Spectral optimization of trichromatic white LEDs based on age of lighting user and application scene.

The optimization of trichromatic white light emitting diodes (LEDs) spectrum for application scenes related to the age of lighting users is proposed and demonstrated. Based on the spectral transmissivity of human eyes at different ages, the visual and non-visual responses of human eyes to different wavelengths of light, we have built the blue light hazards (BLH) and circadian action factor (CAF) related to the age of the lighting user. The BLH and CAF are used to evaluate the spectral combinations of high color rendering index (CRI) white LEDs obtained from different radiation flux ratios of red, green, and blue monochrome spectrum. The best spectra of white LEDs for lighting users at different ages in work and leisure scenes are achieved due to the optimization criterion of BLH proposed by us. This research provides a solution for intelligent health lighting design applicable to light users of different ages and application scenes.

Hyperbaric oxygen may improve vascular endothelial function in patients undergoing coronary stent implantation.

Background: Hyperbaric oxygen (HBO2) therapy improves myocardial function and reduces clinical restenosis in coronary arteries. This study aims to evaluate whether the HBO2 therapy can improve vascular endothelial dysfunction in patients undergoing coronary stent implantation. Methods: The retrospective study included 115 patients undergoing coronary stent implantation. Patients receiving HBO2 therapy were included in the HBO2 group (n=55) and those without HBO2 therapy were included as controls (n=60). The levels of brachial artery endothelial-dependent flow-mediated dilation (FMD), endothelial-independent nitrate-mediated dilatation (NMD), nitric oxide (NO), endothelin-1(ET-1), calcitonin gene-related peptide (CGRP) and high-sensitivity C-reactive protein (hs-CRP) were used to evaluate vascular endothelial function. Results: There were no significant differences with regard to the above parameters at baseline in either group (p⟩0.05). In both the HBO2 and control groups the levels of FMD, NO and CGRP after treatment were significantly higher than those before treatment (p⟨0.05). The levels of hs-CRP and ET-1 after treatment were significantly lower than those before treatment (p⟨0.05). After treatment, the levels of FMD, NO and CGRP in the HBO2 group were significantly higher than those of the control group (p⟨0.05), whereas the hs-CRP and ET-1 levels were significantly lower than those of the control group (p⟨0.05). Conclusion: Using HBO2 therapy as an adjunct treatment in patients undergoing coronary stent implantation may significantly improve vascular endothelial function. HBO2 therapy may have the potential to alter the course of coronary artery disease in the future. Further randomized, multicenter, prospective studies are needed.

Integrin ß-3 is required for the attachment, retention and therapeutic benefits of human cardiospheres in myocardial infarction.

Cardiovascular diseases remain the leading causes of death worldwide. Stem cell therapy offers a promising option to regenerate injured myocardium. Among the various types of stem cells, cardiosphere cells represent a mixture of intrinsic heart stem cells and supporting cells. The safety and efficacy of cardiosphere cells have been demonstrated in recent clinical trials. Cell-matrix interaction plays an important role in mediating the engraftment of injected stem cells. Here, we studied the role of integrin ß-3 in cardiosphere-mediated cell therapy in a mouse model of myocardial infarction. Our results indicated that inhibiting integrin ß-3 reduced attachment, retention and therapeutic benefits of human cardiospheres in mice with acute myocardial infarction. This suggests integrin ß-3 plays an important role in cardiosphere-mediated heart regeneration.

Risk factors for mortality in elderly patients with hip fractures: a meta-analysis of 18 studies.

BACKGROUND: Hip fracture is common and associated with poor outcomes in elderly patients. This meta-analysis aims to investigate the risk factors that might increase the mortality rate in elderly patients with hip fracture. METHODS: PubMed, Embase, and Web of Science were systematically searched for observational studies regarding the prognostic factors of mortality in elderly patients with hip fracture. A fixed-effects or random-effects model was used to calculate pooled hazard ratio (HR) and 95% confidence intervals (95% CIs). RESULTS: Eighteen cohort studies, involving 223,875 patients, were included in this meta-analysis. The most prominent factors associated with mortality were higher age (HR 1.51, 95% CI 1.37, 1.67; P < 0.001), male gender (HR 1.91, 95% CI 1.67, 2.19; P < 0.001), cognitive impairment (HR 2.06, 95% CI 1.25, 3.40; P = 0.005), delirium (HR 2.14, 95% CI 1.50, 3.05; P < 0.001), dementia (HR 2.72, 95% CI 1.41, 5.26; P = 0.003), depression (HR 1.71, 95% CI 1.43, 2.05; P < 0.001), living with caregiver (HR 1.61, 95% CI 1.43, 1.82; P < 0.001), cardiovascular disease (HR 2.10, 95% CI 1.14, 3.86; P = 0.018), renal disease (HR 1.66, 95% CI 1.52, 1.82; P < 0.001), and malignancy (HR 1.75, 95% CI 1.30, 2.37; P = 0.031), whereas respiratory disease (HR 1.49, 95% CI 0.99, 2.24; P = 0.056), diabetes (HR 1.15, 95% CI 0.96, 1.37; P = 0.121), and smoking (HR 1.54, 95% CI 0.64, 3.71; P = 0.337) did not increase the risk of mortality. CONCLUSION: The current study investigated several factors that might increase the risk of mortality in elderly patients with hip fracture. Further studies are needed to evaluate the effectiveness of specific interventions to reduce the risk of mortality.

Use of gated myocardial perfusion imaging to assess clinical value of xinmailong injection in chronic congestive heart failure.

OBJECTIVE: This study used gated myocardial perfusion imaging (G-MPI) to assess the clinical value of Xinmailong injection in chronic congestive heart failure (CHF). METHODS: A total of 102 CHF patients were randomly divided into the control group (n = 51) and the Xinmailong group (n = 51). Patients in the control group were routinely treated. Patients in the Xinmailong group were additionally treated with Xinmailong injection in addition to routine treatment. Before and 3 months after treatment, G-MPI was used to determine changes in the left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV). Fourteen days after treatment, changes in plasma brain natriuretic peptide (BNP) levels were determined. RESULTS: Before treatment, there were no significant differences in LVEF, LVEDV, LVESV, and BNP levels between the two groups (all P > 0.05). After treatment, LVEDV, LVESV, and BNP levels were significantly lower, and LVEF was significantly higher in the Xinmailong group than in the control group (all P < 0.05). CONCLUSION: Additional use of Xinmailong injection in addition to routine treatment improves cardiac function of CHF patients. Because of the safety and effectiveness of Xinmailong injection; this therapy should be promoted.

Effects of dapagliflozin on cardiac function indexes and serum MCP-1 levels in patients with Type 2 diabetes mellitus complicated with heart failure.

Type 2 diabetes mellitus (T2DM) and heart failure (HF) are common in clinic, and they often coexist, triggering poor prognosis of patients and increasing hospitalization rates and mortality. Due to some common pathophysiological mechanisms between T2DM and HF, the two have synergistic effects and require collaborative management . In terms of the treatment of T2DM combined with HF, the effects of drugs on both diseases need to be considered to prevent the impact of HF drugs on glycometabolism. As an SGLT2 inhibitor, dapagliflozin can excrete glucose through the kidneys, reduce blood volume, decrease cardiac load to some extent, improve HF symptoms, and better control blood glucose . Therefore, this study selected 60 HF patients complicated with T2DM as the research subjects, and divided them into control group (CLG, conventional medical treatment) and observation group (ONG, dapagliflozin treatment) to explore the effects of dapagliflozin through comparative analysis. According to the results, compared with CLG, ONG had better improvement of blood glucose, cardiac function, and serum levels (P < 0.05), and a lower rehospitalization rate (P < 0.05), with no obvious between-group differences in the incidence of hypotension and emaciation (P > 0.05). These results showed that dapagliflozin in the treatment of T2DM with HF can improve blood glucose levels, cardiac function indexes and inflammatory factor levels, and decrease rehospitalization rates, presenting good clinical efficacy.

Analysis of correlation between heart failure in the early stage of acute myocardial infarction and serum pregnancy associated plasma protein-A, prealbumin, C-reactive protein, and brain natriuretic peptide levels.

BACKGROUND: The study sought to analyze the predictive value of the early measurement of pregnancy associated plasma protein-A (PAPP-A), prealbumin (PAB), C-reactive protein (CRP), brain natriuretic peptide (BNP), and other indicators of heart failure (HF) after acute myocardial infarction (AMI). METHODS: A total of 200 AMI patients admitted to Wuyi People's Hospital from November 1, 2019 to October 31, 2020 were continuously enrolled as the research objects and divided into a HF group (Killip class II or above, n=94) and HF-free group (Killip class I or below, n=106) according to the Killip Classification for Heart Function. RESULTS: The age, creatine kinase-myocardial band (CK-MB), PAPP-A, CRP, suppression of tumorigenicity 2 (ST2), BNP, aldosterone (ALD), and left ventricular end-diastolic diameter (LVEDD) of the HF group were all significantly higher than those of the HF-free group, while the PAB and left ventricular ejection fraction (LVEF) were significantly lower (P<0.05). The PAPP-A, CRP, and BNP of HF patients increased as the Killip class increased, while the PAB decreased progressively (P<0.05). After including the statistically significant single factors in a multivariate logistic regression analysis, it was found that PAPP-A, PAB, CRP, and BNP were the independent influencing factors causing HF in the early stage of AMI; and the diagnostic efficacy of HF in the early stage of AMI (from high to low) was combined test, PAPP-A, PAB, BNP and CRP. CONCLUSIONS: Serum PAPP-A, PAB, CRP and BNP levels are the independent influencing factors of HF after AMI, but comprehensive tests of clinical indicators, including PAPP-A, PAB, CRP, and BNP, are more accurate at predicting and evaluating HF and can be used to guide clinical decisions.

Effect of Dapagliflozin on Indicators of Myocardial Fibrosis and Levels of Inflammatory Factors in Heart Failure Patients.

Objective: To explore the effect of dapagliflozin on the myocardial fibrosis and the levels of inflammatory factors in heart failure patients. Methods: 60 patients with T2DM who were diagnosed as acute left heart failure or acute exacerbation of chronic left heart failure in the Department of Cardiology of our hospital from November 1, 2020, to December 31, 2021, during hospitalization were the study subjects. According to the treatment regimen, they were divided into the experimental group (EG) which received dapagliflozin and conventional drugs and the control group (CG) which received conventional drugs, with 30 cases in each group to compare and analyze the clinical indicators such as myocardial fibrosis and inflammatory factors. Results: The levels of TNF-α, IL-1ß, IL-6, and hs-CRP in the two groups were decreased gradually after treatment, and the levels of TNF-α, IL-1ß, IL-6, and hs-CRP in the EG were visibly lower compared with those in the CG at week 4 of treatment (P < 0.05). The cardiac function evaluation of patients showed that the levels of LVEF and LVEDD in both groups were gradually improved after treatment, with a significant difference from the fourth week. In other words, compared with the CG, the LVEF level in the EG was obviously higher (P < 0.05), the LVEDD level was distinctly lower (P < 0.05), and the levels of ST2, BNP, and MCP-1 in the EG were clearly lower at week 4 of treatment (P < 0.05) with a statistical significance in difference. Conclusion: Dapagliflozin has a definite curative effect in heart failure patients with type 2 diabetes mellitus, which can effectively reduce the inflammatory response of patients and inhibit the myocardial fibrosis, and has a potential value in improving cardiac function and promoting prognosis.

Efficacy and safety of hybutimibe in combination with atorvastatin for treatment of hypercholesteremia among patients with atherosclerotic cardiovascular disease risk equivalent: A multicenter, randomized, double-blinded phase III study.

Background: To evaluate the safety and efficacy of hybutimibe plus atorvastatin for lipid control in hypercholesterolemia patients with atherosclerotic cardiovascular disease risk equivalent. Methods: In this double-blind phase III study, we 1:1 randomly assigned 255 hypercholesterolemia patients with atherosclerotic cardiovascular disease to receive hybutimibe plus atorvastatin or placebo plus atorvastatin. The primary endpoint was the rate of change of plasma low-density lipoprotein-cholesterol (LDL-C) level at 12 weeks from baseline. The secondary endpoints were plasma total cholesterol (TC), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), non-HDL-C, apoprotein (Apo) B, and 2-, 4-, 8-, and 12-week Apo A1 levels change rate and rates of change of plasma LDL-C levels at 2, 4, and 8 weeks from baseline. Results: From April 2016 to January 2018, 128 in the hybutimibe plus atorvastatin group and 125 in the atorvastatin group were included in modified intention-to-treat (mITT) analysis. After 12 weeks of treatment, LDL-C level changed from 2.61 mmol/L (±0.30) at baseline to 2.18 mmol/L (±0.45) in the hybutimibe plus atorvastatin group and from 2.58 (±0.31) mmol/L to 2.40 (± 0.46) mmol/L in the atorvastatin group (P < 0.0001), in mITT. The change rate in the hybutimibe plus atorvastatin group was significantly higher than that in the atorvastatin group (P < 0.0001); the estimated mean rates of change were -16.39 (95% confidence interval: -19.04, -13.74) and -6.75 (-9.48, -4.02), respectively. Consistently, in per-protocol set (PPS) analysis, the rate of change of LDL-C in the hybutimibe plus atorvastatin group was significantly higher than that in atorvastatin group. Significant decreases in the change rates of non-HDL-C, TC, and Apo B at 2, 4, 8, and 12 weeks (all P < 0.05) were observed for hybutimibe plus atorvastatin, while the differences were not significant for HDL-C, TG, and Apo-A1 (all P > 0.05). During the study period, no additional side effects were reported. Conclusions: Hybutimibe combined with atorvastatin resulted in significant improvements in LDL-C, non-HDL-C, TC, and Apo B compared with atorvastatin alone. The safety and tolerability were also acceptable, although additional benefits of hybutimibe plus atorvastatin were not observed compared with atorvastatin alone in HDL-C, TG, and Apo-A1.

Inhibition of miR-218-5p reduces myocardial ischemia-reperfusion injury in a Sprague-Dawley rat model by reducing oxidative stress and inflammation through MEF2C/NF-κB pathway.

Following myocardial ischemia, myocardial reperfusion injury causes oxidative stress (OS) and inflammation, leading to myocardial cell apoptosis and necrosis. Recently, emerging studies have shown that microRNAs (miRNAs) contribute to the pathophysiology associated with myocardial ischemia-reperfusion (I/R). In this study, we conducted both in-vitro and in-vivo experiments to explore the role of miR-218-5p in ischemia-reperfusion (I/R)- or oxygen and glucose deprivation/reperfusion (OGD/R)-mediated cardiomyocyte injury. A total 44 Sprague-Dawley (SD) rats were used, and randomly divided into four groups, control group (n = 11), miR-218-5p-in group (n = 11), I/R group (n = 11), I/R + miR-218-5p-in group (n = 11). Our data showed that miR-218-5p was overexpressed in H9C2 cardiomyocytes under OGD/R treatment. miR-218-5p inhibition reduced the lactate dehydrogenase (LDH) activity and the levels of reactive oxygen species (ROS), malondialdehyde (MDA) and superoxide dismutase (SOD), as well as the expression of tumor necrosis factor alpha (TNF-α), interleukin (IL-1ß), and IL-6. Oppositely, miR-218-5p overexpression aggravated OGD/R-mediated damage on H9C2 cells, whereas nuclear factor kappa B (NF-κB) pathway inhibition or myocyte enhancer factor 2C (MEF2C) upregulation reversed miR-218-5p mimics-mediated effects. Bioinformatics analysis predicted that miR-218-5p targeted and dampened its expression, which was testified by the dual-luciferase reporter assay and RNA pull-down assay. In vivo, inhibiting miR-218-5p declined LDH activities and ROS, MDA and SOD levels in rat myocardial tissues under I/R injury, alleviated myocardial fibrosis and inflammatory reactions, and reduced myocardial infarction area. Overall, inhibition of miR-218-5p choked oxidative stress and inflammation in myocardial I/R injury via targeting MEF2C/NF-κB axis, thus relieving the disease progression.

Effects of hyperbaric oxygen on vascular endothelial function in patients with slow coronary flow.

BACKGROUND: To improve therapy for slow coronary flow (SCF), the effects of hyperbaric oxygen (HBO) therapy on vascular endothelial function in SCF patients is the focus of this investigation. METHODS: Ninety-eight patients who exhibited chest discomfort were retrospectively analyzed, and di-agnosed with SCF by coronary artery angiography at the Third Hospital of Hebei Medical University, Shijiazhuang, China from 2014 to 2016. The patients were divided into two groups according to the following treatment: HBO group (n = 48) and the control group (n = 50). Patients in the control group were administrated with conventional treatment, while those in the HBO group were administrated HBO therapy for 4 weeks in addition to conventional treatment. To evaluate the effects of HBO on vas-cular endothelial functions, plasma levels of nitric oxide (NO), calcitonin gene-related peptide (CGRP), endothelin-1 (ET-1), high sensitivity C-reactive protein (hsCRP) as well as endothelial-dependent flow-mediated vasodilation (FMD) of the brachial artery were measured in both groups before and after their respective treatments. RESULTS: There were no significant differences in plasma levels of NO, ET-1, CGRP, hsCRP nor in FMD measurements between the two groups before treatment (p > 0.05). Moreover, the levels of all the parameters measured showed no significant changes before and after treatment in the control group. However, when comparing the control group, FMD and plasma NO and CGRP levels were significantly increased in the HBO group after treatment (p < 0.01), whereas hsCRP and ET-1 levels decreased dramatically (p < 0.001). CONCLUSIONS: The HBO treatment in addition to conventional therapy may significantly improve the vascular endothelial function in SCF patients. (Cardiol J 2018; 25, 1: 106-112).

MicroRNA-26a protects against cardiac hypertrophy via inhibiting GATA4 in rat model and cultured cardiomyocytes.

Pathological cardiac hypertrophy is characterized by deleterious changes developed in cardiovascular diseases, whereas microRNAs (miRNAs) are involved in the mediation of cardiac hypertrophy. To investigate the role of microRNA-26a (miR-26a) in regulating cardiac hypertrophy and its functioning mechanisms, overexpression and suppression of miR­26a via its mimic and inhibitor in a transverse abdominal aortic constriction (TAAC)-induced rat model and in angiotensin II (Ang II)-induced cardiomyocytes (CMs) was performed. In the rat model, the heart weight (HW) compared with the body weight (BW), the CM area, and expression of the hypertrophy­associated factors, atrial natriuretic factor (ANF) and ß­myosin heavy chain (ß­MHC), were assessed. In CMs, the protein synthesis rate was determined using a leucine incorporation assay. Mutation of the GATA­binding protein 4 (GATA4) 3'­untranslated region (UTR) and overexpression of GATA4 were performed to confirm whether GATA4 is the target of miR­26a. The results indicated that miR-26a was significantly downregulated in the heart tissue of the rat model, as well as in Ang II­induced CMs (P<0.05). The TAAC-induced rat model exhibited a higher HW/BW ratio, a larger CM area, and higher expression levels of ANF and ß­MHC. CMs, upon Ang II treatment, also demonstrated a larger CM area, higher levels of ANF and ß­MHC, as well as accelerated protein synthesis. miR­26a was not able to regulate GATA4 with mutations in the 3'­UTR, indicating that GATA4 was the direct target of miR­26a. Overexpression of GATA4 abrogated the inhibitory functions of miR­26a in cardiac hypertrophy. Taken together, the present study suggested an anti­hypertrophic role of miR­26a in cardiac hypertrophy, possibly via inhibition of GATA4. These findings may be useful in terms of facilitating cardiac treatment, with potential therapeutic targets and strategies.

The effect of dalteparin versus unfractionated heparin on the levels of troponin I and creatine kinase isoenzyme MB in elective percutaneous coronary intervention: a multicenter study.

BACKGROUND: The aim of this study was to investigate the safety and efficacy of dalteparin during an elective percutaneous coronary intervention (PCI) procedure in a large cohort. MATERIALS AND METHODS: In this prospective, randomized, open-label design study, 733 patients undergoing elective PCI were divided into an unfractionated heparin group (group 1, 323 patients) or a dalteparin group (group 2, 410 patients). Blood samples were collected before and 18-24 h after the PCI procedure to determine the serum levels of cardiac troponin I (cTnI) and creatine kinase isoenzyme MB. Major adverse cardiac events (MACEs) and bleeding events during hospitalization were also recorded. Patients with an increased level of serum cTnI before PCI were excluded from the study. RESULTS: After PCI, the cTnI values were greater than three times the upper limit of normal in 43 cases (13.3%) in group 1 and 52 cases (12.7%) in group 2, without a statistically significant difference between the two groups (P=0.801). An increased creatine kinase isoenzyme MB level of greater than two times the upper limit of normal was found in 10 cases (3.1%) in group 1 and 12 cases (2.9%) in group 2, without a statistically significant difference between the two groups (P=0.894). Postoperative bleeding was observed in nine patients (2.8%) in group 1 and six patients (1.5%) in group 2. Postoperative MACEs were observed in two patients (0.6%) in group 1 and two patients (0.5%) in group 2. There were no significant differences between the two groups with respect to bleeding events or MACEs. CONCLUSION: Our study showed that dalteparin might be as effective and safe as unfractionated heparin for anticoagulation during elective PCI.