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Background: The triglyceride-glucose (TyG) index and estimated glucose disposal rate (eGDR), which are calculated using different parameters, are widely used as markers of insulin resistance and are associated with cardiovascular diseases and prognosis. However, whether they have an additive effect on the risk of mortality remains unclear. This study aimed to explore whether the combined assessment of the TyG index and eGDR improved the prediction of long-term mortality in individuals with and without diabetes., Methods: In this cross-sectional and cohort study, data were derived from the National Health and Nutrition Examination Survey (NHANES) 2001-2018, and death record information was obtained from the National Death Index. The associations of the TyG index and eGDR with all-cause and cardiovascular mortality were determined by multivariate Cox regression analysis and restricted cubic splines., Results: Among the 17,787 individuals included in the analysis, there were 1946 (10.9%) all-cause deaths and 649 (3.6%) cardiovascular deaths during a median follow-up of 8.92 years. In individuals with diabetes, the restricted cubic spline curves for the associations of the TyG index and eGDR with mortality followed a J-shape and an L-shape, respectively. The risk of mortality significantly increased after the TyG index was > 9.04 (all-cause mortality) or > 9.30 (cardiovascular mortality), and after eGDR was < 4 mg/kg/min (both all-cause and cardiovascular mortality). In individuals without diabetes, the association between eGDR and mortality followed a negative linear relationship. However, there was no association between the TyG index and mortality. Compared with individuals in the low TyG and high eGDR group, those in the high TyG and low eGDR group (TyG > 9.04 and eGDR < 4) showed the highest risk for all-cause mortality (hazard ratio [HR] = 1.592, 95% confidence interval [CI] 1.284-1.975) and cardiovascular mortality (HR = 1.683, 95% CI 1.179-2.400) in the overall population. Similar results were observed in individuals with and without diabetes., Conclusions: There was a potential additive effect of the TyG index and eGDR on the risk of long-term mortality in individuals with and without diabetes, which provided additional information for prognostic prediction and contributed to improving risk stratification., (© 2024. The Author(s).)

Aims: Variability of metabolic parameters, such as glycemic variability (GV) and systolic blood pressure variability (SBPV), are associated with adverse cardiovascular outcomes. However, whether these parameters have additive effects on mortality in patients with coronary artery disease (CAD) hospitalized in the intensive care unit (ICU) remains unclear., Methods: We retrospectively enrolled patients with CAD from the Medical Information Mart for Intensive Care-IV database. The highest tertile of variability was defined as high variability. A variability scoring system was established, which assigned 0 points to tertile 1, 1 point to tertile 2, and 2 points to tertile 3 for GV and SBPV., Results: Among 4237 patients with CAD, 400 patients died in hospital, and 967 patients died during 1-year follow-up. High GV and high SBPV were associated with an increased risk of mortality. The effects of GV and SBPV on in-hospital mortality were partially mediated by ventricular arrhythmias (18.0 % and 6.6 %, respectively). The risk of mortality gradually increased with the number of high-variability parameters and increasing variability scores., Conclusions: GV and SBPV have additive effects on the risk of mortality in patients with CAD hospitalized in the ICU. Ventricular arrhythmias partially mediate the effects of GV and SBPV on in-hospital mortality., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Stress hyperglycemia and glycemic variability (GV) can reflect dramatic increases and acute fluctuations in blood glucose, which are associated with adverse cardiovascular events. This study aimed to explore whether the combined assessment of the stress hyperglycemia ratio (SHR) and GV provides additional information for prognostic prediction in patients with coronary artery disease (CAD) hospitalized in the intensive care unit (ICU)., Methods: Patients diagnosed with CAD from the Medical Information Mart for Intensive Care-IV database (version 2.2) between 2008 and 2019 were retrospectively included in the analysis. The primary endpoint was 1-year mortality, and the secondary endpoint was in-hospital mortality. Levels of SHR and GV were stratified into tertiles, with the highest tertile classified as high and the lower two tertiles classified as low. The associations of SHR, GV, and their combination with mortality were determined by logistic and Cox regression analyses., Results: A total of 2789 patients were included, with a mean age of 69.6 years, and 30.1% were female. Overall, 138 (4.9%) patients died in the hospital, and 404 (14.5%) patients died at 1 year. The combination of SHR and GV was superior to SHR (in-hospital mortality: 0.710 vs. 0.689, p = 0.012; 1-year mortality: 0.644 vs. 0.615, p = 0.007) and GV (in-hospital mortality: 0.710 vs. 0.632, p = 0.004; 1-year mortality: 0.644 vs. 0.603, p < 0.001) alone for predicting mortality in the receiver operating characteristic analysis. In addition, nondiabetic patients with high SHR levels and high GV were associated with the greatest risk of both in-hospital mortality (odds ratio [OR] = 10.831, 95% confidence interval [CI] 4.494-26.105) and 1-year mortality (hazard ratio [HR] = 5.830, 95% CI 3.175-10.702). However, in the diabetic population, the highest risk of in-hospital mortality (OR = 4.221, 95% CI 1.542-11.558) and 1-year mortality (HR = 2.013, 95% CI 1.224-3.311) was observed in patients with high SHR levels but low GV., Conclusions: The simultaneous evaluation of SHR and GV provides more information for risk stratification and prognostic prediction than SHR and GV alone, contributing to developing individualized strategies for glucose management in patients with CAD admitted to the ICU., (© 2024. The Author(s).)

Aims: The stress hyperglycemia ratio (SHR) is significantly associated with short-term adverse cardiovascular events. However, the association between SHR and mortality after the acute phase of acute coronary syndrome (ACS) remains controversial., Methods: This study used data from the Medical Information Mart for Intensive Care-IV database. Patients with ACS hospitalized in the intensive care unit (ICU) were retrospectively enrolled., Results: A total of 2668 ACS patients were enrolled. The incidence of in-hospital and 1-year mortality was 4.7 % and 13.2 %, respectively. The maximum SHR had a higher prognostic value for predicting both in-hospital and 1-year mortality than the first SHR. Adding the maximum SHR to the SOFA score could significantly improve the prognostic prediction. In the landmark analysis at 30 days, the maximum SHR was a risk factor for mortality within 30 days regardless of whether patients had diabetes. However, it was no longer associated with mortality after 30 days in patients with diabetes after adjustment (HR = 1.237 per 1-point increment, 95 % CI 0.854-1.790)., Conclusions: The maximum SHR was significantly associated with mortality in patients with ACS hospitalized in the ICU. However, caution is warranted if it is used for predicting mortality after 30 days in patients with diabetes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The zero-valent iron (ZVI) immobilized in an alginate microsphere was prepared by using sodium alginate as a support material. The characteristics of the Fe 0 /alginate microsphere was characterized by FT-IR, SEM, BET, and XPS. The SEM and BET analyses showed that the Fe 0 /alginate microsphere had a multilevel porous structure and could adsorb ARB. Combined with Fe 0 reduction and Fe 3+ /Fe 2+ catalytic oxidation, the mineralization of ARB could be effectively realized. The ARB in the solution was discolored rapidly by the reduction of Fe 0 /alginate microsphere and then oxidized efficiently by the subsequent Fenton reaction. The discoloration rate of ARB in the reduction stage was 96.8%, with an Fe 0 /alginate microsphere dosage of 0.24g·L -1 and pH of 2.96 after reaction time of 180 min. ARB was reduced to organics of lower molecular weight due to the degradation of azo groups by Fe 0 . In the subsequent Fenton oxidation stage, the mineralization degree of ARB increased to 64.7% after the addition of 10.75 mmol·L -1 H 2 O 2 . The influence of the Fe 0 /alginate microsphere dosage, pH, reusability of the Fe 0 /alginate microsphere, and the stability of iron ions in the alginate microsphere were investigated. Due to the coordination of Fe 3+ /Fe 2+ ions with -COO - -in the alginate, the iron ion in the solution was 3.9% of the total iron content in the microsphere. Iron ions could be well immobilized in calcium alginate microspheres, so the iron hydroxides were generated in lower amounts. The Fenton reaction can be conducted in a wide range of pH. The Fe 2+ /Fe 3+ immobilized in the alginate microsphere demonstrated good catalytic performance after it was reused four times. Therefore, the synergy of reduction and Fenton oxidation by the Fe 0 /alginate microsphere was a better strategy for dye degradation.

Objective: To evaluate the therapeutic effect of amniotic membrane transplantation(AMT) for ocular burn., Methods: Twenty patients with ocular burn(28 eyes) were treated with amniotic membrane transplantation. Of them, there were 6 cases of severe alkali burn(10 eyes), 8 cases of severe acid burn(10 eyes), and 6 cases of thermal burn(8 eyes)., Results: In 28 eyes, ocular inflammation was controlled after 3-7 days of surgery; no continued dissolution, perforation and iris atrophy were found. There were corneal transparency in 16 eyes, keratoleukoma in 4 eyes, and total corneal opacity in 8 eyes. All eyeballs were saved and had stable ocular surface. There was no allograft immune rejection and secondary infection., Conclusion: Amnitic membrane transplantation can relieve the inflammatory reaction, reduce the growth of blood vessel and restrain the proliferation of fibrous tissue. It is an effect surgical method for ocular burn in reconstruction of ocular surface and salvage of eyeball.