Efficacy of WeChat-based online smoking cessation intervention ('WeChat WeQuit') in China: a randomised controlled trial.

Background: China has approximately 300 million current smokers, and smoking cessation services are limited. This study aimed to assess the efficacy of a Cognitive Behavioral Theory-based smoking cessation intervention ('WeChat WeQuit') via the most popular social media platform in China, WeChat. Methods: A parallel, single-blind, two-arm randomised controlled trial was conducted via WeChat between March 19, 2020 and November 16, 2022. Chinese-speaking adult smokers (n = 2000) willing to quit within one month were recruited and randomised in a 1:1 ratio. The intervention group (n = 1005) received the 'WeChat WeQuit' program and the control group (n = 955) received control messages for 14 weeks (2-week prequit and 12-week postquit). Participants were followed up to 26 weeks after the quit date. The primary outcome was self-reported continuous smoking abstinence rate, biochemically validated at 26 weeks. The secondary outcomes were self-reported 7-day and continuous abstinence rates at 6 months. All analyses were by intention to treat. The trial is registered at ClinicalTrials.gov (NCT03169686). Findings: By intention-to-treat analysis, the biochemically verified 26-week continuous abstinence rate was 11.94% in the intervention group and 2.81% in the control group (OR = 4.68, 95% CI: 3.07-7.13, p < 0.0001). The self-reported 7-day abstinence rates ranged from 39.70% at week 1-32.04% at week 26 for the intervention group and 14.17%-11.86% in the control group for weeks 1 and 26, respectively; the self-reported continuous abstinence rates at weeks 1 and 26 ranged from 34.33% to 24.28% and 9.65% to 6.13% in the intervention group and the control group respectively (all p < 0.0001). Participants with low nicotine dependence or previous quit attempts were more likely to successfully quit smoking. Interpretation: The 'WeChat WeQuit' intervention significantly increased smoking abstinence rates at 6 months and should be considered for treatment-seeking smokers in China. Funding: The research is supported by the Natural Science Foundation of Hunan Province (2020JJ4794, YLiao), the K.C. Wong Postdoctoral Fellowship for YLiao to study at King's College London, and China Medical Board (CMB) Open Competition Program (grant no. 15-226, 22-485, YLiao).

Case Report: Double-Decker Repair of Partial Pulmonary Venous Return Into the Coronary Sinus.

We present a case of persistent left superior vena cava (LSVC) draining into the right atrium (RA) via the coronary sinus (CS), while the left superior pulmonary vein returns abnormally to the CS. The LSVC may have few clinical consequences but complicates surgical repair of partial anomalous pulmonary venous return (PAPVR). Transthoracic echocardiography and computed tomographic angiography (CTA) showed that a persistent LSVC and PAPVR converged behind the left atrium. During the operation, the left atrium was adjacent to the confluence part. We resected a portion of the adjacent left atrium to create an inlet of the pulmonary veins and used two autologous pericardial patches to reconstruct a tunnel directing flow from the left pulmonary veins to the surgically created inlet in the adjacent left atrium, and another upper tunnel directing flow from the LSVC to the dilated CS. Pulmonary CTA confirmed that both PAPVR flow to LA and LSVC flow to RA were unobstructed. At a 12-month follow-up, the patient was asymptomatic. No supraventricular arrhythmia was detected. We would like to present this additional technique to our armamentarium to treat PAPVR in combination with LSVC.

Effectiveness of the WeChat-based smoking cessation intervention ('WeChat WeQuit' program) in China: study protocol for a randomized controlled trial.

BACKGROUND AND AIMS: Since its first release in 2011, WeChat (Chinese pinyin: Wei Xin) has been widely used to promote health. As the most popular all-in-one social media application providing free instant messaging, voice, text, pictures, videos and location information exchange via smartphone, WeChat holds promise for delivering smoking cessation services to a large number of people at low unit cost in China, a country with more than 300 million smokers. This protocol is for a study that aims to assess the efficacy of a WeChat-based smoking cessation intervention ('WeChat WeQuit') for treatment-seeking smokers in China. DESIGN: In this two-arm randomized controlled trial (RCT), the control group will receive only a digital version of a booklet of 'Happy Quit'. The intervention group will also receive the 2 weeks pre- and 12 weeks post-quit 'WeChat WeQuit' intervention. Both groups will be followed-up to 26 weeks (6 months) after quit day. SETTING: This on-line trial has no restrictions on setting or location. PARTICIPANTS: Chinese-speaking current smokers (have smoked ≥100 cigarettes in their life-time and currently smoke cigarettes) aged 18+ years willing to make a quit attempt within 1 month (n = 2000) will be recruited by on- and off-line advertising. Potential participants will register their interest by sending WeChat messages or text messages, or making a voice call. MEASUREMENTS: The primary outcome measure is self-reported 26-week continuous smoking abstinence with biological verification [test by clinic visit: expired carbon monoxide concentration <10 parts per million (p.p.m.) or by mailing cotinine urine dipsticks: urine cotinine <200 ng/ml]. Secondary outcome measures include: 7-day point prevalence abstinence at weeks 1, 4, 8, 12, 16, 20 and 26 after-quit day; self-reported 12-week continuous smoking abstinence and 26-week continuous smoking abstinence; reductions in number of cigarettes smoked per day; and rates of participation in and completion of the smoking-cessation program. CONCLUSIONS: If the 'WeChat WeQuit' program is found to be effective, it will be an accessible, affordable and widely implementable intervention to help cigarette smokers to quit. The potential public health impact of its expansion into underserved regions or communities is considerable.

Effect of TFAM on ATP content in tachypacing primary cultured cardiomyocytes and atrial fibrillation patients.

Atrial fibrillation (AF) is one of the most common types of arrhythmia worldwide; although a number of theories have been proposed to explain the mechanisms of AF, the treatment of AF is far from satisfactory. Energy metabolism is associated with the development of AF. Mitochondrial transcription factor A (TFAM) serves a role in the maintenance and transcription of mitochondrial DNA. The present study aimed to investigate the association between TFAM and AF and the effect of TFAM on ATP content in cardiomyocytes. Left atrial appendage tissues were collected from 20 patients with normal sinus rhythm (SR) and 20 patients with AF, and the expression levels of TFAM in SR and AF tissues were evaluated. In addition, a tachypacing model of primary cultured cardiomyocytes was constructed to assess ATP content, cell viability and expression levels of TFAM, mitochondrially encoded (MT)­NADH dehydrogenase 1 (ND1), MT­cytochrome c oxidase 1 (CO1), NADH ubiquinone oxidoreductase core subunit 1 (NDUFS1) and cytochrome c oxidase subunit 6C (COX6C). Finally, the effects of overexpression and inhibition of TFAM on ATP content, cell viability and the expression levels of MT­ND1 and MT­CO1 were investigated. The expression levels of TFAM were decreased in AF tissues compared with SR tissues (P<0.05). The ATP content, cell viability and expression levels of TFAM, MT­ND1 and MT­CO1 were decreased in tachypacing cardiomyocytes compared with non­pacing cardiomyocytes (P<0.05), whereas the expression levels of NDUFS1 and COX6C were not changed (P>0.05). Overexpression of TFAM increased ATP content, cell viability and expression levels of MT­ND1 and MT­CO1 (P<0.05). The inhibition of TFAM decreased ATP content, cell viability and expression levels of MT­ND1 and MT­CO1 (P<0.05). In summary, the results of the present study demonstrated that the expression levels of TFAM were decreased in AF tissues and tachypacing cardiomyocytes and that the restoration of TFAM increased the ATP content by upregulating the expression levels of MT­ND1 and MT­CO1 in tachypacing cardiomyocytes. Thus, TFAM may be a novel beneficial target for treatment of patients with AF.

Pharmacokinetic behaviors of ligustrazine after single- and multiple-dose intravenous Shenxiong glucose injection in rats by high-performance liquid chromatography.

Shenxiong glucose injection (SXG) is a traditional Chinese medicine that is used for cardio-cerebral vascular diseases on the national essential drug list of China. To date, a comprehensive knowledge concerning the pharmacokinetic profile of SXG-related components, especially following multiple dosing, is still lacking. This study was designed to investigate the pharmacokinetics and tissue distribution of ligustrazine after single- and multiple-dose intravenous administration of SXG in rats. A simple HPLC method was developed for the determination of ligustrazine in biological samples. The pharmacokinetic profiles of ligustrazine in rats were linear after both single- and multiple-dose intravenous administration of SXG, with a half-life of approximately 35 min. Ligustrazine was readily distributed in highly perfused organs and almost eliminated from organs after 90 min of SXG injection. The AUC0-t and C0 of ligustrazine after SXG injection (18 ml/kg, equal to 9.0 mg/kg ligustrazine) were increased significantly compared to those of single ligustrazine administration (9.0 mg/kg), indicating that the pharmacokinetics of ligustrazine in the SXG were affected by other ingredients. This study provided first evidence for the pharmacokinetic characteristics of ligustrazine after both single and multiple-dose SXG in rats, which would be helpful for its clinical application.

Urinary metabolomics reveals the therapeutic effect of HuangQi Injections in cisplatin-induced nephrotoxic rats.

The side effects of cisplatin (CDDP), notably nephrotoxicity, greatly limited its use in clinical chemotherapy. HuangQi Injections (HI), a commonly used preparation of the well-known Chinese herbal medicine Astragali radix, appeared to be promising treatment for nephrotoxicity without compromising the anti-tumor activity of CDDP. In this study, the urinary metabolomics approach using liquid chromatography time of flight mass spectrometry (LC-TOF/MS) was developed to assess the toxicity-attenuation effects and corresponding mechanisms of HI on CDDP-exposed rats. As a result, successive administration of HI significantly recovered the decline of body weight and downregulated the abnormal increase of serum creatinine and urea. HI partly restored the CDDP-induced alteration of metabolic profiling back into normal condition. Totally 43 toxicity-attenuation potential biomarkers were screened and tentatively identified, which were involved in important metabolic pathways such as amino acid metabolism, TCA cycle, fatty acid metabolism, vitamin B6 metabolism and purine metabolism. The results clearly revealed that HI could alleviate CDDP-induced nephrotoxicity and improve the disturbed metabolic balance induced by repeated CDDP exposure. The present study provided reliable evidence for the protective effect of HI on CDDP-induced toxicity with the multi-target pharmacological characteristics.

Colloid-associated plutonium transport in the vadose zone sediments at Lop Nor.

A framework to describe the characteristics of pore water in unsaturated media was established in order to study transport of colloid-associated (239)Pu (i.e., colloidal Pu) through the vadose sediments. Effluent concentrations and recoveries of Pu were found to decrease with increasing ionic strength. However, they would remain approximately constant at a critical value of 0.0289 M (Na(+)) though ionic strengths were further increased. Fast deposition rate coefficient (k(fast)) was thus experimentally determined. To our knowledge, this relationship between the mobility of colloidal Pu and the critical ionic strength was the first time observed. On the other hand, significant detachment of colloidal Pu once retained in the sediments was not observed during the subsequent chemical and physical perturbations. But slow release and transport could persist as long as flow continued. The threshold infiltration intensity (0.166 cm/min) revealed a nonmonotonic dependence of the cumulative amount of detached colloidal Pu on the intensity.