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OBJECTIVE: Severe right ventricular hypertrophy (SRVH) in hypertrophic cardiomyopathy (HCM) is rare. We studied the clinical characteristics and prognosis of 36 patients with HCM and SRVH in a Chinese cohort. METHODS: Patients with HCM and SRVH were enrolled between 2013 and 2017. The clinical characteristics, treatment therapies, and clinical outcomes of the 36 patients were retrospectively studied and compared with those of 128 patients without SRVH. RESULTS: Patients in the group with SRVH were younger than those in the group without SRVH (27.58±15.09 years vs 40.34±13.21 years, respectively; p

Using network pharmacology to explore the mechanism of the ‘invigorating qi and promoting blood circulation’ drug pair Ginseng-Danshen (Salvia miltiorrhiza) on treatment of ischemic heart disease (IHD). The chemical constituents of ginseng and Danshen drug pair were identified by searching the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), and the potential targets of the pair were identified. The pharmacodynamics of the pair was analyzed using network pharmacology. The targets of IHD were identified by database screening. Using protein-protein interaction network, the interaction targets of Ginseng-Danshen on IHD were constructed. A “constituent-target-disease” interaction network was constructed using Cytoscape software, Gene Ontology (GO) term enrichment analysis and biological pathway enrichment analysis were carried out, and the mechanism of improving myocardial ischemia by the Ginseng-Danshen drug pair was investigated. Seventeen active constituents and 53 targets were identified from ginseng, 53 active constituents and 61 targets were identified from Danshen, and 32 protein targets were shared by ginseng and Danshen. Twenty GO terms were analyzed, including cytokine receptor binding, cytokine activity, heme binding, and antioxidant activity. Sixty Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathways were analyzed, including phosphatidylinositol 3-kinase-serine-threonine kinase (PI3K-AKT) signaling pathway, p53 signaling pathway, interleukin 17 signaling pathway, tumor necrosis factor signaling pathway, and the advanced glycation end product (AGE)-the receptor for AGE (RAGE) signaling pathway in diabetic complications. The specific mechanism of Ginseng-Danshen drug pair in treating IHD may be associated with improving the changes of metabolites inbody, inhibiting the production of peroxides, removing the endogenous oxygen free radicals, regulating the expression of inflammatory factors, reducing myocardial cell apoptosis and promoting vascular regeneration.

ObjectiveTricuspid regurgitation (TR) is a common valvular heart disease with unsatisfactory medical therapeutics and high surgical mortality. The present study aims to evaluate the safety and effectiveness of transcatheter tricuspid valve replacement (TTVR) in high-risk patients with severe TR.MethodsThis was a compassionate multicentre study. Between September 2018 and November 2019, 46 patients with TR who were not suitable for surgery received compassionate TTVR under general anaesthesia and the guidance of trans-oesophageal echocardiography and fluoroscopy in four institutions. Access to the tricuspid valve was obtained via a minimally invasive thoracotomy and transatrial approach. Patients’ data at baseline, before discharge, 30 days and 6 months after the procedure were collected.ResultsAll patients had severe TR with vena contracta width of 12.6 (11.0, 14.5) mm. Procedural success (97.8%) was achieved in all but one case with right ventricle perforation. The procedural time was 150.0 (118.8, 180.0) min. Intensive care unit time was 2.0 (1.0, 4.0) days. 6-month mortality was 17.4%. Device migration occurred in one patient (2.4%) during follow-up. Transthoracic echocardiography at 6 months after operation showed TR was significantly reduced (none/trivial in 33, mild in 4 and moderate in 1) and the primary safety end point was achieved in 38 cases (82.6%). Patients suffered from peripheral oedema and ascites decreased from 100.0% and 47.8% at baseline to 2.6% and 0.0% at 6 months.ConclusionsThe present study showed TTVR was feasible, safe and with low complication rates in patients with severe TR.

Background To identify the association between tricuspid annular circumference and secondary tricuspid regurgitation and analyze the risk factors of recurrent tricuspid regurgitation after concomitant tricuspid annuloplasty during left heart surgery. Methods From October 2018 to June 2019, a total of 117 patients receiving concomitant tricuspid annuloplasty within left heart surgery were enrolled. Severity of tricuspid regurgitation was classified as 4 subtypes: normal, mild, moderate and severe. Perioperative data and mid-term outcome were collected. Tricuspid annular circumference (TAC) was measured under cardiac arrest during surgery procedure by cardioplegia. Optimal TAC and TAC index (TAC/body surface area, BSA) cutoffs of significant tricuspid annulus dilatation (moderate and severe) were obtained. Univariable and multivariable logistic regression analyses were performed to identify the risk factors of postoperative recurrent tricuspid regurgitation. The follow up period is 13–19 months (mean 15.5 ± 3.2 months). Results There was 1 patient was excluded who died after surgery. A total of 116 patients receiving tricuspid annuloplasty were included. Optimal cutoffs of significant tricuspid annulus dilatation were recommended (TAC 11.45 cm, Sensitivity 82.89%, Specificity 73.68%, AUC 0.915; TAC index 7.09 cm/m2, Sensitivity 73.68%, Specificity 85%, AUC 0.825, respectively). Based on findings of multivariable logistic regression, it has been showed that TAC index and postoperative atrial fibrillation were the independent risk factors of recurrent regurgitation after surgery. Optimal TAC index cutoff to predict recurrent tricuspid regurgitation was 7.86 cm/m2 Conclusions The severity of secondary tricuspid regurgitation is associated with the tricuspid annular circumference. The cut-offs of significant tricuspid regurgitation (more than moderate) were TAC 11.45 cm and TAC index 7.09 cm/m2, respectively. Clinically, concomitant tricuspid annuloplasty is relative safe and effective. TAC index ≥ 7.86 cm/m2 and postoperative atrial fibrillation are the risk factors of recurrent significant tricuspid regurgitation after concomitant tricuspid annuloplasty during left heart surgery.

Purpose: Left atrial appendage (LAA) isolation is an effective surgical treatment for decreasing thromboembolic risk. We sought to evaluate the short-term effect of minimally invasive surgery with LAA excision on left atrial dynamic and endocrine function in atrial fibrillation (AF) patients. Methods: A total of 52 patients with paroxysmal AF undergoing minimally invasive surgery with LAA excision in Anzhen Hospital from October 2012 to June 2014 were enrolled in the study. The natriuretic peptide plasma level was determined by enzyme-linked immunosorbent assay (ELISA), and left atrial dynamic function was measured preprocedure by real-time three-dimensional echocardiography and postprocedure after 7 days and 3 months. Results: With the exception of six recurrences, 88.5% (46/52) of the patients were prospectively followed over 3 months in terms of their sinus rhythm postprocedure. No severe operative complications or embolism events occurred within those 3 months. Echocardiography showed a 3–6% decrease in left atrial volume postprocedure, and dynamic function was largely restored by 3 months. There was no significant change in natriuretic peptide levels, although a slight decrease was detected 7 days postprocedure, which gradually recovered by 3 months (P = 0.350). Conclusions: There are no significant differences in left atrial dynamics and natriuretic peptide secretion in AF patients after minimally invasive surgery with LAA excision.

Background Many comparative studies of percutaneous balloon mitral valvuloplasty (PBMV) and surgical mitral commissurotomy (SMC) in rheumatic mitral stenosis (MS) were done in the last few decades. With the development of valve repair techniques, various surgical rheumatic valve repair techniques have been applied in clinic, but there is a lack of comparison with PBMV. Our study was designed to compare the perioperative and mid-term outcomes of PBMV and mitral valve repair with "four-step" procedure in the treatment of rheumatic MS. Methods Patients with MS were treated with PBMV or rheumatic mitral valve repair (rMVP) at Beijing Anzhen Hospital between January 1, 2013 and September 30, 2018 were selected. By using propensity score matching (PSM) method, we compared the changes in post-operation clinical outcomes between the two matched groups. Kaplan-Meier analyses was used for survival analysis and drawing the curve, and log-rank test were used to compare intergroup differences. Results A total of 252 cases were enrolled after selection, 74 cases in PBMV and 178 cases in rMVP. Seventy-four pairs were matched successfully after PSM. There were 53 females in PBMV and 54 in rMVP. The mean age of two groups was 46.95±12.50 and 47.55±11.91 years respectively. There was no significantly differences in mitral valve orifice area (MVOA) (1.05±0.32 vs. 0.97±0.24 cm2, P=0.12) and left ventricular ejection fraction (EF) (62.36%±5.17% vs. 62.52%±4.94%, P=0.76) between two groups preoperatively. Baseline characteristics were basically balanced after PSM. In each group, there was one case transferred to surgical mitral valve replacement due to the failure of valvuloplasty before discharge. All patients survived the interventions and no severe complications were found. MVOA were significantly increased in rMVP compared with PBMV postoperatively, as well as grading of MS and tricuspid regurgitation (TR) were significantly improved in rMVP. Three cases in PBMV were lost during the follow-up. Mitral replacement was performed in 11 patients and one of them died in PBMV, while none of patients underwent re-intervention in rMVP, but one patient died of pneumonia. Conclusions For selected patients with rheumatic MS in China, our study shows that there are comparable clinical outcomes in terms of operative, mid-term mortality and complications between PBMV and surgical rMVP with "four-step" procedure. Surgical rMVP shows more advantageous in the correction of valve stenosis and the management of concomitant tricuspid valve lesions and atrial fibrillation (AF).

As the more-electric aircraft concept is accepted as the key feature of the next-generation civil aircraft, the onboard electromagnetic environment is getting much worse than traditional models, and consequently the interconnecting cables as the major coupling path of the electromagnetic interference (EMI) are required to provide more sufficient EMI protection ability. Shielded cables have been considered as reliable carriers and widely used in the aircraft for years, but any differences in shielding structure or the number of shielding layers may lead to a significant change in shielding performance. Based on the transmission line theory, this paper builds the crosstalk prediction model for two different shielded cables first, and compare the calculated crosstalk with simulation result to verify the reliability and the effectiveness of the prediction model. Furthermore, the impact of the structural parameters of the cable shield on the shielding performance is studied, such as the number of shielding layer, the thickness of the shielding layer and insulating layer.

Background: Rare cases of concurrent primary aldosteronism (PA) and renal artery stenosis (RAS) have been reported. Methods: In this retrospective case–control study, we selected a cohort of 10 PA ...

Background Primary aldosteronism (PA) increases the risk of cardiovascular morbidity, including stroke, coronary artery disease, atrial fibrillation, and heart failure. The relationship between primary aldosteronism and aortic dissection has rarely been reported. We report a case of aortic dissection caused by secondary hypertension from PA and review similar cases in the literature. Case presentation A 56-year-old woman with a history of surgery for aortic dissection presented for follow-up of hypertension and a left adrenal mass. She had been diagnosed with hypertension and hypokalemia in 2003. Blood pressure had been controlled by antihypertensive medications. In 2009, she presented with chest and back pain; she was diagnosed with aortic dissection by computed tomography (CT). She underwent placement of an endovascular aortic stent graft. CT at that time showed a left adrenal mass with a diameter of 1 cm. In 2017, CT reexamination revealed that the left adrenal mass had grown to 3 cm in diameter. Laboratory data showed blood potassium 2.4 mmol/L (reference range: 3.5–5.3 mmol/L). The plasma aldosterone/renin ratio was elevated because of suppressed plasma renin and elevated serum aldosterone levels. Plasma aldosterone levels were not suppressed after taking captopril. Positron emission tomography/CT showed that the left adrenal tumor radiographic uptake was slightly increased (maximum standardized uptake value of 2.2), and metastasis was not detected. Laparoscopic adrenalectomy was performed, and an adrenocortical adenoma was confirmed histopathologically. After surgery, blood pressure and laboratory findings were within their reference ranges without any pharmacological treatment. Conclusions Our patient and the literature suggest that PA is a potential cause of aortic dissection. Diagnosing PA in the early stages of the disease and early treatment are important because affected patients may be at increased risk of aortic dissection.

Aims Single-dose pharmacokinetic (PK) studies in healthy subjects have been the design of choice for bioequivalence determination for decades. This preference has been recently extended to PK similarity studies of proposed biosimilars. However, PK similarity studies can be complicated by the effect of immunogenicity response on drug disposition. The impact is exacerbated when there is an imbalance in host-specific immunological characteristics of subjects between the test and reference groups. Such complications remain poorly understood. The purpose of this communication is to show that the impact of immunogenicity response on PK similarity determination can be critical, using adalimumab as an example. Methods Data for adalimumab concentrations and immunogenicity response over 10 weeks were obtained from 133 healthy subjects receiving a 40 mg dose of Humira® in a PK similarity study. Also, a population PK model with a mechanistic construct for delineating the interplay between adalimumab disposition and antidrug antibodies response was utilized to estimate via simulation the probability that a PK similarity study would fail in typical study settings. Results The simulations showed that the immunogenicity response can have a profound impact on the outcome of PK similarity determination. As such, the probability of failing to achieve the similarity conclusion increased to 51.9%, from 13.8% in the absence of immunogenicity response. Conclusion This study provides a model-based framework for better understanding of how a PK similarity study can be optimally designed and for interpretation of the outcome of PK similarity determination when the drug disposition is affected in the presence of immunogenicity response.

Nearly 70% of breast cancer (BC) is hormone-receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, and endocrine therapy is the mainstay of treatment for this subtype. However, intrinsic or acquired endocrine resistance can occur during the endocrine treatment. Based on insights of endocrine resistance mechanisms, a number of targeted therapies have been and continue to be developed. With regard to HR-positive, HER2-negative advanced BC, aromatase inhibitor (AI) is superior to tamoxifen, and fulvestrant is a better option for patients previously exposed to endocrine therapy. Targeted drugs, such as cyclin-dependent kinases (CDK) 4/6 inhibitors, mammalian target of rapamycin (mTOR) inhibitors, phosphoinositide-3-kinase (PI3K) inhibitors, and histone deacetylase (HDAC) inhibitors, play a significant role in the present and show a promising future. With the application of CDK4/6 inhibitors becoming common, mechanisms of acquired resistance to them should also be taken into consideration.

Background: Function tricuspid regurgitation (TR) is frequently observed in patients undergoing mitral valve surgery. It is unclear that mitral valve repair (MVr) or mitral valve replacement (MVR) has influence on the likelihood of late TR progression. Methods: This study included 193 patients with degenerative mitral valve disease who underwent either MVr or MVR. Detailed preoperative materials, follow-up information, and echocardiographic data were collected and statistically analyzed. Results: At 6 and 12 months postoperatively, MVR patients were more likely to have New York Heart Association (NYHA) class III or IV symptoms than MVr patients (6 mo: 15.2% vs 5.0%, 12 mo: 13.0% vs 4.0%, both P

Objective: To evaluate the diagnostic criteria, surgical indications, and prognostic factors in the surgical treatment of infective endocarditis (IE). Methods: A total of 161 cases of post...

Background: Pyrotinib is a molecular and irreversible tyrosine kinase inhibitor independently developed in China, and its efficacy against HER2- positive breast cancer in the real world is not clear. In this study, we evaluated the efficacy and safety of pyrotinib in the treatment of HER2-positive advanced breast cancer based on real-world evidence. Materials and Methods: We designed a prospective observational study. Thirty-six patients with HER2-positive advanced breast cancer from a single medical center were included in the study from December 2018 to February 2021. All patients received the oral HER2 receptor inhibitor pyrotinib and received concurrent chemotherapy or endocrinotherapy. The follow-up endpoint is set as April 1, 2021. The primary endpoint is Objective Response Rate (ORR) and Disease Control Rate (DCR), and the secondary endpoint is Progression- Free Survival (PFS) and related side effects. Results: By the end point of follow-up, a total of 17 patients had progressed (including 6 deaths), and the progression-free survival rate was 52.78%. The median PFS was 13months (PFS range: 3-22 months). As the best response, 4 patients achieved CR, 20 patients achieved PR, 9 patients achieved SD, and 3 patient developed PD. The ORR was 66.67% and DCR was 91.67%. In the analysis, first-line pyrotinib treatment appeared to have higher ORR (88.88% vs 59.26%), but there was no significant difference. In addition, pyrotinib showed significant efficacy in patients with brain metastases, with an ORR of 42.85%. In terms of safety, the incidence of diarrhea was 80.55%, but only 4 patients had grade 3 diarrhea, which was tolerable after the drug dose was reduced; 1 patient had grade 4 neutropenia and grade 3 and thrombocytopenia, which were considered to be related to the chemotherapy drugs. The incidence of other adverse reactions was low, and all were grade 1 to 2. Conclusion: Pyrotinib combined with chemotherapy has a significant effect on HER2-positive breast cancer, and there is still a high ORR in patients who fail multiple lines of treatment. Side effects are overall controllable and safe.

Ground penetrating radar (GPR) is a recognized nondestructive testing technique, which has been commonly applied to detect the steel bars (rebars) in concrete. However, most commercial GPR systems can only record reflection signals in single polarization, making the inspection of rebar corrosion difficult. In this paper, we employ a full polarization GPR system to record polarimetric information and use H-Alpha polarization decomposition to evaluate the rebar corrosion process. A yearly long corrosion process of one rebar was accelerated within 15 days by applying a constant current density of 0.3 mA/cm2 on the embedded rebar. The preliminary experimental results of polarization decomposition show that the scattering characteristics of rebars change to low entropy surface scattering after corrosion. It is concluded that full-polarimetric GPR has a potential for characterization of the early-stage corrosion of concrete rebar.

Objectives: To determine tuberculosis (TB) recurrence in previously successfully treated patients in a routine program setting and baseline characteristics associated with TB recurrence. Methods: A prospective longitudinal study in Jiangxi Province, China. Patients, ≥14 years old, were consecutively registered and were followed up for seven years to assess TB recurrence against a patients’ individual baseline data that had been entered into a database at TB registration. Results: There were 800 TB patients registered at baseline, and 634 (79.2%) of them completed anti-TB treatments. Fifty-nine (9.3%) died, and 21 (3.3%) were lost to follow-up over the follow-up period. There were 96 patients with recurrent episodes (total incidence 15.2% or annual incidence 2,200/100,000). Of the recurrent cases, 53 (55.2%) happened within 2-year after completion of anti-TB treatments. After controlling confounding factors, the risk of TB recurrence was significantly higher in the age range 34-73 years (P

Background There is a lack of established pathological indications for rheumatic valve repair. Therefore, we summarized the pathological classifications of rheumatic heart diseases and their correlations with the surgical strategies. Methods This observational study enrolled patients with rheumatic heart diseases who underwent mitral valve repair (MVP) or replacement at our centre between January 2017 and January 2019. Mitral leaflet, mitral commissural, and sub-valvular apparatus were classified into three grades from mild to severe, according to their degree of pathological damage. Based on certain principles and the grade of mitral leaflet, mitral commissural, and sub-valvular apparatus damage, three pathological types were identified (types I to III), based on which all patients were classified. The features of each pathological type were summarised. Differences between the three pathological types were analysed using chi-square test of tendency. These data were used to propose a clinico-pathological classification of rheumatic mitral valve damage in Chinese patients. Results Of 398 patients, 284 (70%) underwent MVP for rheumatic mitral valve diseases. There were 58 type I (15%) patients in the study, all of whom underwent repair (repair rate, 100%). Preoperative moderate-to-severe regurgitation with mild pathological lesions was observed in 64% of these patients. In 260 type II (65%) patients, the repair rate was 76% (197/260); preoperative moderate-to-severe stenosis was observed in 88% of these patients. In 80 type III (20%) patients, the repair rate was 36% (29/80); the preoperative rates of extremely severe stenosis and moderate-to-severe regurgitation in these patients were 50% and 40%, respectively. Several preoperative parameters show the change in trend with the increase in the pathological classification severity. Conclusions Our clinico-pathological classification of rheumatic mitral valve damage is applicable to MVP. Considering that the classification principles are based on the possibility of mitral repair, it provides a phased and achievable target ratio for MVP and a principle of screening patients who should undergo rheumatic MVP.

In the last few decades, non-native freshwater fishes have been introduced all over the world for economic purposes, including aquaculture and aquarium trade, as well as improvement for wild stocks resulting in adverse environmental and socio-economic effects. The Guangdong province of China is at a high risk of fish invasions owing to its warm and humid climate, abundance of water courses, flourishing aquaculture and ornamental fish trade, and extensive sea ports. A total of 160 non-native freshwater species were introduced in the Guangdong province and 71.9% of them were imported for aquarium purposes. Fourteen species have established self-sustaining populations and 21 species were found in the main river basin of the Guangdong province. Propagule pressure, rapid evolution and abundant resources in the environment were the factors likely to contribute to successful invasion by non-native fishes. The invasion of non-native fishes in the Guangdong province has already resulted in economic losses, decline of native species, as well as negative impacts on the functional diversity of native fish assemblages. To mitigate these effects and prevent future non-native fish invasions, scientists, policy makers and stakeholders should collaborate on the management of non-native fish introductions by developing risk assessments, statutory regulations, public education and scientific research.

Primary aldosteronism (PA) is mainly treated by mineralocorticoid receptor antagonists or laparoscopic adrenalectomy (LA), but the effectiveness of surgical versus medical treatment in patients with adrenal venous sampling (AVS)-proven unilateral PA is unclear. Fifty-one consecutive patients with AVS-proven PA were enrolled. We compared the therapeutic effects between the surgery group (n = 21) and medication group (n = 30) by evaluating the complete control rate (CCR) of hypertension, blood pressure (BP), and number of antihypertensive drugs after a long-term follow-up (>12 months). The CCR of hypertension was assessed using a multivariate adjusted Cox proportional hazards regression model. After a mean follow-up of 21.18 ± 5.35 months, the CCR was significantly higher in the surgery than medication group (85.7% vs. 13.3%, respectively; p

Fish physiology and behavior are affected by exposure to light of varying colors, but little is known about the effects on swimming performance and metabolism. The purpose of this study was to measure the effects of light color on the swimming performance of bighead carp (Aristichthys nobilis), a planktivorous fish species widely used in aquaculture. Stepped velocity testing was conducted in a modified Brett-type swim tunnel respirometer to determine critical swimming speed (Ucrit), oxygen consumption (MO2), and excess post-exercise oxygen consumption (EPOC) for juvenile bighead carp under red, yellow, blue, and green lights at 25 °C. Ucrit was significantly lower for fish swimming under yellow and green lights compared with red and blue light. Cost of transport (COT), a measure of swimming efficiency, also varied with color. The results, obtained under controlled conditions, add to our knowledge on the effects of artificial color light on fish physiology and behavior and inform decisions on the use of artificial color light in aquaculture and fishway design.

Tilapia is one of the groups of fish species most widely cultured globally. China has been the largest producer of tilapia in the world since 1990s. Guangdong Province produces almost 40% of all tilapia in China because of its suitable geography and weather conditions, and tilapia culture has brought considerable economic benefits. Unfortunately, many of the biological traits that make tilapia popular for culture also contribute to its success as an invader. Tilapia has invaded natural waters and has become the dominant fish in many rivers of Guangdong Province, causing economic loss in capture fisheries, and affecting native fish species, biodiversity and aquatic ecosystems. Poor fishery management, water quality degradation and biodiversity loss have all facilitated the tilapia invasion. Tilapia have filled the niches left vacant by now locally extinct native species resulting from environmental changes in freshwater ecosystems of the province. The introduction of tilapia has both advantages and disadvantages, which should be managed to use effectively the various tilapia species in aquaculture while controlling their spread in natural waters.

Thoracoscopic left atrial appendage (LAA) occlusion is an alternative treatment for stroke prevention in patients with atrial fibrillation. Prospective study comparing thoracoscopic LAA occlusion and warfarin therapy is still lacking. The goal of this prospective cohort study was to assess the safety and efficacy of thoracoscopic LAA occlusion for stroke prevention in patients with nonvalvular atrial fibrillation compared with long-term warfarin therapy. Four hundred and ninety-two nonvalvular atrial fibrillation patients were enrolled. Two hundred and fifty-seven patients were treated with thoracoscopic LAA occlusion and 235 with long-term warfarin therapy. At 24 months, the rate of the first efficacy endpoint (composite of stroke, systemic embolism, and death) was 0.018 in the surgical group versus 0.043 in the warfarin group (p = 0.033). The rate of the second efficacy endpoint (stroke and systemic embolism excluding the first 7 days after procedure) was 0.010 versus 0.034 (p = 0.019). The rate of the first safety endpoint of bleeding was 0.016 versus 0.044 (p = 0.022). In conclusion, this study showed that thoracoscopic LAA occlusion was superior to warfarin for stroke prevention. The surgical group also had significantly lower bleeding risk. The incidence of surgical complications was low, and all occurred in hospital without causing serious outcomes.

Background: Cardiac sympathetic nervous system is usually activated in cardiopulmonary bypass (CPB) surgery, accompanied by excessive release of norepinephrine (NE). Neuropeptide Y (NPY) has been shown to regulate NE release in the terminal of sympathetic fiber, which is a target for regulating heart function. The expression of NPY and NPY receptor (NPYR) genes in the human atrial tissues during CPB in cardiac surgery was investigated in the present study. Methods: A few discarded atrial tissues before and after CPB were collected in 22 patients with rheumatic cardiac valve diseases. The transcriptional levels of NPY and NPYRs were monitored by real-time quantitative polymerase chain reaction (RT-qPCR) method. Moreover, the correlation between the mRNA levels of NPY/NPYRs and the clinical data were investigated in detail. Results: The mRNA levels of NPY Y1 and NPY Y5 genes were statistically attenuated in male patients after CPB. Conversely, the expression of NPY, NPY Y1 and NPY Y5 genes were enhanced in female patients. Correlation analysis suggested that there was a significant negative correlation between cardiac ejection fraction (EF) after CPB with the atrial transcriptional level of NPY in male patients. Conclusions: These results suggested that the expression of NPY/NPYRs in human atrial tissue during CPB was gender specific and activated NPY signaling was only identified in female patients. The elevated expression level of NPY in male patients was correlated with lower cardiac EF after CPB.

Background:This study aimed to evaluate the role of SAMe-TT2R2 score in the prediction of anticoagulation control after mechanical mitral valve replacement.Methods and Results:We retrospectively reviewed clinical data of 161 patients who received mechanical mitral valve replacement at Beijing Anzhen Hospital from January 2013 to December 2013. Collected data included general information of patients, medication and smoking, postoperative embolism due to anticoagulant, bleeding complications and death information. In the SAMe-TT2R2 score results, the lowest score was 2 points (6.3%), the highest score was 7 points (0.7%). The number of people with 4 points was the largest ,60 people (41.4%).When the cut-off value of SAMe-TT2R2 score was set to ≥4, the sensitivity and specificity of predicting TTR≥65% were 69.8% and 93.1%, respectively. The Youden index was 0.629. If the cut-off value of SAMe-TT2R2 score was set to ≤4, the sensitivity and specificity of predicting TTR≥65% were 93.0% and 44.1%, respectively, and the Youden index was 0.371.ROC curve evaluates the predictive power of the SAMe-TT2R2 score for TTR≥65%. The figure showed that when the cut-off point≥4, the best combination of sensitivity and specificity was shown (69.8% and 93.1%, respectively).The area under the curve AUC was 0.854.Conclusions:After mechanical mitral valve replacement, the SAME-TT2R2 model can effectively predict the level of TTR during the course of using oral warfarin anticoagulation, and the SAMe-TT2R2 score ≥4 can be used to predict TTR

Hypertension is an important risk factor in many conditions and creates a heavy burden of disease and mortality globally. Polygenic hypertension is the most common form; however, it is increasingly recognized that monogenic hypertension is not rare, especially in patients with electrolyte disorders. Single genetic alterations are associated with plasma volume expansion and catecholamines/sympathetic excess with simultaneously increased potassium excretion in the urine and potassium intracellular shift. Early-onset refractory hypertension and profound hypokalemia are characteristics of monogenic hypertension. However, accumulated evidence shows the existence of phenotypic heterogeneity in monogenic hypertension meaning that, even for mild symptoms, clinicians cannot easily exclude the possibility of monogenic hypertension. Genetic, epigenetic and non-genetic factors are all possible mechanisms influencing phenotypic diversity. Genetic sequencing is a precise and efficient method that can broaden the mutant gene spectrum of the disease and is very helpful for understanding the pathophysiology of monogenic hypertension. Genetic sequencing, along with biochemical tests and imaging modalities, is essential for the early diagnosis and targeted management of monogenic hypertension to avoid long-term catastrophic complications.

Recent studies reported that miR-128 was differentially expressed in cardiomyocytes in response to pathologic stress. However, its function and mechanism remain to be fully elucidated. The aim of the present study was to investigate the role of miR-128 in chronic angiotensin II (Ang II) infusion-induced cardiac remodeling and its underlying mechanism. The cardiac remodeling and heart failure in vivo were established in C57BL/6 mice by chronic subcutaneous Ang II delivery. Knocking down miR-128 was conducted in the hearts of the mice by intravenous injection of HBAAV2/9-miR-128-GFP sponge (miR-128 inhibitor). In vitro experiments of cardiac hypertrophy, apoptosis, and aberrant autophagy were performed in cultured cells after Ang II treatment or transfection of miR-128 antagomir. Our results showed that chronic Ang II delivery for 28 days induced cardiac dysfunction, hypertrophy, fibrosis, apoptosis, and oxidative stress in the mice, while the miR-128 expression was notably enhanced in the left ventricle. Silencing miR-128 in the hearts of mice ameliorated Ang II-induced cardiac dysfunction, hypertrophy, fibrosis apoptosis, and oxidative stress injury. Moreover, Ang II induced excessive autophagy in the mouse hearts, which was suppressed by miR-128 knockdown. In cultured cells, Ang II treatment induced a marked elevation in the miR-128 expression. Downregulation of miR-128 in the cells by transfection with miR-128 antagomir attenuated Ang II-induced apoptosis and oxidative injury probably via directly targeting on the SIRT1/p53 pathway. Intriguingly, we found that miR-128 inhibition activated PIK3R1/Akt/mTOR pathway and thereby significantly damped Ang II-stimulated pathological autophagy in cardiomyocytes, which consequently mitigated cell oxidative stress and apoptosis. In conclusion, downregulation of miR-128 ameliorates Ang II-provoked cardiac oxidative stress, hypertrophy, fibrosis, apoptosis, and dysfunction in mice, likely through targeting on PIK3R1/Akt/mTORC1 and/or SIRT1/p53 pathways. These results indicate that miR-128 inhibition might be a potent therapeutic strategy for maladaptive cardiac remodeling and heart failure.

BACKGROUND: The elevation of troponin after coronary artery bypass grafting (CABG) is common This study aimed to investigate the association between very early cardiac troponin I (cTnI) concentration and its longitudinal change within 24 hours after CABG and 30-day adverse events. METHODS: This study prospectively enrolled 633 patients who underwent isolated off-pump CABG from January 2019 to May 2019. Serum cTnI levels were measured in all patients at two examinations within 24 hours postoperatively (1 hour and 12–18 hours), and a proportional hazards model was used to determine the association between cTnI levels and their change with adverse events, which were defined as a composite of 30-day mortality, stroke, heart failure, myocardial infarction (MI), and ventricular fibrillation. RESULTS: cTnI levels of the two examinations and absolute change of cTnI levels were significantly higher in the event group than in the non-event group (P

BACKGROUND Rheumatic mitral valve repair and replacement techniques are frequently used with excellent outcomes in experienced centers. This study aims to evaluate the impact of procedural types on left ventricular function in quinquagenarians. METHODS Between January 2018 and September 2019, patients with severe rheumatic mitral stenosis were prospectively recruited. Propensity score matching was performed to reduce the selection bias. We compared the strain, twist and synchrony parameters of left ventricle in 70 quinquagenarian patients who underwent rheumatic mitral valve repair and replacement 12 hours before surgery, at 7 days and 6 months postoperatively. RESULTS The overall group displayed significant improvement of left ventricular deformation after rheumatic mitral valve surgery. Compared with patients undergoing posterior chordal-sparing mitral valve replacement, patients undergoing rheumatic mitral valve repair showed more significant amelioration in global longitudinal strain (-18.6% versus -16.2%, P

The development of technologies such as smart terminals and mobile Internet has made image data one of the most important forms of data in the Internet and personal storage media, and has grown at an alarming rate. As the most effective expression of information, image data can record various information when image content appears, and it can play an unparalleled role in restoring the truth of things. Therefore, the aim of efficiently and accurately identify the source of image is to determine the device that generated the data. It is an effective means of clustering data from the same device, and become a key step in helping to understand the full content. It is one of the core technologies for conducting electronic data forensic evidence. On the basis of summarizing and analyzing the image generation process, this paper analyzes the data shape and acquisition steps of the potential image generation device information, and then obtains the method of image data source identification. It also summarizes the existing related technologies and methods, comparative analysis of their applicability and potential development direction.

Idiopathic hypereosinophilia (IHE) and hypereosinophilic syndrome (HES) are benign haematological disorders. Studies have suggested that venous thromboembolism (VTE) is a rare but sometimes fatal complication of hypereosinophilia; however, data are limited. We retrospectively analysed clinical features and short-term outcomes of 63 consecutive patients (82.5% men; mean age, 40.92 ± 10.89 years) with IHE or HES with concurrent VTE from January 1998 through December 2018. Risk factors for pulmonary embolism (PE) were explored by multivariate logistic analysis. DVT and/or PE was detected by imaging in all patients. Independent risk factors for PE were a body mass index of >24.1 kg/m2 (odds ratio [OR]: 5.62, 95% confidence interval [CI]: 1.21–26.13, P = 0.028), peak absolute eosinophil count of >6.3 × 109/L (OR: 5.55, 95% CI: 1.292–23.875, P = 0.021), and >13.9-month duration of hypereosinophilia (OR: 4.51, 95% CI: 1.123–18.09, P = 0.034). All patients were treated with corticosteroids and anticoagulants. The short-term hypereosinophilia remission rate was 100%; no recurrent VTE or major bleeding was observed. Hypereosinophilia is a potential risk factor for VTE. PE in patients with IHE/HES and DVT is associated with a higher body mass index, higher peak absolute eosinophil count, and longer duration of hypereosinophilia. Corticosteroids and anticoagulants provided effective short-term control of hypereosinophilia and VTE.

Background and aim: Aortic valve (AV) cusp prolapse and subsequent aortic insufficiency (AI) are 2 of factors leading to left ventricular (LV) enlargement and decreased LV function. Aortic valve replacement (AVR) has been the standard surgical procedure for AI. However, few data is available on the prognosis of these patients undergoing AVR procedure, especially in Chinese population. The study aims to evaluate the potential risk factors affecting the mid-term adverse outcomes after AVR. Methods: One hundred thirty-four patients (mean age: 46.7 years old) with AV cusp prolapse and severe AI who all received surgical aortic valve replacement were recruited in our hospital between January 1, 2009 and December 30, 2017. The clinical characteristics, echocardiography parameters, as well as operative parameters were obtained. The primary endpoint included death, heart failure development, and reoperation. Results: There were 14 adverse events altogether with the primary endpoint during a median follow-up of 8.6 (6–10) months. The multivariable Cox regression analysis revealed that baseline LVEDD (hazard rate, HR = 1.08, 95% CI: 1.01–1.15, P = .021), moderate pulmonary hypertension (HR = 9.36, 95% CI: 1.81–48.28, P = .008), and the time of assisted mechanical ventilation (HR = 1.01, 95% CI: 1.00–1.01, P = .022) were independently associated with the primary endpoint. Kaplan–Meier survival curve showed a significant worse survival free of the endpoint for patients with LVEDD≥70 mm, indexed LVEDD≥37.3 mm/m2 (the mean in this study), indexed LVESD≥25 mm/m2 or baseline LVEF

Freezing of gait (FOG) is a disabling phenomenon that is described by patients with Parkinson’s disease (PD). Not only gait may be involved in the freezing phenomenon, but also some nonmotor symptoms, such as freezing of urination (FOU) in this case. The characters of urinary dysfunctions in this case resemble “off” freezing: (1) abrupt difficulty in starting or continuing in urination; (2) the urinary dysfunctions fluctuated with medication state; and (3) the urinary dysfunctions could be alleviated dramatically by an external cueing. Urinary dysfunctions in this patient (and maybe more PD patients) are associated not only with the classical “nonmotor symptoms” but also the freezing phenomenon. FOU could be a part of the spectrum of freezing symptoms. The subtypes of the freezing phenomenon will shed light on the PD pathophysiology and clinical treatment.

Human-induced fish introduction in aquaculture always be considered the most important driver of biological invasions in freshwater ecosystems, yet most introduced species fail to establish though having great economic benefits. Explaining the varying success of introduced fish species is a central question both in invasion biology and aquaculture management. Southern China is a good region to test the invasion hypotheses where lots of non-native fish species were cultured and invaded. In this study, we used four human activities related to aquaculture to test their effects on the establishment of non-native fish species in the rivers of southern China. Our results showed that: open-water aquaculture significantly increased the establishment probabilities of non-native species relative to standardised aquaculture in ponds; the establishment and spread of non-native fish species in rivers had no significant correlation to their production and distribution in standardised aquaculture; non-native fish species with low economic value were more prone to escape and establishment in natural rivers, and had higher establishment probabilities in rivers due to the lower fishing pressure. These results indicate that standardised aquaculture and cultivated species with high economic value do not always result in biological invasions. To mitigate the invasion of exotic species caused by aquaculture, stricter management practices and more optimized economic assessments should be implemented for the introduction and cultivation of non-native fish species.

Background Mitral valve (MV) repair has been recommended for MV diseases. Good repair requires a full understanding of the three-dimensional (3D) structure of the MV, however, currently little is known about the 3D structure of the rheumatic MV. Methods A total of 82 cases underwent 3DTEE. Of these, 41 patients with rheumatic valvular disease (RVD) were studied intraoperatively (17 had severe mitral stenosis, 8 had severe mitral regurgitation, 16 had severe mitral stenosis coupled with regurgitation). There were 19 patients with degenerative MV disease (mitral valve prolapse [MVP] with severe regurgitation) and 22 cases with normal MV served as control subjects (CS). Results Compared with CS, the anteroposterior diameter, anterolateral posteromedial, annulus circumference, and annulus area of both pathological groups, i.e., the RVD and MVP groups, were understandably greater. Though the sphericity index was greater in the RVD group vis-a-vis CS, the MVP group had nearly the same sphericity index as CS. The mitral annulus of patients with RVD tended to be round. Annular unsaddling, defined as annular height to commissural width ratio (an indicator of saddle degree) less than 15%, was significantly more prevalent in the group with degenerative MV disease. Automatic dynamic analysis revealed that the parameters of annular maximum displacement and annulus area fraction (two-dimensional) were considerably decreased in the RVD group. Conclusions Annular unsaddling was significantly more prevalent in the degenerative MV disease group. The mitral annulus of patients with RVD tended to be round and stiff.

Background Closed reduction and percutaneous fixation are considered as the optional treatments for displaced supracondylar humerus fractures. However, there was no published report about the biomechanical analysis in Orthofix® external fixator. In this study, we developed a model of supracondylar humerus fractures and compared the biomechanical analysis of external fixator and different K-wires configurations in order to evaluate the stability of external fixator in supracondylar humerus fractures. Methods We developed an anatomic humerus model by third-generation synthetic composite, and 60 synthetic humeris were osteotomized to simulate the humeral transverse supracondylar fracture. Those fractures were reduced and fixed by external fixator or K-wires, and then biomechanical analysis was performed in extension, varus, valgus, and internal and external rotation loading. A paired-sample t test was used to evaluate the distance at the fracture site between the external fixator and K-wire configurations. Results During all direction loading, there was a significant statistical difference between external fixator and K-wires (P 0.05). In valgus loading, the stability of the external fixator was less than that of three crossed K-wires (P = 0.001) but was not significantly different with those of two crossed or three lateral K-wires (P = 0.126; P = 0.564). In varus loading, the stability of the external fixator was larger than those of two and three lateral K-wires (P = 0.000; P = 007). Conclusions External fixator could provide enough stability for pediatric supracondylar humerus fractures without the injury of the ulnar nerve. Besides, it could enhance the rotational stiffness of the construct in rotation loading to avoid the complication of cubitus varus.

Mobility and flexibility of anterior mitral leaflet (AML) are considered to be the important factor for mitral valve (MV) repair in rheumatic population, we try to use the bending angle of AML to quantify its' mobility and flexibility and investigate whether it can predict the success of rheumatic MV repair or not.Total 54 patients underwent rheumatic MV surgeries with mild lesions of subvalvular apparatus from August, 2017 to November, 2017 at the author institution, we divided the patients into MV repair and MV replacement groups which included directly MV replacement and repair attempt but failed repairing transfer to replacement intraoperatively. Patients' MV structure was carefully evaluated on transthoracic echocardiography (TTE) and scored by the Wilkins score (WS) preoperatively. The bending angle of AML was measured during systole and diastole at different level before surgery.The differences of patients' demographic characteristics between repair group and replacement group were not statistically significant (P value0.05) and the differences among B-angle, T-angle, Bs-angle, C-angle of AML between repair group and replacement groups were not statistically significant (P value0.05). Only BT-angle in repair group was significantly larger than that of replacement group (21.56°±3.84°, 10.29°±6.02°, respectively, P0.001), therefore the BT-angle was tested as a predictor of reparability by observing the receiver operating characteristic (ROC) curve (ROC area: 0.944, standard error: 0.06, 95% CI: 0.826-1), BT-angle of AML on preoperative transthoracic echo of 15.5° or more predicts feasibility of rheumatic MV repair with 100% sensitivity and 85.7% specificity in patients with mild lesions of subvalvular apparatus. Logistic regression for a single area of calcification (diameter0.8 cm) at commissure were shown that: β: 0.08, Exp (β): 1.083, P: 0.7770.05, the minor single calcified area at commissure had no effect on reparability of rheumatic MV disease. The differences of total WS and each component score between repair group and replacement group were not statistically significant (P value0.05). By observing the ROC curve for total WS (ROC area: 0.508), the WS cannot be a predictor for the rheumatic MV repair.The bending angle of AML which was considered as quantification of mobility and flexibility of AML can be a predictor for MV repair in patients with rheumatic heart disease (RHD). The small single area of commissural calcification had no effect on reparability of rheumatic MV disease. WS cannot appropriately predict the outcome of rheumatic MV repair.

Deep learning models have achieved success in image recognition and have shown great potential for interpretation of ground penetrating radar (GPR) data. However, training reliable deep learning models requires massive labeled data, which are usually not easy to obtain due to the high costs of data acquisition and field validation. This paper proposes an improved least square generative adversarial networks (LSGAN) model which employs the loss functions of LSGAN and convolutional neural networks (CNN) to generate GPR images. This model can generate high-precision GPR data to address the scarcity of labelled GPR data. We evaluate the proposed model using Frechet Inception Distance (FID) evaluation index and compare it with other existing GAN models and find it outperforms the other two models on a lower FID score. In addition, the adaptability of the LSGAN-generated images for GPR data augmentation is investigated by YOLOv4 model, which is employed to detect rebars in field GPR images. It is verified that inclusion of LSGAN-generated images in the training GPR dataset can increase the target diversity and improve the detection precision by 10%, compared with the model trained on the dataset containing 500 field GPR images.

Although a large number of fish species have been introduced into Guangdong Province in Southern China, a few species, such as tilapia (Tilapia spp.), North African catfish Clarias gariepinus Burchell, mrigal carp, Cirrhinus mrigala (Bloch) and the sucker mouth catfish (Hypostomus sp.), have established natural populations and can be considered “successful invaders” in large rivers. The specific mechanisms underlying these contrasting results among different introduced fish species remain understudied. The relationship between multiple abiotic–biotic factors and the success of four invasive species was investigated using survey data for the Guangdong Province river ecosystem. In contrast to previous studies that have considered species-specific traits, the focus was on economic, ecological and anthropogenic factors to predict invasion success. Four main predictive indicators were found: (1) successful invaders were of low or no commercial value; (2) successful invaders tolerated a wide range of environmental conditions, including poor water quality; (3) biodiversity loss accelerated the growth of non-native populations; (4) human disturbance facilitated population growth and spread of invasive fish species. To lessen the impacts of invasive fish species, the selection of breeding species and breeding areas, maintenance of water quality and reduction in water pollution, protection of the diversity of fish species and reduction of human interference should be addressed.

Background Aortic aneurysm (AA) is a severe complication of Takayasu arteritis (TA). This study aimed to evaluate the prevalence, clinical and imaging features, management and long-term outcomes of AA in patients with TA. Materials and Methods A retrospective study was performed of TA patients with AA admitted to Fuwai Hospital from 1996-2015. Baseline clinical data and follow-up data of TA patients with AA were collected and analyzed. Results Thirty-nine (4.2%) of 934 patients with TA were identified with AA that was related to vasculitis. The mean age at disease onset was 31 ± 10 years, with a female-to-male ratio of 1.79:1. The ascending aorta was the most common site of the aneurysmal lesion (18, 33.3%), and the most frequent manifestations associated with AA were chest tightness (12, 30.8%) and shortness of breath (12, 30.8%), which were usually concomitant with aortic valve insufficiency. Involvement of multiple sites in AA was found in 8 patients (20.5%), and multiple AAs were found in 5 patients (12.8%). No significant difference was observed in clinical and imaging findings between sexes. Of 25 patients (64.1%) with a median 72-month follow-up, 1 patient suffered from heart failure owing to perivalvular leakage, and 1 patient died, possibly related to severe complications of the operation. Conclusions The prevalence of AA is relatively low in Chinese patients with TA. AA seems to develop more frequently in male patients with TA. Management should consider location and size of AA, complexity of vessel lesions and disease status. Long-term follow-up is indispensable.

Background To investigate the association between the coaptation height of mitral valve and mitral regurgitation after mitral valve repair. Methods From Sep 2014 to Jun 2015, 20 patients underwent mitral valve valvuloplasty for mitral regurgitation were included. Ring annuloplasty was performed in all cases. Mitral valve short-axis dimension (MVd), coaptation height (CH), Left ventricular ejection fraction (LVEF) were measured by the transesophageal echocardiography before the operation in operation room and 3 months and 12 months after the operation by the transthoracic echocardiography. A degree from 0 to 4 was used to measure the degree of mitral regurgitation. Results There were 14 patients with 0, 3 patients with 1, 3 patients with 2 of mitral regurgitation 12 months after the operation. CH (3.53 ± 1.91 mm) increased significantly at 3 months (5.05 ± 1.09 mm) and 12 months after operation (5.22 ± 1.15 mm) (p

Background Mechanical heart valve replacement (MHVR) is an effective method for the treatment of severe heart valve disease; however, it subjects patient to lifelong warfarin therapy after MHVR with the attendant risk of bleeding and thrombosis. Whether internet-based warfarin management reduces complications and improves patient quality of life remains unknown. Objective This study aimed to compare the effects of internet-based warfarin management and the conventional approach in patients who received MHVR in order to provide evidence regarding alternative strategies for long-term anticoagulation. Methods This was a prospective, multicenter, randomized, open-label, controlled clinical trial with a 1-year follow-up. Patients who needed long-term warfarin anticoagulation after MHVR were enrolled and then randomly divided into conventional and internet-based management groups. The percentage of time in the therapeutic range (TTR) was used as the primary outcome, while bleeding, thrombosis, and other events were the secondary outcomes. Results A total of 721 patients were enrolled. The baseline characteristics did not reach statistical differences between the 2 groups, suggesting the random assignment was successful. As a result, the internet-based group showed a significantly higher TTR (mean 0.53, SD 0.24 vs mean 0.46, SD 0.21; P Conclusions The internet-based warfarin management is superior to the conventional method, as it can reduce the anticoagulation complications in patients who receive long-term warfarin anticoagulation after MHVR. Trial Registration Chinese Clinical Trial Registry ChiCTR1800016204; http://www.chictr.org.cn/showproj.aspx?proj=27518 International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2019-032949

BACKGROUND: Mid-aortic syndrome (MAS) may induce changes in cardiac structure among patients with Takayasu arteritis (TA). METHODS: Consecutive adult patients with TA (January 1, 2011 to January 1, 2018) were enrolled and their data was retrospectively analyzed. RESULTS: Patients were divided into MAS group (100/457 patients, 21.8%) and non-MAS group (357, 78.1%). The left ventricular mass index (LVMI) was higher in the MAS group than the non-MAS (113.78±26.82 versus 100.74±23.66 g/m(2), respectively; P

Ovarian cancer is prevalent in women which is usually diagnosed at an advanced stage with a high mortality rate. The aim of this study is to investigate protein-coding gene, long non-coding RNA, and microRNA associated with the prognosis of patients with ovarian serous carcinoma by mining data from TCGA (The Cancer Genome Atlas) public database. The clinical data of ovarian serous carcinoma patients was downloaded from TCGA database in September, 2016. The mean age and survival time of 407 patients with ovarian serous carcinoma were 59.71 ± 11.54 years and 32.98 ± 26.66 months. Cox's proportional hazards regression analysis was conducted to analyze genes that were significantly associated with the survival of ovarian serous carcinoma patients in the training group. Using the random survival forest algorithm, Kaplan–Meier and ROC analysis, we kept prognostic genes to construct the multi-dimensional transcriptome signature with max area under ROC curve (AUC) (0.69 in the training group and 0.62 in the test group). The selected signature composed by VAT1L, CALR, LINC01456, RP11-484L8.1, MIR196A1 and MIR148A, separated the training group patients into high-risk or low-risk subgroup with significantly different survival time (median survival: 35.3 months vs. 64.9 months, P < 0.001). The signature was validated in the test group showing similar prognostic values (median survival: 41.6 months in high-risk vs. 57.4 months in low-risk group, P=0.018). Chi-square test and multivariable Cox regression analysis showed that the signature was an independent prognostic factor for patients with ovarian serous carcinoma. Finally, we validated the expression of the genes experimentally.

Background Coronary artery involvement is not a rare presentation of Takayasu arteritis (TA) and the treatment is challenging. The optimal methods of revascularization, and prognosis of treatment have not been established. Objectives To assess the long-term outcomes of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in TA patients. Methods Patients with coronary artery involved in TA who underwent either PCI or CABG were identified between February 2003 and December 2015. The primary outcome was long-term all-cause mortality. Secondary outcomes were myocardial infarction (MI), stroke, and repeat revascularization. Results Thirty-one patients were enrolled (PCI=19 vs. CABG=12). Most of them were female (25, 80.6%) and the mean age was 42.6±13.8years (16–64years). Angina pectoris was the most common initial symptom (26 cases, 83.9%) and concomitant aortic regurgitation was present in 8 (25.8%) patients. Both groups had a low rate of corticosteroids use [4/19 (21.1%) vs. 2/12 (16.7%)]. During the median follow-up of 101months (10–384months), PCI group had a significantly higher incidence of restenosis [12/19(63.2%) vs. 3/12(25%)]. Two patients with severe aortic regurgitation in PCI group suffered from cardiac death during follow-up. Conclusions Coronary artery involvement should be suspected in TA patients with angina pectoris, especially young women. PCI had a very high rate of in-stent restenosis in patients without corticosteroids and CABG may be a preferred treatment option.

Background Information on left ventricular noncompaction (LVNC) in older people is sparse. This study aimed to investigate the clinical profile of LVNC in an older cohort. Materials and Methods Between August 2007 and September 2015, older patients (age ≥ 60 years) who were diagnosed with LVNC using cardiovascular magnetic resonance were prospectively enrolled at our hospital. Results A total of 35 patients (male, 80%; mean age, 65 ± 5 years) were prospectively included in this study. LVNC was not detected in 18 (51%) patients at the initial echocardiographic evaluation. Of the 21 patients who received coronary imaging, 8 (38%) patients had coronary artery disease. Left ventricular (LV) dysfunction and dilation were detected in 31 (89%) and 30 (86%) patients, respectively. Nine (26%) patients died during a follow-up of 2.9 ± 2.3 years. Cox analysis showed that patients with syncope (hazard ratio [HR] = 20.51; 95% CI: 1.70-246.60; P = 0.02), increased LV end-diastolic diameter (HR = 1.12; 95% CI: 1.01-1.24; P = 0.03), decreased LV ejection fraction (HR = 0.87; 95% CI: 0.77-0.98; P = 0.02) and the presence of late gadolinium enhancement on cardiovascular magnetic resonance (HR = 8.9; 95% CI: 1.07-74.08; P = 0.04) had a higher risk for death. Conclusions The diagnosis of LVNC is easily missed at echocardiographic assessment in older patients. Coronary artery disease is a common concomitant disorder in these patients. Older patients with LVNC have a high risk for mortality. Syncope, LV dilation, systolic dysfunction and late gadolinium enhancement are related to adverse outcomes in older patients.