]

Objective: To evaluate long-term clinical outcomes of consecutive patients treated with coronary artery bypass grafting (CABG) and percutaneous coronary intervention(PCI) with drug-eluting stents(DES) for ostial/shaft lesions in unprotected left main coronary artery(ULMCA). Method: A total of 259 patients with isolated ostial/midshaft lesions in unprotected left main coronary artery were enrolled consecutively who received DES implantation or underwent CABG between January 2003 and July 2009 in Beijing Anzhen Hospital. The endpoints of the study were death, repeat revascularization, myocardial infarction (MI) and stroke. Time to the primary endpoint was evaluated according to the Kaplan-Meier method, and the log-rank test was applied to compare the incidence of the endpoint. Adjusted risks for adverse outcomes were compared by multivariate Cox proportional hazard regression analyses. Results: A total of 259 patients were included, including 149 in PCI group and 110 in CABG group. And 193(74.5%) cases were males.The age was (61.4±9.8) years old. The median follow-up was 10.1 years (interquartile range 8.3 to 11.2 years) in the overall patients. There were no significant difference for the incidence of death [37.0% vs. 43.1% ，P=0.143] , MI [34.0% vs. 19.4% ，P=0.866], stroke [6.4% vs. 11.7% ， P=0.732], repeart revascularization [33.6% vs. 39.9% ，P=0.522] between PCI group and CABG group before multivariate adjusting，according to the incidence calculated with Kaplan-Meier. After adjusting covariates such as age, left ventricular ejection fraction（LVEF） and serum creatine with multivariate Cox hazard regression model, there was still no significant difference between the two groups. Conclusions: PCI with DES is as effective and safe as CABG in patients with left main ostium/shaft lesion during a median follow-up of 10.1 years.

Predictive value of P wave terminal force in lead V1 for atrial fibrillation: A meta-analysis

Background

Several studies have explored the association between P wave terminal force in lead V1 (PTFV1) and risk of atrial fibrillation (AF) occurrence, but the results were controversial. This meta‐analysis aimed to examine whether abnormal PTFV1 could predict AF occurrence.

Methods

We searched PubMed, Embase, and Cochrane Library databases for articles published before August 25, 2018. Pooled odds ratios (ORs) of AF occurrence were calculated using random‐effects models to explore the significance of PTFV1.

Results

A total of 12 studies examining 51,372 participants were included, with 9 studies analyzing PTFV1 as a categorical variable and 4 studies analyzing PTFV1 as a continuous variable. As a categorical variable, abnormal PTFV1 (>0.04 mm s) was significantly associated with AF occurrence with a pooled OR of 1.39 (95% confidence interval [CI] 1.08–1.79, p = .01). Subgroup analysis found that ORs of studies in hemodialysis patients (OR = 4.89, 95% CI 2.54–9.90, p < .001) and acute ischemic stroke patients (OR = 1.60, 95% CI 1.14–2.25, p = .007) were higher than general population (OR = 1.15, 95% CI 1.03–1.29, p = .01). Studies from Europe (OR = 1.05, 95% CI 0.91–1.20, p = .51) yielded lower OR of endpoints compared with Asia (OR = 1.89, 95% CI 1.38–2.60, p < .001) and United States (OR = 1.43, 95% CI 1.19–1.72, p < .001). As a continuous variable, PTFV1 was also significantly associated with AF occurrence with a polled OR per 1 standard deviation (SD) change of 1.27 (95% CI 1.02–1.59, p = .03).

Conclusions

PTFV1 was significantly associated with the risk of AF and was considered to be a good predictor of AF occurrence in population with or without cardiovascular diseases.

[Short-term outcomes of sequential radial artery grafting in patients with coronary artery disease]

Objective: To explore the short-term outcomes of patients with coronary artery disease (CAD) who underwent coronary artery bypass graft (CABG) with sequential radial artery graft. Methods: Clinical data of patients with CAD who underwent CABG with sequential radial artery graft from August to December 2018 in Beijing Anzhen Hospital was retrospectively analyzed. Computer tomography angiography was employed to evaluate the patency of grafts and the incidence of adverse cardiovascular events was followed up 3 months after surgery. Results: A total of thirty patients were included, with an average age of (60.2±7.3) years old, among whom 83.3% were male, and 93.3% had three-vessel disease detected by coronary angiography. All patients had left internal mammary artery (LIMA) anastomosed to the left anterior descending (LAD) and sequential radial artery graft. Among sequential radial artery grafts, the most frequent anastomosis of sequential radial artery graft was aortic artery (AO)-first diagonal branch (D1)-first obtuse marginal branch (OM1) (13 patients, 43.3%), followed by AO-OM1-second obtuse marginal branch (OM2) (9 patients, 30.0%), and 18 patients also underwent saphenous vein graft. None of 30 patients experienced adverse cardiovascular events during postoperative period in hospital. Three-months follow-up outcomes showed that LIMA-LAD in 1 patient (3.3%) occluded, 3 patients had occluded anastomosis of sequential radial artery graft, 1 patient (3.3%) had heart failure, and 1 patient (3.3%) had recurrent angina. Conclusion: The radial artery could be used as the second arterial graft for CAD patients undergoing CABG with a sequential anastomosis technique, and these patients need regular anti-arterial spasm drug treatment after CABG.

The resurgence of the norovirus GII.4 variant associated with sporadic gastroenteritis in the post-GII.17 period in South China, 2015 to 2017

Background

Human norovirus is regarded as the leading cause of nonbacterial acute diarrhea in developing and developed countries. Among all genotypes, GII.4 has been the predominant genotype, but in East Asia, it was replaced by the GII.17 in 2014/2015. However, after the prevalence of new GII.17 variant in South China, a sharply increase in the number of norovirus infections associated with sporadic acute diarrhea was detected. In this study, we would investigate the prevalence and genetic diversity of noroviruses in the sporadic acute gastroenteritis cases in the post-GII.17 period in South China.

Methods

Norovirus was screened from 217 patients with sporadic acute gastroenteritis from August 2015 to October 2017 by reverse transcription-polymerase chain reaction. Then, two regions including the partial RNA polymerase and the capsid gene of positive samples were amplified and sequenced. Phylogenetic analyses were performed to determine norovirus genotypes. Complete VP1 sequences of GII.4 strains detected in this study were also amplified and subjected into evolutionary tracing analyses.

Results

A total of 43 (19.82%) norovirus samples were confirmed from 217 stool specimens, and it was found that GII.4 resurged as the new predominant variant, accounting for 76.74% (33/43) of positive samples. Only one local strain GZ2015-L550 was clustered with the contemporary GII.P16/GII.4–2012 recombinant variant, and other 32 local strains belonged to the clade with the GII.Pe/GII.4–2012 variant. Other genotypes including GII.17 (n = 4), GII.3 (n = 4), GII.8 (n = 1) and GI. 6 (n = 1) were also detected. Furthermore, all GII.4 strains were phylogenetic analyzed based on their capsid P2 subdomains. Combined with other reported 754 strains, the GII.4–2012 variant could be divided into two clades. Most GII.4 strains collected in 2016 and 2017 in this study (7/8) formed a new cluster A in Clade II with additional 103 contemporaneous strains. In addition, evolutionary tracing of the capsid P2 subdomain of this variant was also analyzed, and one specific amino acid substitutions (N373) was identified for Cluster A.

Conclusion

In summary, this study confirmed a norovirus infection peak in the post-GII.17 period in South China, which was caused by the resurgence of the GII.4 variant.

Electronic supplementary material

The online version of this article (10.1186/s12879-019-4331-6) contains supplementary material, which is available to authorized users.

Histological study of intestinal goblet cells, IgA, and CD3+ lymphocyte distribution in Huang-huai white goat

BACKGROUND

Ten healthy adult Huang-huai white goats were selected and sacrificed by jugular vein bleeding after anaesthesia to observe the distribution characteristics of the histological structure of the intestinal mucosa, goblet cells, IgA, and CD3+ lymphocytes.

MATERIALS AND METHODS

Three sections of the duodenum, the jejunum, and the ileum were immediately collected and fixed with 4% paraformaldehyde for 72 h to prepare tissue sections. After haematoxylin and eosin, periodic acid Schiff, and immunohistochemical staining was performed, the distribution characteristics of goblet cells, IgA-positive cells, and CD3+ lymphocytes were observed. Results showed high columnar epithelial cells in the duodenum and jejunum of Huang-huai white goat and low columnar epithelial cells in the ileum mucosa.

RESULTS

Mucopolysaccharides secreted by intestinal goblet cells were mainly neutral, and the number of ileum goblet cells was significantly higher than that of the duodenum and the jejunum (p < 0.05). IgA-positive cells were distributed in the lamina propria of the duodenum, and the number of cells was significantly higher than that in the jejunum and the ileum (p < 0.01). The significant difference was found between the jejunum and the ileum (p < 0.01). The CD3+ cells in the intestinal mucosa were distributed in the lamina propria mucosae, and some of the positive cells in the jejunum were distributed between epithelial cells. CD3+ cells had the largest number in the jejunal lamina propria but had the lowest number in the ileum.

CONCLUSIONS

The jejunum was significantly higher than the duodenum (p < 0.05), and the ileum was much less than the jejunum (p < 0.01).

Prevalence and genetic diversity of human sapovirus associated with sporadic acute gastroenteritis in South China from 2013 to 2017

Human sapovirus (SaV) is an important viral agent for acute diarrhea worldwide, but timely prevalence data of human SaV in South China are still lacking. In this study, a 4-year surveillance was conducted to characterize the prevalence and genetic characteristics of the circulating SaV associated with sporadic diarrhea in South China. From November 2013 to October 2017, 569 fecal samples from patients with acute diarrhea were collected. SaV was detected in 11 samples with a positive rate of 1.93%. Three human genogroups of GI, GII, and GIV were identified, including five GI.1 strains, three GI.2 strains, one GI.3 strain, one GII.8 strain, and one GIV strain. Furthermore, multiple alignments of complete capsid protein VP1 genes of five local GI.1 strains and other available GI.1 strains in GenBank were performed. Average pairwise identities were calculated at 95.33% and 99.36% at nucleotide and amino acid levels, and only six variable amino acid sites were found during its 36-years' evolution process. GI.1 strains could be further phylogenetically divided into four clusters with an approximate temporal evolution pattern, and local strains belonged to Cluster-d with other four strains from China and Japan. In summary, SaV was identified as an etiological agent responsible for sporadic gastroenteritis in Guangzhou with a low prevalence rate as in other Chinese cities, but its high genetic diversity suggested the necessity of continuous SaV surveillance in the future.

Genome characteristics and molecular evolution of the human sapovirus variant GII.8

Human sapovirus is regarded as an important viral agent for acute diarrhea worldwide. GII.8, a recently reported genotype, has been detected in a few countries and regions. In this study, we obtained the first genome sequence of a sapovirus GII.8 strain isolated in mainland China, and comprehensively analyzed the genetic diversity and evolutionary process of this genotype. The viral genome of the new GII.8 Guangzhou strain GZ2014-L231 comprised 7433 nucleotides, including two ORFs. Pairwise alignments of the new genome with representative sequences of different genotypes showed inconsistent homology between different protein-encoding regions, of which NS1 and VP2 were found as the variable proteins, and NS3, NS5, and NS6/7 were found as the conserved ones. Compared with other reported GII.8 genomes, the Guangzhou strain introduced 34 new nucleotide changes and one new amino acid change. Phylogenetic analysis based on full-length VP1 sequences demonstrated that 11 GII.8 strains could be divided into 4 clusters A-D, with 88 SNP and 10 SAP spots occurred during their evolutionary process. The Guangzhou strain has higher homology with seven GII.8 strain detected after 2014, especially the US and Peruvian strains of 2015/2016, which have the identical VP1 amino acid sequences. Using a Bayesian coalescent method based on VP1 sequences, GII.8 was predicted to emerge in 2001 with the evolution rate of 1.45 × 10^-3 nucleotide substitutions/site/year (strict clock). In summary, the data in this study not only provided reference data from mainland China for sapovirus researches in future, but also firstly described the evolutionary process of the GII.8 genotype.

Gas spectroscopy through multimode self-mixing in a double-metal terahertz quantum cascade laser

A multimode self-mixing terahertz-frequency gas absorption spectroscopy is demonstrated based on a quantum cascade laser. A double-metal device configuration is used to expand the laser's frequency tuning range, and a precision-micromachined external waveguide module is used to enhance the optical feedback. Methanol spectra are measured using two laser modes at 3.362 and 3.428 THz, simultaneously, with more than eight absorption peaks resolved over a 17 GHz bandwidth, which provide the noise-equivalent absorption sensitivity of 1.20×10^-3  cm^-1 Hz^-1/2 and 2.08×10^-3  cm^-1 Hz^-1/2, respectively. In contrast to all previous self-mixing spectroscopy, our multimode technique expands the sensing bandwidth and duty cycle significantly.

[Metformin protects against bleomycin-induced pulmonary fibrosis in mice]

Objective: To explore the effect of metformin on murine model of bleomycin (BLM)-induced lung injury and fibrosis. Methods: A total of 30 mice were divided into 3 groups: control, BLM, and BLM with metformin, in accordance with the random number table and each group had 10 mice. To induce the pulmonary fibrosis model, a concentration of 2 mg/ml bleomycin was intratracheally administered in the BLM group and BLM with metformin group with a volume of 1.75 μl/g, while the control group accepted saline with the same volume. Metformin (200 mg/kg) was given to the mice orally once a day from the day before intratracheal instillation of bleomycin to day 14. The daily survival condition of mice was recorded during 14 days. At day 14, HE-staining was used to assess the severity of fibrosis according to the method proposed by Ashcroft. Total lung collagen content was determined by hydroxyproline assay and Masson's trichrome staining. To examine the expression of fibronectin we used the method of immunohistochemistry staining. The changes of Transforming Growth Factor beta 1 (TGF-β(1)) in plasm, bronchoalveolar lavage fluid (BALF) and lung were measured by ELISA. Results: The survival rates of control group, BLM group and BLM with metformin group at day 14 were 10/10, 4/10 and 7/10 respectively. According to the method proposed by Ashcroft the score of metformin treated mice was significantly lower than that of the bleomycin model mice[(3.82±0.58) vs (7.79±0.06), (P<0.05)]. The hydroxyproline level in lung tissue were markedly attenuated in metformin treated mice compared with bleomycin model mice [(0.40±0.05) vs (0.73±0.10) μg/mg, (P<0.05)]. The level of TGF-β(1) in plasma, BALF and lung tissue were also decreased in mice treated with metformin compared with bleomycin model mice [(2.32±0.68) vs (4.59±0.45) ng/ml, (0.81±0.09) vs (1.40±0.06) ng/ml, (17.12±0.83) vs (21.25±0.69) ng/mg, all P<0.05]. Conclusion: Metformin can reduce the severity of pulmonary fibrosis in mice induced by bleomycin.

[Effect of water-soluble C(60) fullerenes on pulmonary fibrosis induced by bleomycin in mice]

Objective: To evaluate the role of water-soluble C(60) fullerenes in mice model of lung injury and fibrosis that induced by bleomycin. Methods: A total of 20 healthy C57BL/6J mice were randomly divided into normal control group, bleomycin group, high dose C(60) group, low dose C(60) group, each group with 5 mice. Mice were induced pulmonary fibrosis by intratracheal injection of bleomycin except the normal control group, which was induced by saline instead. In low dose C(60) group and high dose C(60) group, 1 mg·kg(-1)·d(-1) and 10 mg·kg(-1)·d(-1) water-soluble C(60) fullerenes was injected into mice intraperitoneally every day, which began from one day before intratracheal instillation of bleomycin until the end of observation. Saline was given to mice in the same way in normal control and bleomycin group. This study investigated the variation of weight and survival rate of mice for 14 d. HE-staining and Masson's trichrome staining were used to assess the severity of fibrosis according to the method proposed by Ashcroft at 14th day. Total lung collagen content was determined by hydroxyproline assay. The changes of transforming growth factor-β(1) (TGF-β(1)) and tumor necrosis factor α (TNF-α) in plasma, bronchial alveolar lavage fluid (BALF) and lung tissue were measured by enzyme-linked immunosorbent assay (ELISA). And, the amount of reactive oxygen species (ROS) was tested by 2, 7-dichlorofuorescin diacetate (DCFH-DA), and determined by the ratio of fluorescence intensity and protein content (OD/μg). Results: C(60) can protect mice that injured by bleomycin from weight loss. According the method proposed by Ashcroft et al.HE and Masson's trichrome staining showed that collagen deposition in lung tissue were markedly attenuated in C(60) (1 mg·kg(-1)·d(-1) and 10 mg·kg(-1)·d(-1)) treated mice compared with bleomycin model mice[(4.08±0.52), (3.00±0.41) vs (6.75±0.75) points, both P<0.01]. In low dose C(60) group and high dose C(60) group, the content of hydroxyproline in lung tissue were significantly lower than that in bleomycin group[(0.36±0.06), (0.35±0.08) vs (0.55±0.16) μg/mg, both P<0.05]. The level of TGF-β(1) in BALF and lung tissue were also decreased in mice treated with C(60) (10 mg·kg(-1)·d(-1)) compared with bleomycin model mice, but the difference had no statistical significance[(9.38±5.32) vs (23.60±8.96) pg/ml, (2.89±0.35) vs (6.44±2.95) pg/mg, both P>0.05]. Also, in high dose C(60) group, the content of TNF-α in plasma, BALF and lung tissue were significantly lower than those in bleomycin group[(4.56±0.73) vs (7.21±2.26) pg/ml, (34.58±23.30) vs (151.00±27.34) pg/ml, (22.99±5.83) vs (122.90±22.04) pg/mg, all P<0.05]. In addition, Compared with bleomycin group, ROS in lung tissue was significantly decreased after treatment with C(60) (10 mg·kg(-1)·d(-1))[(19.68±0.91) vs (22.92±1.71) OD/μg, P<0.05]. Conclusion: Water-soluble C(60) fullerenes reduce the severity of pulmonary fibrosis induced by bleomycin in mice.

[Short-term clinical safety and efficacy of No-touch great saphenous vein harvesting technique for off-pump coronary artery bypass grafting]

Objective: To evaluated early clinical outcomes of saphenous vein grafts harvested with a No-touch technique in off-pump coronary artery bypass graft (OPCABG) surgery. Methods: A total of 124 patients with three-vessel disease undergoing OPCABG by No-touch technique between June and November 2017 in Beijing An Zhen Hospital were respectively reviewed. Results: The average age of patients was (60.7±10.3) years, and 80 cases (64.5%) were male, with the average body mass index (BMI)of (25.4±2.5) kg/m(2,) the mean preoperative left ventricular ejection fraction (LVEF) of (58.0±7.0%). The operative time was (4.0±0.4) hours, and 16 cases (12.9%) were harvested for whole vein grafts. The number of vein grafts and venous anastomoses was 144 and 284, respectively. There were 16 cases of single bridge NTSVG-LAD, 4 cases of single bridge NTSVG-D, 99 cases of sequential bridge NTSVG-OM-PDA, 5 cases of sequential bridge NTSVG-OM-PLV, 4 cases of sequential bridge NTSVG-OM-RCA, 16 cases of sequential bridge NTSVG-D-OM-PDA. The mean flow volume of No-touch vein grafts was (51.9±2.4) ml/min. There was no death case in hospital. Postoperative re-exploration for hemorrhage of anastomosis happened in 1 case (0.8%), which was caused by pericardial tamponade due to insufficiency of hemostasis in internal mammary bed. There were 1 case of bad wound healing of lower extremity incision (0.8%). A total of 124 cases were followed up after operation, and the follow-up rate was 100%. There was one all-cause death (0.8%) 27 days after the operation. Conclusion: The short-term clinical observation of the application of No-touch great saphenous vein harvesting technique for OPCABG is safe and effective.

Immunogenicity and Safety of a Chemically Synthesized Divalent Group A Streptococcal Vaccine

BACKGROUND

Group A streptococcus (GAS) infections and poststreptococcal sequelae remain a health problem worldwide, which necessitates searching for an effective vaccine, while no licensed GAS vaccine is available. We have developed a divalent peptide vaccine composed of 84 amino acids to cover the main GAS serotypes (M1 and M12 streptococci) in China, and herein, we aimed to evaluate immunogenicity and safety of this vaccine.

METHODS

Mice were immunized with the vaccine. ELISA, indirect bactericidal test, and immunofluorescent assay were used to study immunogenicity. GAS challenge assay was used to test the protective effect. Safety was tested by histopathological analysis.

RESULTS

Immunized group mice (n=16) developed higher titer antibody after immunization than nonimmunized group mice (n=16) did. This antibody can deposit on the surface of GAS and promote killing of GAS, resulting in 93.1% decrease of M1 GAS and 89.5% of M12 GAS. When challenged with M1 and M12 streptococci, immunized group mice had a higher survival rate (87.5% and 75%) than nonimmunized group mice (37.5% and 25%). No autoimmune reactions were detected on organs of mice.

CONCLUSION

The results suggest that this vaccine shows fair immunogenicity and safety, which will lead our research on GAS vaccine into clinical trial.

The association between plasma homocysteine and ambulatory blood pressure variability in patients with untreated hypertension

BACKGROUND

Both homocysteine (Hcy) and blood pressure variability (BPV) are independent predictors of stroke, however, their relationship is rarely evaluated before. This study aimed to investigate the association Hcy and ambulatory BPV in subjects with untreated primary hypertension.

METHODS

A total of 252 eligible patients were recruited. Plasma Hcy was measured and 24-h ambulatory blood pressure monitoring was performed for each subject. The systolic and diastolic BPV values were calculated as the SD of individual blood pressure values during 24h, daytime and nighttime, and then stratified by the tertiles of Hcy concentration (T1 to T3). Univariate and multivariate linear regression models were used to assess the relationships between Hcy tertiles and BPV variables.

RESULTS

The mean values of Hcy from T1 to T3 were 7.51±1.21μmol/l, 11.09±1.07μmol/l and 19.14±6.26μmol/l, respectively. Systolic and diastolic mean blood pressures were similar among subjects with different Hcy tertiles. However, both systolic and diastolic BPV variables, no matter in 24-h, daytime or nighttime, were increasing significantly along with the rises in Hcy tertiles (all p<0.05 for linear trends analysis). Multivariate linear regression analysis indicated that Hcy tertiles were significantly associated with BPV variables, independently of mean blood pressures other confounding factors. In subgroup analysis, the associations between Hcy tertiles and BPV variables were enhanced by the increased risk stratification of hypertension.

CONCLUSIONS

Plasma Hcy was positively and independently associated with ambulatory BPV in patients with untreated hypertension.

Comparative phylogenetic analyses of recombinant noroviruses based on different protein-encoding regions show the recombination-associated evolution pattern

Noroviruses are the major cause of acute gastroenteritis worldwide, and recombination is recognized as the important mechanism for its continuous emergence. In this study, for the common GII.P12 and GII.3 recombinants, phylogenetic relationships based on different proteins in three ORFs were comparatively analyzed, focusing on the influence of intergenic recombination. By using newly designed primers, genomes of two GII.P12/GII.3 Guangzhou recombinants were firstly amplified. Combined with other reported sequences of GII.P12_ORF1 (n = 20), GII.3_ORF2 (n = 131), GII.3_ORF3 (n = 36), all GII.P12 and GII.3 strains could be divided into 6, 8, and 7 clusters based on different ORFs, which showed an obvious recombination-associated and temporally sequential evolution pattern (with the exception of GII.P12/GII.13 recombinants). Based on multiple alignments, 126 informative sites were identified in three ORFs (44, 54, and 28), and four proteins (p48, p22, VP1, and VP2) were found under positive selection. Furthermore, by using homology modeling, predicted epitopes were mapped on the P proteins of seven GII.3 representative strains, without one (Epi: 353-361) specific to the GII.4 VA387 strain. In summary, via the genome analyses, phylogenetic relationships of GII.P12 and GII.3 recombinants based on the different proteins presented a special temporally sequential evolution process associated with their recombinant types.

[Short-term clinical outcomes and risk factors associated with in-hospital mortality in patients undergoing off-pump coronary artery bypass grafting]

Objective: To explore short-term clinical outcomes and risk factors associated with in-hospital mortality in patients undergoing off-pump coronary artery bypass grafting (OPCABG) and establish a prediction model for in-hospital mortality. Methods: The clinical data of patients undergoing OPCABG in Beijing Anzhen Hospital between January 2014 and January 2016 was retrospectively studied. Univariate analysis and logistic regression were applied to determine the potential risk factors, and then a prediction model for mortality was confirmed. The calibration and discrimination of the prediction model was finally tested. Results: A total of 2 546 patients who underwent OPCABG were recruited. In-hospital mortality of OPCABG was 0.7% (17 cases). Seven variables: female, age, left main disease >50%, low left ventricular ejection fraction (LVEF), acute myocardial infarction before surgery, operative status (selective or emergent), moderate concomitant mitral valve regurgitation were independently correlated with OPCABG mortality (all P<0.05). The result of Hosmer-Lemeshow test was χ(2)=5.912, P=0.676. The area under receiver-operating characteristic curve (ROC) was 0.881. Conclusions: OPCABG is safe and effective for myocardial revascularization in a short term. The following risk factors are associated with an increased operative mortality of OPCABG: male, age, left main disease >50%, low LVEF, acute myocardial infarction before surgery, operative status (selective or emergent), moderate concomitant mitral valve regurgitation. The prediction model established by above-mentioned potential risk factors was proven to perform well by statistical tests.

[The 455th case: swollen leg, jaundice and mental disturbance]

A 17-year-old young man with a history of swollen leg and intermittent jaundice was presented to Peking Union Medical College Hospital with acute fever and mental disturbance. He developed deep venous thrombosis, acute myocardial infarction and plantar skin necrosis during the past four years, and was presented with an acute episode of fever, thrombocytopenia, acute kidney injury, acute myocardial infarction, mental disturbance, and obstructive jaundice. Laboratory tests showed schistocytes on peripheral blood smear.High titer of antiphospholipid antibodies was detected.Strikingly, the activity of a disintegrin and metalloprotease with a thrombospondin type 1 motif, member 13 (ADAMTS13)was significantly decreased without the production of inhibitors. Images indicated stenosis of the common bile duct, common hepatic duct, and cystic duct, which caused dilation of bile ducts and the gall bladder. Corticosteroids and anticoagulation therapy were effective at first, but the disease relapsedonce the corticosteroids tapered down. Plasma exchange was administrated for 17 times, which was effective temporarily during this episode. Methylprednisolone pulse therapy, intravenous immunoglobulin, rituximab, anticoagulation therapy, and bile drainage, were all tried but still could not control the disease. The patient's family agreed to withdraw treatment after he developed septic shock.

Study on the synthesis and tribological properties of anti-corrosion benzotriazole ionic liquid

Anti-corrosion benzotriazole ionic liquid (IL, BTAP₄₄₄₄) was synthesized by neutralizing 1H-benzotriazole (BTAH) with terabutylphosphonium hydroxide (P₄₄₄₄OH).

[Safety and efficacy of off-pump coronary artery bypass grafting in octogenarians]

Objective: To discuss the clinical safety and efficacy about off-pump coronary artery bypass grafting (OPCABG) in octogenarians. Methods: From June 2005 to July 2014, 252 patients (male 208, female 44, with a mean age of 81.7 years old) underwent OPCABG in Beijing Anzhen Hospital who were aged 80 years or older were enrolled. Results: Eight (3.2%) patients were diagnosed as single vessel coronary artery disease (CAD), 29 cases (11.5%) were diagnosed as bifurcation vessel CAD, and 215 cases (85.3%) were multivessel CAD. One hundred and one cases (40.1%) were diagnosed as left main artery disease, among which 51 cases (20.2%) had old myocardial infarction. Two hundred and forty-eight patients belonged to Canadian Cardiovascular Society (CCS) classⅠ-Ⅲ and 4 cases to CCS class Ⅳ. One hundred and forty-five cases belonged to New York Heart Association (NYHA) classⅠ-Ⅱ and 107 cases to NYHA class Ⅲ-Ⅳ. Mean graft number was 3. Two hundred and six patients (81.7%) received total vein graft operation. Intra-aortic balloon pump (IABP) was used in 43 patients (17.1%). In-hospital death occurred in 15 cases (6.0%). Major in-hospital complications included reoperation (16 cases), re-intubation (16 cases), dialysis (11 cases), sternum infection (2 cases), atrial fibrillation (63 cases). The follow-up time was from 1 to 11 years (with a mean time of 6 years). All-cause mortality was 18.1% (43 cases). The major out-of-hospital complications included recurrent myocardial infarction (3 cases), stroke (3 cases), re-admission (27 cases) and recurrent angina pectoris (20 cases). Conclusion: OPCABG is safe and effective for myocardial revascularization in patients aged 80 years and over.

Targeting long non-coding RNA-TUG1 inhibits tumor growth and angiogenesis in hepatoblastoma

Hepatoblastoma is the most common liver tumor of early childhood, which is usually characterized by unusual hypervascularity. Recently, long non-coding RNAs (lncRNA) have emerged as gene regulators and prognostic markers in several cancers, including hepatoblastoma. We previously reveal that lnRNA-TUG1 is upregulated in hepatoblastoma specimens by microarray analysis. In this study, we aim to elucidate the biological and clinical significance of TUG1 upregulation in hepatoblastoma. We show that TUG1 is significantly upregulated in human hepatoblastoma specimens and metastatic hepatoblastoma cell lines. TUG1 knockdown inhibits tumor growth and angiogenesis in vivo, and decreases hepatoblastoma cell viability, proliferation, migration, and invasion in vitro. TUG1, miR-34a-5p, and VEGFA constitutes to a regulatory network, and participates in regulating hepatoblastoma cell function, tumor progression, and tumor angiogenesis. Overall, our findings indicate that TUG1 upregulation contributes to unusual hypervascularity of hepatoblastoma. TUG1 is a promising therapeutic target for aggressive, recurrent, or metastatic hepatoblastoma.

Molecular epidemiology of noroviruses associated with sporadic gastroenteritis in Guangzhou, China, 2013-2015

Norovirus diarrhea is a great threat to public health worldwide. To characterize the prevalence of circulating noroviruses associated with sporadic gastroenteritis cases in Guangzhou, 215 stool specimens were collected during two consecutive cold seasons in 2013-2015. Noroviruses were detected in 25 (11.63 %) samples, and GII.4 (6/9) and GII.17 (10/16) were identified as the most predominant variants of each of those seasons. The remaining strains belonged to the genotypes GII.P12/GII.3, GII.2, and GI.Pb/GI.6. The phylogenetic relationships of the GII.17 strains were analyzed based on their capsid protein sequences. This study suggests a significant shift of predominant variants associated with sporadic gastroenteritis in Guangzhou.