Efficacy and Safety of Laser Balloon Versus Irrigated Radiofrequency Ablation as Initial Therapies for Atrial Fibrillation: A Meta-Analysis.

Background: Catheter ablation (CA) is an effective therapy for atrial fibrillation (AF) and, although radiofrequency ablation (RFA) is the standard treatment for pulmonary vein isolation (PVI), it is complex and time-consuming. Laser balloon ablation (LBA) has been introduced to simplify the conventional RFA; however, results of studies comparing LBA and RFA remain controversial. As such, this investigation aimed to comprehensively evaluate the efficacy and safety of LBA versus RFA. Methods: The PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases were searched for relevant studies. The primary endpoints were the freedom from atrial tachyarrhythmia (ATA) and procedure-related complications. Results: Twelve studies including 1274 subjects were included. LBA and RFA yielded similar rates of freedom from ATA (72.5% vs. 68.7%, odds ratio [OR] = 1.26, 95% confidence interval [CI] 1.0-1.7, p = 0.11) and procedure-related complications (7.7% vs. 6.5%, OR = 1.17, 95% CI 0.72-1.90, p = 0.536). LBA with the second- and third-generation laser balloons (LB2/3) yielded remarkably higher rates of freedom from ATA than RFA using contact-force technology (RFA-CF) (OR = 1.91, p = 0.013). Significantly lower pulmonary vein (PV) reconnection rates (OR = 0.51, p = 0.021), but higher phrenic nerve palsy (PNP) rates (OR = 3.42, p = 0.023) were observed in the LBA group. LBA had comparable procedure (weighted mean difference [WMD] = 8.43 min, p = 0.337) and fluoroscopy times (WMD = 3.09 min, p = 0.174), but a longer ablation time (WMD = 12.57 min, p = 0.00) than those for RFA. Conclusions: LBA and RFA treatments were comparable in terms of freedom from ATA and postprocedural complications in patients with AF. Compared with RFA, LBA was associated with significantly lower PV reconnection rates, but a higher incidence of PNP and longer ablation time.

Association between Hepatitis B virus infection and liver metastasis in colorectal cancer.

The association between Hepatitis B virus (HBV) infection and colorectal liver metastases (CRLM) remains ambiguous in current population-based evidence. To clarify this, we present a retrospective analysis of 5871 colorectal cancer (CRC) patients. Propensity score matching (PSM) was applied to harmonize age and sex disparities within HBV+ (n = 1696) and HBV- (n = 4175) groups and further within HBV+ subgroups of chronic (CHB, n = 474) and occult (OHB, n = 1222) infections. Our initial results indicated a significant association between HBV infection and synchronous colorectal liver metastasis (SYN-CRLM); however, this association dissipated after PSM was employed to adjust for confounding variables. No significant association was observed between HBV infection and metachronous colorectal liver metastases (MET-CRLM) both before and after PSM. Further analysis revealed that HBV replication status did not influence the incidence of CRLM. However, HBV+ participants demonstrated an increased incidence of metachronous extrahepatic metastases, particularly to the lungs. Our findings imply that neither past nor present HBV infection is significantly correlated with the occurrence of SYN-CRLM or MET-CRLM. The absence of an association between HBV replication status and CRLM incidence highlights the importance of incorporating a broader range of factors in the clinical management of CRLM beyond the status of HBV infection.

Comparison of Reduced and Full Field of View in Diffusion-Weighted MRI on Image Quality: A Meta-Analysis.

BACKGROUND: Reduced field of view (rFOV) diffusion-weighted imaging (DWI) in MRI shows potential for enhanced image quality compared with traditional full field of view (fFOV) DWI. Evaluating rFOV DWI's impact on image quality is important for clinical adoption. OBJECTIVE: To assess the efficacy of rFOV DWI in improving image quality, focusing on artifact reduction, signal-to-noise ratio (SNR) improvement, and lesion detectability. STUDY TYPE: Meta-analysis. POPULATION: Systematic literature search was conducted in PubMed, Embase, the Cochrane Library, and Web of Science ending in January 2024. Thirteen studies with 765 participants focusing on DWI quality using rFOV was analyzed. FIELD STRENGTH/SEQUENCE: SS-EPI, Rtr-SS-EPI, 2D-SS-EPI at 3.0 T. ASSESSMENT: Two investigators performed the data extraction. QUADAS-2 assessed bias. The image quality assessment of rFOV and fFOV DWI were compared. STATISTICAL TESTS: Standardized mean difference (SMD) was utilized to evaluate and standardize MRI image quality. Heterogeneity was assessed using the I2 statistic and publication bias was evaluated with Egger's test. RESULTS: The QUADAS-2 analysis revealed that most studies exhibited a low risk of bias and minimal concerns regarding applicability. Statistical analysis indicated that rFOV DWI yielded higher subjective image quality scores (SMD = 0.535, 95% CI: 0.339, 0.731, I2 = 45.7%) compared with fFOV DWI and was more effective in reducing artifacts (SMD = 0.44, 95% CI: 0.209, 0.672, I2 = 42.3%) than fFOV DWI. However, a decrease in SNR was noted with rFOV DWI (SMD = -0.670, 95% CI: -1.187 to -0.152, I2 = 87.9%). Additionally, rFOV DWI demonstrated enhancements in lesion visibility (SMD = 0.432, 95% CI: -1.187, -0.152, I2 = 53.1%) and anatomical details (SMD = 0.598, 95% CI: 0.121, 1.075, I2 = 90.8%). DATA CONCLUSION: rFOV DWI enhances MRI image quality by reducing artifacts and improving lesion visibility with a SNR trade-off. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 1.

A whole-exome sequencing study of patent foramen ovale: investigating genetic variants and their association with cardiovascular disorders.

Background: Patent foramen ovale (PFO) has a genetic predisposition and is closely associated with cryptogenic stroke (CS), migraine, decompression sickness, and hypoxemia. Identifying PFO-related mutant genes through whole-exome sequencing (WES) can help in the early recognition of cardiovascular genetic risk factors, guide timely clinical intervention, and reduce the occurrence of cardiovascular events. Methods: We analyzed mutant genes from ClinVar and OMIM databases. WES was performed on 25 PFO patients from Zhejiang Provincial Hospital of Chinese Medicine. Pathogenicity of variants was evaluated using American College of Medical Genetics and Genomics (ACMG) and Association for Molecular Pathology. (AMP) guidelines. Results: In ClinVar (4 Feb 2023), 113 coding gene mutations were found, including 83 associated with PFO. From OMIM (18 Apr 2023), 184 gene mutations were analyzed, with 110 mutant coding genes. WES identified pathogenic mutations in two of 25 PFO patients (8%). LDLR, SDHC, and NKX2-5 genes were linked to PFO and primarily involved in myocardial tissue function. NKX2-5 may play a crucial role in PFO development, interacting with NOTCH1, GATA4, MYH6, SCN5A signaling pathways regulating cardiomyocyte characteristics. Conclusion: We identified pathogenic mutations in LDLR, SDHC, and NKX2-5 genes, implying their role in PFO development. Functional enrichment analysis revealed NKX2-5's interaction with signaling pathways regulating cardiomyocyte function. These findings enhance our understanding of PFO's genetic basis, suggesting potential therapeutic targets for future research.

Effects of arbuscular mycorrhizal fungi on the reduction of arsenic accumulation in plants: a meta-analysis.

Arsenic (As) accumulation in plants is a global concern. Although the application of arbuscular mycorrhizal fungi (AMF) has been suggested as a potential solution to decrease As concentration in plants, there is currently a gap in a comprehensive, quantitative assessment of the abiotic and biotic factors influencing As accumulation. A meta-analysis was performed to quantitatively investigate the findings of 76 publications on the impacts of AMF, plant properties, and soil on As accumulation in plants. Results showed a significant dose-dependent As reduction with higher mycorrhizal infection rates, leading to a 19.3% decrease in As concentration. AMF reduced As(V) by 19.4% but increased dimethylarsenic acid (DMA) by 50.8%. AMF significantly decreased grain As concentration by 34.1%. AMF also improved plant P concentration and dry biomass by 33.0% and 62.0%, respectively. The most significant reducing effects of As on AMF properties were seen in single inoculation and experiments with intermediate durations. Additionally, the benefits of AMF were significantly enhanced when soil texture, soil organic carbon (SOC), pH level, Olsen-P, and DTPA-As were sandy soil, 0.8%-1.5%, ≥7.5, ≥9.1 mg/kg, and 30-60 mg/kg, respectively. AMF increased easily extractable glomalin-related soil protein (EE-GRSP) and total glomalin-related soil protein (T-GRSP) by 23.0% and 28.0%, respectively. Overall, the investigated factors had significant implications in developing AMF-based methods for alleviating the negative effects of As stress on plants.

Related factors associated with the prognosis of children undergoing liver transplantation under the enhanced recovery after surgery nursing concept.

This study aimed to investigate factors associated with the clinical outcomes of patients who underwent pediatric liver transplantation (LT) and received enhanced recovery after surgery (ERAS) nursing. A cohort of 104 pediatric patients was studied at our hospital. Data on 8 indicators and 2 clinical outcomes, including length of hospital stay (LOS) and 30-day readmission rates, were collected. Linear and logistic regression analyses were employed to examine the associations of the 8 indicators with hospital-LOS and readmission risks, respectively. The predictive value of these indicators for the outcomes was determined using the receiver operating characteristic (ROC) curve, decision curve analysis, and importance ranking through the XGBoost method. A comprehensive model was developed to evaluate its predictive accuracy. Regression analyses identified donor age, donor gender, and intensive care unit (ICU)-LOS of recipients as significant predictors of hospital LOS (all P < .05), whereas no indicators were significantly associated with readmission risk. Further, ROC analysis revealed that 3 indicators provided superior prediction for 28-day hospital LOS compared to the median LOS of 18 days. ICU-LOS demonstrated the highest clinical net benefit for predicting 28-day hospital-LOS. Multivariable regression analysis confirmed the independent predictive value of donor age and ICU-LOS for the hospital-LOS (all ß > 0, all P < .05). Although the comprehensive model incorporating donor age and ICU-LOS showed stable predictive capability for hospital-LOS, its performance did not significantly exceed that of the individual indicators. In pediatric LT, hospital LOS warrants greater emphasis over readmission rates. Donor age and ICU-LOS emerged as independent risk factors associated with prolonged hospital LOS.

Efficacy and safety of visually guided laser balloon versus cryoballoon ablation for paroxysmal atrial fibrillation: a systematic review and meta-analysis.

Background: Newly developed catheter ablation (CA) techniques, such as laser balloon ablation (LBA) and cryoballoon ablation (CBA), have been introduced in recent years and emerged as valuable alternatives to conventional radiofrequency CA strategies for paroxysmal atrial fibrillation (PAF) patients. However, evidence comparing LBA and CBA remain controversial. Thus, we conducted this meta-analysis to assess the efficacy and safety between these two techniques. Methods: Scientific databases (PubMed, Embase) and relevant websites (the Cochrane Library, ClinicalTrials.gov) were systematically searched from inception to March 2023. The primary outcomes of interest were the AF recurrence and the procedure-related complications. Secondary outcomes included procedural time, fluoroscopy time, and left atrial (LA) dwell time. Results: Seven clinical trials with a total of 637 patients were finally enrolled. No significant differences were found between LBA and CBA in terms of AF recurrence [16.3% vs. 22.7%, odds ratio (OR) = 0.66, 95% confidence interval (CI): 0.42-1.05, p = 0.078] or total procedural-related complications (8.4% vs. 6.4%, OR = 1.33, 95% CI: 0.71-2.51, p = 0.371). LBA had a significantly longer procedural time [weighted mean difference (WMD) = 38.03 min, 95% CI: 13.48-62.58 min, p = 0.002] and LA dwell time (WMD = 46.67 min, 95% CI: 14.63-78.72 min, p = 0.004) than CBA, but tended to have shorter fluoroscopy time. Conclusions: LBA and CBA treatment have comparable efficacy and safety for PAF patients. LBA was associated with longer procedural and LA dwell times compared with CBA. Further large-scale studies are warranted to compare these two techniques with the newest generations.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=426513, identifier (CRD42023426513).

Bayesian network meta-analysis comparing hot balloon, laser balloon and cryoballoon ablation as initial therapies for atrial fibrillation.

Background: Balloon-based catheter ablation (CA) technologies, including hot balloon ablation (HBA), laser balloon ablation (LBA) and cryoballoon ablation (CBA) have been introduced in recent years as alternatives to conventional radiofrequency ablation therapy for atrial fibrillation (AF). However, the results remain controversial concerning the optimal approach. Thus, we conducted a network meta-analysis (NMA) to comprehensively evaluate the efficacy and safety of HBA, LBA and CBA. Methods: Clinical trials comparing the efficacy and safety of HBA, LBA and CBA were identified through a systematic search up to October 2022. The primary outcomes of interest were the recurrence of AF and procedure-related complications. Results: Twenty clinical trials with a total of 1,995 patients were included in the meta-analysis. The NMA results demonstrated that HBA, LBA and CBA had comparable AF recurrence rates (HBA vs. CBA: odds ratio OR = 0.88, 95% credible interval CrI: 0.56-1.4; LBA vs. CBA: OR = 1.1, 95% CrI: 0.75-1.5; LBA vs. HBA: OR = 1.2, 95% CrI: 0.70-2.0) and procedure-related complications (HBA vs. CBA: OR = 0.93, 95% CrI: 0.46-2.3; LBA vs. CBA: OR = 1.1, 95% CrI: 0.63-2.1; LBA vs. HBA: OR = 1.2, 95% CrI: 0.44-2.8). The surface under the cumulative ranking curve (SUCRA) suggested that HBA may be the optimal approach concerning the primary outcomes (SUCRA = 74.4%; 61.1%, respectively). However, HBA (40.1%) had a significantly higher incidence of touch-up ablation (TUA) than LBA (8.5%, OR = 2.8, 95% CrI: 1.1-7.1) and CBA (11.9%, OR = 3.7, 95% CrI: 1.9-7.5). LBA required more procedure time than CBA [mean difference (MD = 32.0 min, 95% CrI: 19.0-45.0 min)] and HBA (MD = 26.0 min, 95% CrI: 5.6-45.0 min), but less fluoroscopy time than HBA (MD = -9.4 min, 95% CrI: -17.0--2.4 min). Conclusions: HBA, LBA and CBA had comparable efficacy and safety as initial treatments for AF. HBA ranked highest in the primary outcomes, but at the cost of a higher incidence of TUA and longer fluoroscopy time. Systematic Review Registration: www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022381954, identifier: CRD42022381954.

TFRC in cardiomyocytes promotes macrophage infiltration and activation during the process of heart failure through regulating Ccl2 expression mediated by hypoxia inducible factor-1α.

BACKGROUND: Cardiac hypertrophy is an initiating link to Heart failure (HF) which still seriously endangers human health. Transferrin receptor (TFRC), which promotes iron uptake through the transferrin cycle, is essential for cardiac function. However, whether TFRC is involved in the process of pathological cardiac hypertrophy is not clear. METHODS: Transverse aortic constriction (TAC) mouse model and mice primary cardiomyocytes treated with isoproterenol (ISO) or phenylephrine (PHE) were used to mimic cardiac hypertrophy in vivo and in vitro. Single cell RNA sequence data from heart tissues of TAC-model mice was obtained from the Gene Expression Omnibus (GEO) database, and was analyzed with R package Seurat. TFRC expression and macrophage infiltration in the heart tissue were tested by immunofluorescent staining. Macrophage polarization was detected by Flow Cytometry. TFRC expressions were detected by qRT-PCR, Western blot, and ELISA. RESULTS: TFRC expression is increased in the pathological cardiac hypertrophy of mice model and positively associated with macrophage infiltration. Furthermore, TFRC in cardiomyocytes recruits and activates macrophages by secreting C-C motif ligand 2 (Ccl2) in the mice heart tissue with TAC surgery or in the primary cardiomyocytes stimulated with ISO or PHE to induce myocardial hypertrophy in vitro. Moreover, we find that TFRC promotes Ccl2 expression in cardiomyocytes via regulating signal transducer and activator of transcription 3 (STAT3). In addition, we find that increased TFRC expression in the HF tissue is regulated by hypoxia-inducible factor-1α (HIF-1α). CONCLUSION: This in-depth study shows that TFRC in cardiomyocytes promotes HF development through inducing macrophage infiltration and activation via the STAT3-Ccl2 signaling, and TFRC expression in cardiomyocytes is regulated by HIF-1α during HF. This study first uncovers the role of TFRC in cardiomyocytes on macrophage infiltration and activation during HF.

A quantitative review of the effects of Se application on the reduction of Hg concentration in plant: a meta-analysis.

Mercury (Hg) is a highly toxic heavy metal entering the human body through the food chain after absorption by plant. Exogenous selenium (Se) has been suggested as a potential solution to reduce Hg concentration in plants. However, the literature does not provide a consistent picture of the performance of Se on the accumulation of Hg in plant. To obtain a more conclusive answer on the interactions of Se and Hg, 1,193 data records were collected from 38 publications for this meta-analysis, and we tested the effects of different factors on Hg accumulation by meta-subgroup analysis and meta-regression model. The results highlighted a significant dose-dependent effect of Se/Hg molar ratio on the reduction of Hg concentration in plants, and the optimum condition for inhibiting Hg accumulation in plants is at a Se/Hg ratio of 1-3. Exogenous Se significantly reduced Hg concentrations in the overall plant species, rice grains, and non-rice species by 24.22%, 25.26%, and 28.04%, respectively. Both Se(IV) and Se(VI) significantly reduced Hg accumulation in plants, but Se(VI) had a stronger inhibiting effect than Se(IV). Se significantly decreased the BAFGrain in rice, which indicated that other physiological processes in rice may be involved in restricting uptake from soil to rice grain. Therefore, Se can effectively reduce Hg accumulation in rice grain, which provides a strategy for effectively alleviating the transfer of Hg to the human body through the food chain.

Can As concentration in crop be controlled by Se fertilization? A meta-analysis and outline of As sequestration mechanisms.

Arsenic (As) is a pollutant with a strong toxic effect on animals, plants and human beings. Exogenous selenium (Se) has been suggested to reduce the accumulation of As in crops, but contradictory results were found in the published literature. In order to clarify the possible processes, we collected the literature that reports on the effects of Se application on As uptake and accumulation in crops, analyzed the data by meta-analysis, and tested the effects of different factors on As accumulation by meta-regression model and subgroup analysis. The results highlighted a significant dose-dependent reduction of As content in crops after Se addition. Exogenous Se can significantly reduce As concentrations in grains by 18.76%. The reduction was dose-dependent for rice grains under aerobic soil conditions but not for rice grains under anoxic soil conditions. Se-enriched soils (greater than 0.5 mg kg-1) significantly reduced As concentrations in grains. Selenium significantly decreased the transfer factor of As from root to shoot. Moreover, selenite had a stronger inhibiting effect on the transport of As from root to shoot than selenate. The inhibition of selenium fertilization on As concentrations seems to take place in root and soil, while physiological processes in rice may be involved in restricting uptake and transport from root to shoot. These findings provide new ideas for effectively alleviating the transfer of As to the human body through the food chain.

Integrin αvß6 contributes to the development of intestinal fibrosis via the FAK/AKT signaling pathway.

Intestinal fibrosis is one of the most severe complications of inflammatory bowel disease (IBD) and frequently requires surgery due to intestinal obstruction. Integrin αvß6, which is mainly regulated by the integrin ß6 subunit gene (ITGB6), is a special integrin subtype expressed only in epithelial cells. In our previous study, we found integrin αvß6 can promote the development of IBD, but the role of integrin αvß6 in intestinal fibrosis remains unclear. In this study, we observed a gradual increase of ITGB6 mRNA expression from normal region to stenotic region of IBD patients' intestinal specimens. Next, we established a dextran sulfate sodium (DSS)-induced intestinal fibrosis model and a heterotopic intestinal transplant model, and found intestinal fibrosis was decreased in ITGB6-deficient mice compared to wild-type (WT) mice. Furthermore, we performed RNA-sequencing and KEGG pathway analysis on intestinal tissues from ITGB6-overexpressing transgenic mice and WT mice, and found multiple pathways containing ITGB6, are related to the activation of focal adhesion kinase (FAK); finding was confirmed by Western blot. At last, we generated a heterotopic intestinal transplant model found the FAK/AKT pathway was inhibited in ITGB6-deficient mice. In conclusion, our data demonstrate that integrin αvß6 promotes the pathogenesis of intestinal fibrosis by FAK/AKT pathway, making integrin αvß6 a potential therapeutic target to prevent this condition.

Comparison of Myocardial Injury and Inflammation Biomarkers and Their Impact on Recurrence after Cryoballoon and Radiofrequency Ablation for Atrial Fibrillation: A Systematic Review and Meta-Analysis.

Background: Biomarkers of myocardial injury and inflammation were found to be different after radiofrequency catheter ablation (RFCA) and cryoballoon ablation (CBA) for atrial fibrillation (AF); however, the results are currently controversial. This study was aimed to systematically compare the differences in myocardial injury and inflammation biomarkers after RFCA and CBA procedures and to investigate their impact on AF recurrence. Methods: Databases, including PubMed, Embase, the Cochrane Library, ClinicalTrials.gov, China National Knowledge Infrastructure (CNKI) and China Biology Medicine (CBM), were systematically searched from their date of inception to May 2022. The primary outcomes of interest were the differences in myocardial injury and inflammation biomarkers after CBA and RFCA procedures for AF patients, and the impact of the biomarkers on AF recurrence. Secondary outcomes included the total ablation time, the procedure duration and the freedom from atrial tachycardia (AT). Results: Eighteen studies with a total of 1807 patients were finally enrolled. CBA treatment was associated with significantly greater increases in troponin I (TNI) levels (weighted mean difference [WMD] = 3.13 ug/L, 95% confidence interval [CI] 2.43-3.64) both at 4-6 h (WMD = 3.94 ug/L), 24 h (WMD = 4.23 ug/L), 48 h (WMD = 2.14 ug/L) and 72 h (WMD = 0.56 ug/L), and also creatine kinade MB fraction (CK-MB) levels at 4-6 h (WMD = 33.21 U/L), 24 h (WMD = 35.84 U/L) and 48 h (WMD = 4.62 U/L), while RFCA treatment was associated with greater increases in postablation C-reactive protein (CRP) levels both at 48 h (WMD = -9.32 mg/L) and 72 h (WMD = -10.90 mg/L). The CBA and RFCA treatments had comparable rates of freedom from AT (74.5% vs. 75.2%, RR = 1.08). The CRP levels were significantly higher in patients with early recurrence of AF (ERAF) than in those without ERAF after RFCA treatment (WMD = 3.415 mg/L). Conclusions: The time-course patterns of postablation myocardial injury and inflammation biomarkers are different between RFCA and CBA procedures. The lower postprocedural elevation of myocardial injury biomarkers and the increased CRP levels may be predictive factors for ERAF. PROSPERO Registration Number: CRD42021278564.

Second-generation cryoballoon versus contact force radiofrequency ablation for atrial fibrillation: an updated meta-analysis of evidence from randomized controlled trials.

Catheter ablation has been recommended for patients with symptomatic atrial fibrillation (AF), with pulmonary vein isolation being the cornerstone of the ablation procedure. Newly developed technologies, such as cryoballoon ablation with a second-generation cryoballoon (CB2) and the contact force radiofrequency (CF-RF) ablation, have been introduced in recent years to overcome the shortcomings of the widely used RF ablation approach. However, high-quality results comparing CB2 and CF-RF remain controversial. Thus, we conducted this meta-analysis to assess the efficacy and safety between CB2 and CF-RF using evidence from randomized controlled trials (RCTs). Databases including Embase, PubMed, the Cochrane Library, and ClinicalTrials.gov were systematically searched from their date of inception to January 2021. Only RCTs that met the inclusion criteria were included for analysis. The primary outcome of interest was freedom from atrial tachyarrhythmia (AT) during follow-up. Secondary outcomes included procedure-related complications, procedure time and fluoroscopy time. Six RCTs with a total of 987 patients were finally enrolled. No significant differences were found between CB2 and CF-RF in terms of freedom from AT (relative risk [RR] = 1.03, 95% confidence interval [CI] 0.92-1.14, p = 0.616) or total procedural-related complications (RR = 1.25, 95% CI 0.69-2.27, p = 0.457). CB2 treatment was associated with a significantly higher risk of phrenic nerve palsy (PNP) than CF-RF (RR = 4.93, 95% CI 1.12-21.73, p = 0.035). The occurrences of pericardial effusion/tamponade and vascular complications were comparable between the CB2 and CF-RF treatments (RR = 0.41, p = 0.398; RR = 0.82, p = 0.632). In addition, CB2 treatment had a significantly shorter procedure time than CF-RF (weighted mean difference [WMD] = - 20.75 min, 95% CI - 25.44 ~ - 16.05 min, P < 0.001), whereas no difference was found in terms of fluoroscopy time (WMD = 4.63 min, p = 0.179). CB2 and CF-RF treatment are comparable for AF patients regarding freedom from AT and procedure-related complications. Compared to CF-RF, CB2 treatment was associated with a shorter procedure time but a higher incidence of PNP. Further large-scale studies are warranted to compare these two techniques and provide an up-to-date recommendation.

Effects of continuous positive airway pressure treatment in obstructive sleep apnea patients with atrial fibrillation: A meta-analysis.

BACKGROUND: Obstructive sleep apnea (OSA) is correlated with atrial fibrillation (AF). Over the past decade, there has been an increasing interest in the relationship between OSA with continuous positive airway pressure (CPAP) and progression or recurrence of AF. METHODS: This investigation was an analysis of studies searched in the Cochrane Library, PubMed, EMBASE, EBSCO, OVID, and Web of Science databases from inception to July 2020 to evaluate the recurrence or progression of AF in CPAP users, CPAP nonusers, and patients without OSA. RESULTS: Nine studies with 14,812 patients were recruited. CPAP therapy reduced the risk of AF recurrence or progression by 63% in a random-effects model (24.8% vs 40.5%, risk ratio [RR] = 0.70, 95% confidence interval [CI] = 0.57-0.85, P = .035). Compared with non-OSA patients, AF recurrence or progression was much higher in CPAP nonusers (40.6% vs 21.1%, RR = 1.70, 95% CI = 1.19-2.43, P = .000). However, AF recurrence or progression in the CPAP group was similar to that in the non-OSA group (24.0% vs 21.1%, RR = 1.13, 95% CI = 0.87-1.47, P = .001). Begg correlation test and Egger regression test revealed no publication bias in this analysis. CONCLUSIONS: OSA is a salient factor in the progression or recurrence of AF. CPAP therapy for OSA may contribute to reduction of AF in patients for whom radiofrequency ablation or direct current cardioversion is not performed. TRIAL REGISTRATION: The protocol for this meta-analysis was registered on PROSPERO with a registration No. CRD42019135229.

Comparative efficacy and safety of catheter ablation interventions for atrial fibrillation: comprehensive network meta-analysis of randomized controlled trials.

PURPOSE: Point-by-point radiofrequency (RF) ablation has been the cornerstone of pulmonary vein isolation (PVI) for patients with atrial fibrillation (AF); however, it remains a complex and time-consuming procedure. Many novel AF catheter ablation (CA) techniques have been introduced, but whether they represent valuable alternatives remains controversial. Thus, we conducted a network meta-analysis to comprehensively evaluate the efficacy and safety of different CA interventions. METHODS: We systematically searched several databases (Embase, PubMed, the Cochrane Library, and ClinicalTrials.gov ) from inception to March, 2020. The primary outcomes of interest were freedom from atrial tachyarrhythmia (AT) and procedure-related complications; secondary outcomes included procedure time and fluoroscopy time. RESULTS: Finally, 33 randomized controlled trials (RCTs) with a total of 4801 patients were enrolled. No significant differences were found among the different interventions in terms of primary efficacy or safety outcomes. PVAC was most likely to have the shortest procedure time (Prbest = 61.5%) and nMARQ the shortest fluoroscopy time (Prbest = 60.6%); compared with conventional irrigated RF (IRF) ablation, cryoballoon ablation (CBA) showed comparable clinical efficacy and safety; CBA with second-generation CB (CB2) had a significantly shorter procedure time than IRF with contact force technology (CF-IRF) (WMD = - 20.75; p = 0.00). CONCLUSION: There is insufficient evidence to suggest that one CA technique is superior to another. However, PVAC may be associated with a shorter procedural duration, and the CB2 catheters also seemed to reduce the procedure time compared with that of CF-IRF. Further large-scale studies are warranted to compare the available CA techniques and provide an up-to-date optimum recommendation.

Selenium Biofortification and Interaction With Other Elements in Plants: A Review.

Selenium (Se) is an essential element for humans and animals and its deficiency in the diet is a global problem. Crop plants are the main source of Se for consumers. Therefore, there is much interest in understanding the factors that govern the accumulation and distribution of Se in the tissues of crop plants and the mechanisms of interaction of Se absorption and accumulation with other elements, especially with a view toward optimizing Se biofortification. An ideal crop for human consumption is rich in essential nutrient elements such as Se, while showing reduced accumulation of toxic elements in its edible parts. This review focuses on (a) summarizing the nutritional functions of Se and the current understanding of Se uptake by plant roots, translocation of Se from roots to shoots, and accumulation of Se in grains; and (b) discussing the influence of nitrogen (N), phosphorus (P), and sulfur (S) on the biofortification of Se. In addition, we discuss interactions of Se with major toxicant metals (Hg, As, and Cd) frequently present in soil. We highlight key challenges in the quest to improve Se biofortification, with a focus on both agronomic practice and human health.

Systematic Investigation of Quercetin for Treating Cardiovascular Disease Based on Network Pharmacology.

AIM AND OBJECTIVE: Cardiovascular disease is a serious threat to human health because of its high mortality and morbidity rates. At present, there is no effective treatment. In Southeast Asia, traditional Chinese medicine is widely used in the treatment of cardiovascular diseases. Quercetin is a flavonoid extract of Ginkgo biloba leaves. Basic experiments and clinical studies have shown that quercetin has a significant effect on the treatment of cardiovascular diseases. However, its precise mechanism is still unclear. Therefore, it is necessary to exploit the network pharmacological potential effects of quercetin on cardiovascular disease. MATERIALS AND METHODS: In the present study, a novel network pharmacology strategy based on pharmacokinetic filtering, target fishing, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis, compound-target-pathway network structured was performed to explore the anti- cardiovascular disease mechanism of quercetin. RESULTS: The outcomes showed that quercetin possesses favorable pharmacokinetic profiles, which have interactions with 47 cardiovascular disease-related targets and 12 KEGG signaling pathways to provide potential synergistic therapeutic effects. Following the construction of Compound-Target-Pathway (C-T-P) network, and the network topological feature calculation, we obtained top 10 core genes in this network which were AKT1, IL1B, TNF, IL6, JUN, CCL2, FOS, VEGFA, CXCL8, and ICAM1. KEGG pathway enrichment analysis. These indicated that quercetin produced the therapeutic effects against cardiovascular disease by systemically and holistically regulating many signaling pathways, including Fluid shear stress and atherosclerosis, AGE-RAGE signaling pathway in diabetic complications, TNF signaling pathway, MAPK signaling pathway, IL-17 signaling pathway and PI3K-Akt signaling pathway.

Cardiovascular events associated with nicorandil administration prior to primary percutaneous coronary intervention in patients with acute ST-segment elevated myocardial infarction: a systematic review and meta-analysis.

Introduction: Nicorandil may exert cardioprotective effects in ischemic heart disease. However, its efficacy in combination with early reperfusion is uncertain. The authors performed a meta-analysis of the short- and long-term clinical outcomes of nicorandil administration at the time of primary percutaneous coronary intervention (PCI) in patients with ST-elevated myocardial infarction (STEMI). Methods: PubMed, MEDLINE, Embase, and the Cochrane Library databases were systematically searched for eligible randomized controlled studies. The primary endpoint was major adverse cardiovascular events (MACE), both in-hospital and post-discharge. The secondary endpoint was the incidence of no-reflow phenomenon. Results: Ten studies were included (n = 1105). Mean patient age was 63.0 ± 10.0 years; 76.6% of patients were male. Compared with controls who received primary PCI, combined nicorandil/primary PCI significantly reduced in-hospital MACE (pooled odds ratio [OR] 0.16; 95% confidence interval [CI] 0.09-0.27), follow-up MACE (pooled OR 0.53; 95% CI 0.37-0.75), and total MACE (pooled OR 0.27; 95% CI 0.15-0.49). The combined treatment also reduced the incidence of no-reflow phenomenon (pooled OR 0.34; 95% CI 0.23-0.50). Conclusion: Nicorandil administration at the time of primary PCI is associated with reduced MACE (both short- and long-term) and no-reflow phenomenon in patients with STEMI.