Aim To investigate the effect of interdialytic serum potassium levels on thrombosis of autologous ar-teriovenous fistula(AVF)in patients with chronic kidney disease(CKD)on maintenance haemodialysis(MHD).Methods 159 CKD patients who underwent MHD in our hospital from October 2021 to October 2022 were retrospectively analyzed.They were divided into hyperkalemia group(n=53),normal serum potassium group(n=61)and hypokalemia group(n=45)according to the mean serum potassium level of patients with different dialysis intervals,and all patients were followed up for 1 year or followed up until AVF thrombosis.General datas were collected and the following indicators were detected at the time of patient enrolment,including biochemical indicators,inflammatory factors,ultrasound indicators of AVF and oxidative stress factors levels.Multifactorial Logistic regression equations were used to analyze the effects of clinical indicators on AVF thrombosis in MHD patients,receiver operating characteristic(ROC)curve was used to assess the predictive efficacy of clinical indicators on AVF thrombosis;And interval likelihood ratio was used to stratify interdialyt-ic serum potassium levels,and further observe whether the relationship was stability between AVF thrombosis and interdia-lytic serum potassium levels in MHD patients.Results Compared with the normal serum potassium group,the levels of C-reactive protein(CRP),intact parathyroid hormone(iPTH),procalcitonin(PCT),triglyceride(TG),malondial-dehyde(MDA),myeloperoxidase(MPO),brachial artery resistance index(RI),brachial artery pulsatility index(PI)and radial artery PI were significantly elevated in hyperkalemia group and hypokalemia group,while the levels of albumin(Alb),total cholesterol(TC),superoxide dismutase(SOD)and fistula blood flow were significantly reduced(P＜0.05).Systolic blood pressure,diastolic blood pressure,fistula blood flow,Alb and SOD levels were significantly lower in patients with AVF thrombosis than those in patients with AVF unthrombosis(P＜0.05);Interdialytic mean serum potassium level,CRP,iPTH,PCT,brachial artery RI,brachial artery PI,radial artery PI,radial artery RI,MDA and MPO levels were significantly higher in patients with AVF thrombosis(P＜0.05).The ROC curve was used to analyse the model estab-lished by the multifactorial Logistic regression equation,and it was found that model 1 and model 2 had good predictive effi-cacy,and model 2 had the best predictive efficacy.The results of the interval likelihood ratio showed that:when the patient's interdialytic serum potassium level was 3.5～4.5 mmol/L,the possibility of the patient's AVF thrombosis was the lowest,and when the patient's interdialytic serum potassium level was＞5.5 mmol/L or＜3.5 mmol/L,the possibility of the patient's AVF thrombosis was higher,and when the patient's serum potassium level was＞5.5 mmol/L,the probability of AVF thrombosis was the highest in patients,which was 3.925 times higher than that of patients without AVF thrombosis.Conclusion Abnormal interdialytic serum potassium levels may induce AVF thrombosis in CKD patients.Serum potassium levels can be monitored during MHD treatment to enable timely intervention and improve clinical treatment outcomes for patients.

Aim Based on coronary CT-fractional flow reserve(CT-FFR)combined with machine learning methods,a nomogram prediction model for coronary in-stent restenosis(ISR)was developed to assess the risk of ISR.Methods Retrospective analysis was performed on patients who underwent re-examination after PCI at our hospital from January 2022 to January 2025.According to the exclusion criteria,a total of 210 patients were enrolled,including 100 cases of ISR and 110 cases of non-ISR.The dataset was randomly divided into training and test sets at a 7∶3 ratio.Af-ter univariate analysis to screen potential predictors,LASSO regression was applied to identify feature variables with non-ze-ro coefficients.Subsequently,three machine learning(ML)algorithms including random forest(RF),support vector machine(SVM),and extreme gradient boosting(XGB)were used to rank the importance of the significant factors.The intersection of the top 10 variables from each algorithm was used as input for bidirectional stepwise multivariate Logistic re-gression.An ISR risk score was then constructed and visualized using a nomogram.Results A total of 14 predictive factors were identified through LASSO regression,including diastolic blood pressure,C-reactive protein,triglycerides(TG),N-terminal pro-brain natriuretic peptide(NT-proBNP),low density lipoprotein cholesterol(LDLC),minimum stent diameter＜3 mm,systolic blood pressure,△CT-FFR,CT-FFR,interleukin-6(IL-6),body mass index,glycosylated hemoglobin(HbA1c),history of hypertension,and high density lipoprotein cholesterol(HDLC).Following stepwise screening using three ML algorithms and Logistic regression,six independent risk factors for ISR were identified:elevated△CT-FFR,IL-6,NT-proBNP,TG and CT-FFR values,and minimum stent diameter＜3 mm.The area under the curve for the training set and test set were 0.995(95％CI:0.989～1.000)and 0.965(95％CI:0.927～1.000),respectively.Decision curve analysis demonstrated high net benefit across threshold probabilities of 0～1.00 in the training set and 0～0.92 in the test set.The nomogram integrating these six predictors exhibited high accuracy and clinical utility.Con-clusion The ISR nomogram prediction model based on LASSO-ML combined with CT-FFR technology has high accuracy and clinical utility for ISR.

Angiogenesis is a critical process in the treatment of cardiac ischemic injury,and numerous research findings indicate that macrophages play a vital role in angiogenesis.This review summarizes how macrophages regulate an-giogenesis through the secretion of key factors and the interactions with other cells.M1 macrophages promote new blood vessel formation in the early stages by secreting pro-angiogenic factors,while M2 macrophages are involved in vascular re-modeling and maintaining vessel homeostasis.This review also discusses several new therapeutic strategies for promoting angiogenesis,including direct injection of macrophages,modulation of macrophage phenotype and function,and the use of macrophage-derived exosomes.Numerous studies have shown that macrophages have multiple functions in angiogenesis,and targeting macrophages provides new therapeutic targets and directions for promoting angiogenesis and treating ischemic diseases.

Cardiac mechanical complications are important determinants of prognosis in patients with myocardial in-farction.Early reperfusion therapy after myocardial infarction can significantly reduce the incidence of mechanical compli-cations,however,the mortality rate from mechanical complications does not decrease at the same time.Early diagnosis and treatment are key to improving the prognosis of mechanical complications.Mechanical complications most commonly occur within one week of myocardial infarction,and echocardiography is usually preferred to determine the type,location,and hemodynamic status of mechanical complications.Surgery is the decisive treatment,but the optimal timing is difficult to determine.Percutaneous treatment is emerging as an alternative treatment option for patients with high surgical risk,but there are still shortcomings in clinical practice.There are still many unresolved issues regarding strategies for selecting surgical and percutaneous treatment options for mechanical complications.This article summarizes the key clini-cal evidence for early diagnosis of mechanical complications and new strategies for the management of mechanical complica-tions,and presents relevant statistical data on mechanical complications in our center to provide insights for clinical diagno-sis and treatment.

Acute myocardial infarction is caused by continuous ischemia and hypoxia of myocardial cells,leading to myocardial cell necrosis.Reperfusion therapy is the standard strategy for reducing infarct size and improving the prognosis of myocardial infarction.However,myocardial injury caused by reperfusion therapy is accompanied by various pathophys-iological processes,such as oxidative stress,inflammatory response,myocardial fibrosis,extracellular matrix remodeling,etc.Transcription factor EB(TFEB)is a central regulatory factor in the autophagy-lysosome signaling pathway,involved in signaling pathways such as stress response,myocardial energy metabolism,autophagy,and lysosomal biogenesis.It is closely related to the repair of myocardial injury after myocardial infarction.This review aims to elucidate the mechanism of TFEB in myocardial ischemic injury.

Trimethylamine N-oxide(TMAO)is a small-molecule organic compound.Clinical studies over the past decade have shown that elevated blood levels of TMAO are positively correlated with an increased risk of cardiovascular diseases(CVD).Vascular remodeling(VR)is a critical pathophysiological process in the progression of CVD and is widely involved in the onset and development of conditions such as hypertension and atherosclerosis.Current research in-dicates that TMAO participates in regulating the process of VR through various mechanisms,including promoting inflamma-tory responses,enhancing oxidative stress,and inducing vascular endothelial dysfunction.Present interventional strategies targeting TMAO primarily focus on microbial modulation.This review summarizes the sources and metabolic pathways of TMAO,outlines its potential pathogenic mechanisms in VR,and explores the role of TMAO in VR as well as its potential value as a therapeutic target,aiming to provide a theoretical reference for related medical research.

Proprotein convertase subtilisin/kexin type 9(PCSK9)can modulate low density lipoprotein cholesterol(LDLC)levels,and its dysfunction is closely associated with the progression of atherosclerosis and cardiovascular diseases.Research has shown that PCSK9 inhibitors are highly effective in lowering lipids and have good safety and tolerability.New approaches to targeting PCSK9 inhibition are currently in different stages of clinical development.This review out-lines the primary mechanisms of PCSK9 and its impact on the cardiovascular system,emphasizing the current emerging strategies for targeting PCSK9 in lipid-lowering treatments.

Atherosclerosis is recognized as an inflammatory disease,and its development is regulated by multiple fac-tors,particularly dyslipidemia.Peroxisome proliferator-activated receptor(PPAR)regulate the expression of genes that are involved in lipid metabolism and inflammation;and they have three subfamily members including PPARα,PPARβ,and PPARγ.However,synthetic PPAR agonists exhibit ambiguous effects in atherosclerotic therapy and induce various side effects.Notably,recent studies demonstrate that traditional Chinese medicine(TCM)alleviate atherosclerotic cardiovascular diseases via suppressing hyperlipidemia and inflammation through regulation of PPAR signaling pathway.This article pri-marily reviews the regulatory effects of TCM on PPAR and their therapeutic effects on atherosclerosis,provides valuable in-formation for pharmacologists that are interested in searching for effective herbal prescriptions for atherosclerosis therapy and for clinicians that are interested in prevention and treatment of atherosclerotic cardiovascular diseases using TCM.

Aim To explore the potential mechanism of metformin on ATP-binding cassette transport A1(ABCA1)expression.Methods J774A.1 macrophages were treated with metformin and cycloheximide,and ABCA1 expression was determined by Western blot.His-tagged ABCA1 and HA-tagged Ub plasmids were co-transferred into HEK293 cells and stimulated with metformin.Co-immunoprecipitation(Co-IP)was used to test the binding ability of ABCA1 and ubiquitin.Candidate E3 ubiquitin-protein ligases(CE3)of ABCA1 were identified through Co-IP-based pro-teomics.The MIB1 plasmid was constructed and transferred into HEK293 cells,and Western blot was used to determine the effect of metformin and MIB1 on ABCA1 expression.Results Metformin increased the expression of ABCA1 in J774A.1 cells(P<0.01),and inhibited ABCA1 degradation(P<0.05).Metformin disrupted the binding of ABCA1 to ubiquitin(P<0.05).The proteins regulated by metformin in ABCA1 expression were primarily enriched in pathways re-lated to cell development,inflammation and immune defense.Metformin may upregulate ABCA1 protein expression via MIB1(P<0.05).Conclusion Metformin inhibits the degradation of ABCA1 by blocking the ubiquitin-proteasome system(UPS),and MIB1 might act as a candidate E3 ubiquitin-protein ligase(CE3)for ABCA1.

Cardiovascular diseases have become the leading cause of mortality worldwide.The gut microbiota and its metabolites play an important role in the occurrence and development of cardiovascular diseases,and an imbalance of gut microbiota and its metabolites can promote the progression of cardiovascular diseases.Phenylacetylglutamine is a phenyl-alanine metabolite of intestinal flora.More and more studies have shown that phenylacetylglutamine is an independent risk factor of cardiovascular diseases and a potential biomarker of cardiovascular diseases.It is involved in the pathogenesis of cardiovascular diseases,such as arrhythmia,heart failure,atherosclerosis,etc.Therefore,interventions targeting pheny-lacetylglutamine are expected to become a new strategy for treating cardiovascular diseases.This review focuses on the role of phenylacetylglutamine in the occurrence and development of several common cardiovascular diseases.