Broadband mid-infrared non-reciprocal absorption using magnetized gradient epsilon-near-zero thin films.

The study of magneto-optical absorption has stimulated diverse energy-technology-related explorations, showing potential in breaking the current theoretical efficiency limits of energy devices compared with reciprocal counterparts. However, experimentally realizing strong infrared non-reciprocal absorption remains an open challenge, and existing proposals of non-reciprocal absorbers are restricted to a narrow working waveband. Here we observe highly asymmetric absorption spectra over a broad mid-infrared band (nearly 10 µm) using doped InAs multilayers with gradient epsilon-near-zero frequencies. We reveal that the magnetized epsilon-near-zero behaviours and material loss play important roles in achieving strongly non-reciprocal absorption under a moderate external magnetic field using a thin epsilon-near-zero film (<λ/40, λ is the wavelength). Our approach enables flexible control over the working frequencies and non-reciprocal bandwidths by designing magnetized InAs films with different doping concentrations. The proposed principles can also be generalized to other III-V semiconductors, magnetized metals, topological Weyl semimetals, magnetized zero-index metamaterials and metasurfaces.

Calycosin inhibited MIF-mediated inflammatory chemotaxis of macrophages to ameliorate ischemia reperfusion-induced acute kidney injury.

BACKGROUND: Inflammatory macrophage infiltration plays a critical role in acute kidney disease induced by ischemia-reperfusion (IRI-AKI). Calycosin is a natural flavone with multiple bioactivities. This study aimed to investigate the therapeutic role of calycosin in IRI-AKI and its underlying mechanism. METHODS: The renoprotective and anti-inflammatory effects of calycosin were analyzed in C57BL/6 mice with IRI-AKI and lipopolysaccharide (LPS)-stimulated RAW 264.7 cells. RNA-seq was used for mechanism investigation. The molecular target of calycosin was screened by in silico methods and validated by surface plasmon resonance (SPR). Macrophage chemotaxis was analyzed using Transwell and agarose gel spot assays. RESULTS: Calycosin treatment significantly reduced serum creatinine and urea nitrogen and attenuated tubular destruction in IRI-AKI mice. Additionally, calycosin markedly suppressed NF-κB signaling activation and the expression of inflammatory mediators IL-1ß and TNF-α in IRI-AKI kidneys and LPS-stimulated RAW 264.7 cells. Interestingly, RNA-seq revealed calycosin remarkably downregulated chemotaxis-related pathways in RAW 264.7 cells. Among the differentially expressed genes, Ccl2/MCP-1, a critical chemokine mediating macrophage inflammatory chemotaxis, was downregulated in both LPS-stimulated RAW 264.7 cells and IRI-AKI kidneys. Consistently, calycosin treatment attenuated macrophage infiltration in the IRI-AKI kidneys. Importantly, in silico target prediction, molecular docking, and SPR assay demonstrated that calycosin directly binds to macrophage migration inhibitory factor (MIF). Functionally, calycosin abrogated MIF-stimulated NF-κB signaling activation and Ccl2 expression and MIF-mediated chemotaxis in RAW 264.7 cells. CONCLUSIONS: In summary, calycosin attenuates IRI-AKI by inhibiting MIF-mediated macrophage inflammatory chemotaxis, suggesting it could be a promising therapeutic agent for the treatment of IRI-AKI.

Ultracompact Energy Transfer in Anapole-based Metachains.

Realization of electromagnetic energy confinement beyond the diffraction limit is crucial for high-performance on-chip devices. Herein we construct an array of nonradiative anapoles that originate from the destructive far-field interference of electric and toroidal dipole modes to achieve ultracompact and high-efficiency electromagnetic energy transfer without the coupler. We experimentally investigate the proposed metachain at mid-infrared frequencies and give the first near-field experimental evidence of anapole-based energy transfer, in which the spatial profile of the anapole mode is also unambiguously identified on the nanoscale. We further demonstrate that the metachain is intrinsically lossless and scalable at infrared wavelengths, realizing a 90° bending loss down to 0.32 dB at the optical communication wavelength. The present scheme bridges the gap between the energy confinement and the transfer of anapoles and opens a new gate for more compactly integrated photonic and energy devices, which can operate in a broad spectral range.

Machine learning-assisted soot temperature and volume fraction fields predictions in the ethylene laminar diffusion flames.

Inferring local soot temperature and volume fraction distributions from radiation emission measurements of sooting flames may involve solving nonlinear, ill-posed and high-dimensional problems, which are typically conducted by solving ill-posed problems with big matrices with regularization methods. Due to the high data throughput, they are usually inefficient and tedious. Machine learning approaches allow solving such problems, offering an alternative way to deal with complex and dynamic systems with good flexibility. In this study, we present an original and efficient machine learning approach for retrieving soot temperature and volume fraction fields simultaneously from single-color near-infrared emission measurements of dilute ethylene diffusion flames. The machine learning model gathers information from existing data and builds connections between combustion scalars (soot temperature and volume fraction) and emission measurements of flames. Numerical studies were conducted first to show the feasibility and robustness of the method. The experimental Multi-Layer Perceptron (MLP) neural network model was fostered and validated by the N2 diluted ethylene diffusion flames. Furthermore, the model capability tests were carried out as well for CO2 diluted ethylene diffusion flames. Eventually, the model performance subjected to the Modulated Absorption/Emission (MAE) technique measurement uncertainties were detailed.

Evolution and Nonreciprocity of Loss-Induced Topological Phase Singularity Pairs.

Singular behaviors are increasingly being found in structures supporting bound states in the continuum (BICs), while the nonreciprocity with spectral phase singularity has not been reported. Here, we demonstrate the origin, evolution, and application of topological phase singularity pairs (TPSPs) resulting from BICs in nonreciprocal and non-Hermitian systems. The nonreciprocity contributes to creating accidental BICs asymmetrically, each of which can split into TPSP with topological charges ±1 in reflection phases by inserting loss. The formation, annihilation, and revival processes of these TPSPs can be selectively controlled via either material or radiative loss. The criteria to predict both number and angular positions of asymmetric BICs are established. Near-complete violation of Kirchhoff's law of thermal radiation has been correspondingly manifested over a wide angular range. The unveiled physics synergizing nonreciprocity and topology will bring new opportunities in multidisciplinary areas like thermal science, magneto-optics, or topological metasurfaces.

Effects and Mechanisms of Traditional Chinese Herbal Medicine in the Treatment of Ischemic Cardiomyopathy.

The incidence of ischemic cardiomyopathy (ICM) is increasing yearly, which seriously endangers human health. There is rarely any remarkable progress in the treatment of ICM from the available drugs. Recent research shows that natural herbal medicine may have beneficial effects in the prevention and treatment of cardiovascular diseases. The effective extracts of the herbs may improve myocardial ischemia through various actions, such as hemodynamic, hemorheological, and vascular actions, and on various cell biology aspects, such as intracellular calcium balance, mitochondria function, cell apoptosis, and scavenging free radicals. Here, we review the animal research progress and potential mechanisms in the treatment of ICM using extracts of well-known traditional Chinese herbal medicines.

Probiotics and fructo-oligosaccharide intervention modulate the microbiota-gut brain axis to improve autism spectrum reducing also the hyper-serotonergic state and the dopamine metabolism disorder.

The prevalence of autism spectrum disorders (ASD) is increasing, but its etiology remains elusive and hence an effective treatment is not available. Previous research conducted on animal models suggests that microbiota-gut-brain axis may contribute to ASD pathology and more human research is needed. This study was divided into two stages,.At the discovery stage, we compared the differences in gut microbiota profiles (using 16S rRNA sequencing), fecal SCFAs (using GC-MS) and plasma neurotransmitters (using UHPLC-MS/MS) of 26 children with ASD and 24 normal children. All 26 children with ASD participated in the intervention stage, and we measured the gut microbiota profiles, SCFAs and neurotransmitters before and after probiotics + FOS (n = 16) or placebo supplementation (n = 10). We found that gut microbiota was in a state of dysbiosis and significantly lower levels of Bifidobacteriales and Bifidobacterium longum were observed at the discovery stage in children with ASD. An increase in beneficial bacteria (Bifidobacteriales and B. longum) and suppression of suspected pathogenic bacteria (Clostridium) emerged after probiotics + FOS intervention, with significant reduction in the severity of autism and gastrointestinal symptoms. Compared to children in the control group, significantly lower levels of acetic acid, propionic acid and butyric acid were found, and a hyperserotonergic state (increased serotonin) and dopamine metabolism disorder (decreased homovanillic acid) were observed in children with ASD. Interestingly, the above SCFAs in children with autism significantly elevated after probiotics + FOS intervention and approached those in the control group. In addition, our data demonstrated that decreased serotonin and increased homovanillic acid emerged after probiotics + FOS intervention. However, the above-mentioned changes did not appear in the placebo group for ASD children. Probiotics + FOS intervention can modulate gut microbiota, SCFAs and serotonin in association with improved ASD symptoms, including a hyper-serotonergic state and dopamine metabolism disorder.

Blood Loss Leads to Increase in Relative Abundance of Opportunistic Pathogens in the Gut Microbiome of Rabbits.

Massive blood loss, a common pathological complication in the clinic, is often accompanied by altered gut integrity and intestinal wall damage. Little is known to what extent the gut microbiome could be correlated with this process. The gut microbiome plays a crucial role in human health, especially in immune and inflammatory responses. This study aims to determine whether acute blood loss affects the gut microbiome and the dynamic variation of the gut microbiome following the loss of blood. We used New Zealand rabbits to mimic the blood loss complication and designed a five-time-point fecal sampling strategy including 24-h pre-blood loss procedure, 24 h, 36 h, 48 h, and 1-week post-blood loss procedure. Gut microbiome composition and diversity were analyzed using 16S rRNA gene sequencing and downstream α-diversity, ß-diversity, and taxonomy analysis. The gut microbiome changed dramatically after blood loss procedure. There was a significant increase in diversity and richness of the gut microbiome at 24-h post-procedure (P = 0.038). Based on an analysis of similarities, the composition of gut microbiome in the samples collected at 24-h post-procedure was significantly different from that of pre-procedure samples (r = 0.79, P = 0.004 weighted unifrac distance; r = 0.99, P = 0.002, unweighted unifrac distance). The relative abundance of Lactobacillus was significantly decreased in the post-procedure samples (P = 0.0006), while the relative abundance of Clostridiales (P = 0.018) and Bacteroidales (P = 0.015) was significantly increased after procedure. We also found the relative abundance of Bacilli, Lactobacillus, Myroides, and Prevotella decreased gradually at different time points after blood loss. The relative abundance of the Clostridia, Alphaproteobacteria, and Sporosarcina increased at 24-h post-procedure and decreased thereafter. This preliminary study discovered potential connections between blood loss and dysbiosis of gut microbiome. The diversity and abundance of the gut microbiome was affected to various extents after acute blood loss and unable to be restored to the original microbiome profile even after one week. The increase in relative abundance of opportunistic pathogens after blood loss could be an important indication to reconsider immune and inflammatory responses after acute blood loss from the perspective of gut microbiome.

Colossal Near-Field Radiative Heat Transfer Mediated by Coupled Polaritons with an Ultrahigh Dynamic Range.

Near-field radiative heat transfer (NFRHT) can exceed the blackbody limit by several orders of magnitude owing to the tunneling evanescent waves. Exploiting this near-field enhancement holds significant potential for emerging technologies. It has been suggested that coupled polaritons can give rise to orders of magnitude enhancement of NFRHT. However, a thorough experimental verification of this phenomenon is still missing. Here this work experimentally shows that NFRHT mediated by coupled polaritons in millimeter-size graphene/SiC/SiO2 composite devices in planar plate configuration can realize about 302.8 ±  35.2-fold enhancement with respect to the blackbody limit at a gap distance of 87  ±  0.8 nm. The radiative thermal conductance and effective gap heat transfer coefficient can reach unprecedented values of 0.136 WK-1 and 5440 Wm-2K-1. Additionally, a scattering-type scanning near-field optical measurement, in conjunction with full-wave numerical simulations, provides further evidence for the coupled polaritonic characteristics of the devices. Notably, this work experimentally demonstrates dynamic regulation of NFRHT can be achieved by modulating the bias voltage, leading to an ultrahigh dynamic range of ≈4.115. This work ambiguously elucidates the important role of coupled polaritons in NFRHT, paving the way for the manipulation of nanoscale heat transport, energy conversion, and thermal computing via the strong coupling effect.

Prognostic value of pulmonary hypertension with a nomogram in acute myocardial infarction patients with reduced left ventricular function.

Background: Pulmonary hypertension (PH) is a common prognostic factor for acute myocardial infarction (AMI) and its impact may increase when combined with reduced left ventricular function. Methods: This retrospective cohort study enrolled AMI patients with reduced left ventricular function at the First Affiliated Hospital of Xi'an Jiaotong University from January 2018 to January 2022. Basing on the systolic pulmonary artery pressure assessed by echocardiogram, patients were assigned to the PH group and control group. Propensity score matching (PSM) in sex, age and Killip classification was used to match patients between two groups. The primary outcome was defined as 1-year mortality rate, which were obtained from medical records and phone calls. Results: After the PSM, a total of 504 patients were enrolled, with 252 in both groups. No significant difference of the adjusted factors was observed between the two groups. The 1-year mortality rate was significantly higher in the PH group compared with the control group (15.5% vs. 5.3%, P < 0.001). In the cox regression analysis, PH (HR: 2.068, 95% CI: 1.028-4.161, P = 0.042) was identified as an independent risk factor, alongside left ventricular ejection fraction (HR: 0.948; 95% CI: 0.919-0.979; P < 0.001), creatine kinase-MB isoenzymes (HR: 1.002; 95% CI: 1.000-1.003; P = 0.010) and pro-brain natriuretic peptide (HR: 1.000; 95% CI: 1.000-1.000; P = 0.018) for the 1-year mortality in AMI patients with reduced left ventricular function. A nomogram was established using the above factors to predict the 1-year mortality risks in these patients. Conclusion: AMI patients with reduced left ventricular function showed higher 1-year mortality rate when concomitant with PH. Four independent risk factors, including PH, were identified and used to establish a nomogram to predict the 1-year mortality risks in these patients. Clinical Trialsgov ID: NCT06186713.

Rationale and Design of the IMPROVE Trial: A Multicenter, Randomized, Controlled, Open-label, Blinded-endpoint Trial Assessing the Efficacy of Remote Ischemic Conditioning in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting.

INTRODUCTION: Despite the appearance of off-pump coronary artery bypass grafting (CABG), ischemia-reperfusion injury (IRI) in the perioperative period still arouses concerns of clinicians. Remote ischemic conditioning (RIC) is the process of repeated ischemia and reperfusion in the peripheral vessels, which is proven to reduce IRI in vital organs. However, the effect of RIC in patients undergoing off-pump CABG is still unclear. METHODS: This IMPROVE trial is a national, multicenter, randomized, controlled, open-label, blinded-endpoint clinical trial designed to assess whether RIC intervention can improve short-term prognosis of patients undergoing off-pump CABG. It plans to enroll 648 patients who will be randomly assigned into a RIC group or control group. Patients in the RIC group will receive four cycles of 5 min of pressurization (about 200 mmHg) and 5 min of rest in the 3 days before and 7 days after the surgery. PLANNED OUTCOMES: The primary outcome is the occurrence of major adverse cardiovascular and cerebrovascular events (MACCE) within the 3-month follow-up. MACCE is defined as all-cause death, myocardial infarction, stroke, and coronary revascularization surgery. CLINICAL TRIAL REGISTRATION: NCT06141525 (ClinicalTrials.gov).

Gut Subdoligranulum variabile ameliorates rheumatoid arthritis by promoting TSG-6 synthesis from joint cells.

Background: A burgeoning body of evidence has substantiated the association between alterations in the composition of the gut microbiota and rheumatoid arthritis (RA). Nevertheless, our understanding of the intricate mechanisms underpinning this association is limited. Methods: To investigate whether the gut microbiota influences the pathogenesis of RA through metabolism or immunity, we performed rigorous synthesis analyses using aggregated statistics from published genome-wide association studies (GWAS) using two-sample Mendelian randomization (MR) and mediated MR techniques, including two-step MR and multivariate MR analyses. Subsequently, we conducted in vitro cellular validation of the analyzed Microbial-Cytokine-RA pathway. We determined the optimal culture conditions through co-culture experiments involving concentration and time. Cell Counting Kit-8 (CCK-8) assays were employed to assess cellular viability, and enzyme-linked immunosorbent assays (ELISA) were performed to assess tumor necrosis factor-inducible gene 6 protein (TSG-6) and tumor necrosis factor-α (TNF-α) levels. Results: Our univariable MR results confirmed 15 microbial traits, 7 metabolites and 2 cytokines that may be causally associated with RA (P FDR < 0.05). Mediation analysis revealed that microbial traits influence the risk of RA through metabolite or cytokine (proportion mediated: 7.75% - 58.22%). In vitro experiments demonstrated that TSG-6 was highly expressed in the Subdoligranulum variabile treatment group and was correlated with decreased RA severity (reduced TNF-α expression). Silencing the TSG-6 gene significantly increased TNF-α expression, regardless of treatment with S. variabile. Additionally, S. variabile-secreted exosomes exhibited the same effect. Conclusion: The results of this study suggest that S. variabile has the potential to promote TSG-6 secretion, thereby reducing RA inflammation.

Taxonomic and functional shifts of gut microbiome in immunoglobulin A vasculitis children and their mothers.

Objectives: To examine the gut microbiota characteristics in children with immunoglobulin A vasculitis and their interrelationships with the host, while evaluate the vertical inheritance of microbiota in the development and progression of IgA vasculitis. Methods: This study investigated the gut microbiome of 127 IgA vasculitis mother-child pairs and 62 matched healthy mother-child pairs, and compared the gut microbial composition of different groups. The pathway enrichment analysis evaluated potential gut microbiome-mediated pathways involved in the pathophysiology of IgA vasculitis. The Spearman correlation analysis illustrated the relationships between clinical variables and bacterial biomarkers. Results: This study identified distinct intestinal microbiome in IgA vasculitis children compared to healthy children, and further pointed out the association in gut microbiota between IgA vasculitis children's and their mother's. The relative abundance of Megamonas and Lactobacillus in IgAV children was positively correlated with that in their mothers. The pathway enrichment analysis found microbial biosynthesis of vitamins and essential amino acids was upregulated in children with IgA vasculitis. Correlation analysis showed bacterial biomarkers were correlated with indicators of blood coagulation. Conclusion: Children with IgA vasculitis have unique bacterial biomarkers and may affect coagulation function, and their gut microbiome was closely associated with that of their mothers. The observed association in gut microbiota between IgA vasculitis children and their mothers suggested a potential intergenerational influence of the maternal microbiota on the development or progression of IgA vasculitis in children.

Ultracompact Single-Photon Sources of Linearly Polarized Vortex Beams.

Ultracompact chip-integrated single-photon sources of collimated beams with polarization-encoded states are crucial for integrated quantum technologies. However, most of currently available single-photon sources rely on external bulky optical components to shape the polarization and phase front of emitted photon beams. Efficient integration of quantum emitters with beam shaping and polarization encoding functionalities remains so far elusive. Here, ultracompact single-photon sources of linearly polarized vortex beams based on chip-integrated quantum emitter-coupled metasurfaces are presented, which are meticulously designed by fully exploiting the potential of nanobrick-arrayed metasurfaces. The authors first demonstrate on-chip single-photon generation of high-purity linearly polarized vortex beams with prescribed topological charges of 0, - 1, and +1. The multiplexing of single-photon emission channels with orthogonal linear polarizations carrying different topological charges are further realized and their entanglement is demonstarated. The work illustrates the potential and feasibility of ultracompact quantum emitter-coupled metasurfaces as a new quantum optics platform for realizing chip-integrated high-dimensional single-photon sources.

Gut microbiota-metabolite interactions meditate the effect of dietary patterns on precocious puberty.

Precocious puberty, a pediatric endocrine disorder classified as central precocious puberty (CPP) or peripheral precocious puberty (PPP), is influenced by diet, gut microbiota, and metabolites, but the specific mechanisms remain unclear. Our study found that increased alpha-diversity and abundance of short-chain fatty acid-producing bacteria led to elevated levels of luteinizing hormone and follicle-stimulating hormone, contributing to precocious puberty. The integration of specific microbiota and metabolites has potential diagnostic value for precocious puberty. The Prevotella genus-controlled interaction factor, influenced by complex carbohydrate consumption, mediated a reduction in estradiol levels. Interactions between obesity-related bacteria and metabolites mediated the beneficial effect of seafood in reducing luteinizing hormone levels, reducing the risk of obesity-induced precocious puberty, and preventing progression from PPP to CPP. This study provides valuable insights into the complex interplay between diet, gut microbiota and metabolites in the onset, development and clinical classification of precocious puberty and warrants further investigation.

On-chip generation of single-photon circularly polarized single-mode vortex beams.

Generation of single photons carrying spin and orbital angular momenta (SAM and OAM) opens enticing perspectives for exploiting multiple degrees of freedom for high-dimensional quantum systems. However, on-chip generation of single photons encoded with single-mode SAM-OAM states has been a major challenge. Here, by using carefully designed anisotropic nanodimers fabricated atop a substrate, supporting surface plasmon polariton (SPP) propagation, and accurately positioned around a quantum emitter (QE), we enable nonradiative QE-SPP coupling and the SPP outcoupling into free-space propagating radiation featuring the designed SAM and OAM. We demonstrate on-chip room-temperature generation of well-collimated (divergence < 7.5°) circularly polarized (chirality > 0.97) single-mode vortex beams with different topological charges (𝓁 = 0, 1, and 2) and high single-photon purity, g(2)(0) < 0.15. The developed approach can straightforwardly be extended to produce multiple, differently polarized, single-mode single-photon radiation channels and enable thereby realization of high-dimensional quantum sources for advanced quantum photonic technologies.

Serum CIRP increases the risk of acute kidney injury after cardiac surgery.

Introduction: Acute kidney injury (AKI) is a frequent perioperative complication. The underlying mechanisms of cardiac surgery-associated AKI are still not completely elucidated. Cold-induced RNA-binding protein (CIRP) has been subsequently found to be regulated by various stress conditions. During cardiac surgery and cardiopulmonary bypass (CPB), the host is subjected to hypothermia and inadequate organ perfusion, resulting in an upregulation of CIRP secretion. The aim of this study is to evaluate the role of elevated extracellular CIRP level as a contributing factor in the development of AKI. Methods: A total of 292 patients who underwent cardiac surgery were retrospectively enrolled and their serum samples were collected preoperative and postoperative. Demographic data, intraoperative data, in-hospital outcomes, and the occurrence of AKI were also collected for the patients. The correlation between CIRP and intraoperative procedures, as well as its association with postoperative outcomes were analyzed. Results: In multivariable analysis, higher ΔCIRP (p = 0.036) and body mass index (p = 0.015) were independent risk factors for postoperative AKI. Meanwhile, patients with postoperative AKI exhibited lower survival rate in 2-year follow-up (p = 0.008). Compared to off-pump coronary artery bypass grafting surgery, patients who underwent on-pump coronary artery bypass grafting, valve surgery, aortic dissection and other surgery showed higher ΔCIRP, measuring 1,093, 666, 914 and 258 pg/mL, respectively (p < 0.001). The levels of ΔCIRP were significantly higher in patients who underwent CPB compared to those who did not (793.0 ± 648.7 vs. 149.5 ± 289.1 pg/mL, p < 0.001). Correlation analysis revealed a positive correlation between ΔCIRP levels and the duration of CPB (r = 0.502, p < 0.001). Patients with higher CIRP levels are at greater risk of postoperative AKI (OR: 1.67, p = 0.032), especially the stage 2-3 AKI (OR: 2.11, p = 0.037). Conclusion: CIRP secretion increases with prolonged CPB time after cardiac surgery, and CIRP secretion is positively correlated with the duration of CPB. Cardiac surgeries with CPB exhibited significantly higher levels of CIRP compared to non-CPB surgeries. Elevation of CIRP level is an independent risk factor for the incidence of AKI, especially the severe AKI, and were associated with adverse in-hospital outcomes.

Aortic Root Reinforcement Combined with Vascular Grafts Eversion and Built-in Procedure (XJ-Procedure) for Acute Type A Aortic Dissection Surgery.

INTRODUCTION: Current root reinforcement methods for acute type A aortic dissection (ATAAD) risk the tearing of endothelial tissue by sutures. This study proposed a novel technique for aortic root reinforcement and evaluated its effectiveness. METHODS: Patients who diagnosed with ATAAD and had mild to moderate aortic root involvement, combined with aortic arch involvement undergoing Sun's procedure in the First Affiliated Hospital of Xi'an Jiaotong University from January 2020 to December 2021, were retrospectively enrolled. They were divided into two groups according to their surgical procedures of aortic root: continuous aortic root suture group (CARS group) and aortic root reinforcement combined with vascular grafts eversion and built-in procedure (XJ-procedure) group. The 30-day mortality rates and incidence of operation-related complications were evaluated. RESULTS: The study cohort comprised 183 patients, including 114 in the XJ-procedure group. The 30-day mortality rates were 7.2% in the CARS group and 6.9% in the XJ-procedure group (P = 1.000). The incidence of residual aortic root dissection in the XJ-procedure group was lower than that in the CARS group before discharge (1.8% vs. 10.1%, P = 0.028), at 3-month (0% vs. 8.7%, P = 0.002) and 6-month (0% vs. 7.2%, P = 0.007) follow-up. In the CARS group, the incidence of anastomotic pseudoaneurysm was 2.9%, 2.9%, and 2.9% compared with none in the XJ-procedure group before discharge, at 3 and 6 months. The XJ-procedure group also showed less chest tube drainage in the first 24-h after the surgery, with lower incidence of hemodialysis and sepsis during hospitalization. No differences were observed in the incidence of bleeding necessitating reoperation and severe aortic regurgitation between the two groups. CONCLUSIONS: The XJ-procedure did not increase 30-day mortality and effectively reduced the incidence of residual aortic root dissection during the 6-month follow-up. Subsequent studies with larger samples and prolonged follow-up are needed to evaluate it. TRIAL REGISTRATION: NCT05751200. The video showed the partial process of the XJ-procedure in managing the aortic root in the ATAAD surgery. The vascular graft was folded outward about 15 mm, and the eversion was intermittently sutured to the full layers aortic wall using 2-0 pad polyester sutures. Then, the eversion of the graft and aortic wall were continuously sutured in one more turn using 3-0 polypropylene sutures. (XJ-procedure, aortic root reinforcement combined with vascular grafts eversion and built-in procedure; ATAAD, acute type A aortic dissection.). (MP4 297097 kb).

Prognostic Potential of Pulmonary Hypertension in Patients with Hematologic Malignancy.

INTRODUCTION: Cardiovascular diseases present a great burden for survivors of hematologic malignancy (HM). However, the effect of pulmonary hypertension (PH) on the clinical outcome of patients with HM remains unknown. This study aims to evaluate the prognostic potential of PH in patients with HM and explore the related clinical determinants. METHODS: This retrospective study included 220 patients with HM and PH and 220 controls without PH, the case-matching cohort analysis was performed based on age, sex, the year of diagnosis and disease type. The baseline characteristics and overall survival (OS) of the patients with HM with or without PH were compared. The cumulative overall survival was analyzed using the Kaplan-Meier curves and the log-rank test. Multivariate Cox proportional hazard models were conducted to identify the predictors of OS. RESULTS: PH was found in 11.98% (302/2520) of the patients with HM. The PH group had lower levels of hemoglobin, platelet, albumin, fibrinogen and B cell count; whereas the levels of lactate dehydrogenase, N terminal pro B type natriuretic peptide, D-dimer, fibrinogen degradation products and C-reactive protein were higher. Additionally, the PH group had a higher prevalence of atrial fibrillation. Survival analysis revealed that the PH group had an inferior OS compared to the non-PH group (16.9 vs. 37.6 months, p = 0.002). Further subgroup analysis revealed that the severe PH group had the worst OS, followed by the moderate and the mild PH groups (8.7 vs. 14.7 vs. 23.7 months, p < 0.001). Multivariate analysis showed that PH was an independent predictor for unfavorable clinical outcomes. CONCLUSIONS: Coexisting PH was associated with inferior clinical outcomes in patients with HM, and the severe PH group had the worst prognosis. The study may provide additional risk stratification for patients with HM.

Commercial and novel anticoagulant ECMO coatings: a review.

Extracorporeal membrane oxygenation (ECMO) is an invasive and last-resort treatment for circulatory and respiratory failure. Prolonged ECMO support can disrupt the coagulation and anticoagulation systems in a patient, leading to adverse consequences, such as bleeding and thrombosis. To address this problem, anticoagulation coatings have been developed for use in ECMO circuits. This article reviews commonly used commercial and novel anticoagulant coatings developed in recent years and proposes a new classification of coatings based on the current state. While commercial coatings have been used clinically for decades, this review focuses on comparing the effectiveness and stability of coatings to support clinical selections. Furthermore, novel anticoagulation coatings often involve complex mechanisms and elaborate design strategies, and this review summarises representative studies on mainstream anticoagulation coatings to provide a point of reference for future studies.