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Background: Both atrial fibrillation (AF) and heart failure (HF) are common cardiovascular diseases. If the two exist together, the risk of stroke, hospitalization for HF and all-cause death is increased. Currently, research on left atrial appendage closure (LAAC) in patients with AF and HF is limited and controversial. This study was designed to investigate the safety and effectiveness of LAAC in AF patients with different types of HF. Methods: Patients with non-valvular atrial fibrillation (NVAF) and HF who underwent LAAC in the First Affiliated Hospital of Army Medical University from August 2014 to July 2021 were enrolled. According to left ventricular ejection fraction (LVEF), the study divided into HF with reduced ejection fraction (LVEF < 50%, HFrEF) group and HF with preserved ejection fraction (LVEF ≥ 50%, HFpEF) group. The data we collected from patients included: gender, age, comorbid diseases, CHA2DS2-VASc score, HAS-BLED score, NT-proBNP level, residual shunt, cardiac catheterization results, occluder size, postoperative medication regimen, transthoracic echocardiography (TTE) results and transesophageal echocardiography (TEE) results, etc. Patients were followed up for stroke, bleeding, device related thrombus (DRT), pericardial tamponade, hospitalization for HF, and all-cause death within 2 years after surgery. Statistical methods were used to compare the differences in clinical outcome of LAAC in AF patients with different types of HF. Results: Overall, 288 NVAF patients with HF were enrolled in this study, including 142 males and 146 females. There were 74 patients in the HFrEF group and 214 patients in the HFpEF group. All patients successfully underwent LAAC. The CHA2DS2-VASc score and HAS-BLED score of HFrEF group were lower than those of HFpEF group. A total of 288 LAAC devices were implanted. The average diameter of the occluders was 27.2 ± 3.5 mm in the HFrEF group and 26.8 ± 3.3 mm in the HFpEF group, and there was no statistical difference between the two groups (P = 0.470). Also, there was no statistically significant difference in the occurrence of residual shunts between the two groups as detected by TEE after surgery (P = 0.341). LVEF was significantly higher in HFrEF group at 3 days, 3 months and 1 year after operation than before (P < 0.001). At 45–60 days after surgery, we found DRT in 9 patients and there were 4 patients (5.4%) in HFrEF group and 5 patients (2.3%) in HFpEF group, with no significant difference between the two groups (P = 0.357). One patient with DRT had stroke. The incidence of stroke was 11.1% in patients with DRT and 0.7% in patients without DRT (P = 0.670). There was one case of postoperative pericardial tamponade, which was improved by pericardiocentesis at 24 h after surgery in the HFpEF group, and there was no significant difference between the two groups (P = 1.000). During a mean follow-up period of 49.7 ± 22.4 months, there were no significant differences in the incidence of stroke, bleeding, DRT and HF exacerbation between the two groups. We found a statistical difference in the improvement of HF between HFrEF group and HFpEF group (P < 0.05). Conclusions: LAAC is safe and effective in AF patients with different types of HF. The improvement of cardiac function after LAAC is more pronounced in HFrEF group than in HFpEF group. [ABSTRACT FROM AUTHOR]

Employing elevated CO2 (eCO2), similar to increasing atmospheric CO2 in a greenhouse, is a common practice used to increase vegetable crop yields. However, the responses of nutrient availability, nutrient uptake and use efficiency in leafy vegetables to eCO2 remain largely unknown. The plant biomass production, nitrogen (N), phosphorus (P) and potassium (K) contents, nutrient uptake, and soil enzymatic activities of three Brassica chinensis varieties of 'Longpangqing', 'Heimeiren' and 'Qingjiangbai' were thus assessed under ambient CO2 (C0, 420/470 ppm, day/night) and eCO2 (C1, C0 + 33.3%C0; C2, C0 + 66.7%C0; and C3, C0 + 100%C0) for 4 months. Biomass production was significantly enhanced in these three tested B. chinensis varieties along with eCO2 gradients, with the highest biomass production under C3. Moreover, the eCO2 significantly increased plant N and K uptake, P and K use efficiency, soil saccharase, urease, and phosphatase activities, but decreased plant P content, soil available N and K, and catalase activity. Under eCO2, 'Qingjiangbai' exhibited higher biomass production and P and K uptake, without a decrease in soil available N and P. Consequently, more external fertilizer supplementation (especially N, followed by K) is required to maintain or promote Brassica chinensis yield under eCO2, while these management strategies must be carefully considered for different crop varieties. [ABSTRACT FROM AUTHOR]

Objective: This clinical trial aimed to evaluate the efficacy and safety of Jiandu granule, a Chinese herbal medicine formula, for preventing oral mucositis in patients with nasopharyngeal carcinoma undergoing concurrent chemoradiotherapy. Materials and Methods: A single‐centre, open‐label, randomised controlled trial was conducted, enrolling 138 patients with locally advanced nasopharyngeal carcinoma. Patients were randomly allocated to either the experimental group (n = 69) or the control group (n = 69). Both groups received concurrent chemoradiotherapy and standard care for oral mucositis, with the experimental group additionally receiving Jiandu granule intervention. The primary outcome was the incidence of severe oral mucositis (grade III to IV). Results: In the full‐analysis set, severe oral mucositis occurred in 14 of 69 (20.3%) patients in the experimental group and 31 of 69 (44.9%) patients in the control group (absolute risk reduction: 24.6%; relative risk reduction: 54.8%; p = 0.002; number needed to treat: 4). Jiandu granule was associated with mild/moderate gastrointestinal reactions, with an overall incidence of 5.9%. Conclusion: Jiandu granule reduced the incidence of severe oral mucositis in nasopharyngeal carcinoma patients during concurrent chemoradiotherapy and had an acceptable safety profile. [ABSTRACT FROM AUTHOR]

Background: Observational studies have indicated a high prevalence of erectile dysfunction (ED) among patients with inflammatory bowel disease (IBD), but a definitive causal relationship remains unestablished., Aim: The primary aim of this study was to assess the potential causal relationship between IBD and ED using Mendelian randomization (MR) analysis., Methods: We obtained statistical data for 2 subtypes of IBD, ulcerative colitis (UC) and Crohn's disease (CD), as well as for ED, from publicly available genome-wide association studies (GWASs). Subsequently, a 2-sample MR analysis was conducted using these datasets. The primary MR analysis utilized the inverse variance-weighted (IVW) method, complemented by secondary analyses employing MR-Egger and weighted median methods. Furthermore, we assessed heterogeneity using Cochran's Q test and evaluated pleiotropy with the MR-Egger intercept test. To identify potential influential single nucleotide polymorphisms, we employed a leave-one-out analysis. Additionally, outliers were identified using the MR-PRESSO method., Outcomes: The study outcomes encompassed results from 3 MR analyses, namely IVW, MR-Egger, and weighted median, along with sensitivity analyses involving Cochran's Q test, the MR-Egger intercept test, leave-one-out analysis, and the MR-PRESSO method., Results: There was no causal effect of UC and CD on ED in the MR analysis (IVW P > .05). Results of complementary methods were consistent with those of the IVW method. The results of sensitivity analyses supported our conclusion, and no directional pleiotropy was found., Clinical Implications: Genetically, despite the absence of a causal link between IBD and ED according to MR analysis, we must emphasize the elevated ED prevalence among IBD patients in observational studies, with particular consideration for the influence of negative emotions on erectile function., Strengths & Limitations: This study is the inaugural application of a 2-sample MR analysis using extensive GWAS datasets to evaluate the causal relationship between IBD and ED, effectively mitigating biases stemming from confounding factors and reverse causality often present in observational studies. Nevertheless, it is imperative to exercise caution when drawing conclusions due to inherent limitations in GWAS data, encompassing factors like samples overlap, gender categorization, population ancestry, and the persistent ambiguity surrounding the precise functionality of specific single nucleotide polymorphisms., Conclusions: MR analysis did not provide genetic-level evidence supporting a direct causal relationship between IBD (UC and CD) and ED., Competing Interests: The authors declare no competing interests., (© Published by Oxford University Press on behalf of The International Society of Sexual Medicine 2024.)

Background: Circular RNAs (circRNAs), a class of non-coding RNAs, has been proved as an essential driver of hepatocellular carcinoma (HCC) progression. However, the aim of this study is to explore the role of hsa&#95;circ&#95;0097009 (circ&#95;0097009) in HCC progression., Methods: Ki67 expression in HCC tissues was labeled and examined by IHC assay. Quantitative real-time PCR (qRT-PCR) was applied to assess the expression of circ&#95;0097009, miR-568 and RING finger protein 38 (RNF38). Western blot assay was conducted to analyze protein expression. HCC cell colony formation, proliferation, migration, invasion, angiogenesis ability and apoptosis were determined by colony formation assay, 5-ethynyl-29-deoxyuridine (EdU) assay, wound healing assay, trans well assay, angiogenesis assay and flow cytometry. The interaction between circ&#95;0097009 and miR-568 as well as miR-568 and RNF38 was probed by dual-luciferase reporter and RNA immunoprecipitation (RIP) assays., Results: We found that circ&#95;0097009 and RNF38 expressions were markedly higher, but miR-568 expression was significantly lower in HCC. Circ&#95;0097009 knockdown blocked HCC cell cloning, proliferation, migration, invasion, angiogenesis and facilitated apoptosis. MiR-568 was a target of circ&#95;0097009 in HCC cells. MiR-568 interference could attenuate the circ&#95;0097009 knockdown-induced inhibition on HCC cells progress. MiR-568 depressed cell clonal formation, proliferation, migration, invasion, angiogenesis and promotion of apoptosis, by targeting RNF38, and RNF38 overexpression reversed the suppression of miR-568 in HCC cells. Also, circ&#95;0097009 knockdown blocked tumor growth in vivoCONCLUSION: Together, this study indicated that the oncogenic function of circ&#95;0097009 in HCC, and circ&#95;0097009/miR-568/RNF38 axis was expected to be a novel therapeutic option for HCC patients (Tab. 1, Fig. 7, Ref. 33). Text in PDF www.elis.sk Keywords: circ&#95;0097009, miR-568, RNF38, hepatocellular carcinoma.