BACKGROUND: Changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels may not fully translate into patient-reported health status in patients with heart failure (HF). We aimed to evaluate the correlation between NT-proBNP levels and patient-reported health status changes at one month after discharge of patients, and their associations with risk of death and rehospitalization in patients with acute HF. METHODS: We used data from the China Patient-centered Evaluative Assessment of Cardiac Events Prospective Heart Failure Study (PEACE 5p-HF Study). Patient-reported health status was measured by the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ-12). Patients who were hospitalized for HF and completed the KCCQ-12 and NT-proBNP tests before and one month after discharge were eligible in our study. We stratified patients into different groups based on NT-proBNP levels (i.e., improved, stable, and deteriorated) and KCCQ-12 scores (i.e., not deteriorated and deteriorated). We also examined the associations of the joint NT-proBNP and KCCQ-12 change with the risk of one-year and four-year clinical outcomes. RESULTS: A total of 2461 patients were included in the analysis. The mean age was 64.06 ± 13.51 years, and 36.37% (895/2461) of the study population were female. Among patients with improved NT-proBNP levels, 115 (10.95%) patients had deteriorated KCCQ-12 scores. The correlation between the change in the KCCQ-12 score and NT-proBNP level was weak ( r2 = 0.002, P = 0.013). Stratification by changes in the KCCQ-12 score revealed subgroups with distinctive risks, such that patients with deteriorated KCCQ-12 scores in any of the NT-proBNP change groups exhibited an increased risk of one-year all-cause death than participants with not deteriorated KCCQ-12 scores in any of the NT-proBNP change groups. Patients with improved NT-proBNP levels and deteriorated KCCQ-12 scores presented greater risks of one-year all-cause death (hazard ratio [HR]: 2.45, 95% confidence interval [CI]: 1.34-4.48) than patients with stable NT-proBNP levels and not deteriorated KCCQ-12 scores (HR [95% CI], 1.77 [1.25-2.53]). CONCLUSIONS: A discrepancy between changes in NT-proBNP levels and KCCQ-12 scores was common. The change in NT-proBNP levels was not sufficient to characterize critical aspects related to HF during one month after discharge of patients. Changes in the KCCQ-12 score exhibit complementary information to NT-proBNP levels for the prediction of clinical outcomes in patients with acute HF. REGISTRATION www.clinicaltrials.gov (No. NCT02878811).
Aged ; Female ; Humans ; Male ; Middle Aged ; Health Status ; Heart Failure/metabolism* ; Natriuretic Peptide, Brain/metabolism* ; Peptide Fragments/metabolism* ; Prospective Studies

This research study focuses on addressing the limitations of current neuropathic pain (NP) treatments by developing a novel dual-target modulator, E0199, targeting both Na_V1.7, Na_V1.8, and Na_V1.9 and K_V7 channels, a crucial regulator in controlling NP symptoms. The objective of the study was to synthesize a compound capable of modulating these channels to alleviate NP. Through an experimental design involving both in vitro and in vivo methods, E0199 was tested for its efficacy on ion channels and its therapeutic potential in a chronic constriction injury (CCI) mouse model. The results demonstrated that E0199 significantly inhibited Na_V1.7, Na_V1.8, and Na_V1.9 channels with a particularly low half maximal inhibitory concentration (IC₅₀) for Na_V1.9 by promoting sodium channel inactivation, and also effectively increased K_V7.2/7.3, K_V7.2, and K_V7.5 channels, excluding K_V7.1 by promoting potassium channel activation. This dual action significantly reduced the excitability of dorsal root ganglion neurons and alleviated pain hypersensitivity in mice at low doses, indicating a potent analgesic effect without affecting heart and skeletal muscle ion channels critically. The safety of E0199 was supported by neurobehavioral evaluations. Conclusively, E0199 represents a ground-breaking approach in NP treatment, showcasing the potential of dual-target small-molecule compounds in providing a more effective and safe therapeutic option for NP. This study introduces a promising direction for the future development of NP therapeutics.

ObjectiveTo investigate the effect of intermittent theta burst stimulation (iTBS) of the multi-target cerebral cortex after stroke on functional recovery of the upper limb of the hemiplegic side. MethodsFrom November, 2019 to August, 2020, 40 stroke patients in Gansu Provine Hospital Rehabilitation Center were included and randomly divided into single-target stimulation group (n = 20) and multiple-target stimulation group (n = 20). Both groups underwent basic neurorehabilitation drug therapy and conventional rehabilitation exercises. The single-target stimulation group received repetitive transcranial magnetic stimulation (rTMS) (iTBS mode) only in the primary motor cortex (M1) of the affected side. The multi-target stimulation group received rTMS (iTBS mode) in the cerebellar cortex of the healthy brain and M1 of the affected side, once a day, six days a week, for four weeks. Before and after treatment, the scores of Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Research Arm Test (ARAT) and modified Barthel Index (MBI), and the latency and amplitude of somatosensory-evoked potentials N20 were compared. ResultsNo serious adverse reaction occurred during treatment. After treatment, the scores of FMA-UE, MBI and ARAT, and the amplitude and latency of N20 improved in both groups (|t| > 3.478, |Z| > 2.243, P < 0.05); and the scores of FMA-UE and ARAT, and the amplitude of N20 were better in the multiple-target stimulation group than in the single-target stimulation group (t > 2.939, Z = -2.697, P < 0.01). ConclusionMulti-target stimulation is superior to single-target stimulation for improving upper limb motor function and N20 amplitude in the hemiplegics after stroke.

Emergence of the colistin resistance gene,mcr-1,has attracted worldwide attention.Despite the prevalence of mcr-1-positive Escherichia coli(MCRPEC)strains in human carriage showing a significant decrease between 2016 and 2019,genetic differences in MCRPEC strains remain largely unknown.We therefore conducted a comparative genomic study on MCRPEC strains from fecal samples of healthy human subjects in 2016 and 2019.We identified three major differences in MCRPEC strains between these two time points.First,the insertion sequenceISApll1 was often deleted and the percentage of mcr-1-carrying IncI2 plasmids was increased in MCRPEC strains in 2019.Second,the antibiotic resistance genes(ARGs),aac(3)-Ⅳa and blaCTX-M-1,emerged and coexisted with mcr-1 in 2019.Third,MCRPEC strains in 2019 contained more viru-lence genes,resulting in an increased proportion of extraintestinal pathogenic E.coli(ExPEC)strains(36.1％)in MCRPEC strains in 2019 compared to that in 2016(10.5％),implying that these strains could occupy intestinal ecological niches by competing with other commensal bacteria.Our results suggest that despite the significant reduction in the prevalence of MCRPEC strains in humans from 2016 to 2019,MCRPEC exhibits increased resistance to other clinically important ARGs and contains more virulence genes,which may pose a potential public health threat.

Chemotherapy has been a major option in clinic treatment of malignant tumors. However, single chemotherapy faces some drawbacks, such as multidrug resistance, severe side effects, which hinder its clinic application in tumor treatment. Multifunctional nanoparticles loading with chemotherapeutic agent and photosensitizer could be a promising way to efficiently conduct tumor combination therapy. In the current study, a novel pH-sensitive and bubble-generating mesoporous silica-based drug delivery system (denoted as M(a)D@PI-PEG-RGD) was constructed. Ammonium bicarbonate (NH

OBJECTIVE: To investigate the effect and mechanism of lead exposure on hypothalamic inflammatory factors in mice fed with high-fat diet. METHODS: Specific pathogen free healthy male Kunming mice were randomly divided into control group, high-fat diet group, lead exposure group, and combined exposure group, with 8 rats in each group. The control group and the lead exposure group were given regular diet, while high-fat diet group and combined exposure group were given high-fat diet. The lead exposure group and combined exposure group were given water with 250 mg/L lead acetate. The control group and high-fat diet group were given double distilled water. Continuous lead exposure was given for 9 weeks, 7 days per week. Body weights of the mice were measured every other week. After 9 weeks of exposure, the behavioral changes of mice were detected by open field test. The levels of triglyceride(TG), low density lipoprotein(LDL) and high density lipoprotein(HDL) in serum were detected by microplate reader. Western blotting was used to detect the relative protein expression of interleukin(IL)-1β, IL-6, IL-17 A, IL-22, tumor necrosis factor-α(TNF-α) and transforming growth factor-β(TGF-β) in the hypothalamus of mice. The relative expression of mRNA of IL-1β, IL-6, IL-17 A and TNF-α mRNA was detected by real-time fluorescence quantitative polymerase chain reaction. RESULTS: Beginning from the first week, the body weights of mice in the high-fat diet group and the combined exposure group were higher than that in the control group and the lead exposure group(P<0.05). The numbers of standing in the lead exposure group and the combined exposure group were lower than that in the control group and the high-fat diet group(P<0.05). The distances of central area activity in the high-fat diet group, the lead exposure group and the combined exposure group were lower than that in the control group(P<0.05). The total distances in the high-fat diet group and the combined exposure group were lower than that in the control group(P<0.05). The serum levels of TG and LDL in the combined exposure group increased(P<0.05), and the HDL level decreased(P<0.05), when compared with the control group and the lead exposure group. The relative protein expression of IL-1β, IL-6, IL-17 A and IL-22 in the hypothalamus of the high-fat diet group and lead exposure group was higher than those of the control group(P<0.05). The relative protein expression of TNF-α and TGF-β in the hypothalamus of the lead exposure group was higher than that in the control group(P<0.05). The relative protein expression of IL-1β, IL-6, IL-17 A, TGF-β in the hypothalamus of the combined exposure group was higher than the other 3 groups(P<0.05). The relative protein expression of IL-22 in the hypothalamus of the combined exposure group was higher than that of the control group(P<0.05), while the relative protein expression of TNF-α was higher than that of the control group and the high-fat diet group(P<0.05). The relative expression of IL-1β, IL-6, IL-17 A, and TNF-α mRNA in the hypothalamus of the high-fat diet group, the lead exposure group and the combined exposure group was higher than that in the control group(P<0.05). The above indicators of mice in the lead exposure group were higher than that in the high-fat diet group(P<0.05). The above indicators of mice in the combined exposure group were higher than those in the high-fat diet group and the lead exposure group(P<0.05). CONCLUSION: Lead exposure can promote neurobehavioral changes and hypothalamic inflammatory damage in high-fat diet mice. IL-1β, IL-6, IL-17 A, TGF-β and TNF-α might involve in the process of synergistic effect of lead and high-fat diet exposure on inflammatory hypothalamic injury.

Thyroid-associated ophthalmopathy (TAO) is a kind of autoimmune disease which has complex clinical manifestations.The treatment is diverse and controversial but the effect is uncertain.Nonsurgical treatment is particularly critical in the process of diseases.However, there is no uniform standard for clinical use among various methods,which often makes it difficult to develop the treatment program.This paper summarizes and compares the methods that have been proven or are expected to be effective in the treatment of TAO in recent years, which committed to provide a reference for clinicians.

Genetically engineered intestinal microbes could be powerful tools to detect and treat intestine inflammation due to their non-invasive character, low costs, and convenience. Intestinal inflammation is usually detected along with an increasing concentration of thiosulfate and tetrathionate molecules in the intestines. ThsSR and TtrSR are two-component biosensors to detect the presence of thiosulfate and tetrathionate molecules, respectively. In real-life intestinal inflammation detection, sophisticated instruments are needed if using fluorescent proteins as reporters. However, chromoproteins and other colored small molecules, which can be seen by the unaided eye, could extend the use of ThsSR and TtrSR biosensors to detect intestine inflammation. The feasibility of ThsSR and TtrSR systems was tested by monitoring the fluorescence intensity of sfGFP in response to the concentration of thiosulfate and tetrathionate, followed by the incorporation of the two systems into Escherichia coli Top10 and E. coli Nissle 1917. The potential for the real-life application of the two systems was further corroborated by substituting sfGFP with a series of chromoproteins and a protoviolaceinic acid synthesis cassette as reporter genes. The results indicated that signal expression of the new systems had a positive correlation with the concentration of tetrathionate and thiosulfate molecules. Thus, the modified ThsSR and TtrSR system may potentially be applied in the human body for the detection of intestinal inflammation.
Escherichia coli ; Humans ; Inflammatory Bowel Diseases ; Intestines ; Thiosulfates

OBJECTIVE: To investigate the effects of subacute systemic inhalation exposure of 1,2-dichloroethane(1,2-DCE) on learning and memory in NIH mice. METHODS: Forty-five specific pathogen free healthy 7-week-old NIH mice were randomly divided into control,low-dose and high-dose groups with 5 female mice and 10 male mice in each group. The mice were exposed to 1,2-DCE at dosages of 0. 00,100. 00 and 350. 00 mg/m3 for 6 hours per day for consecutive 28 days by dynamic systemic inhalation. The neurobehavioral tests of mice were performed before and after the first to fourth weeks of exposure using the Morris water maze test. RESULTS: There was no significant difference in body weight and swimming speed among the three groups of mice( P > 0. 05). The navigation experiment results showed that the escape latency of mice in both low-and high-dose groups were longer than that of the control group at the same time point(P < 0. 05) during 1-4 weeks after exposure. In the control group,the escape latency was shorter than that of the same group before exposure( P < 0. 05). The escape latency of high-dose group prolonged with the increase of exposure time,and in the 4 th week the escape latency was significantly higher than that of the same group before exposure( P < 0. 05).The experiment results of space exploration indicated that the first time of crossing platform in low-and high-dose groups were longer than that of the control group at the second to the fourth week( P < 0. 05). The target quadrant retention time and the number of crossing the platform in the low-and high-dose groups were lower than those in the control group( P <0. 05). CONCLUSION: Subacute inhalation exposure of 1,2-DCE can impair the learning and memory ability of NIH mice.The high-dose exposure may reduce learning ability in mice in a time-effect manner.

Objective To investigate the effects of immune system and immuno-related miRNAs expression in low-dose benzene and its homologue mixed-exposed workers in a short time. Methods A total of 40 workers were recruited from a petrochemical factory ,and their blood samples were collected before and after work to detect the levels of IgA,IgG,IgM,IFN-γ,IL-1β,IL-2,IL-8,TNF-αin serum and miRNA-146a,-155 expression in the peripheral blood mononuclear cell. In the meanwhile ,we measured the individual benzene and its homologue exposure level of recruited workers. Results According to the concentration of benzene ,the subjects were divided into benzene-exposed group(20 workers)and control group(20 workers). And toluene exposure level in benzene-exposed group was significantly higher than that in control group(P<0.05). Significant decrease of IgG was found in benzene-exposed workers after one work shift,compared with control group(P<0.05). Moreover,the interaction between benzene and toluene was significant correlated with the decrease of IL-1β and TNF-α(P < 0.05). Additionally,the interaction between miRNA-155 and miRNA-146a was significant correlated with the decrease of TNF-α(P<0.05). Conclusions:Occupational exposure to low-dose benzene and toluene in a short time could decrease immune function. And there may be an effect of miRNAs in the regulation of cytokine.