BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

Elemene is widely recognized as an effective anti-cancer compound and is routinely administered in Chinese clinical settings for the management of several solid tumors, including non-small cell lung cancer (NSCLC). However, its detailed molecular mechanism has not been adequately demonstrated. In this research, it was demonstrated that elemene effectively curtailed NSCLC growth in the patient-derived xenograft (PDX) model. Mechanistically, employing high-throughput screening techniques and subsequent biochemical validations such as microscale thermophoresis (MST), microRNA-145-5p (miR-145-5p) was pinpointed as a critical target through which elemene exerts its anti-tumor effects. Interestingly, elemene serves as a binding stabilizer for miR-145-5p, demonstrating a strong binding affinity (dissociation constant (K _D) = 0.39 ± 0.17 μg/mL) and preventing its degradation both in vitro and in vivo, while not interfering with the synthesis of the primary microRNA transcripts (pri-miRNAs) and precursor miRNAs (pre-miRNAs). The stabilization of miR-145-5p by elemene resulted in an increased level of this miRNA, subsequently suppressing NSCLC progression through the miR-145-5p/mitogen-activated protein kinase kinase kinase 3 (MAP3K3)/nuclear factor kappaB (NF-κB) pathway. Our findings provide a new perspective on revealing the interaction patterns between clinical anti-tumor drugs and miRNAs.

Objectives:To establish a comprehensive system of Cardiovascular Academic Performance Evaluation(CAPE)and rank global TOP100 medical institutions in the fields of cardiovascular diseases(CVD). Methods:CVD-related terms were extracted from Medical Subject Headings(MeSH),Embase thesaurus(EMtrees)and International Classification of Diseases(ICD)by CVD-related professionals,as well as by librarians and information professionals.Terminology databases(named as Fuwai Subject Headings)were established,and nine sub-disciplines were proposed,including ischemic heart diseases,hypertension,vascular diseases,arrhythmia,pulmonary vascular diseases,heart failure,congenital heart diseases,cardiomyopathy,and valvular heart diseases.The mapping patterns of sub-discipline,cardiovascular terminology and entry terms were pre-defined.The CVD-related research literature published from January 1,2016 to December 31,2022 were retrieved from Web of Science,PubMed and Scopus.Based on this,metadata were fused and duplicates were excluded.Fuwai Subject Headings were searched and matched into four respects for each literature,including subject words,titles,keywords,and abstracts,which was used to generate an information table of"Position—CVD terminology—Frequency",and to calculate CVD correlation scores and sub-discipline scores.We standardized the names of medical institutions and scholars,and make a ranking system for CAPE based on original articles with strong cardiovascular correlation(correlation score≥4).When evaluating the science and technological performance for Chinese hospitals in cardiovascular diseases,National Natural Science Foundation Projects,authorized invention patents,prize achievements,research platforms,and registered data of drug clinical trials in Center for Drug Evaluation(CDE)were considered besides research papers. Results:During 2016 and 2022,1 545 103 CVD research literatures were found worldwide.After excluding meeting abstracts,books,biographies,news,videos,audio texts,retracted publications,and corrections,1 178 019 CVD research literatures were further evaluated.518 058 literatures were indexed as"strongly correlated to CVD"using Fuwai Subject Headings.Besides papers,other data sources were also collected,including 11 143 CVD-related Natural Science Foundation Projects,19 382 CVD-related effective authorized invention patents,103 CVD-related national prize achievements,24 CVD-related national research platforms,and 2 084 CDE registered data of CVD-related drug clinical trials.Research teams from nine sub-disciplines reviewed and validated research literature in respective fields,and classification rules of corresponding sub-disciplines were created and improved based on their opinions.Finally,eleven individual indexes were chosen to construct CAPE system for ranking global TOP100 medical institutions in overall CVD field and TOP30 in nine sub-disciplines.From 2016 to 2022,the number of cardiovascular disease research papers published by Chinese institutes has increased by 123.5%,with a total of approximately 76.8 thousands papers published(about 30 papers per day on average),ranked the second under the United States(approximately 114.1 thousands papers).However,the proportion of papers published by the Chinese Journal Citation Reports(JCR)and the Chinese Academy of Sciences only ranked eighth in the world.In the comprehensive academic performance of original cardiovascular research papers in global hospitals from 2020 to 2022,only two Chinese medical institutions ranked in the TOP20 as evaluated by CAPE system. Conclusions:Based on multi-source data from 2016 to 2022,CAPE initiated to establish a cardiovascular academic performance evaluation system.

Objective To investigate the risk factors for recurrence of persistent atrial fibrillation(AF)after radiofrequency ablation with circumferential pulmonary vein isolation+top line+back wall line based on the features of cardiac imaging and serum biomarkers,and then to establish a nomogram risk prediction model.Methods A total of 172 patients with persistent AF admitted to our hospital from June 2022 to September 2023 were enrolled and then according to recurrence or not in 6 months after surgery,they were divided into the recurrence group(51 cases)and the non-ecurrence group(121 cases).Before surgery,routine electrocardiography,and transthoracic and esophageal echocardiography were performed,while blood routine indicators and related biochemi-cal indicators were measured.All patients underwent radiofrequency ablation with circumferential pulmonary vein isolation,top line,and back wall line.They were followed up for 6 months after surgery.Binary logistic analysis was used to analyze the independent risk factors for postoperative recurrence,and then a nomogram risk prediction model was constructed and its diagnostic per-formance was evaluated.Results Lager LAD,higher LAVI,neutrophil count and NLR,and ele-vated BNP and CRP levels,while lower LAAFV,LAAEV and LAAEF were observed in the re-current group than those in the non-recurrent group(P＜0.01).Binary logistic regression analysis showed that elevated LAVI(OR=1.160,95％CI:1.006-1.337),decreased LAAEV(OR=0.740,95％CI:0.583-0.940),decreased LAAEF(OR=0.608,95％CI:0.422-0.877),elevated BNP(OR=1.017,95％CI:1.004-1.030),and higher NLR(OR=10.116,95％CI:1.316-77.755)were independent risk factors for recurrence after radiofrequency ablation of pulmonary vein isolation+top line+posterior wall line in persistent AF patients(P＜0.05,P＜0.01).The AUC value of the nomogram model constructed with LAVI,LAAEV,LAAEF,BNP and NLR in predicting postop-erative recurrence was 0.889(95％CI:0.833-0.932).Conclusion The cardiac imaging parame-ters LAVI,LAAEV and LAAEF,and serum biomarkers BNP and NLR are closely associated with postoperative recurrence of persistent AF in patients after radiofrequency ablation with cir-cumferential pulmonary vein isolation+top line+back wall line,and the relevant nomogram mod-el has better diagnostic value for postoperative recurrence.

Objective:To investigate the effect of astragaloside A (AS-A) on the photoreceptor degeneration induced by sodium iodate (NaIO 3) and its related mechanism. Methods:Sixty healthy male C57BL/6J mice, aged 6-8 weeks, were randomly divided into normal control (NC) group, NaIO 3 group, and ASA group, with twenty mice in each group. 30 min before modeling, AS-A group mice were intraperitoneally injected with 100 μl AS-A at a dose of 100 mg/kg body weight. 30 min later, mice in NaIO 3 group and AS-A group were intraperitoneally injected with 100 μl NaIO 3 at a dose of 30 mg/kg body weight. Subsequently, AS-A group mice were administered AS-A twice daily at 12 h intervals until the end of the experiment. On day 1 post-modeling, zonula occludens-1 (ZO-1) immunohistochemistry was performed to observe the structure of retinal pigment epithelium (RPE) cells; real-time quantitative polymerase chain reaction (qPCR) was conducted to detect the mRNA expression of various retinal chemokine ligand-2 ( Ccl2), interleukin-1 beta ( Il-1β), mixed lineage kinase domain-like protein ( Mlkl), receptor-interacting protein kinase 3 ( Ripk3), and tumor necrosis factor ( Tnf). On day 3 post-modeling, immunohistochemistry was performed to observe the expression of ionized calcium binding adaptor molecule 1 (Iba1) and glial fibrillary acid protein (GFAP) in the retina; TdT-mediated dUTP nick-end labeling (TUNEL) assay was used to detect photoreceptor cell death in each group. On day 4 post-modeling, fundus morphology of mice in each group was observed by fundus color photography and optical coherence tomography (OCT). Hematoxylin-eosin staining (HE) was used to observe the morphological structure of the retina in each group. Inter-group comparisons between two groups were conducted using independent samples t-test, while comparisons among three groups were performed using one-way ANOVA. Results:Fundus color photography and OCT examination showed that a large number of scattered yellow-white subretinal nodular structures in the fundus of NaIO 3 group mice, and a large number of strong reflection areas in the RPE layer. The number of strong reflection areas in the RPE layer was reduced in the AS-A group. Immunohistochemical analysis of ZO-1 showed that ZO-1 was largely lost on the RPE cell membrane in that NaIO 3 group; whereas in the AS-A group, ZO-1 was evenly distributed on the RPE cell membrane. HE staining results showed circular black deposits were visible in the RPE layer of the NaIO 3 group, and the inner and outer segments of photoreceptors were severely damaged, with a significant decrease in the number of outer nuclear layer (ONL) cell nuclei; whereas in the AS-A group, the RPE layer pigments were orderly, the inner and outer segments of photoreceptors were intact, and the number of ONL cell nuclei significantly increased. The results of TUNEL staining show that numerous TUNEL-positive cell nuclei were observed in the ONL of the retina in the NaIO 3 group, while the number of TUNEL-positive cell nuclei in the ONL of the retina was significantly reduced in the AS-A group, with statistically significant differences ( t=2.66, P<0.05). The analysis of qPCR data showed that compared with the AS-A group, the relative expression levels of Mlkl, Ripk3, Ccl2, Il-1β and Tnf mRNA in the retina were significantly increased in the NaIO 3 group, with statistically significant differences ( F=39.18, 10.66, 53.51, 41.40, 24.13; P<0.001). Immunohistochemical staining results showed that compared with NC group and AS-A group, the positive expression of GFAP in retina of NaIO 3 group was significantly increased, and the difference was statistically significant ( F=9.62, P<0.05). Conclusion:AS-A antagonizes NaIO 3-induced photoreceptor degeneration in part by inhibiting photoreceptor cell death and neuroinflammation. Meanwhile, AS-A treatment protects against NaIO 3-triggered perturbation of retinal homeostasis.

Objective:To explore the impact of coronary CT angiography (CCTA) image quality and related factors on the diagnostic performance of CT-derived fractional flow reserve (CT-FFR).Methods:Based on the CT-FFR CHINA trial, the prospective multicenter trial enrolled patients with suspected coronary artery disease who underwent CCTA, CT-FFR and FFR measurement. The subjective and objective assessments of CCTA image were performed on a per-vessel level. The objective assessments included the enhancement degree of coronary artery, the signal-to-noise ratio (SNR) of the aortic root. We used χ 2 test and DeLong test to compare the diagnostic performance of CT-FFR with FFR as the reference standard in different subjective groups (non-artifact vs. artifact), enhancement degree of coronary artery groups (≤400 vs. 401-500 vs.>500 HU), SNR of the aortic root groups (≤16.9 vs.>16.9), body mass index (BMI) groups (<25 kg/m 2 vs.≥25 kg/m 2) and heart rate groups (<75 bpm vs.≥75 bpm). FFR and CT-FFR values≤0.80 was identified as myocardial ischemia. Results:The study enrolled 317 patients with 366 vessels. All target vessels in CCTA images were successfully analyzed by CT-FFR. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value and AUC of the non-artifact group were 90.45%, 86.75%, 93.10%, 90.00%, 90.76% and 0.928, respectively, and those of the artifact group were 83.23%, 87.21%, 79.01%, 81.52%, 85.33% and 0.869, respectively. The differences in accuracy and specificity were statistically significant (χ 2=4.23, P=0.040; χ 2=8.55, P=0.003). The diagnostic efficacy of CT-FFR had no statistically significant differences among different objective groups (all P>0.05). Conclusions:The artifact of CCTA image has an effect on CT-FFR in the diagnosis of myocardial ischemia. The degree of vascular enhancement, SNR, BMI, and heart rate have no significant effect on the diagnostic performance of CT-FFR.

Objective:To evaluate the postoperative symmetry of soft and hard tissues in patients with unilateral old zygomatic fractures.Methods:A retrospective analysis of patients who underwent computer-assisted open reduction and internal fixation for unilateral old zygomatic complex fractures. The spiral CT data of the patient before and 1 year after operation was imported into ProPlan CMF 3.0 software to segment the skin and bone STL models. Eleven sets of soft tissue landmarks and 10 sets of hard tissue landmarks in the middle of the face were marked, with a coordinated system for measurement established. The asymmetry index (AI) between each mark point was calculated. The data were expressed by Mean±SD. Paired t-test was used to compare whether there was a statistical difference in the AI of each landmark before and after operation. P<0.05 was considered the difference to be statistically significant. At the same time, the study subjects were selected from the Chinese craniomaxillofacial three-dimensional morphological database. Microsoft Excel 2017 software was used to draw the AI baseline data map of common people. The patients’ soft and hard tissue landmarks AI (before and 1 year after surgery) were included in the AI baseline map of common people, and the patient’s soft and hard tissue symmetry was evaluated. Results:A total of 30 patients were included in the study, including 17 males and 13 females, age range from 18 to 55 years old, with an average age of 25.2 years. The preoperative hard tissue AI was 4.5±4.1, and the hard tissue AI was 2.0±1.7 one year after surgery, and the difference in the AI of each hard tissue landmark before and 1 year after operation was statistically significant( P<0.01 or <0.05). The preoperative soft tissue AI was 4.5±4.0, and the soft tissue AI was 2.3±1.9 one year after surgery, and the difference in the AI of each soft tissue landmark before and 1 year after operation was statistically significant( P<0.01 or <0.05). 50 common people were selected from the total database, including 25 men and 25 women, aged from 18 to 57 years old, with an average of 23.8 years old. The hard tissue landmark AI was 2.1±2.0, and the soft tissue landmark AI was 2.0±1.9. The hard tissue landmarks AI of patients 1 year after operation were all within the symmetrical baseline value, with good symmetry. The AI values of some soft tissue landmarks were higher than the symmetrical baseline value, indicating poor symmetry. Conclusion:The three-dimensional symmetry of the soft and hard tissues of patients with unilateral old zygomatic complex fractures after surgery was significantly improved compared with that before surgery. Compared with the normal range of the database, the postoperative hard tissue has better symmetry, but the postoperative soft tissue has poor symmetry.

Objective:To evaluate the postoperative symmetry of soft and hard tissues in patients with unilateral old zygomatic fractures.Methods:A retrospective analysis of patients who underwent computer-assisted open reduction and internal fixation for unilateral old zygomatic complex fractures. The spiral CT data of the patient before and 1 year after operation was imported into ProPlan CMF 3.0 software to segment the skin and bone STL models. Eleven sets of soft tissue landmarks and 10 sets of hard tissue landmarks in the middle of the face were marked, with a coordinated system for measurement established. The asymmetry index (AI) between each mark point was calculated. The data were expressed by Mean±SD. Paired t-test was used to compare whether there was a statistical difference in the AI of each landmark before and after operation. P<0.05 was considered the difference to be statistically significant. At the same time, the study subjects were selected from the Chinese craniomaxillofacial three-dimensional morphological database. Microsoft Excel 2017 software was used to draw the AI baseline data map of common people. The patients’ soft and hard tissue landmarks AI (before and 1 year after surgery) were included in the AI baseline map of common people, and the patient’s soft and hard tissue symmetry was evaluated. Results:A total of 30 patients were included in the study, including 17 males and 13 females, age range from 18 to 55 years old, with an average age of 25.2 years. The preoperative hard tissue AI was 4.5±4.1, and the hard tissue AI was 2.0±1.7 one year after surgery, and the difference in the AI of each hard tissue landmark before and 1 year after operation was statistically significant( P<0.01 or <0.05). The preoperative soft tissue AI was 4.5±4.0, and the soft tissue AI was 2.3±1.9 one year after surgery, and the difference in the AI of each soft tissue landmark before and 1 year after operation was statistically significant( P<0.01 or <0.05). 50 common people were selected from the total database, including 25 men and 25 women, aged from 18 to 57 years old, with an average of 23.8 years old. The hard tissue landmark AI was 2.1±2.0, and the soft tissue landmark AI was 2.0±1.9. The hard tissue landmarks AI of patients 1 year after operation were all within the symmetrical baseline value, with good symmetry. The AI values of some soft tissue landmarks were higher than the symmetrical baseline value, indicating poor symmetry. Conclusion:The three-dimensional symmetry of the soft and hard tissues of patients with unilateral old zygomatic complex fractures after surgery was significantly improved compared with that before surgery. Compared with the normal range of the database, the postoperative hard tissue has better symmetry, but the postoperative soft tissue has poor symmetry.

Objective:To evaluate the independent prognostic value of minute ventilation/carbon dioxide production slope (VE/Vco 2 slope)on heart failure after acute myocardial infarction. Methods:131 patients with acute myocardial infarction (AMI) treated in the cardiology department of China-Japan Friendship Hospital from September 2018 to September 2019 were collected and followed up 3 months after discharge. They were divided into heart failure (HF) group and non-heart failure (NHF) group. All the patients underwent cardiopulmonary exercise test (CPET) before discharge.Results:Three months after discharge, the VE/Vco 2 slope was higher in HF group than in NHF group (36.7±3.8 vs 29.7±4.0, P=0.014). The best VE/Vco 2 slope cutoff for the prediction of heart failure after 3 month was 33.05 with a sensitivity of 81.4% and a specificity of 80.6% [area under curve (AUC) was 0.844, P<0.001]. VE /Vco 2 slope level was an independent predictor of heart failure in patients with acute myocardial infarction after discharge ( OR=1.245, 95% CI: 1.021-1.366, P=0.019). Other independent indicators related to heart failure included N-terminal pro-B type natriuretic peptid (NT-proBNP) level ( OR=1.283, 95% CI: 1.019-1.399, P=0.033). Conclusions:VE/Vco 2 slope yielded strong, independent predictive value for heart failure at 3 month after discharge to AMI patients.

Objective:To investigate the effect of continuous intracranial pressure (ICP) and brain oxygen partial pressure (PbtO 2) monitoring and guiding treatment after the application of standard large bone flap decompression and microhematoma removal in patients with severe traumatic brain injury (TBI). Methods:A retrospective analysis was done of 41 patients with TBI in Department of Neurosurgery in the Inner Mongolia People's Hospital from January 2018 to May 2020. Patients with Glasgow coma scale (GCS)<8 points were treatesd with microscopical removal of hematoma and contusion brain tissue and standard large bone flap decompression. Intraoperative intracranial pressure and brain tissue oxygen partial pressure monitoring probes were placed. Postoperatively, continuous intracranial pressure monitoring and partial oxygen pressure monitoring of brain tissue were performed, and target-based treatment under ICP and PbtO 2 monitoring was performed. According to the Glasgow Outcome (GOS) score after six months, patients were divided into a good outcome group (4-5 scores) and a poor outcome group (1-3 scores). There were 26 cases in good prognosis group and 15 cases in poor prognosis group. Linear regression analysis was used to further evaluate the relationship between PbtO 2, ICP and GOS score. The measurement data of normal distribution were compared by independent sample t-test. The counting data were expressed in cases (%), and the comparison between groups was adopted χ 2 inspection. The general linear bivariate Pearson correlation test was used. Results:The mean value of PbtO 2 (17.42±5.34) mmHg in the poor prognosis group was lower than that in the good prognosis group (24.65±5.61) mmHg, with statistical significance ( t=4.04, P<0.001). The mean value of ICP (22.32±3.45) mmHg in the poor prognosis group was higher than that (17.32±3.23) mmHg in the good prognosis group, with statistical significance ( t=4.15, P<0.001). Using PbtO 2 and ICP as independent variables and GOS score after 6 months as dependent variable, a regression equation was established ( Y=4.040 X+7.497; Y=-2.549 X+28.63). The mean value of PbtO 2 was positively correlated with GOS scores after 6 months in patients with severe head injury ( r=0.75, P<0.001). The mean value of ICP was negatively correlated with the prognosis of patients with severe head injury ( r=-0.87, P<0.001). Conclusion:The treatment guided by ICP combined with PbtO 2 monitoring is valuable in improving the prognosis of patients with severe traumatic brain injury after standard decompressive craniectomy, and may improve the prognosis 6 months after the injury.