AC Group Research Articles

Clinical characteristics of primary vesicoureteral reflux in children with an allergic constitution.

This study was designed to compare the clinical data of vesicoureteral reflux (VUR) in children with and without an allergic constitution. The clinical data of patients hospitalized with VUR due to a urinary tract infection (UTI) between September 1, 2019, and December 31, 2020, were retrospectively analyzed. The patients were divided into two groups: an anallergic constitution group (AC group) and a non-allergic constitution (NAC group), and their UTIs and VUR were compared at baseline and during the follow-up period. (1) Between September 1, 2019, and December 31, 2020, a total of 284 children were hospitalized at Shengjing Hospital Affiliated to China Medical University due to a UTI. These children included 37 cases with primary VUR and 247 cases without VUR (including 59 cases of non-VUR urinary malformation). The proportion of children with an allergic constitution was significantly higher in the patients with VUR than it was in those without VUR or with other urinary malformations (72.97% vs. 48.18% vs. 50.85%, P = 0.005, 0.032). (2) At baseline, the levels of immunoglobulin and immunoglobulin E in the AC group were significantly higher than those in the NAC group (P = 0.042, 0.017). (3) During the follow-up period, the number of recurrent UTI cases in the AC group was significantly higher than that in the NAC group (0.70 ± 0.91 vs. 0.10 ± 0.32, P= 0.005). The difference between the two groups in the VUR remission rate was not statistically significant (40% vs. 50%, P = 0.563). (4) During the follow-up period, the differences in the remission rates of recurrent UTIs and VUR in the two groups were not statistically significant. The incidence of having an allergic constitution is high in patients with VUR, and patients with an allergic constitution present with a higher frequency of recurrent UTIs.

Diagnostic performance of coronary computed tomography angiography for coronary in-stent re-stenosis

Abstract Background Through the development of CT equipment and proper preparation before CT scanning, the accuracy of Coronary computed tomography angiography (CCTA) diagnosis of ischemic heart disease (IHD) is improving, and the role of CCTA in treatment decision is gradually expanding. The latest guidelines recommend CCTA as Class IIa to evaluate stent patency and native vessels in patients with chronic coronary disease. However, diagnostic performance of CCTA to evaluate stent patency in patients who underwent coronary stent was not clarified, respectively the role of CCTA in the evaluation of IHD in native coronary artery was established.. Purpose In the present study, we evaluate the agreement between CCTA and CAG in assessing stent patency in patients with de novo ischemic chest pain who underwent percutaneous coronary intervention (PCI) and evaluated which factors contribute to the differences. Methods From January 1, 2010 to December 31, 2020, we analyzed 845 patients who underwent new CCTA and CAG sequentially for the evaluation of chest pain previously underwent PCI. In CAG and CCTA, ISR is equally defined as a stenosis greater than 50% of the vessel diameter of within the stented segment or its edge (5-mm segments adjacent to the stent). The degree of In-stent restenosis was analyzed by an independently by quantitative coronary angiography (QCA). Results A total of 208 stents were analyzed, the pooled sensitivity and specificity for CCTA on the diagnosis of ISR were 0.78 (0.65-0.89) and 0.93 (0.88-0.96), respectively. LR+ and LR- were 11.19 (6.22-20.15) and 0.23 (0.14-0.39). As a result of analyzing the ISR diagnostic agreement of CCTA by dividing into ACS and CCD group, the agreement of CCTA for ISR diagnosis was relatively low in the ACS group (Sensitivity 0.69 (0.48-0.86) vs. 0.88 (0.69-0.97), specificity 0.92 (0.84-0.97) vs. 0.94 (0.86-0.98), LR+ 9 (4-20.24) vs. 13.9 (5.88-32.88), LR- 0.33 (0.19-0.6) vs. 0.13 (0.04-0.37)) (Table 1). As a result of analyzing related factors in cases of discrepancy in ISR diagnosis, the degree of stenosis in both ACS and CCD groups was mostly intermediate stenosis, which often required additional clinical evaluation (Figure 1). Conclusion When new ischemic chest pain occurred in a patient who previously underwent PCI, the diagnostic accuracy of ISR by CCTA differed depending on the patient’s IHD category. In the CCD group, the diagnostic usefulness of CCTA was comparable both native vessels and ISR, but not in the ACS group. As majority of ISR diagnostic discrepancies were in intermediate lesions, even in the ACS group, CCTA may be considered as a diagnostic tool.

Factors Associated with Weaning in Infants with Cow's Milk Allergy: A Cohort Study.

Objective: To analyze the factors associated with weaning in infants with cow's milk allergy (CMA) treated at a food allergy reference center in a state in the northeast of Brazil. Method: A prospective cohort study, with a case group (children with CMA) and two control groups (symptomatic nonallergic children [SC] and asymptomatic [AC]). At the beginning of the study, 30 children comprised the CMA group, 84 the SC group, and 52 the AC group. Survival analysis was performed to compare breastfeeding time between the three groups and an adjusted linear regression model to verify the factors associated with breastfeeding time. Results: At the beginning of the study, 33.3% of children in the CMA group, 17.1% in the SC group, and 69.6% in the AC group were exclusively breastfeeding (p = 0.005). The most common factors for weaning in children with CMA were the cow's milk elimination diet (30%), allergic symptoms in the child (20%), and breast engorgement (20%). Children who used a cup as a means of offering infant formula spent 281 more days breastfeeding compared with those who used a baby bottle (Bstd = 1.39; p = 0.031). Conclusion: Children with CMA and nonallergic gastrointestinal complaints weaned earlier compared with asymptomatic children. The main causes of weaning in CMA children were maternal difficulty adhering to the elimination diet, breast engorgement, and allergic symptoms in the child. Using a cup was the main factor associated with longer breastfeeding duration, regardless of gastrointestinal symptoms and socioeconomic factors.

The impact of blood pressure guidelines on the cardiovascular event risk in Japanese patients with coronary artery disease in a real-world database using a multimodal data acquisition system

Abstract Background The European Society of Hypertension and the Japanese Society of Hypertension have established a blood pressure (BP) guideline for coronary artery disease (CAD): 130/80 mmHg. The impact of adhering to this BP guideline on the prognosis of Japanese patients with CAD after they have undergone percutaneous coronary intervention (PCI) is unclear. Purpose We investigated the impact of the current guideline-recommended BP value 130/80 mmHg on the prognosis of Japanese patients with CAD by using 'big data,' i.e., the Clinical Deep Data Accumulation System (CLIDAS) database. Methods We evaluated the data of 8,793 CAD patients who underwent cardiac catheterization at six university hospitals and Japan's National Cerebral and Cardiovascular Center (mean ± std. dev. 70 ± 11 years, 78% male, 43% with acute coronary syndrome [ACS]). We categorized the patients based on their BP management: those adhering to the guideline-recommended BP (<130/80 mmHg) and those under stricter BP control criteria (<120/70 mmHg and <110/60 mmHg). We compared the incidence of major adverse cardiovascular events (MACCEs) between these groups, with MACCEs being a composite endpoint (cardiovascular death, stroke, and myocardial infarction). We analyzed the relationship between BP classification and MACCE separately in two groups: the patients with ACS and those with chronic coronary syndrome (CCS). Results During an average follow-up period of 33 months, 710 MACCEs occurred, comprising 234 cardiovascular deaths, 305 strokes, and 270 myocardial infarctions, with some cases overlapping. No significant difference in the MACCE rate was observed between the group with BP below 130/80 mmHg and the group with BP above 130/80 mmHg (hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.75–1.04, p=0.133). In the ACS group, the patients maintaining BP below 130/80 mmHg had a significantly lower MACCE incidence (HR 0.75, 95%CI: 0.59–0.95, p=0.017) and a significantly lower incidence of stroke (HR 0.47, 95%CI: 0.33–0.68, p<0.001), whereas no significant difference in the MACCE incidence was observed in the CCS group (HR 0.91, 95%CI: 0.73–1.13, p=0.393). Blood pressure values below 120/70 mmHg (HR 1.13, 95%CI: 0.97–1.31, p=0.109) and 110/60 mmHg (HR 1.23, 95%CI: 1.06–1.43, p=0.008), corresponded to an increased rate of MACCEs, becoming more pronounced at BP values <110/60 mmHg. Conclusion Achieving the BP guideline target of <130/80 mmHg is associated with improved outcomes in CAD patients, particularly regarding reducing the risk of stroke among patients with ACS. However, BP control at values that are too low may potentially worsen the prognosis for CAD patients.Kaplan–Meier curve

Classification, angioarchitecture and treatment outcomes of medullary bridging vein-draining dural arteriovenous fistulas in the foramen magnum region: a multicenter study.

This study aimed to classify medullary bridging vein-draining dural arteriovenous fistulas (MBV-DAVFs) located around the foramen magnum (FM) according to their location and characterize their angioarchitecture and treatment outcomes. Patients with MBV-DAVFs diagnosed between January 2013 and October 2022 were included. MBV-DAVFs were classified into four groups. Jugular vein-bridging vein (JV-BV) DAVF: located in proximity to jugular fossa, Anterior condylar vein (ACV)-BV DAVF: proximity to anterior condylar canal, Marginal sinus (MS)-BV DAVF: lateral surface of FM and Suboccipital cavernous sinus (SCS)-BV DAVF: proximity to dural penetration of vertebral artery. Twenty patients were included, three JV-BV, four ACV-BV, three MS-BV and ten SCS-BV DAVFs, respectively. All groups showed male predominance. There were significant differences in main feeders between JV (jugular branch of ascending pharyngeal artery) and SCS group (C1 dural branch). Pial feeders from anterior spinal artery (ASA) or lateral spinal artery (LSA) were visualized in four SCS and one MS group. Drainage pattern did not differ between groups. Transarterial embolization (TAE) was performed in three, two, one and two cases and complete obliteration was obtained in 100%, 50%, 100% and 0% in JV, ACS, MS and SCS group, respectively. Successful interventions without major complications were finally obtained in 100%, 75%, 100%, and 40% in JV, ACS, MS and SCS group, respectively. JV-BV DAVFs were successfully treated using TAE alone. SCS-BV DAVFs were mainly fed by small C1 dural branches of vertebral artery often with pial feeders from ASA or LSA, and difficultly treated by TAE alone.

Comparing anticoagulant therapy alone, anticoagulant therapy in combination with catheter-directed thrombolysis, and anticoagulant therapy in combination with pharmacomechanical catheter-directed thrombolysis in the patients with optional inferior vena cava filter-related thrombosis: A single-center retrospective study.

To analyze the treatment methods and efficacy of inferior vena cava filter thrombosis (IVCFT). In this retrospective study, the clinical data for 47 patients with IVCFT who underwent sequential treatment at the Department of Vascular Surgery, Tianjin Medical University Second Hospital, from January 2020 to January 2023 were analyzed. Patients were divided into three groups according to the treatment method: anticoagulant therapy (AC group), anticoagulation plus catheter-directed thrombolysis (CDT group), and anticoagulation plus AngioJet thrombectomy plus catheter-directed thrombolysis (PCDT group). The evaluation criteria for efficacy mainly included preoperative and postoperative clinical symptoms (Villalta score), thrombus diameter, thrombus clearance rate, filter retrieval rate, filter retention time, and urokinase dosage. This study included 47 patients, of whom 31 were males (65.9%) and 16 females (34.1%), with a mean age of 72.05 ± 8.32years. An Aegisy filter was used in seven patients, whereas an Illicium filter was used in forty patients. There were a total of nineteen patients in the anticoagulation-only group, with complete dissolution of the intraluminal thrombus in five patients, a residual thrombus with a maximum diameter ≤1cm in three patients, and a residual thrombus with a maximum diameter >1cm in eleven patients. The Villalta score was 7.16 ± 0.6 before treatment and decreased to 3.79 ± 0.59 after treatment. The thrombus diameter decreased from an average of 1.46 ± 0.2cm before treatment to an average of 0.85 ± 0.14cm after treatment. The retrieval rate for the filters was 42.11% (8/19), with an average dwell time of 27.4 ± 1.3days for the filters. The CDT group consisted of 17 patients. Among whom we observed, complete dissolution of the intraluminal thrombus was observed in six patients, residual thrombus with a maximum diameter ≤1cm in nine patients, and residual thrombus with a maximum diameter >1cm in two patients. The Villalta score decreased from 7.53 ± 0.83 before treatment to 2.06 ± 0.39 after treatment. The thrombus diameter also decreased from 1.46 ± 0.16cm before treatment to 0.35 ± 0.11cm after treatment. The retrieval rate of the filters was 88.24% (15/17), and the average filter indwelling time was 19.25 ± 4.5days. The PCDT group consisted of 11 patients. We observed complete dissolution of the intraluminal thrombus in four patients, residual thrombus with a maximum diameter ≤1cm in six patients, and residual thrombus with a maximum diameter >1cm in one patient. The Villalta score decreased from 7.45 ± 0.76 before treatment to 2.09 ± 0.55 after treatment. The thrombus diameter decreased from 1.50 ± 0.21cm before treatment to 0.33 ± 0.35cm after treatment, and the rate of filter retrieval was 90.91% (10/11). The three treatments of anticoagulation therapy, CDT, and PCDT were meaningful for preoperative and postoperative thrombolysis and symptom improvement in patients with IVCFT. The application of CDT and PCDT was superior to anticoagulation therapy, while there was no significant difference between the CDT and PCDT group. The retrieval rate of filters in the anticoagulation therapy group was the lowest, with no significant difference between the CDT and PCDT group.

Baseline level of interleukin-6 is associated with the risk of acute coronary syndrome development in SARS-CoV‐2 infection

BackgroundAcute coronary syndrome (ACS) is frequently reported in patients with coronavirus disease 2019 (COVID-19). Cytokine storm induced by interleukin-6 (IL-6) has been suggested to potentially cause myocardial injury in COVID-19. We investigated the association between baseline level of IL-6 and development of ACS in COVID-19 patients.MethodsDemographic and clinical data of hospitalized COVID-19 patients from 2020 to 2022 were reviewed. Extracted data including patient characteristics, laboratory biomarkers, and systemic inflammation indexes in patients with or without ACS were reviewed and analyzed. Logistic regression models were applied to analyze predictors of ACS development and receiver-operating characteristic (ROC) curves were used to assess discriminatory power of IL-6 and other risk factors for predicting ACS development.ResultsAmong 1,753 COVID-19 patients, 37 cases experienced ACS and 159 patients without main COVID-19 complications were randomly selected as controls. ACS patients were older (p = 0.001) and suffered from more comorbidities including diabetes (43% vs. 18%, p = 0.001), hypertension (40.5% vs. 24.5%, p = 0.050), ischemic heart disease (49% vs. 9%, p = 0.001), and hyperlipidemia (19% vs. 5%, p = 0.010). Also, decreased level of consciousness (31.6% vs. 2.5%, p = 0.001), ICU admission (65% vs. 2%, p = 0.001), and mortality events (70% vs. 0.6%, p = 0.001) were more prevalent in the ACS group. Baseline levels of IL-6 (p = 0.001), D-dimer (p = 0.026), troponin (p = 0.001), blood urea nitrogen (p = 0.002), and creatinine (p = 0.008) were higher in ACS patients but erythrocyte sedimentation rate (p = 0.013), hemoglobin (p = 0.033), and red blood cells (p = 0.028) were lower compared with controls. Also, age (OR: 1.06, p = 0.019), IL-6 (OR: 1.44, p = 0.047), and cardiovascular disease (CVD) (OR: 3.66, p = 0.043) were associated with ACS development. The area under the curve (AUC) of IL-6 and combined predictors respectively was 0.661 (p = 0.002) and 0.829 (p = 0.001).ConclusionsHigh IL-6 concentration at baseline is a strong predictor for ACS development in COVID-19 patients. Also, elderly and concurrent CVD are significantly associated with ACS development.

The Impact of Bilateral Cerebellar Transcranial Direct Current Stimulation on Balance Control in Healthy Young Adults.

Cerebellar transcranial direct current stimulation (tDCS) has been shown to influence movement functions, but little is known about the specific effects of stimulation polarity on balance control. This study investigated the impact of bilateral cerebellar tDCS on balance functions as a function of stimulation polarity. In this randomized, controlled trial, thirty-nine healthy young adults were assigned to one of three groups: right anodal/left cathodal cerebellar stimulation (AC group), right cathodal/left anodal cerebellar stimulation (CA group), and a control sham group. Each participant underwent a daily 30-minute session of tDCS at 2mA for one week. Balance function was assessed pre- and post-intervention and the data were analyzed using generalized estimating equations. The CA group exhibited a significant reduction in sway area when standing on the left leg and on both stable and unstable surfaces with eyes open, compared to both the AC and sham groups. However, there were no significant differences among the groups in terms of sway length, anteroposterior velocity, or mediolateral velocity. Our results indicate the polarity-dependent effects of bilateral cerebellar tDCS on balance functions, with enhanced stability observed only following cathodal tDCS over the right cerebellum paired with anodal tDCS over the left cerebellum. This polarity-specific modulation may have implications for developing cerebellar neuromodulation interventions for movement disorders.

Tailoring tea residue-derived nitrogen-doped activated carbon for CO2 adsorption: influence of activation temperature and activating agents.

Embracing CO2 mitigation strategies, such as state-of-the-art CO2 capture technologies, is essential for effectively reducing atmospheric carbon levels and advancing global efforts toward a more sustainable future. In this context, adsorption sequestering techniques utilising carbon materials have emerged as promising candidates for CO2 capture. These materials have been extensively researched with a range of tuning methods to optimise their physicochemical features. In this study, an alteration of the N-doped activated carbon was successfully performed, utilizing tea residue as the carbon precursor and ammonia as the nitrogen source, facilitated through an impregnation procedure. With the objective of discovering the effect of diverse activation parameters on prepared adsorbent physicochemical properties, several selections of activating agents (AA) were investigated: KOH, H3PO4, ZnCl2, and NaOH, together with broad thermal activation temperature from 873 to 1173K. The best-performed adsorbents from the respective AC group were subjected to several characterisation analyses and found to the enhanced structural features, heteroatom doped-rich surface (i.e. N and O); together with AA-induced metal/mineral functionalization, the NaOH-used AC (NAC-N-1173) was the optimum-performed adsorbent with a promising 4.12mmol/g CO2 uptake capacity, higher than other prepared adsorbent including N-doped tea residue-derived char and commercialized AC with 175 and 325% higher, respectively.

Single and Multi-Hop Question-Answering Datasets for Reticular Chemistry with GPT-4-Turbo.

The rapid advancement in artificial intelligence and natural language processing has led to the development of large-scale datasets aimed at benchmarking the performance of machine learning models. Herein, we introduce "RetChemQA", a comprehensive benchmark dataset designed to evaluate the capabilities of such models in the domain of reticular chemistry. This dataset includes both single-hop and multi-hop question-answer pairs, encompassing approximately 45,000 question and answers (Q&As) for each type. The questions have been extracted from an extensive corpus of literature containing about 2,530 research papers from publishers including NAS, ACS, RSC, Elsevier, and Nature Publishing Group, among others. The dataset has been generated using OpenAI's GPT-4 Turbo, a cutting-edge model known for its exceptional language understanding and generation capabilities. In addition to the Q&A dataset, we also release a dataset of synthesis conditions extracted from the corpus of literature used in this study. The aim of RetChemQA is to provide a robust platform for the development and evaluation of advanced machine learning algorithms, particularly for the reticular chemistry community. The dataset is structured to reflect the complexities and nuances of real-world scientific discourse, thereby enabling nuanced performance assessments across a variety of tasks.

Effect of long-term oral administration of the flavonoid quercetin on the antioxidant profile of young and adult reproductive rabbit does.

In industrialized farms, rabbit does undergo intensive production rhythms which overlap lactation and gestation, leading to a high energy mobilization and increasing oxidative stress. Accordingly, we hypothesize that administration of the flavonoid quercetin (QUR) may improve the antioxidant status of young and adult rabbit reproductive females. In this study, the effect of daily oral administration of 300 mg/kg QUR for 8 weeks was assessed on the antioxidant profile of 24 New Zealand × Californian rabbit does, assigned to 4 experimental groups: rearing young (8-16 weeks old) and adult does at the end of their reproductive life (12-14 months old, with at least 3-4 reproductive cycles) treated (YQ and AQ) or not (YC and AC) with QUR, respectively. Plasma glutathione (GSH), as well as serum superoxide dismutase (SOD) and malondialdehyde (MDA) were measured during the experimental period. To assess the health status of the animals, a physical examination was also performed. GSH plasma concentrations were significantly higher in young does at weeks 1 and 4, but not at week 8 of the experiment, irrespectively of QUR administration. An increase in GSH plasma concentration was observed during the 8-week experiment in both AQ and AC groups. Furthermore, QUR administration did not alter either SOD or MDA serum activity and concentration in any group during the experimental period. Physical examination revealed no differences between the experimental groups. In conclusion, under our experimental conditions, QUR did not modify the general clinical or the antioxidant profile of young and adult reproductive rabbit females.

Non-radical activation of peracetic acid by Fe-Co sulfide modified activated carbon for the degradation of refractory organic matter

Recently, the non radical activation system had attracted much attention due to its strong anti-interference ability. In this study, a novel FeCo2S4/activated carbon (AC) catalyst was prepared and used to construct a non radical dominated degradation system. Due to the electron-donating groups (C-OH) of AC and the conversion of free radicals generated from the activation of PAA by iron (Fe) and cobalt (Co) ions, a large amount of singlet oxygen (1O2) were produced, making the activation system possessed excellent universality and applicability for the removal of organic pollutants. Within 5 min, about 89.87 % of tetracycline hydrochloride (TCH) was removed in FeCo2S4 /AC + PAA. After only 20 min of reaction, the TCH removal efficiency reached 94.12 %, accompany with the reaction rate reached 0.099 min−1. Other organic pollutants including ibuprofen (IBU), sulfamethoxazole (SMX), ciprofloxacin (CIP), p-nitrophenol (PNP) and atrazine (ATZ) were also efficiently removed within 20 min, with the removal efficiencies were 92.0 %, 91.5 %, 89.4 %, 88.3 %, and 84.5 %, respectively. When the solution pH changed from 5.01 to 9.48, FeCo2S4 /AC also showed excellent catalytic performances, with the TCH removal rates were maintained at over 85.18 %. Moreover, the removal rate of TCH still reached 90.23 % after 5 recycles. This study offered an efficient non-radical peracetic acid (PAA) activation system, which can be effectively used to degrade refractory organic pollutants from complex water environment.

Impact of antenatal corticosteroids-to-delivery interval on very preterm neonatal outcomes: a retrospective study in two tertiary centers in Japan

BackgroundAntenatal corticosteroids (ACS) are administered to prevent neonatal complications and death in women at risk of imminent preterm birth. Internationally, the optimal interval from ACS to delivery (ACS-to-delivery interval) is within seven days; however, evidence in Asian populations specifically is limited. This study aimed to investigate the association between ACS-to-delivery interval and the incidence of neonatal complications in Japan.MethodsThis retrospective observational study enrolled singleton neonates born preterm at < 32 weeks of gestational age between 2012 and 2020 at two tertiary centers. A total of 625 neonates were divided into the following four groups according to the timing of ACS (measured in days): no ACS (n = 145), partial ACS (n = 85), ACS 1–7 (n = 307), and ACS ≥ 8 (n = 88). The following outcomes were compared between the groups: treated respiratory distress syndrome (RDS), severe intraventricular hemorrhage (IVH), treated patent ductus arteriosus (PDA), necrotizing enterocolitis, sepsis, bronchopulmonary dysplasia (BPD), treated retinopathy of prematurity (ROP), periventricular leukomalacia, and death discharge.ResultsThe ACS 1–7 group had significantly decreased adjusted odds ratios (ORs) for treated RDS (0.37 [95% confidence interval: 0.23, 0.57]), severe IVH (0.21 [0.07, 0.63]), treated PDA (0.47 [0.29, 0.75]), and treated ROP (0.50 [0.25, 0.99]) compared with the no ACS group. The ACS ≥ 8 group also showed significantly reduced adjusted ORs for RDS (0.37 [0.20, 0.66]) and treated PDA (0.48 [0.25, 0.91]) compared with the no ACS group. However, the adjusted ORs for BPD significantly increased in both the ACS 1–7 (1.86 [1.06, 3.28]) and ACS ≥ 8 groups (2.94 [1.43, 6.05]) compared to the no ACS group.ConclusionsAn ACS-to-delivery interval of 1–7 days achieved the lowest incidence of several complications in preterm neonates born at < 32 weeks of gestational age. Some of the favorable effects of ACS seem to continue even beyond ≥ 8 days from administration. In contrast, ACS might be associated with an increased incidence of BPD, which was most likely to be prominent in neonates delivered ≥ 8 days after receiving ACS. Based on these findings, the duration of the effect of ACS on neonatal complications should be studied further.

The influence of Helicobacter pylori infection on acute coronary syndrome and lipid metabolism in the Chinese ethnicity.

Acute coronary syndrome (ACS) patients frequently present a relatively high prevalence of Helicobacter pylori (H. pylori) infection. H. pylori was previously hypothesized to induce ACS through the regulation of lipid levels. However, the risk of H. pylori-induced ACS varies significantly among different ethnic groups, and the associations between H. pylori and lipid parameters remain unclear. This study aimed to systematically assess the risk of ACS in Chinese populations with H. pylori infection while also evaluating the effects of H. pylori on lipid parameters. A hospital-based case-control study involving 280 participants was conducted. Immunoblotting was used for the detection and genotyping of H. pylori. The associations between H. pylori and ACS, as well as lipid parameters, were analyzed via the chi-square test and a multiple logistic regression model. H. pylori infection significantly increased the risk of ACS among all participants (adjusted odds ratio (OR) = 4.04, 95% confidence interval (CI): 1.76-9.25, P < 0.05), with no associations with virulence factors (cytotoxin-associated gene A (CagA) or vacuole toxin geneA (VacA)). Subgroup analysis revealed a significant increase in the risk of ACS among the elderly population aged 56-64 years with H. pylori infection. Additionally, a substantial association was observed between H. pylori and acute myocardial infarction (AMI). No significant differences were found in lipid parameters, including low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and the LDL/HDL ratio, between individuals positive and negative for H. pylori infection. Similar results were observed between the ACS group and the control group. Our study has demonstrated for the first time that H. pylori does not significantly impact lipid metabolism but increases the risk of ACS fourfold in the Chinese population (OR = 4.04, 95% CI: 1.76-9.25). Furthermore, the virulence factors of H. pylori (CagA and VacA) may not be involved in the mechanisms by which they promote the development of ACS. This finding provides additional evidence for the association between H. pylori and ACS among different ethnic groups and refutes the biological mechanism by which H. pylori affects ACS through lipid metabolism regulation. Regular screening for H. pylori and eradication treatment in elderly individuals and those at high risk for ACS may be effective measures for reducing the incidence of ACS. Future research should include multicenter randomized controlled trials and explore host genetics and the effects of H. pylori on the gut microbiota as potential biological pathways linking H. pylori and ACS.

Ligustilide Inhibits the PI3K/AKT Signalling Pathway and Suppresses Cholangiocarcinoma Cell Proliferation, Migration, and Invasion.

Angelica sinensis (Oliv.) Diels, a renowned traditional Chinese medicine, has gained widespread recognition for its antitumor properties. Further investigation is warranted to determine whether ligustilide (LIG), which is extracted from this plant, can effectively inhibit tumors. We delved into the impact of LIG on cholangiocarcinoma cells, aiming to unravel the mechanisms underlying its effects. Cholangiocarcinoma cells (HuccT1 and RBE) were exposed to varying concentrations of LIG (2, 5, 10, 15, 20 μg/mL) for 24, 48, and 72 h. After identifying differentially expressed genes, stable transcription strains were utilized to explore LIG's antitumor mechanism. The inhibitory effects of LIG (5 μg/mL, 48 h) were assessed by CCK-8, colony formation, wound healing, transwell migration, western blotting, and immunofluorescence. In vivo, experiments in NOG mice (Ac, Ac+LIG; five per group) evaluated LIG's antiproliferative efficacy (5 mg/kg, intraperitoneal injection, 18-day period). LIG significantly inhibited cell proliferation and migration with IC50 5.08 and 5.77 μg/mL in HuccT1 and RBE cell lines at 48h, increased the expression of E-cadherin while decreased N-cadherin and the protein of PI3K/AKT pathway. Silenced NDRG1 (N-Myc downstream- regulated gene 1) attenuated these effects. In vivo, the AC+LIG group (LIG, 5 mg/kg, qd, 18 d) exhibited smaller tumor volumes compared to the Ac group. The expression of Ki-67 was significantly downregulated in the AC+LIG group. For the first time, our study has revealed that LIG holds therapeutic potential for treating cholangiocarcinoma. These findings hold promise for advancing innovative therapeutic approaches in the treatment of cholangiocarcinoma. LIG may serve as a useful patent for treating CCA.

Use of teicoplanin monotherapy for the treatment of enterococcal infective endocarditis: a retrospective and comparative study at a referral centre.

Clinical experience in the use of teicoplanin for treating enterococcal infective endocarditis (EIE) is scarce. The aim of this study was to describe the characteristics and outcomes of patients with EIE treated with teicoplanin monotherapy compared to standard therapy with ampicillin plus ceftriaxone. All consecutive adult patients diagnosed with EIE between January 2018 and September 2022 at a referral centre were reviewed. Characteristics of individuals treated with teicoplanin for ≥14 days [the treated with teicoplanin (TT) group] were compared with those who received ampicillin plus ceftriaxone (AC group). Sixty-six patients were included [61 (92%) E. faecalis infective endocarditis (IE) and 5 (8%) E. faecium IE]. Twenty-seven (41%) received teicoplanin: eight as first-line treatment and 19 as continuation therapy.The median duration of teicoplanin treatment was 30 (25-43) days. Surgery was indicated in 14/27 (52%) in the TT group and in 21/39 (54%) in the AC group, but was finally performed in 11/14 (79%) and 13/21 (62%) (P = 0.46), respectively. In-hospital mortality rate was 3/27 (11%) in the TT group and 12/39 (31%) in the AC group (P = 0.06). Patients treated with teicoplanin were more often discharged on outpatient parenteral antibiotic therapy [18/27 (67%) versus 6/39 (15%), P < 0.001] and median hospital stay was shorter [29 days (IQR 20-61) versus 50 days (IQR 43-68), P = 0.006]. One-year cumulative mortality was 8/27 (30%) in the TT group and 13/39 (33%) in the AC group (P = 0.46). There was one relapse in each group. Teicoplanin seems an effective treatment for selected patients with enterococcal IE, mainly to facilitate discharge.

Effects of cardiac rehabilitation on in vivo nailfold microcirculation in patients with cardiovascular disease.

This study aimed to explore the impact of cardiac rehabilitation (CR) on in vivo and ex vivo microcirculation, exercise capacity, and oxidative stress in patients with cardiovascular disease (CVD). The study included patients with acute coronary syndrome (ACS; n = 45; age, 69.0 ± 14.1 years) and heart failure (HF; n = 66; age, 77.3 ± 10.7 years) who underwent supervised CR during hospitalization. The control group comprised patients without CVD (NCVD; n = 20; age, 75.9 ± 11.2 years). In vivo microcirculatory observations using nailfold video capillary endoscopy at rest and during hyperemia, exercise capacity, and oxidative stress were assessed at baseline and 12 weeks after discharge. Baseline capillary densities were significantly lower in the ACS (5.0 ± 1.7 capillaries/mm2) and HF (4.9 ± 1.7 capillaries/mm2) groups than in the NCVD group (6.5 ± 1.1 capillaries/mm2, p < 0.01). Similarly, capillary density during reactive hyperemia was significantly lower in the ACS (5.8 ± 1.7 capillaries/mm2) and HF (5.4 ± 1.8 capillaries/mm2) groups than in the NCVD group (7.3 ± 1.4 capillaries/mm2, p < 0.01). Patients with ACS and HF had increased capillary densities at 12 weeks compared with at baseline (p < 0.05). This improvement was particularly pronounced among post-discharge outpatient CR participants (n = 20). Grip strength, exercise capacity, and oxidative stress improved at 12 weeks. Baseline capillary density changes were positively correlated with grip strength changes (r = 0.45, p < 0.001). CR significantly improved nailfold capillary density in patients with ACS and HF 12 weeks after discharge.

Chemical Synthesis and Antigenicity Evaluation of an Aminoglycoside Trisaccharide Repeating Unit of Pseudomonas aeruginosa Serotype O5 O-Antigen Containing a Rare Dimeric-ManpN3NA.

Pseudomonas aeruginosa bacteria are becoming increasingly resistant against multiple antibiotics. Therefore, the development of vaccines to prevent infections with these bacteria is an urgent medical need. While the immunological activity of lipopolysaccharide O-antigens in P. aeruginosa is well-known, the specific protective epitopes remain unidentified. Herein, we present the first chemical synthesis of highly functionalized aminoglycoside trisaccharide 1 and its acetamido derivative 2 found in the P. aeruginosa serotype O5 O-antigen. The synthesis of the trisaccharide targets is based on balancing the reactivity of disaccharide acceptors and monosaccharide donors. Glycosylations were analyzed by quantifying the reactivity of the hydroxyl group of the disaccharide acceptor using the orbital-weighted Fukui function and dual descriptor. The stereoselective formation of 1,2-cis-α-fucosylamine linkages was achieved through a combination of remote acyl participation and reagent modulation. The simultaneous SN2 substitution of azide groups at C2' and C2″ enabled the efficient synthesis of 1,2-cis-β-linkages for both 2,3-diamino-D-mannuronic acids. Through a strategic orthogonal modification, the five amino groups on target trisaccharide 1 were equipped with a rare acetamidino (Am) and four acetyl (Ac) groups. Glycan microarray analyses of sera from patients infected with P. aeruginosa indicated that trisaccharides 1 and 2 are key antigenic epitopes of the serotype O5 O-antigen. The acetamidino group is not an essential determinant of antibody binding. The β-D-ManpNAc3NAcA residue is a key motif for the antigenicity of serotype O5 O-antigen. These findings serve as a foundation for the development of glycoconjugate vaccines targeting P. aeruginosa serotype O5.

Impact of adjuvant chemotherapy on survival after pathological complete response in rectal cancer: a meta-analysis of 31,558 patients

BackgroundLocally advanced rectal cancer (LARC) typically involves neoadjuvant chemoradiotherapy (nCRT) followed by surgery (total mesorectal excision, TME). While achieving a complete pathological response (pCR) is a strong indicator of a positive prognosis, the specific benefits of adjuvant chemotherapy after pCR remain unclear. To address this knowledge gap, we conducted a systematic review and meta-analysis to assess the potential advantages of adjuvant therapy in patients who achieve pCR.MethodsIn this study, we searched Medline, Embase, and Web of Science databases for relevant research. We focused on binary outcomes, analyzing them using odds ratios (ORs) with 95% confidence intervals (CIs). To account for potential variability between studies, all endpoints were analyzed with DerSimonian and Laird random-effects models. We assessed heterogeneity using the I2 statistic and employed the R statistical software (version 4.2.3) for all analyses.ResultsThirty-four studies, comprising 31,558 patients, were included. The outcomes demonstrated a significant difference favoring the AC group in terms of overall survival (OS) (HR 0.75; 95% CI 0.60–0.94; p = 0.015; I2 = 0%), and OS in 5 years (OR 1.65; 95% CI 1.21–2.24; p = 0.001; I2 = 39%). There was no significant difference between the groups for disease-free survival (DFS) (HR 0.94; 95% CI 0.76–1.17; p = 0.61; I2 = 17%), DFS in 5 years (OR 1.19; 95% CI 0.82–1.74; p = 0.36; I2 = 43%), recurrence-free survival (RFS) (HR 1.10; 95% CI 0.87–1.40; p = 0.39; I2 = 0%), and relapse-free survival (OR 1.08; 95% CI 0.78–1.51; p = 0.62; I2 = 0%).ConclusionThis systematic review and meta-analysis found a significant difference in favor of the ACT group in terms of survival after pCR. Therefore, the administration of this treatment as adjuvant therapy should be encouraged in clinical practice.

Clinical and Angiographic Pattern of Coronary Artery Disease in a Urban Sri Lankan Population

Clinical and Angiographic Pattern of Coronary Artery Disease In A Urban Sri Lankan Population. Introduction: Coronary artery disease (CAD) is a leading cause of mortality worldwide. Objectives: This study was conducted to describe the clinical and angiographic pattern of CAD in a urban Sri Lankan population. Methods: We studied consecutive patients of all ages who underwent coronary angiogram done by a single operator in a leading private hospital, Colombo. This study was a retrospective descriptive study conducted among the total number of 352 patients who underwent angiogram from May 2013 to December 2016. Results: The population with CAD is predominantly male and old (≥41 years). Non-Acute Coronary Syndrome (ACS) is the most common clinical presentation. Triple Vessel Disease (TVD) is most prevalent 136 (38.6%) with the multiplicity of synergistic risk factors. In Single Vessel Disease (SVD), the distribution of disease in LAD, RCA and LCX are 44%, 15% and 8% respectively. Higher rate of ectasia is found in RCA. Diabetes Mellitus (DM) is present in 49% of our patients, which is the second common risk factor next to dyslipidemia (DL) 55% and is significantly associated with TVD. Conclusion: ST-Elevation Myocardial Infarction (STEMI) is the commonest ACS type in the study group. TVD is more common in old age group whereas SVD is the common pattern in younger population. LAD is the predominantly and severely affected artery among both ACS and non – ACS groups. DL is the commonest risk factor. DM is commonly associated with TVD, which is related to multiple risk factors.