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It remains controversial to choose anesthesia for transcatheter aortic valve implantation (TAVI). A meta-analysis of cohort studies was conducted to assess the efficacy and safety of local anesthesia (LA) compared to general anesthesia (GA) in TAVI. All relevant studies published from 1 January 2002, to 31 June 2022, were searched in Ovid, PubMed, Embase, Web of Science, and Cochrane Library. A total of 34 studies involving 23,480 patients were included in the meta-analysis. TAVI with LA was associated with a significant reduction in hospital stay [WMD = −2.48, 95% CI (−2.80, −2.16), p < 0.00001], operative [WMD = −12.25, 95% CI (−13.73, −10.78), p < 0.00001] and fluoroscopy time [WMD = −3.30, 95% CI (−5.40, −1.19), p = 0.002], and an increased risk of acute kidney injury [OR = 1.31, 95% CI (1.01, 1.69), p = 0.04] and a reduced incidence of major bleeding [OR = 0.59, 95% CI (0.46, 0.75), p < 0.0001] and the use of cardiovascular drugs [OR = 0.17, 95% CI (0.05, 0.57), p = 0.004]. No differences were found between LA and GA for 30-day mortality, procedural success rate, myocardial infarction, permanent pacemaker implantation, paravalvular leak, shock, and cerebrovascular events. Overall, 4.4% of LA converted to GA. Based on current evidence, our results suggested that LA strategies reduced hospital stay, operative time, fluoroscopy time, cardiovascular drug consumption, and major bleeding rates in patients undergoing TAVI but led to increased acute kidney injury rates. Further studies and randomized trials are required to verify the presented findings and to identify patients who might benefit from LA. [ABSTRACT FROM AUTHOR]

Currently, there is a lack of expert consensus and clinical guidelines about the treatment strategy for aortic roots in patients with acute Stanford type A aortic dissection with aortic sinuses less than 45 mm in diameter and without combined connective tissue disorder. The physiological aortic sinus plays a key role in the protection of the aortic valve and cardiac function. Thus, we invented a "watching without dealing with" technique of aortic root repair to preserve the aortic sinus as much as possible. This technique could simplify the operation and improve the patient's prognosis, which is worth learning and promoting. [ABSTRACT FROM AUTHOR]

Acute alcohol intoxication is a harmful clinical condition characterized by behavioral and neurological symptoms, for which few effective therapies are available at present. Dysfunction of microglial BV-2 cells has been reported to be associated with acute alcohol-induced brain injuries. In the present study, the protective effects of Eucommia ulmoides Oliv. leaves polysaccharides (EULP) on acute alcoholic brain injury and microglial dysfunction were investigated. 14-day pretreatment of EULP significantly attenuated neurobehavioral deficit and neurotransmitter damage in the brain tissue of mice caused by acute alcohol exposure. Additionally, EULP regulated the metabolic disorder of brain tissue. Consistently, it was shown that EULP pretreatment significantly improved alcohol-induced phagocytosis decrease, oxidative stress and inflammation in BV-2 cells. Therefore, EULP may be proposed and employed as a potential therapeutic agent for alcohol-induced brain damage. [ABSTRACT FROM AUTHOR]

Background: Total aortic arch replacement (TAR) with frozen elephant trunk (FET) requires hypothermic circulatory arrest (HCA) for 20 min, which increases the surgical risk. We invented an aortic balloon occlusion (ABO) technique that requires 5 min of HCA on average to perform TAR with FET and investigated the possible merit of this new method in this study.Methods: This retrospective study included consecutive patients who underwent TAR and FET (consisting of 130 cases of ABO group and 230 cases of conventional group) in Fuwai Hospital between August 2017 and February 2019. In addition to the postoperative complications, the alterations of blood routine tests, alanine transaminase (ALT) and aspartate transaminase (AST) during in-hospital stay were also recorded.Results: The 30-day mortality rates were similar between ABO group (4.6%) and conventional group (7.8%, P = 0.241). Multivariate analysis showed ABO reduced postoperative acute kidney injury (23.1% vs. 35.7%, P = 0.013) and hepatic injury (12.3% vs. 27.8%, P = 0.001), and maintained similar cost to patients (25.5 vs. 24.9 kUSD, P = 0.298). We also found that AST was high during intensive care unit (ICU) stay and recovered to normal before discharge, while ALT was not as high as AST in ICU but showed a rising tendency before discharge. The platelet count showed a rising tendency on postoperative day 3 and may exceed the preoperative value before discharge.Conclusions: The ABO achieved the surgical goal of TAR with FET with an improved recovery process during the in-hospital stay. [ABSTRACT FROM AUTHOR]

Background: The management of patients with disorders of consciousness (DOC) presents substantial challenges in clinical practice. Deep brain stimulation (DBS) has emerged as a potential therapeutic approach, but the lack of standardized regulatory parameters for DBS in DOC hinders definitive conclusions. Objective: This comprehensive review aims to provide a detailed summary of the current issues concerning patient selection, target setting, and modulation parameters in clinical studies investigating the application of DBS for DOC patients. Methods: A meticulous systematic analysis of the literatures was conducted, encompassing articles published from 1968 to April 2023, retrieved from reputable databases (PubMed, Embase, Medline, and Web of Science). Results: The systematic analysis of 21 eligible articles, involving 146 patients with DOC resulting from acquired brain injury or other disorders, revealed significant insights. The most frequently targeted regions were the Centromedian‐parafascicular complex (CM‐pf) nuclei and central thalamus (CT), both recognized for their role in regulating consciousness. However, other targets have also been explored in different studies. The stimulation frequency was predominantly set at 25 or 100 Hz, with pulse width of 120 μs, and voltages ranged from 0 to 4 V. These parameters were customized based on individual patient responses and evaluations. The overall clinical efficacy rate in all included studies was 39.7%, indicating a positive effect of DBS in a subset of DOC patients. Nonetheless, the assessment methods, follow‐up durations, and outcome measures varied across studies, potentially contributing to the variability in reported efficacy rates. Conclusion: Despite the challenges arising from the lack of standardized parameters, DBS shows promising potential as a therapeutic option for patients with DOC. However, there still remains the need for standardized protocols and assessment methods, which are crucial to deepen the understanding and optimizing the therapeutic potential of DBS in this specific patient population. [ABSTRACT FROM AUTHOR]

• A new type of BFRP-SWSSC beam with TRE composite shell was proposed. • Composite beams after the coupled action of dry-wet cycles and load was discussed. • TRE composite shells alter the deformation and cracking characteristics of composite beams. • The ductility of composite beams after the coupled action of dry-wet cycles and load was analyzed. In order to study the effect on the flexural behavior and durability of the textile reinforced engineered cementitious composites (TRE) shell for specimens under a dry-wet environment, the basalt fiber reinforced polymer (BFRP) reinforced seawater sea-sand concrete beams composited the TRE shell were subjected to the dry-wet cycles and the coupling of dry-wet cycles and the sustained load. The failure pattern, ultimate bearing capacity, deflection and crack width of composite beams under different dry-wet cycles, TRE shell shapes and sustained loadings were studied, and the ductility of beams with the TRE shell was further evaluated by energy and deformation. The experimental results showed that all composite beams with the U-shaped TRE shell suffered from the failure of concrete crushing. During the test, the interface of the TRE shell and concrete was debonded for all beams with the TRE shell, and the deformation of beams with TRE shell recovered after unloading. The ultimate bearing capacity of beams decreased slightly with the dry-wet cycles, while the deflection and crack width of the specimens hardly changed significantly. The ultimate bearing capacity of beams with the TRE shell decreased with the stress level of the sustained loading, whose stiffness increased and the cracks became sparse. Crack width decreased with the suatained load before the interface debonding, but the opposite phenomenon occurred after the interface debonding. From the ductility evaluation, the energy absorption index of beams with the U-shape TRE shell is higher than that of the BFRP reinforced seawater sea-sand concrete beam, indicating that TRE shells can effectively improve the energy dissipation capacity of beams. [ABSTRACT FROM AUTHOR]

Alcohol (ethanol) has proven to be toxic to nearly all organs, with the brain being one of the principal targets. As one of the important components of the brain's blood-brain barrier (BBB) and central nervous system, the state of microglia may be associated with some symptoms of alcohol intoxication. In the present study, microglia BV-2 cells were exposed to various concentrations of alcohol for 3 or 12 h, imitating different stages of drunkenness after alcohol use, respectively. From the perspective of the autophagy-phagocytosis axis, our findings show that alcohol alters autophagy levels or promotes apoptosis in BV-2 cells. The current study adds to the understanding of the action mechanisms of alcohol neurotoxicity. We anticipate that this study will increase public awareness of alcohol's negative effects and contribute to the creation of novel alcoholism treatment approaches. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to investigate the expression of matrix metalloproteinase-9 (MMP-9) and interleukin-6 (IL-6) in patients with subarachnoid hemorrhage (SAH) and the clinical significance thereof. Forty-three patients with SAH and 23 healthy individuals were enrolled in this study. Patients were divided into the cerebral vasospasm (CVS) and non-cerebral vasospasm (non-CVS) groups, or the good and poor prognosis groups. Serum levels of MMP-9 and IL-6 were detected by ELISA. Expression levels of MMP-9 and IL-6 mRNAs were detected by RT-qPCR. Expression levels of MMP-9 and IL-6 were elevated with the increase of grades as determined by the Hunt-Hess grading method. Serum levels of MMP-9 and IL-6 in the CVS and poor prognosis groups were significantly higher than those in the control group. Expression levels of MMP-9 and IL-6 in the CVS group were significantly higher than those in the non-CVS group (P<0.05). Compared with the good prognosis group, the expression levels of MMP-9 and IL-6 were significantly increased in the poor prognosis group at 1, 4, 7 and 10 days after SAH (P<0.05). Additionally, the expression level of MMP-9 was significantly positively correlated with that of IL-6 (P<0.05). Expression levels of MMP-9 and IL-6 were significantly increased in patients with SAH, and the expression level of MMP-9 was positively correlated with that of IL-6. Thus, MMP-9 and IL-6 are involved in the development of SAH. [ABSTRACT FROM AUTHOR]

• The bonding properties between TRE and SWSSC under dry-wet cycles were studied. • The factors influence the bonding properties between TRE and SWSSC were investigated. • The average bond strength, load-slip curves and interfacial fracture energies were analyzed. • The fracture energies with different TRE thicknesses have different changing patterns. In order to promote the application of cementitious composites in the marine environment, it is crucial to clarify the interfacial bonding properties of cementitious composites to concrete. Therefore, the interfacial bonding performance of a new cementitious composite, textile reinforced ECC (TRE), to seawater sea-sand concrete (SWSSC) in a chloride salt dry-wet environment was investigated by single shear test. The interface behavior was evaluated from the failure modes, average bond strength, load-slip curves, and fracture energy of TRE-SWSSC interface. The main research factors included the erosion environment, the thickness of TRE composite, and the dry-wet cycles. The study showed that the failure mode of specimens with a small thickness of TRE composite are mainly the fracture and sliding of matrix in the free length of TRE. The failure pattern of the TRE-SWSSC interface with 20 mm thickness changed from the fracture and sliding of matrix in bond length of TRE to that in free length of TRE with the increase of dry-wet cycles. And the failure of specimens in immersion environment was interfacial peeling. The average bond strength of TRE-SWSSC interface increased with the thickness of TRE. After 270 days of environmental action, the interfacial average bond strength in the dry-wet environment was 15.94 % higher than that in the immersion environment. The load-slip curves were smoother for specimens with smaller TRE thickness, and the descending section of the load-slip curves became steeper with the increase of TRE thickness. The interfacial fracture energies of the specimens with different TRE thicknesses showed different growing trend with the dry-wet cycles. With the increase of the dry-wet cycles, the interfacial fracture energy of the specimens with a TRE thickness of 10 mm gradually increased, but the interfacial fracture energy of the specimens with a TRE thickness of 20 mm gradually decreased. [ABSTRACT FROM AUTHOR]

• The BFRP reinforced SWSSC beams composite stay-in-place formwork of TRE was proposed. • The composite beams after chloride salt dry-wet environment were studied. • Chloride salt dry-wet environment can improve the stiffness of BFRP reinforced SWSSC beam. • A method for predicting the bearing capacity of composite beams was proposed. In order to improve the serviceability performance and durability of basalt fiber-reinforced polymer (BFRP) reinforced seawater sea-sand concrete (SWSSC) beams in the marine environment, a composite of stay-in-place (SIP) form of textile-reinforced ECC (TRE) and BFRP reinforced seawater sea-sand concrete (BFRP-SWSSC) was designed, to enhance bearing capacity and deformation suppression ability of this composite structure in the marine environment. A total of 10 specimens with an effective span of 1500 mm and section size of 150 mm × 250 mm were designed in this experiment, including one BFRP-SWSSC beam and the rest composed of TRE composite as SIP forms. The effects of different dry-wet cycles, thicknesses of TRE SIP forms, shape of TRE SIP forms and production methods of TRE SIP forms on the bending performance of composite beams were studied. The specimens displayed as the TRE thickness increased, the failure mode changed from bending shear failure to balanced or compression failure. Whereas the bearing capacity of the specimens was indistinctively affected by 90∼270 dry-wet cycles. The deflection deformation and crack width of the beams were effectively improved by TRE SIP forms. Meanwhile the stiffness of composite beams was effectively improved by the chlorine salt dry-wet environment. With the effective bonding between TRE and SWSSC, the deflection and crack width of the composite beams were within specification limits. The eminent ductility of the composite beams was shown by the chlorine salt dry-wet environment, the ductility index of the specimen decreased with the dry-wet cycles increased from 90 to 270. Based on the section analysis method, a calculation method was proposed for the disabled bearing capacity of BFRP-SWSSC beams with U-shape TRE SIP forms in a normal environment. On this basis, the environmental impact factor of the salt dry-wet environment was suggested, and the experimental value is in commendable agreement with the theoretical value. [ABSTRACT FROM AUTHOR]

• AAA and normal samples have different immune infiltration statuses. • FOS, IL-6 and IL2RB are identified as AAA immune-related hub genes. • IL2RB is an immune-related hub gene and a potential hub gene with significant diagnostic value in AAA. Abdominal aortic aneurysm (AAA) is potentially life threatening and characterized by immune-inflammatory cell infiltration and extracellular matrix degradation. Currently, pharmacotherapy mainly aims to control risk factors without reversion of the dilated aorta. This study analyzed the immune-inflammatory response and identified the immune-related hub genes of AAA. Gene Expression Omnibus datasets (GSE57691, GSE47472 and GSE7084) were downloaded. After identification of GSE57691 differentially expressed genes (DEGs), weighted gene co-expression network analysis of the DEGs was performed. Through enrichment analysis of each module and screening in Immunology Database and Analysis Portal, immune-related hub genes were identified via protein–protein interaction (PPI) network construction and lasso regression. CIBERSORT was utilized to analyze AAA immune infiltration. The correlations between the immune-related hub genes and infiltrating immune cells were investigated. Receiver operating characteristic (ROC) curve analysis was performed to determine immune-related hub gene cutoff values, which were validated in GSE47472 and GSE7084. In GSE57691, 1,018 DEGs were identified. Five modules were identified in the co-expression network. The blue and green modules were found to be related to immune-inflammatory responses, and 61 immune-related genes were identified. PPI and lasso regression analyses identified FOS, IL-6 and IL2RB as AAA immune-related hub genes. CIBERSORT analysis indicated significantly increased infiltration of naive B cells, memory activated CD4 T cells, follicular helper T cells, monocytes and M1 macrophages and significantly decreased infiltration of M2 macrophages in AAA compared with normal samples. IL2RB was more strongly associated with immune infiltration in AAA than were FOS and IL6. The IL2RB area under the ROC curve (AUC) value was > 0.9 in both the training and validation set, demonstrating its strong, stable diagnostic value in AAA. AAA and normal samples had different immune infiltration statuses. IL2RB was identified as an immune-related hub gene and a potential hub gene with significant diagnostic value in AAA. [ABSTRACT FROM AUTHOR]

A new alternative calculation procedure is developed to quantify the effect of yarn distortion characteristics on the mechanical properties of three-dimensional (3D) braided carbon/resin composites. Firstly, the multi-type yarn distortion characteristics factors including path, cross-section shape and cross-section torsion effects are described based on the stochastic theory. Then, the multiphase finite element method is employed to overcome the complex discretization in traditional numerical analysis, and the parametric studies including multi-type yarn distortion and different braided geometrical parameters on the resulting mechanical properties are performed. It is shown that the proposed procedure can simultaneously capture the yarn path and cross-section distortion characteristics caused by the mutual squeeze of component materials, which is difficult to characterize by experimental methods. In addition, it is found that even small distortions of yarn may significantly affect the mechanical properties for 3D braided composites, and the 3D braided composites with different braiding geometric parameters will show different sensitivity to the distortion characteristics factors of yarn. The procedure, which could be implemented into commercial finite element codes, is an efficient tool for the design and structural optimization analysis of a heterogeneous material with anisotropic properties or complex geometries. [ABSTRACT FROM AUTHOR]

[Display omitted] • We compared pore features and morphology before and after compression treatment. • Land subsidence transformed elongated macropores to regular and spherical pores. • Silt and silty clay soils > 100-m deep were the main contributors to land subsidence. • Compression decreased saturated hydraulic conductivity. • Saturated hydraulic conductivity was highly related to pore parameters. The extraction of deep confined groundwater has been widely identified as the main factor leading to land subsidence. However, how soil pore characteristics and morphology may change as a result of land subsidence remains unclear. The objective of this study was to (1) quantify and compare the effects of soil compression due to deep confined aquifer exploitation on soil pore characteristics and morphology and (2) assess the relationships between pore parameters and saturated hydraulic conductivity (K sat). Three kinds of lithology (clay, silt, and silty clay soils) from two 300-m engineering geological boreholes were investigated at natural saturated state (NSS) and complete drainage state (CDS). Seventeen undisturbed soil samples, 70 and 50-mm in diameter and height, respectively, were collected and subjected to steps of uniformly increasing loads in uniaxial confined compression tests to analyze pore characteristics, morphology, and K sat. Keeping the samples in a strain-locked state, pore parameters were assessed after each loading step by using X-ray micro-computed tomography (CT; voxel resolution: 3-μm) images. A hundred CT images were acquired and quantified for each treatment in each soil sample. Soil pore characteristics and morphological parameters including number of pores, number of macropores (diameter (∅) > 1000-μm), number of coarse mesopores (∅ 200–1000-μm), number of fine mesopores (∅ < 200-μm), porosity, macroporosity, coarse mesoporosity, fine mesoporosity, largest pore area, average pore diameter, shape factor, structure model index, degree of anisotropy, and the Euler number were analyzed using ImageJ software. All parameters differed between NSS and CDS treatments, especially in silt and silty clay soils below 100-m depth, and the differences seemed to increase with increasing depth. However, parameter variations were not obvious for clay soil. Furthermore, K sat differed significantly between treatments. The largest pore area, average pore diameter, and regular porosity accounted for 78.2 % of the change in K sat. Thus, the decrease in proportion of elongated macropores favors land subsidence, particularly in silt and silty clay soils below 100-m depth. Efforts such as optimization of groundwater exploitation depth should be made to alleviate and control land subsidence. [ABSTRACT FROM AUTHOR]

• A new type of BFRP-SWSSC beam with TRE tension zone cover was proposed. • Effects of various factors were revealed (such as number of textile layers). • The composite layer can promote the serviceability and ductility of the beam. • A method for predicting the bearing capacity of composite beams was proposed. To improve the service behavior of basalt fiber reinforced polymer (BFRP) reinforced seawater sea-sand concrete (BFRP-SWSSC) beams, textile reinforced ECC (TRE) are utilized in the tensile zone to replace the traditional SWSSC. The experimental parameters of TRE included the number of textile layers, the matrix thickness, and the matrix type. The results showed that the failure mode of the composite beams transitioned from tensile failure to balanced failure with the increase in the matrix thickness and the number of textile layers. The composite layer can promote the ultimate capacity to some extent. Compared with engineered cementitious composites (ECC) and textile reinforced concrete (TRC), TRE can more effectively reduce the deflection and crack width, as well as improve the ductility, at the service stage. The improvement was more significant when the matrix thickness and the number of textile layers increased. Compared with those of the control beams, the deflection and crack width were reduced by 63.2% and 71.3% under the service loads, respectively, while the ductility index was improved by 29.1% for the TRE composite beam with three textile layers. Furthermore, the formulas for the ultimate capacity of the composite beams were developed and verified by the experiments. [ABSTRACT FROM AUTHOR]

[Display omitted] • The PVDF membranes with high aspect ratio and stable microstructures were prepared. • The peeling process was added to the traditional template method membrane. • The membrane exhibited excellent long-term stability in concentration test. • A model of the full VMD process with coupled heat-mass-flow was developed. In recent years, membrane distillation (MD) has emerged as an effective solution to mitigate the high energy consumption associated with conventional fermentable sugar concentration processes. However, the inherent low mechanical strength of traditional organic membrane surfaces can result in issues related to membrane wetting during long-term MD experiments. In this work, superhydrophobic PVDF/MWCNTs (multi-walled carbon nanotubes) distillation membranes with high mechanical strength were prepared by a combination of templating and co-blending techniques. The process involved peeling the semi-gelation membrane from a sandpaper template, subsequently forming a high aspect ratio microstructure on the membrane surface via tearing and pulling. Additionally, the incorporation of MWCNTs further bolstered the mechanical strength of the membrane. At a peeling time of 90 s and a MWCNTs content of 0.08 wt%, the distillation membrane exhibited an impressive water contact angle of 153.2°, indicating it possess exceptional hydrophobicity while maintaining high mechanical strength. The separation performance of the prepared distillation membranes has been inspected by conducting both experimental analyses and computational fluid dynamics (CFD) modeling of the entire MD process. An appropriate elevation in both feed flow rate and temperature could effectively mitigate the problem of temperature and concentration polarization on the membrane surface. PVDF/MWCNTs distillation membrane demonstrated a modest reduction in permeate flux of about 11.69 % and a stable rejection rate exceeding 99.95 % throughout a 100-hour operational period, and it required only 15 h to concentration of aqueous glucose solution to 100 g/L, significantly enhancing the efficiency of the process. This study also employed a combination of experiments and simulations to optimizes the process conditions guiding the vacuum membrane distillation (VMD) process and could provide guidance for the future application of membrane distillation in the concentration of sugar solutions. [ABSTRACT FROM AUTHOR]

Membrane separation technologies have attracted great attentions in chemical engineering, food science, analytical science, and environmental science. Compared to traditional membrane separation techniques like reverse osmosis (RO), ultrafiltration (UF), electrodialysis (ED) and others, pervaporation (PV)-based membrane separation shows not only mutual advantages such as small floor area, simplicity, and flexibility, but also unique characteristics including low cost as well as high energy and separation efficiency. Recently, different polymer, ceramic and composite membranes have shown promising separation applications through the PV-based techniques. To show the importance of PV for membrane separation applications, we present recent advances in the fabrication, properties and performances of polymeric membranes for PV separation of various chemicals in petrochemical, desalination, medicine, food, environmental protection, and other industrial fields. To promote the easy understanding of readers, the preparation methods and the PV separation mechanisms of various polymer membranes are introduced and discussed in detail. This work will be helpful for developing novel functional polymer-based membranes and facile techniques to promote the applications of PV techniques in different fields. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES To evaluate the impact of antiplatelet therapy on the long-term descending thoracic aorta (DTA) fate and prognosis of extensive repaired type A aortic dissection (TAAD). METHODS 1147 eligible TAAD patients from January 2010 to December 2019 were stratified into non-antiplatelet (n  = 754) and antiplatelet groups (n  = 393). The primary end points were overall survival, and DTA remodelling, including false lumen (FL) thrombosis and aortic redilation. The secondary end points were DTA reintervention or rupture and major bleeding events (MBEs). RESULTS The 5-year overall survival rates were 95.6% and 94.3% in the non-antiplatelet and antiplatelet groups (P  = 0.53), respectively. In the stent covering segment, the 1-year FL complete thrombosis rates were 92.1% and 92.4% in the non-antiplatelet and antiplatelet groups (P  = 0.27), respectively, while in the stent uncovering segment, the 5-year FL complete thrombosis rates were 47.1% and 56.5% in the non-antiplatelet and antiplatelet groups (P  = 0.12), respectively. Antiplatelet therapy was not an independent predictor of aortic redilation at the pulmonary artery bifurcation (β±SE = –0.128 ± 0.203, P  = 0.53), diaphragm (β±SE = 0.143 ± 0.152, P  = 0.35) or coeliac artery (β±SE = 0.049 ± 0.136, P  = 0.72) levels. With death as a competing risk, the cumulative incidences of DTA reintervention or rupture at 5 years were 4.6% and 4.0% in the non-antiplatelet and antiplatelet groups (sHR = 0.85, 95% CI, 0.49∼1.19; P  = 0.58), respectively, and the 5-year cumulative incidences of MBEs were 2.1% and 2.3% in the non-antiplatelet and antiplatelet groups (sHR = 0.82, 95% CI, 0.56∼2.67; P  = 0.62), respectively. CONCLUSIONS Antiplatelet therapy did not impact long-term DTA FL thrombosis, redilation, reintervention or rupture, MBEs or overall survival on extensive repaired TAAD. Thus, antiplatelet therapy can be administered as indicated on extensive repaired TAAD. [ABSTRACT FROM AUTHOR]

• TRC (Textile-reinforced concrete) has good crack control performance for eccentric column. • Failure modes and bearing capacity of eccentric column can be improved by TRC. • The coupling of chloride and load has a negative effect on TRC-strengthened columns. • The eccentricity and previous load have an influence on the strengthening effect of TRC. Building structures located in tidal areas are more vulnerable to damage due to the coupled effect of the chloride exposure during dry/wet cycling and loading during their service life; thus, such structures need to be repaired and strengthened. In this study, to examine the mechanical properties of textile-reinforced concrete (TRC)-strengthened eccentrically loaded columns under the coupled action of chloride corrosion and loading, eccentric compression testing of 10 TRC-strengthened rectangular reinforced concrete (RC) columns is conducted, and the influence of parameters such as the eccentricity and previous load level on the effect of TRC strengthening is considered. The results show that TRC strengthening can effectively inhibit the development and extension of cracks in eccentrically compressed specimens placed in a corrosive environment (due to chloride salt) while exhibiting a satisfactory crack control. With increasing eccentricity, the utilization rate of the tensile strength of the textile increases, and the contribution of the TRC strengthening layer to the specimen strength increases. With the increase in the previous load level, the strengthening effect of the TRC becomes more notable. Finally, the changes in the microstructure in the TRC strengthening layer under different previous load levels are analysed through scanning electron microscopy (SEM), and the damage degradation mechanism of the TRC strengthening effect is explored from a microscopic viewpoint. [ABSTRACT FROM AUTHOR]

Background: Obesity is dramatically increasing worldwide, and more obese patients may develop aortic dissection and present for surgical repair. The study aims to analyse the impact of body mass index (BMI) on surgical outcomes in patients with acute Stanford type A aortic dissection (ATAAD).Methods: From January 2017 to June 2019, the clinical data of 268 ATAAD patients in a single centre were retrospectively reviewed. They were divided into three groups based on the BMI: normal weight (BMI 18.5 to < 25 kg/m2, n = 110), overweight (BMI 25 to < 30 kg/m2, n = 114) and obese (BMI ≥30 kg/m2, n = 44).Results: There was no statistical difference among the three groups in terms of the composite adverse events including 30-day mortality, stroke, paraplegia, renal failure, hepatic failure, reintubation or tracheotomy and low cardiac output syndrome (20.9% vs 21.9% vs 18.2% for normal, overweight and obese, respectively; P = 0.882). No significant difference was found in the mid-term survival among the three groups. The proportion of prolonged ventilation was highest in the obese group followed by the overweight and normal groups (59.1% vs 45.6% vs 34.5%, respectively; P = 0.017). Multivariable logistic regression analysis suggested that BMI was not associated with the composite adverse events, while BMI ≥30 kg/m2 was an independent risk factor for prolonged ventilation (OR 2.261; 95% CI 1.056-4.838; P = 0.036).Conclusions: BMI had no effect on the early major adverse outcomes and mid-term survival after surgery for ATAAD. Satisfactory surgical outcomes can be obtained in patients with ATAAD at all weights. [ABSTRACT FROM AUTHOR]

AT2Rs [AngII (angiotensin II) type 2 receptors] contribute to the cardioprotective effects of angiotensin II receptor blockers, possibly via kinins acting on the B1R (B1 receptor) and B2R (B2 receptor). Recent studies have shown that a lack of B2R up-regulates B1R and AT2R; however, the pathophysiological relevance of such an event remains unclear. We hypothesized that up-regulation of AT2R and B1R compensates for the loss of B2R. Blockade of AT2R and/or B1R worsens cardiac remodelling and dysfunction following MI (myocardial infarction) in B2R-/- (B2-receptor-knockout mice). B2R-/- mice and WT (wild-type) controls were subjected to sham MI or MI and treated for 4 weeks with (i) vehicle, (ii) a B1R-ant (B1R antagonist; 300 µg/kg of body weight per day), (iii) an AT2R-ant [AT2 receptor antagonist (PD123319); 20 mg/kg of body weight per day], or (iv) B1R-ant+AT2R-ant. B2R-/- mice had a greater MCSA (myocyte cross-sectional area) and ICF (interstitial collagen fraction) at baseline and after MI compared with WT controls. Cardiac function and increase in macrophage infiltration, TGFß1 (transforming growth factor ß1) expression and ERK1/2 (extracellular-signal-regulated kinase 1/2) phosphorylation post-MI were similar in both strains. Blockade of AT2R or B1R worsened cardiac remodelling, hypertrophy and dysfunction associated with increased inflammation and ERK1/2 phosphorylation and decreased NO excretion in B2R-/- mice, which were exacerbated by dual blockade of B1R and AT2R. No such effects were seen in WT mice. Our results suggest that, in the absence of B2R, both B1R and AT2R play important compensatory roles in preventing deterioration of cardiac function and remodelling post-MI possibly via suppression of inflammation, TGFß1 and ERK1/2 signalling. [ABSTRACT FROM AUTHOR]