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Atrial fibrillation (AF) is the most common arrhythmia among the elderly, and more frequently occur in those with chronic kidney disease (CKD). Left atrial appendage occlusion (LAAO) is used as a mechanical alternative approach for prevention of AF-related thromboembolisms. This meta-analysis was conducted to provide suggestions for the clinical application of LAAO in AF patients with CKD. The incidence of perioperative adverse events and other clinical effects after operation was by a single rate meta-analysis. Results showed that incidence of adverse events in the perioperative period after LAAO was generally low, with only pericardial effusion / tamponade (1.90%) and mortality rate (1.10%). During the follow-up period, the incidence of stroke/transient ischemic attack (TIA) and bleeding were 2.17% and 4.53%, respectively. A low incidence rate of adverse events was found in the perioperative period following LAAO. These results indicate that LAAO more effectively prevents the occurrence of stroke/TIA and minimizes bleeding events than oral anticoagulants.

BACKGROUND Organic carbon and nitrogen stable isotopes (δ13C, δ15N) in marine sediments are used as effective indicators to trace the changes of air, temperature, precipitation and other parameters in different geological time. Elemental analysis-isotope ratio mass spectrometry is a reasonable and effective method to measure the composition of organic carbon and nitrogen stable isotopes in marine sediments. At present, many domestic laboratories use the method of element analyzer (EA) and stable isotope ratio mass spectrometer (IRMS) to analyze the stable isotopes of organic carbon and nitrogen. However, the comparison of analytical method and data stability between different laboratories is lacking. The analytical results lack effective traceability, and the process lacks standardization and unification. OBJECTIVES To develop a method for determining organic carbon and nitrogen stable isotopes in marine sediments. METHODS Three newly developed national first-class standard materials (GBW04701, GBW04702, GBW04703) and two international standard materials (EMA-B2152, EMA-B2151) were sent to 10 domestic laboratories, in order to verify the stability, precision and accuracy of EA-IRMS online technology test method through the comparative measurement between laboratories. RESULTS The data of each collaborative laboratory was accurate and stable, and the method had good repeatability and reproducibility. The results showed that precisions of 13C and 15N were better than 0.10‰ and 0.14‰, respectively. CONCLUSIONS Through comparative study, it has been proved that EA-IRMS online technology is suitable for the determination of organic carbon and nitrogen stable isotopes in marine sediments. A suitable method for the determination of marine sediment samples has been preliminarily established.

This meta-analysis aimed to evaluate the effects of walking exercise on bowel preparation in patients undergoing colonoscopy.

Objective To investigate the learning needs of communication training between Intensive Care Unit(ICU) nurses and patients families in Peking Union Medical College Hospital. Methods The Department of Critical Care Medicine of Peking Union Medical College Hospital distributed questionnaires to 143 nurses working in the department, and scored whether nurses had negative experience in communicating with patients'families, confidence in building harmonious relationship and the need for training. Results A total of 138 questionnaires were obtained. 46.4% of nurses in ICU think they sometimes or often encounter negative experiences in their work. Only 30.4% of nurses were very confident or confident in their communication skills. As much as 83.3% of nurses believed that they should be trained in communication with patients family members. Conclusions Communication training is very important for intensive care nurses.

Objectives: CD4+ T cell helper and regulatory function in human cancers has been well characterised. However, the definition of tumor‐infiltrating CD4+ T cell exhaustion and how it contributes to the immune response and disease progression in human gastric cancer (GC) remain largely unknown. Methods: A total of 128 GC patients were enrolled in the study. The expression of CD39 and PD‐1 on CD4+ T cells in the different samples was analysed by flow cytometry. GC‐infiltrating CD4+ T cell subpopulations based on CD39 expression were phenotypically and functionally assessed. The role of CD39 in the immune response of GC‐infiltrating T cells was investigated by inhibiting CD39 enzymatic activity. Results: In comparison with CD4+ T cells from the non‐tumor tissues, significantly more GC‐infiltrating CD4+ T cells expressed CD39. Most GC‐infiltrating CD39+CD4+ T cells exhibited CD45RA−CCR7− effector–memory phenotype expressing more exhaustion‐associated inhibitory molecules and transcription factors and produced less TNF‐α, IFN‐γ and cytolytic molecules than their CD39−CD4+ counterparts. Moreover, ex vivo inhibition of CD39 enzymatic activity enhanced their functional potential reflected by TNF‐α and IFN‐γ production. Finally, increased percentages of GC‐infiltrating CD39+CD4+ T cells were positively associated with disease progression and patients' poorer overall survival. Conclusion: Our study demonstrates that CD39 expression defines GC‐infiltrating CD4+ T cell exhaustion and their immunosuppressive function. Targeting CD39 may be a promising therapeutic strategy for treating GC patients. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness and safety of perampanel (PER) monotherapy (MT) or add‐on therapy (AT) in Chinese children with epilepsy, as well as to evaluate the data from routine therapeutic drug monitoring (TDM) of PER for these pediatric patients. Methods: This retrospective and observational study was carried out on children with epilepsy (n = 340) from 2020 to 2022 at the Children's Hospital of Nanjing Medical University. Outcome measures were the responder rate (50% or greater seizure reduction), long‐term efficacy, and tolerability (number and types of adverse events) in MT and AT groups. Concentrations of plasma PER obtained from these patients, if available, were analyzed too. Results: A total of 279 patients achieved at least 3 months of therapy, and 58.1% responded to PER therapy. 53 of the responders were seizure‐free (32.7%). The retention rate dropped from 88.0% at 3 months to 40.6% at 12 months after treatment. Patients with MT achieved better seizure control than those with AT (P < 0.001). Intriguingly, PER exerted a very weak effect on patients who took more than 2 ASMs or were diagnosed with drug‐resistant epilepsy. There were no significant differences in tolerability between the two groups. In addition, 179 patients were routinely monitored for PER, and the trough concentrations (C0) for these patients ranged from 30.0 to 992.0 ng/mL. However, no significant difference in C0 was observed between responders and nonresponders (333 ng/mL vs 325.5 ng/mL, P = 0.264). Significance: This study provides effectiveness and safety data on Chinese children with epilepsy treated with PER either as MT or as AT. The efficacy of patients receiving MT was much better than cases administered with more than 2 ASMs or diagnosed with drug‐resistant epilepsy. In addition, no association was found between the plasma PER concentration and efficacy or safety. Plain Language Summary: The study reports the effects of perampanel on seizures and adverse effects in Chinese patients with epilepsy younger than 18 years. Seizures decreased in 58.1% of patients (responders); in a third of these responders, seizures stopped. After treatment was started, 88% of patients were still on perampanel at 3 months and 40.6% at 12 months. People who were treated with perampanel only were more likely to respond than those who received perampanel and other antiseizure treatments, although perampanel was tolerated equally well in these groups. Plasma perampanel concentration did not predict seizure response or adverse effects. [ABSTRACT FROM AUTHOR]

Objectives: Due to the urgent need to develop innovative, environmentally sustainable bactericides, we use the natural product isoquinoline as a lead compound to discover highly active bactericides from isoquinoline derivatives. Methods: In this paper, the antibacterial activity of 49 isoquinoline derivatives was evaluated against three plant bacteria in vitro. Results: Among all the derivatives, isoquinoline-3-carboxylic acid (IQ3CA) demonstrated significant antibacterial activity against Ralstonia solanacearum (Rs), Acidovorax citrulli (Ac), X. oryzae pv. oryzicola (Xoc), X. campestris pv. campestris (Xcc), P. carotovorum subsp. carotovorum (Pcc), and X. fragariae (Xf), with EC50 values ranging from 8.38 to 17.35 μg/mL. Furthermore, IQ3CA exhibited a potent protective effect against Ac, with an efficacy of 68.56% at 200 μg/mL, which was not significantly different from that of the positive control kasugamycin (72.48%) and was superior to that of the positive control thiosen copper (64.62%). The scanning electron microscopy observations revealed that treatment of Ac cells with IQ3CA at a concentration of 25 μg/mL resulted in a curved and sunken cell morphology, along with destroyed cell membrane integrity. Additionally, the motility and exopolysaccharides production of Ac were inhibited, and biofilm formation was prevented. Conclusion: These results suggest that IQ3CA holds promise as a lead compound with antibacterial properties against plant diseases. [ABSTRACT FROM AUTHOR]

Myelodysplastic syndromes (MDS) are a group of heterogeneous myeloid clonal disorders characterized by ineffective hematopoiesis. Accumulating evidence has shown that macrophages (MΦs) are important components in the regulation of tumor progression and hematopoietic stem cells (HSCs). However, the roles of bone marrow (BM) MΦs in regulating normal and malignant hematopoiesis in different clinical stages of MDS are largely unknown. Age‐paired patients with lower‐risk MDS (N = 15), higher‐risk MDS (N = 15), de novo acute myeloid leukemia (AML) (N = 15), and healthy donors (HDs) (N = 15) were enrolled. Flow cytometry analysis showed increased pro‐inflammatory monocyte subsets and a decreased classically activated (M1) MΦs/alternatively activated (M2) MΦs ratio in the BM of patients with higher‐risk MDS compared to lower‐risk MDS. BM MФs from patients with higher‐risk MDS and AML showed impaired phagocytosis activity but increased migration compared with lower‐risk MDS group. AML BM MΦs showed markedly higher S100A8/A9 levels than lower‐risk MDS BM MΦs. More importantly, coculture experiments suggested that the HSC supporting abilities of BM MΦs from patients with higher‐risk MDS decreased, whereas the malignant cell supporting abilities increased compared with lower‐risk MDS. Gene Ontology enrichment comparing BM MΦs from lower‐risk MDS and higher‐risk MDS for genes was involved in hematopoiesis‐ and immunity‐related pathways. Our results suggest that BM MΦs are involved in ineffective hematopoiesis in patients with MDS, which indicates that repairing aberrant BM MΦs may represent a promising therapeutic approach for patients with MDS. [ABSTRACT FROM AUTHOR]

This study investigates the influence of donor‐specific anti‐HLA antibodies (DSA) levels on primary poor graft function (PGF) and graft rejection (GR) after haploidentical stem cell transplantation (haplo‐SCT) with rituximab desensitization. A total of 155 DSA‐positive haplo‐SCT candidates with mean fluorescence intensity (MFI) between 2000 and 10,000 were enrolled in this prospective clinical trial. Receiver operating characteristic (ROC) curves determined the optimal DSA MFI cutoff for identifying high‐risk patients. Patients were categorized into two groups: DSA low‐level group (2000 ≤ DSA MFI < 5000, Group A) and high‐level group (5000 ≤ DSA MFI ≤ 10,000, Group B). The incidence of primary PGF was 6.5% (2.6%–10.3%), while GR incidence was 0.6% (0.0%–1.9%). Group A had significantly lower primary PGF rates than Group B (2.3% [0.0%–5.7%] vs. 12.9% [4.8%–21.0%], p = 0.017). Only one patient in Group B experienced GR. High DSA levels (5000 ≤ MFI ≤ 10,000) were identified as the sole independent risk factor for primary PGF and GR after haplo‐SCT with rituximab desensitization (HR = 7.282, 95% CI 1.517–34.953, p = 0.013). The 4‐year cumulative incidence of relapse, non‐relapse mortality, disease‐free survival, and overall survival were 14.7% (11.6%–17.8%), 16.3% (13.1%–19.4%), 69.0% (65.9%–76.2%), and 70.6% (66.4%–74.8%), respectively. DSA levels have an impact on efficiency of rituximab desensitization, and a DSA MFI threshold is provided for predicting primary PGF and GR. [ABSTRACT FROM AUTHOR]