Early postoperative constrictive pericarditis in China: a single-center retrospective observational study.

Background: The diagnosis, treatment, and prognosis of early postoperative constrictive pericarditis (EPCP) have not been discussed in depth. The objective of this study was to devise and propose a management strategy for EPCP. Methods: In this study, constrictive pericarditis (CP) within 6 months after cardiac surgery was defined as EPCP, and patients were divided into two groups based on intraoperative findings: a parietal thickening group and a visceral thickening group. Results: A total of 20 patients were included in this study, and the incidence rate of recurrent pericardiectomy was 0.32% among all patients undergoing cardiovascular surgery. EPCP after valve surgery occurred in 85.0% of patients. Pleural effusion was the most common preoperative symptom, occurring in 90% of patients. Pericardial thickening occurred in the visceral layer in seven cases and in the parietal layer in 13 cases. There were no differences in comorbidities, C-reactive protein (CRP) level, or erythrocyte sedimentation rate (ESR) between the two groups. Most patients with visceral thickening (83.3%) needed cardiopulmonary bypass (CPB) assistance during surgery and had a longer hospital stay than those with parietal thickening (52.8±21.8 vs. 34.9±13.8 days, P=0.049). Central venous pressure (CVP) was decreased in all patients after pericardiectomy (24.9±6.96 vs. 8.9±2.92 cmH2O, P<0.001), and the cardiac function improved significantly in patients with parietal thickening [New York Heart Association (NYHA) grade ≥ III accounted for 28.6% of patients]. The long-term survival rate of patients with parietal thickening was 92.3% and that of patients with visceral thickening was 57.1%, and there was no significant difference between them (P=0.056). Conclusions: Recurrent episodes of chest tightness, pleural effusion, and elevated CVP within 6 months after cardiac surgery should be considered highly suggestive of EPCP. There are few points of difference between pericarditis with thickening of the parietal and visceral layers. After failure of conservative medical treatment, pericardiectomy results in significant improvements in cardiac function and quality of life, especially in patients with thickening of the parietal layer.

Construction of clinical research nurse training program based on position competence.

BACKGROUND: As one of the most important members in clinical trials, the number of clinical research nurses (CRN) can't keep up with the growth of experimental projects, so it is urgent to build clinical research training and strengthen the background knowledge of nurses. AIM: To construct CRN training program based on position competence, accelerate the construction of CRN talent pool, and provide scientific guidance significance for CRN training. METHODS: Based on the position competence model, combined with literature research and qualitative interview results, the first draft was prepared of the CRN training program. Two rounds of correspondence with 16 experts were conducted using the Delphi method to determine the training program. RESULTS: The effective recovery rate of the expert correspondence questionnaire was 100% and the authority coefficients of the 2 rounds of experts were 0.826 and 0.895. Finally, 4 first-level indicators and determine 15 s-level indicators of training objectives. The training program included 4 first-level indicators, training requirements, content, methods, assessment and evaluation, 15 s-level indicators, and 74 third-level indicators. CONCLUSION: The CRN training program based on position competence is scientific and extendable, providing a basis for participation in CRN training.

Modulation of ultrathin nanosheet structure and nitrogen defects in graphitic carbon nitride for efficient photocatalytic bacterial inactivation.

The efficient generation and utilization of ROSs is a key step in determining the achievement of safe drinking water by photocatalytic bacterial inactivation technology. Although graphitic carbon nitride (g-C3N4) serves as a green and promising photocatalyst for water disinfection, insufficient bacterial capturing capacity and serious charge recombination of pristine g-C3N4 extremely restrict its bactericidal activity. Herein, we develop a facile thermal exfoliation and thermal polymerization method to prepare the nitrogen-defective ultrathin g-C3N4 nanosheets (DUCN-500). Our results showed that ultrathin nanosheet structure greatly enhanced bacterial capturing capacity of g-C3N4 to increase the utilization efficiency of ROS, which contributed to the performance of DUCN-500 greatly outperforming bulk g-C3N4. The nitrogen defects increased ROS generation (·O2- and H2O2) by approximately 4.6 times, which was attributed to negative shift of the conduction band potential and rapid separation of charge carriers. The DUCN-500 could rapidly and completely inactivate Escherichia coli and Bacillus subtilis in real sewage under simulated solar irradiation, accompanied by good anti-interference capability and stability. Additionally, bacterial morphology destruction, the loss of antioxidant enzyme activity and the leakage of protein were proven to be the main mechanisms of photocatalytic sterilization. This study offers new insight into the rational design of efficient g-C3N4-based photocatalysts for water disinfection.

Face mask derived micro(nano)plastics and organic compounds potentially induce threat to aquatic ecosystem security revealed by toxicogenomics-based assay.

Micro(nano)plastics widely detected in aquatic environments have caused serious threat to water quality security. However, as a potential important source of micro(nano)plastics in surface water during the COVID-19 pandemic, the ecological risks of face mask waste to aquatic environments remain poorly understood. Herein, we comprehensively characterized the micro(nano)plastics and organic compounds released from four daily used face masks in aqueous environments and further evaluated their potential impacts on aquatic ecosystem safety by quantitative genotoxicity assay. Results from spectroscopy and high-resolution mass spectrum showed that plastic microfibers/particles (∼11%-83%) and leachable organic compounds (∼15%-87%) were dominantly emitted pollutants, which were significantly higher than nanoplastics (< ∼5%) based on mass of carbon. Additionally, a toxicogenomics approach using green fluorescence protein-fused whole-cell array revealed that membrane stress was the primary response upon the exposure to micro(nano)plastics, whereas the emitted organic chemicals were mainly responsible for DNA damage involving most of the DNA repair pathways (e.g., base/nucleotide excision repair, mismatch repair, double-strand break repair), implying their severe threat to membrane structure and DNA replication of microorganisms. Therefore, the persistent release of discarded face masks derived pollutants might exacerbate water quality and even adversely affect aquatic microbial functions. These findings would contribute to unraveling the potential effects of face mask waste on aquatic ecosystem security and highlight the necessity for more developed management regulations in face mask disposal.

Risk factors for in-hospital mortality after total arch procedure in patients with acute type A aortic dissection.

Object: Knowledge about the risk factors of in-hospital mortality for acute type A aortic dissection (ATAAD) patients who received total arch procedure is limited. This study aims to investigate preoperative and intraoperative risk factors of in-hospital mortality of these patients. Methods: From May 2014 to June 2018, 372 ATAAD patients received the total arch procedure in our institution. These patients were divided into survival and death groups, and patients` in-hospital data were retrospectively collected. Receiver operating characteristic curve analysis was adopted to determine the optimal cut-off value of continuous variables. Univariate and multivariable logistic regression analyses were used to detect independent risk factors for in-hospital mortality. Results: A total of 321 patients were included in the survival group and 51 in the death group. Preoperative details showed that patients in the death group were older (55.4 ± 11.7 vs. 49.3 ± 12.6, P = 0.001), had more renal dysfunction (29.4% vs. 10.9%, P = 0.001) and coronary ostia dissection (29.4% vs. 12.2%, P = 0.001), and decreased left ventricular ejection fraction (LVEF) (57.5 ± 7.9% vs. 59.8 ± 7.3%, P = 0.032). Intraoperative results showed that more patients in the death group experienced concomitant coronary artery bypass grafting (35.3% vs. 15.3%, P = 0.001) with increased cardiopulmonary bypass (CPB) time (165.7 ± 39.0 vs. 149.4 ± 35.8 min, P = 0.003), cross-clamp time (98.4 ± 24.5 vs. 90.2 ± 26.9 min, P = 0.044), and red blood cell transfusion (913.7 ± 629.0 vs. 709.7 ± 686.6 ml, P = 0.047). Logistic regression analysis showed that age >55 years, renal dysfunction, CPB time >144 min, and RBC transfusion >1,300 ml were independent risk factors for in-hospital mortality in patients with ATAAD. Conclusion: In the present study, we identified that older age, preoperative renal dysfunction, long CPB time, and intraoperative massive transfusion were risk factors for in-hospital mortality in ATAAD patients with the total arch procedure.

Effect of Defecation Delay in Patients After Tricuspid Valve Replacement: A Retrospective Study.

BACKGROUND: Defecation delay is a common symptom in patients after tricuspid valve replacement (TVR). Previous studies have demonstrated that defecation delay was associated with worse clinical outcomes of critically ill patients. Our study aimed to investigate the incidence and risk factors of defecation delay in patients after TVR and its adverse clinical outcomes. METHODS: A retrospective study was conducted in 206 patients undergoing TVR under cardiopulmonary bypass from May 2005 to July 2021. According to the first postoperative defecation time after surgery, patients were divided into the delayed group (>3 days) and control group (≤3 days). Baseline characteristics and preoperative, intraoperative, and postoperative data were collected to investigate the clinical outcomes of defecation delay. RESULTS: Among the 206 patients, 51.9% (107/206) cases were classified into the defecation delay group. Univariate analysis showed that age (P = 0.043), preoperative platelets (PLT) (P < 0.001), cardiopulmonary bypass (CPB) time (P = 0.013), minimum rectal temperature (P = 0.042), and the use of prokinetic drugs (P = 0.015) were significantly different in the two groups. In addition, the perioperative adverse events in the defecation delay group were significantly higher than that of the control group. Logistic regression analysis indicated that the mortality of patients was associated with postoperative renal dysfunction (P = 0.047) and postoperative respiratory failure (P = 0.004) but was not associated with defecation delay (P > 0.05). CONCLUSION: Patients with defecation delay after TVR were more likely to appear adverse events, however, defecation delay was not associated with mortality after TVR.

Consumption of whole grains in relation to mortality from all causes, cardiovascular disease, and diabetes: Dose-response meta-analysis of prospective cohort studies.

BACKGROUND: To investigate the correlation between consumption of whole grains and the risk of all-cause, cardiovascular disease (CVD), and diabetes-specific mortality according to a dose-response meta-analysis of prospective cohort studies. METHODS: Observational cohort studies, which reported associations between whole grains and the risk of death outcomes, were identified by searching articles in the MEDLINE, EMBASE, and the reference lists of relevant articles. The search was up to November 30, 2015. Data extraction was performed by 2 independent investigators, and a consensus was reached with involvement of a third. RESULTS: Ten prospective cohort studies (9 publications) were eligible in this meta-analysis. During follow-up periods ranging from 5.5 to 26 years, there were 92,647 deaths among 782,751 participants. Overall, a diet containing greater amounts of whole grains may be associated with a lower risk of all-cause, CVD-, and coronary heart disease (CHD)-specific mortality. The summary relative risks (RRs) were 0.93 (95% confidence intervals [CIs]: 0.91-0.95; Pheterogeneity < 0.001) for all-cause mortality, 0.95 (95% CIs: 0.92-0.98; Pheterogeneity < 0.001) for CVD-specific mortality, and 0.92 (95% CIs: 0.88-0.97; Pheterogeneity < 0.001) for CHD-specific mortality for an increment of 1 serving (30 g) a day of whole grain intake. The combined estimates were robust across subgroup and sensitivity analyses. Higher consumption of whole grains was not appreciably associated with risk of mortality from stroke and diabetes. CONCLUSION: Evidence from observational cohort studies indicates inverse associations of intake of whole grains with risk of mortality from all-cause, CVD, and CHD. However, no associations with risk of deaths from stroke and diabetes were observed.

Decreased expression of microRNA-320a promotes proliferation and invasion of non-small cell lung cancer cells by increasing VDAC1 expression.

Accumulating evidence indicates that Voltage Dependent Anion Channel 1 (VDAC1) correlates with the initiation and progression of non-small cell lung cancer (NSCLC). However, the regulatory mechanism of VDAC1 in NSCLC remains unclear. Previous studies have reported that expression of miR-320a was decreased in human primary squamous cell lung carcinoma, which prompted us to investigate whether there is a functional link between decreased miR-320a and a high expression of VDAC1. In the present report, using computational analysis, we first show that miR-320a has a potential binding site on VDAC1 mRNA, and expression of miR-320a was decreased in NSCLC cell lines. Using gain-of-function and rescue experiments, we demonstrate that VDAC1 is a direct target of miR-320a in NSCLC cells, and miR-320a inhibits VDAC1 expression in NSCLC cells. Further we show that MiR-320a was significantly decreased in NSCLC tissues compared with adjacent non-tumor tissues, and MiR-320a level is negatively correlated with VDAC1 in NSCLC tissues by Pearson's correlation coefficient analysis. Moreover, using cellular ATP assay, we found that suppression of VDAC1 expression may inhibit cell proliferation and invasion of NSCLC by decreasing cell energy and metabolism. Importantly, we showed that ectopic overexpression of miR-320a blocked tumor cell proliferation and invasion, both in vitro and in vivo, through inhibiting VDAC1. Our results suggest that reduced expression of miR-320a facilitates the development of NSCLCs by increasing VDAC1 expression. We identified a novel regulatory mechanism between miR-320a and VDAC1, and miR-320a may serve as a tumor suppressor gene and a promising therapeutic target of NSCLCs.

MicroRNA-30b/c inhibits non-small cell lung cancer cell proliferation by targeting Rab18.

BACKGROUND: MicroRNAs (miRNAs) are small noncoding RNAs that post-transcriptional regulate gene expression in a variety of cancers. Increasing evidences indicate that miR-30 expression is down-regulated in numerous human cancers including non-small cell lung cancer (NSCLC) which hypothesizes that miR-30 may play an important role in tumorigenesis. The aim of this study was to investigate the target gene of miR-30 and its roles in tumor growth of NSCLC. METHODS: Luciferase reporter assays were employed to validate regulation of a putative target of miR-30. The effect of miR-30 on endogenous levels of this target were subsequently confirmed via Western blot (WB). Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was performed to determine the expression level of miR-30 in NSCLC specimens and adjacent non-tumor tissues. MTT assays were conducted to explore the impact of miR-30 overexpression on the proliferation of human NSCLC cells. RESULTS: Both miR-30b and miR-30c (miR-30b/c) were found having target site in same region of Rab18 mRNA. Luciferase assays using a reporter carrying a putative miR-30b/c target site in the coding DNA sequence (CDS) region of Rab18 revealed that miR-30b/c directly targeted Rab18. Overexpression of miR-30b/c led to down-regulation of Rab18 in A549 and H23 cells at protein levels but not mRNA levels. Down-regulation of miR-30b/c and up-regulation of Rab18 protein levels were detected in NSCLC specimens compared with adjacent non-tumor tissues. Overexpression of miR-30b/c suppressed NSCLC cells growth. Knockdown of Rab18 by siRNA significantly inhibited the proliferation of NSCLC cells. CONCLUSIONS: We demonstrated that miR-30b/c was down-regulated in NSCLC specimens compared with adjacent non-tumor tissues. miR-30b/c directly targeted and down-regulated Rab18 expression and inhibited NSCLC cells proliferation. These data indicated that miR-30b/c could serve as a tumor suppressor gene involved in NSCLC pathogenesis.

Pulmonary artery haemodynamic properties in patients with pulmonary hypertension secondary to rheumatic mitral stenosis.

We sought to explore the pulmonary haemodynamic changes in rheumatic mitral stenosis patients with secondary pulmonary hypertension. The pulmonary artery resistance and compliance of 35 patients with rheumatic mitral stenosis and 12 controls without cardiopulmonary vascular disease were evaluated by using an improved method, which is based on making calculations with parameters obtained from right heart catheterisation. The results are as follows: (1) pulmonary artery compliance in patients with secondary pulmonary hypertension was significantly lower than that of the control group (P<0.01); (2) linear correlation analyses showed that preoperative mean pulmonary artery pressure (mPAP) closely correlated with zero-pressure compliance in the mitral stenosis group (r=-0.745, P<0.05); (3) PAP and pulmonary vascular resistance decreased significantly in both groups with mitral stenosis after infusing 0.5 µg kg(-1) min(-1) of sodium nitroprusside (P<0.01). The pulmonary zero pressure compliance and mean pressure compliance increased significantly in the group with mild pulmonary hypertension; whereas in the severe group, the mean compliance changed with significance as the mPAP decreased (1.51 ± 0.59 vs 1.81 ± 0.77 ml/mmHg), however no significant change occurred in the pulmonary zero pressure compliance (2.35 ± 1.24 ml/mmHg vs. 2.24 ± 1.53 ml/mmHg, P>0.05) The walls of pulmonary artery vessels in patients with pulmonary hypertension secondary to rheumatic mitral stenosis appeared to be remodelled by varying degrees as indicated by their haemodynamic properties. Structural remodelling may be a factor affecting preoperative pulmonary artery pressure. Mitral stenosis patients with severe pulmonary hypertension have significantly lower responses to sodium nitroprusside possibly due to aggradation and deposition of collagen in the artery walls, decreasing constriction and dilation, or atrophy of smooth muscle cells.

[Correlation of aquaporin 3 expression with the clinicopathologic characteristics of non-small cell lung cancer].

BACKGROUND: Lung cancer is a major health problem worldwide. The aim of this study is to investigate aquaporin 3 (AQP3) expression and its relationship with the clinicopathologic characteristics of non-small cell lung cancer (NSCLC). METHODS: AQP3 expression and the microvascular density (MVD) of tissue samples from 180 cases with NSCLC were detected by immunohistochemistry. RESULTS: AQP3 expression was negative in 25 (13.9%), positive in 67 (37.2%), and strongly positive in 88 (48.9%) of the 180 cases, which was significantly higher than that in the normal tissue (P<0.01). A significant correlation was found between AQP3 expression and MVD (P<0.01), whereas a high MVD was found among patients with strongly positive AQP3 expression. Male patients with positive or strongly positive AQP3 expression had significantly higher expression than female patients did (P=0.003). AQP3 expression was more significantly enhanced in adenocarcinoma than that in squamous cell carcinoma (P<0.001). Statistical analysis indicated that the positive rate of AQP3 expression in well-differentiated carcinoma was significantly higher than that in poorly differentiated tumors (P<0.001). Lymph node metastasis was positively correlated with high AQP3 expression (P=0.026). CONCLUSIONS: AQP3 expression was closely correlated with MVD in NSCLC, whereas high MVD was frequently found in tumors with high AQP3 expression. AQP3, as a therapeutic target for inhibiting high AQP3 expression in NSCLC tissues, may weaken cancer cell proliferation, invasion, and metastasis.

[Establishment and characterization of a human lung adenocarcinoma cell line, Ch-Huang-1].

BACKGROUND AND OBJECTIVE: Lung cancer is a major worldwide health problem. The aim of this study is to establish a novel Chinese human lung adenocarcinoma cell line and examine its biological characteristics. METHODS: Lung adenocarcinoma specimens were freshly resected during surgery. The tissues were incubated in vitro and the cell line was named Ch-Huang-1. The biological characteristics of the cells were investigated by light microscopy, chromosome analysis, and transplantation experiment. RESULTS: Light microscopy revealed that cells from the primary tumor, Ch-Huang-1 cell line, and transplanted tumor possessed the characteristics of a malignant glandular epithelial tumor. The cell growth curve, doubling time, and mitotic index were also observed in vitro. Nuclear chromosome analysis revealed that the tumor was a subtriploid with a mode of 35-44 per cell. Tumor nodes were observed under the skin of nude mice by heterogenic transplantation. CONCLUSION: The characteristics of the established cell line suggest that it is a newly established human adenocarcinoma cell line.

[Clinical effects of alprostadil injection on acute kidney injury after cardiac surgical procedures].

OBJECTIVE: To explore the clinical effects of alprostadil injection on acute kidney injury (AKI) after cardiac surgical procedures by a prospective randomized controlled trial. METHODS: A total of 63 AKI-patients after cardiac surgical procedures were randomly divided into the control group (n = 31) and the study group (n = 32). All patients received routine therapy while patients in the study group were additionally given alprostadil injection (10 µg i.v. once every 12 hours) for 7 days. A 11-year-old patient weighing 29 kg was given half of the conventional dose. During the period of control treatment (7 days), 1 patient in the control group and 2 patients in the study group were excluded because of hemodialysis or peritoneal dialysis. Urine volume, urine ß-N-acetylglucosaminidase, urine α(1)-microglobulin, urine ß(2)-microglobulin, serum creatinine and blood urea nitrogen were measured before and after the control treatment. And the ICU stay duration and the percentage of dialysis after the control treatment were calculated. Adverse reactions of alprostadil injection were observed simultaneously in the study group. RESULTS: After the treatment, urine volume in the study group was obviously more than that in the control group [(65.9 ± 3.1) ml/h vs (58.8 ± 4.5) ml/h, P < 0.05] while urine ß-N-acetylglucosaminidase, urine α(1)-microglobulin, urine ß(2)-microglobulin, serum creatinine and blood urea nitrogen in the study group were obviously lower than those in the control group (all P < 0.05). The ICU stay duration in the study group was obviously less than that in the control group [(12 ± 5) d vs (17 ± 5) d, P < 0.05]. But there was no significant difference in the percentage of dialysis after the control treatment between two groups (3.3% vs 6.7%, P > 0.05). And no serious adverse reaction was reported in the study group. CONCLUSION: On the basis of routine therapy, alprostadil injection may promote the recovery of renal function in AKI-patients after cardiac surgical procedures.