Efficacy of Non-Invasive Ventilation in Acute Coronary Syndrome Patients with Acute Systolic Heart Failure.

Background: Acute systolic heart failure (ASHF) is one of the most serious complications of the acute coronary syndrome (ACS), and increases the likelihood of adverse clinical outcomes. It remains unclear whether the use of non-invasive ventilation (NIV) could improve symptoms and reduce mortality in patients with ASHF derived from ACS. Methods: Data on biological, clinical, and demographic factors, as well as therapy data, were collected from patients with ASHF in the cardiac department. A total of 1257 ACS patients with ASHF were included in the study. Patients were divided into two groups. The control group received standard oxygen therapy. The comparison group consisted of those who underwent NIV as part of their immediate care. During hospitalization and at follow-up, information on both groups was systematically compared. Results: In comparison with the control group, mean 24-hour urine output was found to be significantly higher in the NIV group. A significant reduction in the duration of symptoms was observed among patients in the NIV group from the time of admission until relief of dyspnea. Heart rate, C-reactive protein, estimated glomerular filtration rate, and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) was also improved, compared with those in the control group. The NIV group was found to have a higher survival rate. NIV was independently related to all-cause mortality in 1-year follow-up (hazard ratio, 0.674; p = 0.045). Conclusions: Our study shows that NIV, as compared with standard oxygen therapy, has a beneficial impact on heart rate, metabolic balance, and relief of dyspnea in ACS patients with ASHF which results in reduced intubation rate, duration of in-hospital stay, and 1-year mortality.

Caspase-1 inhibition mediates neuroprotection in experimental stroke by polarizing M2 microglia/macrophage and suppressing NF-κB activation.

Stroke is a life-threatening neurological disease with limited therapeutic options. Inflammation is believed to be involved in the pathogenesis of ischemic stroke and contribute to the degree of brain injury. Vx-765 is a potent, selective, small-molecule caspase-1 inhibitor. Current studies have shown the anti-inflammatory properties of vx-765 in various disease; however, the impact of vx-765 on the ischemic stroke is still unclear. In the present study, we determine the neuroprotective effect of vx-765 in mice subjected to transient middle cerebral artery occlusion (MCAO). We found that caspase-1 inhibition by administration of vx-765 ameliorated cerebral injury in mice after ischemic stroke by reducing infarct volume and ameliorating the neurological deficits. Mechanistically, we showed that the contribution of vx-765 to ischemic injuries may be associated with reducing microglial activation, and downregulating the production of associated pro inflammatory cytokines including IL-1ß, TNF-α, and iNOS, as well as upregulating anti-inflammatory cytokines such as TGF-ß and YM-1. Additionally, vx-765 altered the phenotype of microglia via switching the microglia polarization toward M2 phenotype, as demonstrably related to inhibition of the NF-κB activation. Our findings indicate that vx-765 protects against MCAO injury and attenuated microglia mediated neuroinflammation primarily by shifting microglia polarization from M1 phenotype toward M2 phenotype. Vx-765 might be a potential therapeutic drug for ameliorating ischemic stroke.

Using literature-based discovery to identify candidate genes for the interaction between myocardial infarction and depression.

BACKGROUND: A multidirectional relationship has been demonstrated between myocardial infarction (MI) and depression. However, the causal genetic factors and molecular mechanisms underlying this interaction remain unclear. The main purpose of this study was to identify potential candidate genes for the interaction between the two diseases. METHODS: Using a bioinformatics approach and existing gene expression data in the biomedical discovery support system (BITOLA), we defined the starting concept X as "Myocardial Infarction" and end concept Z as "Major Depressive Disorder" or "Depressive disorder". All intermediate concepts relevant to the "Gene or Gene Product" for MI and depression were searched. Gene expression data and tissue-specific expression of potential candidate genes were evaluated using the Human eFP (electronic Fluorescent Pictograph) Browser, and intermediate concepts were filtered by manual inspection. RESULTS: Our analysis identified 128 genes common to both the "MI" and "depression" text mining concepts. Twenty-three of the 128 genes were selected as intermediates for this study, 9 of which passed the manual filtering step. Among the 9 genes, LCAT, CD4, SERPINA1, IL6, and PPBP failed to pass the follow-up filter in the Human eFP Browser, due to their low levels in the heart tissue. Finally, four genes (GNB3, CNR1, MTHFR, and NCAM1) remained. CONCLUSIONS: GNB3, CNR1, MTHFR, and NCAM1 are putative new candidate genes that may influence the interactions between MI and depression, and may represent potential targets for therapeutic intervention.

Removal of chloramphenicol by sulfide-modified nanoscale zero-valent iron activated persulfate: Performance, salt resistance, and reaction mechanisms.

Herein, sulfide-modified nanoscale zero-valent iron (S-nZVI) was prepared by a liquid-phase reduction route and then applied to activate persulfate (PS) for the degradation of chloramphenicol (CAP). The effects of Fe/S molar ratio, catalyst dosage, PS concentration, initial pH, and co-existing ions (Cl-, SO42-, CO32-) on the catalytic performance of S-nZVI/PS system were investigated. Simultaneously, the fluctuations of solution pH, oxidation-reduction potential, dissolved oxygen, and Fe2+ concentration were also monitored during the reaction. Results shown that 98.8 % of CAP could be removed under the optimum reaction conditions (S-nZVI dosage = 0.1 g/L, PS concentration = 3 mM, initial pH = 6.86). Compared to the pristine nZVI, the sulfidation behavior could critically improve the removal efficiency of CAP, ascribe to the enhancements of hydrophobicity of nZVI, production of hydroxyl radicals, and salt resistance. Furthermore, possible degradation pathways of CAP in S-nZVI/PS system were inferred based on liquid chromatography-mass spectrometry (LC-MS) and density functional theory (DFT) calculations. This study proves that the S-nZVI is a more promising catalyst for activating PS than nZVI, especially in the field of saline pharmaceutical wastewater treatment.

Low-temperature carbonization synthesis of carbon-based super-hydrophobic foam for efficient multi-state oil/water separation.

In view of the complexity and diversity of multi-state oils, the development of green and low-cost materials with high selectivity to oils has important ecological significance in the polluted water treatment. Herein, a simple method was proposed to develop large-scale production of superhydrophobic sponges (CPMF200 sponges) for high-efficiency oil/water separation under different complex environments. The as-prepared CPMF200 sponges possessed many superior properties, including high roughness, well-developed porosity, good thermal stability, excellent chemical stability, and superhydrophobic properties (water contact angle is 152°), which is conducive to high oil adsorption capacity (up to 70-179 times of its own weight) and oil-water separation. More importantly, the CPMF400 sponge has an excellent photothermal conversion capability to improve the fluidity of high viscosity oil for oil recovery. Based on a simple synthesis method, it exhibits high-efficiency absorption of multi-state oils and excellent oil-water separation performance and strongly proves their application prospects in treating oily wastewater.

Preparation of a rice straw-based green separation layer for efficient and persistent oil-in-water emulsion separation.

Inefficiency, high cost, and complex operation have emerged as shackles for large-scale separate oil-in-water emulsion. Herein, a low-cost and eco-friendly separation layer with a rough structure and rich anionic groups was fabricated from rice straw (RS) via a simple acid-base treatment and slight squeeze process. The separation layer's morphology, composition, and wettability were investigated. It was then employed to separate oil-in-water emulsion. The RS after acid and alkali treatment (A1A2-RS) exhibited a clear fiber structure and abundant humps, which made the separation layer superwettable and highly electronegative (-26.55 mV). The overlapped and intertwined A1A2-RS layer structure owned a superior performance for hexadecyl-trimethyl-ammonium-bromide (CTAB) adsorption and tiny oil interception. As a result, the separation layer had stable fluxes (>500 LMH) for multiple CTAB-stabilized emulsions and the obtained filtrates performed low total organic carbon (TOC) contents (<30 mg/L). In addition, the A1A2-RS layer had excellent renewability (10 cycles/ 200 mL) and the flux could be substantially recovered merely by aqueous wash. Moreover, filtrate analysis showed that the A1A2-RS layer had a good effect on actual emulsion treatment with a TOC removal rate of 89.56%.

Prognostic potential of layer-specific global longitudinal strain in patients with non-ST-segment elevated acute coronary syndrome and preserved left ventricular ejection fraction.

This study sought to investigate the prognostic potential of layer-specific global longitudinal strain (GLS) in predicting cardiac events among non-ST-segment elevated acute coronary syndrome (NSTE-ACS) patients with preserved LVEF. In this prospective study, we enrolled 160 consecutive NSTE-ACS patients with preserved LVEF (≥ 50%) who underwent successful percutaneous coronary intervention (PCI). Transthoracic two-dimensional echocardiography examinations were performed within 48 h of admission (before PCI). Cardiac events were defined as all-cause death, re-infarction, and hospitalization for heart failure. During a median follow-up of 30.2 months, 23 patients (14.4%) developed cardiac events. GLS for all three myocardial layers were reduced in patients with adverse outcome (all P < 0.001). Yet GLSendo (area under curves = 0.85) and GLSmid (area under curves = 0.83) showed relatively higher predictive power than GLSepi when identifying patients with cardiac events. The best cut-off value of GLSendo was - 20.8%, with a diagnostic sensitivity and specificity of 87% and 71% respectively. A significant increase in the risk of cardiac events development was shown among patients with impaired layer GLS (log-rank test, P < 0.001). In conclusion, NSTE-ACS patients with preserved LVEF, layer GLS assessed before PCI all had good abilities to predict cardiac events, which might provide more prognostic information against conventional echocardiographic risk factors.

Association between type D personality and in-stent restenosis in patients treated with percutaneous coronary intervention: A mediation analysis of dietary patterns.

OBJECTIVE: Type D personality is a psychosocial risk factor for cardiovascular events and in-stent restenosis (ISR), but the mechanisms involved are not well understood. This study aimed to evaluate the effects of dietary patterns on the association between Type D personality and ISR in patients with coronary artery disease treated with percutaneous coronary intervention (PCI). METHODS: This cross-sectional study comprised a total of 230 post-PCI patients who were assessed for Type D personality, depression, dietary patterns, physical activity and medication adherence via self-administered questionnaires. ISR was assessed by coronary angiography. RESULTS: Type D personality (odds ratio [OR], 3.35; 95% confidence interval [CI], 1.05-10.71, p=0.042), low fruit intake (OR, 0.30; 95% CI, 0.12-0.68, p=0.008) and low vegetable intake (OR, 0.48, 95% CI, 0.27-0.91, p=0.021) were independent risk factors for ISR after adjustment for psychosocial, lifestyle and cardiovascular risk factors. Mediation analyses revealed that Type D personality had a significant direct effect on the development of ISR (p<0.05). In addition, nutrients in fruits and vegetables, including vitamin C, vitamin E and fiber, were important mediators of the relationship between Type D personality and ISR (p<0.05), the percentage of total indirect effect was 24.65%. CONCLUSIONS: These findings suggested that the low intake of fruit and vegetables in Type D patients can predict ISR. The healthy dietary interventions to supply vitamin C, vitamin E and fiber may help to improve the prognosis in post-PCI patients with Type D personality.

Association of C-reactive protein and vitamin D deficiency with cardiovascular disease: A nationwide cross-sectional study from National Health and Nutrition Examination Survey 2007 to 2008.

OBJECTIVES: The association of C-reactive protein (CRP) and serum 25-hydroxyvitamin D [25(OH)D] and cardiovascular disease (CVD) remains unknown. METHODS: We performed a cross-sectional analysis on 3848 participants by using the data from the National Health and Nutrition Examination Surveys (2007 to 2008). CVD was defined as a compromise of stroke, myocardial infarction, heart failure, and coronary heart disease. High CRP was defined as ≥0.2 mg/dL, and vitamin D status were categorized as severe deficiency, <25 nmol/mL; deficiency, 25 to 49.9 nmol/mL; insufficiency, 50 to 74.9 nmol/mL; and normal, ≥75 nmol/mL. Statistical analysis was performed using logistic regression models. RESULTS: We found that both high CRP and low 25(OH)D levels were associated with CVD. Participants with high CRP levels and severe vitamin D deficiency had a higher likelihood of having CVD than those with neither risk factor (odds ratio = 2.69, 95% confidence interval = 1.45-4.98, P = .0017). In stratified analysis, a significant positive association between vitamin D level and CVD was observed only in the high CRP group. However, in the absence of high CRP, even with severe vitamin D deficiency, no association was found with an increasing risk of CVD (P = .6416). CONCLUSION: Within a cross-sectional, nationally representative sample, these findings suggest that vitamin D status evaluation, or vitamin D supplement may be especially important for individuals with high CRP levels.

Comparing children and adults with medulloblastoma: a SEER based analysis.

Medulloblastoma (MB) is a brain malignancy, which commonly occurs in children, but is rare in adults. The Surveillance, Epidemiology, and End Results (SEER) database was used to compare survival, clinical features, and prognostic factors of children and adults with MB from 1992 to 2013. Overall survival estimates were compared using the Kaplan-Meier method, and Cox Proportion Hazard Regression modeling was used to evaluate prognostic variables. We identified 616 children (63.8%) and 349 adults (36.2%) with diagnosis of MB. The estimated survival rates for children diagnosed with MB for 2, 5, and 10 years were 85.6%, 75.5%, and 67.9%, respectively; the corresponding estimates for adults were 84.9%, 74.2%, and 67.3%. Radiotherapy was the only identical prognostic factor observed in the two groups. Children MB patients were more likely to experience distal metastases that was associated with increased hazard of mortality, and be diagnosed after 2003. Among adult MB patients, gross total resection (GTR) was a favorable prognostic factor, while large cell/anaplastic (LC/A) histology was correlated with decreased survival. Our analysis highlighted that both groups had similar overall survival time, but the prognostic factors were not comparable, except radiotherapy which was associated with better survival.

[Treatment of floating knee injury].

OBJECTIVE: To explore the clinical outcome of floating knee injury treated by open reduction and internal fixation. METHODS: The course of treatment of floating knee in 78 cases by open reduction and internal fixation were reviewed. There were 59 males and 19 females, aged from 17 to 58 years old, with an average age of 37.5 years. Intramedullary nail, pressure plate hollow screw, multi-function single side external fixation holder and other internal fixature were used in the operation. Early exercises were followed postoperatively. RESULTS: All patients were followed-up for 8 to 35 months (mean 18.6 months). According to the criterion of Karlström, of the 48 cases with femoral shaft fracture, 45 were excellent and 3 were good. In the 11 cases of bimalleolar fracture, 5 were excellent, 3 good, 1 fair and 2 bad. Of the 19 cases of mixed fracture, 9 were excellent,6 good, 3 fair and 1 bad. CONCLUSION: Strict sterilization, non-invasion and standard internal and external fixation could make the fracture anatomical reduction and firm fixation. It is beneficial to early rehabilitation exercise. Complications such as malunion, and stiff joint could be avoided. The clinical outcome were satisfactory.