Relationship between low relative muscle mass and aortic regional morphological changes in adults underwent contrast CT scans for cancer diagnostics.

OBJECTIVES: Low muscle mass is related to cardiovascular risk factors. This study aimed to investigate whether relative low muscle mass is related to the diameter and tortuosity of the aorta. METHODS: We performed a cross-sectional study of 208 adults without known cardiovascular disease who underwent Computed Tomography (CT) enhanced scan between 2020 and 2021. Skeletal muscle index (SMI) was estimated. The morphology of the aorta was measured by diameter and tortuosity using CT. We assessed the relationship between SMI and diameter and tortuosity of the aorta using Spearman correlation analysis and univariate and multivariate-adjusted regression models. RESULTS: Of all -individuals, 124 (59.6%) were male. The average age was 60.13 ± 16.33 years old. SMI was inversely associated with the diameter and tortuosity of the aorta (p < 0.05). Specifically, in a multivariable-adjusted model adjusting for potential confounders, a one-unit increase in the SMI was associated with a -13.56mm(95% confidence intervals (CI): -18.16 to -8.96, p < 0.001), -7.93 mm (95% CI: -10.85 to -5.02, p < 0.001), -8.01 mm (95% CI: -11.30 to -4.73, p < 0.001), -5.16 mm (95% CI: -7.57 to -2.75, p < 0.001) and -2.73 mm (95% CI: -5.18 to -0.27, p = 0.031) increase in L1-L5 diameter respectively, a -0.89 (95% CI: -1.14 to -0.64, p < 0.001) increase in the aorta tortuosity, a -0.48 (95% CI: -0.59 to -0.36, p < 0.001) increase in the descending thoracic aorta tortuosity, and a -0.44 (95% CI: -0.52 to -0.35, p < 0.001) increase in the abdominal aorta tortuosity. CONCLUSIONS: Relative muscle mass was negatively associated with the diameter and tortuosity of the aorta, suggesting muscle mass maintenance may play a role in preventing aortic morphological changes.

ZnSe/SnSe Heterostructure Incorporated with Selenium/Nitrogen Co-Doped Carbon Nanofiber Skeleton for Sodium-Ion Batteries.

Effective strategies toward building exquisite nanostructures with enhanced structural integrity and improved reaction kinetics will carry forward the practical application of alloy-based materials as anodes in batteries. Herein, a free-standing 3D carbon nanofiber (CNF) skeleton incorporated with heterostructured binary metal selenides (ZnSe/SnSe) nanoboxes is developed for Na-ion storage anodes, which can facilitate Na+ ion migration, improve structure integrity, and enhance the electrochemical reaction kinetics. During the carbonization and selenization process, selenium/nitrogen (Se/N) is co-doped into the 3D CNF skeleton, which can improve the conductivity and wettability of the CNF matrices. More importantly, the ZnSe/SnSe heterostructures and the Se/N co-doping CNFs can have a synergistic interfacial coupling effect and built-in electric field in the heterogeneous interfaces of ZnSe/SnSe hetero-boundaries as well as the interfaces between the CNF matrix and the selenide heterostructures, which can enable fast ion/electron transport and accelerate surface/internal reaction kinetics for Na-ion storage. The ZnSe/SnSe@Se,N-CNFs exhibit superior Na-ion storage performance than the comparative ZnSe/SnSe, ZnSe and SnSe powders, which deliver an excellent rate performance (882.0, 773.6, 695.7, 634.2, and 559.0 mAh g-1 at current rates of 0.1, 0.2, 0.5, 1, and 2 A g-1) and long-life cycling stability of 587.5 mAh g-1 for 3500 cycles at 2 A g-1.

The impact of baseline calcified plaque volume on coronary rapid plaque progression by serial coronary computed tomography angiography in patients with type 2 diabetes.

OBJECTIVES: Patients with type 2 diabetes mellitus (T2DM) are susceptible to coronary artery disease (CAD), and coronary outcomes in these patients are heterogeneous. However, the impact of coronary plaque compositions on rapid plaque progression (RPP) in patients with T2DM has rarely been reported. This study aimed to investigate the association of coronary plaque compositions with rapid lesion volume progression in patients with T2DM. MATERIALS AND METHODS: A total of 159 subjects (aged 62.51 ± 10.3 years, 68.6% were male) who underwent serial coronary computed tomography angiography (CCTA) with type 2 diabetic status were enrolled. Annual change of plaque volume (PV) (mm3/year) was defined as PV change divided by inter-scan period. RPP was defined as the progression of plaque burden (PV divided by vessel volume multiplied by 100) ≥0.59%/year. Plaque components were compared between RPP and no RPP groups. Then all patients were divided into 3 groups according to the baseline calcified plaque volume tertiles. The outcome was whether RPP occurred. RESULTS: The median inter-scan period was 2.09 (range 1.41-3.33) years. The overall incidence of RPP was 61.0%. The calcified plaque volume decreased significantly in the RPP group as compared to the no RPP group. The risk of RPP (odds ratio [OR] 0.39; 95% confidence interval [CI]: 0.17-0.88; p = 0.024) was reduced in tertiles III as compared to that in tertiles I even after adjustment for baseline variables (OR 0.21; 95% CI: 0.07-0.63; p = 0.005). Moreover, adding the calcified plaque volume significantly raised the predictive value for the RPP (0.370, p = 0.030, and 0.059, p = 0.025, NRI, and IDI respectively) as compared to traditional factors. CONCLUSION: The baseline calcified plaque volume is an independent protective factor for the rapid progression of coronary atherosclerosis in patients with T2DM.

The calcified plaque volume of the coronary was significantly lower in T2DM subjects with RPP than in those without RPP.Higher levels of atherosclerotic calcification may have a protective value on plaque stabilization in patients with T2DM.Calcified plaque volume of the coronary should be considered when proposing risk stratification in T2DM patients.

The Effect of Cooling Rates on Thermal, Crystallization, Mechanical and Barrier Properties of Rotational Molding Polyamide 11 as the Liner Material for High-Capacity High-Pressure Vessels.

The rapid development of hydrogen fuel cells has been paralleled by increased demand for lightweight type IV hydrogen storage vessels with high hydrogen storage density, which raises the performance requirements of internal plastic liners. An appropriate manufacturing process is important to improve the quality of polymer liners. In this paper, DSC, WAXD, a universal testing machine and a differential pressure gas permeameter were used to investigate the effect of the cooling rate of the rotational molding polyamide 11 on the thermal, crystallization, mechanical and barrier properties. The cooling rate is formulated according to the cooling rate that can be achieved in actual production. The results suggest that two PA11 liner materials initially exhibited two-dimensional (circular) growth under non-isothermal crystallization conditions and shifted to one-dimensional space growth due to spherulite collision and crowding during the secondary crystallization stage. The slower the cooling process, the greater the crystallinity of the specimen. The increase in crystallinity significantly improved the barrier properties of the two PA11 liner materials, and the gas permeability coefficient was 2-3-fold higher than at low crystallinity. Moreover, the tensile strength, the tensile modulus, the flexural strength, and the flexural modulus increased, and the elongation at break decreased as the crystallinity increased.

GSDME-mediated pyroptosis promotes the progression and associated inflammation of atherosclerosis.

Pyroptosis, a type of Gasdermin-mediated cell death, contributes to an exacerbation of inflammation. To test the hypothesis that GSDME-mediated pyroptosis aggravates the progression of atherosclerosis, we generate ApoE and GSDME dual deficiency mice. As compared with the control mice, GSDME-/-/ApoE-/- mice show a reduction of atherosclerotic lesion area and inflammatory response when induced with a high-fat diet. Human atherosclerosis single-cell transcriptome analysis demonstrates that GSDME is mainly expressed in macrophages. In vitro, oxidized low-density lipoprotein (ox-LDL) induces GSDME expression and pyroptosis in macrophages. Mechanistically, ablation of GSDME in macrophages represses ox-LDL-induced inflammation and macrophage pyroptosis. Moreover, the signal transducer and activator of transcription 3 (STAT3) directly correlates with and positively regulates GSDME expression. This study explores the transcriptional mechanisms of GSDME during atherosclerosis development and indicates that GSDME-mediated pyroptosis in the progression of atherosclerosis could be a potential therapeutic approach for atherosclerosis.

Nonsteroidal anti-inflammatory drug monitoring in serum: a Tb-MOF-based luminescent mixed matrix membrane detector with high sensitivity and reliability.

The identification of drugs or biomolecules for public health monitoring requires facile analytical technologies with excellent sensitivity, portability and reliability. In the past decades, different sensing materials have inspired the development of various bioanalytical strategies. However, sensing platforms based on powder materials are not suitable for medical diagnosis, which limits further exploration and application of biosensors. Herein, a point-of-care testing (POCT) membrane was designed from an energy competition mechanism and achieved the detection of the nonsteroidal antiphlogistic diclofenac, and exhibited remarkable testing efficacy at the ppb level. The mixed matrix membrane (MMM) sensor consists of electrospun polyacrylonitrile nanofibers and luminescent Tb-MOFs and possess the advantages of high stability, outstanding anti-interference ability, efficient detection (LOD = 98.5 ppb) and easy visual recognition. Furthermore, this MMM sensor exhibits excellent recyclability in serum, which is beneficial for developing a portable and convenient device to distinguish diclofenac in practical sensing applications. Meanwhile, the feasibility and mechanism of this recyclable sensor were verified by theory and experiments, indicating that it is a promising device for diclofenac detection in biological environments to evaluate the toxic effect caused by the accumulation of nonsteroidal drugs.

The Association between Serum Total Bile Acid Level and Long-Term Prognosis in Patients with Coronary Chronic Total Occlusion Undergoing Percutaneous Coronary Intervention.

Background and Aims: Bile acids, the key products for elimination of cholesterol, play an important role in coronary artery disease (CAD). However, few studies focused on the roles of more accessible serum total bile acids (TBA) in the prediction of adverse cardiovascular events for coronary chronic artery occlusion (CTO). The aim of this study was to explore the potential relationship between serum TBA and long-term prognosis in patients with CTO undergoing percutaneous coronary intervention (PCI). Methods: Baseline TBA was determined in 613 patients with CTO after PCI in the present study. All patients were divided into 3 groups according to the median (3.5 µmol/l) and the normal upper limit of the TBA (10 µmol/l). The primary endpoint was all-cause mortality, and the secondary endpoint was major adverse cardiovascular events (MACE). Results: Average age in this study was 65.44 ± 9.94 years old. The median of TBA was 3.5 (2.1-6.1) µmol/l. Over a median follow-up of 33.5 months, compared to those with below 3.5 µmol/l TBA, 3.5 ~ 10 µmol/l TBA was associated with significantly reduced risk for the MACE (hazard ratio (HR): 0.59, 95% confidence interval (CI): 0.40 to 0.88; p = 0.009) even after adjustment for baseline variables. However, TBA did not predict all-cause mortality and cardiovascular death. Spline analyses showed an L-shaped relationship of the serum TBA with the incidence of MACE. Conclusions: Moderate fasting serum TBA level has a predictive value for MACE even after adjusting for lifestyle and clinical risk factors in CTO patients undergoing PCI.

The Usefulness of C-Reactive Protein to Albumin Ratio in the Prediction of Adverse Cardiovascular Events in Coronary Chronic Total Occlusion Undergoing Percutaneous Coronary Intervention.

Inflammation and nutrition as main factors can affect the prognosis of patients with chronic total coronary occlusion (CTO) undergoing percutaneous coronary intervention (PCI). The C-reactive protein to albumin ratio (CAR) can clarify the inflammation and nutrition status, which are highly related to clinical outcomes. This study aims to investigate the association between CAR and adverse cardiovascular events in patients with CTO undergoing PCI. For this study, 664 patients were divided into three groups based on the tertiles of CAR. The primary endpoint was all-cause mortality and the secondary endpoint was major adverse cardiovascular events (MACE). Over a median follow-up of 33.7 months, the primary endpoint occurred in 64 patients (9.6%) and the secondary endpoint occurred in 170 patients (25.6%). The patients with higher CAR represented a worse prognosis with all-cause death and cardiovascular death after the adjustment for the baseline risk factors. Adding the CAR values raised the predictive value for the incidence of the all-cause death and cardiovascular death but not MACE. The capacity of prognosis prediction was improved after the addition of the CAR value to the traditional prediction model.

Potential Influential Factors of In-Hospital Myocardial Reinfarction in ST-Segment Elevation Myocardial Infarction (STEMI) Patients: Finding from the Improving Care for Cardiovascular Disease in China- (CCC-) Acute Coronary Syndrome (ACS) Project.

In this study, 39915 inpatients with a discharge diagnosis of STEMI from the CCC-ACS project phase I and II were included. The prevalence of the medical history, clinical complications on admission and treatment during hospitalization in the STEMI inpatients with and without in-hospital reinfarction was presented. The factors that were differentially distributed and of critical clinical significance (e.g., age, sex, heart rate, smoking, MI history, HF history, COPD history, stroke, hypertension, diabetes, PCI treatment, administration of DAPT, and statins) were entered into standard Cox regression model and competing risk model for potential influential factors of in-hospital reinfarction. Patients with a higher heart rate (OR 1.018; 95% CI 1.003 to 1.033) were more susceptible to in-hospital reinfarction. Myocardial infarction history (OR 2.840; 95% CI 1.160 to 6.955) was a risk factor of in-hospital reinfarction independent of hypertension, diabetes, and dyslipidaemia.

Glycoursodeoxycholic acid ameliorates diet-induced metabolic disorders with inhibiting endoplasmic reticulum stress.

Recent studies reveal that bile acid metabolite composition and its metabolism are changed in metabolic disorders, such as obesity, type 2 diabetes and metabolic associated fatty liver disease (MAFLD), yet its role and the mechanism remain largely unknown. In the present study, metabolomic analysis of 163 serum and stool samples of our metabolic disease cohort was performed, and we identified glycoursodeoxycholic acid (GUDCA), glycine-conjugated bile acid produced from intestinal bacteria, was decreased in both serum and stool samples from patients with hyperglycemia. RNA-sequencing and quantitative PCR results indicated that GUDCA alleviated endoplasmic reticulum (ER) stress in livers of high fat diet (HFD)-fed mice without alteration of liver metabolism. In vitro, GUDCA reduced palmitic acid induced-ER stress and -apoptosis, as well as stabilized calcium homeostasis. In vivo, GUDCA exerted effects on amelioration of HFD-induced insulin resistance and hepatic steatosis. In parallel, ER stress and apoptosis were decreased in GUDCA-treated mice as compared with vehicle-treated mice in liver. These findings demonstrate that reduced GUDCA is an indicator of hyperglycemia. Supplementation of GUDCA could be an option for the treatment of diet-induced metabolic disorders, including insulin resistance and hepatic steatosis, with inhibiting ER stress.

Prognostic value of malnutrition using geriatric nutritional risk index in patients with coronary chronic total occlusion after percutaneous coronary intervention.

BACKGROUND: Malnutrition is associated with poor prognosis in a wide range of chronic illnesses, however, the impact of malnutrition on long-term outcomes of patients at advanced stages of atherosclerosis, coronary chronic artery occlusion (CTO), is not known. AIMS: This study aims to investigate the relationship between malnutrition and adverse cardiovascular events in patients with CTO after percutaneous coronary intervention (PCI). METHODS: Baseline malnutrition risk was determined in 669 patients with CTO after PCI in this study. All patients were divided into 3 groups according to 3 categories of the geriatric nutritional risk index (GNRI): moderate to severe, GNRI of <92 (n = 70); low, GNRI of 92-98 (n = 197); and absence of risk, GNRI of ≥98 (n = 402). The primary endpoint was all-cause mortality and the secondary endpoint was major adverse cardiovascular events (MACE). RESULTS: Average age in this study was 65.32 ± 9.97 years old. More than one-third of patients were at risk of malnutrition (moderate to severe: 10.5%; low: 29.4%; and absence of risk: 60.1%). Over a median follow-up of 33 months, compared to those with absent risk for malnutrition, moderate to severe risk was associated with significantly increased risk for the all-cause death, cardiovascular death and MACE (hazard ratio [HR]: 2.90, 95% confidence interval [CI]: 1.43 to 5.87, P for trend = 0.002; HR: 3.72, 95% CI: 1.42 to 9.77, P for trend = 0.010; HR: 1.76, 95% CI: 1.02 to 3.03, P for trend = 0.040; respectively) after adjustment for baseline variables. Moreover, addition of the GNRI score significantly raised the predictive value for the all-cause death (0.383, p = 0.004 and 0.022, p = 0.011, NRI and IDI respectively), cardiovascular death (0.488, p < 0.001 and 0.013, p = 0.014, NRI and IDI respectively) and MACE (0.368, p = 0.004 and 0.014, p = 0.008, NRI and IDI respectively) as compared to traditional factors. CONCLUSIONS: Malnutrition assessed by the GNRI score on admission was an independent predictor for adverse cardiovascular events in CTO patients after PCI. Addition of the GNRI score to the existing risk prediction model significantly increased the predictive ability for cardiovascular events in CTO patients after PCI.

LGR4 silence aggravates ischemic injury by modulating mitochondrial function and oxidative stress via ERK signaling pathway in H9c2 cells.

It is reported that LGR4 (leucine-rich repeat domain containing G protein-coupled receptor 4) plays a crucial role in the physiological function of many organs. However, few data are available on the function and mechanism of LGR4 in myocardial ischemia-reperfusion (I/R) injury. The aim of this study was to explore the function and mechanism of LGR4 in I/R injury. We incubated H9c2 cells in simulating ischemia buffer and then re-incubated them in normal culture medium to establish a model of I/R injury in vitro. The expression of LGR4 was evaluated by RT-PCR and western blot. Besides, the cell apoptosis was evaluated by flow cytometric analysis and the content of ROS, SOD, MDA, LDH, CK, ATP, cyt c were detected by special commercial kits. The expression of mitochondrial function-related proteins were detected by western blot. Then, the roles of ERK signaling pathway was determined with TBHQ (ERK activator) treatment. Our data have demonstrated that I/R boosted the expression of LGR4 in H9c2 cells. Knockdown of LGR4 increased the apoptosis rate of H9c2 cells and led to excessed oxidant stress and impaired mitochondrial function by increasing the levels of ROS, MDA, LDH, CK and cyt c and inhibiting SOD activity, ATP production. In addition, LGR4 silence inhibited the activation of ERK pathway. And TBHQ partially reversed the effects of LGR4 knockdown on H9c2 cells. To conclude, our study indicated that LGR4 regulated mitochondrial dysfunction and oxidative stress by ERK signaling pathways, which provides a potential cardiac protective target against I/R.

Learning From Large-Scale Noisy Web Data With Ubiquitous Reweighting for Image Classification.

Many important advances of deep learning techniques have originated from the efforts of addressing the image classification task on large-scale datasets. However, the construction of clean datasets is costly and time-consuming since the Internet is overwhelmed by noisy images with inadequate and inaccurate tags. In this paper, we propose a Ubiquitous Reweighting Network (URNet) that can learn an image classification model from noisy web data. By observing the web data, we find that there are five key challenges, i.e., imbalanced class sizes, high intra-classes diversity and inter-class similarity, imprecise instances, insufficient representative instances, and ambiguous class labels. With these challenges in mind, we assume every training instance has the potential to contribute positively by alleviating the data bias and noise via reweighting the influence of each instance according to different class sizes, large instance clusters, its confidence, small instance bags, and the labels. In this manner, the influence of bias and noise in the data can be gradually alleviated, leading to the steadily improving performance of URNet. Experimental results in the WebVision 2018 challenge with 16 million noisy training images from 5000 classes show that our approach outperforms state-of-the-art models and ranks first place in the image classification task.

Cystatin C-Based Renal Function in Predicting the Long-Term Outcomes of Chronic Total Occlusion After Percutaneous Coronary Intervention.

Renal function estimated by various biomarkers predicting for adverse cardiovascular events has not been well-identified in received percutaneous coronary intervention (PCI) for chronic total occlusion (CTO), the advanced stages of atherosclerosis. We aim to determine whether the serum cystatin C-based-estimated glomerular filtration rate (eGFR) can have an improved predictive value in patients with CTO lesions undergoing PCI as compared with multiple creatinine-based estimates of kidney function. Six hundred and seventy-one patients received CTO PCI were retrospectively included in the study. The eGFR was calculated by modification of diet in renal disease equation for Chinese (cMDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations at baseline, respectively. Then, the cohort was categorized into three groups according to standard KDIGO kidney stages based on eGFR. The primary endpoint was all-cause mortality, and the secondary endpoint was cardiac death. Strikingly, cystatin C-based eGFR showed a better performance with the greater area being under the receiver operating characteristic (ROC) curve (0.73 for all-cause mortality and 0.73 for cardiac death, separately) and a better assessment for survival free from adverse event across renal levels among four eGFR equations. Compared with eGFR calculated by other formulas, serum cystatin C-based eGFR showed the highest prognostic value for both all-cause mortality (adjusted HR 3.6, 95% CI 1.6-8.1, P = 0.002) and cardiac death (adjusted HR 2.9, 95% CI 1.0-8.1, P = 0.028). Moreover, cystatin C-based eGFR significantly improved the risk reclassification of event with a high value of net reclassification improvement and integrated discrimination improvement. This study may prove that cystatin C-based eGFR is a better predictor of both all-cause mortality and cardiac death than other equations in populations with CTO undergoing PCI.

Prognostic Value of Admission Mean Corpuscular Volume for Major Adverse Cardiovascular Events following Stent Implantation in Nondiabetic and Diabetic Patients with Acute Coronary Syndrome.

BACKGROUND: One of the key concerns of the clinician is to identify and manage risk factors for major adverse cardiovascular events (MACEs) in nondiabetic and diabetic patients with acute coronary syndrome (ACS) undergoing stent implantation. Mean corpuscular volume (MCV) is a marker of erythrocyte size and activity and is associated with prognosis of cardiovascular disease. However, the role of admission MCV in predicting MACEs following stent implantation in diabetes mellitus (DM), non-DM, or whole patients with ACS remains largely unknown. METHODS AND RESULTS: A total of 437 ACS patients undergoing stent implantation, including 294 non-DM (59.08 ± 10.24 years) and 143 DM (63.02 ± 9.92 years), were analyzed. Admission MCV was higher in non-DM than DM patients. During a median of 31.93 months follow-up, Kaplan-Meier curve demonstrated that higher admission MCV level was significantly associated with increased MACEs in whole and non-DM, but not in DM patients. In Cox regression analysis, the highest MCV tertile was associated with higher MACEs in whole ([HR] 1.870, 95% CI 1.113-3.144, P = 0.018), especially those non-DM ([HR] 2.089, 95% CI 1.077-4.501, P = 0.029) patients after adjustment of several cardiovascular risk factors. MCV did not predict MACEs in DM patients. During landmark analysis, admission MCV showed better predictive value for MACEs in the first 32 months of follow-up than in the subsequent period. Finally, the receiver operating characteristic (ROC) curve was conducted to confirmed the value of admission MCV within 32 months. CONCLUSION: In patients with ACS, elevated admission MCV is an important and independent predictor for MACEs following stent implantation, especially amongst those without DM even after adjusting for lifestyle and clinical risk factors. However, as the follow-up period increased, the admission MCV lost its ability to predict MACEs.

Clinically relevant high levels of human C-reactive protein induces endothelial dysfunction and hypertension by inhibiting the AMPK-eNOS axis.

Successful treatment of resistant hypertension accompanied by elevated human C-reactive protein (hCRP) remains a key challenge in reducing the burden of cardiovascular diseases. It is still unclear whether clinically relevant high-level hCRP is merely a marker or a key driver of hypertension. Here, we investigated the role and mechanism of clinically relevant high level of hCRP in hypertension. Elevated blood pressure was observed in all three hCRP overexpression models, including adeno-associated virus 9 (AAV9)-transfected mice, AAV9-transfected rats and hCRP transgenic (hCRPtg) rats. hCRPtg rats expressing clinically relevant high-level hCRP developed spontaneous hypertension, cardiac hypertrophy, myocardial fibrosis and impaired endothelium-dependent relaxation. Mechanistically, studies in endothelial nitric oxide (NO) synthase (eNOS) knockout mice transfected with AAV9-hCRP and phosphoproteomics analysis of hCRP-treated endothelial cells revealed that hCRP inhibited AMP-activated protein kinase (AMPK)-eNOS phosphorylation pathway. Further, activation of AMPK by metformin normalized endothelial-dependent vasodilation and decreased the blood pressure of hCRPtg rats. Our results show that clinically relevant high-level hCRP induces hypertension and endothelial dysfunction by inhibiting AMPK-eNOS signaling, and highlight hCRP is not only an inflammatory biomarker but also a driver of hypertension. Treatment with metformin or a synthetic AMPK activator may be a potential strategy for vaso-dysfunction and hypertension in patients with high hCRP levels.

Fasting serum total bile acid level is associated with coronary artery disease, myocardial infarction and severity of coronary lesions.

BACKGROUND AND AIMS: Bile acids play important roles in lipid metabolism. Several studies have found that patients with coronary artery disease (CAD) have lower bile acid fecal excretion compared to individuals without CAD. However, few studies have focused on the roles of more accessible serum total bile acids (TBA) in the progression of CAD. The aim of this study was to explore the potential relationship between fasting serum TBA and the presence of CAD, myocardial infarction (MI) and severity of coronary lesions. METHODS: A total of 7438 consecutive patients with suspected CAD, who had undergone coronary angiography, were enrolled. The severity of coronary lesions was evaluated using the Gensini score (GS). The relationships between fasting serum TBA and the presence and severity of CAD were evaluated. RESULTS: CAD patients had lower serum TBA than individuals without CAD, and patients with MI had lower TBA than those without CAD. Spline analyses showed an L-shaped relationship of the fasting serum TBA with the presence and severity of CAD, and the breakpoint approximated the normal upper limit (10 µmol/L). A lower TBA concentration (less than the median 3.6 µmol/L) was independently and significantly associated with the presence and severity of CAD, especially for the presence of MI (odds ratios 2.04, 95% confidence interval (1.71-2.44), C-index 0.9269). CONCLUSIONS: Fasting serum TBA level is highly associated with the presence and severity of CAD in patients undergoing coronary angiography for suspected CAD.

Combination of the CYP2C19 metabolizer and the GRACE risk score better predicts the long-term major adverse cardiac events in acute coronary syndrome undergoing percutaneous coronary intervention.

INTRODUCTION: Both Global Registry of Acute Coronary Events (GRACE) risk score and CYP2C19 metabolizer status can independently predict major adverse cardiac events (MACEs) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). We investigated whether their combination could better predict MACE occurrence in patients with ACS undergoing PCI. MATERIALS AND METHODS: This retrospective cohort study included 548 consecutive patients with ACS undergoing PCI. A cumulative MACE curve was calculated using the Kaplan-Meier method. Multivariate Cox regression was used to identify MACE predictors. The predictive value of GRACE risk score alone and CYP2C19 metabolizer status was estimated by the area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). RESULTS: In a median of 28.58 months, 17 patients (3%) were lost to follow-up, and 62 (11.3%) experienced MACEs. Multivariate Cox regression analysis showed that both GRACE score and CYP2C19 metabolizer status were independent MACE predictors (hazard ratio 1.019, 95% CI 1.011-1.027, p < 0.001; hazard ratio 2.383, 95% CI 1.601-3.547, p < 0.001, respectively). Kaplan-Meier analysis showed that CYP2C19 PM increased the MACE risk (log rank test = 10.848, p = 0.004). The GRACE score adjustment by CYP2C19 metabolizer status enhanced the predictive value (AUC increased from 0.682 for GRACE score alone to 0.731 for GRACE score plus CYP2C19 metabolizer). This result was further verified by IDI and NRI. CONCLUSIONS: CYP2C19 metabolizer status and GRACE score are readily available predictive approaches for MACEs, and their combination derives a more accurate long-term MACE prediction in clopidogrel-treated patients with ACS undergoing PCI.

A Novel Polyaniline-Coated Bagasse Fiber Composite with Core-Shell Heterostructure Provides Effective Electromagnetic Shielding Performance.

A facile route was proposed to synthesize polyaniline (PANI) uniformly deposited on bagasse fiber (BF) via a one-step in situ polymerization of aniline in the dispersed system of BF. Correlations between the structural, electrical, and electromagnetic properties were extensively investigated. Scanning electron microscopy images confirm that the PANI was coated dominantly on the BF surface, indicating that the as-prepared BF/PANI composite adopted the natural and inexpensive BF as its core and the PANI as the shell. Fourier transform infrared spectra suggest significant interactions between the BF and PANI shell, and a high degree of doping in the PANI shell was achieved. X-ray diffraction results reveal that the crystallization of the PANI shell was improved. The dielectric behaviors are analyzed with respect to dielectric constant, loss tangent, and Cole-Cole plots. The BF/PANI composite exhibits superior electrical conductivity (2.01 ± 0.29 S·cm-1), which is higher than that of the pristine PANI with 1.35 ± 0.15 S·cm-1. The complex permittivity, electromagnetic interference (EMI), shielding effectiveness (SE) values, and attenuation constants of the BF/PANI composite were larger than those of the pristine PANI. The EMI shielding mechanisms of the composite were experimentally and theoretically analyzed. The absorption-dominated total EMI SE of 28.8 dB at a thickness of 0.4 mm indicates the usefulness of the composite for electromagnetic shielding. Moreover, detailed comparison of electrical and EMI shielding properties with respect to the BF/PANI, dedoped BF/PANI composite, and the pristine PANI indicate that the enhancement of electromagnetic properties for the BF/PANI composite was due to the improved conductivity and the core-shell architecture. Thus, the composite has potential commercial applications for high-performance electromagnetic shielding materials and also could be used as a conductive filler to endow polymers with electromagnetic shielding ability.