Predictive value of combining urinary N-acetyl-ß-D-glucosaminidase and serum homocysteine for contrast-induced nephropathy in patients after percutaneous coronary intervention.

Background: Contrast-induced nephropathy (CIN) can lead to serious complications following percutaneous coronary intervention (PCI). Urine N-Acetyl-ß-D-glucosaminidase (uNAG) and serum homocysteine (sHCY) are both potential predictors for CIN detection, but their combination has not been explored. We aimed to combine uNAG and sHCY as predictors for the early detection of CIN and for prognosis prediction in patients after PCI. Methods: A total of 232 consecutive patients who underwent PCI at a university hospital were recruited for this study. According to the European Society of Urology and Reproduction (ESUR) criterion, CIN is defined as an elevation of serum creatinine (sCr) by ≥25% or ≥0.5 mg/dl from baseline within 48 h. We assessed the use of individual biomarkers (uNAG and sHCY) measured around PCI and their combinations for CIN detection and prognosis prediction. Receiver operating characteristic curves (ROC) and area under the curve (AUC) were used to evaluate the predictive efficiency of potential predictors. Results: In total, 54 (23.28%) patients developed CIN. Concentrations of uNAG and sHCY increased significantly in CIN subjects (p < 0.05) than non-CIN. CIN could be predicted by uNAG and sHCY but not by creatinine at an early stage. At pre-PCI, 0, 12, 24, and 48 h after PCI, the AUC-ROC value of uNAG in calculating total CIN was 0.594, 0.603, 0.685, 0.657, and 0.648, respectively. The AUC-ROC value of sHCY in calculating total CIN was 0.685, 0.726, 0.771, 0.755, and 0.821, respectively. The panel of uNAG plus sHCY detected CIN with significantly higher accuracy than either individual biomarker alone and earlier than sCr. For detecting total CIN, this panel yielded AUC-ROCs of 0.693, 0.754, 0.826, 0.796, and 0.844 at pre-PCI, 0, 12, 24, and 48 h after PCI, respectively, which were superior to those of the individual biomarkers. For predicting the incidence of major adverse cardiovascular events (MACE) within 30 days to 12 months, the AUC-ROC values for uNAG and sHCY measured before discharge were 0.637 and 0.826, respectively. The combined panel yielded an AUC-ROC of 0.832. The combined detection did not significantly enhance the predictive capability for MACE in patients with CIN. The CIN group and the non-CIN group showed no significant difference in the Coronary Heart Disease Intensive Care Unit (CCU) stay time, hospital stay time, demand for renal replacement therapy, CCU mortality rate, and in-hospital mortality rate. Conclusions: The uNAG and sHCY panel demonstrated better sensitivity and specificity for predicting the diagnosis and prognosis of CIN in patients after PCI, earlier than sCr. The combination of these biomarkers revealed a significantly superior discriminative performance for CIN detection and prognosis compared to using uNAG or sHCY alone.

Bioinformatics analysis of the role of cuproptosis gene in acute myocardial infarction.

BACKGROUND: Immune infiltration plays a vital role in the course of acute myocardial infarction (AMI). Cuproptosis is a new type of programmed cell death discovered recently. Currently, there is no study on the mechanism of cuproptosis gene regulating immune infiltration in AMI. Therefore, by integrating cuproptosis-related genes and GEO database-related microarray data, this study analyzed the association between cuproptosis genes and immune infiltration and built a risk model. METHODS: The GSE59867 was used to extract cuproptosis gene expression profile. The R limma package was used to analyze the differentially expressed genes associated with AMI-Cuproptosis. The risk model was constructed according to AMI-cuproptosis differentially expressed genes. Prediction of AMI-cuproptosis-related gene drugs through Coremine Medical database. The upstream miRNAs were predicted using miRWalk, TargetScan, and miRDB libraries, and a miRNA-mRNA network was constructed. RESULTS: Cuproptosis-related genes (DLST, LIAS, DBT, ATP7A, LIPT1, PDHB, GCSH, DLD, DLAT) were down-regulated in AMI patients. One (ATP7B) gene was up-regulated in AMI patients (P<0.05). These 10 Cuproptosis-related genes were significantly associated with immune cell infiltration. Based on these 10 differential genes, the AMI risk prediction model was constructed, and the AUC value was 0.825, among which the abnormal expression of DLST was a risk factor for AMI. Additionally, we also predicted DLAT upstream miRNAs and associated drug targets, finding that 9 miRNAs were upstream of DLST. CONCLUSIONS: DLST is a potential cuproptosis gene associated with AMI, but its specific mechanism remains unclear and requires further investigation in future studies.

Exploring the mechanism of cytisine in treating respiratory depression following venomous snake bites based on network pharmacology and molecular docking.

OBJECTIVE: To investigate the antivenom mechanism of cytisine through network pharmacology and molecular docking (MD) techniques, with the intention of exploring its clinical applications. METHODS: The cytisine target and the snakebite respiratory inhibition target were obtained using the Swiss Target Prediction platform and the Gene Cards database. The two target sets were overlapped to form a protein interaction network. Additionally, pathway enrichment analysis was conducted on cross targets, and the related pathways for the treatment of snake venom-induced respiratory failure were obtained. Verification of the MD between cytisine and its related targets was performed using the Autodock 1.5.7 software. The respiratory depression model of rats bitten by venomous snakes was established, and the expression of key target genes in the rat model was verified by western blot (WB). RESULT: A total of 16 targets of cytisine and 9 potential targets of cytisine in treating snake venom-induced respiratory depression were obtained. Core targets including CHRNA7, CHRNG, CHRNB1, CHRND, CHRNA1 and DRD2 were obtained. These targets are mainly enriched in neuroactive ligand-receptor interaction pathway and cholinergic synaptic pathway. The MD results demonstrated favorable docking activity of cytisine with its related targets. WB experiments showed that snake venom reduced the levels of CHRNA7 and CHRNG. Treatment with serum and cytisine could slow down this decline. CONCLUSION: Cytisine may synergistically target CHRNA7, CHRNG, CHRNB1, CHRND, CHRNA1, DRD2 and other proteins, modulating cholinergic and neuroactive pathways to alleviate neuromuscular block and protect acetylcholine receptors.

Effect of Several Naja atra Antivenom Injection Methods on the Rabbit Model of Naja naja atra Bite Poisoning.

Snakebite is a global public health concern, which often occurs in tropical and subtropical underdeveloped areas, but it is often neglected. In the southern China, Naja naja atra (Chinese cobra) is a common venomous snake that causes swelling and necrosis of local tissues, even amputation and death. Currently, the main therapy is the administration of Naja atra antivenom, which greatly reduces mortality. However, the antivenom is not particularly effective in the improvement of local tissue necrosis. Clinically, antivenom is mainly administered intravenously. We speculated that the method of injection influences the efficacy of antivenom. In this study, the rabbit model was used to explore the effects of different antivenom injection methods on systemic and local poisoning symptoms. If topical injection of antivenom contributes to ameliorate tissue necrosis, then we need to reconsider the use of Naja atra antivenom.

Effect of systematic nursing on the stress response and recovery of gastrointestinal function in patients undergoing laparoscopic cholecystectomy.

OBJECTIVE: To explore the effect of systematic nursing on the stress response and recovery of gastrointestinal function in patients undergoing laparoscopic cholecystectomy. METHODS: A retrospective study was conducted among 102 patients with gallbladder system disease. They were divided into an observation group (n=51, perioperative systematic care) and a control group (n=51, perioperative conventional care) according to a random number table. The clinical indicators, postoperative recovery of gastrointestinal function, and patients' stress response, psychological status and quality of life before and after intervention were compared between the two groups. RESULTS: Compared with the control group, the time to get out of bed for the first time after operation, the recovery time of bowel sounds, and the time of first gas/defecation after operation in the observation group were significantly earlier (all P<0.01), and the hospital stay was significantly shorter (P<0.001). Compared with 12 hours before operation, the serum adrenaline and cortisol levels of the two groups were significantly higher at 48 hours after operation, and the levels in the observation group were lower than the control group (all P<0.001). Compared with 1 day before the operation, the scores of Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) in both groups were reduced when they were discharged from the hospital, and the scores in the observation group were lower than that of the control group (all P<0.01). Three months after the operation, the scores of Generic Quality of Life Inventory-74 (GQOLI-74) in the two groups increased in all dimensions, and the scores in the observation group were higher than the control group (all P<0.05). CONCLUSION: Systematic care during the perioperative period of laparoscopic cholecystectomy can alleviate the degree of stress, promote the recovery of postoperative gastrointestinal function, relieve the level of anxiety and depression, and improve the quality of life of patients after discharge from the hospital.

Different exercise therapies for treating heart failure: A protocol for overview of systematic reviews and network meta-analysis.

BACKGROUND: Exercise therapies has been shown to be safe and effective as a non-pharmacological management for treating heart failure, At the same time, many clinical trials, systematic review, and meta-analyses have demonstrated the advantages of exercise therapies in heart failure. However, the methodological quality of these systematic reviews and the differences in efficacy between different exercise modes are unclear. Therefore, this study intends to overview of systematic reviews and network meta-analysis of exercise therapies intervention in heart failure, and finally to rank the effects of exercise therapies in the intervention of heart failure, so as to provide certain reference for clinical decision-making. METHODS: From the seven databases: PubMed, EMBASE.com, Web of Science, the Cochrane Library, Chinese biomedical literature database (CBM), Chinese National Knowledge Infrastructure (CNKI), Wan fang Database, and Chongqing VIP (CQVIP) databases. To search for systematic or meta-analysis of different exercise therapies for heart failure from inception to August 2020. According to the inclusion criteria and exclusion criteria, the two researchers independently selected articles and extracted data. In case of differences, a third party shall be sought for settlement. The AMSTAR2 scale, PRISMA scale and GRADE were used to assess the quality and evidence grade of the literature. The eligible randomized controlled trials (RCTs) were selected from the included systematic reviews and updated RCTs from the above systematic reviews to August 2020. GRADE was used for the risk of bias of the included RCTs. Pairwise meta-analyses were performed using the random-effects model, and network meta-analysis of the included RCTs were performed the frequentist framework. All data analyses were completed in Stata 15.0. RESULTS: Finally, a total of 33 articles related to systematic review and meta-analysis were included, there are 28 articles in Chinese and 5 articles in English. The results of this overview and network meta-analysis will be submitted to a peer-reviewed journal for publication. CONCLUSION: This review will provide a comprehensive overview of existing systematic reviews of exercise therapies interventions for heart failure and provide recommendations for clinical practice or guidelines. PROTOCOL REGISTRATION: INPLASY202080118.

A systematic review and meta-analysis of dengue risk with temperature change.

Dengue fever (DF) is the most serious mosquito-borne viral disease in the world and is significantly affected by temperature. Although associations between DF and temperatures have been reported repeatedly, conclusions have been inconsistent. Six databases were searched up to 23 March 2014, without language and geographical restrictions. The articles that studied the correlations between temperatures and dengue were selected, and a random-effects model was used to calculate the pooled odds ratio and 95% confidence intervals. Of 1589 identified articles, 137 were reviewed further, with 33 satisfying inclusion criteria. The closest associations were observed between mean temperature from the included studies (23.2-27.7 °C) and DF (OR 35.0% per 1 °C; 95% CI 18.3%-51.6%) positively. Additionally, minimum (18.1-24.2 °C) (29.5% per 1 °C; 20.9%-38.1%) and maximum temperature (28.0-34.5 °C) (28.9%; 10.3%-47.5%) were also associated with increased dengue transmission. The OR of DF incidence increased steeply from 22 °C to 29 °C, suggesting an inflexion of DF risk between these lower and upper limits of DF risk. This discovery is helpful for government decision-makers focused on preventing and controlling dengue in areas with temperatures within this range.