BACKGROUND: Patients with atrial fibrillation (AF) and prior stroke history have a high risk of cardiovascular events despite anticoagulation therapy. It is unclear whether catheter ablation (CA) has further benefits in these patients. METHODS: AF patients with a previous history of stroke or systemic embolism (SE) from the prospective Chinese Atrial Fibrillation Registry study between August 2011 and December 2020 were included in the analysis. Patients were matched in a 1:1 ratio to CA or medical treatment (MT) based on propensity score. The primary outcome was a composite of all-cause death or ischemic stroke (IS)/SE. RESULTS: During a total of 4.1 ± 2.3 years of follow-up, the primary outcome occurred in 111 patients in the CA group (3.3 per 100 person-years) and in 229 patients in the MT group (5.7 per 100 person-years). The CA group had a lower risk of the primary outcome compared to the MT group [hazard ratio (HR) = 0.59, 95% CI: 0.47-0.74, P < 0.001]. There was a significant decreasing risk of all-cause mortality (HR = 0.43, 95% CI: 0.31-0.61, P < 0.001), IS/SE (HR = 0.73, 95% CI: 0.54-0.97, P = 0.033), cardiovascular mortality (HR = 0.32, 95% CI: 0.19-0.54, P < 0.001) and AF recurrence (HR = 0.33, 95% CI: 0.30-0.37, P < 0.001) in the CA group compared to that in the MT group. Sensitivity analysis generated consistent results when adjusting for time-dependent usage of anticoagulants. CONCLUSIONS In AF patients with a prior stroke history, CA was associated with a lower combined risk of all-cause death or IS/SE. Further clinical trials are warranted to confirm the benefits of CA in these patients.

Hematopoietic progenitor kinase 1 ( HPK1 ) , also known as MAP4K1 , is a serine/threonine protein kinase and a member of the MAP4K family of mammalian Ste20-related pro¬tein kinases.Recent studies have found that HPK1 is assoeiated with the occurrence and progression of a variety of tumors, and may play an important role in some malignant tumors.This pa¬ per reviews the HPK1 signaling pathway, its relationship with tumor and drug development progress, so as to provide referenee for the research of HPK1 protein kinase.

Objective: The relationship between serum uric acid (SUA) levels and glycemic indices, including plasma glucose (FPG), 2-hour postload glucose (2h-PG), and glycated hemoglobin (HbA1c), remains inconclusive. We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population. Methods: The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study. A total of 105,922 community-dwelling adults aged ≥ 40 years underwent the oral glucose tolerance test and uric acid assessment. The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models. Results: A total of 30,941 men and 62,361 women were eligible for the current analysis. Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels, but with different inflection points in men and women. The thresholds for FPG, 2h-PG, and HbA1c for men and women were 6.5/8.0 mmol/L, 11.0/14.0 mmol/L, and 6.1/6.5, respectively (SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices). Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes, while the inflection points were reached earlier in men than in women.
Aged ; Asian Continental Ancestry Group ; Blood Glucose/analysis* ; China/epidemiology* ; Cohort Studies ; Diabetes Mellitus/blood* ; Female ; Glucose Tolerance Test ; Glycated Hemoglobin A/analysis* ; Glycemic Index ; Humans ; Male ; Middle Aged ; Uric Acid/blood*

Objective To identify new genes that correlate with prognosis of clear-cell renal cell carcinoma (ccRCC)

Objective: To observe the preventive and therapeutic effect of Huanglian Ejiao Tang on myocardial injury induced by anthracycline chemotherapeutic drugs in all kinds of cancer patients undergoing chemotherapy. Method:We chosen all kinds of cancer patients with combined use of anthracycline chemotherapy drugs in our hospital, 21 days as one cycle. The cardiac toxicity reaction was observed after three continuous chemotherapy cycles. A total of 64 patients who met the dialectical criteria of "imbalance between heart-Yang and kidney-Yin" were randomly divided into treatment group (32 cases) and control group (32 cases). Patients in treatment group were treated with Chinese medicine Huanglian Ejiao Tang based on original chemotherapy regimen, adding and subtracting Chinese medical materials according to the symptoms. Patients in control group continued to maintain the original chemotherapy regimen, and both two groups of patients continued to receive 3 cycles of continuous chemotherapy. By comparing the cardiac function classification and cardiac function tolerance between the 3 cycles and 6 cycles of two groups of patients after chemotherapy; changes of echocardiography index, QTc interval, creatine kinase isoenzyme (CK-MB), Myoglobin (MYO), cardiac troponin I (cTNI)and nitrogenous terminal-pro-brain natriuretic peptide(NT-pro-BNP) concentration value were compared between two groups; and the concentrations of adrenaline (E), norepinephrine (NE) and angiotensin Ⅱ(AngⅡ) were observed and compared; meanwhile, the correlation analysis was carried out at the same time. Result:After 6 cycles of chemotherapy in Chinese medicine treatment group, degree of cardiac function classification and the 6 minute walking heart function tolerance were significantly better than those at the 3 cycles of chemotherapy (P<0.05), but there was no significant change in control group; the concentrations of CK-MB, cTNI, MYO and NT-pro-BNP in treatment group were significantly lower than those in control group(P<0.05), and the electrocardiogram QTc interval in the treatment group was significantly lower than that in the control group (P<0.05); echocardiography indexes E/A ratio and left ventricular ejective fraction (LVEF) value in the treatment group were significantly higher than those in control group (P<0.05). There were no significant changes in left ventricular end-systolic diameter (LVDd) and left ventricular end-systolic diameter (LVDs) between the treatment and the control group. After 3 cycles and 6 cycles of chemotherapy, the blood NE,E and AngⅡ concentrations in the treatment group were significantly lower than those in the control group (P<0.05). There were positive linear correlation in concentration changes of blood NE, E and AngⅡ as well as the concentration changes of CK-MB, cTNI, MYO and NT-pro-BNP between 3 cycles and 6 cycles after chemotherapy. After 6 cycles of chemotherapy, the incidence of cardiovascular events in the treatment group was significantly lower than that in the 3 cycles of chemotherapy, while the incidence in control group was increased. Conclusion:Huanglian Ejiao Tang can reduce the excitability of the symppthetic nervous system (SNS) and renin-angiotensin system(RAS) in human body and inhibit the release level of NE, E and AngⅡ by effect of "invigorating the kidney and clearing the heart". It has a certain preventive and treatment effect on the cardiac toxicity of patients with the cumulative use of anthracycline chemotherapy. To a certain extent, it can inhibit myocardial injury, improve cardiac function and reduce the incidence of cardiovascular events.

Objective To investigate the value of 18F-FDG/99Tcm-MIBI SPECT myocardial imaging for the detection of myocardial viability and prognosis in patients with AMI. Methods 18F-FDG/99Tcm-MIBI SPECT myocardial imaging was performed in 98 consecutive patients [man 87, women 11; average age (58 ±11)y] with AMI. The myocardium was scored individually for nine segments: mildly decreased uptake = 1,significantly decreased uptake = 2, and no uptake = 3. Perfusion defect but preserved 18 F-FDG uptake was defined as perfusion-metabolism mismatch, indicating jeopardized but viable myocardium. Perfusion defect and decreased 18 F-FDG uptake were defined as match, indicating myocardial necrosis. Echocardiogram was performed before and after treatment for evaluating the LVEF. All patients were followed after treatment.The rate of cardiac events was calculated and compared between patients with medication and revascularization. Paired t test, Chi-square test and log-rank test were used for statistical analysis. Results In the group with viable myocardium, 27 patients received revascularization and 10 received medication. In the group with infarcted myocardium, 26 patients received medication and 35 received revascularization. Patients underwent revascularization and with medication had no significant difference in improvement of LVEF between both groups (viable myocardium group: χ2 = 0.509, P > 0. 05; infarcted myocardium group: χ2 =0.035, P > 0.05). In viable myocardium group, cardiac event rate was significantly higher in patients with medication than in those who had undergone revascularization (50.0% vs 14.8%, χ2 =4.91, P<0.05).In the infarcted myocardium group, cardiac event rate was also significantly higher in patients with medication (30.7% vs5.7% ,χ2 =6.83, P<0.05). Conclusions 18F-FDG/ -MIBI SPECT myocardial imaging may well be of value but limited for the detection of myocardial viability and prediction of improvement in cardiac function as well as prognosis. However, more prospective data are needed for final evaluation.

Objective To evaluate the clinical application of stress/rest MPI in the patients with 50％-75％ coronary artery stenosis.Methods The criteria for patient selection were that the patients should have at least one main coronary artery with stenosis more than 50％,and the maximal stenosis should be less than 75％ according to CAG.The stress/rest MPI was performed in 2 weeks before or after CAG.A total of 244 patients (178 males,66 females) with mean age (57 ± 10) years were included in this study.Symptom restriction stress test was used and stress MPI was performed 1 - 1.5 h after 99Tcm-MIBI (925 MBq)injection at the exercise peak.Rest MPI was performed within 48 - 72 h after stress MPI.Myocardial ischemia was diagnosed when there was a reduced uptake or even a defect in 2 different tomographic sections or in the same part of a myocardium in the continuous 2 slices.When there was an irreversible reduced uptake or defect,myocardial infarction was given as the final diagnosis.No reduced uptake or defect in all slices was shown as normal.The impact of MPI images on the selection for optimal clinical therapy plans was also discussed.X2 test was used for statistical analysis.Results A total of 340 coronary arteries with stenosis 50％ - 75％ were found by CAG.According to stress/rest MPI results,207 patients (84.8％)presented normal,33 had myocardial ischemia,3 had myocardial infarction,and 1 had both myocardial infarction and ischemia.In abnormal MPI images,there were 61 ischemic segments and 9 infarct segments,which were associated with 43 stenotic arteries (23 LAD,10 LCX,and 10 RCA).Patients were divided into 2 groups according to the results of MPI:Group 1 with normal MPI (207/244,84.8％ ) and Group 2 with abnormal MPI (37/244,15.2％ ).In Group 1,9 patients underwent coronary artery revascularization (PTCA or CABG),and the others had medical treatment.Eight patients had PTCA and 29 patients had medical treatment in Group 2.There was a statistically significant difference between the two groups ( X 2 =11.9,P =0.001 ).Conclusion Stress-rest MPI may be an effective method to evaluate ischemia degree for patients with 50％ -75％ coronary artery stenosis and a useful indicator for the individual treatment.

OBJECTIVETo investigate the distribution characteristics of autoantibody against beta1 adrenergic receptor (beta1 AR) in the sera of arrhythmia patients and whether the autoantibody could induce arrhythmia.

METHODSHealthy subjects and patients with arrhythmia or coronary artery disease were chosen. The autoantibody against beta1 AR in the sera was screened by enzyme-linked immunosorbent assay (ELISA). IgG in the positive autoantibody sera from arrhythmia patients were purified and administrated to normal rats; then the ECGs were dynamic monitored.

RESULTSThe positive rate of autoantibody against beta1 AR in arrhythmia patients was 52.8%, which was significantly higher than that in coronary heart disease group (24%, P < 0.01) and healthy people group (5%, P < 0.01), respectively. Moreover, the autoantibody against beta1 AR could lead to the occurring of arrhythmia in normal rats, most of which were ventricular arrhythmia.

CONCLUSIONIn the sera of arrhythmia patients, the autoantibody against beta1 AR has a high titer and it could lead to the arrhythmia of rats in vivo.

Animals ; Arrhythmias, Cardiac ; etiology ; immunology ; Autoantibodies ; blood ; immunology ; Case-Control Studies ; Female ; Humans ; Immunoglobulin G ; blood ; Male ; Middle Aged ; Rats ; Receptors, Adrenergic, beta-1 ; immunology

OBJECTIVETo explore the influence of occupational stress and negative life events on low birth weight (LBW).

METHODS1:1 matched case-control study was employed, in which 438 singleton LBW infants with birth weight less than 2500 g (their pregnancy term being 28 to 42 weeks) served as case group while 438 with singleton term normal birth weight served as control group matched by sex, delivery time and hospital. All of their mothers were inquired by well trained investigators about their socio-demographic characteristics, occupational stress, and negative life events occurring in different pregnancy term. After controlling for mother's age, occupation, education level and family income, conditional logistic regression was employed to asses the influence of occupational stress and negative life events on LBW.

RESULTSCompared with those with low technical skill utilization and low job decision, mothers with high technical skill utilization (OR=0.62; 95% CI=0.43 approximately 0.91) and high job decision (OR=0.67; 95% CI=0.46 approximately 0.97) significantly decreased the risk of laboring LBW. Compared with those not exposed to negative life events, mothers with negative life event score being=3 in the middle three months of pregnancy (OR=18.85; 95% CI=1.58 approximately 225.02), with negative life event score being 1 in the later three months of pregnancy (OR=2.67; 95% CI=1.14 approximately 6.28), with negative life event score being 2 (OR=2.80; 95% CI=1.04 approximately 7.52) and=3 in the whole time of pregnancy (OR=2.94; 95% CI=1.22 approximately 7.09) were the risk factors of LBW.

CONCLUSIONNegative life events might affect LBW and negative life events occurring in the different term of pregnancy impact LBW differently.

Adult ; Burnout, Professional ; Case-Control Studies ; Female ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Life Change Events ; Logistic Models ; Male ; Pregnancy ; Young Adult

The coordination compound of L-hydroxyproline (Hyp)-Zn (II) was synthesized with Hyp and zinc sulfate as raw materials in water medium, coordination Synthesizing Mechanism and Antioxidant Activity of Hyp-Zn(II) coordination compound has been researched. Compared with Hyp, the infrared spectrogram of Hyp-Zn (II) coordination compound emerge a new absorption peak at 1100 cm(-1). Conclusion could be obtained that there exists a coordination effect between Hyp and ZnSO4; TG and DSC curve of Hyp and Hyp-Zn(II) coordination compound were analysed. Compared with Hyp, the peak of Hyp-Zn(II) disappear at 290 degrees C and 375 degrees C. This phenomenon confirmed the front conclusion; At the NMR graph of Hyp-Zn(II) coordination compound, the disappearance of the alpha-carboxyl-hydrogen and alpha-hydroxyl-hydrogen's peak at 3.5-3.9 ppm could indicate that combination's position of Hyp is alpha-carboxyl and alpha-hydroxyl; Structure of Hyp-Zn(II) coordination compound were exosyndrome by the Atomic Force microscopy. It is showed that centr-atom Zn(II) was surrounded by several Hyp at Hyp-Zn(II) coordination compound's phase diagram; The proportion of Hyp-Zn(H) coordination compound was determined by dialysis experiment, the proportion is 4:1; Above-mentioned determination and exosyndrome indicated that the molecular formula of Hyp-Zn (II) coordination compound is Zn(Hyp)4.H2O. The results indicated that the Hyp-Zn(II) coordination compound can inhibit hydroxyl free radicals of Zn(II), and the Percentage of Inhibition is 75.5%; the total antioxidant activities of Hyp-Zn(II) coordination compound is 80.167 u/mL, the anti-superoxide activities of Hyp-Zn (II) coordination compound is 53.19 u/mL.
Antioxidants ; chemistry ; Drug Compounding ; Hydroxyproline ; chemistry ; Zinc Sulfate ; chemistry