Background:Atrial septal defect(ASD)is one of the common congenital heart diseases.The MYH6 gene has a critical role in cardiac development but the role of MYH6 promoter variants in patients with ASD has not been expl...Background:Atrial septal defect(ASD)is one of the common congenital heart diseases.The MYH6 gene has a critical role in cardiac development but the role of MYH6 promoter variants in patients with ASD has not been explored.Methods:In 613 subjects including 320 ASD patients,we investigated the MYH6 gene promoter variants and verified the effect on gene expression by using cellular functional experiments and bioinformatics analysis.Results:Eleven variants were identified in the MYH6 gene promoter,of which four variants were found only in ASD patients,and two variants(g.3434G>C and g.4524C>T)were identified for the first time.Cellular functional experiments indicated that all four variants reduced the transcriptional activity of the MYH6 gene promoter(p<0.05).Subsequent analysis through the JASPAR(A database of transcription factor binding profiles)suggests that these variants may alter transcription factor binding sites,which may in turn lead to changes in myocardin subunit expression and ASD formation.Conclusions:Our study for the first time focuses on variants in the promoter region of the MYH6 gene in Chinese patients with ASD and the discovered variants have functional significance.The study provides new insights in the role of the MYH6 gene promoter region to better understand the genetic basis of ASD formation and facilitates clinical diagnosis.展开更多
Background:Preeclampsia(PE),characterized by hypertension and proteinuria,leads to serious maternal and infant complications.Uridine-cytidine kinase 2(UCK2)belongs to the UCK family,a class of enzymes that catalyzes t...Background:Preeclampsia(PE),characterized by hypertension and proteinuria,leads to serious maternal and infant complications.Uridine-cytidine kinase 2(UCK2)belongs to the UCK family,a class of enzymes that catalyzes the conversion of uridine and cytidine to monophosphate form.However,the role of UCK2 in PE has not been reported.Methods:The expression of UCK2 was detected in the placenta of PE patients and N(ω)-nitro-L-arginine methyl esterinduced PE mouse model.Through forced up-regulation or down-regulation of UCK2 in vitro,we examined the effects of UCK2 on the proliferation,apoptosis,migration,and invasion of trophoblast cells.Stattic,the inhibitor of STAT3 pathway,was used to investigate whether the STAT3 pathway mediates the biological function of UCK2 in trophoblast cells.Results:The present study found that UCK2 showed low expression in the placenta of PE patients and PE mouse model.MTT(3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide)and flow cytometry assays verified that up-regulation of UCK2 promoted the proliferation of trophoblast cells,while the silence of UCK2 suppressed cell proliferation.Besides,flow cytometry and TdT-mediated dUTP Nick-End Labeling assays demonstrated that knockdown of UCK2 resulted in apoptosis of trophoblast cells.The wound healing and transwell assays showed that the migration and invasion activities of the trophoblast cells were facilitated by the overexpression of UCK2 and were blocked by the silence of UCK2.Furthermore,the expression of phosphorylated STAT3 was increased with the upregulation of UCK2 and decreased with the inhibition of UCK2.When the STAT3 pathway was blocked by its inhibitor stattic,the promotion effects of UCK2 on trophoblast cells were suppressed.Conclusion:UCK2 promotes the proliferation,migration,and invasion of trophoblast cells,and these effects may be partly mediated by the activation of the STAT3 pathway.展开更多
The current situation of medical staff＇s awareness about high alert medication was investigated in order to promote safe medication and standardized management of the high alert medication in China. Twenty questions ...The current situation of medical staff＇s awareness about high alert medication was investigated in order to promote safe medication and standardized management of the high alert medication in China. Twenty questions were designed concerning elementary knowledge of high alert medications, storage management, medication issues and risks. In order to understand the knowledge level and education status of high alert medication, a convenient survey was conducted among 300 medical staffs in Tianjin. Medical staff＇s average score of high alert medication knowledge was 12.43±0.27, and the average scores of elementary knowledge of high alert medication, storage management, medication issues and risks were 3.38±0.11, 2.46±0.14, 3.17±0.11 and 3.41±0.12 respectively. Occupation（F=4.86, P=0.003）, education background（F=5.57, P=0.019） and professional titles（F=13.44, P≤0.001） contributed to the high alert medications knowledge scores. Currently, the most important channel to obtain high alert medication knowledge was hospital files or administrative rules, and clinical pharmacist seminars were the most popular education form. It was suggested that the high alert medication knowledge level of the medical staff needs to increase, and it might benefit from targeted, systematic and diverse training to the medical staff working in the different circulation nodes of the medications. Further research to develop and validate the instrument is needed.展开更多
BACKGROUND:The predictive scoring systems for early stent thrombosis(EST)remains blank in China.The study aims to evaluate the risk factors and conduct a prediction model of EST in the Chinese population.METHODS:EST w...BACKGROUND:The predictive scoring systems for early stent thrombosis(EST)remains blank in China.The study aims to evaluate the risk factors and conduct a prediction model of EST in the Chinese population.METHODS:EST was defined as thrombosis that occurs within the first 30 days after primary percutaneous coronary intervention(PCI).Patients from ten Chinese hospitals diagnosed as stent thrombosis(ST)from January 2010 to December 2016 were retrospectively included as the study group.A control group(1 case:2 controls)was created by including patients without ST,major adverse cardiovascular events,or cerebrovascular events during follow-up.The present study evaluated 426 patients with single-vessel lesions and ultimately included 40 patients with EST and 80 control patients,who were included to identify factors that predicted EST and to develop a prediction scoring system.The other 171 patients without integrated 1:2 pair were used for external validation.RESULTS:EST was independently associated with a low hemoglobin concentration(adjusted odds ratio[OR]0.946,95%confi dence interval[95%CI]0.901-0.993,P=0.026),a high pre-PCI Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery(SYNTAX)score(OR 1.166,95%CI 1.049-1.297,P=0.004),and a DAPT(DAPT)duration of<30 days(OR 28.033,95%CI 5.302-272.834,P<0.001).The simple EST prediction score provided an area under the curve(AUC)of 0.854(95%CI 0.777-0.932,P<0.001)with 70.0%sensitivity and 90.0%specifi city,and 0.742(95%CI 0.649-0.835,P<0.001)with 54.5%sensitivity and 81.0%specifi city for external validation dataset.CONCLUSIONS:EST may be independently associated with DAPT discontinuation within 30 days,a low hemoglobin concentration,and a high SYNTAX score.The scoring system also has a good ability to predict the risk of EST and may be useful in the clinical setting.展开更多
The deterioration of vestibular function is a side effect of numerous diseases of the inner ear. Vertigo is the most common symptom of vestibular dysfunction. Vestibule-suppressing drugs can control symptoms but imped...The deterioration of vestibular function is a side effect of numerous diseases of the inner ear. Vertigo is the most common symptom of vestibular dysfunction. Vestibule-suppressing drugs can control symptoms but impede the rehabilitation of vestibular function. Surgical treatment can effectively resolve vestibular dysfunction associated with some progressive diseases, including tumors. However, unilateral vestibular function remains permanently damaged after surgery, causing problems like vertigo and imbalance. To enhance the understanding of Vestibular rehabilitation therapy, this paper presents a summary of the progress in research on Vestibular rehabilitation therapy for patients with vestibular dysfunction.展开更多
Cancer stem cells(CSCs)are related to tumorigenesis,recurrence,metastasis,and drug resistance in hepatocellular carcinoma(HCC).1 Let-7i is a noncoding small RNA,belonging to the famous miRNA let-7 family.Recently,let-...Cancer stem cells(CSCs)are related to tumorigenesis,recurrence,metastasis,and drug resistance in hepatocellular carcinoma(HCC).1 Let-7i is a noncoding small RNA,belonging to the famous miRNA let-7 family.Recently,let-7i has been revealed as a tumor suppressor on CsCs in ovarian cancer.展开更多
To improve the standard screening, diagnosis, and treatment of hypertension in patients in China;realize the standardization of clinical practice of hypertension;and improve the prevention and control level of hyperte...To improve the standard screening, diagnosis, and treatment of hypertension in patients in China;realize the standardization of clinical practice of hypertension;and improve the prevention and control level of hypertension in China, it is both important and necessary to develop a clinical practice guideline for hypertension according to a recognized methodology. Jointly sponsored by the National Center for Cardiovascular Diseases, Chinese Medical Doctor Association, Hypertension Committee of the Chinese Medical Doctor Association, Chinese Society of Cardiology, and Hypertension Committee of Cross-Straits Medicine Exchange Association, the “Chinese Clinical Practice Guidelines of Hypertension” was proposed. Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences, Guideline and Standards Research Centre of Chinese Medical Association Publishing House, Lanzhou University Institute of Health Data Science, and Lanzhou University GRADE Center will provide methodological support for the guidelines.展开更多
Due to extremely severe morbidity and mortality worldwide,it is worth achieving a more in-depth and comprehensive understanding of cardiovascular diseases.Tremendous effort has been made to replicate the cardiovascula...Due to extremely severe morbidity and mortality worldwide,it is worth achieving a more in-depth and comprehensive understanding of cardiovascular diseases.Tremendous effort has been made to replicate the cardiovascular system and investigate the pathogenesis,diagnosis and treatment of cardiovascular diseases.Microfluidics can be used as a versatile primary strategy to achieve a holistic picture of cardiovascular disease.Here,a brief review of the application of microfluidics in comprehensive cardiovascular disease research is presented,with specific discussions of the characteristics of microfluidics for investigating cardiovascular diseases integrally,including the study of pathogenetic mechanisms,the development of accurate diagnostic methods and the establishment of therapeutic treatments.Investigations of critical pathogenetic mechanisms for typical cardiovascular diseases by microfluidic-based organ-on-a-chip are categorized and reviewed,followed by a detailed summary of microfluidic-based accurate diagnostic methods.Microfluidic-assisted cardiovascular drug evaluation and screening as well as the fabrication of novel delivery vehicles are also reviewed.Finally,the challenges with and outlook on further advancing the use of microfluidics technology in cardiovascular disease research are highlighted and discussed.展开更多
The systemic benefits of anti-inflammatory pharmacotherapy vary across cardiovascular diseases in clinical practice.We aimed to evaluate the application of artificial intelligence to acute type A aortic dissection(ATA...The systemic benefits of anti-inflammatory pharmacotherapy vary across cardiovascular diseases in clinical practice.We aimed to evaluate the application of artificial intelligence to acute type A aortic dissection(ATAAD)patients to determine the optimal target population who would benefit from urinary trypsin inhibitor use(ulinastatin).Patient characteristics at admission in the Chinese multicenter 5A study database(2016-2022)were used to develop an inflammatory risk model to predict multiple organ dysfunction syndrome(MODS).展开更多
Objective::Data comparing the outcomes of MiStent(Micell Technologies,Durham,North Carolina,USA)microcrystalline biodegradable polymer(BP)drug-eluting stent(DES)and those of another post-marketing BP-DES,TIVOLI(EssenT...Objective::Data comparing the outcomes of MiStent(Micell Technologies,Durham,North Carolina,USA)microcrystalline biodegradable polymer(BP)drug-eluting stent(DES)and those of another post-marketing BP-DES,TIVOLI(EssenTech,Beijing,China)are rare.This study sought to compare the angiographic efficacy and clinical outcomes of the microcrystalline BP sirolimus-eluting stent(SES)system MiStent and those of TIVOLI BP-SES.Methods::The DESSOLVE-C trial was a prospective,single-blinded,multicenter,randomized trial(NCT02448524),which randomly assigned patients with de novo coronary lesions to receive MiStent or TIVOLI BP-SES by a 1:1 ratio.The primary endpoint was a non-inferiority comparison of in-stent late lumen loss(LLL)by quantitative coronary angiography at 9 months.The secondary endpoint was device-related clinical cardiovascular composite events(target lesion failure(TLF),composite of cardiac death,target vessel myocardial infarction(MI),and clinically driven target lesion revascularization)and 1-year outcomes.Results::A total of 428 patients(216 patients in the MiStent group and 212 patients in the TIVOLI group)were enrolled and included in an intention-to-treat analysis.MiStent was not only non-inferior but superior to TIVOLI for in-stent LLL at 9 months((0.23±0.37)mm vs.(0.34±0.48)mm,P for non-inferiority<0.001,P for superiority=0.02).Although without significant difference,the rate of TLF in MiStent was quantitatively lower than that in TIVOLI(3.70%vs.6.60%;P=0.17).Conclusion::Compared with TIVOLI BP-SES,the MiStent system was superior in in-stent LLL at 9 months and had a comparable clinical benefit at 1 year in de novo coronary lesions.展开更多
Macroangiopathy is a complication of Type II Diabetes Mellitus(T2 DM),which is mainly caused by fibrosis of blood vessels.Using T2 DM rat models,we investigated whether the traditional Chinese medicine,Di-Dang Decocti...Macroangiopathy is a complication of Type II Diabetes Mellitus(T2 DM),which is mainly caused by fibrosis of blood vessels.Using T2 DM rat models,we investigated whether the traditional Chinese medicine,Di-Dang Decoction(DDD),exhibited antifibrotic actions on great vessels.T2 DM rats were randomly divided into non-intervention group,early-,middle-,late-stage DDD intervention groups and control groups,including pioglitazone group and aminoguanidine group.After administration of DDD to T2 DM rats at different times,we detected the amount of extracellular matrix(ECM)deposition in the thoracic aorta.The results showed that early-stage intervention with DDD could effectively protect great vessels from ECM deposition.Considering that TGF-β1 is the master regulator of fibrosis,we further validated at the molecular level that,compared to middle-and late-stage intervention with DDD,early-stage intervention with DDD could significantly decrease the expression levels of factors related to the activated TGF-β1/Smad signalling pathway,as well as the expression levels of downstream effectors including CTGF,MMP and TIMP family proteins,which were directly involved in ECM remodelling.Therefore,early-stage intervention with DDD can reduce macrovascular fibrosis and prevent diabetic macroangiopathy.展开更多
To the Editor:Revascularization,regardless of whether it is percutaneous coronary intervention(PCI)or coronary artery bypass grafting(CABG),is still the dominant treatment of severe coronary heart disease(CHD).The lon...To the Editor:Revascularization,regardless of whether it is percutaneous coronary intervention(PCI)or coronary artery bypass grafting(CABG),is still the dominant treatment of severe coronary heart disease(CHD).The long-term clinical outcome of revascularization is unpredictable because of the progression of atherosclerosis continuing after surgery.[1]Many studies and trials have proven that optimal medical therapy(OMT)with or without revascularization is critical for decreasing the incidence of adverse events and improving quality of life.In recent years,patients from China with higher adherence to medical therapy have shown a lower incidence of adverse events at 1 year after PCI.[2]However,there have been no large clinical trials or observational studies for accurate understanding of maintenance of medical strategies in patients with CHD in China.展开更多
Background： Atrial AutoCaptureTM （ACapTM） was a new technological development that confirmed atrial capture by analyzing evoked response （ER） with a new method - paced depolarization integral ER detection- and op...Background： Atrial AutoCaptureTM （ACapTM） was a new technological development that confirmed atrial capture by analyzing evoked response （ER） with a new method - paced depolarization integral ER detection- and optimized energy output to changes in the stimulation threshold. The purpose of this study was to evaluate the clinical performance ofACapTM function. Methods： This was a prospective, observational, nonrandomized two-center study. Between November 2008 and August 2014, 102 patients were enrolled from two different institutions. Data were collected by case report forms at enrollment, hospital discharge, and in-office follow-ups scheduled at 1, 2, 3, 6, and 12 months postimplantation. Results： Ambulatory ACapTM function started to become available for 20.6% of patients at 1 day, then progressed to 30.4% at 7 days, 38.6% at 1 month, 41.6% at 2 months, 47.5% at 3 months, 53.5% at 6 months, and 63.4% at 1 year. The cause of the unsuccessful attempts to perform ACapTM threshold was ER/polarization 〈2：1. Availability for SD, BND, and HOCM indications had shown better results than AVB indication. For SD indication cases, feasibility was significantly better for SD with paroxysmal atrial fibrillation （pAF） than SD without pAF （78.4% vs. 35.0% at 1 year, n = 71, P 〈 0.001）. At each stage of the clinical follow-ups, there had been a strict correlation between ACapTM measurements and those conducted manually with P 〈 0.001 （n = 299）. Conclusions： It has been concluded that ACapTM function was safe and effective to confirm atrial threshold and reduce energy output automatically. ACapTM function is unavailable for some patients at early stages of the implantation; however, availability has been progressively increasing during follow-up.展开更多
Dear Editor,Atrial fibrillation(AF)is one of the most common cardiac arrhythmias.Its prevalence increases significantly with age.It is well known that patients with AF are associated with an increased risk of stroke,1...Dear Editor,Atrial fibrillation(AF)is one of the most common cardiac arrhythmias.Its prevalence increases significantly with age.It is well known that patients with AF are associated with an increased risk of stroke,1 and AF is a great economic burden on the worldwide socioeconomic system.Previous studies have shown that electrical,contractile,and structural remodeling play key roles in the onset and maintenance of AF.2 Other possible pathogenesis mechanisms include calcium handling abnormalities,autonomic imbalance,and genetic factors.3 However,the exact molecular mechanism associated with AF remains unknown.展开更多
Background： Secondary preventive therapies play a key role in the prevention of adverse outcomes after coronary artery bypass grafting （CABG）. However, medication adherence alter CABG is often poor, and conventiona...Background： Secondary preventive therapies play a key role in the prevention of adverse outcomes after coronary artery bypass grafting （CABG）. However, medication adherence alter CABG is often poor, and conventional interventions for improving adherence have limited success. With increasing penetration of smartphones, health-related smartphone applications might provide an opportunity to improve adherence. Carefully designed trials are needed to provide reliable evidence for the use of these applications in patients after CABG. Methods： The Measurement and Improvement Studies of Surgical Coronary Revascularization： Medication Adherence （MISSION-2） study is a multicenter randomized controlled trial, aiming to randomize 1000 CABG patients to the intervention or control groups in a 1 ： 1 ratio. We developed the multifaceted, patient-centered, smartphone-based Heart Health Application to encourage lnedication adherence in the intervention group through a health self management program initiated dnring hospital admission for CABG. The application integrated daily scheduled reminders to take the discharge medications, cardiac edticational materials, a dynamic dashboard to review cardiovascular risk factors and secondary prevention targets, and weekly questionnaires with interactive feedback. The primary outcome was secondary preventive medication adherence measured by the Chinese version of the 8-item Morisky Medication Adherence Scale at 6 months after randomization. Secondary outcomes included all-cause death, cardiovascular rehospitalization, and a composite of death, myocardial infarction, stroke, and repeat revascularization.Discussion： Findings will not only provide evidence regarding the feasibility and effectiveness of the described intervention for improving adherence to CABG secondary preventive therapies but also explore a model tor outpatient health self-managenlent that could be translated to various chronic diseases and widely disseminated across resource-limited settings.展开更多
To the Editor： Coronary arterial involvement is rare in Takayasu＇s arteritis. We describe successful coronary artery stenting in a 17-year-old teenager with Takayasu＇s arteritis and acute inferior myocardial infarc...To the Editor： Coronary arterial involvement is rare in Takayasu＇s arteritis. We describe successful coronary artery stenting in a 17-year-old teenager with Takayasu＇s arteritis and acute inferior myocardial infarction due to occlusion of the right coronary artery.展开更多
基金This study involving human participants was reviewed and approved by the ethics committee of TEDA International Cardiovascular Hospital,China(No.0715-4,2021,02 August 2021)the National Natural Science Foundation of China[82170353&81870288]+4 种基金the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences[2020-PT310-007]Tianjin Municipal and Binhai New Area Health Commissions[KJ20071&2019BWKY010]Tianjin Science and Technology Project[18PTZWHZ00060]TEDA International Cardiovascular Hospital[2021-TD-006&2021-ZX-002&2019-TD-013]Tianjin Key Medical Discipline(Specialty)Construction Project[TJYXZDXK-019A].
文摘Background:Atrial septal defect(ASD)is one of the common congenital heart diseases.The MYH6 gene has a critical role in cardiac development but the role of MYH6 promoter variants in patients with ASD has not been explored.Methods:In 613 subjects including 320 ASD patients,we investigated the MYH6 gene promoter variants and verified the effect on gene expression by using cellular functional experiments and bioinformatics analysis.Results:Eleven variants were identified in the MYH6 gene promoter,of which four variants were found only in ASD patients,and two variants(g.3434G>C and g.4524C>T)were identified for the first time.Cellular functional experiments indicated that all four variants reduced the transcriptional activity of the MYH6 gene promoter(p<0.05).Subsequent analysis through the JASPAR(A database of transcription factor binding profiles)suggests that these variants may alter transcription factor binding sites,which may in turn lead to changes in myocardin subunit expression and ASD formation.Conclusions:Our study for the first time focuses on variants in the promoter region of the MYH6 gene in Chinese patients with ASD and the discovered variants have functional significance.The study provides new insights in the role of the MYH6 gene promoter region to better understand the genetic basis of ASD formation and facilitates clinical diagnosis.
基金supported by“Heart Health Research Fund,”Special Fund for Cardiovascular Disease Development of China,China International Medical Foundation(Grant No.Z-2019-42-1908-3),Tianjin Key Medical Discipline(Specialty)Construction Project,and the Young Talents Training Program of Tianjin First Central Hospital.
文摘Background:Preeclampsia(PE),characterized by hypertension and proteinuria,leads to serious maternal and infant complications.Uridine-cytidine kinase 2(UCK2)belongs to the UCK family,a class of enzymes that catalyzes the conversion of uridine and cytidine to monophosphate form.However,the role of UCK2 in PE has not been reported.Methods:The expression of UCK2 was detected in the placenta of PE patients and N(ω)-nitro-L-arginine methyl esterinduced PE mouse model.Through forced up-regulation or down-regulation of UCK2 in vitro,we examined the effects of UCK2 on the proliferation,apoptosis,migration,and invasion of trophoblast cells.Stattic,the inhibitor of STAT3 pathway,was used to investigate whether the STAT3 pathway mediates the biological function of UCK2 in trophoblast cells.Results:The present study found that UCK2 showed low expression in the placenta of PE patients and PE mouse model.MTT(3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide)and flow cytometry assays verified that up-regulation of UCK2 promoted the proliferation of trophoblast cells,while the silence of UCK2 suppressed cell proliferation.Besides,flow cytometry and TdT-mediated dUTP Nick-End Labeling assays demonstrated that knockdown of UCK2 resulted in apoptosis of trophoblast cells.The wound healing and transwell assays showed that the migration and invasion activities of the trophoblast cells were facilitated by the overexpression of UCK2 and were blocked by the silence of UCK2.Furthermore,the expression of phosphorylated STAT3 was increased with the upregulation of UCK2 and decreased with the inhibition of UCK2.When the STAT3 pathway was blocked by its inhibitor stattic,the promotion effects of UCK2 on trophoblast cells were suppressed.Conclusion:UCK2 promotes the proliferation,migration,and invasion of trophoblast cells,and these effects may be partly mediated by the activation of the STAT3 pathway.
基金supported by grants from Basic Scientific Research Business Expenses Foundation of Huazhong University of Science and Technology,China(No2014QN136)Natural Science Foundation of Hube Province,China(No.2014CFB955)
文摘The current situation of medical staff＇s awareness about high alert medication was investigated in order to promote safe medication and standardized management of the high alert medication in China. Twenty questions were designed concerning elementary knowledge of high alert medications, storage management, medication issues and risks. In order to understand the knowledge level and education status of high alert medication, a convenient survey was conducted among 300 medical staffs in Tianjin. Medical staff＇s average score of high alert medication knowledge was 12.43±0.27, and the average scores of elementary knowledge of high alert medication, storage management, medication issues and risks were 3.38±0.11, 2.46±0.14, 3.17±0.11 and 3.41±0.12 respectively. Occupation（F=4.86, P=0.003）, education background（F=5.57, P=0.019） and professional titles（F=13.44, P≤0.001） contributed to the high alert medications knowledge scores. Currently, the most important channel to obtain high alert medication knowledge was hospital files or administrative rules, and clinical pharmacist seminars were the most popular education form. It was suggested that the high alert medication knowledge level of the medical staff needs to increase, and it might benefit from targeted, systematic and diverse training to the medical staff working in the different circulation nodes of the medications. Further research to develop and validate the instrument is needed.
基金from National Key R&D Program of China(2016YFC1301300,2016YFC1301302)。
文摘BACKGROUND:The predictive scoring systems for early stent thrombosis(EST)remains blank in China.The study aims to evaluate the risk factors and conduct a prediction model of EST in the Chinese population.METHODS:EST was defined as thrombosis that occurs within the first 30 days after primary percutaneous coronary intervention(PCI).Patients from ten Chinese hospitals diagnosed as stent thrombosis(ST)from January 2010 to December 2016 were retrospectively included as the study group.A control group(1 case:2 controls)was created by including patients without ST,major adverse cardiovascular events,or cerebrovascular events during follow-up.The present study evaluated 426 patients with single-vessel lesions and ultimately included 40 patients with EST and 80 control patients,who were included to identify factors that predicted EST and to develop a prediction scoring system.The other 171 patients without integrated 1:2 pair were used for external validation.RESULTS:EST was independently associated with a low hemoglobin concentration(adjusted odds ratio[OR]0.946,95%confi dence interval[95%CI]0.901-0.993,P=0.026),a high pre-PCI Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery(SYNTAX)score(OR 1.166,95%CI 1.049-1.297,P=0.004),and a DAPT(DAPT)duration of<30 days(OR 28.033,95%CI 5.302-272.834,P<0.001).The simple EST prediction score provided an area under the curve(AUC)of 0.854(95%CI 0.777-0.932,P<0.001)with 70.0%sensitivity and 90.0%specifi city,and 0.742(95%CI 0.649-0.835,P<0.001)with 54.5%sensitivity and 81.0%specifi city for external validation dataset.CONCLUSIONS:EST may be independently associated with DAPT discontinuation within 30 days,a low hemoglobin concentration,and a high SYNTAX score.The scoring system also has a good ability to predict the risk of EST and may be useful in the clinical setting.
文摘The deterioration of vestibular function is a side effect of numerous diseases of the inner ear. Vertigo is the most common symptom of vestibular dysfunction. Vestibule-suppressing drugs can control symptoms but impede the rehabilitation of vestibular function. Surgical treatment can effectively resolve vestibular dysfunction associated with some progressive diseases, including tumors. However, unilateral vestibular function remains permanently damaged after surgery, causing problems like vertigo and imbalance. To enhance the understanding of Vestibular rehabilitation therapy, this paper presents a summary of the progress in research on Vestibular rehabilitation therapy for patients with vestibular dysfunction.
基金supported by the National Natural Science Foundation of China(No.81773984,81402441)Chongqing Natural Science Foundation of China(No.CSTC2020JCYJMSXMX0451)+3 种基金Traditional Chinese medicine research project of Chongqing Health Bureau(No.2020ZY023665)Chinese Medicine Rehabilitation-the Key Discipline Constructed by Chongqing Health Bureau(No.2021-4322190044)Fundamental Research Funds for the Central Universities(China)(No.XDJK2012C054)Southwest University Doctor Foundation(Chongqing,China)(No.SWU111074).
文摘Cancer stem cells(CSCs)are related to tumorigenesis,recurrence,metastasis,and drug resistance in hepatocellular carcinoma(HCC).1 Let-7i is a noncoding small RNA,belonging to the famous miRNA let-7 family.Recently,let-7i has been revealed as a tumor suppressor on CsCs in ovarian cancer.
基金Project of Bureau for Disease Control and Prevention,National Health Commission(T2021-ZC02)Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2M-1-007).
文摘To improve the standard screening, diagnosis, and treatment of hypertension in patients in China;realize the standardization of clinical practice of hypertension;and improve the prevention and control level of hypertension in China, it is both important and necessary to develop a clinical practice guideline for hypertension according to a recognized methodology. Jointly sponsored by the National Center for Cardiovascular Diseases, Chinese Medical Doctor Association, Hypertension Committee of the Chinese Medical Doctor Association, Chinese Society of Cardiology, and Hypertension Committee of Cross-Straits Medicine Exchange Association, the “Chinese Clinical Practice Guidelines of Hypertension” was proposed. Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences, Guideline and Standards Research Centre of Chinese Medical Association Publishing House, Lanzhou University Institute of Health Data Science, and Lanzhou University GRADE Center will provide methodological support for the guidelines.
基金This work was supported by the National Science Foundation of China(22008130 and 51806123)the China Postdoctoral Science Foundation(2020M682124)+3 种基金the Natural Science Foundation of Tianjin(18JCYBJC42000)the Research Fund of TEDA International Cardiovascular Hospital(2018-TD-001)the Qingdao Postdoctoral Researchers Applied Research Project Foundation(RZ2000001426)the Scientific Research Foundation for Youth Scholars from Qingdao University(DC1900014265).
文摘Due to extremely severe morbidity and mortality worldwide,it is worth achieving a more in-depth and comprehensive understanding of cardiovascular diseases.Tremendous effort has been made to replicate the cardiovascular system and investigate the pathogenesis,diagnosis and treatment of cardiovascular diseases.Microfluidics can be used as a versatile primary strategy to achieve a holistic picture of cardiovascular disease.Here,a brief review of the application of microfluidics in comprehensive cardiovascular disease research is presented,with specific discussions of the characteristics of microfluidics for investigating cardiovascular diseases integrally,including the study of pathogenetic mechanisms,the development of accurate diagnostic methods and the establishment of therapeutic treatments.Investigations of critical pathogenetic mechanisms for typical cardiovascular diseases by microfluidic-based organ-on-a-chip are categorized and reviewed,followed by a detailed summary of microfluidic-based accurate diagnostic methods.Microfluidic-assisted cardiovascular drug evaluation and screening as well as the fabrication of novel delivery vehicles are also reviewed.Finally,the challenges with and outlook on further advancing the use of microfluidics technology in cardiovascular disease research are highlighted and discussed.
基金supported in part by the Scientific Research Common Program of the Beijing Municipal Commission of Education(KM202110025014)Beijing Municipal Science and Technology Commission(Z211100002921010)Jiangsu Province Capability Improvement Project through Science,Technology and Education(ZDXK202230).
文摘The systemic benefits of anti-inflammatory pharmacotherapy vary across cardiovascular diseases in clinical practice.We aimed to evaluate the application of artificial intelligence to acute type A aortic dissection(ATAAD)patients to determine the optimal target population who would benefit from urinary trypsin inhibitor use(ulinastatin).Patient characteristics at admission in the Chinese multicenter 5A study database(2016-2022)were used to develop an inflammatory risk model to predict multiple organ dysfunction syndrome(MODS).
文摘Objective::Data comparing the outcomes of MiStent(Micell Technologies,Durham,North Carolina,USA)microcrystalline biodegradable polymer(BP)drug-eluting stent(DES)and those of another post-marketing BP-DES,TIVOLI(EssenTech,Beijing,China)are rare.This study sought to compare the angiographic efficacy and clinical outcomes of the microcrystalline BP sirolimus-eluting stent(SES)system MiStent and those of TIVOLI BP-SES.Methods::The DESSOLVE-C trial was a prospective,single-blinded,multicenter,randomized trial(NCT02448524),which randomly assigned patients with de novo coronary lesions to receive MiStent or TIVOLI BP-SES by a 1:1 ratio.The primary endpoint was a non-inferiority comparison of in-stent late lumen loss(LLL)by quantitative coronary angiography at 9 months.The secondary endpoint was device-related clinical cardiovascular composite events(target lesion failure(TLF),composite of cardiac death,target vessel myocardial infarction(MI),and clinically driven target lesion revascularization)and 1-year outcomes.Results::A total of 428 patients(216 patients in the MiStent group and 212 patients in the TIVOLI group)were enrolled and included in an intention-to-treat analysis.MiStent was not only non-inferior but superior to TIVOLI for in-stent LLL at 9 months((0.23±0.37)mm vs.(0.34±0.48)mm,P for non-inferiority<0.001,P for superiority=0.02).Although without significant difference,the rate of TLF in MiStent was quantitatively lower than that in TIVOLI(3.70%vs.6.60%;P=0.17).Conclusion::Compared with TIVOLI BP-SES,the MiStent system was superior in in-stent LLL at 9 months and had a comparable clinical benefit at 1 year in de novo coronary lesions.
基金supported by the National Natural Science Foundation of China(No.81473622)。
文摘Macroangiopathy is a complication of Type II Diabetes Mellitus(T2 DM),which is mainly caused by fibrosis of blood vessels.Using T2 DM rat models,we investigated whether the traditional Chinese medicine,Di-Dang Decoction(DDD),exhibited antifibrotic actions on great vessels.T2 DM rats were randomly divided into non-intervention group,early-,middle-,late-stage DDD intervention groups and control groups,including pioglitazone group and aminoguanidine group.After administration of DDD to T2 DM rats at different times,we detected the amount of extracellular matrix(ECM)deposition in the thoracic aorta.The results showed that early-stage intervention with DDD could effectively protect great vessels from ECM deposition.Considering that TGF-β1 is the master regulator of fibrosis,we further validated at the molecular level that,compared to middle-and late-stage intervention with DDD,early-stage intervention with DDD could significantly decrease the expression levels of factors related to the activated TGF-β1/Smad signalling pathway,as well as the expression levels of downstream effectors including CTGF,MMP and TIMP family proteins,which were directly involved in ECM remodelling.Therefore,early-stage intervention with DDD can reduce macrovascular fibrosis and prevent diabetic macroangiopathy.
基金the Tianjin Science and Technology Committee(CN)(No.16ZXMJSY00080).
文摘To the Editor:Revascularization,regardless of whether it is percutaneous coronary intervention(PCI)or coronary artery bypass grafting(CABG),is still the dominant treatment of severe coronary heart disease(CHD).The long-term clinical outcome of revascularization is unpredictable because of the progression of atherosclerosis continuing after surgery.[1]Many studies and trials have proven that optimal medical therapy(OMT)with or without revascularization is critical for decreasing the incidence of adverse events and improving quality of life.In recent years,patients from China with higher adherence to medical therapy have shown a lower incidence of adverse events at 1 year after PCI.[2]However,there have been no large clinical trials or observational studies for accurate understanding of maintenance of medical strategies in patients with CHD in China.
文摘Background： Atrial AutoCaptureTM （ACapTM） was a new technological development that confirmed atrial capture by analyzing evoked response （ER） with a new method - paced depolarization integral ER detection- and optimized energy output to changes in the stimulation threshold. The purpose of this study was to evaluate the clinical performance ofACapTM function. Methods： This was a prospective, observational, nonrandomized two-center study. Between November 2008 and August 2014, 102 patients were enrolled from two different institutions. Data were collected by case report forms at enrollment, hospital discharge, and in-office follow-ups scheduled at 1, 2, 3, 6, and 12 months postimplantation. Results： Ambulatory ACapTM function started to become available for 20.6% of patients at 1 day, then progressed to 30.4% at 7 days, 38.6% at 1 month, 41.6% at 2 months, 47.5% at 3 months, 53.5% at 6 months, and 63.4% at 1 year. The cause of the unsuccessful attempts to perform ACapTM threshold was ER/polarization 〈2：1. Availability for SD, BND, and HOCM indications had shown better results than AVB indication. For SD indication cases, feasibility was significantly better for SD with paroxysmal atrial fibrillation （pAF） than SD without pAF （78.4% vs. 35.0% at 1 year, n = 71, P 〈 0.001）. At each stage of the clinical follow-ups, there had been a strict correlation between ACapTM measurements and those conducted manually with P 〈 0.001 （n = 299）. Conclusions： It has been concluded that ACapTM function was safe and effective to confirm atrial threshold and reduce energy output automatically. ACapTM function is unavailable for some patients at early stages of the implantation; however, availability has been progressively increasing during follow-up.
基金supported by the National Natural Science Foundation of China[81870288&81641017]the Nonprofit Central Research Institute Fund of the Chinese Academy of Medical Sciences[2019XK310001&2018TX31002&2017NL31001]the Tianjin Science and Technology Committee[18PTZWHZ00060].
文摘Dear Editor,Atrial fibrillation(AF)is one of the most common cardiac arrhythmias.Its prevalence increases significantly with age.It is well known that patients with AF are associated with an increased risk of stroke,1 and AF is a great economic burden on the worldwide socioeconomic system.Previous studies have shown that electrical,contractile,and structural remodeling play key roles in the onset and maintenance of AF.2 Other possible pathogenesis mechanisms include calcium handling abnormalities,autonomic imbalance,and genetic factors.3 However,the exact molecular mechanism associated with AF remains unknown.
文摘Background： Secondary preventive therapies play a key role in the prevention of adverse outcomes after coronary artery bypass grafting （CABG）. However, medication adherence alter CABG is often poor, and conventional interventions for improving adherence have limited success. With increasing penetration of smartphones, health-related smartphone applications might provide an opportunity to improve adherence. Carefully designed trials are needed to provide reliable evidence for the use of these applications in patients after CABG. Methods： The Measurement and Improvement Studies of Surgical Coronary Revascularization： Medication Adherence （MISSION-2） study is a multicenter randomized controlled trial, aiming to randomize 1000 CABG patients to the intervention or control groups in a 1 ： 1 ratio. We developed the multifaceted, patient-centered, smartphone-based Heart Health Application to encourage lnedication adherence in the intervention group through a health self management program initiated dnring hospital admission for CABG. The application integrated daily scheduled reminders to take the discharge medications, cardiac edticational materials, a dynamic dashboard to review cardiovascular risk factors and secondary prevention targets, and weekly questionnaires with interactive feedback. The primary outcome was secondary preventive medication adherence measured by the Chinese version of the 8-item Morisky Medication Adherence Scale at 6 months after randomization. Secondary outcomes included all-cause death, cardiovascular rehospitalization, and a composite of death, myocardial infarction, stroke, and repeat revascularization.Discussion： Findings will not only provide evidence regarding the feasibility and effectiveness of the described intervention for improving adherence to CABG secondary preventive therapies but also explore a model tor outpatient health self-managenlent that could be translated to various chronic diseases and widely disseminated across resource-limited settings.
文摘To the Editor： Coronary arterial involvement is rare in Takayasu＇s arteritis. We describe successful coronary artery stenting in a 17-year-old teenager with Takayasu＇s arteritis and acute inferior myocardial infarction due to occlusion of the right coronary artery.
