Association of Postoperative Atrial Fibrillation Duration after Coronary Artery Bypass Grafting with Poor Postoperative Outcomes.

Background: Postoperative atrial fibrillation (POAF) has long been associated with poor perioperative outcomes after coronary artery bypass grafting (CABG). In this study, we aimed to investigate the effect of prolonged POAF durations on perioperative outcomes of CABG. Methods: This retrospective cohort study examined CABG patients enrolled at Beijing Anzhen Hospital from January 2018 to September 2021. We compared patients with POAF durations ≥ 48 hours to patients with POAF durations < 48 hours. Primary outcomes were in-hospital mortality, stroke, acute respiratory failure (ARF), acute kidney injury (AKI), and significant gastrointestinal bleeding (GIB); secondary outcomes were postoperative length of stay (LOS) and intensive care unit (ICU) duration. Associations between primary outcomes and POAF duration were determined using logistic regression and restricted cubic spline analyses. Differences in baseline characteristics were controlled using propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). Results: Out of 11,848 CABG patients, 3604 (30.4%) had POAF, while 1131 (31.4%) had it for a duration of ≥ 48 hours. ARF (adjusted odds ratio [OR]: 2.96, 95% confidence interval [CI]: 1.47-6.09), AKI (adjusted OR: 2.37, 95% CI: 1.42-3.99), and significant GIB (adjusted OR: 2.60, 95% CI: 1.38-5.03) were associated with POAF durations ≥ 48 hours; however, neither in-hospital mortality (adjusted OR: 1.60, 95% CI: 0.97-2.65) nor stroke (adjusted OR: 1.28, 95% CI: 0.71-2.34) was. These results remained even following PSM and IPTW analyses. Conclusions: POAF durations longer than 48 hours were independently associated with poorer perioperative recovery from CABG, with respect to the occurrence of ARF, AKI, and GIB, as well as a longer postoperative LOS and ICU duration. However, it was not associated with greater in-hospital mortality or stroke occurrence. All these findings suggest that postoperative monitoring of POAF and positive intervention after detection may be more helpful in optimizing post-CABG patient outcomes.

Calcium promotes vascular smooth muscle cell phenotypic switching in Marfan syndrome.

Fibrillin 1 (Fbn1) mutations cause Marfan syndrome (MFS), with aortic root dilatation, dissection, and rupture. Few studies reported the blood calcium and lipid profile of MFS, and the effect of vascular smooth muscle cell (VSMC) phenotypic switching on MFS aortic aneurysm is unclear. Here, we aimed to investigate the role of calcium-related VSMC phenotypic switching in MFS. We retrospectively collected MFS patients' clinical data, performed bioinformatics analysis to screen the enriched biological process in MFS patients and mice, and detected markers of VSMC phenotypic switching on Fbn1C1039G/+ mice and primary aortic vascular smooth muscle cells. We found that patients with MFS have elevated blood calcium levels and dyslipidemia. Furthermore, the calcium concentration levels were increased with age in MFS mice, accompanied by the promoted VSMC phenotypic switching, and SERCA2 contributed to maintaining the contractile phenotype of VSMCs. This study provides the first evidence that the increased calcium is associated with the promoted VSMC phenotype switching in MFS. SERCA may become a novel therapeutic target for suppressing aneurysm progression in MFS.

Predictive Value of the CT-Based Visceral Adiposity Tissue Index and Triglyceride-Glucose Index on New-Onset Atrial Fibrillation after Off-Pump Coronary Artery Bypass Graft: Analyses from a Longitudinal Study.

Background: The visceral-adiposity-tissue index (VATI) and the triglyceride-glucose (TyG) index were found to be correlated with an increased risk of cardiovascular events. However, data concerning the association between the visceral adiposity/TyG indexes and the complication of new-onset postoperative atrial fibrillation (POAF), especially in patients who had just undergone off-pump coronary artery bypass grafting (OPCABG), are rare. We explored the predictive value of the computed-tomography-based VATI and the TyG index on new-onset POAF after OPCABG. Methods: This study used longitudinal data from the cohort of 542 participants who underwent OPCABG in Beijing Anzhen Hospital since June 2017. The predictive relevance of the VATI and TyG index were evaluated through Cox proportional hazards models and receiver operating characteristic (ROC) curves. The dose‒response relationship of the VATI and TyG index with new-onset POAF was analyzed by multiple-adjusted spline regression models, and sensitivity analysis was used to explore the stability of our findings. Results: The analysis found that the highest tertile of VATI [hazard ratio (HR) 2.58, 95% confidence interval (CI) 1.12-3.45; p = 0.01] and TyG index (HR 2.88, 95% CI 1.76-4.71; p = 0.01) were significantly associated with new-onset POAF compared to the lowest tertile after full adjustment for age, sex, body mass index, c-reactive protein levels, diabetes, emergency operation, New York Heart Association (NYHA) III-IV, and left atrial diameter. The area under the ROC curve (AUC) was 0.897 (p < 0.001) and 0.878 (p < 0.001) for the VATI and TyG index, respectively. In addition, the multiple-adjusted spline regression models showed a nonlinear relationship between new-onset POAF and VATI and TyG index (p for nonlinearity < 0.001). Sensitivity analyses confirmed that the results were similar for most tertiles. Conclusions: The VATI and TyG index were significantly associated with an increased risk for the development of new-onset POAF after OPCABG. Clinical Trial Registration: NCT03729531, https://beta.clinicaltrials.gov/study/NCT03729531.

Rationale and design of a randomized trial of the dapagliflozin evaluation on atrial fibrillation patients followed Cox-Maze IV: the DETAIL-CMIV study.

AIMS: Dapagliflozin has been widely used for the treatment of type 2 diabetes mellitus (T2DM) and heart failure (HF). However, data concerning the association between dapagliflozin and the recurrence of atrial fibrillation (AF), especially in patients following Cox-Maze IV (CMIV), are rare. We aim to explore the effect of dapagliflozin on the recurrence of AF after CMIV with and without T2DM or HF. METHODS AND RESULTS: The study of dapagliflozin evaluation in AF patients followed by CMIV (DETAIL-CMIV) is a prospective, double-blind, randomized, placebo-controlled trial. A total of 240 AF patients who have received the CMIV procedure will be randomized into the dapagliflozin group (10 mg/day, n = 120) and the placebo group (10 mg/day, n = 120) and treated for 3 months. The primary endpoint is any documented atrial tachyarrhythmia (AF, atrial flutter or atrial tachycardia) lasting 30 s following a blanking period of 3 months after CMIV. CONCLUSION: DETAIL-CMIV will determine whether the sodium-glucose cotransporter-2 inhibitor dapagliflozin, added to guideline-recommended post-operative AF therapies, safely reduces the recurrence rate of AF in patients with and without T2DM or HF.

Detection of Various Microplastics in Patients Undergoing Cardiac Surgery.

Microplastics have been detected in human stool, lungs, and placentas, which have direct exposure to the external environment through various body cavities, including the oral/anal cavity and uterine/vaginal cavity. Crucial data on microplastic exposure in completely enclosed human organs are still lacking. Herein, we used a laser direct infrared chemical imaging system and scanning electron microscopy to investigate whether microplastics exist in the human heart and its surrounding tissues. Microplastic specimens were collected from 15 cardiac surgery patients, including 6 pericardia, 6 epicardial adipose tissues, 11 pericardial adipose tissues, 3 myocardia, 5 left atrial appendages, and 7 pairs of pre- and postoperative venous blood samples. Microplastics were not universally present in all tissue samples, but nine types were found across five types of tissue with the largest measuring 469 µm in diameter. Nine types of microplastics were also detected in pre- and postoperative blood samples with a maximum diameter of 184 µm, and the type and diameter distribution of microplastics in the blood showed alterations following the surgical procedure. Moreover, the presence of poly(methyl methacrylate) in the left atrial appendage, epicardial adipose tissue, and pericardial adipose tissue cannot be attributed to accidental exposure during surgery, providing direct evidence of microplastics in patients undergoing cardiac surgery. Further research is needed to examine the impact of surgery on microplastic introduction and the potential effects of microplastics in internal organs on human health.

The prognostic role of tumor size in stage T1 gastric cancer.

BACKGROUND: The purpose was to assess the contribution of tumor size to the prognosis of patients with gastric cancer. METHODS: Patient data were sourced from the Surveillance, Epidemiology, and End Results program (SEER) database. Cox proportional risk regression was performed to determine the prognostic role of tumor size. Kaplan-Meier curves were conducted to calculate survival curves. Consistency index (c-index) and subject exercise curve (ROC) were utilized to assess the predictive ability of each factor on the prognosis of gastric cancer. RESULTS: Tumor size is preferable to other widely accepted prognostic clinical features in forecasting the survival of patients with gastric cancer. CONCLUSIONS: The discriminatory ability of tumor size at T1 stage is superior to many other clinical prognostic factors.

Prognostic significance of combined α-fetoprotein and CA19-9 for hepatocellular carcinoma after hepatectomy.

BACKGROUND: The prognosis of hepatocellular carcinoma (HCC) varies considerably among patients with the same disease stage and characteristics, and only about two thirds show high levels of α-fetoprotein (AFP), a common prognostic indicator for HCC. Here, we assessed whether the combination of presurgical serum levels of AFP and carbohydrate antigen 19-9 (CA19-9) can predict the prognosis of HCC patients after hepatectomy. METHODS: The clinicopathological characteristics and post-hepatectomy outcomes of 711 HCC patients were retrospectively reviewed. The patients were classified into three groups based on whether their preoperative serum levels of both AFP and CA19-9 were higher than the respective cut-offs of 400 ng/ml and 37 U/ml [double positive (DP)], the level of only one marker was higher than the cut-off [single positive (SP)], or neither level was higher than the cut-off [negative (N)]. The overall survival (OS) and recurrence-free survival (RFS) rates were estimated using Kaplan-Meier curves. Univariate and multivariate survival analyses were performed to identify the clinicopathological factors significantly associated with HCC prognosis. RESULTS: The 1-year, 3-year, and 5-year RFS and OS rates in the N group were significantly higher than those in the SP group, while the DP group showed the lowest rates. Multivariate Cox regression analysis showed that large tumor size (> 5 cm), multiple tumors (≥ 2), incomplete tumor capsule, positive microvascular invasion, Barcelona Clinic Liver Cancer C stage, and CA19-9 level > 37 U/mL were independent risk factors for RFS and OS in HCC patients. Moreover, aspartate aminotransferase levels > 40 U/L proved to be an independent prognostic factor for OS. CONCLUSION: The combination of serum AFP and CA19-9 levels may be a useful prognostic marker for HCC patients after hepatectomy.

Surface Engineering of Antisymmetric Linear Magnetoresistance and Spin-Polarized Surface State Transport in Dirac Semimetals.

Topological materials that possess spin-momentum locked surface states provide an ideal platform to manipulate the quantum spin states by electrical means. However, an antisymmetric magnetoresistance (MR) superimposed on the spin-polarized transport signals is usually observed in the spin potentiometric measurements of topological materials, rendering more power loss and reduced signal-to-noise ratio. Here we reveal the mechanism of surface-bulk interaction for the observed antisymmetric linear MR in the spin transport of Dirac semimetal Cd3As2 nanoplates. The antisymmetric linear MR can be eliminated through sample surface modifications. As a consequence, clean signals of charge current induced spin-polarized transport are observed, robust up to room temperature. The purification of spin signals can be attributed to the isolation of surface and bulk transport channels via forming a charge depletion layer with surface modifications. This surface engineering strategy should be valuable for high-performance spintronic devices on topological materials.

Survival of Tricuspid Valve Replacement in Patients With Previous Tricuspid Valve Surgery.

OBJECTIVES: This study was performed to investigate the short-term and long-term survival of patients who underwent reoperative tricuspid valve replacement (TVR). METHODS: A retrospective analysis was performed of 273 patients who underwent TVRs while hospitalised in Beijing Anzhen Hospital from November 1993 to August 2018. Fifty-six (56) of them underwent reoperative TVR: 36 had previous tricuspid valve repair and 20 had previous TVR. Follow-up was 100% complete, with a mean follow-up of 8 years (range, 1-15 years). RESULTS: The overall in-hospital mortality was 17.9% (n=10). In the univariate analysis, the overall in-hospital mortality and renal failure rate in the replacement group were lower than those in the repair group (5.0% vs 25%; p=0.046 and 27.8% vs 5%; p=0.040). However, in-hospital mortality was no longer statistically significant after multivariate adjustment (adjusted OR 0.318; 95% CI 0.030-3.338; p=0.340). There was no significant difference in survival between the patients with previous repair and those with previous replacement (log-rank test, p=0.839). Factors that correlated with long-term mortality on multivariate analysis were age >60 years (adjusted HR 11.753; 95% CI 1.686-81.915; p=0.013); cardiopulmonary bypass time (adjusted HR 1.019; 95% CI 1.005-1.034; p=0.009); intensive care unit time (adjusted HR 1.024; 95% CI 1.006-1.042; p=0.009); and ventilation time (adjusted HR 0.982; 95% CI 0.965-0.998; p=0.030). CONCLUSIONS: Reoperative TVR was associated with high in-hospital mortality and morbidity. Overall in-hospital mortality was similar between the previous replacement group and the previous repair group. Previous tricuspid valve repair and replacement had similar long-term survival.

A New Parameter, the Smallest Oblique Sagittal Area of the Neural Foramen, as an Index to Diagnose Cervical Neural Foramen Stenosis.

OBJECTIVE: The objective was to reconstruct the cervical neural foramen and accurately measure the minimum oblique sagittal area of the neural foramen. Then, a quantitative diagnostic standard for cervical neural foramen stenosis was proposed and its value as an indication for surgery was evaluated. METHODS: (1) CT data were used to reconstruct the neural foramen using Mimics software, and the minimum area was measured. (2) The optimal cut-off value was determined using a receiver operating characteristic (ROC) curve. (3) Patients who underwent single-segment surgery were divided into 2 groups according to the cut-off value. Then the postoperative neurological function improvement rate was analyzed to identify any significant difference between the 2 groups. RESULTS: A total of 1056 neural foramens were measured in 132 patients, of which 495 (46.88%) were diagnosed as radiculopathy by clinical neurological examination. The optimal cut-off value determined by the ROC curve was 25.95 mm2 (sensitivity 74.1%, specificity 80.9%) and the area under the curve (AUC) was 0.827 (95%CI: 0.803-0.849). There was a significant difference in the neurological function improvement rate between the 2 groups after surgery (P < 0.05). The intraclass correlation coefficient (ICC) was 0.969. CONCLUSION: Three-dimensional digital simulation reconstruction of CT data is a good measurement method. The optimal cut-off value determined here not only has a certain reference value for the diagnosis of cervical neural foramen bony stenosis, but also helps to select patients suitable for neural foramen decompression and can be used as a reference for surgical indication.

Comparison of three treatment methods for simple bone cyst in children.

BACKGROUND: The unicameral bone cyst (UBC) is a kind of benign tumor whose clinical treatments and efficacy are controversial. The purpose of this study was to evaluate the efficacy of the elastic stable intramedullary nail (ESIN), the injection of autologous bone marrow (ABM), and the combination of ESIN and ABM in the treatment of bone cyst in children. METHODS: Eighty-three cases with simple bone cyst were analyzed retrospectively. Twenty-eight cases were treated with ABM. Twenty-eight cases were treated with ESIN. Twenty-seven cases were treated with ABM and ESIN. All cases were diagnosed through X-ray, CT, or MRI scans. For the suspicious ones, the pathological biopsy was performed for an accurate diagnosis. X-ray examinations were carried out for the postoperative follow-up. Capanna criteria for bone cyst was used for postoperative evaluation of three methods. RESULTS: All cases accomplished the follow-up. The effective rate of the ABM + ESIN group was significantly higher than that of the ABM group (P < 0.05), and the cure rates of the ESIN group and the ABM + ESIN group were higher than that of the ABM group (P < 0.05, respectively). The cure time in the ESIN group was lower than that of the other two groups (P < 0.05, respectively). The times for admission were 2.0 ± 0.0 in the ESIN group, 5.7 ± 1.9 in the ABM group, and 4.7 ± 2.4 in the ABM + ESIN group (P < 0.05 when compared with each other). CONCLUSIONS: The method of ABM combined with ESIN for children's bone cyst has the highest effective rate and curative rate. For the individual method, ESIN has a higher effective rate and curative rate than that of ABM. Meanwhile, it has the fewest time of hospitalization.

Diagnostic Performance of Single-Photon Emission Computed Tomography/Computed Tomography in Aseptic Loosening: A Systematic Review and Meta-Analysis.

BACKGROUND: The aim of this study is to evaluate the diagnostic value and clinical applicability of single-photon emission computed tomography/computed tomography (SPECT/CT) in aseptic loosening (AL) of prostheses by meta-analysis. METHOD: Literature on the diagnostic value of SPECT/CT in AL of prostheses was obtained by computer and manual review. The quality of the included studies was evaluated according to the Quality Assessment Diagnostic Accuracy Studies 2. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and other indicators were calculated, and a forest map and summary receiver operating characteristic were drawn to calculate the area under the curve. Meta-regression analysis was performed to identify the sources of heterogeneity and corresponding subgroup analysis was performed. A Fagan plot, likelihood ratio point plot, and Deek's funnel plot were drawn and analyzed. RESULTS: A total of 15 studies were included. The meta-analysis results showed that the pooled sensitivity and specificity of SPECT/CT for the diagnosis of aseptic prosthetic loosening were 0.94, 95% confidence interval [CI] (0.90-0.96) and 0.89, 95% CI (0.78-0.95), respectively while the pooled positive likelihood ratio and pooled negative likelihood ratio were 8.65, 95% CI (4.18-17.90) and 0.07, 95% CI (0.04-0.11), respectively. The pooled diagnostic odds ratio was 130.36, 95% CI (45.18-376.19), and the area under the curve was 0.97, 95% CI (0.95-0.98). CONCLUSION: As a diagnostic method for AL, SPECT/CT has high diagnostic sensitivity and specificity as well as high diagnostic efficiency. It has good clinical application value and should be a primary choice in the diagnosis of AL after joint replacement.

Long-Term Survival and Risk Factors for Post-Infarction Ventricular Septal Rupture.

BACKGROUND: This study was performed to assess long-term survival and identify risk factors for acute myocardial infarction in patients complicated with ventricular septal rupture (VSR). METHOD: A retrospective analysis of 116 patients with post-infarction VSR (PI-VSR) hospitalised in Beijing Anzhen Hospital from January 2008 to February 2019 was performed. The independent risk factors for in-hospital mortality were assessed using multivariate analysis with a logistic regression model. The Kaplan-Meier method and log-rank test were carried out for long-term survival in the surgery group. RESULTS: The overall in-hospital mortality rate was 47.4%. Logistic regression analysis revealed that age (p<0.05), female sex (p<0.05), no surgical repair (p<0.05), liver dysfunction (p<0.05), high heart rate (p<0.05), and low platelet count (PLT; p<0.05) were independent risk factors for in-hospital mortality. The 1-year mortality rate was lower in the surgery group than in the medical treatment group (18.3% vs 84.5%; p<0.005). During the mean follow-up of 5.2±5.1 years (median, 1.3 years), the actuarial survival rates of these patients at 5 and 10 years were 72.3% and 43.2%, respectively. CONCLUSIONS: The overall in-hospital mortality rate remained high. The independent risk factors for in-hospital mortality associated with PI-VSR were age, female sex, no surgical repair, liver dysfunction, tachycardia, and low PLT level. The 1-year mortality and long-term outcomes of patients treated with surgery were significantly better than those of patients who were treated conservatively.

[Short-term and long-term outcomes of tricuspid valve replacement in patients with left ventricular dysfunction].

Objective: To examine the short-term and long-term outcomes of tricuspid valve replacement (TVR) in patients with left ventricular dysfunction. Methods: The clinical data of 24 patients with left ventricular dysfunction who received TVR at Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University from November 1993 to August 2018 were consecutively enrolled. There were 14 males and 10 females,aged (41.9±13.2) years old (range: 19 to 66 years old). The preoperative ejection fraction was (42.9±6.4)% (range: 21% to 49%), while less than 35% in 3 patients. The scores of Charlson comorbidity index were as follows: 5 patients for 0, 6 patients for 1, 7 patients for 2, 1 patient for 3 and 5 patients for 4. The European system for cardiac operative risk evaluation (EuroSCORE) Ⅰ was 3.6±2.1 (range: 1 to 9). The EuroSCORE Ⅱ was (4.91±2.40)% (range: 1.58% to 11.60%). The model for end-staged liver disease score was 1.8±1.2 (range: 0.2 to 7.1). The simplified model for end-staged liver disease score was 5.6±2.5 (range: 1.5 to 13.4). Follow-up was conducted by clinic. The long-term survival rate was calculated by Kaplan-Meier survival curve. Results: In-hospital mortality was 16.7% (4/24), including 1 patient for multiple organ failure and 3 patients for low cardiac output syndrome (LCOS). One patient needed continuous renal replacement therapy and 6 patients suffered from LCOS. The follow-up time was 1 to 19 years, with a median of 8 years. During the follow-up period, 4 patients died, including 2 deaths for cardiogenic cause, 1 death for anticoagulant complications, and 1 death for lung cancer. The 1, 5 and 10-year survival rates were 76.2%, 71.4% and 64.9%, respectively. Conclusion: The short-term and long-term clinical outcomes of TVR in patients with left ventricular dysfunction are acceptable, but the mortality and morbidity are still high.

Diagnostic performance of the nerve root sedimentation sign in lumbar spinal stenosis: a systematic review and meta-analysis.

PURPOSE: This meta-analysis intends to use all available evidence to clarify the diagnostic performance of the nerve root sedimentation sign (NRSS). METHODS: The PubMed, EMBASE, the Cochrane Library database, China knowledge Infrastructure Project (CNKI), and Wanfang Database were searched up to January 2019 for relevant original studies. Data were extracted to calculate the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative likelihood ratios (PLR and NLR), and areas under summary receiver operating characteristic curve (SROC) for analysis. The clinical applicability was evaluated with a Fagan's plot and likelihood ratio dot diagram. Deek's funnel plot was used to assess publication bias. RESULTS: A total of 14 studies including 1333 positive cases and 2658 negative controls were available for the meta-analysis. The pooled sensitivity and specificity of the NRSS for the diagnosis of LSS was 0.84 (95% CI 0.75, 0.91) and 0.95 (95% CI 0.81, 0.99), respectively. The PLR was 18.6 (95% CI 4.0, 86.8), the NLR was 0.17 (95% CI 0.10, 0.28), and the DOR was 112 (95% CI 17,741). The SROC value was 0.93 (95% CI 0.91, 0.95). The Fagan's plot showed that the pre-test probability was 50% and the post-test probability was 95%. The likelihood ratio dot graph showed that the combined effect of the diagnosis fell on the right upper quadrant. Deek's funnel found no publication bias. CONCLUSION: NRSS has high diagnostic sensitivity, specificity, and efficacy, and good clinical application value for the diagnosis of LSS. It can be recommended as an auxiliary tool for diagnosis and screening in clinical practice.

Preparation of Cellulose/Graphene Oxide Composite Membranes and Their Application in Removing Organic Contaminants in Wastewater.

Cellulose/graphene oxide composite membranes (CGCMs) were prepared using a vacuum-filtration method. The CGCMs were then used as filters to remove organic pollutants from wastewater. It was found that the CGCM filters could efficiently and simultaneously achieve wastewater treatment and adsorbent separation. Their adsorption of Rhodamine B (RhB, an organic dye) varied with varying cellulose/graphene oxide mass ratios. The CGCM obtained at a cellulose/graphene oxide mass ratio of 8:1 exhibited the maximum removal efficiency for RhB. The maximum adsorption capacity of the CGCMs for RhB was found to be 86.4 mg/g. In addition, the CGCMs were easily regenerated and the regenerated CGCMs retained good abilities to remove contaminants, which could be significant for their application in wastewater treatment.

A cell-based high-throughput protocol to screen entry inhibitors of highly pathogenic viruses with Traditional Chinese Medicines.

Emerging viruses such as Ebola virus (EBOV), Lassa virus (LASV), and avian influenza virus H5N1 (AIV) are global health concerns. Since there is very limited options (either vaccine or specific therapy) approved for humans against these viruses, there is an urgent need to develop prophylactic and therapeutic treatments. Previously we reported a high-throughput screening (HTS) protocol to identify entry inhibitors for three highly pathogenic viruses (EBOV, LASV, and AIV) using a human immunodeficiency virus-based pseudotyping platform which allows us to perform the screening in a BSL-2 facility. In this report, we have adopted this screening protocol to evaluate traditional Chinese Medicines (TCMs) in an effort to discover entry inhibitors against these viruses. Here we show that extracts of the following Chinese medicinal herbs exhibit potent anti-Ebola viral activities: Gardenia jasminoides Ellis, Citrus aurantium L., Viola yedoensis Makino, Prunella vulgaris L., Coix lacryma-jobi L. var. mayuen (Roman.) Stapf, Pinellia ternata (Thunb.) Breit., and Morus alba L. This study represents a proof-of-principle investigation supporting the suitability of this assay for rapid screening TCMs and identifying putative entry inhibitors for these viruses. J. Med. Virol. 89:908-916, 2017. © 2016 Wiley Periodicals, Inc.

Diagnostic Value of Neutrophil-Lymphocyte Ratio in Predicting Post-Operative Infection after Orthopedic Surgery: A Systematic Review and Meta-Analysis.

Objective: This study aims to evaluate the predictive value of neutrophil-lymphocyte ratio (NLR) in determining infection after orthopedic surgery. Methods: A comprehensive search was conducted in PubMed, EBASE, CNKI, and Wanfang databases to identify relevant studies. The quality of the included studies was assessed using QUADAS-2. Data extraction was performed to calculate sensitivity, specificity, and other indicators. Bivariate mixed-effects meta-analysis was conducted using Stata software. The sources of heterogeneity were evaluated, and a summary receiver operating characteristic curve was generated. Results: A total of 16 literatures comprising 18 studies involving 3737 patients were included in this analysis. NLR demonstrated moderate sensitivity (0.77) and specificity (0.69) in diagnosing orthopedic post-operative infection, with an area under the curve of 0.80 and diagnostic odds ratio of 7.76. Significant heterogeneity was observed among the studies, primarily due to variations in surgical type, infection type, blood test timing, and NLR cutoff value. Fagan nomogram indicated that NLR could increase the positive posterior probability to 72% and decrease the negative posterior probability to 25%. The pooled effect of the likelihood ratio dot plot for diagnosis fell in the lower right quadrant. Deek funnel plot suggested no publication bias in this study. Conclusion: NLR holds certain value in diagnosing infection after orthopedic surgery and can provide additional information to assess the risk of infection. However, its predictive performance is influenced by various factors, and it cannot be used as a sole criterion for confirming the diagnosis. Prospective studies should be conducted in the future to optimize the diagnostic threshold and explore its combination with other indicators.

A novel image semantic communication method via dynamic decision generation network and generative adversarial network.

Effectively compressing transmitted images and reducing the distortion of reconstructed images are challenges in image semantic communication. This paper proposes a novel image semantic communication model that integrates a dynamic decision generation network and a generative adversarial network to address these challenges as efficiently as possible. At the transmitter, features are extracted and selected based on the channel's signal-to-noise ratio (SNR) using semantic encoding and a dynamic decision generation network. This semantic approach can effectively compress transmitted images, thereby reducing communication traffic. At the receiver, the generator/decoder collaborates with the discriminator network, enhancing image reconstruction quality through adversarial and perceptual losses. The experimental results on the CIFAR-10 dataset demonstrate that our scheme achieves a peak SNR of 26 dB, a structural similarity of 0.9, and a compression ratio (CR) of 81.5% in an AWGN channel with an SNR of 3 dB. Similarly, in the Rayleigh fading channel, the peak SNR is 23 dB, structural similarity is 0.8, and the CR is 80.5%. The learned perceptual image patch similarity in both channels is below 0.008. These experiments thoroughly demonstrate that the proposed semantic communication is a superior deep learning-based joint source-channel coding method, offering a high CR and low distortion of reconstructed images.

The association between low serum calcium level and new-onset atrial fibrillation after coronary artery bypass grafting.

OBJECTIVES: This study aims to investigate the relationship between serum calcium (SC) levels and the incidence of postoperative atrial fibrillation (POAF) in patients undergoing coronary artery bypass graft surgery. METHODS: This retrospective, observational cohort study consecutively enrolled patients undergoing isolated coronary artery bypass grafting in Beijing Anzhen Hospital from January 2018 to December 2021. Patients with a previous history of atrial fibrillation or atrial flutter or requiring concomitant cardiac surgery were excluded. A logistic regression model was used to determine predictors of POAF. Multivariable adjustment, inverse probability of treatment weighting and propensity score matching were used to adjust for confounders. Moreover, we conducted univariable and multivariable logistic regression analyses on preoperative and postoperative SC and ionized SC levels. RESULTS: The analysis encompassed 12 293 patients. The POAF rate was significantly higher in patients with low SC level than those without (1379 [33.9%] vs 2375 [28.9%], P < 0.001). Low SC level was associated with an increased odds ratio of POAF (odds ratio [95% confidence interval]: 1.27 [1.18-1.37], P < 0.001). Inverse probability of treatment weighting and propensity score matching analyses confirmed the results. The increased POAF rate in low SC level group still existed among subgroup analysis based on different age, sex, body mass index, hypertension, hyperlipidaemia, CHA2DS2-VASc and magnesium. CONCLUSIONS: Low SC level indicates elevated POAF risk in patients undergoing isolated coronary artery bypass graft surgery even after the adjustment for age, sex, cardiovascular risk factors, echocardiographic parameters and laboratory markers.