Objective:To systematically evaluate the association between maternal arsenic exposure and spontaneous abortion, stillbirth and preterm birth.Methods:Web of Science, PubMed, CNKI database, the VIP Chinese Journal Service Platform and Wanfang Data Knowledge Service Platform were searched for studies on the association between maternal arsenic exposure and spontaneous abortion, stillbirth, and preterm birth before December 2023. Meta-analysis of binary variables was conducted using Stata MP 17.0 software, with OR value(95% CI) as the effect analysis indicator, and subgroup analysis was used to explore the sources of heterogeneity. Results:A total of 21 articles were included ( n = 5 150 286). The meta-analysis results showed that maternal arsenic exposure was positively correlated with spontaneous abortion, stillbirth, and preterm birth, with pooled OR values (95% CI) of 1.48 (1.28 - 1.70), 1.98 (1.60 - 2.45), and 1.05 (1.02 - 1.07), respectively. Subgroup analyses showed that arsenic exposure was positively correlated with the risk of preterm birth in both prospective cohort studies ( OR = 1.18, 95% CI: 1.09 - 1.27) and cross-sectional studies ( OR = 1.10, 95% CI: 1.06 - 1.15). Internal exposure to arsenic ( OR = 1.15, 95% CI: 1.04 - 1.28) presented a more pronounced risk of preterm birth compared to external exposure ( OR = 1.05, 95% CI: 1.01 - 1.10). Moreover, the impact was more substantial in developing countries ( OR = 1.17, 95% CI: 1.06 - 1.29), while it was not statistically significant in developed countries [1.04 (1.00 - 1.09), P > 0.05]. Conclusion:There is a positive association between maternal arsenic exposure and spontaneous abortion, stillbirth and preterm birth.

Arsenic (organoarsenic) compound is one of the oldest drugs used by humans to treat various diseases. From its initial application in treating various skin diseases to the 1970s when arsenic trioxide (ATO) was proven to be able to significantly relieve acute promyelocytic leukemia (APL), arsenic (organoarsenic) compounds gradually occupied an important position in the history of medical development. This article reviews the pharmaceutical research progress of inorganic arsenic compounds and organic arsine compounds, covering anticancer, antiparasitic, antiviral and antibiotic aspects. It further explores the potential for developing new arsenic (organoarsenic) drugs with higher efficacy and lower toxicity, aiming to provide new research directions and ideas for the application of arsenic (organoarsenic) compounds in disease treatment.

Objective:To systematically evaluate the association between maternal arsenic exposure and spontaneous abortion, stillbirth and preterm birth.Methods:Web of Science, PubMed, CNKI database, the VIP Chinese Journal Service Platform and Wanfang Data Knowledge Service Platform were searched for studies on the association between maternal arsenic exposure and spontaneous abortion, stillbirth, and preterm birth before December 2023. Meta-analysis of binary variables was conducted using Stata MP 17.0 software, with OR value(95% CI) as the effect analysis indicator, and subgroup analysis was used to explore the sources of heterogeneity. Results:A total of 21 articles were included ( n = 5 150 286). The meta-analysis results showed that maternal arsenic exposure was positively correlated with spontaneous abortion, stillbirth, and preterm birth, with pooled OR values (95% CI) of 1.48 (1.28 - 1.70), 1.98 (1.60 - 2.45), and 1.05 (1.02 - 1.07), respectively. Subgroup analyses showed that arsenic exposure was positively correlated with the risk of preterm birth in both prospective cohort studies ( OR = 1.18, 95% CI: 1.09 - 1.27) and cross-sectional studies ( OR = 1.10, 95% CI: 1.06 - 1.15). Internal exposure to arsenic ( OR = 1.15, 95% CI: 1.04 - 1.28) presented a more pronounced risk of preterm birth compared to external exposure ( OR = 1.05, 95% CI: 1.01 - 1.10). Moreover, the impact was more substantial in developing countries ( OR = 1.17, 95% CI: 1.06 - 1.29), while it was not statistically significant in developed countries [1.04 (1.00 - 1.09), P > 0.05]. Conclusion:There is a positive association between maternal arsenic exposure and spontaneous abortion, stillbirth and preterm birth.

Objective:To evaluate the outcomes of minimally invasive therapy for aortic arch pathology after ascending aortic replacement.Methods:A retrospective analysis was conducted at the Department of Cardiovascular Surgery, West China Hospital of Sichuan University from 2016 to 2024. After multidisciplinary discussion, these included patients were evaluated to be at high risk for traditional open surgery. Various minimally invasive repair techniques were employed, including Ⅳb hybrid technique, physician-modified endograft and novel unibody endograft. The study outcomes were technical success, in-hospital and follow-up mortality, stroke, endoleak, and the patency of the supra-aortic vessels.Results:A total of 40 patients(32 males and 8 females) with a median age of 60 years old were included in this study. The technique success rate was 100%, with no deaths or strokes reported. The patency of the supra-aortic vessels was 100%. 10 patients underwent Type Ⅳb hybrid surgery without any endoleaks occurring. Among the 22 patients who received physician-modified endograft, endoleaks were observed in 2 cases. One of these type Ⅰc endoleaks persisted and underwent reintervention. One patient underwent femoral artery replacement due to vascular injury. For the 8 patients who received novel unibody endograft, one case required reintervention due to persistent type Ⅰc endoleaks.Conclusion:With the development of different endovascular techniques and novel branched endograft, patients with aortic arch pathology who are at high risk for redo open surgery can achieve favorable outcomes with various minimal invasive techniques. However, long-term and large-sample follow-up studies are needed for further evaluation.

Objective:To evaluate the outcomes of minimally invasive therapy for aortic arch pathology after ascending aortic replacement.Methods:A retrospective analysis was conducted at the Department of Cardiovascular Surgery, West China Hospital of Sichuan University from 2016 to 2024. After multidisciplinary discussion, these included patients were evaluated to be at high risk for traditional open surgery. Various minimally invasive repair techniques were employed, including Ⅳb hybrid technique, physician-modified endograft and novel unibody endograft. The study outcomes were technical success, in-hospital and follow-up mortality, stroke, endoleak, and the patency of the supra-aortic vessels.Results:A total of 40 patients(32 males and 8 females) with a median age of 60 years old were included in this study. The technique success rate was 100%, with no deaths or strokes reported. The patency of the supra-aortic vessels was 100%. 10 patients underwent Type Ⅳb hybrid surgery without any endoleaks occurring. Among the 22 patients who received physician-modified endograft, endoleaks were observed in 2 cases. One of these type Ⅰc endoleaks persisted and underwent reintervention. One patient underwent femoral artery replacement due to vascular injury. For the 8 patients who received novel unibody endograft, one case required reintervention due to persistent type Ⅰc endoleaks.Conclusion:With the development of different endovascular techniques and novel branched endograft, patients with aortic arch pathology who are at high risk for redo open surgery can achieve favorable outcomes with various minimal invasive techniques. However, long-term and large-sample follow-up studies are needed for further evaluation.

Arsenic (organoarsenic) compound is one of the oldest drugs used by humans to treat various diseases. From its initial application in treating various skin diseases to the 1970s when arsenic trioxide (ATO) was proven to be able to significantly relieve acute promyelocytic leukemia (APL), arsenic (organoarsenic) compounds gradually occupied an important position in the history of medical development. This article reviews the pharmaceutical research progress of inorganic arsenic compounds and organic arsine compounds, covering anticancer, antiparasitic, antiviral and antibiotic aspects. It further explores the potential for developing new arsenic (organoarsenic) drugs with higher efficacy and lower toxicity, aiming to provide new research directions and ideas for the application of arsenic (organoarsenic) compounds in disease treatment.

Objective:To study the role and specific mechanisms of glucose-6-phosphate dehydrogenase (G6PD), a key enzyme for glycometabolism, mediated reduction stress in arsenic-induced malignant transformation of cells.Methods:Immortalized human skin keratinocyte-forming cells (HaCaT cells) were treated with sodium arsenite (NaAsO 2) at a concentration of 0.0 (control group) and 1.0 μmol/L (arsenic group), and malignant transformation indicators were tested using cell growth kinetics assay, cell scratch assay, and soft agar colony formation assay. At different stages of arsenic treatment (0, 1, 7, 14, 21, 28, 35 passages of cells), the effects of NaAsO 2 on glycometabolism in HaCaT cells were determined using corresponding reagent kits and Western blot, including glucose-6-phosphate (G6P), lactate, acetyl CoA, G6PD levels, as well as protein expression levels of hexokinase 2 (HK-2), 6-phosphofructose-2-kinase/fructose-2, 6-diphosphatase 3 (PFKFB3), pyruvate dehydrogenase kinase 1 (PDK1), 6-phosphoglucose dehydrogenase (PGD), and G6PD. Mitochondria were extracted, and the effects of NaAsO 2 on HaCaT cells and mitochondrial redox [reduced nicotinamide adenine dinucleotide phosphate (NADPH)/nicotinamide adenine dinucleotide phosphate (NADP +) ratio, reduced glutathione (GSH)/oxidized glutathione (GSSG) ratio] were determined using corresponding reagent kits. The effect of G6PD on reduction stress and NaAsO 2-induced malignant transformation of HaCaT cells was determined using small interfering RNA (siRNA) intervention method. Results:Compared 1.0 μmol/L NaAsO 2-cultured HaCaT cells up to 35 generations (T-HaCaT cells) with matching passage 0.0 μmol/L NaAsO 2-cultured HaCaT cells [(33.797 ± 0.280) h, 0.177 ± 0.015, 13.667 ± 2.625], the multiplication time [(24.042 ± 0.479) h] was shorter ( t = 30.45, P < 0.001), the cell migration rate (0.396 ± 0.039) was higher ( t = 9.08, P < 0.001), and the number of colonies formed in soft agar (73.667 ± 4.450) was higher ( t = 20.11, P < 0.001). Compared with matching passage control group cells and 0 generation of the same group, G6P level in the arsenic group was higher at passages 1, 7, 14, 21, 28 and 35 ( P < 0.05), lactate and G6PD levels were higher at passages 14, 21, 28 and 35 ( P < 0.05), acetyl CoA level was lower at passages 21, 28 and 35 ( P < 0.05), and protein expression levels of HK-2, PFKFB3, PDK1, PGD, and G6PD were higher at passages 7, 14, 21, 28 and 35 ( P < 0.05). The NADPH/NADP + ratio of cells was higher at passages 1, 14, 21, 28 and 35 ( P < 0.05), GSH/GSSG ratio was higher at passages 21, 28 and 35 ( P < 0.05). The ratio of mitochondrial NADPH/NADP + was higher at passages 1, 7, 21, 28 and 35 ( P < 0.05), the GSH/GSSG ratio was higher at passages 1, 7, 14, 21, 28 and 35 ( P < 0.05). G6PD expression was silenced by siRNA in T-HaCaT cells, compared with the T-HaCaT con siRNA-treated group, the T-HaCaT G6PD siRNA-treated group had lower NADPH/NADP + and GSH/GSSG ratios in both cells and mitochondria ( P < 0.05), longer cell multiplication time, lower cell migration rate, and fewer soft agar colonies ( P < 0.05). Conclusion:During the malignant transformation of HaCaT cells induced by NaAsO 2, G6PD and other enzymes related to glycometabolism are activated, leading to reprogramming of glycometabolism, resulting in an imbalance of cell redox homeostasis and enhanced reduction stress in cells and mitochondria, thereby promoting NaAsO 2 induced malignant transformation of HaCaT cells.

Objective:To systematically evaluate the impact of maternal arsenic exposure during pregnancy on newborn birth indicators.Methods:Relevant literature on maternal arsenic exposure during pregnancy and newborn birth indicators published domestically and internationally were included in the study by searching databases such as CNKI, WanFang Data, VIP, PubMed, Web of Science, Embase, etc., the search was conducted from the establishment of the database until August 31, 2022. Meta-analysis of effect values was performed using Stata SE16 software, and heterogeneity was tested using I2 statistics and Q-test. Random effects model or a fixed effects model was selected for comprehensive quantitative analysis based on the test results, and regression coefficient (β) was used as the effect indicator. Subgroup analysis was conducted according to the sample type, study area, study type. Results:A total of 34 articles (a total of 57 530 pairs of maternal infant combinations) were included, including 2 Chinese articles and 32 English articles. Among them, there were 31, 16, 18, and 5 articles including maternal arsenic exposure during pregnancy and newborn birth weight, length, head circumference, and chest circumference, respectively. After heterogeneity testing, I2 were 81.1%, 97.1%, 62.8%, and 98.3%, respectively. I2 was ≥50% and P < 0.05, indicating significant heterogeneity. A random effects model was used for meta-analysis. The combined β values (95% CI) of birth weight, length, head circumference, and chest circumference were - 10.99 (- 15.60, - 6.39), - 0.02 ( - 0.10, 0.06), - 0.01 (- 0.04, 0.03), and - 0.18 (- 0.35, - 0.01), respectively. The results of subgroup analysis showed that maternal arsenic exposure during pregnancy had a significant impact on newborn birth weight when the sample type was the blood sample [β(95% CI): - 25.72 (- 44.46, - 6.98)]. Conclusions:Maternal arsenic exposure during pregnancy may cause a relative decrease in newborn birth indicators, especially a significant decrease in birth weight. Blood arsenic level may be an important indicator for evaluating the decrease in birth indicators caused by maternal arsenic exposure during pregnancy.

Objective:To systematically evaluate the correlation between chronic non-occupational arsenic exposure and hypertension.Methods:A literature search was conducted through Web of Science, Pubmed, Embase, Cochrane Library, WanFang Data, China National Knowledge Infrastructure (CNKI), VIP Chinese Journal Service Platform (VIP) Database and China Biomedical Literature Database to comprehensively collect epidemiological literature related to chronic non-occupational arsenic exposure and hypertension published domestically and internationally for inclusion in the study, with a time limit from database establishment to January 1, 2023. Meta-analysis of dichotomous variables was conducted using Stata MP15 software, with odds ratio ( OR) value [95%confidence interval( CI)] as the effect evaluation indicator. A random-effects model or a fixed-effects model was selected for comprehensive quantitative analysis according to the heterogeneity results; the sources of heterogeneity were identified through subgroup analysis; a funnel plot was used for qualitative analysis of publication bias and the results were further assessed by Egger test. Stata 15.0 software was then used to analyze the dose-response relationship between chronic non-occupational arsenic exposure and hypertension using restricted cubic spline function and generalized least squares estimation (GLST) method. Results:Twenty-nine articles ( n = 127 258) were finally included, including 24 English articles and 5 Chinese articles. Through Meta-analysis, the combined OR value (95% CI) for hypertension was 1.07 (1.04 - 1.09), with a statistically significant difference ( P < 0.05). The combined OR values (95% CI) for urinary arsenic, drinking water arsenic, and hair arsenic in subgroup analysis were 1.10 (1.04 - 1.17), 1.13 (1.07 - 1.20), and 2.55 (1.55 - 4.20), respectively. The combined OR values (95% CI) for cross-sectional studies, case-control studies and cohort studies were 1.11 (1.06 - 1.16), 1.13 (1.04 - 1.23) and 1.04 (1.00 - 1.07), respectively. For every unit (μg/L) increase in arsenic exposure in drinking water, the risk of hypertension increased by 0.13% [ OR value (95% CI): 1.001 269 (1.000 104 - 1.002 434), P < 0.05]. Conclusions:There is a correlation between chronic non-occupational arsenic exposure and adult hypertension, with urinary arsenic, drinking water arsenic and hair arsenic as possible exposure markers. There is a non-linear dose-response relationship between chronic non-occupational arsenic exposure and adult hypertension.

Objective To evaluate the clinical effect of minimally invasive aortic valve replacement with Perceval sutureless aortic bioprosthesis in upper ministernotomy or right anterior thoracotomy. Methods From March to November 2022, the patients with simple aortic valve disease were enrolled in the Department of Cardiovascular Surgery of West China Hospital, Sichuan University. After preoperative evaluation, Perceval sutureless bioprosthesis was successfully used to perform aortic valve replacement through the upper ministernotomy or right anterior thoracotomy. The perioperative clinical data and ultrasonic measurement data of all patients were recorded. Results A total of 5 patients with simple aortic valve disease were included, including 3 females and 2 males, with a mean age of 71.2 years. Perceval sutureless bioprosthesis was successfully implanted in 5 patients, with a success rate of 100%. There were 3 patients receiving upper ministernotomy and 2 patients receiving right anterior thoracotomy. Two patients underwent ascending aortic plasty at the same time. The mean cardiopulmonary bypass time was 61.0 min, and aortic cross-clamping time was 32.2 min. All patients were discharged successfully without perivalvular leakage, atrioventricular block or stroke. Conclusion The implantation method of Perceval sutureless bioprosthesis is simple, which can effectively reduce the perioperative risk by shortening the overall operation time, cardiopulmonary bypass time and aortic cross-clamping time. At the same time, its clinical application has promoted the development and popularization of minimally invasive aortic valve replacement, which together with Perceval sutureless bioprosthesis effectively combinates surgical effect and minimally invasive treatment, and has a good clinical application prospect because of its reliable safety and effectiveness.