Glycyrrhizin attenuates myocardial ischemia reperfusion injury by suppressing Inflammation, oxidative stress, and ferroptosis via the HMGB1-TLR4-GPX4 pathway.

Ferroptosis, a form of regulated cell death process, play an important role in myocardial ischemia‒reperfusion (I/R) injury. Glycyrrhizin (GL), a natural glycoconjugate triterpene, has the property to improve growth rate, immune regulation, antioxidant, anti-inflammatory. However, whether GL can attenuate myocardial I/R injury by modulating ferroptosis or other mechanisms are still unclear. In this study, SD rats underwent in vivo myocardial ischemia/reperfusion (I/R) surgery, while H9C2 cells were subjected to the hypoxia/reoxygenation (H/R) model for in vitro experiments. In addition, TAK-242, a TLR4-specific antagonist, and GL were also used to evaluate the effect and mechanisms of GL on the cardiac function and expression of ferroptosis-related gene and protein in vivo and vitro. The results show that GL decreased not only the expression of the inflammation-related factors (HMGB1, TNF-α, IL-6, IL-18 and IL-1ß), but also reduced the number of TUNEL-positive cardiomyocytes, and mitigated pathological alterations in I/R injury. In addition, GL decreased the levels of MDA, promoted antioxidant capacity such as GSH, CAT, Cu/Zn-SOD, Mn-SOD, and SOD in vivo and vitro. More importantly, GL and TAK-242 regulate ferroptosis-related protein and gene expression in I/R and H/R model. Surprisingly, GL may ameliorate cardiomyocyte ferroptosis and ultimately improves cardiac function induced by H/R via the HMGB1-TLR4-GPX4 axis. Therefore, we have highlighted a novel mechanism by which GL regulates inflammation, oxidative stress, and ferroptosis via the HMGB1-TLR4-GPX4 pathway to prevent myocardial I/R injury. GL appears to be a potentially applicable drug for the treatment of myocardial I/R injury.

Single-Crystal-Assisted In Situ Phase Reconstruction Enables Efficient and Stable 2D/3D Perovskite Solar Cells.

Perovskite solar cells (PSCs) that incorporate both two-dimensional (2D) and three-dimensional (3D) phases possess the potential to combine the high stability of 2D PSCs with the superior efficiency of 3D PSCs. Here, we demonstrated in situ phase reconstruction of 2D/3D perovskites using a 2D perovskite single-crystal-assisted method. A gradient phase distribution of 2D RP perovskites was formed after spin-coating a solution of the 2D Ruddlesden-Popper (RP) perovskite single crystal, (DFP)2PbI4, onto the 3D perovskite surface, followed by thermal annealing. The resulting film exhibits much reduced trap density, increased carrier mobility, and superior water resistance. As a result, the optimized 2D/3D PSCs achieved a champion efficiency of 24.87% with a high open-circuit voltage (VOC) of 1.185 V. This performance surpasses the control 3D perovskite device, which achieved an efficiency of 22.43% and a VOC of 1.129 V. Importantly, the unencapsulated device demonstrates significantly enhanced operational stability, preserving over 97% of its original efficiency after continuous light irradiation for 1500 h. Moreover, the extrapolated T80 lifetimes surpass 5700 h. These findings pave the way for rational regulation of the gradient phase distribution at the interface between 2D and 3D perovskites by employing 2D RP perovskite crystals to achieve stable and efficient PSCs.

Multiarmed Aromatic Ammonium Salts Boost the Efficiency and Stability of Inverted Organic Solar Cells.

Inverted organic solar cells (OSCs) have attracted much attention because of their outstanding stability, with zinc oxide (ZnO) being commonly used as the electron transport layer (ETL). However, both surface defects and the photocatalytic effect of ZnO could lead to serious photodegradation of acceptor materials. This, in turn, hampers the improvement of the efficiency and stability in OSCs. Herein, we developed a multiarmed aromatic ammonium salt, namely, benzene-1,3,5-triyltrimethanaminium bromide (PhTMABr), for modifying ZnO. This compound possesses mild weak acidity aimed at removing the residual amines present within ZnO film. In addition, the PhTMABr could also passivate surface defects of ZnO through multiple hydrogen-bonding interactions between its terminal amino groups and the oxygen anion of ZnO, leading to a better interface contact, which effectively enhances charge transport. As a result, an efficiency of 18.75% was achieved based on the modified ETL compared to the bare ZnO (PCE = 17.34%). The devices utilizing the modified ZnO retained 87% and 90% of their initial PCE after thermal stress aging at 65 °C for 1500 h and continuous 1-sun illumination with maximum power point (MPP) tracking for 1780 h, respectively. Importantly, the extrapolated T80 lifetime with MPP tracking exceeds 10 000 h. The new class of materials employed in this work to modify the ZnO ETL should pave the way for enhancing the efficiency and stability of OSCs, potentially advancing their commercialization process.

Crystal Growth Regulation of Ruddlesden-Popper Perovskites via Self-Assembly of Semiconductor Spacers for Efficient Solar Cells.

The crystal growth and orientation of two-dimensional (2D) perovskite films significantly impact solar cell performance. Here, we incorporated robust quadrupole-quadrupole interactions to govern the crystal growth of 2D Ruddlesden-Popper (RP) perovskites. This was achieved through the development of two unique semiconductor spacers, namely PTMA and 5FPTMA, with different dipole moments. The ((5FPTMA)0.1 (PTMA)0.9 )2 MAn-1 Pbn I3n+1 (nominal n=5, 5F/PTMA-Pb) film shows a preferred vertical orientation, reduced grain boundaries, and released residual strain compared to (PTMA)2 MAn-1 Pbn I3n+1 (nominal n=5, PTMA-Pb), resulting in a decreased exciton binding energy and reduced electron-phonon coupling coefficients. In contrast to PTMA-Pb device with an efficiency of 15.66 %, the 5F/PTMA-Pb device achieved a champion efficiency of 18.56 %, making it among the best efficiency for 2D RP perovskite solar cells employing an MA-based semiconductor spacer. This work offers significant insights into comprehending the crystal growth process of 2D RP perovskite films through the utilization of quadrupole-quadrupole interactions between semiconductor spacers.

Orbital Interactions in 2D Dion-Jacobson Perovskites Using Oligothiophene-Based Semiconductor Spacers Enable Efficient Solar Cells.

2D Dion-Jacobson (DJ) perovskites have emerged as promising photovoltaic materials, but the insulating organic spacer has hindered the efficient charge transport. Herein, we successfully synthesized a terthiophene-based semiconductor spacer, namely, 3ThDMA, for 2D DJ perovskite. An interesting finding is that the energy levels of 3ThDMA extensively overlap with the inorganic components and directly contribute to the band formation of (3ThDMA)PbI4, leading to enhanced charge transport across the organic spacer layers, whereas no such orbital interactions were found in (UDA)PbI4, a DJ perovskite based on 1,11-undecanediaminum (UDA). The devices based on (3ThDMA)MAn-1PbnI3n+1 (nominal n = 5) obtained a champion efficiency of 15.25%, which is a record efficiency for 2D DJ perovskite solar cells using long-conjugated spacers (conjugated rings ≥ 3) and a 22.60% efficiency for 3ThDMA-treated 3D PSCs. Our findings provide an important insight into understanding the orbital interactions in 2D DJ perovskite using an organic semiconductor spacer for efficient solar cells.

Nucleation and Crystallization in 2D Ruddlesden-Popper Perovskites using Formamidinium-based Organic Semiconductor Spacers for Efficient Solar Cells.

The conjugated organic semiconductor spacers have drawn wide attention in two-dimensional (2D) perovskites and formamidinium (FA) has been widely used as A-site cation in high-performance 3D perovskite solar cells (PSCs). However, the FA-based semiconductor spacers have rarely been investigated in 2D Ruddlesden-Popper (RP) perovskites. Here, we developed two FA-based spacers containing thieno[3,2-b]thiophene (TT) and 2,2'-bithiophene (BT) units, namely TTFA and BTFA, respectively, for 2D RP PSCs. The nucleation and crystallization kinetics of TTFA-Pb and BTFA-Pb from sol-gel to film were investigated using in situ optical microscopy and in situ grazing incidence wide-angle X-ray scattering (GIWAXS) measurements. It is found that the TTFA spacer could reduce the energy barrier of nucleation and induces crystal vertical orientation of 2D perovskite by forming larger clusters in precursor solution, resulting in much improved film quality. Benefiting from the enlarged crystal grains, reduced exciton binding energy, and decreased electron-phonon coupling coefficient, the photovoltaic device based on (TTFA)2 MAn-1 Pbn I3n+1 (n=5) achieved a champion efficiency of 19.41 %, which is a record for 2D RP PSCs with FA-based spacers. Our work provides deep understanding of the nucleation and crystallization process of 2D RP perovskite films and highlights the great potential of FA-based semiconductor spacers in highly efficient 2D PSCs.

Progress in molecular mechanisms of coronary microvascular dysfunction.

Coronary microvascular dysfunction is a high-risk factor for many cardiovascular events. However, because of multiple risk factors and limited understanding about its underlying pathophysiological mechanisms, it was easily misdiagnosed. Therefore, its clinical diagnosis and treatment were greatly restricted. Coronary microcirculation refers to microvessels that play an important role in the physiological regulation of myocardial perfusion and regulating blood flow distribution, fulfilling myocardial metabolic needs and moderating peripheral vascular resistance. In coronary microvascular dysfunction, vascular endothelial celldamage is a critical link. The main feature of early coronary microvascular dysfunction is the impairment of endothelial cell proliferation, adhesion, migration, apoptosis, and secretion. Moreover, coronary microvascular dysfunction risk factors include hyperglycemia, lipid metabolism disorders, ischemia-reperfusion injury, aging, and hypertension, similar to coronary atherosclerosis. There are various mechanisms by which these risk factors harm endothelial function and cause microcirculatory disturbances. Therefore, we reviewed coronary microvascular dysfunction's risk factors and pathogenesis in this article.

Recent Progress of Layered Perovskite Solar Cells Incorporating Aromatic Spacers.

Layered two dimensional (2D) or quasi-2D perovskites are emerging photovoltaic materials due to their superior environment and structure stability in comparison with their 3D counterparts. The typical 2D perovskites can be obtained by cutting 3D perovskites along < 100 > orientation by incorporation of bulky organic spacers, which play a key role in the performance of 2D perovskite solar cells (PSCs). Compared with aliphatic spacers, aromatic spacers with high dielectric constant have the potential to decrease the dielectric and quantum confinement effect of 2D perovskites, promote efficient charge transport and reduce the exciton binding energy, all of which are beneficial for the photovoltaic performance of 2D PSCs. In this review, we aim to provide useful guidelines for the design of aromatic spacers for 2D perovskites. We systematically reviewed the recent progress of aromatic spacers used in 2D PSCs. Finally, we propose the possible design strategies for aromatic spacers that may lead to more efficient and stable 2D PSCs.

Perspectives and Considerations of IABP in the Era of ECMO for Cardiogenic Shock.

The development of mechanical circulatory support (MCS) has been rapid, and its use worldwide in patients with cardiogenic shock is increasingly widespread. However, current statistical data and clinical research do not demonstrate its significant improvement in the patient prognosis. This review focuses on the widely used intra-aortic balloon pumps (IABP) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO), analyzing and comparing their characteristics, efficacy, risk of complications, and the current exploration status of left ventricular mechanical unloading. Subsequently, we propose a rational approach to viewing the negative outcomes of current MCS, and look ahead to the future development trends of IABP.

Dimensional Tuning of Perylene Diimide-Based Polymers for Perovskite Solar Cells with Over 24% Efficiency.

The hygroscopic dopants used in Spiro-OMeTAD hole transport material (HTM) in state-of-the-art perovskite solar cells (PSCs) inevitably induce premature degradation of the devices. Here, two multifunctional polymer interface materials based on the perylene diimides (PDI) unit are developed. It is found that quasi-two-dimensional (2D) polymer 2DP-PDI can form a denser film and exhibit better hydrophobicity than linear polymer P-PDI. Importantly, 2DP-PDI can passivate the surface defects and extract hole carriers of perovskite film more effectively, leading to much reduced nonradiative recombination loss. With polymer interface material between the perovskite and HTM layers, the optimized device using 2DP-PDI and P-PDI yields a champion PCE of 24.20% and 23.09%, respectively, along with significantly improved stability, whereas the control device shows a lower efficiency of 22.23%. These results suggest that developing multifunctional polymer interface materials can be a promising strategy to improve the efficiency and stability of PSCs.

Chiral Naphthalenediimides with High-Efficiency Fluorescence and Circularly Polarized Luminescence in the Solid State for the Application in Organic Optoelectronics.

Naphthalenediimides (NDIs) have been extensively studied due to their tunable luminescent properties. However, generally, the monomers or aggregates of non-core substituted NDIs exhibit low fluorescence quantum yields (ΦFL <10 %) in the solid state, which limit their applications as light-emitting materials and render their chiral species unsuitable for circularly polarized luminescence (CPL). Herein, a series of non-core substituted chiral NDIs that exhibit high luminous efficiencies (ΦFL up to 56.8 % for racemate and 36.5 % for enantiomer) and a strong CPL behavior in the solid state is reported. These significant improvements are attributed to the unique molecular conformation of the chiral NDIs and the formation of distinctive discrete dimers. The structures of the NDIs were significantly simpler and more accessible than those of other NDIs. The findings evidence that non-core substituted NDIs can exhibit strong fluorescence in the solid state and provide a new pathway to improve photophysical properties of NDIs.

Prognostic value of circulating microRNA-21-5p and microRNA-126 in patients with acute myocardial infarction and infarct-related artery total occlusion.

Background: Cardiovascular disease, including acute myocardial infarction (AMI), is a major global cause of mortality and morbidity. Specificity and sensitivity limit the utility of classic diagnostic biomarkers for AMI. Therefore, it is critical to identify novel biomarkers for its accurate diagnosis. Cumulative studies have demonstrated that circulating microRNAs (miRs) participate in the pathophysiological processes of AMI and are promising diagnostic biomarkers for the condition. This study aimed to ascertain the diagnostic accuracy of circulating miR-21-5p and miR-126 used as biomarkers in patients with AMI and infarct-related artery total occlusion (IR-ATO) or infarct-related blood-vessel recanalization (IR-BVR). Methods: The expression of miR-21-5p and miR-126 was examined separately in 50 healthy subjects, 51 patients with IR-ATO AMI, and 49 patients with IR-BVR AMI using quantitative real-time polymerase chain reaction. Results: When compared with the control group, the IR-ATO AMI group exhibited increased miR-21-5p (p < 0.0001) and miR-126 (p < 0.0001), and the IR-BVR AMI group exhibited increased miR-21-5p (p < 0.0001). However, there was no significant difference in miR-126 between the IR-BVR AMI and the control groups. A Spearman's correlation coefficient showed a strong correlation was found between miR-21-5p, miR-126, cardiac troponin-I, and creatine kinase isoenzyme in all three groups, while a receiver operating characteristic analysis revealed that miR-21-5p and miR-126 exhibited considerable diagnostic accuracy for IR-ATO AMI. Conclusion: Circulating miR-21-5p and miR-126 may be promising prognostic biomarkers for patients with AMI and IR-ATO.

A novel heterozygous ERCC6 variant identified in a Chinese family with non-syndromic primary ovarian insufficiency.

BACKGROUND: Premature ovarian insufficiency (POI) is a clinical syndrome occurring in women before 40 with decreased ovarian function. Up to 25% of POI cases result from genetic factors that remain largely unknown. The Excision repair cross-complementing, group 6 (ERCC6) variant has been found to cause POI, which is hardly ever diagnosed in adolescents. METHODS: Whole-exome sequencing was performed on a 19-year-old proband with non-syndromic POI and her parents. Sanger sequencing was used to confirm the identified variant. The effect of the variant on the protein was analyzed in silico and Swiss-MODEL. RESULTS: A novel heterozygous missense variant, c.2444G > A (p. GLy815Asp) of ERCC6 was identified in the proband who inherited the variant from her father. The variant was confirmed in another POI patient from the pedigree and was absent in the proband's mother and sister who presented normally. In silico analysis predicted this variant was deleterious. Swiss-Model revealed that the mutant amino acid formed multiple H-bonds with adjacent residues, which may lead to a dysfunction of ERCC6 protein. CONCLUSION: We firstly diagnosed an adolescent POI case associated with a novel heterozygous ERCC6 variant. The results expanded the variants spectrum of ERCC6 and provided guidance for POI diagnosis and genetic counselling.

Clinical Effect of Nicorandil Combined with Aspirin in the Treatment of Myocardial Ischemia.

Objective: To investigate the clinical effect of nicorandil combined with aspirin in the treatment of myocardial ischemia. Methods: A total of 104 patients with myocardial ischemia were admitted to our hospital from June 2019 to August 2020. These patients were selected as the research objects and randomly divided into two groups: the control group and the observation group. The control group was given asilin, and the observation group was given nicorandil tablets based on the control group. Both groups were given continuous treatment for 3 months. The curative effect, cardiac function indexes, dynamic electrocardiogram, and the occurrence of adverse reactions were observed in the two groups. Results: The total effective rate of the observation group was 96.15% (50/52), which was higher than that of the control group (61.54%, 32/52), and the difference was statistically significant (P < 0.05). After treatment, left ventricular ejection fraction (LVEF) and peak early/late diastolic flow velocity (E/A) were increased (P < 0.05), while peak early diastolic flow velocity to peak mitral annular root movement velocity (E/Ea) was decreased (P < 0.05). After treatment, LVEF and E/A in the observation group were higher than those in the control group, while E/Ea was lower than that in the control group (P < 0.05). The frequency, duration of ST segment, and a total load of myocardial ischemia in the ST segment within 24 h after treatment were decreased compared with those before treatment (P < 0.05). The frequency and duration of ST segment decreased, and the total load of myocardial ischemia in the observation group was lower than those in the control group within 24 h after treatment (P < 0.05). After treatment, the total occurrence of adverse reactions in the observation group was lower than that in the control group (P < 0.05). Conclusion: Nicorandil combined with aspirin in the treatment of patients with myocardial ischemia has a significant effect, which can effectively improve the electrocardiogram and cardiac function indicators of patients and reduce the incidence of adverse reactions and is worthy of clinical application.

Serum Homocysteine Level Predictive Capability for Severity of Restenosis Post Percutaneous Coronary Intervention.

Background: In stent restenosis (ISR) is one of the major complications after stent implantation. Thus, there is a growing interest in identifying a biomarker for the onset of ISR. High levels of serum homocysteine (Hcy) have been associated with the progression of cardiovascular disease. Therefore, the study was carried out to quantify the correlation between serum Hcy and ISR severity. Compared with coronary angiography (CAG), Hcy levels provided a significantly better clinical detection of ISR severity after PCI. Methods: A total of 155 patients were recruited from Shanxi Bethune hospital, from 6 months to 2 years post PCI. Serum Hcy levels and postoperative angiography results were used to differentiate the patients into two experimental groups: ISR (>50% diametrical stenosis), and non-ISR. The non-ISR included two subgroups: intimal hyperplasia (10-50% diametrical stenosis), and recovery (<10% diametrical stenosis). In addition, a group of 80 healthy individuals was used as a negative control. The correlation between homocysteine level and ISR severity t was analyzed for all groups. In addition, the correlation between serum Hcy level and the severity of ISR in the experimental group was analyzed by the Pearson correlation test. Results: The serum Hcy level in the experimental group and control group was determined to be (20.21 ± 11.42) µmol/L and (15.11 ± 10.25) µmol/L respectively. The level of serum Hcy in the experimental group was significantly higher than in the control group (t-value of 2.385; p-value of 0.019). The serum Hcy level in the restenosis and the intimal hyperplasia group was (25.72 ± 13.71) µmol/L and (17.35 ± 7.70) µmol/L respectively. The serum Hcy level in the restenosis group was significantly higher than in the intimal hyperplasia group (t-value of 2.215; p-value of 0.033). The level of serum Hcy in the group without a plaque in the stent was (16.30 ± 6.08) µmol/L, whereas in the control group was (15.11 ± 10.25) µmol/L. The no plaque group had a slightly higher serum Hcy level than the control group (t-value of 0.634; p-value of 0.528). All included patients were divided into four quartiles based on the serum Hcy concentration: quartile 1 (8.90-13.20 µmol/L), quartile 2 (13.30-16.45 µmol/L), quartile 3 (16.60-24.25 µmol/L) and quartile 4 (24.30-65.30 µ mol/L). The incidence of ISR was 5, 6.25, 7.5 and 15%, in the 1,2,3 and four quartiles respectively. The serum Hcy level in the experimental group was (20.21 ± 11.42) µmol/L, the severity of in-stent restenosis was (0.25 ± 0.31), (R-value was 0.234; p-value was 0.037), indicating a correlation between serum Hcy and the severity of restenosis (p < 0.05). Taking coronary angiography as the gold standard, a ROC curve analysis was performed on the serum Hcy levels for the experimental group. The area under the curve (AUC) was 0.718 (95% CI 0.585-0.854, p < 0.001), indicating that the serum Hcy concentration could predict ISR. On the ROC curve, the best critical value of serum Hcy concentration for predicting ISR was 20.05 µmol/L, with a sensitivity of 45% and specificity of 88.1%. Conclusion: A positive correlation was observed between homocysteine and the severity of restenosis after PCI, The level of Hcy could serve as a predictive biomarker for the severity of ISR.

[Clinical and genetic analysis of a Chinese pedigree affected with Dyggve-Melchior-Clausen syndrome due to a novel frameshift variant of DYM gene].

OBJECTIVE: To explore the genetic basis of a Chinese pedigree affected with Dyggve-Melchior-Clausen syndrome. METHODS: Whole exome sequencing and Sanger sequencing were carried out to detect potential pathogenic variants associated with the syndrome. The function of candidate variant was verified by Western blotting. RESULTS: A novel homozygous variant, c.1222delG of the DYM gene was detected in the two affected siblings, for which both parents were heterozygous carriers. The variant has caused replacement of Asp by Met at amino acid 408 and generate a premature stop codon p.Asp408Metfs*10. Western blotting confirmed that the variant can result in degradation of the mutant DYM protein, suggesting that it is a loss of function variant. CONCLUSION: The homozygous c.1222delG frameshift variant of the DYM probably underlay the Dyggve-Melchior-Clausen syndrome in the two affected siblings. Above findings has enabled clinical diagnosis and genetic counseling for the family.

Dihydrotestosterone through blockade of TGF-ß/Smad signaling mediates the anti-fibrosis effect under hypoxia in canine Sertoli cells.

The hypoxic microenvironment of cryptorchidism is an important factor to induce the impairment of the structure and function of Sertoli cells and thus lead to spermatogenesis loss or tumorigenesis. Dihydrotestosterone (DHT), as a potent nonaromatizable 5α-reduced androgen, has both positive and negative effect on pathological fibrosis process. However, it is still unknown whether DHT can regulate hypoxia-induced fibrosis of Sertoli cells. Herein, in this study, we evaluate the DHT level, two 5α-reductase isoforms, 5α-red1 and 5α-red2, as well as HIF-1α expression pattern in canine cryptorchidism and contralateral normal testis. Results showed that the abdominal testes presented low DHT levels and 5α-red1 and 5α-red2 expression, while significantly higher HIF-1α expression and ECM production compared with the scrotum. Moreover, we established a hypoxia-induced fibrosis model in canine Sertoli cells induced by cobalt chloride (CoCl2), and found that DHT inhibited the fibrosis of Sertoli cells in a dose-dependent manner. Meanwhile, DHT interfered with the TGF-ß signaling by reducing the expression of TGF-ßRI and TGF-ßRII and inhibiting the expression and phosphorylation of Smad2 and Smad3, while flutamide (androgen receptor inhibitor) inhibited these effects of DHT. Furthermore, use of LY2109761 (TGF-ß receptor type I/II inhibitor) to interfere with the TGF-ß/Smad pathway showed a similar effect with DHT suppression of the fibrosis in Sertoli cells. Our research data demonstrated that cryptorchidism is located in a hypoxic and DHT deficiency microenvironment. Moreover, supplementing DHT can alleviate the fibrosis process of Sertoli cells caused by hypoxia, which is associated with AR regulating the inhibition of TGF-ß/Smad signaling.

Long-term outcomes of delayed percutaneous coronary intervention for patients with ST-segment elevation myocardial infarction: A propensity score-matched retrospective study.

ABSTRACT: The best time window of percutaneous coronary intervention (PCI) is within 12 hours for ST-segment elevation myocardial infarction (STEMI). However, there is limited evidence about the proper time of PCI for delayed STEMI patients.From June 2014 to June 2015, a total of 268 patients receiving PCI with second-generation drug-eluting stent in a Chinese hospital after 3 days of STEMI onset were enrolled in this retrospective study, who were divided into the early group (3-14 days) and the late group (>14 days). A propensity score match was conducted to reduce the baseline difference. The primary endpoint of all-cause death and secondary endpoints of major adverse cardiac and cerebrovascular event (myocardial infarction [MI], stroke, emergent revascularization, and rehospitalization due to heart failure) were compared using survival analysis.At last, 182 cases were matched after propensity score match, with no statistical difference in baseline characteristics and PCI data. Kaplan-Meier survival curve demonstrated no difference in all-cause death of the 2 groups (P = .512). However, the early group presented a higher incidence of MI than the late group (P = .036). The multivariate Cox regression analysis also demonstrated that the early PCI was an independent risk factor for MI compared with late PCI (hazard ratio = 3.83, 95%CI [1.91-8.82], P = .001). There was no statistical difference in other major adverse cardiac and cerebrovascular event, including stroke, emergent revascularization, and rehospitalization due to heart failure.Using the 2nd drug-eluting stent, early PCI (3-14 days) and late PCI (>14 days) have comparable efficacy and outcomes. However, patients receiving early PCI are subjected to a relatively higher risk of recurrent MI.

Direct oral anticoagulants versus vitamin K antagonists for patients with left ventricular thrombus.

BACKGROUND: A retrospective cohort study was conducted to compare the efficacy and safety of direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs) in the treatment of patients with left ventricular thrombus (LVT). METHODS: Consecutive patients admitted to our institution with LVT between February 2009 and December 2020 and treated with either DOACs or VKAs were considered for inclusion in this study. The outcomes included stroke or systemic embolism (SSE), thrombus resolution, and bleeding events. RESULTS: Eighty-seven patients with LVT were identified. Of these, 25 patients were treated with DOACs and 62 patients were treated with VKA. The average follow-up period was 2.37±2.1 years. DOACs were associated with similar incidences of stroke (4.0% vs. 4.8%; P=0.158), systemic embolism (0% vs. 1.6%; P=0.906), SSE (4.0% vs. 6.5%; P=0.657), thrombus resolution (76.0% vs. 74.2%; P=0.057), and blooding events (4.0% vs. 3.2%; P=0.858) as compared to VKAs. In the univariate logistic regression analysis, there was a significant difference between the DOAC and VKA groups in the incidence of SSE when antiplatelets were controlled [odds ratio (OR) =0.34, 95% confidence interval (CI): 0.21, 0.98; P=0.027]. However, in the multivariate analysis, antiplatelets had no significant effect on the outcome (OR =0.41, 95% CI: 0.36, 1.54; P=0.366). CONCLUSIONS: DOACs had similar efficacy and safety to VKAs in the treatment of patients with LVT. Randomized controlled trials should be conducted to verify our findings.

Dioscin attenuates lipopolysaccharide-induced inflammatory myocardial injury through oxidative stress-related pathway.

BACKGROUND: Lipopolysaccharide (LPS) is one of the main causes of myocardial injury. Dioscin has a protective effect on myocardial injury induced by LPS; however, the biological function and mechanism remain unclear. The purpose of this study was to investigate the effect of dioscin on myocardial injury induced by LPS. METHODS: The myocardial injury model was constructed through LPS treatment of primary rat cardiomyocytes. Cardiomyocytes were treated with different concentrations of dioscin (50, 100, and 200 ng/mL). MTT was used to detect the activity of cardiomyocytes; flow cytometry and TUNEL assay were used to detect apoptosis; and enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of inflammatory cytokines, tumor necrosis factor-α (TNF-α), interleukin-1ß (IL-1ß), and interleukin-6 (IL-6). The release of superoxide dismutase (SOD), malondialdehyde (MDA), and glutathione (GSH) was detected according to the kit instructions. The levels of apoptosis-related proteins (Bax, caspase-3, and Bcl 2) and the Nrf2-Keap1 pathway proteins were detected by western blot. RESULTS: Dioscin significantly reduced LPS-induced cardiomyocyte injury in neonatal rats in a concentration- and time-dependent manner. Dioscin also significantly inhibited cardiomyocyte inflammation and apoptosis induced by LPS. With the increase of dioscin concentration, reactive oxygen species (ROS) and MDA were downregulated, and SOD and GSH were upregulated. Moreover, dioscin inhibited LPS-induced myocardial injury by inhibiting the Nrf2-Keap1 pathway. CONCLUSIONS: Our study suggests that dioscin attenuates LPS-induced myocardial injury through oxidative stress-related pathways.