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BackgroundIt has been seemed that the gut microbiome alterations might be proposed as the metabolic disorder. However, the relationship between the microbiome and AMI has not been well validated. Methods The feces of the 44 subjects (AMI: 19; control: 25) were collected for fecal genomic DNAs extraction. The variable region V3–V4 of the 16S rRNA gene was sequencing by the platform of Illumina Miseq. The abundances of metabolites were analyzed by the Kyoto Encyclopedia of Genes and Genomes (KEGG) metabolic pathways. ResultsThe abundance of bacteria was more enriched in the AMI group both in the observed operational taxonomic units (OTUs) and faith phylogenetic diversity (PD) (p-value=0.01 and Selenomonadales was less enriched in the AMI group at the Family, Genus, and Species levels [all linear discriminant analysis (LDA) scores >2]. The seleno-compound was more abundant in the AMI group at the Family, Genus, and Species levels (all LDA scores >2).Conclusions This is the first study to demonstrate Selenomonadales and seleno-compound to be associated with the occurrence of AMI. Our findings provide an opportunity for a novel prevention and treatment of AMI.

Background: Left atrial (LA) size represents atrial fibrillation (AF) burden and has been shown to be a predictor for AF stroke. The CHA2DS2-VASc score is also a well-established predictor of AF stroke. It is unknown to cardiologists whether these two risk scores are correlated, whether both are independent prognostic predictors and complimentary to each other, or whether one of them is a major determinant of stroke risk for AF patients.Method: A total of 708 patients from the National Taiwan University Atrial Fibrillation Registry were longitudinally followed up for more than 15 years. Left atrial size was measured by M mode of echocardiography. Adverse thromboembolic endpoints during follow-up were defined as ischemic stroke or transient ischemic attack.Results: The mean age was 72.1 ± 12.9 years, with 53% men. Both LA size and CHA2DS2-VASc score were associated with the risk of stroke in univariate analyses. There was a weak but significant positive correlation between LA size and CHA2DS2-VASc score (r = 0.17, P < 0.0001). Patients with higher CHA2DS2-VASc scores had a higher mean LA size (P < 0.01 for trend). When combining LA size and CHA2DS2-VASc score in the multivariable Cox model, only CHA2DS2-VASc score remained statistically significant [HR 1.39 (1.20–1.63); P < 0.001].Conclusion: LA size is not an independent predictor of AF stroke, and calculation of CHA2DS2-VASc score may be an alternative to measurement of echocardiographic LA size when evaluating the risk of stroke for AF patients.

Background/purpose In patients with non-valvular atrial fibrillation (NVAF), the left atrial appendage occluder (LAAO) is an alternative treatment for stroke prevention. However, the long-term outcomes in Asia was generally unknown. Methods and results This was a retrospective longitudinal study and a total of 124 patients with contraindications to oral anticoagulants or stroke despite under anticoagulants had been enrolled since 2013. Primary efficacy was defined as any type of stroke/systemic embolization and adverse event as any procedure or anti-thrombotic related complications. Twelve patients were excluded due to thrombus in the LAA or oversize LAA. Watchman was successfully implanted in 55 patients (98%) and ACP/Amulet also 55 patients (98%). During follow-up, the ischemic stroke rate was 1.9 in the Watchman and 1.4 per 100 patient-year in the ACP/Amulet group. There were 2 Watchman patients experiencing intracranial hemorrhage. Device-related thrombus (DRT) was noted in 3 patients (2.7%).There was no patient with peri-device lead ≧5 mm. In those patients receiving only local anesthesia, the follow-up echocardiography showed no significant peri-device leak, malposition of LAAO and DRT. Conclusion This long-term follow-up study shows that percutaneous closure of LAA is a safe and technically feasible procedure with satisfactory outcomes in Asia. The procedure success rate, efficacy and adverse event were similar to those reported in the Caucasian populations.

Background: There is an increasing interest about the mechanisms of acute myocardial infarction (AMI). To investigate the influence of the gut microbiota and the metabolic pathway in associated with AMI, we conduct this case-control study. Methods: We explore 44 subjects with/without AMI (AMI: 19 vs control: 25) and feces are collected from each subject. The fecal microbial genomic DNA is extracted and the variable region, V3–V4, of the 16S rRNA gene is sequencing by the platform of Illumina Miseq. The number of observed operational taxonomic units (OTUs) at 97% similarity level is classified. A histogram of linear discriminant analysis (LDA) distribution is also implemented by the LDA effect size analysis (LEfSe) to find bacteria with significant differences in relative abundance between two groups. The abundances of metabolites are analyzed by the KEGG metabolic pathways. Findings: The abundance of bacteria is more enriched in the AMI group both in the observed OTUs and faith phylogenetic diversity (PD) ( p -value= 0.01 and 2). There is also a difference of the seleno-compound distribution between the groups. The seleno-compound is more abundant in the AMI group at the Family, Genus, and Species levels (all LDA scores >2). Interpretation: This is the first study to demonstrate Selenomonadales and seleno-compound to be associated with the occurrence of AMI. Our findings provided an opportunity for the novel therapeutic strategies for prevention and treatment of AMI. Funding Statement: None. Declaration of Interests: All authors disclose no financial and personal relationships with other people or organisations that could inappropriately influence (bias) their work. Ethics Approval Statement: This study is approved by the Institutional Review Board committee on human research of the medical research department, National Taiwan University Hospital Taiwan.

© The Royal Society of Chemistry 2015. A water-soluble nanocarrier for a photo-activated CO releasing moiety (photoCORM) that can be triggered with NIR excitation is described. This has an upconversion nanoparticle core encapsulated by an amphiphilic polymer imparting both water solubility and a hydrophobic interior containing the photoCORM trans-Mn(bpy)(PPh3)2(CO)2. Such an ensemble offers a unique strategy for CO delivery to biological targets. This journal is