Risk factors and prognosis of postoperative acute myocardial infarction in elderly hip fracture patients combined with coronary heart disease.

INTRODUCTION: This article mainly studies the risk factors for postoperative acute myocardial infarction (AMI) in elderly hip fracture patients combined with coronary heart disease (CHD), constructs a prediction model, and evaluates the prognosis of all the patients. METHODS: This article retrospectively collected elderly patients with hip fracture and CHD who underwent hip fracture surgery at the Third Hospital of Hebei Medical University from January 2019 to December 2021. Demographic data, laboratory indicators, and imaging examination results were collected from the medical case system. The risk factors of postoperative AMI were determined by univariate and multivariate logistic regression, and a nomogram prediction model was established. The ROC curve, calibration curve and DCA decision curve were plotted by R language software. The patients in the training set were followed up for 2 years to evaluate their survival situation. RESULTS: 1094 eligible patients were divided into a training set (n = 824 from January 1, 2019 to September 31, 2021) and a validation set (n = 270 from October 1, 2021 to December 31, 2022). In the training set, women accounted for 58.6%; The average age of the patients was 79.45 years old; The main type of fracture was intertrochanteric fracture. There were 64.7% patients taken B receptor blockers; A total of 166 (20.1%) patients underwent percutaneous coronary intervention (PCI); Hypertension accounted for 55.5%; 520 (63.1%) patients had a preoperative waiting time greater than 3 days; The average hemoglobin value upon admission was 101.36 g/L; The average intraoperative bleeding volume was 212.42 ml; The average surgical time was 2.5 ± 0.3 h; Reginal anesthesia accounted for 29.7%; 63 (68.5%) AMI patients had no obvious clinical symptoms; 68 (73.9%) AMI patients did not show ST-segment elevation in ECG; The risk factors of postoperative AMI were age, hemoglobin at admission, diabetes, chronic kidney disease, intraoperative bleeding, and reginal anesthesia. The AUC of the nomogram prediction model was 0.729. The AUC in the validation set was 0.783. Survival analysis showed a significant statistical difference in 2-year mortality between patients with AMI and without AMI, among all the patients with AMI, patients with ECG ST-segment elevation has higher mortality than patients without ECG ST-segment elevation. CONCLUSION: Our research results found that the incidence of postoperative AMI in elderly patients with hip fractures and CHD was 11.1%. Age, diabetes, hemoglobin at admission, regional anesthesia, chronic kidney disease, and intraoperative bleeding are risk factors. The AUC of the nomogram in training set is 0.729. The 2-year mortality rate of the patients with AMI is higher than that of patients without AMI.

Predictive characteristics and model development for acute heart failure preceding hip fracture surgery in elderly hypertensive patients: a retrospective machine learning approach.

BACKGROUND: Hip fractures are a serious health concern among the elderly, particularly in patients with hypertension, where the incidence of acute heart failure preoperatively is high, significantly affecting surgical outcomes and prognosis. This study aims to assess the risk of preoperative acute heart failure in elderly patients with hypertension and hip fractures by constructing a predictive model using machine learning on potential risk factors. METHODS: A retrospective study design was employed, collecting preoperative data from January 2018 to December 2019 of elderly hypertensive patients with hip fractures at the Third Hospital of Hebei Medical University. Using SPSS 24.0 and R software, predictive models were established through LASSO regression and multivariable logistic regression analysis. The models' predictive performance was evaluated using metrics such as the concordance index (C-index), receiver operating characteristic curve (ROC curve), and decision curve analysis (DCA), providing insights into the nomogram's predictive accuracy and clinical utility. RESULTS: Out of 1038 patients screened, factors such as gender, age, history of stroke, arrhythmias, anemia, and complications were identified as independent risk factors for preoperative acute heart failure in the study population. Notable predictors included Sex (OR 0.463, 95% CI 0.299-0.7184, P = 0.001), Age (OR 1.737, 95% CI 1.213-2.488, P = 0.003), Stroke (OR 1.627, 95% CI 1.137-2.327, P = 0.008), Arrhythmia (OR 2.727, 95% CI 1.490-4.990, P = 0.001), Complications (OR 2.733, 95% CI 1.850-4.036, P < 0.001), and Anemia (OR 3.258, 95% CI 2.180-4.867, P < 0.001). The prediction model of acute heart failure was Logit(P) = -2.091-0.770 × Sex + 0.552 × Age + 0.487 × Stroke + 1.003 × Arrhythmia + 1.005 × Complications + 1.181 × Anemia, and the prediction model nomogram was established. The model's AUC was 0.785 (95% CI, 0.754-0.815), Decision curve analysis (DCA) further validated the nomogram's excellent performance, identifying an optimal cutoff value probability range of 3% to 58% for predicting preoperative acute heart failure in elderly patients with hypertension and hip fractures. CONCLUSION: The predictive model developed in this study is highly accurate and serves as a powerful tool for the clinical assessment of the risk of preoperative acute heart failure in elderly hypertensive patients with hip fractures, aiding in the optimization of preoperative risk assessment and patient management.

Interface Optimizing Core-Shell PZT@Carbon/Polyurethane Composites with Enhanced Passive Piezoelectric Vibration Damping Performance.

Presently, piezoelectric materials are gradually playing a significant role within composites to improve the damping and vibrational attenuation capacities of host composites. Previous studies paid attention to isolating the mechanical damping contribution and piezoelectric contribution of polymer-based piezoelectric composites (PPCs). However, reports detailing the piezoelectric damping of such materials have not paid sufficient attention to the technologies and methods to improve the piezoelectric damping of PPCs. In this study, we propose novel damping polyurethane (PU)-based piezoelectric composites with carbon-coated piezoelectric fillers (PZT@C/PU) with improved piezoelectric damping ability. The mechanical damping and piezoelectric damping of composites were theoretically decoupled, and we elaborate on the mechanism enhancing piezoelectric damping through the carbon coating strategy by comparing with the composites with nonpiezoelectric fillers. The as-fabricated core-shell structure having an optimized interface exhibits the proposed PZT@C/PU composite pads with relatively prominent damping ability (loss factor tan δmax = 1.0, tan δRT = 0.3), ductility (400.63%), and sound isolating behavior (transmission loss TL > 23 dB). Moreover, the vibration test results of as-fabricated sandwich structural PZT@C/PU composite damping devices exhibit outstanding vibration attenuating behavior (damping ratio ζ = 0.198). The study herein validates that the carbon shell coated on piezoelectric fillers would effectively increase damping performance of PU-based piezoelectric composites by the enhancement of piezoelectric performance caused by carbon coating piezoelectric fillers, which indicates that this material has potential for future applications in the field of vibration and noise reduction, thereby driving forward and expanding the fundamental understanding in the area of PPCs damping and vibration attenuation.

Characterization of peroxiredoxin from Neocaridina denticulata sinensis and its antioxidant and DNA protection activity analysis.

Peroxiredoxin (Prx) is an antioxidant protein that widely exists in various organisms. To further investigate the role of Prx in the antioxidant and immune responses of Neocaridina denticulata sinensis, the full-length cDNA sequence of a Prx gene (Nd-Prx) from N. denticulata sinensis was obtained. The open reading frame (ORF) of Nd-Prx is 597 bp and encodes 198 amino acids. Amino acid similarity alignment showed that Nd-Prx contained a conserved sequence region "FYPLDFTFVCPTEI". qRT-PCR assay showed that Nd-Prx was expressed in all tested tissues and its expression was highest in the ovary. Nd-Prx was most highly expressed at 36 h after copper stimulation. Nd-Prx expression levels in hepatopancreas were significantly upregulated after Vibrio parahaemolyticus challenge (P < 0.05). In addition, the recombinant Nd-Prx was prepared and its enzyme activity was most stable at 70 °C with pH of 6.0. The antioxidant activity and DNA protection of recombinant Nd-Prx was also demonstrated. In summary, this study investigated the role of Prx in antioxidant and immune responses of N. denticulata sinensis, which might provide a foundation for further exploring Prx in immune system of crustaceans and for the application in disease control.

Chitin/egg shell membrane@Fe3O4 nanocomposite hydrogel for efficient removal of Pb2+ from aqueous solution.

The development of adsorbents by using the byproducts or waste from large-scale industrial and agricultural production is of great significance, and is considered to be an economic and efficient strategy to remove the heavy metals from polluted water. In this work, a novel chitin/EM@Fe3O4 nanocomposite hydrogel was obtained from a NaOH/urea aqueous system, where the proteins of egg shell membrane and Fe3O4 nanoparticles were chemically bonded to chitin polymer chains with the help of epichlorohydrin. Due to the existence of a large number of -NH2, -OH, -CONH-, -COOH and hemiacetal groups, the adsorption efficiency for Pb2+ into the absorbent was dramatically enhanced. The experimental results revealed that the adsorption behavior strongly depends on various factors, such as initial pH, initial Pb2+ concentration, incubation temperature and contact time. The kinetic experiments indicated that the adsorption process for Pb2+ in water solution agreed with the pseudo-second-order kinetic equation. The film diffusion or chemical reaction is the rate limiting process in the initial adsorption stage, and the adsorption of Pb2+ into the nanocomposite hydrogel can well fit the Langmuir isotherm. Thermodynamic analysis demonstrated that such adsorption behaviors were dominated by an endothermic (ΔH° > 0) and spontaneous (ΔG° < 0) process.

Comparison of tenofovir versus entecavir on reducing incidence of hepatocellular carcinoma in chronic hepatitis B patients: A systematic review and meta-analysis.

BACKGROUND AND AIM: Studies had shown that tenofovir (TDF) and entecavir (ETV) are widely used as the first-line therapy to inhibit hepatitis B virus replication, which can reduce the risk of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients, but it was unclear which nucleos(t)ide analogue was most effective. Therefore, we performed a meta-analysis and a systematic review to compare the incidence of HCC in CHB patients who are either on TDF or ETV. METHODS: For this study, the following databases were searched for clinical trials published from its inception until November 2019: PubMed, Web of Science, MEDLINE, Embase, and Cochrane Library. RESULTS: A total of 11 eligible studies were selected, including 70 864 patients. The meta-analysis showed that TDF was superior to ETV with regard to the incidence of HCC, the incidence of death or transplantation, and virologic response. There were no significant differences in terms of biochemical response and loss of seroconversion response among the entire cohort. CONCLUSIONS: The conclusion was that CHB patients treated with TDF had a reduced incidence of HCC compared with patients treated with ETV.

Strain differences in cuprizone induced demyelination.

BACKGROUND: Multiple sclerosis (MS) is a severe neurological disorder, characterized by demyelination of the central nervous system (CNS), and with a prevalence of greater than 2 million people worldwide. In terms of research in MS pathology, the cuprizone toxicity model is widely used. Here we investigated the contribution of genetic differences in response to cuprizone-induced demyelination in two genetically different mouse strains: CD1 and C57BL/6. RESULTS: We demonstrate that exposure to a diet containing 0.2% cuprizone resulted in less severe demyelination in the midline of the corpus callosum over the fornix in CD1 mice than C57BL/6 mice. With continuous cuprizone feeding, demyelination in CD1 mice was not prominent until after 7 weeks, in contrast to C57BL/6 mice, which showed prominent demyelination after 4 weeks of exposure. Concomitantly, immunohistochemical analysis demonstrated more oligodendrocytes, as well as fewer oligodendrocyte progenitor cells, microglia and astrocytes in cuprizone treated CD1 mice. We also analyzed 4-weeks-cuprizone treated corpus callosum tissue samples and found that cuprizone treated CD1 mice showed a smaller reduction of myelin-associated glycoprotein (MAG) and a smaller increase of Iba1 and NG2. CONCLUSIONS: These observations suggest that CD1 mice are less vulnerable to cuprizone-induced demyelination than C57BL/6 mice and thus genetic background factors appear to influence the susceptibility to cuprizone-induced demyelination.

EphA5 and EphA6: regulation of neuronal and spine morphology.

BACKGROUND: The Eph family of receptor tyrosine kinases plays important roles in neural development. Previous studies have implicated Eph receptors and their ligands, the ephrins, in neuronal migration, axon bundling and guidance to specific targets, dendritic spine formation and neural plasticity. However, specific contributions of EphA5 and EphA6 receptors to the regulation of neuronal cell morphology have not been well studied. RESULTS: Here we show that deletion of EphA5 and EphA6 results in abnormal Golgi staining patterns of cells in the brain, and abnormal spine morphology. CONCLUSION: These observations suggest novel functions of these Eph receptors in the regulation of neuronal and spine structure in brain development and function.

Breakdown of interlocking domains may contribute to formation of membranous globules and lens opacity in ephrin-A5(-/-) mice.

Ephrin-A5, a ligand of the Eph family of receptor tyrosine kinases, plays a key role in lens fiber cell packing and cell-cell adhesion, with approximately 87% of ephrin-A5(-/-) mice develop nuclear cataracts. Here, we investigated the extensive formation of light-scattering globules associated with breakdown of interlocking protrusions during lens opacification in ephrin-A5(-/-) mice. Lenses from wild-type (WT) and ephrin-A5(-/-) mice between 2 and 21 weeks old were studied with light and electron microscopy, immunofluorescence labeling, freeze-fracture TEM and filipin cytochemistry for membrane cholesterol detection. Lens opacities with various densities were first observed in ephrin-A5(-/-) mice at around 60 days old. Dense cataracts in the mutant lenses were seen primarily in the nuclear region surrounded by transparent cortices from all eyes examined. We confirmed that a majority of nuclear cataracts were dislocated posteriorly and ruptured the thinner posterior lens capsule. SEM analysis indicated that numerous interlocking protrusions and wavy ridge-and-valley membrane surfaces in deep cortical and nuclear fibers did not cause lens opacity in both transparent ephrin-A5(-/-) and WT mice. In contrast, abundant isolated membranous globules of approximately 1000 nm in size were distributed randomly along the intact fiber cells during early stage of all ephrin-A5(-/-) cataracts examined. A further examination using both SEM and TEM revealed that isolated globules were generated from the disintegrated interlocking protrusions originally located along the corners of hexagonal fiber cells. Freeze-fracture TEM further revealed the association of square-array aquaporin junctions with both isolated globules and interlocking membrane domains. This study reports for the first time that disrupted interlocking protrusions are the source of numerous large membranous globules that contribute to light scattering and nuclear cataracts in the ephrin-A5(-/-) mice. Our results further suggest that dissociations of N-cadherin and adherens junctions in the associated interlocking domains may result in the formation of isolated globules and nuclear opacities in the ephrin-A5(-/-) mice.