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Abstract Objective The objective of this study was to report the 12‐month oncological outcomes for patients with non‐muscle‐invasive bladder cancer (NMIBC) within the prospective, international COVIDSurg Cancer study. Patients and methods Eligible patients were aged ≥18 years and scheduled for elective surgical management of NMIBC with curative intent (transurethral resection of bladder tumour [TURBT] or bladder biopsy) from 21 January to 14 April 2020. The primary outcome was disease recurrence within 12 months of previous elective TURBT/bladder biopsy. Secondary outcomes included disease progression within 12 months of previous elective TURBT/bladder biopsy, site‐declared delay to surgery from diagnosis as a consequence of COVID‐19 and deviation in standard care due to COVID‐19. Comparisons were made to cohorts from the pre‐pandemic era. Results Bladder cancer accounted for 2.2% (n = 446) of patients in the COVIDSurg Cancer study, with data contributed by 27 centres across 12 countries internationally. Within this included cohort, 229 patients had NMIBC and 12‐month follow‐up data available. On application of National Institute for Health and Care Excellence (NICE) criteria, 47.2% were classified as having high‐risk disease. Overall disease recurrence and progression rates were 29.3% and 9.7% at 12 months, respectively. In purely high‐risk pre‐pandemic cohorts, the International Bladder Cancer Group (IBCG) estimates a recurrence rate of 25% at 12 months, and the European Association of Urology (EAU) NMIBC 2021 scoring model estimates a 12‐month progression rate of 3.5%. As a consequence of the COVID‐19 pandemic, 10.9% of patients had site‐declared delay to TURBT/bladder biopsy; 7.4% did not undergo intravesical therapy or had early discontinuation of this; 9.2% did not undergo early repeat resection for high‐risk disease; and 18.3% had a delay to cystoscopic follow‐up surveillance. Conclusions This prospective study indicates that there were widespread deviations in usual care for NMIBC during the pandemic and that 12‐month oncological outcomes appear to be impaired compared to published pre‐pandemic outcomes.

Abstract Ventricular septal rupture (VSR) is a mechanical complication of acute myocardial infarction (AMI), and its mortality has not decreased significantly in recent decades. However, no clinical model has been developed to predict short-term mortality in patients with post-infarction VSR (PIVSR). This study aimed to develop a nomogram to predict the 30-day mortality by using the clinical characteristics of hospitalized patients with PIVSR. The least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression analysis was used to construct a nomogram by R. The model was evaluated by the area under the curve (AUC), calibration curve and decision curve analysis (DCA). The bootstrap method was used to validate the model internally. As a result, a nomogram was constructed by using six variables, including CRRT, mechanical ventilation, PPCI, WBC, PASP and methods of treatment. The AUC of the prediction model was 0.96 (0.93, 0.98). The prediction model was well calibrated. The DCA showed that if the threshold probability was between 15% and 95%, the nomogram model would provide a net benefit. The well-constructed and evaluated nomogram can be beneficial to clinicians to predict the risk of death within 30 days in patients with PIVSR.

Abstract This study investigates how dynamic fluctuations in matrix stiffness affect the behavior of cardiac fibroblasts (CFs) within a three-dimensional (3D) hydrogel environment. Using hybrid hydrogels with tunable stiffness, we created an in vitro model to mimic the varying stiffness of the cardiac microenvironment. By manipulating hydrogel stiffness, we examined CF responses, particularly the expression of α-smooth muscle actin (α-SMA), a marker of myofibroblast differentiation. Our findings reveal that increased matrix stiffness promotes the differentiation of CFs into myofibroblasts, while matrix softening reverses this process. Additionally, we identified the role of focal adhesions and integrin β1 in mediating stiffness-induced phenotypic switching. This study provides significant insights into the mechanobiology of cardiac fibrosis and suggests that modulating matrix stiffness could be a potential therapeutic strategy for treating cardiovascular diseases.

Abstract Background This study aimed to investigate the potential association between the circadian rhythm of blood pressure and deceleration capacity (DC)/acceleration capacity (AC) in patients with essential hypertension. Methods This study included 318 patients with essential hypertension, whether or not they were being treated with anti-hypertensive drugs, who underwent 24-hour ambulatory blood pressure monitoring (ABPM). Patients were categorized into three groups based on the percentage of nocturnal systolic blood pressure (SBP) dipping: the dipper, non-dipper and reverse dipper groups. Baseline demographic characteristics, ambulatory blood pressure monitoring parameters, Holter recordings (including DC and AC), and echocardiographic parameters were collected. Results In this study, the lowest DC values were observed in the reverse dipper group, followed by the non-dipper and dipper groups (6.46 ± 2.06 vs. 6.65 ± 1.95 vs. 8.07 ± 1.79 ms, P

Abstract Nocturnal blood pressure and nighttime dipping patterns are associated with the occurrence of cardiovascular events. However, there is few research on whether riser pattern is associated with the poor prognosis of patients with coronary heart disease (CHD) and hypertension independent of nighttime systolic blood pressure (SBP). This prospective and observational clinical study included 568 hospitalized patients with CHD and hypertension. All patients underwent 24‐h ambulatory blood pressure (BP) monitoring during their hospitalization. Multivariate adjusted Cox proportional hazard models were utilized to examine the associations of nocturnal blood pressure and dipping status with primary endpoint events. Additionally, Harrell's C‐statistics were employed to compare the discriminative ability of each model. During the 1‐year follow‐up period, 64 (11.3%) primary endpoint events were recorded, including 55 (9.7%) atherosclerotic cardiovascular disease (ASCVD) events. After adjusting for demographic and clinical risk variables, nighttime SBP was significantly related to the risk of incident primary endpoint events [per 20 mm Hg increase: hazard ratio (HR) = 1.775, 95% confidence interval (CI) 1.256–2.507]. The riser pattern group exhibited a significantly higher risk for primary endpoint events compared to the dipper pattern group, even after adjusting for office SBP (HR: 2.687, 95% CI: 1.015–7.110, p = .047). Furthermore, the addition of nighttime SBP or dipping status to the base model yielded statistically significant increments in C‐statistic values (p = .036 and p = .007). However, adding both nighttime SBP and dipping status did not significantly enhance the model's performance in predicting the risk of primary endpoint events and ASCVD events according to the C‐index (p = .053 and p = .054), which meant that the riser pattern group did not exhibit a significantly higher risk for primary endpoint events compared to the dipper pattern group after adjusting for nighttime SBP. In conclusion, nocturnal SBP and riser pattern demonstrated an association with adverse prognosis in patients with CHD and hypertension. Notably, nocturnal SBP proved to be a more reliable predictor than dipping status.

AbstractBackground The incidence of mortality is considerable after ST-elevation myocardial infarction (STEMI) hospitalization; risk assessment is needed to guide postdischarge management. Age shock index (SI) and age modified shock index (MSI) were described as useful prognosis instruments; nevertheless, their predictive effect on short and long-term postdischarge mortality has not yet been sufficiently confirmed.Methods This analysis included 3389 prospective patients enrolled from 2016 to 2018. Endpoints were postdischarge mortality within 30 days and from 30 days to 1 year. Hazard ratios (HRs) were evaluated by Cox proportional-hazards regression. Predictive performances were assessed by area under the curve (AUC), integrated discrimination improvement (IDI), net reclassification improvement (NRI) and decision curve analysis (DCA) and compared with TIMI risk score and GRACE score.Results The AUCs were 0.753, 0.746 for age SI and 0.755, 0.755 for age MSI for short- and long-term postdischarge mortality. No significant AUC differences and NRI were observed compared with the classic scores; decreased IDI was observed especially for long-term postdischarge mortality. Multivariate analysis revealed significantly higher short- and long-term postdischarge mortality for patients with high age SI (HR: 5.44 (2.73–10.85), 5.34(3.18–8.96)), high age MSI (HR: 4.17(1.78–9.79), 5.75(3.20–10.31)) compared to counterparts with low indices. DCA observed comparable clinical usefulness for predicting short-term postdischarge mortality. Furthermore, age SI and age MSI were not significantly associated with postdischarge prognosis for patients who received fibrinolysis.Conclusions Age SI and age MSI were valuable instruments to identify high postdischarge mortality with comparable predictive ability compared with the classic scores, especially for events within 30 days after hospitalization.

Fire is a key ecological factor in marshes, significantly influencing the nitrogen (N) cycle. The impacts of different fire regimes on marshes have garnered increasing attention. This study aims to reveal the effects of fire regimes on N distribution in marshes. We conducted field experiments with fixed–point prescribed burning in typical Sanjiang Plain freshwater marshes, exploring the influences of various fire regimes on the distribution of N in marshes. We found that in the spring–burned plots, the soil ammonium (NH4+–N) content increased by 318% with thrice–burned approaches compared to once–burned, and by 186% with thrice–burned compared to twice–burned. In the autumn–burned plots, NH4+–N content increased by 168% and 190%, respectively. Similarly, the soil nitrate (NO3––N) content three years subsequent to burning increased by 29.1% compared to one year since burning, and by 5.96% compared to two years since burning in the spring–burned plots (73.8% and 32.9% increases, respectively, in the autumn–burned plots). The plant stem–N content of the autumn burns increased by 30.9%, 119%, and 89.1% compared to the spring burns after one, two, and three years since burning, respectively. Our results indicate that high fire–frequency promotes marsh N cycling within the span of three years. The marsh soil conversion of NH4+–N to NO3––N was enhanced with increased time since burning. High fire–frequency promotes plant growth, exacerbating competition between plant populations, with this effect being more significant in autumn–burned plots than in spring–burned plots.

Background: The higher prevalence of anemia in females and elderly may be attributed to its association with worsened outcomes in ST-elevation myocardial infarction (STEMI) patients. We aimed to evaluate the precise effects of age and gender on the association between anemia and 30-day outcomes. Method: We identified 4350 STEMI patients and divided into anemia and non-anemia. Effects were analyzed as categories using Cox proportional-hazards regression and as continuous using restricted cubic splines. Propensity score matching (PSM) and mediation analysis were applied to identify intermediate effects. Results: Anemic patients were older, more likely to be female, and experienced doubled all-cause death (7.3 % versus 15.0 %), main adverse cardiovascular and cerebrovascular events (MACCE, 11.1 % versus 20.2 %), heart failure (HF, 5.1 % versus 8.6 %), and bleeding events (2.7 % versus 5.4 %). After adjustment, the association between anemia and all-cause death (Hazard ratio (HR) 1.15, 95 % confidence interval (95 %CI) 0.93–1.14), MACCE (HR 1.14, 95 %CI 0.95–1.36) and HF (HR 1.19, 95 %CI 0.92–1.55) were insignificant, the effects persisted nullified across age classes (P-interaction > 0.05) and PSM (P > 0.05). Ulteriorly, age mediated 77.6 %, 66.2 %, 48.0 %, gender mediated 38.1 %, 15.0 %, 3.2 %, age and gender together mediated 99.8 % 72.9 %, 48.1 % of the relationship. Anemia was independently associated with bleeding events (HR 2.02, 95 %CI 1.42–2.88), the effects consisted significant regardless of PSM (P 0.05), and no mediating role of age and gender were observed. Conclusions: In STEMI patients, age and gender largely mediated the relationship between anemia and all-cause death, MACCE, and HF, anemia was independently associated with bleeding complications.

Abstract. Background:. Limited data are available on the changes in the quality of care for ST elevation myocardial infarction (STEMI) during China's health system reform from 2009 to 2020. This study aimed to assess the changes in care processes and outcome for STEMI patients in Henan province of central China between 2011 and 2018. Methods:. We compared the data from the Henan STEMI survey conducted in 2011-2012 (n = 1548, a cross-sectional study) and the Henan STEMI registry in 2016-2018 (n = 4748, a multicenter, prospective observational study). Changes in care processes and in-hospital mortality were determined. Process of care measures included reperfusion therapies, aspirin, P2Y12 antagonists, β-blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and statins. Therapy use was analyzed among patients who were considered ideal candidates for treatment. Results:. STEMI patients in 2016-2018 were younger (median age: 63.1 vs. 63.8 years) with a lower proportion of women (24.4% [1156/4748] vs. 28.2% [437/1548]) than in 2011-2012. The composite use rate for guideline-recommended treatments increased significantly from 2011 to 2018 (60.9% [5424/8901] vs. 82.7% [22,439/27,129], P

Abstract Background The triglyceride–glucose (TyG) index has been proposed as a potential predictor of adverse prognosis of cardiovascular diseases (CVDs). However, its prognostic value in patients with coronary heart disease (CHD) and hypertension remains unclear. Methods A total of 1467 hospitalized patients with CHD and hypertension from January 2021 to December 2021 were included in this prospective and observational clinical study. The TyG index was calculated as Ln [fasting triglyceride level (mg/dL) × fasting plasma glucose level (mg/dL)/2]. Patients were divided into tertiles according to TyG index values. The primary endpoint was a compound endpoint, defined as the first occurrence of all-cause mortality or total nonfatal CVDs events within one-year follow up. The secondary endpoint was atherosclerotic CVD (ASCVD) events, including non-fatal stroke/transient ischemic attack (TIA) and recurrent CHD events. We used restricted cubic spline analysis and multivariate adjusted Cox proportional hazard models to investigate the associations of the TyG index with primary endpoint events. Results During the one-year follow-up period, 154 (10.5%) primary endpoint events were recorded, including 129 (8.8%) ASCVD events. After adjusting for confounding variables, for per standard deviation (SD) increase in the TyG index, the risk of incident primary endpoint events increased by 28% [hazard ratio (HR) = 1.28, 95% confidence interval (CI) 1.04–1.59]. Compared with subjects in the lowest tertile (T1), the fully adjusted HR for primary endpoint events was 1.43 (95% CI 0.90–2.26) in the middle (T2) and 1.73 (95% CI 1.06–2.82) in highest tertile (T3) (P for trend = 0.018). Similar results were observed in ASCVD events. Restricted cubic spline analysis also showed that the cumulative risk of primary endpoint events increased as TyG index increased. Conclusions The elevated TyG index was a potential marker of adverse prognosis in patients with CHD and hypertension.

Abstract There is currently few research on clinical characteristics and outcomes of coronary heart disease (CHD) with resistant hypertension in central region of China. This study aimed to assess the risk factors and outcomes of CHD and resistant hypertension in population of central region of China. A total of 1467 CHD patients with hypertension were included and considered to three groups according to blood pressure control: controlled group (blood pressure

The driving force of climate change in the monsoon margin is complex, making it a key area for regional and global climate change research. Palaeohydrological studies in the monsoon margin have increased the resolution of research in the long term, transitioning from qualitative to quantitative studies to comprehend climate change processes, patterns, and mechanisms. Testate amoebae (TA) in peat sediments are used as a proxy indicator organism for quantitative reconstruction of palaeohydrology. Thus, their community changes are directly related to precipitation, and widely used to reconstruct the patterns of summer precipitation globally. We investigated TA species and reconstructed palaeohydrological changes in the Greater Khingan Mountains’ Hongtu (HT) peatland, located in the East Asian Summer Monsoon (EASM) margin. The result showed that the most abundant TA species were Assulina muscorum (12.4 ± 5.0%) and Nebela tincta (8.9 ± 4.9%) in the HT peat core. The increase in dry indicator species (e.g., A. muscorum and Alabasta militaris) indicated a drying pattern in the HT peatland since 150 cal yr BP. Principal component analysis (PCA) explained 47.6% of the variation in the selected TA assemblages. During 400 to 250 cal yr BP, PCA axis 1 scores ranged from 0.2 to −1.3 (reflecting a drier climate), associating with the Little Ice Age. The paleohydrology of the northern part of the Greater Khingan Mountains was mainly controlled by the EASM, which was associated with changes in North Atlantic Sea surface temperature and solar radiative forcing. The apparent drying pattern may be the result of the gradual intensification of anthropogenic activities and the increase in EASM intensity.

Fire is an important disturbance of wetland P reservoirs by changing the distribution of P in soils and plants. However, the effects of various fire regimes on the distribution of P in wetlands are not known. In a three-year burn experiment, we evaluated the effects of three burn factors on the P distribution of plants (stem, leaf, and litter) and soils (upper and lowerlayer soil) in the freshwater wetlands of China's Sanjiang Plain. We discovered that when burn frequency increased, soil P content and total plant biomass P also increased. Soil P content peaked at a high of 2198.0 ± 559.0 mg kg−1 after three burns. Three burns increased C. angustifolia biomass and therefore increased total plant biomass P. However, the increase in time after burning caused stem and leaf P content and litter necromass density P to decrease, suggesting a steady transfer of plant P to the soil. Furthermore, the stem biomass P density in September after the three burns was higher in spring burns than in autumn burns (1231.0 ± 129.0 mg m−2 after spring burns compared to 542.0 ± 176.0 mg m−2 after autumn burns). The transfer of litter P to the soil was hindered by spring burns, which conserved more P in the litter than autumn burns, which was the opposite of what was found for litter necromass P. Compared to spring burns, frequent autumn burns will hasten the transfer of plant P to the soil, preserving more P in the soil. Thus, conducting once-a-year prescribed burning in the autumn will be an important tool for improving P cycling in freshwater wetlands compared to spring.

Abstract Background ST-segment elevation (STE) represents a repolarization dispersion marker underlying arrhythmogenesis in ST-segment elevation myocardial infarction (STEMI); however, its value for predicting malignant ventricular arrhythmia events (MVAEs) remains uncertain. Methods In total, 285 patients with STEMI and those with or without MVAEs who presented within 6 h of symptom onset were enrolled. The relationships between STE and clinical characteristics of MVAEs (defined as ventricular tachycardia or ventricular fibrillation) were analyzed using t-test, chi-square test, binary multivariate logistic regression, and receiver operating characteristic curve analysis. Results Patients with STEMI and MVAEs had a shorter time from symptom onset to balloon time (p = 0.0285) and greater STE (p

Abstract Aims Heart failure (HF) remains a major public health problem with increasing prevalence in China. This study evaluated the clinical performance and quality measures for HF management to identify gaps in the standardization of care for patients hospitalized for HF in China. Methods and results Following the results of China‐HF stage I (2012–2015), the second stage of the China‐HF was launched in 2017. Among 113 hospitals with ≥100 cases, the China‐HF Stage II assessed the quality of care measures for HF and compared results with previous data in China and the US‐based Get with The Guidelines‐Heart Failure (GWTG‐HF) registries. In total, 34 938 patients hospitalized with HF were enrolled from January 2017 to October 2020. Echocardiographic left ventricular function and natriuretic peptide test were performed in 93.7% and 93.0% of the cases, respectively. Adherence to standardized guidelines in China‐HF stage II was higher than that in the China‐HF stage I, but generally lower than GWTG‐HF registry with 78.2% of eligible patients was prescribed oral diuretics, 78.7% renin‐angiotensin‐system inhibitors, and 82.2% beta‐blockers. Implantable cardioverter‐defibrillators and cardiac resynchronization devices were implanted in 3.9% and 14.6%, respectively. In contrast, the proportion of eligible patients discharged with spironolactone (87.8%) was higher than GWTG‐HF. The median length of hospitalization was 9 (6, 12) days, and 938 (2.8%) patients died or withdrew from treatment during hospitalization. Conclusions Despite significant improvements in the use of guideline‐recommended testing and therapy, there remain major gaps in quality of care for patients hospitalized for HF in China that are generally larger than gaps observed in the United States.

IntroductionThe peat carbon pool stores 30% of the total global soil carbon accounting for 3–4% of the global land surface. The stability of the peatland carbon pool is a key factor affecting global carbon cycling that is seriously disturbed by climate change and regional human activities. However, the impact of these factors on carbon pool stability remains poorly understood.MethodsBased on the physicochemical properties and carbon compounds of 973 peat samples from Jilin Province (China), which are widely distributed in different altitude regions of the Changbai Mountains, we investigated the stability of the carbon pool in different dominant plants and degradation types of peatlands and assessed the effects of regional environmental factors on the peatland carbon pool.Results and DiscussionOur results showed that the carbohydrate content of peat soils in different peatland types ranged from 33.2 ± 6.9% to 40.5 ± 4.8%, and the aromatic content ranged from 19.8 ± 1.2% to 22.7 ± 2.3%. Bulk density is the most important physicochemical factor, and annual average temperature is the most important environmental factor that influences carbon stability. The effects of selected environmental factors on the peatland carbon pool covered by different plants were different, and the carbon stability in shrub peatlands is more sensitive to climate characteristics than in peatlands dominated by the other two plant types. Peatland degradation decreases the carbon stability in herb and herb/shrub peatlands and increases the carbon stability in shrub peatlands, leading the peatland carbon pool to be more easily influenced by regional human activities than natural peatlands.

Presently, as human activity and climate warming gradually increase, straw burning leads to more accidental burning in neighbouring wetlands, which threatens wetland carbon stores. Plants are important carbon fixers in wetlands, converting carbon dioxide to biomass through photosynthesis and releasing carbon into the soil as plants die off. Nitrogen and phosphorus limitation in wetlands is a key factor affecting plant growth, and different burning seasons have different effects on mitigating this limitation. To further elucidate the effects of nitrogen and phosphorus distribution on wetland inter-month nutrient dynamics after different burning seasons, we selected a Calamagrostis angustifolia wetland in the Sanjiang Plain that was burned in spring and autumn, respectively, and conducted a monthly survey from May to September. We found that the leaf nitrogen content in September at spring burning sites was 3.59 ± 2.69 g/kg, which was significantly lower than that in July, while the difference at the unburned sites was only 0.60 ± 3.72 g/kg, and after the autumn burning, soil nitrogen and phosphorus contents remained higher than at the unburned sites in August, being 0.55 ± 1.74 g/kg and 0.06 ± 0.12 g/kg, respectively. Our results indicate that spring burning immediately increased the nitrogen and phosphorus contents in soil and plants but that these effects only lasted for a short time, until June. In comparison, autumn burning had a long-term effect on soil nitrogen and phosphorus levels and significantly increased the aboveground biomass. Thus, we recommend that conducting autumn burning before the commencement of agricultural burning not only reduces combustible accumulation to prevent fires but also promotes nitrogen and phosphorus cycling in wetlands, and the increase in plant biomass after autumn burning also enhances the carbon fixation capacity of the wetland.

Objective We aimed to assess hypertension prevalence and management in Central China. Methods In this cross-sectional study conducted from February 2019 to February 2020, we applied stratified multistage random sampling to investigate residents aged 35 to 75 years in Dancheng county of Zhoukou city and Xincai county of Zhumadian city, both in Central China. Results We enrolled 63,940 participants in this survey. A total of 43.6% (95% confidence interval [CI]: 43.2–44.0) of participants had hypertension. Of these, 49.3% (95% CI: 48.7–49.9) were aware of their diagnosis, 36.5% (95% CI: 35.9–37.1) took antihypertensive medication, and 14.3% (95% CI: 13.9–14.7) had their blood pressure under control. Only 31.4% of hypertensive people receiving antihypertensive treatment had achieved control. The hypertension prevalence was lower in urban areas than in rural areas, with higher rates of awareness, treatment, and control. Among subgroups, rural men had the highest prevalence of hypertension. Prevalence, awareness, and treatment rates all increased with age, except for control rates, which declined in the 65- to 75-year-old group. Conclusions People in Central China have a high hypertension prevalence but low rates of awareness, treatment, and control. Great effort is needed to improve the prevention and management of hypertension in this region.

Myocardial infarction is a very dangerous cardiovascular disease with a high mortality rate under the modern developed medical technology. miRNA is a small molecule regulatory RNA discovered in recent years, which can play an important role in many cancers and other diseases. Medical data, machine learning and medical care strategies supporting the Internet of Things (IoMT) have certain applications in the treatment of myocardial infarction. However, the specific pathogenesis of myocardial infarction is still unclear. Therefore, this paper aimed to explore the expression of microRNA-320 and microRNA-204 in myocardial infarction and used the expression of microRNA-320 and microRNA-204 to predict the prognosis of patients with myocardial infarction. In order to discuss the expression of microRNA-320 and microRNA-204 in myocardial infarction in more detail. In this paper, 40 patients in the trial period were selected for clinical research, and 10 patients with normal cardiac function were selected in NHF group as control group. 10 patients with heart failure were selected as AMHF group. 10 patients with acute myocardial infarction were selected as AMNHF group. 10 patients with heart failure after old myocardial infarction were selected as OMHF group. AMHF group, AMNHF group and OMHF group were taken as the case group. This paper analyzed the difference of miR between different groups and determined that there were significant differences in the expression of miR-320 and miR-204 between different groups. Finally, the expression and prognosis of miR-320 and miR-204 in myocardial infarction were analyzed. The analysis results showed that the expression of microRNA-320 and microRNA-204 can inhibit the activity of myocardial cells. On the fifth day, the corresponding expression of microRNA-320 and microRNA-204 reduced the optical density of myocardial cells to 1.75 and 1.76, which was significantly lower than that on the first day. Moreover, excessive miR-320 expression and excessive miR-204 expression can increase the apoptosis rate of myocardial cells. The above results indicated that the high expression of microRNA-320 and microRNA-204 can be a bad prognostic factor in patients with myocardial infarction, showing that medical data, machine learning and medical care strategies supporting IoMT can play a role in the treatment of myocardial infarction. Therefore, it is urgent to understand the pathogenesis of heart failure after myocardial infarction and find new treatment schemes to improve the positive prognosis.

Abstract Histone deacetylases (HDACs) and microRNAs (miRs) have been reported to exert pivotal roles on the pathogenesis of myocardial ischemia-reperfusion injury (MIRI). Therefore, the present study was performed to define the underlying role of HDAC4 and miR-206 in the pathological process of MIRI. An IRI rat model was established. The interaction between HDAC4 and the promoter region of miR-206 was determined using ChIP, and that between miR-206 and mitogen-activated protein kinase kinase kinase 1 (MEKK1) was determined using dual luciferase reporter gene assay. After the loss- or gain-of-function assay in cardiomyocytes, western blot analysis, RT-qPCR, TUNEL, and ELISA assay were performed to define the roles of HDAC4, miR-206, and MEKK1. Up-regulation of HDAC4 and down-regulation of miR-206 occurred in rat myocardial tissues and cardiomyocytes in MIRI. HDAC4 down-regulation or miR-206 up-regulation contributed to reduced cell apoptosis and the levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and malondialdehyde (MDA), while elevating the superoxide dismutase (SOD) and glutathione (GSH) contents. Meanwhile, HDAC4 silencing promoted the expression of miR-206, which targeted and negatively regulated MEKK1. Then inhibition of JNK phosphorylation reduced the cardiomyocyte apoptosis to alleviate MIRI. Coherently, HDAC4 silencing could up-regulate the expression of miR-206 to reduce cardiomyocyte apoptosis and inhibit oxidative stress, and exerting a protective effect on MIRI via the MEKK1/JNK pathway.

Wetlands store >30% of the global soil carbon pool, which is important for global carbon cycling. However, with global warming and the increase in regional human activities, an increasing number of wetlands are being threatened by fires, which have serious effects on carbon cycling in wetlands. Although plant litter decomposition is one of the key stages of carbon cycling in wetlands, it is still unclear whether fires affect residual plant litter decomposition in burnt wetlands and whether the fire season also causes different effects. To address these knowledge gaps, a plant litter decomposition experiment was conducted during the growing season in autumn burnt, spring burnt, and unburnt sites in a Calamagrostis angustifolia wetland in the Sanjiang Plain (Northeast China). The results show that autumn burning promotes more mass loss (i.e., 15.9 ± 1.6% in autumn burnt sites and 14.8 ± 1.7% in autumn unburnt sites) and accelerates the decomposition of plant litter, whereas spring burning decreases the decomposition rates of plant litter (i.e., 15.7 ± 1.7% in spring burnt sites and 22.0 ± 2.5% in spring unburnt sites). As the decomposition time increased, the accumulation index indicated that carbon was released from plant litter to the surrounding environment accompanied by mass loss and nutrient elements accumulated in the residual plant litter. The N/P ratio of plant litter decreased from ca. 20 on day 26th to ca. 9 on day 121st, indicating that N acts as the limiting element for plant litter decomposition in C. angustifolia wetlands, and the limitation increased with increasing decomposition time. Our results also suggest that the autumn burning may promote more carbon loss and nutrient elements accumulated in plant litter in C. angustifolia wetlands than the spring burning.

Abstract The aim of this study was to explore the long‐term clinical results of Renal denervation (RDN) from the adventitia of the renal artery plus unilateral laparoscopic adrenalectomy to treat patients with resistant hypertension caused by unilateral aldosterone‐producing adenoma (APA). Sixty patients with resistant hypertension caused by APA who were treated at Henan Provincial People's Hospital from December 2016 to March 2018 were selected and randomly assigned to undergo RDN from the adventitia of the renal artery plus adrenalectomy (RDN group, n = 30) or adrenalectomy alone (control group, n = 30). Office blood pressure (BP), antihypertensive medication usage and other laboratory characteristics were followed every 6 months through 36 months. Follow‐up data were available at 36 months for 23 of 30 subjects in the RDN group and for 21 of 30 subjects who were in the control group. At 36 months postprocedure, the reduction in the RDN group was 42.2 ± 21.6 mmHg and that in the control group was 29.8 ± 13.5 mmHg (p = .029 between the groups). During the follow‐up to 36 months postprocedure, no patients in either the RDN group or the control group died due to surgical complications, and the RDN group had no procedural complications, including renal artery dissection, perforation, and renal artery stenosis. There was no change in the mean eGFR of the two groups, and no serious adverse events were reported. In conclusion, RDN from the adventitia of the renal artery plus unilateral laparoscopic adrenalectomy resulted in sustained lowering of BP at 3 years in a selected population of subjects with resistant hypertension caused by unilateral APA without serious safety concerns.

Introduction To elucidate the candidate biomarkers involved in the patho�genesis process of heart failure (HF) via analysis of differentially expressed genes (DEGs) of the dataset from the Gene Expression Omnibus (GEO). Material and methods The GSE76701 gene expression profiles regarding the HF and control subjects were respectively analysed. Briefly, DEGs were firstly identified and subjected to Cytoscape plug-in ClueGO + CluePedia and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. A protein-protein interaction (PPI) network was then built to analyse the in�teraction between DEGs, followed by the construction of an interaction net�work by combining with hub genes with the targeted miRNA genes of DEGs to identify the key molecules of HF. In addition, potential drugs targeting key DEGs were sought using the drug-gene interaction database (DGIdb), and a drug-mRNA-miRNA interaction network was also constructed. Results A total of 489 DEGs were verified between HF and control, which mainly enriched in type I interferon and leukocyte migration according to molecular function. Significantly increased levels of GAPDH, GALM1, MMP9, CCL5, and GNAL2 were found in the HF setting and were identified as the hub genes based on the PPI network. Furthermore, according to the drug-mRNA-miRNA network, FCGR2B, CCND1, and NF-κb, as well as corre�sponding miRNA-605-5p, miRNA-147a, and miRNA-671-5p were identified as the drug targets of HF. Conclusions The hub genes GAPDH, GALM1, MMP9, CCL5, and GNAL2 were significantly increased in HF. miRNA-605-5p, miRNA-147a, and miRNA-671-5p were predicted as the drug target-interacted gene-miRNA of HF.

The novel coronavirus pandemic has led to morbidity and mortality throughout the world. Until now, it is a highly virulent contagion attacking the respiratory system in humans, especially people with chronic diseases and the elderly who are most vulnerable. A majority of afflicted are those suffering from cardiovascular and coronary diseases. In this review article, an attempt has been made to discuss and thoroughly review the mode of therapies that alleviate cardiac complications and complications due to hypercoagulation in patients infected with the SARS-CoV-2 virus. Presently a host of thrombolytic drugs are in use like Prourokinase, Retelapse, RhTNK-tPA and Urokinase. However, thrombolytic therapy, especially if given intravenously, is associated with a serious risk of intracranial haemorrhage, systemic haemorrhage, immunologic complications, hypotension and myocardial rupture. The effects of the SARS-CoV-2 virus upon the cardiovascular system and coagulation state of the body are being closely studied. In connection to the same, clinical prognosis and complications of thrombolytic therapy are being scrutinized. It is noteworthy to mention that myocardial oxygen supply/demand mismatch, direct myocardial cells injury and acute plaque rupture are the multiple mechanisms responsible for acute coronary syndrome and cardiac complications in Covid-19 infection. However, this review has limitations as data available in this context is limited, scattered and heterogenous that questions the reliability of the same. So, more multi-centric studies involving representative populations, carried out meticulously, could further assist in responding better to cardiac complications among Covid-19 patients.

Abstract Ecosystem resilience to pressures expanding and contracting within the adaptive cycle as slow variables change. However, little is known about their role in defining reference conditions for wetland restoration. Here, we applied paleoecological data of two wetlands that have been degraded (Honghe, riparian peatland) and disappeared (Shenjiadian, valley peatland) to evaluate ecosystem resilience to anthropogenic pressures as the phases of the adaptive cycle progress. The slow variables of plants and diatoms gradually began to change from moisture to dry loving species under severe disturbances in the late 1970s. Then regime shift took place around 1990 CE (Current Era) based on a sequential T‐test analysis and F statistics on the slow variables. A drop in water level caused by human activities rather than climate moisture led to regime shifts in Honghe and Shenjiadian wetlands. Therefore, the ecosystem were in the conservation phase before the late 1970s, and were in the reorganization phase after 1990 CE. The ecosystems had high resilience and a stable state at the early conservation phase, and its characteristics can be used as reference conditions for wetland restoration. The reference water level was 11–13 cm and the NH4‐N ranged from 0.8 to 1.2 mg/L. The dominant vegetation was Drepanocladus aduncus and the dominant diatom was Pinnularia brevicostata. The referred enrich factors of nitrogen, phosphorus, and heavy metals were under 4.45, 2.12, and 1.11, respectively. Considering both adaptive cycle and resilience to define reference conditions can provide insight into the future restoration and management of wetland ecosystems worldwide.

Abstract Background Coronary artery disease (CAD) and atrial fibrillation (AF) frequently coexist in clinical practice, making it challenging for the treating physician to choose anticoagulation and antiplatelet therapies. The aim of this study was to investigate antithrombotic strategies and assess related adverse outcomes in stable coronary artery disease (SCAD) and acute coronary syndrome (ACS) patients with AF when the CHA2DS2-VASc score was ≥2. Methods We performed a retrospective study and collected data from a computer-based patient record management system in Zhengzhou University People’s Hospital in China. In total, 2978 patients with a hospital discharge diagnosis of CAD and concomitant AF who met the inclusion criteria were enrolled from January 1, 2012 to December 31, 2016, and data from 2050 patients were finally analysed. The χ2 test was used to compare the incidences of clinical endpoints between the SCAD+AF group and the ACS + AF group. Multivariable Cox regression analysis was performed to identify independent predictive factors of adverse outcomes in both groups. Results Oral anticoagulant (OAC) monotherapy was the most common antithrombotic therapy in SCAD+AF patients (49.55%), while double antiplatelet therapy (DAPT) was the most common treatment in ACS + AF patients (54.19%) at discharge. OAC monotherapy significantly increased and the use of single antiplatelet therapy (SAPT) decreased during follow-up (34 ± 13 months) when compared to their use at discharge in the SCAD+AF group (all p

Abstract Background This study aims to evaluate the effects and safety of laparoscopic-based perivascular renal sympathetic nerve denervation (RDN) in a porcine model fed a high-fat diet. Method Thirty-six high-fat diet-fed Bama minipigs were randomly divided into an RDN group (n = 18), in which minipigs received laparoscopic-based perivascular RDN, and a sham group (n = 18). All pigs were fed the high-fat diet after the operation to establish a model of obesity-induced hypertension. Bama pigs in the RDN and sham groups were killed at 3 time points [2 days after RDN (n = 6), day 90 (n = 6) and day 180 (n = 6)]. Result The systolic blood pressure (SBP) and noradrenaline (NE) concentration in the kidney tissue were significantly lower in the RDN group than in the sham group at 2 days (113.83 ± 3.26 mmHg vs 129.67 ± 3.32 mmHg, P = 0.011, and 112.02 ± 17.34 ng/g vs 268.48 ± 20.61 ng/g, P

Objective: The purpose of this study was to determine the effects of surgical resection of muscle layer on the long-term survival of patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods: The original study cohort consisted of 552 patients with hypertrophic cardiomyopathy (HCM), including 380 patients with HOCM and 172 patients with nonobstructive HCM. All these patients had a definite diagnosis in our center from October 1, 2009, to December 31, 2012. They were divided into three groups, viz., HOCM with myectomy group (n=194), nonoperated HOCM group (n=186), and nonobstructive HCM group (n=172). Median follow-up duration was 57.57+-13.71 months, and the primary end point was a combination of mortality from all causes. Results: In this survival study, we compared the prognoses of patients with HOCM after myectomy, patients with nonoperated HOCM, and patients with nonobstructive HCM. Among the three groups, the myectomy group showed a lower rate of reaching the all-cause mortality with statistically indistinguishable overall survival compared with patients with nonobstructive HCM (p=0.514). Among patients with left ventricular outflow tract (LVOT) obstruction, the overall survival in the myectomy group was noticeably better than that in the nonoperated HOCM group (log-rank p

Abstract Background Renal denervation (RDN) targeting the sympathetic nerves in the renal arterial adventitia as a treatment of resistant hypertension can cause endothelial injury and vascular wall injury. This study aims to evaluate the risk of atherosclerosis induced by RDN in renal arteries. Methods A total of 15 minipigs were randomly assigned to 3 groups: (1) control group, (2) sham group, and (3) RDN group (n = 5 per group). All pigs were fed a high-fat diet (HFD) for 6 months after appropriate treatment. The degree of intimal thickening of renal artery and the conversion of endothelin 1 (ET-1) receptors were evaluated by histological staining. Western blot was used to assess the expression of nitric oxide (NO) synthesis signaling pathway, ET-1 and its receptors, NADPH oxidase 2 (NOX2) and 4-hydroxynonenal (4-HNE) proteins, and the activation of NF-kappa B (NF-κB). Results The histological staining results suggested that compared to the sham treatment, RDN led to significant intimal thickening and significantly promoted the production of endothelin B receptor (ETBR) in vascular smooth muscle cells (VSMCs). Western blotting analysis indicated that RDN significantly suppressed the expression of AMPK/Akt/eNOS signaling pathway proteins, and decreased the production of NO, and increased the expression of endothelin system proteins including endothelin-1 (ET-1), endothelin converting enzyme 1 (ECE1), endothelin A receptor (ETAR) and ETBR; and upregulated the expression of NOX2 and 4-HNE proteins and enhanced the activation of NF-kappa B (NF-κB) when compared with the sham treatment (all p 0.05). Conclusions RDN aggravated endothelial endocrine dysfunction and intimal thickening, and increased the risk of atherosclerosis in renal arteries of HFD-fed pigs.

Abstract Background Pulmonary arterial hypertension (PAH) is often characterized by cell proliferation and migration of pulmonary arterial smooth muscle cells (PASMCs). LncRNA cancer susceptibility candidate 2 (CASC2) has been revealed to be involved in PASMC injury in hypoxia-induced pulmonary hypertension. However, the exact molecular mechanisms whereby CASC2 regulates PASMC proliferation and migration are still incompletely understood. Methods The expression levels of CASC2, miR-222 and inhibitor of growth 5 (ING5) were measured using quantitative real-time polymerase chain reaction (qRT-PCR) or western blot, respectively. Cell proliferation was analyzed by Cell Counting Kit-8 (CCK-8) assay. Wound healing assay was used to analyze cell migration ability. The relationship between miR-222 and CASC2 or ING5 was confirmed using bioinformatics analysis, luciferase reporter assay and RNA immunoprecipitation assay. Results CASC2 was down-regulated in hypoxia-induced PASMCs in a dose- and time-dependent manner. Functional experiments showed that CASC2 overexpression could reverse hypoxia-induced proliferation and migration of PASMCs. Bioinformatics analysis indicated that CASC2 acted as a competing endogenous RNA of miR-222, thereby regulating the expression of ING5, the downstream target of miR-222, in PASMCs. In addition, rescue assay suggested that the inhibition mediated by CASC2 of hypoxia-induced PASMC proliferation and migration could be attenuated by miR-222 inhibition or ING5 overexpression. Conclusion CASC2 attenuated hypoxia-induced PASMC proliferation and migration by regulating the miR-222/ING5 axis to prevent vascular remodeling and the development of PAH, providing a novel insight and therapeutic strategy for hypoxia-induced PAH.

Introduction: Patients with myocardial infarction (MI) and cardiogenic shock (CS) have poor outcomes in terms of morbidity and mortality. Many devices act as a ‘bridge’ in case of cardiogenic shock, by providing circulatory support and buy time so that the patient either recovers or receives a transplant or a long-term device. Materials and methods: This is a retrospective observational study where all patients (n = 286) getting admitted for MI and CS were included. The different variables are compared across the three groups [extracorporeal membrane oxygenation (ECMO), Intra-aortic balloon pump (IABP) and IABP + ECMO]. The fourth group (Impella) had only 6 patients and no statistical analysis has been done for the same, to avoid skewness of results. Results: There are a total of 286 patients in the study out of which ECMO was used in 99 patients, IABP in 138 patients, both IABP and ECMO in 43 patients, and Impella in 6 patients. The patients differed in terms of diagnosis category, pre-existing hypertension, pre-existing diabetes, pre-existing hyperlipidemia, pre-existing heart failure, and other co-morbidities. The groups also differed in terms of the cardiac findings like heart rate, left ventricular end-diastolic diameter (LVED), and left ventricular ejection fraction (LVEF). Stents were implanted more commonly among the IABP (22.5%) and IABP + ECMO group (25.6%) as compared to the ECMO group (6.1%), and the difference was statistically significant (p Value = 0.0012). The median time for device usage in ECMO group was 147 h, as compared to 130 h among IABP group and 144 h among IABP + ECMO group, and the difference was statistically significant between the ECMO and IABP group (p Value = 0.047). The median time for breathing machine assisted ventilation was also highest in the ECMO group (262 h), as compared to IABP (86 h) and IABP + ECMO group (177 h). Patients in the ECMO group had the higher heart rate than patients in IABP group (median heart rate: 95 vs 86 beats per minute). Left ventricular ejection fraction was highest in the IABP group (41% in IABP group Vs 24.5% in ECMO group & 35% in IABP + ECMO group). Conclusion: Though the three groups (IABP, ECMO and ECMO + IABP) were heterogenous, there was a clear advantage in terms of outcomes in the group in which more than one device was used. In conclusion we can say that all three devices have their own advantages and disadvantages, and they have a distinct hemodynamic footprint and thus should be used after detailed assessment of the patient.

Acute myocardial infarction (AMI) is still a huge danger to human health. Sensitive markers are necessary for the prediction of the risk of AMI and would be beneficial for managing the incidence rate. N6-methyladenosine (m6A) RNA methylation regulators have been confirmed to be involved in the development of various diseases. However, their function in AMI has not been fully elucidated. The purpose of this study was to determine the expression of m6A RNA methylation regulators in AMI as well as their possible functions and prognostic values. The GEO database was used to get the gene expression profiles of patients with and without AMI, and bioinformatics assays of genes with differently expressed expression were performed. We establish two separate m6A subtypes, and relationships between subtypes and immunity were studied. In this study, we identified IGF2BP1, FTO, RBM15, METTL3, YTHDC2, FMR1, and HNRNPA2B1 as the seven major m6A regulators. A nomogram model was developed and confirmed. The consensus clustering algorithm was conducted to categorize AMI patients into two m6A subtypes from the identified m6A regulators. Patients who have activated T-cell activities were found to be in clusterA; they may have a better prognosis as a result. Importantly, we found that patients with high METTL3 expressions had an increased level of Activated.CD4.T.cell and Type.2.T.helper.cell, while having a decreased level of CD56bright.natural.killer.cell, Macrophage, Monocyte, Natural.killer.cell, and Type.17.T.helper.cell. Overall, a diagnostic model of AMI was established based on the genes of IGF2BP1, FTO, RBM15, METTL3, YTHDC2, FMR1, and HNRNPA2B1. Our investigation of m6A subtypes may prove useful in the developments of therapy approaches for AMI.

Background. Women hospitalized with ST-elevation myocardial infarction (STEMI) experience higher risk of early mortality than men. We aimed to investigate the potential impact of risk factors, clinical characteristics, and management among gender-related risk differences. Method. We analyzed 5063 STEMI patients prospectively enrolled from 66 hospitals during 2016–2018 and compared sex differences in mortality, death, or treatment withdrawal and main adverse cardiovascular and cerebrovascular events (MACCE) using the generalized linear mixed model, following sequential adjustment for covariates. Results. Women were older and had a higher prevalence of hypertension (53.3% vs. 41.1%, P

Objective. This study is aimed at comparing cardiac computed tomographic angiography (CTA) with echocardiography in the assessment of ventricular septal perforation diameter. Methods. A total of 44 ventricular septal rupture (VSR) patients undertaking transcatheter occlusion were included and randomly divided into the CTA group and echocardiography group with a 1 : 1 ratio. Clinical data, operation-related data, and 30 d follow-up data were collected and analyzed. Results. Incidence of closure failure, occluder displacement, poor occluder molding, and occluder waist diameter shrinkage between the two groups were not statistically different. The mean residual shunt volume in the echocardiography group (4.2 (3.1, 5.9) mm) was significantly higher than that in the CTA group (2.1 (0, 4.0) mm) with a p value of 0.005. However, no significant differences were found in all-cause mortality and incidence of operative complications within 30 days after surgery. Within the CTA group, the correlation was strongest between postoperative occluder diameter and long diameter measured by CTA with a correlation coefficient of 0.799 and p

Abstract Background This study aims to compare whether two different routes of Renal denervation (RDN) from the intima and adventitia of the renal artery can reduce renal fibrosis in a pig model of hypertension induced by a high-fat diet and to explore possible molecular mechanisms. Methods Twenty-four Bama miniature pigs were randomly divided into a control group (normal diet, n=6) or a hypertension model group (high-fat diet, n=18). The model group was randomly divided into the intima-RDN group (n=6), the adventitia-RDN group (n=6), or the renal arteriography only group (sham group, n=6). All animals were fed separately. The model group was fed a high-fat diet after the operation, and the control group was fed conventionally for 6 months. After 6 months, renal artery angiography was performed again to observe the condition of the renal arteries, after which all animals were euthanized. The blood pressure (BP) and blood biochemical results of each group were evaluated 6 months after the operation; kidney tissue morphology and collagen fiber content were examined by hematoxylin-eosin (HE) staining and Masson staining; Superoxide dismutase (SOD) activity and the malondialdehyde (MDA) content of kidney tissue were assessed by a biochemical enzyme method; the protein expression level of transforming growth factor-β 1 (TGF-β1), α smooth muscle actin (αSMA) and Smad3 were assessed by Western blot; and electron microscopy was used to examine changes in kidney microstructure. Results After 6 months of a high-fat diet, the blood lipid levels of the model group were significantly higher compared to baseline and to that of the control group during the same period (all showed P0.05). The degree of glomerular damage caused by hyperlipidemia in the intima-RDN group and the adventitia-RDN group was significantly lower than that of the sham and control groups, and the renal fibrosis area percentage was also significantly lower (P

Abstract Background Cardiovascular disease including ST elevation myocardial infarction (STEMI) is increasing and the leading cause of death in China. There has been limited data available to characterize STEMI management and outcomes in rural areas of China. The Henan STEMI Registry is a regional STEMI project with the objectives to timely obtain real-world knowledge about STEMI patients in secondary and tertiary hospitals and to provide a platform for care quality improvement efforts in predominantly rural central China. Methods The Henan STEMI Registry is a multicentre, prospective and observational study for STEMI patients. The registry includes 66 participating hospitals (50 secondary hospitals; 16 tertiary hospitals) that cover 15 prefectures and one city direct-controlled by the province in Henan province. Patients were consecutively enrolled with a primary diagnosis of STEMI within 30 days of symptom onset. Clinical treatments, outcomes and cost are collected by local investigators and captured electronically, with a standardized set of variables and standard definitions, and rigorous data quality control. Post-discharge patient follow-up to 1 year is planned. As of August 2018, the Henan STEMI Registry has enrolled 5479 patients of STEMI. Discussion The Henan STEMI Registry represents the largest Chinese regional platform for clinical research and care quality improvement for STEMI. The board inclusion of secondary hospitals in Henan province will allow for the exploration of STEMI in predominantly rural central China. Trial registration [ NCT02641262 ] [29 December, 2015].

Endothelial dysfunction induced by chronic inflammation has been considered one of the most important mechanisms behind a variety of cardiovascular diseases. Extensive efforts have been made in past decades to explore the underlying mechanisms of endothelial dysfunction and to develop new therapeutic agents for the treatment of cardiovascular diseases. Zafirlukast, a selective antagonist of CysLT receptor 1 (CysLT1R), has been licensed by the U.S. Food and Drug Administration (FDA) for the treatment of asthma. In this study, we found that zafirlukast possesses beneficial protective effects on endothelial cells from TNF-α-induced inflammatory response and injury. Our results indicate that TNF-α treatment induces CysLT1R expression. The addition of zafirlukast to culture media suppressed TNF-α-induced expression of endothelial vascular adhesion molecules, such as ICAM-1, VCAM-1, and induction of cytokines, including IL-1β, IL-6, and IL-8. Zafirlukast also ameliorated production of reactive oxygen species (ROS) and adhesion of monocytes to endothelial cells induced by TNF-α. Mechanistically, we demonstrate that zafirlukast suppresses MAPK kinase p38 and NF-κB activation to inhibit inflammatory mediators. Collectively, our findings provide insights into the mechanisms of a potential therapeutic strategy for endothelial dysfunction-related diseases and shed light on the possible application of zafirlukast in cardiovascular diseases such as atherosclerosis.

Abstract Background Resistant hypertension and renal sympathetic hyperactivity are closely linked, and catheter-based renal denervation (RDN) is regarded as a new treatment strategy. However, the acute changes in vascular morphology and relaxation function have yet to be evaluated, and these may be important for the efficacy and safety of the procedure. In this study, we explored these questions by conventional temperature-controlled cardiac radiofrequency catheter-based RDN in a pig model. Methods Six mini-pigs were randomly divided into the renal denervation (RDN) group (n = 3) and the Sham-RDN group (n = 3). Animals in the RDN group underwent unilateral radiofrequency ablation, and those in the Sham-RDN group underwent the same procedure except for the ablation. The pigs were examined by angiography pre- and post-RDN and were euthanized immediately thereafter. Renal arteries were processed for histological and molecular biology analyses as well as for in vitro vascular tension testing. Results Compared with the Sham-RDN group, the RDN caused vascular intima and media injury, renal nerve vacuolization, mild collagen fiber hyperplasia and elastic fiber cleavage (all p

Objectives To develop a model of in-hospital mortality using medical record front page (MRFP) data and assess its validity in case-mix standardisation by comparison with a model developed using the complete medical record data.Design A nationally representative retrospective study.Setting Representative hospitals in China, covering 161 hospitals in modelling cohort and 156 hospitals in validation cohort.Participants Representative patients admitted for acute myocardial infarction. 8370 patients in modelling cohort and 9704 patients in validation cohort.Primary outcome measures In-hospital mortality, which was defined explicitly as death that occurred during hospitalisation, and the hospital-level risk standardised mortality rate (RSMR).Results A total of 14 variables were included in the model predicting in-hospital mortality based on MRFP data, with the area under receiver operating characteristic curve of 0.78 among modelling cohort and 0.79 among validation cohort. The median of absolute difference between the hospital RSMR predicted by hierarchical generalised linear models established based on MRFP data and complete medical record data, which was built as ‘reference model’, was 0.08% (10th and 90th percentiles: −1.8% and 1.6%). In the regression model comparing the RSMR between two models, the slope and intercept of the regression equation is 0.90 and 0.007 in modelling cohort, while 0.85 and 0.010 in validation cohort, which indicated that the evaluation capability from two models were very similar.Conclusions The models based on MRFP data showed good discrimination and calibration capability, as well as similar risk prediction effect in comparison with the model based on complete medical record data, which proved that MRFP data could be suitable for risk adjustment in hospital performance measurement.

Objective: To investigate the relationship between morning hypertension (MH) and T-peak to T-end interval (Tp-e interval) in patients with suspected coronary heart disease. Methods: Patients with typical symptoms of coronary heart disease were examined by ambulatory blood monitoring, electrocardiogram, echocardiography, and coronary angiography, and were assigned to two groups on the basis of blood pressure: an MH group and a morning normotension (MN) group. The following data were collected and compared: basic characteristic, Tp-e interval, corrected QT (QTc) interval, echocardiography parameters, and Gensini score of the two groups. Results: Three hundred fifty-eight patients, with a mean age of 64 years (54.1% men), were divided into the MH group ( n =170) and the MN group ( n =188). Tp-e interval (84.52±14.77 ms vs. 65.19±19.03 ms, P

Percutaneous coronary intervention (PCI) has become the mainstay in the treatment of coronary heart disease (CHD). In the past 10 years, the number of PCI procedures for CHD has maintained an annual growth of 15%–20% on average in China. As a consequence, in-stent restenosis (ISR) has become an increasingly serious problem with the wide application of coronary stents. Certainly, current treatment regimens for ISR are unsatisfactory in some aspects. Coronary artery bypass surgery has many risk factors and contradictions and a second stent implantation is associated with the risk for recurrent ISR and additional stent implantations; the rate of recurrent ISR in lesions after plain old balloon angioplasty is high (up to 27%). Therefore, all these regimens are suboptimal for the treatment of ISR. In recent years, drug-coated balloon (DCB), a novel interventional technique, has been increasingly used in coronary and peripheral artery interventions in Europe and Asia. In China, several DCB products have been or will be marketed for clinical application. The introduction of DCB provides a new choice for the treatment of coronary artery diseases in China. Based on several national and international clinical trials, >20 experienced experts in the PCI field from China have proposed the China expert consensus on clinical application of the DCB with evidence-based validation and session discussion in order to promote the standardized application of the DCB in the treatment of coronary artery diseases in China.

BackgroundVascular endothelial growth factor (VEGF) exerts a number of beneficial effects on ischemic myocardium via its angiogenic properties. However, little is known about whether VEGF has a direct effect on the electrical properties of cardiomyocytes. In the present study, we investigated the effects of different concentrations of VEGF on delayed rectifier potassium currents (IK) in guinea pig ventricular myocytes and their effects on action potential (AP) parameters. Methods and ResultsIK and AP were recorded by the whole‐cell patch clamp method in ventricular myocytes. Cells were superfused with control solution or solution containing VEGF at different concentrations for 10 minutes before recording. Some ventricular myocytes were pretreated with a phosphatidylinositol 3‐kinase inhibitor for 1 hour before the addition of VEGF. We found that VEGF inhibited the slowly activating delayed rectifier potassium current (IKs) in a concentration‐dependent manner (18.13±1.04 versus 12.73±0.34, n=5, P=0.001; 12.73±0.34 versus 9.05±1.20, n=5, P=0.036) and prolonged AP duration (894.5±36.92 versus 746.3±33.71, n=5, P=0.021). Wortmannin, a phosphatidylinositol 3‐kinase inhibitor, eliminated these VEGF‐induced effects. VEGF had no significant effect on the rapidly activating delayed rectifier potassium current (IKr), resting membrane potential, AP amplitude, or maximal velocity of depolarization. ConclusionsVEGF inhibited IKs in a concentration‐dependent manner through a phosphatidylinositol 3‐kinase–mediated signaling pathway, leading to AP prolongation. The results indicate a promising therapeutic potential of VEGF in prevention of ventricular tachyarrhythmias under conditions of high sympathetic activity and ischemia.

BackgroundAlthough atrial fibrillation (AF) is the most common abnormal heart rhythm and its prevalence continues to rise, there is a marked paucity of effective and safe antiarrhythmic drugs for AF. This study was done to test whether combined use of dofetilide and mexiletine exhibits not only a synergistic effect on AF suppression but also a safer profile in drug‐induced ventricular proarrhythmias. Methods and ResultsThe effects of dofetilide plus mexiletine on atrial effective refractory period (ERP), AF inducibility, QT, and QT‐related ventricular arrhythmias were studied using the isolated arterially perfused rabbit atrial and ventricular wedge preparations. Dofetilide or mexiletine alone mildly to moderately prolonged atrial ERP, but their combined use produced a markedly rate‐dependent increase in atrial ERP. Dofetilide (3 nmol/L) plus mexiletine (10 μmol/L) increased the ERP by 28.2% from 72.2±5.7 to 92.8±5.9 ms (n=9, P

Hollow, tubular organs including oesophagus, trachea, stomach, intestine, bladder and urethra may require repair or replacement due to disease. Current treatment is considered an unmet clinical need, and tissue engineering strategies aim to overcome these by fabricating synthetic constructs as tissue replacements. Smart, functionalised synthetic materials can act as a scaffold base of an organ and multiple cell types, including stem cells can be used to repopulate these scaffolds to replace or repair the damaged or diseased organs. Epithelial cells have not yet completely shown to have efficacious cell–scaffold interactions or good functionality in artificial organs, thus limiting the success of tissue-engineered grafts. Epithelial cells play an essential part of respective organs to maintain their function. Without successful epithelialisation, hollow organs are liable to stenosis, collapse, extensive fibrosis and infection that limit patency. It is clear that the source of cells and physicochemical properties of scaffolds determine the successful epithelialisation. This article presents a review of tissue engineering studies on oesophagus, trachea, stomach, small intestine, bladder and urethral constructs conducted to actualise epithelialised grafts.

Flooding regime changes resulting from natural and human activity have been projected to affect wetland plant community structures and functions. It is therefore important to conduct investigations across a range of flooding gradients to assess the impact of flooding depth on wetland vegetation. We conducted this study to identify the pattern of plant height, species richness and aboveground biomass variation along the flooding gradient in floodplain wetlands located in Northeast China. We found that the response of dominant species height to the flooding gradient depends on specific species, i.e., a quadratic response for Carex lasiocarpa, a negative correlation for Calamagrostis angustifolia, and no response for Carex appendiculata. Species richness showed an intermediate effect along the vegetation zone from marsh to wet meadow while aboveground biomass increased. When the communities were analysed separately, only the water table depth had significant impact on species richness for two Carex communities and no variable for C. angustifolia community, while height of dominant species influenced aboveground biomass. When the three above-mentioned communities were grouped together, variations in species richness were mainly determined by community type, water table depth and community mean height, while variations in aboveground biomass were driven by community type and the height of dominant species. These findings indicate that if habitat drying of these herbaceous wetlands in this region continues, then two Carex marshes would be replaced gradually by C. angustifolia wet meadow in the near future. This will lead to a reduction in biodiversity and an increase in productivity and carbon budget. Meanwhile, functional traits must be considered, and should be a focus of attention in future studies on the species diversity and ecosystem function in this region.

Black carbon (BC) is one of the major drivers of climate change and a useful indicator of environmental pollution from industrialization, and thus it is essential to reconstruct the historical trend in BC flux to better understand its impact. The Yancheng coastal wetland reserve in Jiangsu province is an area sensitive to global sea level change and is also located in the most developed as well as most polluted region of China. We investigated the concentration and historical flux of BC over the past 150 years through geochemical analysis of two 210Pb-dated sediment cores from Yancheng coastal wetland. Measured BC contents ranged from 0.24 mg g-1 to 1.41 mg g-1 with average values of 0.51mg g-1-0.69 mg g-1, and BC fluxes ranged from 0.69 g m-2 yr-1 to 11.80 g m-2 yr-1 with averages of 2.94g m-2 yr-1-3.79 g m-2 yr-1. These values are consistent with other records worldwide. Both BC content and flux show a gradual and continuous increase over time and clearly reflect increased emissions from anthropogenic activities. The BC records have a significant peak in recent years (from 2000 to 2007), which is accompanied by the sharp increase of energy consumption and total carbon emission in the region. It is reasonable to conclude that changes in BC from increasing human activities have controlled BC fluxes during the last 150 years. Industrial contamination, especially BC emission, in the coastal region of eastern China should be taken into account when developing management strategies for protecting the natural environment.