Clinical and Experimental Study of High Mobility Group Box-2 and Valvular Calcification in Elderly Patients with Degenerative Heart Valve Disease.

INTRODUCTION: The aim of this study was to investigate the relationship between the high mobility group box-2 (HMGB2) and valve calcification in senile degenerative heart valve disease (SDHVD). METHODS: According to the echocardiographic results, patients with calcified heart valves were used as the experimental group and patients without calcified heart valves were used as the control group; blood was drawn for testing, and serum levels of HMGB2 were measured by an enzyme-linked immunosorbent assay. Human heart valve interstitial cells (hVICs) cultured in vitro were randomly divided into two groups. The calcification group was cultured with a medium containing calcification induction solution and cells were induced on days 1, 3, and 5, and the control group was cultured with a standard medium. Expression of bone morphogenetic protein 4 (BMP-4) and HMGB2 in both groups was detected by Western blot. RT-PCR was performed to detect the expression of the HMGB2 gene during calcification. The hVICs were cultured in vitro for 4 days with different concentrations of exogenous HMGB2 (0.01 µg/mL, 0.1 µg/mL, 1 µg/mL, 2 µg/mL), while the control group was cultured with a standard medium and the expression of BMP-4 and NF-κB P65 was detected by Western blot. RESULTS: The serum level of HMGB2 was 7.90 (5.92, 12.39) µg/L, higher than that of 7.06 (5.06, 9.73) µg/L in the valve calcification group in elderly patients with degenerative valve disease (p = 0.005); the differences were statistically significant. In in vitro experiments, the cellular calcification protein BMP-4 and the HMGB2 protein were higher in the calcification group compared to the control group (p < 0.05). Exogenous stimulation of hVICs with HMGB2 was able to upregulate the expression of BMP-4 and NF-κB P65 (p < 0.05). CONCLUSIONS: HMGB2 is correlated with valvular calcification in senile degenerative heart valve disease. The HMGB2 protein may promote the process of SDHVD valve calcification by activating the NF-κB pathway and upregulating the expression of BMP-4.

The relationship between red blood cell distribution width at admission and post-stroke fatigue in the acute phase of acute ischemic stroke.

Introduction: Post-stroke fatigue (PSF) is a common complication in the patients with acute ischemic stroke (AIS). This prospective study aimed to investigate the relationship between red blood cell distribution width (RDW) at admission and PSF in the acute phase. Methods: The AIS patients were enrolled in Nantong Third People's Hospital, consecutively. PSF in the acute phase was scored according to the Fatigue Severity Scale. Levels of RDW were measured at admission. The associations were analyzed using multivariate regression and restricted cubic splines (RCS). Results: From April 2021 to March 2022, a total of 206 AIS patients (mean age, 69.3 ± 10.7 years; 52.9% men) were recruited. After the adjustment for potential confounding factors, RDW at admission remained the independent associated factor with PSF in the acute phase (OR [odds ratio], 1.635; 95% CI [confidence interval], 1.153-2.318; P = 0.006). The linear dose-response associations of RDW with PSF in the acute phase were found, based on the RCS model (P for non-linearity = 0.372; P for linearity = 0.037). These results remained significant in other models. Conclusions: RDW at admission could serve as a novel biomarker of PSF in the acute phase of AIS.

Association between homocysteine levels in acute stroke and poststroke depression: A systematic review and meta-analysis.

BACKGROUND: Homocysteine (Hcy) has been confirmed to be associated with depression, but its relationship with poststroke depression (PSD) remains controversial. So far, there is no meta-analysis of the correlation between Hcy level in acute stroke and PSD. METHODS: A systematic search of a sub-database of studies reporting the level of Hcy in the acute phase of ischemic stroke and PSD as of November 2021 was performed. Data extraction was performed strictly according to the inclusion and exclusion criteria. All data were analyzed using STATA 11.0. The standardized root mean square difference (SMD) and 95% confidence interval (CI) were used to compare continuous variables. RESULTS: A total of 11 studies were included in this study, including 2789 participants. The results of this meta-analysis showed that admission the levels of Hcy were significantly higher in PSD survivors, compared to non-PSD survivors (SMD = 0.37, 95%CI = 0.07-0.66, P ï¼œ .001). Subgroup analysis showed that survivors with PSD diagnosed more than 3 months after stroke had significantly different the levels of from non-PSD survivors (6 months: SMD = 0.61, 95%CI = 0.40-0.82, 9 months: SMD = 1.00, 95%CI = 0.59-1.41). CONCLUSION: The level of Hcy in the acute phase of ischemic stroke is a risk factor for PSD.

Status and determinants of health behavior knowledge among the elderly in China: a community-based cross-sectional study.

BACKGROUND: Limited studies are available on health behavior knowledge among the elderly and the interaction between the elderly and their children living with them. Using a survey of the elderly in the community and their children living with them, we explored the characteristics that determine health behavior knowledge. We also identified the influencing factors affecting such knowledge. The relationship between the health behavior knowledge of the elderly and that of their children was also investigated. METHODS: A total of 1207 elderly people were selected by multistage probability sampling (number of children of the elderly = 201). We used a self-designed behavior knowledge questionnaire (38 questions) to survey the participants. After the 38 questions were answered, the total score was determined. The group with adequate health behavior knowledge (score ≥ 24) and that with inadequate knowledge (score < 24) were distinguished by logistic regression to explain the influencing factors affecting health knowledge. RESULTS: On the basis of the responses to 38 questions in the survey, approximately 46.7% of elderly people were identified as having a good knowledge of health. Knowledge of the proper amount of certain foods and liquids as well as that of psychological disorder among the elderly recorded a low percentage at < 60%. Factors related to health behavior knowledge among the elderly were as follows educational attainment, past occupation, and location of residence. Participants who finished high school or higher had 6, 4, and 3 times greater odds of possessing adequate health knowledge than those who attained below primary school, primary school, and junior high school levels, respectively. Those with experience as administrative and technical personnel, workers, migrant workers, and farmers had 2.5, 2.3, 3.9, and 2.1 times greater odds of possessing adequate health knowledge, respectively, than those who were unemployed. Respondents living in the city had 3.7 times greater odds of possessing adequate health knowledge than those living in the countryside. In the stem family, the health knowledge of the elderly was significantly lower than that of their children (P < 0.001). However, the influence of their children's knowledge upper their elder's was relatively weak. CONCLUSION: The need to improve health behavior knowledge among the Chinese elderly remains high. Medical personnel in the community should provide health education related to proper diet and alcohol intake, as well as psychological health, particularly for those elderly who only reached primary school and below, used to be unemployed, and are living in rural areas. Children of stem families should be guided to enhance their health education and contribute to the health knowledge of their elderly parents.