Roles of Immune and Oxidative Stress-Related Factors in the Diagnosis of Coronary Artery Disease: A Retrospective Study.

BACKGROUND: Coronary artery disease (CAD) is one of the main causes of sudden death, but its exact pathogenesis requires further study. Thus, this study aimed to explore the immune and oxidative stress-related factors in CAD progression and their roles in CAD diagnosis. METHODS: Bioinformatics analysis was used in this study, and the GSE23561 dataset (training set) we used contained the transcriptome sequencing results of six CAD peripheral blood samples and nine control samples. The data were obtained and analysed by querying the Gene Expression Omnibus database. First, the differentially expressed immune and oxidative stress-related genes (DEIOGs) between the groups were identified. DEIOGs were then analysed based on Gene Ontology annotation and Kyoto Encyclopedia of Genes and Genomes pathway enrichment. A protein-protein interaction (PPI) network for DEIOGs was constructed using the Search Tool for the Retrieval of Interacting Genes/Proteins database, and hub genes were identified through the PPI network. Moreover, transcription factors and microRNAs (miRNAs) targeting hub genes were identified to explore the potential regulatory mechanisms of hub genes. The receiver operating characteristic (ROC) curve analysis was constructed to examine the role of hub genes in CAD diagnosis. Finally, the data of GSE23561 (validated set) were used to validate the diagnostic potential of these hub genes. RESULTS: Primarily, 66 DEIOGs were identified, which are involved in many important pathways related to CAD, such as the "mitogen-activated protein kinase (MAPK) signalling pathway" and "lipid and atherosclerosis". A PPI network of DEIOGs was then constructed, and 10 hub genes were identified sequentially. A total of 37 transcription factors and 481 miRNAs that played important roles in hub genes regulation were identified. The ROC curves indicated that five special hub genes (Fos, Il6, Jun, Mapk3, and Mmp9) could serve as potential diagnostic biomarkers for CAD. CONCLUSIONS: Bioinformatics analysis technology was used to identify 10 hub DEIOGs that might play a crucial role in CAD progression, and five special hub genes (Fos, Il6, Jun, Mapk3, and Mmp9) could be regarded as potential biomarkers for CAD diagnosis. However, further studies are required to verify the functions of these hub genes.

Hyperuricemia: A key contributor to endothelial dysfunction in cardiovascular diseases.

As an end product of purine metabolism, uric acid (UA) is a major endogenous antioxidant in humans. However, impaired UA synthesis and excretion can lead to hyperuricemia (HUA), which may in turn induce endothelial dysfunction (ED) and contribute to the pathogenesis of cardiovascular diseases (CVDs; e.g., atherosclerosis and hypertension). In this review, we discuss recent advances and novel insights into the effects exerted by HUA conditions in ED and related underlying mechanisms focusing on impaired UA metabolism, reduction in the synthesis and bioavailability of nitric oxide, endothelial cell injury, the endothelial-to-mesenchymal transition, insulin resistance, procoagulant activity, and acquisition of an inflammatory phenotype. We additionally discuss intervention strategies for HUA-induced ED and the paradoxical roles of UA in endothelial function. We summarize major conclusions and perspectives: the deleterious effects of HUA contribute to the initiation and progression of CVD-related ED. However, the treatment strategies (in addition to urate-lowering therapy) for increasing endothelial function are limited because the majority of literature on pharmacological and pathophysiological mechanisms underlying HUA-induced ED solely describes in vitro models. Therefore, a better understanding of the mechanisms involved in HUA-induced ED is critical to the development of novel therapies for preventing and treating CVD-HUA comorbidities.

The Relationships between Waxes and Storage Quality Indexes of Fruits of Three Plum Cultivars.

In the present study, the cuticular wax morphology, composition and the relationship with storage quality in three plum cultivars of Prunus salicina 'Kongxin' (KXL), Prunus salicina 'Fengtang' (FTL) and Prunus salicina 'Cuihong' (CHL) were investigated during storage at room temperature of 25 ± 1 °C. The results illustrated that the highest cuticular wax concentration was discovered in KXL, followed by FTL and the lowest in CHL. The fruit wax composition of the three plum cultivars was similar and principally composed of alkanes, alcohols, fatty acids, ketones, aldehydes, esters, triterpenes and olefins. Alcohols, alkanes and triterpenes were the dominant fruit wax compounds of the three plum cultivars. After storage for 20 d at room temperature, the variation of cuticular wax crystal structure and composition showed significant cultivar-associated differences. The total wax content decreased for FTL and CHL and increased for KXL, and the wax crystal degraded and melted together over time. The higher contents of the main components in the three plum cultivars were nonacosane, 1-triacontanol, 1-heneicosanol, nonacosan-10-one, octacosanal, ursolic aldehyde and oleic acid. Alcohols, triterpenes, fatty acids and aldehydes were most dramatically correlated with the softening of fruit and storage quality, and alkanes, esters and olefins were most significantly correlated with the water loss. Nonacosane and ursolic aldehyde can enhance the water retention of fruit. Overall, this study will provide a theoretical reference for the further precise development of edible plum fruit wax.

A Nomogram for Predicting 3-Year Mortality in Patients with Pulmonary Hypertension due to Left Heart Failure: A Retrospective Analysis of a Prospective Registry Study.

INTRODUCTION: Pulmonary hypertension due to left heart failure (PH-LHF) is a disease with high prevalence and 3-year mortality rates. Consequently, timely identification of patients with high mortality risk is critical. This study aimed to build a nomogram for predicting 3-year mortality and screening high-risk PH-LHF patients. METHODS: This nomogram was developed on a training cohort of 175 patients with PH-LHF diagnosed by right heart catheterization. Multivariate Cox regression was used to identify independent predictors and develop this nomogram. The median total points obtained from the nomogram were used as a cutoff point, and patients were classified into low- and high-risk groups. The concordance index (C-index) and calibration curve were utilized to ascertain the predictive accuracy and discriminative ability of the nomogram. External validation was performed using a validation cohort of 77 PH-LHF patients from other centers. RESULTS: Multivariate Cox regression showed that the New York Heart Association Functional classification (NYHA FC), uric acid level, and mean pulmonary arterial pressure were all independent predictors and incorporated into the nomogram. The nomogram showed good discrimination (C-index of 0.756; 95% CI: 0.688-0.854) and good calibration. The Kaplan-Meier survival analysis showed that patients in the high-risk group had worse survival (p < 0.001). In the external validation, the nomogram showed both good discrimination (C-index of 0.738; 95% CI: 0.591-0.846) and calibration. CONCLUSION: The nomogram had a good performance in predicting 3-year mortality and can effectively identify high-risk patients. The nomogram may help to reduce the mortality of PH-LHF.

Melatonin Treatment Affects Wax Composition and Maintains Storage Quality in 'Kongxin' Plum (Prunus salicina L. cv) during Postharvest.

Cuticular wax is an essential barrier against biological and abiotic stress and is also an important factor affecting fruit storage quality. This paper investigated the effect of melatonin treatment on cuticular wax and the storage quality of plum fruit at low temperature storage of 4 ± 1 °C. 'Kongxin' plum was treated with 150 µmol·L-1 melatonin, dried overnight at room temperature 25 ± 1 °C, and then stored at 4 ± 1 °C for 40 d. The microstructure of the fruit epidermis was examined after 0, 20, and 40 d of storage, and the wax composition and fruit storage quality were measured at 10 d intervals. The results demonstrated that melatonin promoted the disintegration and thickening of rod-shaped waxy crystals of 'Kongxin' plum fruit and inhibited the combination of disintegrated wax and inner wax. Melatonin maintained fruit firmness and decreased the correlation between fruit firmness and other storage quality parameters. The correlation between firmness and wax composition was enhanced. Melatonin promoted long-chain alkanes that were positively correlated with firmness and water retention and strengthened the correlation between the length of the alkane chain and storage quality parameters but reduced the difference between alkane isomers and storage quality parameters.

Prevalence, risk factors, and survival associated with pulmonary hypertension and heart failure among patients with underlying coronary artery disease: a national prospective, multicenter registry study in China.

BACKGROUND: Coronary artery disease (CAD) is the commonest cause of heart failure (HF), whereas pulmonary hypertension (PH) has not been established or reported in this patient population. Therefore, we assessed the prevalence, risk factors, and survival in CAD-associated HF (CAD-HF) complicated with PH. METHODS: Symptomatic CAD-HF patients were continuously enrolled in this prospective, multicenter registry study. Echocardiography, coronary arteriography, left and right heart catheterization (RHC), and other baseline clinical data were recorded. Patients were followed up and their survival was recorded. RESULTS: One hundred and eighty-two CAD-HF patients were enrolled, including 142 with HF with a preserved ejection fraction (heart failure with preserved ejection fraction [HFpEF]; left ventricular ejection fraction [LVEF] ≥50%) and 40 with a reduced ejection fraction (heart failure with reduced ejection fraction [HFrEF]; LVEF < 50%). PH was diagnosed with RHC in 77.5% of patients. Patients with PH showed worse hemodynamic parameters and higher mortality. HFrEF-PH patients had worse survival than HFpEF-PH patients. CAD-HF patients with an enlarged left ventricular end-diastolic diameter and reduced hemoglobin were at higher risk of PH. Nitrate treatment reduced the risk of PH. Elevated creatinine and mean pulmonary arterial pressure (mPAP), diastolic pressure gradient (DPG) ≥7 mmHg, and previous myocardial infarction (MI) entailed a higher risk of mortality in CAD-HF patients with PH. CONCLUSIONS: PH is common in CAD-HF and worsens the hemodynamics and survival in these patients. Left ventricle enlargement and anemia increase the risk of PH in CAD-HF. Patients may benefit from nitrate medications. Renal impairment, elevated mPAP, DPG ≥7 mmHg, and previous MI are strong predictors of mortality in CAD-HF-PH patients. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02164526.

Changes in the Primary Metabolites of 'Fengtang' Plums during Storage Detected by Widely Targeted Metabolomics.

Plums are one of the most popular stone fruits worldwide owing to their high nutritional value. After harvest, plum fruit quality and flavor change during storage; however, little is known about the changes in metabolites during this period. A comprehensive comparison of primary metabolites in 'Fengtang' plum fruits during storage is performed using widely targeted primary metabolomics. A total of 272 primary metabolites were identified by means of ultra-performance liquid chromatography and tandem mass spectrometry (UPLC-MS/MS) in the plums at different storage periods. There was a significant increase in the relative amounts of twenty-eight lipids, twenty amino acids and their derivatives, thirteen organic acids, ten saccharides and alcohols, six nucleotides and their derivatives, and two vitamins. A Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of differential metabolites revealed that glucosinolate biosynthesis, starch and sucrose metabolism, ascorbate and aldarate metabolism, lysine degradation, and other metabolic pathways were significantly enriched; therefore, changes in these metabolic pathways may be key to the quality and flavor change in 'Fengtang' plum fruits during storage. Our results provide a theoretical foundation and technical support to evaluate 'Fengtang' plum fruit quality.

Impact of globalization on the environment in major CO2-emitting countries: Evidence using bootstrap ARDL with a Fourier function.

Alongside sustainable development as a major global aim, the contribution made by globalization to environmental issues has become crucial in recent decades. Prior studies have focused on how trade in globalization influences the environment. However, multiple economic, social, and political factors are also important, the integration of which needs to be considered in sustainable development. Sharp and smooth breaks in time series models are the consequence of real-world structures. Using the bootstrap autoregressive-distributed lag test with a Fourier function, the present study reexamined the nexus between globalization and the environment in China, the United States, and India. The empirical results indicate that in the United States, the nexus between globalization and the environment is cointegrated in the long-term. In the short term, globalization is improving the environment in the United States and India. However, in China, globalization is resulting in environmental degradation. This research will assist policymakers in developing comprehensive strategies for sustainable development.

The prevalence and survival of pulmonary hypertension due to left heart failure: A retrospective analysis of a multicenter prospective cohort study.

Background: Pulmonary hypertension due to left heart failure (PH-LHF) is currently the most common form of pulmonary hypertension (PH) encountered in clinical practice. Despite significant advances that have improved our understanding of PH-LHF over the past two decades, the mortality is still high in recent decades. This study aimed to describe the prevalence and survival of patients with PH-LHF, and explored the potential risk factors which may predict the prognosis of PH-LHF. Methods: A retrospective analysis of a prospective cohort study of left heart failure (LHF) patients who underwent right heart catheterization (RHC) between January 2013 and November 2016 was performed. The endpoint was all-cause mortality. Follow-ups were performed every 6 months ± 2 weeks. Results: A total of 480 patients with LHF were enrolled, with 215 (44.8%) having PH-LHF. The proportion of PH-LHF was significantly lower in coronary artery disease (CAD) group than without CAD (41.3 vs. 57.8%, p = 0.003). However, multivariable logistic regression analysis revealed that CAD was not associated with PH-LHF (Adjusted OR: 1.055, 95% CI: 0.576 - 1.935, p = 0.862). 75 of 215 (34.9%) patients with PH-LHF died during a median follow-up period of 84.6 months. The 1-, 3-, 5-, and 8-year survival rates of all PH-LHF patients were 94.3, 76.9, 65.8, and 60.2%, respectively. New York Heart Association Functional Class (NYHA FC), hemoglobin, and systolic pulmonary artery pressure (sPAP) were associated with mortality of PH-LHF in multivariate Cox analysis. Conclusion: PH is commonly identified in patients with LHF, with a prevalence of approximately 45%. The mortality is still high in patients with PH-LHF. NYHA FC, hemoglobin, and sPAP are independent risk predictors of mortality for PH-LHF. These findings may be useful for risk stratification in future clinical trial enrollment.

Erratum: "Baicalin prevents pulmonary arterial remodeling in vivo via the AKT/ERK/NF-κB signaling pathways".

[This corrects the article DOI: 10.1177/2045894019878599.].

Impact of borderline pulmonary hypertension due to left heart failure on mortality in a multicenter registry study: A 3-year survivorship analysis.

Background: Patients with left heart failure (LHF) are often associated with the development of pulmonary hypertension (PH) which leads to an increased risk of death. Recently, the diagnostic standard for PH has changed from mean pulmonary arterial pressure (mPAP) ≥25 mmHg to >20 mmHg. Nonetheless, the effect of borderline PH (mPAP: 21-24 mmHg) on the prognosis of LHF patients is unclear. This study aimed to investigate the relationship between borderline PH and 3-year clinical outcomes in LHF patients. Methods: A retrospective analysis of a prospective cohort study was done for LHF patients who underwent right heart catheterization (RHC) between January 2013 and November 2016. The primary outcome was all-cause mortality; the secondary outcome was rehospitalization. Results: Among 344 patients, 62.5% were identified with a proportion of PH (mPAP ≥ 25), 10.8% with borderline PH (21-24), and 26.7% with non-PH (≤20), respectively. Multivariable Cox analysis revealed that borderline PH patients had a higher adjusted mortality risk (HR = 3.822; 95% CI: 1.043-13.999; p = 0.043) than non-PH patients. When mPAP was treated as a continuous variable, the hazard ratio for death increased progressively with increasing mPAP starting at 20 mmHg (HR = 1.006; 95% CI: 1.001-1.012). There was no statistically significant difference in adjusted rehospitalization between borderline PH and non-PH patients (HR = 1.599; 95% CI: 0.833-3.067; p = 0.158). Conclusions: Borderline PH is independently related to increased 3-year mortality in LHF patients. Future research is needed to evaluate whether more close monitoring, and managing with an intensifier improves clinical outcomes in borderline PH caused by LHF. Clinical trials registration: www.clinicaltrials.gov NCT02164526.

Abnormal ADAMTS2 and VSIG4 in Serum of HF Patients and their Relationship with CRP, UA, and HCY.

BACKGROUND: Abnormal A Disintegrin and Metalloproteinase with Thrombospondin Motifs 2 (ADAMTS2) and V-set and immunoglobulin domain-containing 4 (VSIG4) were explored in serum of heart failure (HF) patients and its association with C-reactive protein (CRP), uric acid (UA), and homocysteine (HCY) indexes was manifested. METHODS: ADAMTS2 and VSIG4 expression in serum of HF patients was analyzed. Pearson's correlation coefficient analysis was employed to evaluate the correlation between the indexes. Receiver operating characteristic (ROC) curves to assess the recognition ability of ADAMTS2, VSIG4, and brain natriuretic peptide (BNP) for HF. Kaplan-Meier survival curve and multivariate Cox regression were applied to analyze the prognostic value of ADAMTS2 and VSIG4. RESULTS: ADAMTS2 and VSIG4 were upregulated in serum of HF patients. ROC curve affirmed that ADAMTS2 and VSIG4 in serum manifested diagnostic value for HF, and the combined diagnosis accuracy of ADAMTS2, VSIG4, and BNP was greatly improved. Kaplan-Meier and multivariate Cox regression analysis suggested that reduced ADAMTS2 and VSIG4 could forecast the overall survival of HF patients. CONCLUSIONS: This study assures that ADAMTS2 and VSIG4 are strengthening in HF patients, which makes them new non-invasive biomarkers for the diagnosis and prognosis of HF.

Hydrogen-oxygen therapy alleviates clinical symptoms in twelve patients hospitalized with COVID-19: A retrospective study of medical records.

ABSTRACT: A global public health crisis caused by the 2019 novel coronavirus disease (COVID-19) leads to considerable morbidity and mortality, which bring great challenge to respiratory medicine. Hydrogen-oxygen therapy contributes to treat severe respiratory diseases and improve lung functions, yet there is no information to support the clinical use of this therapy in the COVID-19 pneumonia.A retrospective study of medical records was carried out in Shishou Hospital of Traditional Chinese Medicine in Hubei, China. COVID-19 patients (aged ≥ 30 years) admitted to the hospital from January 29 to March 20, 2020 were subjected to control group (n = 12) who received routine therapy and case group (n = 12) who received additional hydrogen-oxygen therapy. The clinical characteristics of COVID-19 patients were analyzed. The physiological and biochemical indexes, including immune inflammation indicators, electrolytes, myocardial enzyme profile, and functions of liver and kidney, were examined and investigated before and after hydrogen-oxygen therapy.The results showed significant decreases in the neutrophil percentage and the concentration and abnormal proportion of C-reactive protein in COVID-19 patients received additional hydrogen-oxygen therapy.This novel therapeutic may alleviate clinical symptoms of COVID-19 patients by suppressing inflammation responses.

Risk prediction in pulmonary hypertension due to chronic heart failure: incremental prognostic value of pulmonary hemodynamics.

BACKGROUND: There is no generally accepted comprehensive risk prediction model cooperating risk factors associated with heart failure and pulmonary hemodynamics for patients with pulmonary hypertension due to left heart disease (PH-LHD). We aimed to explore outcome correlates and evaluate incremental prognostic value of pulmonary hemodynamics for risk prediction in PH-LHD. METHODS: Consecutive patients with chronic heart failure undergoing right heart catheterization were prospectively enrolled. The primary endpoint was all-cause mortality. Individual variable selection was performed by machine learning methods. Cox proportional hazards models were conducted to identify the association between variables and mortality. Incremental value of hemodynamics was evaluated based on the Seattle heart failure model (SHFM) and Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) scores. RESULTS: A total of 276 PH-LHD patients were enrolled, with a median follow-up time of 34.7 months. By L1-penalized regression model and random forest approach, diastolic pressure gradient (DPG) and mixed venous oxygen saturation (SvO2) were the hemodynamic predictors most strongly associated with mortality (coefficient: 0.0255 and -0.0176, respectively), with consistent significance after adjusted for SHFM [DPG: HR 1.067, 95% CI 1.024-1.113, P = 0.022; SvO2: HR 0.969, 95% CI 0.953-0.985, P = 0.002] or MAGGIC (DPG: HR 1.069, 95% CI 1.026-1.114, P = 0.011; SvO2: HR 0.970, 95% CI 0.954-0.986, P = 0.004) scores. The inclusion of DPG and SvO2 improved risk prediction compared with using SHFM [net classification improvement (NRI): 0.468 (0.161-0.752); integrated discriminatory index (IDI): 0.092 (0.035-0.171); likelihood ratio test: P < 0.001] or MAGGIC [NRI: 0.298 (0.106-0.615); IDI: 0.084 (0.033-0.151); likelihood ratio: P < 0.001] scores alone. CONCLUSION: In PH-LHD, pulmonary hemodynamics can provide incremental prognostic value for risk prediction. CLINICAL TRIAL REGISTRATION: NCT02164526 at https://clinicaltrials.gov .

Measuring the Impact of Health on Economic Growth Using Pooling Data in Regions of Asia: Evidence From a Quantile-On-Quantile Analysis.

Health improvement has become a significant social priority since a moderately good human capital condition improves the workforce's abilities, efficiency, and quality of life. A rapid increase in healthcare expenditure is a trend in major developing and developed countries; however, healthcare expenditure widely varies among most Asian countries. Asian countries contribute a significant amount of output to economic development worldwide. The statistical test power is more efficient for the pooling of national data than individual national data because of the economic value and trade integration of regional nations. This is the first study that applies the quantile-on-quantile approach to investigate the influence of the quantiles of healthcare on the quantiles of the economy's growth for pooling forty countries in the Asian region. As the quantile of healthcare expenditure increases in the countries, the impact of healthcare expenditure on the economy's growth does not guarantee an increase. The positive and negative effects of healthcare expenditure on developing the economic relationship will repeatedly occur when the quantiles of the economy's growth increase in the countries. One implication is that the governments should account for problems such as corruption, bureaucracy, underinvestment, and inefficiency in health-related resource utilization.

Acute conduction recurrence of mitral isthmus: Incidence, clinical characteristics, and implications.

BACKGROUND: Data on the incidence, clinical characteristics, and implications of acute conduction recurrence during mitral isthmus (MI) ablation are scarce. METHODS: MI ablation was performed in patients with atrial fibrillation. After confirming bidirectional conduction block, the acute conduction recurrence of MI was systematically evaluated. Clinical and electrophysiological characteristics were analyzed. RESULTS: A total of 66 consecutive patients in whom bidirectional conduction block of MI was achieved were prospectively enrolled in a single center. Acute conduction recurrence of MI developed in 12 (18.2%) patients within 14.2 ± 11.5 minutes after the confirmation of bidirectional conduction block. There were two recurrent conduction breakthrough sites of MI along the course of the great cardiac vein (4.5 ± 3.5 min) in two patients and 11 along the course of the ligament of Marshall (LOM) (16.0 ± 11.6 min, P = .035) in 11 patients. LOM accounted for most (84.6%, 11/13) acute MI conduction recurrence. MI length, total ablation time, and procedure time for MI were greater in patients with acute conduction recurrence than in those without acute conduction recurrence. During follow-up, arrhythmia recurrences were less observed in patients with acute conduction when compared to patients without acute conduction recurrence (0% vs 26.4%, P = .055). CONCLUSION: Acute conduction recurrence, predominantly due to recurrent LOM conduction, was a common phenomenon during MI ablation, and its evaluation should therefore be the focus to improve MI ablation efficacy and durability.

Heart­lung crosstalk in pulmonary arterial hypertension following myocardial infarction (Review).

Left heart disease is the main cause of clinical pulmonary arterial hypertension (PAH). Common types of left heart disease that result in PAH include heart failure, left ventricular systolic dysfunction, left ventricular diastolic dysfunction and valvular disease. It is currently believed that mechanical pressure caused by high pulmonary venous pressure is the main cause of myocardial infarction (MI) in individuals with ischemic cardiomyopathy and left ventricular systolic dysfunction. In the presence of decreased cardiac function, vascular remodeling of pulmonary vessels in response to long­term stimulation by high pressure in turn leads to exacerbation of PAH. However, the underlying pathological mechanisms remain unclear. Elucidating the association between the development of MI and PAH may lead to a better understanding of potential risk factors and better disease treatment. In this article, the pathophysiological effects of multiple systems in individuals with MI and PAH were reviewed in order to provide a general perspective on various potential interactions between cardiomyocytes and pulmonary vascular cells.

Resting heart rate control and prognosis in coronary artery disease patients with hypertension previously treated with bisoprolol: a sub-group analysis of the BISO-CAD study.

BACKGROUND: Resting heart rate (RHR) is considered as a strong predictor of total mortality and hospitalization due to heart failure in hypertension patients. Bisoprolol fumarate, a second-generation beta-adrenoreceptor blockers (ß-blocker) is commonly prescribed drug to manage hypertension. The present study was to retrospectively evaluate changes in the average RHR and its association with cardiovascular outcomes in bisoprolol-treated coronary artery disease (CAD) patients from the CAD treated with bisoprolol (BISO-CAD) study who had comorbid hypertension. METHODS: We performed ad-hoc analysis for hypertension sub-group of the BISO-CAD study (n = 866), which was a phase IV, multination, multi-center, single-arm, observational study carried out from October 2011 to July 2015 across China, South Korea, and Vietnam. Multivariate regression analysis was used to identify factors associated with incidence of composite cardiac clinical outcome (CCCO), the results were presented as adjusted odds ratio (OR) along with 95% confidence interval (CI) and adjusted P value. RESULTS: A total of 681 patients (mean age: 64.77 ± 10.33 years) with hypertension from BISO-CAD study were included in the analysis. Bisoprolol improved CCCOs in CAD patients with comorbid hypertension, with RHR <65 and <70 beats/min compared with RHR ≥65 and ≥75 beats/min, respectively, in the efficacy analysis (EA) set. In addition, it lowered RHR in both intent-to-treat (ITT) and EA groups after 6, 12, and 18 months of treatment. Further, RHR 70 to 74 beats/min resulted in significantly higher risk of CCCOs EA set of patients (adjusted OR: 4.34; 95% CI: 1.19-15.89; P = 0.03). Also, events of hospitalization due to acute coronary syndrome were higher when RHR 69 to 74 beats/min compared to RHR <69 beats/min in ITT patients. CONCLUSION: Bisoprolol can effectively reduce RHR in Asian CAD patients with comorbid hypertension and hence, improve CCCO without affecting their blood pressure.

Melting and Recrystallization of Copper Nanoparticles Prepared by Microwave-Assisted Reduction in the Presence of Triethylenetetramine.

The small sized copper nanoparticles (Cu-NPs), prepared in the presence of triethylene tetramine (TETA) and assisted with microwave irradiation, have an extremely low melting temperature. Melting of the small sizezd Cu-NPs can be triggered by the heat generated from the e-beam irradiation during SEM and TEM image construction. The dispersed Cu atoms around the agglomerated big Cu particles can undergo recrystallization immediately due to the strong driving force of the huge temperature difference to normal melting temperature (Tm = 1085 °C). Some of the Cu-NPs with bigger sizes also recrystallize and agglomerate into dense, big particles. According to X-ray diffraction patterns, these particles can agglomerate into compact, ordered Cu crystals in less than five minutes at 60 °C. The melting and recrystallization related endothermic and exothermic phase transitions of Cu-NPs can be found from differential scanning calorimeter (DSC) thermograms and optical microscopic pictures.