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Background The evidence for optical coherence tomography (OCT)–guided percutaneous coronary intervention (PCI) in improving the prognosis of individuals with in‐stent restenosis (ISR) is lacking. Methods and Results This retrospective study enrolled 588 consecutive individuals with drug‐eluting stent ISR undergoing PCI from March 2010 to March 2022. Two hundred seven (35.2%) underwent OCT guidance, and 381 (64.8%) underwent angiography guidance. Clinical outcomes were analyzed using survival curves. The primary clinical endpoint was 2‐year major adverse cardiovascular events (MACEs), a composite of all‐cause death, myocardial infarction, and target‐vessel revascularization. Compared with angiography guidance, OCT guidance demonstrated a higher frequency of drug‐coated balloon use and adjunctive therapeutic modalities, including predilation, postdilation, nonslip element balloons, and noncompliant balloons (P

Abstract Objective The medical instruments used in the emergency department have a wide coverage and prominent importance. The study was aimed to observe the effect of joint commission international (JCI) standard combined with 6S management mode in emergency medical equipment. Methods Medical equipment and nursing staff in the emergency department of our hospital were the subjects of the research. We compared the management status (standard placement, good cleaning, good maintenance, complete records) of medical equipment after the application of JCI standard combined with 6S management mode was compared with that before the application. Working time associated with medical equipment, equipment repair ratio, nurses' satisfaction with medical equipment use and management were also compared. Results After the application of JCI standard combined with 6S management mode, the proportion of instances meeting standards for placement, cleaning, maintenance, and record‐keeping was higher than before the application (p 0.05). Conclusion JCI standard combined with 6S management mode can standardize the use of emergency medical instruments, reduce the risk of instrument damage, increase work efficiency, improve nurses' satisfaction with medical instrument management, and are therefore worthy of clinical application.

Abstract Ulcerative colitis (UC) is a digestive disease with a high incidence and is difficult to be cured due to its complex etiology. It has evidenced that intestinal barrier dysfunction plays a predominant role in UC. 20(S)‐protopanaxadiol saponins (PDS) isolated from Panax notoginseng possess anti‐inflammatory and antioxidative activities, suggesting its potential of treating UC. Herein, the therapeutic effects of PDS against UC and underlying mechanisms in the aspect of intestinal barrier dysfunction were investigated in vivo and in vitro. The results showed PDS had protective effects against dextran sulfate sodium–induced colitis, including attenuating weight loss, disease activity index score elevation, colon length shortening, and histological lesions. Additionally, PDS reduced the colonic activity of myeloperoxidase and the cytokine levels of TNF‐α, IL‐6, and IL‐1β, decreased MDA production, and elevated colonic activities of SOD and GSH‐Px in the colitis mice. The expressions of proteins related to tight junction (TJ), including ZO‐1, claudin‐5, occludin, caveolin‐1 (Cav‐1), and Nrf2 were downregulated, whereas that of Keap1 was upregulated after colitis induction. These changes were reversed by PDS. Cav‐1 expression was downregulated in lipopolysaccharides (LPS)‐ and H2O2‐induced HCT116 cells, and the expressions of ZO‐1, claudin‐5, and occludin were suppressed in HCT116 cells stimulated by LPS and H2O2 combined with Cav‐1 small interfering RNA transfection, which were ameliorated by PDS, suggesting PDS targeted Cav‐1 against intestinal barrier damage. Collectively, PDS alleviates inflammatory injury and oxidative stress by regulating the Nrf2/Keap1 pathway, contributing to targeting Cav‐1 against intestinal epithelial TJ proteins loss. It suggests PDS might be a promising therapeutic natural product for UC treatment.

Abstract 2D nanomaterials play a critical role in realizing high‐performance flexible electrodes for wearable energy storge devices, owing to their merits of large surface area, high conductivity and high strength. The electrode is a complex system and the performance is determined by multiple and interrelated factors including the intrinsic properties of materials and the structures at different scales from macroscale to atomic scale. Multiscale design strategies have been developed to engineer the structures to exploit full potential and mitigate drawbacks of 2D materials. Analyzing the design strategies and understanding the working mechanisms are essential to facilitate the integration and harvest the synergistic effects. This review summarizes the multiscale design strategies from macroscale down to micro/nano‐scale structures and atomic‐scale structures for developing 2D nanomaterials‐based flexible electrodes. It starts with brief introduction of 2D nanomaterials, followed by analysis of structural design strategies at different scales focusing on the elucidation of structure‐property relationship, and ends with the presentation of challenges and future prospects. This review highlights the importance of integrating multiscale design strategies. Finding from this review may deepen the understanding of electrode performance and provide valuable guidelines for designing 2D nanomaterials‐based flexible electrodes.

Abstract Objective To explore the impact of inflammatory factors on the incidence of cerebral small vessel disease (CSVD), we performed a mendelian randomization (MR) study to analyze the causal relationship between multiple inflammatory factors and CSVD imaging markers and utilized summary‐data‐based mendelian randomization (SMR) analysis to infer whether the impact of instrumental variables (IVs) on disease is mediated by gene expression or DNA methylation. Methods Using public databases such as UKB and IEU, and original genome‐wide association studies, we obtained IVs related to exposure (inflammatory factors) and outcome (CSVD imaging markers). We performed the inverse variance weighted, weighted median, and MR‐Egger methods to assess causal effects between exposure and outcome in univariate MR analysis. To evaluate their heterogeneity, a series of sensitivity analyses were conducted, including the Cochrane Q test, MR‐Egger intercept test, MR‐Presso, and leave‐one‐out analysis. We also applied mediation and multivariate MR analysis to explore the interactions between positive exposures on the same outcome. Additionally, we conducted the SMR, which utilizes instruments within or near relevant genes in blood or brain tissues, to elucidate the causal associations with CSVD markers. Results ABO Univariate MR of multiple cohorts revealed that the risk of small vessel stroke (SVS) increases with elevated levels of TNF‐related apoptosis‐inducing ligand (TRAIL, OR, 1.23, 95% CI, 1.08–1.39) and interleukin‐1 receptor‐like 2, (IL‐1RL2, OR, 1.29, 95% CI, 1.04–1.61). IL‐18 was a potential risk factor for extensive basal ganglia perivascular space burden (BGPVS, OR, 1.02, 95% CI, 1.00–1.05). Moreover, the risk of extensive white matter perivascular space burden (WMPVS) decreased with rising levels of E‐selectin (OR, .98, 95% CI, .97–1.00), IL‐1RL2 (OR, .97, 95% CI, .95–1.00), IL‐3 receptor subunit alpha (IL‐3Ra, OR, .98, 95% CI, .97–1.00), and IL‐5 receptor subunit alpha (IL‐5Ra, OR, .98, 95% CI, .97–1.00). Mediation and multivariate MR analysis indicated that E‐selectin and IL‐3Ra might interact during the pathogenesis of WMPVS. SMR estimates showed that TRAIL‐related IVs rs5030044 and rs2304456 increased the risk of SVS by increasing the expression of gene Kininogen‐1 (KNG1) in the cerebral cortex, particularly in the frontal cortex (βsmr = .10, Psmr = .003, FDR = .04). Instruments (rs507666 and rs2519093) related to E‐selectin and IL‐3Ra could increase the risk of WMPVS by enhancing DNA methylation of the gene ABO in blood tissue (βsmr = .01–.02, Psmr = .001, FDR = .01–.03). Conclusion According to MR and SMR analysis, higher levels of TRAIL increased the risk of SVS by upregulating gene expression of KNG1 in brain cortex tissues. In addition, protective effects of E‐selectin and IL‐3a levels on WMPVS were regulated by increased DNA methylation of gene ABO in blood tissue.

Abstract Background and purpose According to the classic cognitive behavioral theory proposes, dysfunctional goal‐directed and habit control systems are considered central to the pathogenesis of dependent behavior and impair recovery from addictions. The functional connectivity (FC) of the brain circuits for goal‐directed or habitual behavior has not been clearly reported in tobacco‐dependent groups. Smoking is one of the factors in the formation of atherosclerosis. Studies have shown that the thickness of carotid intima‐media (cIMT) is associated with attention‐executive‐psychomotor functioning. Therefore, we hypothesized whether cIMT in tobacco‐dependent individuals is associated with changes in the FC of the dual‐system network. Methods A total of 29 male tobacco‐dependent subjects (tobacco‐dependent group) (mean age: 64.20 years, standard deviation [SD]: 4.81 years) underwent resting‐state functional magnetic resonance imaging (rs‐fMRI). Exactly 28 male nonsmokers (control group) (mean age: 61.95 years, SD: 5.52 years) were also recruited to undergo rs‐fMRI. We used the dorsolateral striatum (putamen) and dorsomedial striatum (caudate) as regions of interest for whole‐brain resting‐state connectivity to construct habitual and goal‐directed brain networks, respectively. In addition, all participants were evaluated by carotid artery ultrasound to obtain the cIMT values. Then, we compared the dual‐system brain networks between the tobacco dependence and control groups and the relationship between cIMT and imbalance of dual‐system brain networks in tobacco dependence. Results The results showed a reduction in the connection between the caudate and precuneus and an increased connection between the putamen and prefrontal cortex; and supplementary motor area. The bilateral connectivity between the caudate and inferior frontal gyrus showed a significant negative correlation with the cIMT, and no positive correlation was observed with cIMT in the brain region that connects to the caudate. However, for the putamen, increased connectivity with the inferior temporal and medial frontal gyri was strongly associated with a high cIMT. Conclusions The results indicate that the formation of tobacco dependence behavior is related to changes in the dual‐system brain network. Carotid sclerosis is associated with the weakening of the goal‐directed network and enhancement of the habit network in tobacco dependence. This finding suggests that tobacco dependence behavior and clinical vascular diseases are related to changes in brain functional networks.

Abstract Objective/Background Proliferation is a widely recognized trigger for pulmonary hypertension (PH), a life‐threatening, progressive disorder of pulmonary blood vessels. This study was aimed to identify some proliferation associated genes/targets for better comprehension of PH pathogenesis. Methods Human pulmonary arterial smooth muscle cells (hPASMCs) were cultured in the presence or absence of human recombinant platelet derived growth factor (rhPDGF)‐BB. Cells were collected for metabolomics or transcriptomics study. Gene profiling of lungs of PH rats after hypoxia exposure or of PH patients were retrieved from GEO database. Results 90 metabolites (VIP score >1, fold change >2 or 2 or

Hypertrophic scarring (HS) is a dermal fibroproliferative disorder characterized by excessive deposition of collagen and other extracellular matrix components. The aim of this study is to explore crucial long noncoding RNAs (lncRNAs) and circular RNAs (circRNAs) associated with HS and provide a better understanding of the molecular mechanism of HS. To investigate the lncRNA, circRNA and mRNA expression profiles, we performed RNA sequencing of human HS and normal skin tissues. After the identification of differentially expressed mRNAs (DEmRNAs), lncRNAs (DElncRNAs) and circRNAs (DEcircRNAs), we performed functional enrichment of DEmRNAs. Further on, we constructed DElncRNA/DEcircRNA–DEmRNA coexpression networks and competing endogenous RNA regulatory networks, and performed functional analyses of the DEmRNAs in the constructed networks. In total, 487 DEmRNAs, 92 DElncRNAs and 17 DEcircRNAs were identified. DEmRNAs were significantly enriched in processes such as collagen fibril organization, extracellular matrix–receptor interaction and the phosphatidylinositol 3‐kinase (PI3K)–Akt signaling pathway. In addition, we detected 580 DElncRNA–DEmRNA and 505 DEcircRNA–DEmRNA coexpression pairs. The competing endogenous RNA network contained 18 circRNA–microRNA (miRNA) pairs, 18 lncRNA–miRNA pairs and 409 miRNA–mRNA pairs, including 10 circRNAs, 5 lncRNAs, 15 miRNAs and 160 mRNAs. We concluded that MIR503HG/hsa‐miR‐204‐3p/ACAN, MIR503HG/hsa‐miR‐431‐5p/TNFRSF9, MEG3/hsa‐miR‐6884‐5p/ADAMTS14, AC000035.1‐ADAMTS14 and hsa_circ_0069865‐COMP/ADAM12 interaction pairs may play a central role in HS.

Abstract Background Due to the increasing ageing population, neurocognitive disorders (NCDs) have been a global public health issue, and its prevention and early diagnosis are crucial. Our previous study demonstrated that there is a significant correlation between specific populations and NCDs, but the biological characteristics of the vulnerable group predispose to NCDs are unclear. The purpose of this study is to investigate the predictors for the vulnerable group by a multi‐omics analysis. Methods Multi‐omics approaches, including metagenomics, metabolomic and proteomic, were used to detect gut microbiota, faecal metabolites and urine exosome of 8 normal controls and 13 vulnerable elders after a rigorous screening of 400 elders in Macao. The multi‐omics data were analysed using R and Bioconductor. The two‐sided Wilcoxon's rank‐sum test, Kruskal–Wallis rank sum test and the linear discriminant analysis effective size were applied to investigate characterized features. Moreover, a 2‐year follow‐up was conducted to evaluate cognitive function change of the elderly. Results Compared with the control elders, the metagenomics of gut microbiota showed that Ruminococcus gnavus, Lachnospira eligens, Escherichia coli and Desulfovibrio piger were increased significantly in the vulnerable group. Carboxylates, like alpha‐ketoglutaric acid and d‐saccharic acid, and levels of vitamins had obvious differences in the faecal metabolites. There was a distinct decrease in the expression of eukaryotic translation initiation factor 2 subunit 1 (eIF2α) and amine oxidase A (MAO‐A) according to the proteomic results of the urine exosomes. Moreover, the compound annual growth rate of neurocognitive scores was notably decreased in vulnerable elders. Conclusions The multi‐omics characteristics of disturbed glyoxylate and dicarboxylate metabolism (bacteria), vitamin digestion and absorption and tricarboxylic acid cycle in vulnerable elders can serve as predictors of NCDs risk among the elderly of Macao. Intervention with them may be effective therapeutic approaches for NCDs, and the underlying mechanisms merit further exploration.

To investigate the effects of thunderstorm downburst on the characteristics of wind field at bridge sites in flat and gorge terrains, firstly, numerical simulation of wind fields in the flat terrain under the thunderstorm downburst was conducted through the SST k-ω turbulence model, combined with the impinging jet technology. After verification of the reliability of the numerical model, settings, and methods, the characteristics of wind field over a long-span bridge site in a gorge terrain under the thunderstorm downburst were investigated and the distributions of wind speed and wind attack angle in the flat and gorge terrains were compared. The results show that, under the effects of the thunderstorm downburst, the wind speeds are relatively maximum at the midspan point of the girder in the flat terrain. Besides, the farther away from the midspan point, the smaller the wind speeds, which is opposite to the case in the gorge terrain. The wind speeds at each typical monitoring point are basically the same in the two terrains, before the thunderstorm downburst hits the bridge girder. Later the wind speeds at each point in the gorge terrain are much higher than those in the flat terrain. Most wind attack angles are negative at the monitoring points in the flat terrain, but the farther away they are from the midspan point, the greater the wind attack angles will be. However, the wind attack angles at the monitoring points in the gorge terrain are generally larger than those in the flat terrain, and they gradually turn to be positive farther away from the midspan point. In the flat terrain, both wind speeds and wind attack angles (or their absolute values) at the girder are large within about t = 75∼130 s, indicating that the thunderstorm downburst may exert significant effects on the bridge. However, in the gorge terrain, due to the large wind speeds and wind attack angles (or their absolute values) at the girder after t = 75 s, full attention needs to be paid to the effects of the thunderstorm downburst during this period.

In this paper, we firstly introduce the generalized Reich‐Ćirić‐Rus-type and Kannan-type contractions in cone b-metric spaces over Banach algebras and then obtain some fixed point theorems satisfying these generalized contractive conditions, without appealing to the compactness of X. Secondly, we prove the existence and uniqueness results for fixed points of asymptotically regular mappings with generalized Lipschitz constants. The continuity of the mappings is deleted or relaxed. At last, we prove that the completeness of cone b-metric spaces over Banach algebras is necessary if the generalized Kannan-type contraction has a fixed point in X. Our results greatly extend several important results in the literature. Moreover, we present some nontrivial examples to support the new concepts and our fixed point theorems.