ABSTRACT
Metal-organic frameworks (MOFs) have the potential to efficiently carry cargo due to their excellent porosity and high surface area. Nevertheless, conventional MOFs and their derivatives exhibit low efficiency in transporting nucleic acids and other small molecules, as well as having poor colloidal stability. In this study, a ZIF-90 loaded with iron oxide nanoparticles and Au nanorods was prepared, and then surface-functionalized with polyethyleneimine (PEI) to create a multifunctional nanocomposite (AFZP25k) with pH, photothermal, and magnetic responsiveness. AFZP25k can condense plasmid DNA to form AFZP25k/DNA complexes, with a maximum binding efficiency of 92.85â¯%. DNA release assay showed significant light and pH responsiveness, with over 80â¯% cumulative release after 6â¯h of incubation. When an external magnetic field is applied, the cellular uptake efficiency in HeLa cells reached 81.51â¯%, with low cytotoxicity and specific distribution. In vitro transfection experiments demonstrated a gene transfection efficiency of 44.77â¯% in HeLa cells. Following near-infrared irradiation, the uptake efficiency and transfection efficiency of AFZP25k in HeLa cells increased by 21.3â¯% and 13.59â¯% respectively. The findings indicate the potential of AFZP25k as an efficient and targeted gene delivery vector in cancer gene therapy.
ABSTRACT
In the advancement of spintronic devices, spin valves play a critical role, especially in the sensor and information industries. The emergence of two-dimensional (2D) van der Waals (vdW) magnetic materials has opened up new possibilities for the development of high-performance spin-valve devices. However, the Curie temperature (TC) of most 2D vdW ferromagnets falls below room temperature, resulting in a scarcity of room-temperature spin-valve devices. In this study, we have prepared spin-valve devices without spacer layers based on Fe3GaTe2 vdW homojunctions and observed notable two-state magnetoresistance (MR) from 2 K to room temperature. A maximum MR of 50% surpasses some heterojunctions with spacer-layer structures and it remains 0.6% at room temperature. Furthermore, spin-valve devices exhibit favorable ohmic contact and low operating current as low as 10 nA. These findings demonstrate the enormous potential of Fe3GaTe2-based room-temperature devices and the simplified two-layer structure shows significant prospect in the context of the ongoing trend towards miniaturization of contemporary devices.
ABSTRACT
The ability to manipulate magnetic states by a low electric current represents a fundamental desire in spintronics. In recent years, two-dimensional van der Waals (vdW) magnetic materials have attracted an extensive amount of attention due to their appreciable spin-orbit torque effect. However, for most known vdW ferromagnets, their relatively low Curie temperatures (TC) limit their applications. Consequently, low-power vdW spintronic devices that can operate at room temperature are in great demand. In this research, we fabricate nanodevices based on a solitary thin flake of vdW ferromagnet Fe3GaTe2, in which we successfully achieve nonvolatile and highly efficient magnetization switching by small currents at room temperature. Notably, the switching current density and the switching power dissipation are as low as 1.7 × 105 A/cm2 and 1.6 × 1013 W/m3, respectively, with an external magnetic field of 80 Oe; both are much reduced compared to those of conventional magnet/heavy metal heterostructure devices and other vdW devices.
ABSTRACT
To address challenges related to the inadequate representation and inaccurate discrimination of pedestrian attributes, we propose a novel method for person re-identification, which leverages global feature learning and classification optimization. Specifically, this approach integrates a Normalization-based Channel Attention Module into the fundamental ResNet50 backbone, utilizing a scaling factor to prioritize and enhance key pedestrian feature information. Furthermore, dynamic activation functions are employed to adaptively modulate the parameters of ReLU based on the input convolutional feature maps, thereby bolstering the nonlinear expression capabilities of the network model. By incorporating Arcface loss into the cross-entropy loss, the supervised model is trained to learn pedestrian features that exhibit significant inter-class variance while maintaining tight intra-class coherence. The evaluation of the enhanced model on two popular datasets, Market1501 and DukeMTMC-ReID, reveals improvements in Rank-1 accuracy by 1.28% and 1.4%, respectively, along with corresponding gains in the mean average precision (mAP) of 1.93% and 1.84%. These findings indicate that the proposed model is capable of extracting more robust pedestrian features, enhancing feature discriminability, and ultimately achieving superior recognition accuracy.
ABSTRACT
The tumor immune microenvironment (TIME) can limit the effectiveness and often leads to significant side effects of conventional cancer therapies. Consequently, there is a growing interest in identifying novel targets to enhance the efficacy of targeted cancer therapy. More research indicates that tumor-associated macrophages (TAMs), originating from peripheral blood monocytes generated from bone marrow myeloid progenitor cells, play a crucial role in the tumor microenvironment (TME) and are closely associated with resistance to traditional cancer therapies. Lipid metabolism alterations have been widely recognized as having a significant impact on tumors and their immune microenvironment. Lipids, lipid derivatives, and key substances in their metabolic pathways can influence the carcinogenesis and progression of cancer cells by modulating the phenotype, function, and activity of TAMs. Therefore, this review focuses on the reprogramming of lipid metabolism in cancer cells and their immune microenvironment, in which the TAMs are especially concentrated. Such changes impact TAMs activation and polarization, thereby affecting the tumor cell response to treatment. Furthermore, the article explores the potential of targeting the lipid metabolism of TAMs as a supplementary approach to conventional cancer therapies. It reviews and evaluates current strategies for enhancing efficacy through TAMs' lipid metabolism and proposes new lipid metabolism targets as potential synergistic options for chemo-radiotherapy and immunotherapy. These efforts aim to stimulate further research in this area.
Subject(s)
Lipid Metabolism , Neoplasms , Tumor Microenvironment , Tumor-Associated Macrophages , Humans , Neoplasms/immunology , Neoplasms/therapy , Neoplasms/metabolism , Tumor Microenvironment/immunology , Tumor-Associated Macrophages/immunology , Tumor-Associated Macrophages/metabolism , Animals , Immunotherapy/methodsABSTRACT
Ursodeoxycholic acid (UDCA) is a hydrophilic bile acid commonly used for treating cholestatic liver disease. However, its efficacy on non-alcoholic steatohepatitis (NASH) was controversial. This study aimed to investigate the impact of a high dosage of UDCA on a mouse model of NASH. Forty 6-week-old mice were fed a high-fat high-cholesterol (HFHC) diet for 12 weeks to establish a mouse model of NASH, and then divided into four groups: two groups transitioned to a normal diet, and the other two groups maintained the HFHC diet. Each group was administered a daily dosage of 300â¯mg/kg of UDCA or saline for a period of 8 weeks. The 16â¯s ribosomal RNA genes extracted from mice fecal pellets were sequenced using next-generation sequencing techniques. Serum bile acid profiles were quantified using liquid chromatography electrospray ionization tandem mass spectrometry method. The results showed that UDCA treatment ameliorated liver inflammation, without affecting liver fibrosis. UDCA treatment reduced the relative abundance of the genera Bacteroides, Parabacteroides, and Intestinimonas, whereas increased the relative abundance of the genera norank_f_Muribaculaceae and Parasutterella in the HFHC-maintaining groups. The serum levels of total bile acids and total primary bile acids increased, whereas those of endogenous primary bile acids decreased after UDCA treatment. Correlation analysis showed that primary bile acids were negatively correlated with the genera norank_f_Christensenellaceae and unclassified_f_Ruminococcaceae. In conclusion, a high dosage of UDCA can alleviate liver inflammation, probably by modifying the composition of gut microbiota and serum bile acid profiles in NASH mice.
Subject(s)
Bile Acids and Salts , Disease Models, Animal , Gastrointestinal Microbiome , Mice, Inbred C57BL , Non-alcoholic Fatty Liver Disease , Ursodeoxycholic Acid , Animals , Ursodeoxycholic Acid/pharmacology , Ursodeoxycholic Acid/administration & dosage , Non-alcoholic Fatty Liver Disease/drug therapy , Non-alcoholic Fatty Liver Disease/microbiology , Non-alcoholic Fatty Liver Disease/pathology , Gastrointestinal Microbiome/drug effects , Bile Acids and Salts/metabolism , Bile Acids and Salts/blood , Male , Mice , Diet, High-Fat , Liver/drug effects , Liver/metabolism , Liver/pathologyABSTRACT
Objective. Electrocardiographic (ECG) lead misplacement can result in distorted waveforms and amplitudes, significantly impacting accurate interpretation. Although lead misplacement is a relatively low-probability event, with an incidence ranging from 0.4% to 4%, the large number of ECG records in clinical practice necessitates the development of an effective detection method. This paper aimed to address this gap by presenting a novel lead misplacement detection method based on deep learning models.Approach. We developed two novel lightweight deep learning model for limb and chest lead misplacement detection, respectively. For limb lead misplacement detection, two limb leads and V6 were used as inputs, while for chest lead misplacement detection, six chest leads were used as inputs. Our models were trained and validated using the Chapman database, with an 8:2 train-validation split, and evaluated on the PTB-XL, PTB, and LUDB databases. Additionally, we examined the model interpretability on the LUDB databases. Limb lead misplacement simulations were performed using mathematical transformations, while chest lead misplacement scenarios were simulated by interchanging pairs of leads. The detection performance was assessed using metrics such as accuracy, precision, sensitivity, specificity, and Macro F1-score.Main results. Our experiments simulated three scenarios of limb lead misplacement and nine scenarios of chest lead misplacement. The proposed two models achieved Macro F1-scores ranging from 93.42% to 99.61% on two heterogeneous test sets, demonstrating their effectiveness in accurately detecting lead misplacement across various arrhythmias.Significance. The significance of this study lies in providing a reliable open-source algorithm for lead misplacement detection in ECG recordings. The source code is available athttps://github.com/wjcai/ECG_lead_check.
Subject(s)
Deep Learning , Electrocardiography , Humans , Signal Processing, Computer-Assisted , ThoraxABSTRACT
Objective. Myocardial infarction (MI) is a serious cardiovascular disease that can cause irreversible damage to the heart, making early identification and treatment crucial. However, automatic MI detection and localization from an electrocardiogram (ECG) remain challenging. In this study, we propose two models, MFB-SENET and MFB-DMIL, for MI detection and localization, respectively.Approach. The MFB-SENET model is designed to detect MI, while the MFB-DMIL model is designed to localize MI. The MI localization model employs a specialized attention mechanism to integrate multi-instance learning with domain knowledge. This approach incorporates handcrafted features and introduces a new loss function called lead-loss, to improve MI localization. Grad-CAM is employed to visualize the decision-making process.Main Results.The proposed method was evaluated on the PTB and PTB-XL databases. Under the inter-patient scheme, the accuracy of MI detection and localization on the PTB database reached 93.88% and 67.17%, respectively. The accuracy of MI detection and localization on the PTB-XL database were 94.89% and 85.83%, respectively.Significance. Our method achieved comparable or better performance than other state-of-the-art algorithms. The proposed method combined deep learning and medical domain knowledge, demonstrates effectiveness and reliability, holding promise as an efficient MI diagnostic tool to assist physicians in formulating accurate diagnoses.
Subject(s)
Electrocardiography , Myocardial Infarction , Myocardial Infarction/diagnosis , Humans , Signal Processing, Computer-Assisted , Machine Learning , Algorithms , Databases, FactualABSTRACT
OBJECTIVE: Comparing the effects of extracorporeal cardiopulmonary resuscitation (ECPR) and conventional cardiopulmonary resuscitation (CCPR) on outcomes in patients with in-hospital cardiac arrest (IHCA) in China. The benefits of ECPR over CCPR in patients with IHCA remain controversial. DESIGN: This article analyzed data from the BASeline Investigation of In-hospital Cardiac Arrest (BASIC-IHCA) study, which consecutively enrolled patients with IHCA from July 1, 2019, to December 31, 2020. Patients who received ECPR were selected as the case group and matched with patients who received CCPR as the control group by propensity score at a ratio of 1:4. A parallel questionnaire survey of participating hospitals was conducted, to collect data on ECPR cases from January 1, 2021 to November 30, 2021. The primary outcome was survival to discharge or 30-day survival. SETTING: We included 39 hospitals across 31 provinces in China. PATIENTS: Patients receiving cardiopulmonary resuscitation and without contraindications to ECPR were selected from the BASIC-IHCA database. Patients older than 75 years, not witnessed, or with cardiopulmonary resuscitation duration less than 10 min were excluded. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 4853 patients met the inclusion criteria before matching, with 34 undergoing ECPR (median age, 56.5 yr; 67.65% male) and 4819 underwent CCPR (median age, 59 yr; 64.52% male). There were 132 patients receiving CCPR and 33 patients receiving ECPR who were eventually matched. The ECPR group had significantly higher survival rates at discharge or 30-day survival (21.21% vs. 7.58%, p = 0.048). The ECPR group had significantly lower mortality rates (hazard ratio 0.57; 95% CI, 0.38-0.91) than the CCPR group at discharge or 30 days. Besides the BASIC-IHCA study, the volume of ECPR implementations and the survival rate of patients with ECPR (29.4% vs. 10.4%. p = 0.004) in participating hospitals significantly improved. CONCLUSIONS: ECPR may be beneficial compared with CCPR for patient survival after IHCA and should be considered for eligible patients with IHCA.
Subject(s)
Cardiopulmonary Resuscitation , Extracorporeal Membrane Oxygenation , Heart Arrest , Propensity Score , Humans , Male , Middle Aged , Female , Cardiopulmonary Resuscitation/methods , Heart Arrest/therapy , Heart Arrest/mortality , Extracorporeal Membrane Oxygenation/methods , Extracorporeal Membrane Oxygenation/mortality , China/epidemiology , Aged , Cohort Studies , Adult , Hospital MortalityABSTRACT
[This corrects the article DOI: 10.3389/fonc.2023.1132972.].
ABSTRACT
Histone deacetylase 6 (HDAC6) plays a crucial role in the acetylation of non-histone proteins and is notably implicated in angiogenesis, though its underlying mechanisms were previously not fully understood. This study conducted transcriptomic and proteomic analyses on vascular endothelial cells with HDAC6 knockdown, identifying endoglin (ENG) as a key downstream protein regulated by HDAC6. This protein is vital for maintaining vascular integrity and plays a complex role in angiogenesis, particularly in its interaction with bone morphogenetic protein 9 (BMP9). In experiments using human umbilical vein endothelial cells (HUVECs), the pro-angiogenic effects of BMP9 were observed, which diminished following the knockdown of HDAC6 and ENG. Western blot analysis revealed that BMP9 treatment increased SMAD1/5/9 phosphorylation, a process hindered by HDAC6 knockdown, correlating with reduced ENG expression. Mechanistically, our study indicates that HDAC6 modulates ENG transcription by influencing promoter activity, leading to increased acetylation of transcription factor SP1 and consequently altering its transcriptional activity. Additionally, the study delves into the structural role of HDAC6, particularly its CD2 domain, in regulating SP1 acetylation and subsequently ENG expression. In conclusion, the present study underscores the critical function of HDAC6 in modulating SP1 acetylation and ENG expression, thereby significantly affecting BMP9-mediated angiogenesis. This finding highlights the potential of HDAC6 as a therapeutic target in angiogenesis-related processes.
Subject(s)
Endothelial Cells , Growth Differentiation Factor 2 , Humans , Histone Deacetylase 6/metabolism , Growth Differentiation Factor 2/metabolism , Endoglin/metabolism , Phosphorylation , Endothelial Cells/metabolism , Angiogenesis , Proteomics , Transcription Factors/metabolismABSTRACT
Currently, pancreatic cancer (PC) is one of the most lethal malignant tumors. PC is typically diagnosed at a late stage, exhibits a poor response to conventional treatment, and has a bleak prognosis. Unfortunately, PC's survival rate has not significantly improved since the 1960s. Cancer-associated fibroblasts (CAFs) are a key component of the pancreatic tumor microenvironment (TME). They play a vital role in maintaining the extracellular matrix and facilitating the intricate communication between cancer cells and infiltrated immune cells. Exploring therapeutic approaches targeting CAFs may reverse the current landscape of PC therapy. In recent years, nano-drug delivery systems have evolved rapidly and have been able to accurately target and precisely release drugs with little or no toxicity to the whole body. In this review, we will comprehensively discuss the origin, heterogeneity, potential targets, and recent advances in the nano-drug delivery system of CAFs in PC. We will also propose a novel integrated treatment regimen that utilizes a nano-drug delivery system to target CAFs in PC, combined with radiotherapy and immunotherapy. Additionally, we will address the challenges that this regimen currently faces.
Subject(s)
Cancer-Associated Fibroblasts , Pancreatic Neoplasms , Humans , Nanoparticle Drug Delivery System , Pancreatic Neoplasms/drug therapy , Immunotherapy , Pancreas , Tumor MicroenvironmentABSTRACT
[This retracts the article DOI: 10.3892/etm.2019.8036.].
ABSTRACT
Optical vortices with spin and orbital angular momentum (SAM and OAM) states offer multiple degrees of freedom for manipulating optical fields and thus enable great potentials in optical information processing. Recently, the optical metasurface has become an important platform for vortex beam generation and steering. However, the strong spin-orbit interaction on such metasurfaces usually leads to spin locked OAM generation, which limits the complete control of the angular momentum state of light. Here, we propose to solve this constraint using geometric phase controlled nonlinear chiroptical metasurfaces. The metasurface consists of two types of plasmonic meta-atoms which have opposite handedness and exhibit a strong spin-dependent circular dichroism effect. By encoding specific phase singularities and phase gradients to different channels, we experimentally demonstrate the spin unlocked second harmonic beam steering. The proposed nonlinear chiroptical metasurfaces may have important applications in developing multifunctional nonlinear optical devices.
ABSTRACT
Recently, van der Waals (vdW) antiferromagnets have been proposed to be crucial for spintronics due to their favorable properties compared to ferromagnets, including robustness against magnetic perturbation and high frequencies of spin dynamics. High-performance and energy-efficient spin functionalities often depend on the current-driven manipulation and detection of spin states, highlighting the significance of two-dimensional metallic antiferromagnets, which have not been much explored due to the lack of suitable materials. Here, we report a new metallic vdW antiferromagnet obtained from the ferromagnet Fe3GaTe2 by cobalt (Co) doping. Through the layer-number-dependent Hall resistance and magnetoresistance measurements, an evident odd-even layer-number effect has been observed in its few-layered flakes, suggesting that it could host an A-type antiferromagnetic structure. This peculiar layer-number-dependent magnetism in Co-doped Fe3GaTe2 helps unravel the complex magnetic structures in such doped vdW magnets, and our finding will enrich material candidates and spin functionalities for spintronic applications.
ABSTRACT
Immune checkpoint blockade (ICB) has shown considerable promise for treating various malignancies, but only a subset of cancer patients benefit from immune checkpoint inhibitor therapy because of immune evasion and immune-related adverse events (irAEs). The mechanisms underlying how tumor cells regulate immune cell response remain largely unknown. Here we show that hexokinase domain component 1 (HKDC1) promotes tumor immune evasion in a CD8+ T cell-dependent manner by activating STAT1/PD-L1 in tumor cells. Mechanistically, HKDC1 binds to and presents cytosolic STAT1 to IFNGR1 on the plasma membrane following IFNγ-stimulation by associating with cytoskeleton protein ACTA2, resulting in STAT1 phosphorylation and nuclear translocation. HKDC1 inhibition in combination with anti-PD-1/PD-L1 enhances in vivo T cell antitumor response in liver cancer models in male mice. Clinical sample analysis indicates a correlation among HKDC1 expression, STAT1 phosphorylation, and survival in patients with hepatocellular carcinoma treated with atezolizumab (anti-PD-L1). These findings reveal a role for HKDC1 in regulating immune evasion by coupling cytoskeleton with STAT1 activation, providing a potential combination strategy to enhance antitumor immune responses.
Subject(s)
Carcinoma, Hepatocellular , Liver Neoplasms , Animals , Humans , Male , Mice , B7-H1 Antigen , Carcinoma, Hepatocellular/metabolism , Cell Line, Tumor , Cytoskeleton/metabolism , Hexokinase/metabolism , Immune Evasion , Liver Neoplasms/pathology , STAT1 Transcription Factor/metabolism , Tumor EscapeABSTRACT
OBJECTIVE: To explore the factors influencing C-reactive protein (CRP) status in neonates on admission after birth. METHODS: 820 newborns born and hospitalized at Xiangya Hospital of Central South University from Jan. 2020 to Dec. 2020 were retrospectively analyzed. Maternal medical history and medication use during pregnancy, neonatal demographic information and status at birth were collected through the electronic medical record system. Statistical software was used to analyze the possible relationship between perinatal factors and CRP on admission after birth. RESULTS: A total of 820 neonates were analyzed, including 463 males and 357 females with a mean gestational age (GA) of 36.07 ± 3.30 weeks. (1) Multifactor Logistic regression analysis: larger GA (OR: 1.13, 95%CI: 1.00-1.28, P = 0.042), premature rupture of membranes (PROM) ≥ 18 h (OR: 2.39, 95%CI: 1.35-4.23, P = 0.003) and maternal autoimmune diseases (OR: 5.30, 95%CI: 2.15-13.07, P < 0.001) were independent risk factors for CRP ≥ 8 mg/L. Cesarean delivery (OR 0.40, 95%CI: 0.26-0.60, P < 0.001) was independent protective factor for CRP ≥ 8 mg/L. (2) Threshold effect analysis: A non-linear relationship was found between GA and CRP. When GA is less than 33.9 weeks, the risk of CRP ≥ 8 mg/L was reduced by 28% with one week increased (P < 0.001), and when GA is more than 33.9 weeks, the risk of CRP ≥ 8 mg/L was increased by 61% with one week increased (P < 0.001). CONCLUSIONS: GA, PROM, maternal autoimmune diseases and cesarean delivery were all independent influences neonatal CRP ≥ 8 mg/L on admission, and there was a nonlinear relationship between GA and neonatal CRP ≥ 8 mg/L on admission.
Subject(s)
Autoimmune Diseases , Infant, Newborn, Diseases , Premature Birth , Pregnancy , Male , Female , Infant, Newborn , Humans , Infant , C-Reactive Protein/analysis , Retrospective Studies , Gestational AgeABSTRACT
BACKGROUND: To investigate the association between sex and neonatal respiratory distress syndrome (NRDS). METHODS: Neonates born at our hospital and transferred to the neonatal department within 1 h were retrospectively analyzed. Depending on whether they developed NRDS during their hospital stay, the neonates was divided into NRDS and non-NRDS groups. There were 142 neonates in the NRDS group (95 males and 47 females) and 310 neonates in the non-NRDS group (180 males and 140 females). The neonates' data on gestational age (GA), sex, birth weight, white blood cell count (WBC), platelet count (PLT), C-reactive protein (CRP), total immunoglobulin M (total IgM), gestational diabetes mellitus(GDM), antenatal steroids use, meconium-stained amniotic fluid, and preterm premature rupture of membranes(PPROM) were gathered. RESULTS: 452 neonates (265 males and 187 females) were involved for the purpose of collecting basic characteristic. Multivariate analysis, males had a 1.87 times higher risk of NRDS than females (P < 0.05) after controlling for the confounding effects of GA, birth weight, WBC, PLT, CRP, total IgM, GDM, antenatal steroids use, meconium-stained amniotic fluid, and PPROM. CONCLUSIONS: Sex was associated with NRDS; males had a considerably higher risk of NRDS than females.
Subject(s)
Fetal Membranes, Premature Rupture , Infant, Newborn, Diseases , Pregnancy Complications , Respiratory Distress Syndrome, Newborn , Infant, Newborn , Male , Pregnancy , Humans , Female , Birth Weight , Retrospective Studies , Steroids , Immunoglobulin MABSTRACT
Polyethylenimine (PEI) is a broadly exploited cationic polymer due to its remarkable gene-loading capacity. However, the high cytotoxicity caused by its high surface charge density has been reported in many cell lines, limiting its application significantly. In this study, two different molecular weights of PEI (PEI10k and PEI25k) were crosslinked with red blood cell membranes (RBCm) via disulfide bonds to form PEI derivatives (RMPs) with lower charge density. Furthermore, the targeting molecule folic acid (FA) molecules were further grafted onto the polymers to obtain FA-modified PEI-RBCm copolymers (FA-RMP25k) with tumor cell targeting and glutathione response. In vitro experiments showed that the FA-RMP25k/DNA complex had satisfactory uptake efficiency in both HeLa and 293T cells, and did not cause significant cytotoxicity. Furthermore, the uptake and transfection efficiency of the FA-RMP25k/DNA complex was significantly higher than that of the PEI25k/DNA complex, indicating that FA grafting can increase transfection efficiency by 15 %. These results suggest that FA-RMP25k may be a promising non-viral gene vector with potential applications in gene therapy.
Subject(s)
Gene Transfer Techniques , Polyethyleneimine , Humans , Cell Membrane/metabolism , DNA/chemistry , Genetic Therapy/methods , Glutathione/genetics , HeLa Cells , Polyethyleneimine/chemistry , Polymers/chemistry , Transfection , Folic Acid/chemistry , Erythrocyte Membrane/metabolismABSTRACT
ABSTRACT: Aims: Targeted temperature management is recommended for at least 24 h in comatose survivors of in-hospital cardiac arrest (IHCA) after the return of spontaneous circulation; however, whether an extension for 72 h leads to better neurological outcomes is uncertain. Methods: We included data from the Qilu Hospital of Shandong University between July 20, 2019, and June 30, 2022. Unconscious patients who had return of spontaneous circulation lasting >20 consecutive min and received endovascular cooling (72 h) or normothermia treatment were compared in terms of survival-to-discharge and favorable neurological survival. Propensity score matching was used to formulate balanced 1:3 matched patients. Results: In total, 2,084 patients were included. Sixteen patients received extended endovascular cooling and 48 matched controls received normothermia therapy. Compared with the normothermia group, patients who received prolonged endovascular cooling had a higher survival-to-discharge rate. However, good neurological outcomes did not differ significantly. Before matching, Cox regression analysis, using mortality as the event, showed that extended endovascular cooling independently affected the survival of IHCA patients. Conclusions: Among comatose patients who had been resuscitated from IHCA, the use of endovascular cooling for 72 h might confer a benefit on survival-to-discharge.