Prognostic models for patients suffering a heart failure with a preserved ejection fraction: a systematic review.

The purpose of this study was to systematically review the development, performance, and applicability of prognostic models developed for predicting poor events in patients with heart failure with preserved ejection fraction (HFpEF). Databases including Embase, PubMed, Web of Science Core Collection, the Cochrane Library, China National Knowledge Infrastructure, Wan Fang, Wei Pu, and China Biological Medicine were queried from their respective dates of inception to 1 June 2023, to examine multivariate models for prognostic prediction in HFpEF. Both forward and backward citations of all studies were included in our analysis. Two researchers individually used the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies (CHARMS) checklist to extract data and assess the quality of the models using the Predictive Mode Bias Risk Assessment Tool (PROBAST). Among the 6897 studies screened, 16 studies derived and/or validated a total of 39 prognostic models. The sample size ranges for model development, internal validation, and external validation are 119 to 5988, 152 to 1000, and 30 to 5957, respectively. The most frequently employed modelling technique was Cox proportional hazards regression. Six studies (37.50%) conducted internal validation of models; bootstrap and k-fold cross-validation were the commonly used methods for internal validation of models. Ten of these models (25.64%) were validated externally, with reported the c-statistic in the external validation set ranging from 0.70 to 0.96, while the remaining models await external validation. The MEDIA echo score and I-PRESERVE-sudden cardiac death prediction mode have been externally validated using multiple cohorts, and the results consistently show good predictive performance. The most frequently used predictors identified among the models were age, n-terminal pro-brain natriuretic peptide, ejection fraction, albumin, and hospital stay in the last 5 months owing to heart failure. All study predictor domains and outcome domains were at low risk of bias, high or unclear risk of bias of all prognostic models due to underreporting in the area of analysis. All studies did not evaluate the clinical utility of the prognostic models. Predictive models for predicting prognostic outcomes in patients with HFpEF showed good discriminatory ability but their utility and generalization remain uncertain due to the risk of bias, differences in predictors between models, and the lack of clinical application studies. Future studies should improve the methodological quality of model development and conduct external validation of models.

Can virtual reality have effects on cardiac rehabilitation? An overview of systematic reviews.

OBJECTIVE: This paper aims to provide a review of the use of virtual reality in cardiac rehabilitation. BACKGROUND: Can virtual reality technology improve outcomes in patients with cardiovascular disease? The question is still open. DESIGN: Systematic review and meta-analyses. METHODS: A literature search was conducted in the Embase, the Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure Database, Wanfang Database, and China Biological Medicine Database. Databases were searched to July 2023. The inclusion criteria were as follows: the nature of the studies was set as a systematic review; the research participants were patients with cardiovascular diseases undergoing cardiac rehabilitation; the research content was a comparison of virtual reality effects between other care approaches. A Measurement Tool to Assess Systematic Reviews was employed to evaluate the quality of included studies and judge the overall certainty of evidence by using the Grading of Recommendations, Assessment, Development, and Evaluation methodology. When there were differences between the outcomes, we used the RevMan 5.3 to recalculate. RESULTS: A total of 7 reviews were included in our synthesis, including 3 low-quality articles and 4 very low-quality articles. Virtual reality was effective in improving patients' depression symptoms, anxiety, stress, and improving athletic ability, but it remains unknown whether virtual reality is effective for other outcomes or not. CONCLUSIONS: Virtual reality can effectively improve the mental health of patients with cardiovascular disease. However, its role in improving other health indicators such as adherence, satisfaction, and quality of life has not been shown.

Boron-Assisted Selective Citrulline Modification under Mild Conditions.

Protein citrullination is one type of protein post-translational modification. Previous methods entail the use of a strongly acidic condition (pH <1), which impedes its exploration under physiological and pathological conditions. Here, we developed a biocompatible method based on o-boron-assisted citrulline modification. We demonstrated that this method enables selective and mainly irreversible modification of citrulline residues under neutral conditions. We expect that it will provide a valuable tool for the study of protein citrullination.

Garcinia Biflavonoid 1 Improves Lipid Metabolism in HepG2 Cells via Regulating PPARα.

Garcinia biflavonoid 1 (GB1) is one of the active chemical components of Garcinia kola and is reported to be capable of reducing the intracellular lipid deposition, which is the most significant characteristic of non-alcoholic fatty liver disease. However, its bioactive mechanism remains elusive. In the current study, the lipid deposition was induced in HepG2 cells by exposure to oleic acid and palmitic acid (OA&PA), then the effect of GB1 on lipid metabolism and oxidative stress and the role of regulating PPARα in these cells was investigated. We found that GB1 could ameliorate the lipid deposition by reducing triglycerides (TGs) and upregulate the expression of PPARα and SIRT6, suppressing the cell apoptosis by reducing the oxidative stress and the inflammatory factors of ROS, IL10, and TNFα. The mechanism study showed that GB1 had bioactivity in a PPARα-dependent manner based on its failing to improve the lipid deposition and oxidative stress in PPARα-deficient cells. The result revealed that GB1 had significant bioactivity on improving the lipid metabolism, and its potential primary action mechanism suggested that GB1 could be a potential candidate for management of non-alcoholic fatty liver disease.

High tumor mutation burden indicates a poor prognosis in patients with intrahepatic cholangiocarcinoma.

BACKGROUND: Intrahepatic cholangiocarcinoma (ICC) is malignancies of the biliary duct system and constitutes approximately 10%-20% of all primary liver cancers. Tumor mutation burden (TMB) is a useful biomarker across many cancer types for the identification of patients who will benefit from immunotherapy. Despite the role of TMB in calculating the effectiveness and prognosis of immune checkpoint inhibitors has been confirmed in multiple human cancer types, the prognostic value of TMB in ICC patients is rare investigated. AIM: To investigate the prognostic value of TMB in patients with ICC. METHODS: Data of 412 patients with ICC were included in the study. TMB was calculated as the total number of somatic non-silent protein-coding mutations divided by the coding region. The Kaplan-Meier method was used to analyze overall survival (OS), and relapse free survival (RFS). The cut-off value of TMB was determined by time-dependent receiver operating characteristic (ROC) curve. Cox regression was performed for multivariable analysis of OS. The nomogram and calibration curve were analyzed to construct and evaluate the prognostic model. RESULTS: In the analysis of the time-dependent ROC curve, we defined 3.1 mut/Mb as the cut-off value of TMB. The Kaplan-Meier plot revealed that patients with high TMB had poor OS (HR = 1.47, P = 0.002) and RFS (HR = 1.42, P = 0.035). Cox regression analysis also demonstrated that TMB was an independent risk predictor for ICC (HR = 1.43, P = 0.0240). Furthermore, independent prognostic factors of ICC included CA19-9 (HR = 1.78, P = 0.0005), chronic viral hepatitis (HR = 1.72, P = 0.0468), tumor resection (HR = 2.58, P < 0.0001) and disease progression (metastatic disease vs. solitary liver tumor; HR = 2.55, P = 0.0002). The nomogram and calibration curve also indicated the effectiveness of the constructed prognostic model. CONCLUSION: TMB was an independent prognostic biomarker in patients with ICC. Moreover, patients with ICC with high TMB had poor OS and RFS as compared to those with low TMB.

MOF-derived nitrogen-doped core-shell hierarchical porous carbon confining selenium for advanced lithium-selenium batteries.

The lithium-selenium (Li-Se) battery has attracted growing interest recently due to its high energy density and theoretical capacity. However, the shuttle effect and volume change during cycling severely hinder its further application. In this work, we report a metal-organic framework (MOF)-derived nitrogen-doped core-shell hierarchical porous carbon (N-CSHPC) with interconnected meso/micropores to effectively confine Se for high-performance Li-Se batteries. The micropores were located at the ZIF-8-derived core and the ZIF-67-derived shell, while mesopores appeared at the core-shell interface after the pyrolysis of the core-shell ZIF-8@ZIF-67 precursor. Such a special hierarchical porous structure effectively confined selenium and polyselenides to prevent their dissolution from the pores and also alleviated the volume change. In particular, in situ nitrogen doping, which afforded N-CSHPC, not only improved the electrical conductivity of Se but also provided strong chemical adsorption on Li2Se, as confirmed by density functional theory calculations. On the basis of dual-physical confinement and strong chemisorption, Se/N-CSHPC-II (molar ratio of Co source to Zn source of 1.0 in the core-shell ZIF-8@ZIF-67 precursor) exhibited reversible capacities of up to 555 mA h g-1 after 150 cycles at 0.2 C and 462 mA h g-1 after 200 cycles at 0.5 C and even a discharge capacity of 432 mA h g-1 after 200 cycles at 1 C. Our demonstration here suggests that the carefully designed Se/C composite can improve the reversible capacity and cycling stability of Se cathodes for Li-Se batteries.

Three Constituents of Moringa oleifera Seeds Regulate Expression of Th17-Relevant Cytokines and Ameliorate TPA-Induced Psoriasis-Like Skin Lesions in Mice.

As a folk medicine, Moringa oleifera L. is used effectively to treat inflammatory conditions and skin diseases. However, its mechanism of action is not well understood, limiting its medical use. We isolated and identified three compounds, namely niazirin, marumoside A and sitosterol-3-O-ß-d-glucoside, from the seeds of Moringa oleifera, and studied their effects on the expression of Th17-relevant cytokines (IL-12/IL-23 p40, IL-17A, IL-22 and IL-23 p19) using lipopolysaccharide-stimulated THP-1 cells. Additionally, as Th17 plays a critical role in the pathogenesis of psoriasis, we used a 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced psoriasis-like skin lesion mouse model to study their potential therapeutic application in vivo. The compounds suppressed the expression of IL-12/IL-23 p40, IL-17A, IL-22 and IL-23 p19 in vitro, and in vivo they ameliorated psoriasis-like skin lesions, decreased IL-17A mRNA expression, and increased the expression of keratinocyte differentiation markers. To our knowledge, this is the first report regarding the mechanism and therapeutic application of Moringa oleifera seeds to treat psoriasis-like lesions in vivo.

Hierarchically Dual-Mesoporous TiO2 Microspheres for Enhanced Photocatalytic Properties and Lithium Storage.

Hierarchically dual-mesoporous TiO2 microspheres have been synthesized by a solvothermal process in the presence of 1-butyl-3-methylimidazolium tetrafluoroborate ([BMIm][BF4 ]) and diethylenetriamine (DETA) as co-templates. Secondary mesostructured defects in the hierarchical TiO2 microspheres produce oxygen vacancies, which not only significantly enhance photocatalytic activity in the degradation of methylene blue (1.7 times that with P25) and acetone (2.9 times that with P25), but are also beneficial for lithium storage. Moreover, we propose a mechanism to rationalize the role of this dual mesoporosity of the TiO2 microspheres in enhancing molecular diffusion, ion transportation, and electronic transitions.

Epidemiological Features of Nontraumatic Spontaneous Subarachnoid Hemorrhage in China: A Nationwide Hospital-based Multicenter Study.

BACKGROUND: Nontraumatic spontaneous subarachnoid hemorrhage (SAH) is associated with a high mortality. This study was conducted to investigate the epidemiological features of nontraumatic spontaneous SAH in China. METHODS: From January 2006 to December 2008, the clinical data of patients with nontraumatic SAH from 32 major neurosurgical centers of China were evaluated. Emergent digital subtraction angiography (DSA) was performed for the diagnosis of SAH sources in the acute stage of SAH (≤3 days). The results and complications of emergent DSA were analyzed. Repeated DSA or computed tomography angiography (CTA) was suggested 2 weeks later if initial angiographic result was negative. RESULTS: A total of 2562 patients were enrolled, including 81.4% of aneurysmal SAH and 18.6% of nonaneurysmal SAH. The total complication rate of emergent DSA was 3.9% without any mortality. Among the patients with aneurysmal SAH, 321 cases (15.4%) had multiple aneurysms, and a total of 2435 aneurysms were detected. The aneurysms mostly originated from the anterior communicating artery (30.1%), posterior communicating artery (28.7%), and middle cerebral artery (15.9%). Among the nonaneurysmal SAH cases, 76.5% (n = 365) had negative initial DSA, including 62 cases with peri-mesencephalic nonaneurysmal SAH (PNSAH). Repeated DSA or CTA was performed in 252 patients with negative initial DSA, including 45 PNSAH cases. Among them, the repeated angiographic results remained negative in 45 PNSAH cases, but 28 (13.5%) intracranial aneurysms were detected in the remaining 207 cases. In addition, brain arteriovenous malformation (AVM, 7.5%), Moyamoya disease (7.3%), stenosis or sclerosis of the cerebral artery (2.7%), and dural arteriovenous fistula or carotid cavernous fistula (2.3%) were the major causes of nonaneurysmal SAH. CONCLUSIONS: DSA can be performed safely for pathological diagnosis in the acute stage of SAH. Ruptured intracranial aneurysms, AVM, and Moyamoya disease are the major causes of SAH detected by emergent DSA in China.

[Analytical studies on flavonoids constituents in Apocynum venetom leaves by UPLC-Q-TOF-MS].

OBJECTIVE: To establish an ultra-performance liquid chromatography quadrupole-time-of-flight mass spectrometric (UPLC-Q-TOF-MS) method for analyzing the flavonoids constituents in Apocynum venetom leaves. METHODS: The analysis was performed on an Alltima C18 analytical column with a gradient solvent system of acetonitrile-1.0% acetic acid at the flow rate of 0.8 mL/min. The detection wavelength was at 254 nm and the column temperature was at 30 degrees C. Identification and detection were collected under the negative electrospray ion mode using Q-TOF-MS. RESULTS: 11 flavonoids constituents being separated and identified, six of them were detected simultaneously. The results showed that the six detected flavonoids constituents had good linearity between concentrations and peak area (r > 0.9996), and the average recoveries of the method were between 94.3% - 103.3%. CONCLUSION: The method is accurate, reproducible, and can be used for the quality control of Apocynum venetom leaves.

[Study on HPCE-DAD fingerprint of Salviae Miltiorrhizae Radix et Rhizoma].

OBJECTIVE: To establish the analytical method for the fingerprint of Salviae Miltiorrhizae Radix et Rhizoma by HPCE-DAD and estimate its quality. METHODS: Salviae Miltiorrhizae Radix et Rhizoma were analyzed and the chromatographic fingerprint were determined by HPCE-DAD. The data were analysed by fuzzy cluster and fingerprint similarity evaluation software was used to compare the similarity of samples. RESULTS: HPCE-DAD fingerprint of 10 main common peaks was established preliminarily. It was discovered that a small number of samples were different from the others. CONCLUSION: The method is reliable, accurate and can be used for the quality control of Salviae Miltiorrhizae Radix et Rhizoma

Emotion and cognitive function assessment of patients with central neurocytoma resection through transcortical frontal approach: a 5-year postoperative follow-up study.

BACKGROUND: Central neurocytoma accounts for 0.1% of primary brain tumor that often occurs in young adults. Surgery is the main treatment for central neurocytoma and the rate of 5-year survival reaches up to over 90%. This study aimed to assess the effect of transcortical frontal approach to surgical resection of central neurocytoma on emotion and cognitive function 5 years after surgery. METHODS: Telephone following-up visits were used in this study. By means of neuropsychological testing, assayed emotion, memory and abstract thinking ability of 18 patients undergoing central neurocytoma resection by transcortical frontal approach for 5 years or more, with another 21 normal cases as control group were enrolled. The data were analyzed statistically by paired t test with SPSS11.5. RESULTS: Patients whose central neurocytoma was removed by transcortical frontal approach were not affected on calculating ability 5 years after operation while ability of memory declined sharply (P = 0.000), the older, the more sharply (P = 0.036). Ability of abstract thinking was significantly reduced (P = 0.000), the older, the more significantly as well (P = 0.012); additionally, anxiety and depression occurred in patients rather more than those of control group (P = 0.000), especially cognitive impairment. CONCLUSIONS: Transcortical frontal approach for surgical resection of central neurocytoma has certain long-term influence on patients' life quality, vulnerable to anxiety, depression and cognitive impairment, the severity of which was correlated to age. Therefore, improving surgical approach will be of value for better long-term life quality of patients.

Polymorphisms of VEGFA gene and susceptibility to hemorrhage risk of brain arteriovenous malformations in a Chinese population.

AIM: To evaluate the influence of the vascular endothelial growth factor A (VEGFA) polymorphisms on risk of presentation with intracerebral hemorrhage (ICH). METHODS: Nine selected VEGFA single-nucleotide polymorphisms (SNPs) were genotyped in 311 patients with brain arteriovenous malformations (BAVM) in a Chinese population. Associations between individual SNPs/haplotypes and the hemorrhage risk of BAVMs were evaluated using logistic regression analysis. RESULTS: In the single-locus analysis, rs1547651 was associated with increased risk of ICH (adjusted OR=2.11, 95% CI=1.01-4.42 compared with the AA genotype). In particular, an increased risk for ICH was associated with this variant in female patients (adjusted OR=3.21, and 95% CI=0.99-10.36). Haplotype-based analyses revealed that haplotype 'GC' in block 1 and haplotype 'ACC' in block 2 were associated with a 30%-38% reduction in the risk of ICH in patients with BAVMs compared to the most common haplotype (P(sim)=0.033 and P(sim)=0.005, respectively). The protective effect of haplotype 'ACC' in block 2 was more evident in male patients and subjects with BAVMs of a size ≥3 cm (adjusted OR=0.57, 95% CI=0.34-0.97 and adjusted OR=0.57, 95% CI=0.31-0.86, respectively). CONCLUSION: The results suggest that VEGFA gene variants may contribute to ICH risk of BAVM.

Two novel mutations of the MYBPC3 gene identified in Chinese families with hypertrophic cardiomyopathy.

BACKGROUND: Hypertrophic cardiomyopathy (HCM) is one of the most common genetic cardiovascular disorders. Mutations in the MYBPC3 gene are one of the most frequent genetic causes of HCM. OBJECTIVES: To screen MYBPC3 gene mutations in Chinese patients with HCM, and analyze the correlation between the genotype and the phenotype. METHODS: The 35 exons of the MYBPC3 gene were amplified by polymerase chain reaction in the 11 consecutive unrelated Chinese pedigrees. The sequences of the products were analyzed and the mutation sites were determined. The clinical data of genotype-positive families were collected, and the correlation between genotype and phenotype was analyzed. RESULTS: Two mutations of the MYBPC3 gene were confirmed among 11 pedigrees. A frameshift mutation (Pro459fs) was identified in exon 17 in family H8, and a splice mutation (IVS5+5G−>C) was identified in intron 5 in family H3. These two mutations were first identified in Chinese patients with familial HCM and were absent in 110 chromosomes of healthy controls. Seven known polymorphisms were found in the cohort. CONCLUSIONS: Compared with what was reported abroad, the MYBPC3 gene is a common pathogenic gene responsible for HCM in Chinese patients, and the phenotypes of these two mutations in their respective families may have their own clinical characteristics.

[Studies on HPCE fingerprint of Folium Apocyni Veneti].

OBJECTIVE: To establish the analytical method for the fingerprint of Folium Apocyni Veneti by HPCE and estimate the quality of Folium Apocyni Veneti from different habitats. METHODS: Folium Apocyni Veneti from different habitats were analyzed and the chromatographic fingerprint were determined by HPCE. The data were analysed by Fuzzy Cluster and Fingerprint Similarity Evaluation Software to compare the similarity of samples. RESULTS: HPCE fingerprint of 7 main peaks was established preliminarily. It was discovered that a small number of samples differed from others. CONCLUSION: The method is reliable, accurate and can be used for quality control of Folium Apocyni Veneti.

[Effects of docosahexaenoic acid on action potential and transient outward potassium current on ventricular myocytes of Sprague-Dawley rat].

OBJECTIVE: To investigate the effects of docosahexaenoic acid (DHA) on action potential (AP) and transient outward potassium current (I(to)) on ventricular myocytes of Sprague-Dawley rat. METHODS: Calcium-tolerant ventricular myocytes were isolated by enzyme digestion. The changes of AP and I(to) with increasing DHA at concentrations of 0, 10, 20, 40, 60, 80, 100, 120 and 200 micromol/L were recorded by whole-cell patch clamp configuration. RESULTS: (1) Action potential durations (APDs) were not affected by DHA at concentrations from 0 micromol/L to 30 micromol/L, while APDs were gradually prolonged in proportion with increasing DHA concentrations from 30 micromol/L to 200 micromol/L within 5 minutes and remained stable thereafter. APD(25), APD(50) and APD(75) were (7.7 +/- 2.0) ms, (21.2 +/- 3.5) ms, and (100.1 +/- 9.8) ms respectively at 100 micromol/L DHA. APD(25), APD(50), and APD(75) were (15.2 +/- 4.0) ms, (45.7 +/- 6.8) ms, and (215.6 +/- 15.7) ms respectively at 200 micromol/L DHA. (2) I(to) was gradually reduced with the increasing DHA concentrations from 10 micromol/L to 200 micromol/L. I(to) was blocked by DHA in a dose-dependent manner. I(to) current density was (30.1 +/- 7.2) pA/pF at DHA concentration of 60 micromol/L and its half-inhibition concentration was 58.3 micromol/L. CONCLUSION: APDs are gradually prolonged while I(to) reduced with increasing concentrations of DHA which might contribute to the anti-arrhythmia mechanisms of DHA.

[Studies on X-ray diffraction Fourier fingerprint pattern of Cornu Elaphuri Davidiani].

OBJECTIVE: To establish the analytical method for the fingerprint pattern of Cornu Elaphuri Davidiani by X-ray diffraction. METHODS: Cornu Elaphuri Davidiani from different ages and different parts were analyzed and the fingerprint patterns were determined by X-ray diffraction. The degree of different fingerprint patterns was calculated and analyzed. RESULTS: The reference X-ray diffraction Fourier fingerprint pattern and characteristic diffraction peaks of Cornu Elaphuri Davidiani were obtained by fifteen samples of Cornu Elaphuri Davidiani from different ages and different parts. CONCLUSION: This method can be used for identification and evaluation of Cornu Elaphuri Davidiani.

[Surgical treatment for the giant aneurysms of middle cerebral artery].

OBJECTIVE: To discuss the surgical treatment of the giant aneurysms of middle cerebral artery. METHODS: Clinical data, surgical methods and outcomes were analyzed in 17 giant aneurysms of middle cerebral artery treated from January 2001 to March 2008. CT scan, CTA, MRA, DSA and 3D-DSA were performed before operations so that we could comprehend the location, size, and shape of aneurysms and compensatory circulation of collateral branches to design the individualized treatment options. All patients had been surgically treated mostly by modified pterional approach, of which, direct clipping of the aneurysms was accomplished in 4 patients, aneurysms trapping or removal after trapping in 4, aneurysms excision or trapping combined with vessels reconstruction in 7, and aneurysms wrapping in 2 cases. RESULTS: CT and MRI revealed the shape and size of aneurysms clearly, while DSA and 3D-DSA could demonstrate the aneurysm's neck and relationship with the adjacent structure. Postoperative neurological function was evaluated according to Glasgow Outcome Scale when patients were discharged. Twelve patients had excellent neurological outcomes. However 4 patients were moderately disabled and one were severely disabled. No patient was dead postoperatively. CONCLUSIONS: It is necessary to perform elaborate imaging before operations for individualized surgical planning. The temporary occlusion of the parent artery and elimination of intra-aneurysmal thrombus are helpful to clipping the aneurysmal neck. Vessels reconstruction is a new and effective method of treating the giant aneurysms of middle cerebral artery.

[Relationship between characteristic geometry and risk of rupture in cerebral saccular aneurysm].

OBJECTIVE: To explore the relationship between the characteristic geometry and the risk of rupture in cerebral saccular aneurysm. METHODS: The clinical features of 473 cerebral saccular aneurysm patients with complete materials of cerebral angiography, 426 with ruptured aneurysm and 47 with unruptured aneurysm, were analyzed retrospectively. The relation of depth, neck width, and aspect ratio (AR) of aneurysms to the risk of rupture were analyzed. RESULTS: The mean depth, neck width, and the AR of the patients with ruptured aneurysm were (5.9+/-3.0) mm, (3.0+/-1.2) mm, and (2.1+/-0.9), all significantly lower than those of the unruptured aneurysm patients [(8.0+/-4.2) mm, (4.8+/-2.4) mm, and (1.7+/-0.6) respectively, all P<0.01]. CONCLUSION: AR is not correlated with the location of aneurysms, but reflects the geometrical and hemodynamic features of cerebral saccular aneurysms very well. High AR may be useful in predicting imminent aneurysmal rupture. But by now, no definitive AR level is accepted in discriminating between unruptured and ruptured aneurysms.