Differentiation of Atrial Fibrillation and Atrial Fibrillation-Associated Ischemic Stroke Based on Serum Exosome miRNA-Seq.

INTRODUCTION: Atrial fibrillation (AF) is the most common cardiac arrhythmia in the general population, and stroke is the most severe complication of AF. Exosomal miRNAs have been reported to be candidates as biomarkers for cardiovascular diseases, including AF and stroke. This study aimed to identify differentially expressed miRNAs (DEMs) in serum exosomes of AF and AF-associated ischemic stroke (AF-IS) patients and evaluate their potential in distinguishing AF and AF-IS patients. METHODS: Serum exosomes were isolated from 8 healthy individuals with sinus rhythm (SR controls), 8 AF patients, and 8 AF-IS patients. miRNA-seq was performed to identify DEMs, and qRT-PCR analysis was performed to confirm the sequencing results. A support vector machine (SVM) model was developed using Python to distinguish AF and AF-IS patients. RESULTS: 68 and 86 DEMs were identified in serum exosomes of AF patients compared to AF-IS patients and SR controls, respectively. Levels of miR-641 and miR-30e-5p were found significantly higher in AF-IS patients. The SVM model achieved an accuracy of 100%, with an area under curve of 1. CONCLUSIONS: The results indicated that miRNA expression profiles of serum exosomes in AF patients were distinct from those in AF-IS patients, and based on the distinction, AF and AF-IS patients can be distinguished.

Development and validation of a prediction model for in-hospital death in patients with heart failure and atrial fibrillation.

BACKGROUND: To develop a prediction model for in-hospital mortality of patients with heart failure (HF) and atrial fibrillation (AF). METHODS: This cohort study extracted the data of 10,236 patients with HF and AF upon intensive care unit (ICU) from the Medical Information Mart for Intensive Care (MIMIC). The subjects from MIMIC-IV were divided into the training set to construct the prediction model, and the testing set to verify the performance of the model. The samples from MIMIC-III database and eICU-CRD were included as the internal and external validation set to further validate the predictive value of the model, respectively. Univariate and multivariable Logistic regression analyses were used to explore predictors for in-hospital death in patients with HF and AF. The receiver operator characteristic (ROC), calibration curves and the decision curve analysis (DCA) curves were plotted to evaluate the predictive values of the model. RESULTS: The mean survival time of participants from MIMIC-III was 11.29 ± 10.05 days and the mean survival time of participants from MIMIC-IV was 10.56 ± 9.19 days. Simplified acute physiology score (SAPSII), red blood cell distribution width (RDW), beta-blocker, race, respiratory rate, urine output, coronary artery bypass grafting (CABG), Charlson comorbidity index, renal replacement therapies (RRT), antiarrhythmic, age, and anticoagulation were predictors finally included in the prediction model. The AUC of our prediction model was 0.810 (95%CI: 0.791-0.828) in the training set, 0.757 (95%CI: 0.729-0.786) in the testing set, 0.792 (95%CI: 0.774-0.810) in the internal validation set, and 0.724 (95%CI: 0.687-0.762) in the external validation set. The calibration curves of revealed that the predictive probabilities of our model for the in-hospital death in patients with HF and AF deviated slightly from the ideal model. The DCA curves revealed that the use of our prediction model increased the net benefit than use no model. CONCLUSION: The prediction model had good discriminative ability, and might provide a tool to timely identify patients with HF complicated with AF who were at high risk of in-hospital mortality.

Improved spectral demodulation algorithm with EEMDAD for sapphire fiber Fabry-Perot high-temperature sensing.

In this paper, an improved spectral demodulation algorithm with the ensemble empirical mode decomposition average denoising is proposed to suppress order jumps in the sapphire fiber Fabry-Perot high-temperature sensing system. It is proven that the signal-to-noise ratio of the sensor is closely related to the severity of the demodulation jumps. The proposed algorithm can reduce the fluctuations of key parameters by reducing the noise in the spectrum, thus overcoming this obstacle. The simulations and experiment demonstrate that the algorithm can effectively eliminate the order jumps in both stable and variable temperature environments. The proposed algorithm solves the order jumping problem that has long plagued the demodulation of this system, improves demodulation accuracy, ensures the reliable operation of the high-temperature sensor, and exhibits excellent demodulation performance.

All-sapphire-based fiber-optic pressure sensor for high-temperature applications based on wet etching.

In this paper, we proposed an all-sapphire-based extrinsic Fabry-Perot interferometer (EFPI) pressure sensor based on an optimized wet etching process, aiming to improve the quality of the interference signal. The sapphire pressure sensitive diaphragm (SPSD) was fabricated by wet etching solutions with different mixture ratios of H3PO4 and H2SO4 at 280°C. The differences of mixture ratios affect the surface roughness of SPSD. SPSDs with surface roughness of 3.91nm and 0.39nm are obtained when the mixture ratios of H3PO4 and H2SO4 is 1:1 and 1:3, respectively. We constructed pressure sensing test system adopting these two kinds of SPSD and performed comparative test. The experiment results show that the demodulation jump can be solved and cavity length fluctuation is decreased to ±5nm when the surface roughness of SPSD is 0.39nm.

Long Noncoding RNA LNC_000898 Alleviates Cardiomyocyte Apoptosis and Promotes Cardiac Repair After Myocardial Infarction Through Modulating the miR-375/PDK1 Axis.

Increasing evidence has confirmed that both long noncoding RNAs (lncRNAs) and microRNAs (miRNAs) exert key roles in the pathogenesis of myocardial infarction (MI). Previous microarray assay results revealed that lncRNA LNC_000898 expression was significantly downregulated in acute MI. However, the specific function of LNC_000898 on MI is still unclear. Our study was aimed to explore the role of LNC_000898 on cardiac MI injury and investigate its underlying mechanism. The male C57BL/6 mouse was used as cardiac MI injury animal models, and neonatal mouse ventricular cardiomyocytes (NMCMs) exposed to hypoxia were used as an in vitro model. Quantitative real-time polymerase chain reaction analysis, Western blot analysis, Tunel immunofluorescence staining assay, and cardiac echocardiography measurement were conducted to detect corresponding indicators. The results indicated that LNC_000898 expression was downregulated in marginal tissue of MI and in NMCMs exposed to hypoxia. Overexpression of LNC_000898 decreased cardiomyocyte apoptosis both in vivo and in vitro. In addition, we elaborated that LNC_000898 exerts its inhibitory effect on apoptosis after MI through the miR-375/PDK1 axis. Through miR-375 overexpression or silencing PDK1, the biological effects of LNC_000898 on hypoxia-induced NMCM injury were partially reversed. These data not only demonstrate that LNC_000898 could protect the heart against MI injury by regulating miR-375/PDK1 but also provide a new understanding to better protection of MI injury through the LNC_000898/miR-375/PDK1 axis.

Dynamic changes in inflammatory responses and 3-year clinical outcomes of XINSORB scaffolds in coronary stenting.

BACKGROUND: Inflammation is known to play a crucial role in the development of coronary atherosclerosis and vascular healing after stenting. This study aimed to investigate the dynamic changes in inflammatory responses between XINSORB and TIVOLI scaffolds and their correlation with 3-year clinical outcomes. METHOD: A total of 140 patients in the XINSORB group and 42 patients in the TIVOLI group were included in this prospective, single-center study, conducted in Shanghai tenth People's Hospital. Blood samples were collected at baseline, 24 h, 6 months, and 12 months after stent implantation to measure high sensitivity C-reactive protein (hsCRP), fibrinogen (FBG), white blood cell count (WBC), tumor necrosis factor (TNF), and interleukin-6 (IL-6). Receiver-operating characteristic curves and proportional hazards models were generated to evaluate the relationship between 24-h postoperative inflammatory indicators and 3-year patient-oriented composite endpoints (POCE). RESULT: The levels of hsCRP, FBG, WBC, TNF, and IL-6 reached their peak levels 24 h after stenting and then gradually decreased to levels comparable to baseline at 6 and 12 months. During the 3-year follow-up, 11.4 % of the XINSORB cohort and 9.5 % of the TIVOLI cohort experienced POCE (P = 0.948). High levels of hsCRP and IL-6 24 h after the procedure were associated with clinical endpoints, and the combination of these two biomarkers improved the predictive ability of prognosis. CONCLUSIONS: There were no significant differences between the changes in the concentration of inflammatory biomarkers after XINSORB stents or drug-eluting stent implantation. Reduction in postoperative inflammatory levels may decrease the occurrence of clinical outcomes. This study provides insights into the dynamic changes of inflammatory responses and their correlation with clinical outcomes, which could have implications for the management of patients undergoing coronary stenting. TRIAL REGISTRATION: The study has been registered on the official website of the China Clinical Trial Registry (ChiCTR1800014966).

Impact of the Xinsorb Scaffold-Related Parameters on Platelet Reactivity in Patients with Single De Novo Coronary Artery Lesions Undergoing Clopidogrel Treatment.

BACKGROUND: This study aimed to assess the relationship between stent parameters and platelet function, as well as the platelet reactivity profiles over time in patients treated with the Xinsorb scaffold. METHODS: Adenosine diphosphate-induced maximal amplitude was measured as clopidogrel on-treatment platelet reactivity using thrombelastography. High residual platelet reactivity was defined as MAADP > 47 mm. Platelet function testing was induced at baseline, discharge, and 6- and 12-month visits. RESULTS: A total of 40 individuals undergoing Xinsorb scaffold implantation and platelet function testing were included. No adverse events were recorded during follow-up. No correlation was observed among thrombelastography indices, stent diameters, and stent coverage surface area. Significant correlation was found between MAADP and lengths of stents (Spearman rank correlation = 0.324, P =.031). Multiple logistic regression analyses demonstrated that high levels of high-density lipoprotein cholesterol was an independent protective factor for high residual platelet reactivity (odds ratio = 0.049, 95% confidence interval = 0.011-0.296, P =.016). No significant risk factors were identified; MAADP presented to be 20.6 [13.1-36.2] mm, 26.8 [18.2-35.0] mm, and 30.0 [19.6-33.4] mm 48 hours, 6 months, and 12 months after procedure, respectively; 12-month MAADP was significantly higher than the 48-hour MAADP (P =.026). There was no obvious trend for platelet response status over time. CONCLUSION: Among patients on a clopidogrel-based dual antiplatelet treatment regimen following Xinsorb scaffold implantation, stent parameters had no significant effects on platelet reactivity. The high residual platelet reactivity phenotype is relatively stable over time. High residual platelet reactivity is more likely to occur in patients with lower high-density lipoprotein cholesterol levels.

Effect of pulmonary vein cryoballoon ablation in dogs with coolant-nitrogen.

Background: The Arctic Front Advance System with nitrous oxide (N2O) refrigerant is the leading system for the cryoballoon ablation of atrial fibrillation (AF). A novel cryoablation system with nitrogen (N2) refrigerant was developed with technical improvements seeking to improve outcomes. Cryoballoon ablation with the N2 refrigerant may be effective and safe for pulmonary vein isolation (PVI). Methods: In total, 16 dogs were included in the study, of which 13 underwent PVI procedures, and 3 served as baseline controls. Cryoballoons (Cryofocus, Int.) with N2 refrigerant were used for the study group, which comprised 8 dogs, and second-generation cryoballoons with N2O refrigerant (Arctic Front Advance; Medtronic, Inc., MN, USA) were used for the control group, which comprised 5 dogs. Three dogs of the study group and 2 dogs of the control group were euthanized on the same day post-ablation. The other 8 dogs of the two groups were euthanized 1 month post-ablation. The removed organs were examined for gross anatomy and histological review. Results: The average ablation times for each pulmonary vein (PV) in the study group were less than those in the control group (1.1±0.3 vs. 2.0±0.8; P=0.006). The procedure duration of the study group was shorter than that of the control group (379±46 vs. 592±162 s; P=0.013). And the time to isolation (TTI) was similar between the groups. The PVI rate of the single-ablation was higher in the study group than the control group (92.9% vs. 60.0%; P=0.05). In relation to safety, there was no evidence of thrombus, esophageal injury, or pericardial tamponade in any of the dogs. Only 1 incidence of self-limited phrenic nerve paralysis (PNP) was observed in the control group. Conclusions: The novel cryoablation system with the N2 refrigerant had better efficacy than and similar safety to that of the system (Medtronic, Int.) with the N2O refrigerant.

Association of serum vaspin and adiponectin levels with renal function in patients with or without type 2 diabetes mellitus.

Vaspin and adiponectin are two adipocytokines with antidiabetic effects. Some studies reported that levels of adiponectin and vaspin were correlated with decreased glomerular filtration rate (FGR) and increased albuminuria. We therefore evaluated the vaspin and adiponectin levels in renal insufficiency (RI) patients with or without T2DM. Serum vaspin, adiponectin levels were measured in 416 subjects with or without T2DM. Analysis was made between groups divided by these subjects presence or absence of RI. We found that serum adiponectin level was significantly higher in nondiabetic patients with RI than in nondiabetic subjects without RI; however, there were no statistical differences between the diabetic patients with RI and without RI. In all the subjects, the serum adiponectin level was also higher in 50 individuals with RI than that in 366 subjects without RI. The serum vaspin levels showed no significant differences between the diabetic patients or nondiabetics subjects with RI and without RI. Contrary to adiponectin, the serum vaspin level was lower in 169 patients with T2DM than in 247 individuals without T2DM. Our data suggested that both of T2DM and renal insufficiency were correlated with the serum level of adiponectin. However, the serum vaspin levels showed no significant difference between the individuals with renal insufficiency and without renal insufficiency.

[Association of HLA-A, B and DRB1 alleles with leukemia in Han population in Hunan Province].

OBJECTIVE: To investigate the association of HLA-A, B, and DRB1 alleles with leukemia in the Han population in Hunan Province. METHODS: HLA-A, B, and DRB1 alleles were genotyped in 105 patients with chronic myelocytic leukemia, 25 with acute lymphocytic leukaemia, and 48 with acute nonlymphocytic leukemia using polymerase chain reaction with sequence-specific primer (PCR-SSP). The hemopoietic stem cells from 3,664 unrelated normal individuals of Han nationality in Hunan were used as the control group. RESULTS: The phenotypic frequencies of HLA-B58, DR12, and DR14 were significantly higher in patients with chronic myelocytic leukemia than in the control group, with relative risk of 6.1287, 1.6519, and 1.6479, respectively. In patients with acute lymphocytic leukaemia, the phenotypic frequency of HLA-B58 was significantly higher than that in the control group, with the relative risk of 7.4055. In patients with acute nonlymphocytic leukemia, the frequencies of HLA-B58 and DR8 phenotypes were significantly higher but HLA-A24 frequency was significantly lower than those of the control group, with the relative risk of 13.9789, 2.2839, and 0.4012, respectively. CONCLUSION: HLA-B58, DR12, DR14 alleles appear to contribute to the genetic susceptibility of patients with chronic myelocytic leukemia. HLA-B58 allele can be associated with the genetic susceptibility for patients with acute lymphocytic leukaemia. In patients with acute nonlymphocytic leukemia, HLA-B58 and DR8 are probably the susceptible alleles whereas HLA-A24 allele may play a protective role.