Construction of a Clinical Predictive Model of Left Atrial and Left Atrial Appendage Thrombi in Patients with Nonvalvular Atrial Fibrillation.

Background: The purpose of this study was to investigate the risk factors of left atrial (LA) or left atrial appendage (LAA) thrombi in patients with nonvalvular atrial fibrillation (NVAF) and to establish and validate relevant predictive models. It might improve thromboembolic risk stratification in patients with NVAF. Methods: This study retrospectively included 1210 consecutive patients with NVAF undergoing transesophageal echocardiography (TEE), of whom 139 patients had thrombi in LA or in LAA. Through literature review and the ten events per variable (10EPV) principle, 13 variables were finally identified for inclusion in multivariate analysis. Models were constructed by multivariate logistic stepwise regression and least absolute shrinkage and selection operator (lasso) regression. Results: After logistic regression, five variables (AF type, age, B-type natriuretic peptide, E/e' ratio, and left atrial diameter) were finally screened out as model 1. After Lasso regression, AF type, age, gender, B-type natriuretic peptide, E/e' ratio, left atrial diameter, and left ventricular ejection fraction were finally screened as model 2. After comparing the two models, the simpler model 1 was finally selected. The area under the ROC curve (AUC) of the model 1 was 0.865 (95% CI: 0.838-0.892), the Hosmer-Lemeshow test = 0.898, and the AUC = 0.861 after internal validation. The clinical decision curve showed that the new clinical prediction model could achieve a net clinical benefit when the expected threshold was between 0 and 0.6. Conclusion: This study constructed a new clinical prediction model of LA or LAA thrombi, with a higher discriminative degree than the CHADS2 and CHA2DS2-VASc scoring systems (AUC: 0.865 vs. 0.643; AUC: 0.865 vs 0.652).

[Role and mechanism of hydrogen sulfide in vascular calcification].

Vascular calcification is a common pathological process in patients with diabetes, chronic kidney disease, and cardiovascular disease, manifested by the deposition of hydroxyapatite on the walls of blood vessels. Hydrogen sulfide is the third gas signal molecule found in mammals after nitric oxide and carbon monoxide, which has anti-inflammatory, antioxidant stress and other effects in the cardiovascular system. In recent years, it has been recognized that hydrogen sulfide has an anti-vascular calcification effect, and supplementation with hydrogen sulfide and its donors can alleviate vascular calcification. In this review, we discussed the various evidence of the protective effect of hydrogen sulfide on vascular calcification, and highlighted the hydrogen sulfide metabolism changes and the potential regulatory mechanisms of hydrogen sulfide on the pathophysiological changes in vascular calcification.

Ultrasound-assisted enzymatic extraction of soluble dietary Fiber from Hericium erinaceus and its in vitro lipid-lowering effect.

Dietary fiber (DF) is an important active polysaccharide in Hericium erinaceus. Obesity can lead to a wide range of diseases. In this work, we investigated the in vitro lipid-lowering effect of soluble dietary fiber (SDF) from H. erinaceus, aiming to provide a basis for the subsequent development of lipid-lowering products. Ultrasound-assisted enzymatic extraction (UAEE) of SDF from H. erinaceus was performed. The optimal extraction parameters determined via single-factor experiments and response surface methodology (RSM) were as follows: Lywallzyme concentration, 1.0%; complex protease concentration, 1.2%; ultrasonication time, 35 min; and ultrasonication power, 150 W. In vitro lipid-lowering experiments revealed that the adsorption amount of cholesterol micelles by H. erinaceus SDF was 11.91 mg/g. The binding amount and binding rate of sodium taurocholate were 3.73 mg/g and 42.47%, respectively, and those of sodium glycocholate were 3.43 mg/g and 39.12%, respectively. The pancreatic lipase inhibition rate reached 52.11%, and the type of inhibition was competitive. Therefore, H. erinaceus SDF has good in vitro lipid-lowering ability.