Clinical characteristics and outcomes of maintenance hemodialysis patients with COVID-19 during the Omicron wave of the pandemic in Beijing: a single center retrospective study.

BACKGROUND: The clinical manifestations and prognosis of hemodialysis patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) during the Omicron wave of the pandemic infection were still unclear. This study investigated the clinical characteristics of patients undergoing maintenance hemodialysis (MHD) infected with it. METHODS: This retrospective single-center study included 151 patients undergoing MHD. Healthcare workers were selected as control group were assessed from December 1, 2022 to March 31, 2023. Clinical data, laboratory test results, treatment protocols, and prognoses were collected and analyzed. RESULTS: The study population included 146 patients with MHD, 93 (63.7%) of whom were infected with SARS-CoV-2. The number of non-severe, severe, and critical cases was 84 (90.3%), 4 (4.3%), and 5 (5.3%), respectively. Six patients (6.5%) died during the study period. The main symptoms of SARS-CoV-2 infection, including fever, cough, and fatigue, were less common in patients with MHD than the controls. During SARS-CoV-2 infection, the C-reactive protein (2.9 vs. 11.8 mg/dl, p < 0.0001) and ferritin levels(257.7 vs. 537 ng/l, p < 0.0001) were elevated. The hemoglobin(113vs 111 g/L, p = 0.0001) and albumin levels(39.4 vs. 36.1 g/L, p < 0.0001) decreased. Generally, it took two months for the hemoglobin levels to recover. Positivity rate for SARS-COV-2 serum immunoglobin G (IgG) antibodies and IgG titers were lower in dialysis patients than the controls. Age was positively associated with disease severity, while age and hyponatremia were associated with death. CONCLUSIONS: Patients with MHD and COVID-19 were primarily classified as non-severe. SARS-CoV-2 infection would soon lead to the increase of inflammation related acute response protein in dialysis patients, and then lead to the decrease of hemoglobin and albumin. About 9.6% in HD patients were severe cases and had poor prognosis. Advanced age and hyponatremia were associated with disease severity and prognosis.

The impact of mindfulness on nurses' perceived professional benefits: the mediating roles of workplace spirituality and work-life balance.

This study delves into the effects of mindfulness on workplace spirituality, work-life balance, and perceived professional benefits among nurses operating in the high-pressure environments of hospitals in Jiangxi Province, China. Utilizing a robust sample of 303 valid questionnaires and employing partial least squares (PLS) analysis, the research uncovers a significant positive relationship between mindfulness and workplace spirituality. Furthermore, it demonstrates how both workplace spirituality and work-life balance serve as crucial mediators in enhancing nurses' perception of their professional benefits. The findings illuminate the potential of mindfulness training in substantially elevating job satisfaction and reducing burnout among nurses. The study not only reinforces the value of mindfulness in the healthcare sector but also advocates for its integration into professional development programs and healthcare policies. By doing so, it aims to bolster the overall wellbeing and professional effectiveness of nurses facing the myriad challenges inherent in demanding healthcare environments. This study contributes to the growing discourse on mindfulness in occupational settings, highlighting its pivotal role in enhancing both the personal wellbeing and professional capabilities of healthcare professionals.

Effects of the Omicron variant of coronavirus disease 2019 on anaemia treatment for patients undergoing peritoneal dialysis.

AIM: Patients undergoing dialysis are at high risk for coronavirus disease 2019 (COVID-19). Haemoglobin (Hb) levels may be changed in patients infected with the Omicron variant of COVID-19 who are undergoing peritoneal dialysis (PD). Therefore, we aimed to explore the effect of anti-anaemia treatment on such patients. METHODS: This study enrolled patients undergoing PD who were infected with the Omicron variant of COVID-19 at our centre between November 2022 and February 2023. We retrospectively analysed changes in Hb levels and explored the effectiveness of roxadustat and recombinant human erythropoietin (rhEPO) for patients infected with the Omicron variant of COVID-19. RESULTS: Among 125 enrolled patients, 83 (66.4%) were infected with the Omicron variant and 75 (90.4%) patients mainly experienced mild or moderate disease. During infection, C-reactive protein (CRP) levels were higher than those before infection (p < .001). Additionally, their CRP levels were negatively correlated with Hb levels (p = .002). However, Hb levels were decreased 1 month after infection (109.61 ± 10.64 g/L vs. 115.69 ± 12.04 g/L; p < .001). The roxadustat treatment group did not exhibit significantly decreased Hb levels 1 month after infection (114.57 ± 14.11 vs. 117.51 ± 10.74 g/L; p = .225). Conversely, the rhEPO treatment group experienced a mild decrease in Hb levels (108.69 ± 11.20 vs. 115.03 ± 12.23 g/L; p = .001). Ferritin levels increased in both groups during infection (p = .495). Two months after infection, ferritin levels (median, 205.0 ng/mL) were significantly decreased compared with during infection (median, 377.4 ng/mL) (p < .001) in the roxadustat treatment group. CONCLUSION: Roxadustat was effective than rhEPO for treating anaemia in patients undergoing PD who were infected with the Omicron variant of COVID-19.

Protein-guided biomimetic nanomaterials: a versatile theranostic nanoplatform for biomedical applications.

Over the years, bioinspired mineralization-based approaches have been applied to synthesize multifunctional organic-inorganic nanocomposites. These nanocomposites can address the growing demands of modern biomedical applications. Proteins, serving as vital biological templates, play a pivotal role in the nucleation and growth processes of various organic-inorganic nanocomposites. Protein-mineralized nanomaterials (PMNMs) have attracted significant interest from researchers due to their facile and convenient preparation, strong physiological activity, stability, impressive biocompatibility, and biodegradability. Nevertheless, few comprehensive reviews have expounded on the progress of these nanomaterials in biomedicine. This article systematically reviews the principles and strategies for constructing nanomaterials using protein-directed biomineralization and biomimetic mineralization techniques. Subsequently, we focus on their recent applications in the biomedical field, encompassing areas such as bioimaging, as well as anti-tumor, anti-bacterial, and anti-inflammatory therapies. Furthermore, we discuss the challenges encountered in practical applications of these materials and explore their potential in future applications. This review aspired to catalyze the continued development of these bioinspired nanomaterials in drug development and clinical diagnosis, ultimately contributing to the fields of precision medicine and translational medicine.

NIR-II light triggered burst-release cascade nanoreactor for precise cancer chemotherapy.

The current strategy of co-delivering copper ions and disulfiram (DSF) to generate cytotoxic CuET faces limitations in achieving rapid and substantial CuET production, specifically in tumor lesions. To overcome this challenge, we introduce a novel burst-release cascade reactor composed of phase change materials (PCMs) encapsulating ultrasmall Cu2-xSe nanoparticles (NPs) and DSF (DSF/Cu2-xSe@PCM). Once triggered by second near-infrared (NIR-II) light irradiation, the reactor swiftly releases Cu2-xSe NPs and DSF, enabling catalytic reactions that lead to the rapid and massive production of Cu2-xSe-ET complexes, thereby achieving in situ chemotherapy. The mechanism of the burst reaction is due to the unique properties of ultrasmall Cu2-xSe NPs, including their small size, multiple defects, and high surface activity. These characteristics allow DSF to be directly reduced and chelated on the surface defect sites of Cu2-xSe, forming Cu2-xSe-ET complexes without the need for copper ion release. Additionally, Cu2-xSe-ET has demonstrated a similar (to CuET) anti-tumor activity through increased autophagy, but with even greater potency due to its unique two-dimensional-like structure. The light-triggered cascade of interlocking reactions, coupled with in situ explosive generation of tumor-suppressive substances mediated by the size and valence of Cu2-xSe, presents a promising approach for the development of innovative nanoplatforms in the field of precise tumor chemotherapy.

Human Serum Albumin Based Nanodrug Delivery Systems: Recent Advances and Future Perspective.

With the success of several clinical trials of products based on human serum albumin (HSA) and the rapid development of nanotechnology, HSA-based nanodrug delivery systems (HBNDSs) have received extensive attention in the field of nanomedicine. However, there is still a lack of comprehensive reviews exploring the broader scope of HBNDSs in biomedical applications beyond cancer therapy. To address this gap, this review takes a systematic approach. Firstly, it focuses on the crystal structure and the potential binding sites of HSA. Additionally, it provides a comprehensive summary of recent progresses in the field of HBNDSs for various biomedical applications over the past five years, categorized according to the type of therapeutic drugs loaded onto HSA. These categories include small-molecule drugs, inorganic materials and bioactive ingredients. Finally, the review summarizes the characteristics and current application status of HBNDSs in drug delivery, and also discusses the challenges that need to be addressed for the clinical transformation of HSA formulations and offers future perspectives in this field.

Tolvaptan for water retention in heart failure: a systematic review.

OBJECTIVE: The purpose of this systematic review is to collect, appraise, and synthesize existing evidence from systematic reviews and meta-analyses (SRs/MAs) on the effectiveness of tolvaptan for water retention in heart failure. METHODS: A comprehensive literature search was performed on PubMed, EMBASE, web of science, Cochrane reviews for SRs/Mas published between the databases' establishment to November 17, 2021. All the records were managed with Endnote 20. Standardized forms were used to extract data. Revman 5.3 was used to make forest plots to show the characteristics of outcomes. The methodological and evidence quality were respectively evaluated by AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews 2) and GRADE (Grading of Recommendation of Assessment, Development, and Evaluation) system. RESULTS: A total of 9 SRs/Mas between 2015 to 2020 met inclusion criteria. Serum sodium concentration and urine output were considered as primary outcomes and body weight change and all-cause mortality as second outcomes. Through conducting forest plots, it appeared that tolvaptan brought more positive effect than conventional therapies. It was pessimistic when it comes to the quality of the 9 studies. all the 9 articles were rated as low-quality because AMSTAR 2 evaluation showed that they each had at least one critical item (items 2, 4, 7, 9, 11, 13 and 15) defect. Besides, every article had a few non-critical item defects too. The result of GRADE assessment was not optimistic, so the overall quality of the evidences was low as well. CONCLUSION: Tolvaptan can be recommended for water retention in HF patients, but more evidence is needed.

Immune-regulating camouflaged nanoplatforms: A promising strategy to improve cancer nano-immunotherapy.

Although nano-immunotherapy has advanced dramatically in recent times, there remain two significant hurdles related to immune systems in cancer treatment, such as (namely) inevitable immune elimination of nanoplatforms and severely immunosuppressive microenvironment with low immunogenicity, hampering the performance of nanomedicines. To address these issues, several immune-regulating camouflaged nanocomposites have emerged as prevailing strategies due to their unique characteristics and specific functionalities. In this review, we emphasize the composition, performances, and mechanisms of various immune-regulating camouflaged nanoplatforms, including polymer-coated, cell membrane-camouflaged, and exosome-based nanoplatforms to evade the immune clearance of nanoplatforms or upregulate the immune function against the tumor. Further, we discuss the applications of these immune-regulating camouflaged nanoplatforms in directly boosting cancer immunotherapy and some immunogenic cell death-inducing immunotherapeutic modalities, such as chemotherapy, photothermal therapy, and reactive oxygen species-mediated immunotherapies, highlighting the current progress and recent advancements. Finally, we conclude the article with interesting perspectives, suggesting future tendencies of these innovative camouflaged constructs towards their translation pipeline.

Effect of injection of different doses of isoproterenol on the hearts of mice.

BACKGROUND: Heart failure (HF) is one of the diseases that seriously threaten human health today and its mechanisms are very complex. Our study aims to confirm the optimal dose ISO-induced chronic heart failure mice model for better study of HF-related mechanisms and treatments in the future. METHODS: C57BL/6 mice were used to establish mice model of chronic heart failure. We injected isoproterenol subcutaneously in a dose gradient of 250 mg/kg, 200 mg/kg, 150 mg/kg, 100 mg/kg and 50 mg/kg. Echocardiography and ELISA were performed to figure out the occurrence of HF. We also supplemented the echocardiographic changes in mice over 30 days. RESULTS: Except group S and group E, echocardiographic abnormalities were found in other groups, suggesting a decrease in cardiac function. Except group S, myofibrolysis were found in the hearts of mice in other groups. Brain natriuretic peptide was significantly increased in groups B and D, and C-reactive protein was significantly increased in each group. CONCLUSION: Our research finally found that the HFrEF mice model created by injection at a dose of 100 mg/kg for 7 days was the most suitable and a relatively stable chronic heart failure model could be obtained by placing it for 21 days.

Phase-change materials-based platforms for biomedicine.

Recently, phase-change materials (PCMs) have gathered enormous attention in diverse fields of medicine, particularly in bioimaging, therapeutic delivery, and tissue engineering. Due to the excellent physicochemical characteristics and morphological characteristics of PCMs, several developments have been demonstrated in the construction of diverse PCMs-based architectures toward providing new burgeoning opportunities in developing innovative technologies and improving the therapeutic benefits of the existing formulations. However, the fabrication of PCM-based materials into colloidally stable particles remains challenging due to their natural hydrophobicity and high crystallinity. This review systematically emphasizes various PCMs-based platforms, such as traditional PCMs (liposomes) and their nanoarchitectured composites, including PCMs as core, shell, and gatekeeper, highlighting the pros and cons of these architectures for delivering bioactives, imaging anatomical features, and engineering tissues. Finally, we summarize the article with an exciting outlook, discussing the current challenges and future prospects for PCM-based platforms as biomaterials.

The impact of chronic pre-dialysis hyponatremia on clinical outcomes in maintenance hemodialysis patients.

OBJECTIVE: Chronic pre-dialysis hyponatremia is not rare in maintenance hemodialysis (MHD) patients. However, the association between chronic pre-dialysis hyponatremia and mortality is uncertain due to multiple potential confounders such as hyperglycemia, fluid overload, and malnutrition. This study aimed to more comprehensively evaluate the association between chronic pre-dialysis hyponatremia and clinical outcomes in MHD patients. METHODS: We analyzed the data of 194 MHD patients with regular real-time measurements of pre-dialysis serum sodium from July 2015 to March 2021. Hyponatremia was defined as SNa ≤ 135 mmol/L and normonatremia as SNa > 135 mmol/L and < 145 mmol/L. We evaluated the association of baseline pre-dialysis serum sodium (SNa) and time-averaged SNa (TASNa) levels with all-cause mortality or new major adverse cardiovascular events (MACE) in MHD patients. Furthermore, the SNa levels were glucose, serum albumin, and fluid overload adjusted. The associations between SNa levels and all-cause mortality or new MACE were analyzed using time-varying Cox regression models. RESULTS: Among the total of 194 patients, 24 patients died and 45 new MACE occurred during a mean 35.2-month follow-up period. The baseline pre-dialysis SNa level was 137.1 ± 2.8 mmol/L (127-144 mmol/L). Kaplan-Meier survival analysis showed that there were no significant differences in all-cause mortality or new MACE between hyponatremia and normonatremia groups according to baseline pre-dialysis SNa or glucose-corrected SNa (gcSNa). The mean values of both TASNa and time-averaged glucose-corrected SNa (TAgcSNa) were 136.9 ± 2.4 mmol/L and 138.3 ± 2.0 mmol/L, respectively. Kaplan-Meier survival analysis showed that patients with pre-dialysis hyponatremia had higher all-cause mortality or new MACE compared with normonatremia patients whether grouped on TASNa or TAgcSNa. Cox models showed an increased risk of all-cause mortality and new MACE in MHD patients with pre-dialysis hyponatremia based on TASNa or TAgcSNa. Even after full adjustment including time-dependent age and dialysis vintage, gender, diabetes, time-averaged weight gain (TAWG), and serum albumin, patients with pre-dialysis hyponatremia based on TASNa (HR 2.89; 95% CI 1.18-7.04; model 3) or TAgcSNa (HR 5.03; 95% CI 1.87-13.57; model 3) had approximately twofold or fourfold greater risk of all-cause mortality, respectively, compared with those with normonatremia. The risk of new MACE was also significantly elevated in patients with pre-dialysis hyponatremia based on TASNa (HR 3.86; 95% CI 2.13-7.01; model 1) or TAgcSNa (HR 2.43; 95% CI 1.14-5.15; model 1). After adjustment for time-dependent age and dialysis vintage, gender, diabetes, TAWG, and serum albumin, patients with pre-dialysis hyponatremia based on TASNa (HR 2.33; 95% CI 1.16-4.68; model 3) had a higher risk of new MACE compared with those with normonatremia. CONCLUSIONS: Pre-dialysis time-averaged hyponatremia is independently associated with increased risks of all-cause mortality or new MACE in MHD patients. The baseline SNa level is not a predictor of clinical outcomes due to its variation over time. Hyperglycemia, fluid overload, and malnutrition do not have a significant impact on the risk association between chronic hyponatremia and all-cause mortality or new MACE in MHD patients.

Network Pharmacology Study on Molecular Mechanisms of Zhishi Xiebai Guizhi Decoction in the Treatment of Coronary Heart Disease.

BACKGROUND: Coronary heart disease is characterized by the formation of arterial plaque. If not taken seriously, it will cause serious consequences such as myocardial infarction and heart failure. Zhishi Xiebai Guizhi Decoction first appeared in "Synopsis of Prescriptions of the Golden Chamber" and is a representative prescription for the treatment of coronary heart disease. This study aims to explain the mechanism of Zhishi Xiebai Guizhi Decoction in the treatment of coronary heart disease through network pharmacology and clinical trials. METHODS: We first identified the core compounds of Zhishi Xiebai Guizhi Decoction and their potential targets through TCMSP. Then, We analyzed the molecular targets of Zhishi Xiebai Guizhi Decoction in coronary heart disease with OMIM and GeneCards databases. After the common targets were screened out, we manage to figure out the pathways of these target genes through STRING. Finally, we verify the treatment results in clinical trials. RESULTS: Through network pharmacology analysis, we discovered that several core compounds of Zhishi Xiebai Guizhi Decoction have anti-inflammatory effects and are of great significance to treatment of cardiovascular diseases. The mechanism may be closely related to PPARγ, inflammation, TNF signaling pathway, AMPK signaling pathway, and PI3K-Akt signaling pathway. Clinical trials have also proved the key role of inflammation. CONCLUSIONS: Zhishi Xiebai Guizhi Decoction may play a role in treating coronary heart disease by activating PPARγ. TNF signaling pathway, AMPK signaling pathway, and PI3K-Akt signaling pathway are potential mechanisms as well. The application of network pharmacology can provide a novel method for the research of Chinese herbal medicine. We hope that Zhishi Xiebai Guizhi Decoction will be recognized as a complementary or alternative treatment for coronary heart disease.

Role of supercritical carbon dioxide (scCO2) in fabrication of inorganic-based materials: a green and unique route.

In recent times, the supercritical carbon dioxide (scCO2) process has attracted increasing attention in fabricating diverse materials due to the attractive features of environmentally benign nature and economically promising character. Owing to these unique characteristics and high-penetrability, as well as diffusivity conditions of scCO2, this high-pressure technology, with mild operation conditions, cost-effective, and non-toxic, among others, is often applied to fabricate various organic and inorganic-based materials, resulting in the unique crystal architectures (amorphous, crystalline, and heterojunction), tunable architectures (nanoparticles, nanosheets, and aerogels) for diverse applications. In this review, we give an emphasis on the fabrication of various inorganic-based materials, highlighting the recent research on the driving factors for improving the quality of fabrication in scCO2, procedures for production and dispersion in scCO2, as well as common indicators utilized to assess quality and processing ability of materials. Next, we highlight the effects of specific properties of scCO2 towards synthesizing the highly functional inorganic-based nanomaterials. Finally, we summarize this compilation with interesting perspectives, aiming to arouse a more comprehensive utilization of scCO2 to broaden the horizon in exploring the green/eco-friendly processing of such versatile inorganic-based materials. Together, we firmly believe that this compilation endeavors to disclose the latent capability and universal prevalence of scCO2 in the synthesis and processing of inorganic-based materials.

Blood Pressure is Associated with Rapid Kidney Function Decline in a Very Elderly Hypertensive Chinese Population.

PURPOSE: In prior analyses, blood pressure (BP) was related to rapid kidney function decline (RKFD). However, studies of this relationship in populations of advanced age are lacking. In the present study, we therefore examined the relationship between BP and RKFD in a population of 284 hypertensive Chinese individuals over the age of 80. PATIENTS AND METHODS: All study participants were diagnosed with hypertension (systolic BP [SBP] 160-200 mmHg; diastolic BP [DBP] <110 mmHg). RKFD was defined based upon a decline in estimated glomerular filtration rate (eGFR) >5mL/min per 1.73 m2 per year during follow-up. The Cox regression models (competing risk models) were used for calculating hazard ratios (HRs) to examine the relationship between SBP, DBP, pulse pressure (PP) and RKFD. RESULTS: Over a 3.3-year median follow-up period, 68 study participants (23.9%) were diagnosed with RKFD, while 35 (12.3%) died. After adjusting for confounding variables, we determined that each 10 mmHg rise in SBP and PP was associated with a 34% and 110% increase, respectively, in RKFD risk (adjusted HR: 1.34, 95% confidence interval [CI]: 1.05-1.71 for SBP, p=0.02; HR: 2.10, 95% CI: 0.87-5.08 for PP, p=0.10). In addition, we determined that each 10 mmHg increase in DBP was linked to a 10% reduction in RKFD risk (adjusted HR: 0.90, 95% CI: 0.70-1.14, p=0.37). CONCLUSION: Our results indicate that SBP, but not DBP or PP, is positively correlated with RKFD risk in a very elderly hypertensive Chinese population.

GFR Estimation Using a Panel of Filtration Markers in Shanghai and Beijing.

RATIONALE & OBJECTIVES: Estimated glomerular filtration rate (eGFR) using creatinine and cystatin C (eGFRcr-cys) may be less accurate compared to measured GFR (mGFR) in China than in North America, Europe, and Australia due to variation across regions in their non-GFR determinants. The non-GFR determinants of ß2-microglobulin (B2M) and ß-trace protein (BTP) differ from those of creatinine and cystatin C. Thus, the average eGFR using all 4 markers (eGFRavg) could be more accurate than eGFRcr-cys in China. STUDY DESIGN: Diagnostic test study. SETTING & PARTICIPANTS: 1,066 participants in Shanghai and Beijing with creatinine and cystatin C and 666 participants with all 4 filtration markers. TESTS COMPARED: Index tests were previously developed equations for eGFR using creatinine, cystatin C, B2M, and BTP and combinations. The reference test was mGFR using plasma clearance of iohexol. We compared the performance of eGFRavg to eGFRcr-cys using the proportion of participants with errors in eGFR >30% of mGFR (1 - P30) and root mean square error (RMSE) of the regression of eGFR on mGFR on the logarithmic scale. We also compared classification and reclassification of mGFR categories using eGFRavg compared to eGFRcr-cys. OUTCOMES: Accuracy was significantly better for eGFRavg (1 - P30 of 10.4% and RMSE of 0.214) compared to eGFRcr-cys (1 - P30 of 13.8% and RMSE of 0.232; P = 0.004 and P = 0.006, respectively). However, improvements in accuracy did not generally translate into significant improvement in classification or reclassification of mGFR categories. LIMITATIONS: Study population may not be generalizable to clinical settings other than large urban medical centers in China. CONCLUSIONS: A panel of endogenous filtration markers including B2M and BTP in addition to creatinine and cystatin C may improve GFR estimation in China. Further study is necessary to determine whether GFR estimation using B2M and BTP can be improved and whether these improvements lead to useful clinical applications.

Electrocardiographic left ventricular hypertrophy and mortality in an oldest-old hypertensive Chinese population.

PURPOSE: Previous studies have identified that electrocardiographic pattern of left ventricular hypertrophy (ECG LVH) is associated with mortality, but studies of its correlation in the oldest-old hypertensive population is extremely limited. We investigated the correlation between ECG LVH and mortality in a hypertensive Chinese population aged 80 years and older. PATIENTS AND METHODS: In this study, we included 284 Chinese participants older than 80 years. All included participants with hypertension (sitting systolic blood pressure [BP] 160 to 200 mmHg; sitting diastolic BP <110 mmHg) were ascertained at the baseline. ECG LVH was defined as a Sokolow-Lyon voltage calculated as the amplitude of SV1+ (max RV5 or RV6) greater than 3.5 mV. We categorized participants into two groups by the status of baseline ECG LVH. We used Cox regression models to calculate hazard ratio (HRs) for mortality due to ECG LVH, including cardiovascular mortality and all-cause mortality. RESULTS: In this study, with a 28-month median follow-up, a total of 35 (12.3%) patients died; 21 of those died due to cardiovascular causes. Compared with participants without ECG LVH, there was an increased risk of cardiovascular mortality in participants with ECG LVH (adjusted HR 4.25 [95% confidence interval [CI], 1.50-12.06]) but ECG LVH did not predict all-cause mortality (adjusted HR 2.31 [95% CI, 0.93-5.72]). CONCLUSION: Our study shows that ECG LVH predicts the risk of cardiovascular mortality in an oldest-old hypertensive Chinese population.

Acupuncture therapy for essential hypertension: a network meta-analysis.

BACKGROUND: To evaluate the efficacy and safety of acupuncture therapies for the treatment of essential hypertension. METHODS: We performed a systematic electronic search of PubMed, Embase, the Cochrane Library, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), and Wan-fang Data Database. The main outcome indicators measured were the amount of major adverse cardiovascular events (MACE), a change of blood pressure, and the response rate. STATA15.0 software was used for the network meta-analysis. RESULTS: A total of 31 trials with 2,649 patients were included. Patients were allocated to 15 kinds of interventions. These including acupuncture types were electroacupuncture, moxibustion, warm needle therapy, sham acupuncture, behavioral therapy, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), calcium channel blocker (CCB), beta-blocker, acupuncture combined ACEI, acupuncture combined CCB, acupuncture combined behavior, electroacupuncture combined CCB, and non-treatment. The results of the network meta-analysis showed that there was no significant clinical or statistic difference in systolic blood pressure (SBP) change magnitude between acupuncture treatment and the other 14 therapies. Moxibustion may be better than acupuncture in reducing diastolic blood pressure (DBP) [mean difference (MD): 15.9, 95% confidence interval (CI): 5.96-25.85]. There was no significant difference in reducing DBP between acupuncture and the other 13 interventions. The effective rate of acupuncture combined with AECI [odds ratio (OR) =7.96, 95% CI: 1.11-56.92] and acupuncture combined with behavioral therapy (OR =3.53, 95% CI: 1.08-11.51) in treating hypertension was better than that of acupuncture alone, and there was no statistically significant difference in the effective rate between acupuncture and the other therapies. CONCLUSIONS: The existing evidence shows that acupuncture could be used for treating hypertension, and it may have the same effects as common medication. However, due to the low qualities of the original studies, the quality of this evidence is poor. Therefore, it is recommended that more scientific research be performed to confirm the efficacy of acupuncture.

A coumarin-based fluorescent probe for hypochlorite ion detection in environmental water samples and living cells.

In this study, we developed a new fluorescent probe (CMM) based on coumarin dye and malononitrile, for highly sensitive and selective detection of hypochlorite ion (ClO-). CMM showed a 45-fold fluorescence enhancement at 459 nm in the presence of ClO- and displayed an excellent selectivity over other competing species. The probe featured a fast response time (<15 s), which could be in favor of the real-time detection towards ClO-. Meanwhile, probe CMM could effectively monitor ClO- in physiological pH condition and the detection limit was estimated to be as low as 5.7 nM. Furthermore, its preeminent recognition properties made the successful application for monitoring ClO- in environmental water samples and labeling ClO- in living biological cells.

Cognitive function and 3-year mortality in the very elderly Chinese population with chronic kidney disease.

BACKGROUND: Cognitive function has been suggested to be correlated with mortality, while studies regarding the association among the very elderly population with chronic kidney disease (CKD) are extremely limited. AIM: To explore the association between cognitive function and mortality among the very elderly Chinese population with CKD. METHODS: This prospective study included 163 Chinese participants aged 80 years or older with CKD. CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2. Cognitive function was evaluated using the mini-mental state examination (MMSE) at baseline. Participants were divided into three groups based on the MMSE score. Cox proportional hazard models were used to assess the contribution of cognitive function to mortality. RESULTS: During a median follow-up of 28 months, 24 (14.7%) participants died, and 14 of the events were cardiovascular death. After making adjustment for potential confounders, every 1-point increase of MMSE score was associated with 29% decreased risk of all-cause mortality (adjusted hazards ratio [HR], 0.71; 95% CI, 0.58-0.87) and 39% decreased risk of cardiovascular mortality (adjusted HR, 0.61; 95% CI, 0.44-0.83). Compared with participants with top category of MMSE score, the adjusted HRs for all-cause mortality and cardiovascular mortality among those with bottom category of MMSE score were 8.18 (95% CI, 2.05-32.54) and 14.72 (95% CI, 1.65-131.16). CONCLUSION: Cognitive function was associated with all-cause mortality and cardiovascular mortality among the very elderly population with CKD.