Relationship Between Fasting Blood Glucose and Readmission Within 1 Year in Elderly Patients with Heart Failure.

INTRODUCTION: Elevated blood glucose has been linked to unfavorable outcomes among individuals with heart failure (HF). Nevertheless, evidence is scarce regarding the association between fasting blood glucose (FBG) levels and the likelihood of readmission within one year for elderly patients. To address this gap, a retrospective cohort study was conducted, integrating electronic health records of restricted health data from PhysioNet. METHODS: The study focused on HF patients aged 60 years and older, utilizing baseline data, comorbidities, and laboratory test results as covariates. A total of 374 patients were included in the study. The relationship between 1-year readmission rates and various glucose levels was assessed using Kaplan-Meier plots. The analysis employed three multivariate Cox regression models to examine patients with varying glucose levels. RESULTS: Following adjustments for relevant factors, an association was observed between FBG levels and the rate of readmission in elderly patients with HF (HR=1.0264 [95% CI 0.9994-1.0541]). The diabetes group faced a higher risk of readmission compared to the normal group. However, this difference in outcome events was not statistically significant, with hazard ratios and their corresponding 95% confidence intervals of 1.2134 (0.9811~1.5007), 1.2393 (0.9993~1.5371), and 1.1905 (0.9570~1.4809), respectively. The robustness of the model was further demonstrated through risk models with subgroup analysis, revealing that FBG levels consistently exerted a stable effect on outcome events, unaffected by covariates such as age, gender, body mass index, glomerular filtration rate, and brain natriuretic peptide. CONCLUSION: These findings suggest a notable association between elevated FBG at the time of initial hospitalization and the likelihood of readmission within one year among elderly patients with HF.

Gene-Based Network Analysis Reveals Prognostic Biomarkers Implicated in Diabetic Tubulointerstitial Injury.

Background: Diabetic nephropathy (DN), a significant cause of chronic kidney disease (CKD), is a devastating disease worldwide. Objective: The aim of this study was to reveal crucial genes closely linked to the molecular mechanism of tubulointerstitial injury in DN. Methods: The Gene Expression Omnibus (GEO) database was used to download the datasets. Based on this, a weighted gene coexpression network analysis (WGCNA) network was constructed to detect DN-related modules and hub genes. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichments were performed on the selected hub genes and modules. Least absolute shrinkage and selection operator (LASSO) Cox regression analysis was performed on the obtained gene signature. Results: The WGCNA network was constructed based on 3019 genes, and nine gene coexpression modules were generated. A total of 57 genes, including 34 genes in the magenta module and 23 genes in the purple module, were adapted as hub genes. 61 significantly downregulated and 119 upregulated genes were screened as differentially expressed genes (DEGs). 25 overlapping genes between hub genes chosen from WGCNA and DEG were identified. Through LASSO analysis, a 9-gene signature may be a potential prognostic biomarker for DN. To further explore the potential mechanism of DN, the different immune cell infiltrations between tubulointerstitial samples of DN and healthy samples were estimated. Conclusions: This bioinformatics study identified CX3CR1, HRG, LTF, TUBA1A, GADD45B, PDK4, CLIC5, NDNF, and SOCS2 as candidate biomarkers for the diagnosis of DN. Moreover, DN tends to own a higher proportion of memory B cell.

Molecular Effects of Auto-Antibodies on Angiotensin II Type 1 Receptor Signaling and Cell Proliferation.

The angiotensin II (Ang II) type 1 receptor (AT1R) is involved in the regulation of blood pressure (through vasoconstriction) and water and ion homeostasis (mediated by interaction with the endogenous agonist). AT1R can also be activated by auto-antibodies (AT1R-Abs), which are associated with manifold diseases, such as obliterative vasculopathy, preeclampsia and systemic sclerosis. Knowledge of the molecular mechanisms related to AT1R-Abs binding and associated signaling cascade (dys-)regulation remains fragmentary. The goal of this study was, therefore, to investigate details of the effects of AT1R-Abs on G-protein signaling and subsequent cell proliferation, as well as the putative contribution of the three extracellular receptor loops (ELs) to Abs-AT1R signaling. AT1R-Abs induced nuclear factor of activated T-cells (NFAT) signaling, which reflects Gq/11 and Gi activation. The impact on cell proliferation was tested in different cell systems, as well as activation-triggered receptor internalization. Blockwise alanine substitutions were designed to potentially investigate the role of ELs in AT1R-Abs-mediated effects. First, we demonstrate that Ang II-mediated internalization of AT1R is impeded by binding of AT1R-Abs. Secondly, exclusive AT1R-Abs-induced Gq/11 activation is most significant for NFAT stimulation and mediates cell proliferation. Interestingly, our studies also reveal that ligand-independent, baseline AT1R activation of Gi signaling has, in turn, a negative effect on cell proliferation. Indeed, inhibition of Gi basal activity potentiates proliferation triggered by AT1R-Abs. Finally, although AT1R containing EL1 and EL3 blockwise alanine mutations were not expressed on the human embryonic kidney293T (HEK293T) cell surface, we at least confirmed that parts of EL2 are involved in interactions between AT1R and Abs. This current study thus provides extended insights into the molecular action of AT1R-Abs and associated mechanisms of interrelated pathogenesis.

Single Heterocyclic Compounds as Monoamine Oxidase Inhibitors: From Past to Present.

Inhibitors of monoamine oxidase (MAO) have shown therapeutic values in a variety of neurodegenerative diseases such as depression, Parkinson's disease and Alzheimer's disease. Heterocyclic compounds exhibit a broad spectrum of biological activities and vital leading compounds for the development of chemical drugs. Herein, we focus on the synthesis and screening of novel single heterocyclic derivatives with MAO inhibitory activities during the past decade. This review covers recent pharmacological advancements of single heterocyclic moiety along with structure- activity relationship to provide better correlation among different structures and their receptor interactions.

Modulating mitochondrial morphology enhances antitumor effect of 5-ALA-mediated photodynamic therapy both in vitro and in vivo.

5-aminolevulinic acid mediated PDT (5-ALA-PDT) is an approved therapeutic procedure for treating carcinomas of the cervix. However, when employed as a monotherapy, 5-ALA-PDT could not produce satisfactory results toward large and deep tumors. Therefore, developing a method to improve the efficacy of 5-ALA-PDT becomes important. In this study, we demonstrate an enhanced antitumor effect of 5-ALA-PDT by the modulation of mitochondrial morphology. The mitochondria in the cells were regulated into tubular mitochondria or fragmented mitochondria through over expression of Drp1 or Mfn2. Then these cells were treated with identical dose of 5-ALA-PDT. Our results suggest that HeLa cells predominantly containing fragmented mitochondria were more sensitive to 5-ALA-PDT than the cells predominantly containing tubular mitochondria. The morphology of mitochondria changed as the cell cycle progressed, with tubular mitochondria predominantly exhibited in the S phase and uniformly fragmented mitochondria predominantly displayed in the M phase. Paclitaxel significantly increased the population of M-phase cells, while 5-fluorouracil significantly increased the population of S-phase cells in xenograft tumors. Furthermore, low-dose paclitaxel significantly increased the antitumor effects of PDT. However, 5-fluorouracil didn't improve the antitumor effects of PDT. These results demonstrated an enhanced antitumor effect of 5-ALA-PDT from the modulation of mitochondrial morphology. We anticipate that our results will provide an insight for selecting potential chemotherapeutic agents to combine with PDT for tumor treatment.

In vitro photodynamic inactivation effects of Ru(II) complexes on clinical methicillin-resistant Staphylococcus aureus planktonic and biofilm cultures.

Photosensitizers (PSs) combined with light are able to generate antimicrobial effects. Ru(II) complexes have been recognized as a novel class of PSs. In this study, we investigated the effectiveness of photodynamic inactivation (PDI) mediated by three Ru(II) polypyridine complexes, 1-3, against four isolates of clinical methicillin-resistant Staphylococcus aureus (MRSA-1, MRSA-2, MRSA-3 and MRSA-4). In PDI of a planktonic culture of MRSA-1, compound 3 showed the highest efficacy, likely owing to its advantageous light absorption, (1) O2 quantum yield and bacterial cellular binding. The PDI efficacy of 3 was further evaluated against all other strains and MRSA-1 biofilms. At appropriate PS concentrations, viability reduction of 100% or 96.83% was observed in planktonic or biofilm forms of MRSA, respectively. The mechanisms of action were investigated using negative staining transmission electron microscopy (TEM), confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). It was demonstrated that PDI of planktonic bacteria was achieved primarily through damage to the cell envelope. Biofilms were eliminated through both the destruction of their structure and inactivation of the individual bacterial cells. In conclusion, Ru(II) complexes, especially 3, are potential candidates for the effective photodynamic control of MRSA infections.

Comparison of 5-aminolevulinic acid and its hexylester mediated photodynamic action on human hepatoma cells.

5-Aminolevulinic acid (ALA) is a precursor to heme synthesis pathway and currently used to induce endogenous protoporphyrin IX (PpIX, a potent photosensitizer) for photodynamic therapy of cancer. ALA has, however, a limited ability to cross cellular membranes due to its low lipid solubility. The use of lipophilic ALA esters may increase cellular uptake, which results in an enhanced PpIX synthesis. In the present study, a comparison of ALA and its hexyl ester (He-ALA) was made in the QGY human hepatoma cell line with respect to PpIX production and its photocytotoxicity. The fluorescence emission spectrum of the cells incubated with He-ALA was identical to that of PpIX, indicating that He-ALA could induce PpIX in the cells. Fluorescence images demonstrated that the He-ALA induced PpIX was localized in the cytoplasm of the cells. Moreover, a similar amount of Pp IX was found in the cells incubated with 0.2 mmol/L He-ALA or 2 mmol/L ALA and a similar level of cell survival was reached following light exposure. These results suggest that He-ALA is much more efficient at producing PpIX and photocytotoxicity than ALA itself in the cells.