Assessment of causal associations between obesity and peripheral artery disease: a bidirectional Mendelian randomization study.

Background: Several observational studies have documented a potential link between obesity and peripheral artery disease (PAD), although conflicting findings exist. The causal relationship between obesity and PAD continues to be a subject of ongoing debate in the medical community. Objectives: In this study, we employed a bidirectional Mendelian randomization (MR) analysis to explore the potential causal relationship between obesity and the risk of PAD. Methods: To investigate these causal relationships, we conducted bidirectional MR analysis using publicly available genome-wide association study (GWAS) data. Effect estimates were calculated using the random-effects inverse variance-weighted (IVW) method. Results: We identified eight independent single nucleotide polymorphisms (SNPs) associated with obesity in 218,735 samples involving 16,380,465 SNPs, all of which met the genome-wide significance threshold (p < 5 × 10-8). The IVW analysis indicates a significant positive association between genetic obesity and multiple datasets with PAD as the outcome: Queue-1 (GWAS ID: finn-b-I9_PAD) (OR = 1.138, 95% CI: 1.027-1.261, p = 0.013), Queue-2 (GWAS ID: bbj-a-144) (OR = 1.190, 95% CI: 1.019-1.390, p = 0.028), Queue-3 (GWAS ID: ebi-a-GCST90018670) (OR = 1.174, 95% CI: 1.014-1.360, p = 0.032), and Queue-4 (GWAS ID: ebi-a-GCST90018890) (OR = 1.194, 95% CI: 1.099-1.296, p < 0.001). However, we did not observe a significant genetic-level association between obesity and PAD for Queue-5 (GWAS ID: ukb-d-I9_PAD) (OR = 1.001, 95% CI: 1.000-1.002, p = 0.071). Furthermore, we conducted a reverse causal MR analysis to explore the potential reverse causal relationship between obesity and PAD. This comprehensive analysis did not provide evidence of a reverse causal association between these two factors. Conclusions: In summary, our study offers genetic evidence suggesting a possible causal link between obesity and PAD. While we did not find evidence supporting the "obesity paradox", prudent weight management remains crucial, as lower weight does not necessarily guarantee better outcomes. As with any study, caution is required in interpreting the findings. Further research is essential to assess the clinical relevance of weight in preventing PAD, which could inform the development of more precise intervention strategies.

Assessment of the efficacy of alkaline water in conjunction with conventional medication for the treatment of chronic gouty arthritis: A randomized controlled study.

BACKGROUND: Chronic gouty arthritis, a prevalent metabolic disorder, has prompted interest in the role of diet and lifestyle in its management. This study examines alkaline water as a non-pharmacological adjunct to traditional medicine, hypothesizing its positive effects on uric acid levels and gout symptoms. METHODS: In this research, 400 chronic arthritis patients from Guangdong Hydropower Hospital (September 2021-September 2023) were randomly assigned to groups receiving varying concentrations of alkaline water alongside conventional Western medicine, or Western medicine alone. A 1-year follow-up involved assessments using visual analogue scales, joint swelling scores, functional assessment scales, and biochemical markers (serum uric acid, creatinine, urea nitrogen) for comprehensive evaluation. RESULTS: Pain relief: High-concentration alkaline water significantly reduced VAS pain scores posttreatment (P < .05). Joint swelling: Greatest improvement observed in high-concentration group (P < .001). Daily activity capability: Notable enhancements in daily activity scores in experimental groups (P < .05). Range of joint motion: All groups showed significant improvement posttreatment (P < .05). Inflammatory markers: Experimental groups experienced a notable decrease in C-reactive protein, especially in the low concentration group (P < .001). Erythrocyte sedimentation rate decreases were marginal and not statistically significant (P > .05). Interleukin-1ß and tumor necrosis factor-α levels significantly decreased, particularly in the low concentration group. Serum uric acid levels: Significant reduction in serum uric acid observed in all alkaline water groups (P < .05), contrasting with the control group. CONCLUSION: Alkaline water, particularly at high concentrations, effectively alleviated pain, reduced joint swelling, enhanced daily activities, and improved joint motion in chronic gouty arthritis treatment. It significantly reduced key inflammatory markers (C-reactive protein, interleukin-1ß, tumor necrosis factor-α) and serum uric acid levels, suggesting its potential as a valuable adjunct in gout management. The limited impact on erythrocyte sedimentation rate warrants further investigation.

Exploring the potential causal relationship between gut microbiota and heart failure: A two-sample mendelian randomization study combined with the geo database.

OBJECTIVE: In recent years, researchers have observed a potential association between alterations in gut microbiota and the onset and progression of heart failure. Nevertheless, the causal relationship between gut microbiota and heart failure remains a topic of controversy. This study employed a two-sample Mendelian randomization approach to investigate the causal link between gut microbiota and heart failure. METHOD: We extracted single nucleotide polymorphism (SNPs) data for heart failure (ebi-a-gcst009541) and gut microbiota from the publicly available genome-wide association analysis (GWAS) summary database. The primary analytical method employed was inverse variance weighting (IVW), complemented by validation using MR-PRESSO, weighted median, and MR pleiotropic residual methods. Additionally, gene pleiotropy (MR-Egger), heterogeneity testing, and a "leave-one-out" analysis were conducted to assess the robustness of the findings. Utilizing the limma package, differentially expressed genes (DEGs) from the Gut Microbiota datasets (GSE3586, GSE5406) and Heart Failure datasets (GSE47908, GSE87466) sourced from the Gene Expression Omnibus (GEO) were curated. Subsequent enrichment analysis was conducted using the Cluster Profiler and GO plot packages to validate the MR analysis outcomes. RESULTS: The results of our analysis revealed seven distinct bacterial groups in the intestines that exhibited associations.with.the.risk.of.heart.failure. These.included.class.negativicutes (P = 0.02,OR:1.11,95%CI:1.02,1.21), gene.eubacterium.eligensgroup (P = 0.02,OR:1.10,95%CI:1.01,1.20),gene.eubacteriummoxidoreducensgroup (P = 0.01,OR:1.10,95%CI:1.02,1.19),Order.selenium (P = 0.02,OR:1.11,95%CI:1.02,1.21), gene.familyxiiiucg001 (P = 0.03,OR=1.09.95%CI:1.01,1.19), gene.familyxiiiad3011group (P = 0.03,OR:0.92,95%CI:0.86,0.99), and.gene.anaerostipes (P = 0.00,OR:0.87,95%CI:0.80,0.94). Nevertheless, upon conducting reverse causal MR analysis, no evidence of a causal relationship between heart failure and the aforementioned seven gut microbiota groups was found.Bioinformatics analysis reveals shared DEGs between gut microbiota and heart failure. CONCLUSION: This Mendelian randomization study represents the first endeavor to explore the causal relationship between specific gut microbiota and heart failure. The findings suggest a significant correlation between these seven specific gut microbiota groups and the risk of heart failure, potentially offering valuable insights for heart failure prevention and control efforts.

Efficacy and safety of different traditional Chinese health exercises in patients with coronary heart disease combined with chronic heart failure: A network meta-analysis.

BACKGROUND: Non-pharmacological treatments, particularly TCM health exercises, have garnered attention for their affordability, ease of access, and potential health advantages. Despite this interest, systematic and direct comparative studies assessing the effectiveness and safety of these therapies in patients with CHD-CHF remain scarce. METHODS: This study aimed to compare the efficacy and safety of conventional treatment, conventional treatment integrated with aerobic endurance training, and various TCM health exercises in treating patients with CHD-CHF using NMA. The analysis was designed to provide a reference for developing treatment plans. To achieve this, literature databases were searched for RCTs on different TCM health exercises for CHD-CHF patients up to December 6, 2022. Major outcomes analyzed included NT-proBNP, LVEF, 6-minute walk test, MLHFQ, clinical effectiveness, and adverse event occurrence. The Cochrane risk of bias tool was employed to assess the risk of bias in the included RCT studies. Systematic review with NMA was conducted using RevMan 5.4 and Stata for cumulative ranking, and comparative adjustment funnel plot analysis. RESULTS: Traditional Chinese medicine gong methods included BaDuanJin (A) and TaiChiQuan (B). The NMA and SUCRA results revealed that: A + D and A + C + D were most likely to be the best interventions to improve NT-proBNP; B + D and A + C + D were most likely to be the best interventions to improve LVEF; A + D and A + C + D were the best interventions to improve 6WMT in CHD-CHF patients; B + C + D had the best effect on shrinking LVESD;A + D and B + C + D was likely the best interventions for contracting LVEDD;B + D and A + D were consistent in their capacity to improve MLHFQ in patients with CHD-CHF, but B + D had better efficacy. Unlike A + C + D, B + C + D was the best intervention to improve MLHFQ. In contrast with interventions, including Dand C + D, B + D was the most clinically effective intervention. Unlike interventions including B + C + D, C + D, and D, A + C + D was the most clinically efficient intervention. CONCLUSION: The findings of this NMA showed that traditional Chinese health exercises integrated with conventional treatment are more effective than conventional treatment (D) alone in patients with CHD-CHF, with A + D, B + D, B + C + D, and A + C + D considered potentially optimal treatment interventions.

A nomogramic model for predicting the left ventricular ejection fraction of STEMI patients after thrombolysis-transfer PCI.

Background: The prognosis of ST-segment elevation myocardial infarction (STEMI) is closely linked to left ventricular ejection fraction (LVEF). In contrast to primary percutaneous coronary intervention (PPCI), thrombolysis-transfer PCI (TTPCI) is influenced by multiple factors that lead to heterogeneity in cardiac function and prognosis. The aim of this study is to develop a nomogram model for predicting early LVEF in STEMI patients with TTPCI, based on routine indicators at admission. Method: We retrospectively reviewed data from patients diagnosed with STEMI at five network hospitals of our PCI center who performed TTPCI as door-to-balloon time (the interval between arrival at the hospital and intracoronary balloon inflation) over 120 min, from February 2018 to April 2022. Categorical variables were analyzed using Pearson χ2 tests or Fisher exact tests, while Student's t-test or Mann-Whitney U-test was used to compare continuous variables. Subsequently, independent risk factors associated with reduced LVEF one week after TTPCI were identified through comprehensive analysis by combining All-Subsets Regression with Logistic Regression. Based on these indicators, a nomogram model was developed, and validated using the area under the receiver operating characteristic (ROC) curve and the Bootstrap method. Results: A total of 288 patients were analyzed, including 60 with LVEF < 50% and 228 with LVEF ≥ 50%. The nomogram model based on six independent risk factors including age, heart rate (HR), hypertension, smoking history, Alanine aminotransferase (ALT), and Killip class, demonstrated excellent discrimination with an AUC of 0.84 (95% CI: 0.78-0.89), predicted C-index of 0.84 and curve fit of 0.713. Conclusions: The nomogram model incorporating age, HR, hypertension, smoking history, ALT and Killip class could accurately predict the early LVEF ≥ 50% probability of STEMI patients undergoing TTPCI, and enable clinicians' early evaluation of cardiac function in STEMI patients with TTPCI and early optimization of treatment.

Study on Morphology, Microstructure and Properties of 6063-T6 Aluminum Alloy Joints in MIG Welding.

In this paper, a metal inert gas (MIG) shielded welding method was used for high-quality welding of 6063-T6 aluminum alloy sheet with a thickness of 2.5 mm. The welding process of MIG welding was accurately simulated and the welding temperature field and thermal cycle curve were calculated using a combination of Gaussian body heat source and double ellipsoidal heat source. As the welding current increased from 75 A to 90 A, the reinforcing phase precipitated under the microstructure of the joint gradually became larger and re-solidified into the body, resulting in a reduction in mechanical properties. When the welding current is 85 A, the pitting resistance of weld forming and weld area reaches its optimum. At this time, the tensile strength of the joint is up to 110.9 MPa, the elongation is up to 16.3% and the Vickers Microhardness is up to 46.9 HV.

Effectiveness and safety of electroacupuncture combined with conventional drugs in the treatment of stable angina pectoris in coronary artery disease: A systematic evaluation and meta-analysis.

BACKGROUND: The objective of this study is to systematically evaluate the clinical effectiveness and safety of electroacupuncture combined with conventional drugs in the treatment of stable angina pectoris. METHODS: Computer searches of 3 Chinese literature databases (CNKI, VIP, WangFang) and 4 English literature databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science), all searched from the time of database construction to October 2022. Two researchers were selected to independently perform literature screening, data extraction, and risk of bias evaluation, and meta-analysis of the included studies was performed using RevMan 5.3 software. RESULTS: A total of 7 publications with a total of 1042 patients were included, and electroacupuncture combined with conventional drug therapy compared with drug therapy alone was effective in improving clinical symptoms of angina pectoris (relative risk [RR] = 1.19, 95% CI = [1.09, 1.31], P = .0002), clinical treatment efficiency of electrocardiography (RR = 1.34, 95% CI = [1.19, 1.50], P = .00001), visual analog score (VAS) (mean deviation = 0.07, 95% CI = [-0.11, 0.25], P = .44), and Seattle Angina Scale (mean deviation = 4.91, 95% CI = [2.91, 6.91], P < .00001) were better than conventional drug therapy, while the number of adverse events in the intervention group was lower than that in the control group. One of the outcome indicators with greater heterogeneity was tested by sensitivity analysis, and each outcome indicator was found to be more robust. The risk of bias evaluation of each outcome indicator using funnel plots suggested the possibility of publication bias. CONCLUSION: The current study results found that electroacupuncture combined with conventional drugs can significantly improve the clinical symptoms of patients with stable angina pectoris compared with conventional drug therapy, with a low incidence of adverse reactions, but the number of high-quality literature with rigorous study design protocols is currently low, which may cause bias in the results of this study, so the above conclusions need to be further verified through clinical trials.

Morphology, Microstructure, and Mechanical Properties of S32101 Duplex Stainless-Steel Joints in K-TIG Welding.

In this paper, the S32101 duplex stainless steel welded joints were produced by a K-TIG welding system. The weld geometry parameters under different welding speeds were analyzed by combining the morphological characteristics of the keyhole. The microstructure and impact toughness of the base metal and weld metal zone under different welding speeds were studied. The experiment results show that the welding speed has quite an effect on the geometry profile of the weld. In addition, the characteristic parameters of the keyhole can effectively predict the geometry profile of the weld. The test results prove that the microstructure, Σ3 coincidence site lattice grain boundary, and phase boundary of ferrite and austenite have an effect on the impact property of the weld metal zone. When the proportion of the austenite, Σ3 coincidence site lattice grain boundary and random phase boundary increased, the impact property of the weld metal zone also increased.

Influence of Different Welding Parameters on the Morphology, Microstructure, and Mechanical Properties of 780 Duplex-Phase Steel Laser Lap Welded Joint.

This paper attempted to establish a relationship between the morphology, microstructure and mechanical properties of a laser lap welded joint (WJ) of 780 duplex-phase (DP) steel under different welding parameters. The experimental results showed that the microstructure of the heat-affected zone (HAZ) of all the WJs were tempered martensite and equiaxed ferrite. The microstructure at the fusion zone (FZ) in all the WJs was dominated by lath martensite and ferrite, and the grain size of the FZ was larger than that in the base materials (BMs). The mechanical properties of the welded joints were tested by a universal testing machine, and the changing law of lap tensile resistance with the laser-welding parameters was analyzed. The results show that there was a linear relationship between the width of the weld and the tensile-shear forces of the weld, and the penetration of the weld had no obvious effect on the tensile-shear forces of the weld. A binary linear-regression equation was established to reveal the degree of influence of welding speed and laser power on the mechanical properties of WJs. It was found that the laser power had a greater influence on the mechanical properties of WJs than the welding speed.

The Microstructure and Pitting Corrosion Behavior of K-TIG Welded Joints of the UNS S32101 Duplex Stainless Steel.

In this paper, the microstructure and pitting corrosion resistance of S32101 duplex stainless steel keyhole tungsten inert gas welded joints with different heat inputs were studied. The electrochemical experiments were conducted in a 1 mol/L NaCl solution at room temperature. The pitting rupture potential of the heat affected zone and the weld metal zone under different heat inputs were tested. The research showed that with the increase of heat inputs, more ferrite was converted to austenite and the number and size of intragranular austenite grains in the weld metal zone increased. The austenite content of the heat affected zone and the weld metal zone increase with the increase of heat inputs, and the CrN and Cr2N in the heat affected zone and the weld metal zone were mainly precipitated in the ferrite, in the austenite and ferrite/austenite interfaces. The pitting rupture potential value of the heat affected zone and the weld metal zone were increased with the increase of heat inputs, and the pitting corrosion resistance of the heat affected zone and weld metal zone were also increased with the increase of heat inputs. The relationship between the position CrN and Cr2N, the austenite content and the pitting corrosion resistance were elucidated, and the initiation mechanism of the pitting was investigated. Additionally, in this work, the heat affected zone and weld metal zone made at 2.46 kJ/mm heat inputs had the best pitting corrosion resistance. The research results provided useful information for improving the pitting corrosion resistance of S32101 duplex stainless steel keyhole tungsten inert gas welded joints.

Influence of Welding Speeds on the Morphology, Mechanical Properties, and Microstructure of 2205 DSS Welded Joint by K-TIG Welding.

In this paper, 8.0 mm thickness 2205 duplex stainless steel (DSS) workpieces were welded with a keyhole tungsten inert gas (K-TIG) welding system under different welding speeds. After welding, the morphologies of the welds under different welding speed conditions were compared and analyzed. The microstructure, two-phase ratio of austenite/ferrite, and grain boundary characteristics of the welded joints were studied, and the microhardness and tensile properties of the welded joints were tested. The results show that the welding speed has a significant effect on the weld morphology, the two-phase ratio, grain boundary misorientation angle (GBMA), and mechanical properties of the welded joint. When the welding speed increased from 280 mm/min to 340 mm/min, the austenite content and the two-phase ratio in the weld metal zone (WMZ) decreased. However, the ferrite content in the WMZ increased. The proportion of the Σ3 coincident site lattice grain boundary (CSLGB) decreased as the welding speed increased, which has no significant effect on the tensile strength of welded joints. The microhardness of the WMZ and the tensile strength of the welded joint gradually increased when the welding speed was 280-340 mm/min. The 2205 DSS K-TIG welded joints have good plasticity.