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Outbreaks of short beak and dwarfism syndrome (SBDS), caused by a novel goose parvovirus (NGPV), have occurred in China since 2015. This rapidly spreading, infectious disease affects ducks in particular, with a high morbidity and low mortality rate, causing huge economic losses. This study analyzed the evolution of NGPV isolated from Jing-Xi partridge duck with SBDS in South China. Complete genome sequences of the NGPV strains GDQY1802 and GDSG1901 were homologous with other GPV/NGPV and Muscovy duck parvovirus (MDPV) strains. Phylogenetic analysis showed that the NGPV isolated from mainland China was related to the Taiwan 82-0321v strain of GPV. In contrast to 82-0321v and the SDLC01 strain, which was first isolated from China, the two isolates showed no deletions in the inverted terminal repeat (ITR) region. Further, in these isolates, 24 amino acid sites of the replication protein were different compared to that of GPV live vaccine strain 82-0321v, and 12 sites were unique across all NGPV isolates. These isolates also showed differences in 17 amino acid sites of the capsid protein from that of 82-0321v, two of which were the same as those in MDPV. Recombination analysis identified the major parents of GDSG1901 and GDQY1802 as the NGPV-GD and NGPV-Hun18 strains, and the minor parents as the classical GPV 06-0329 and GPV LH strains, respectively. GDQY1802 and GDSG1901 are recombinant GPV-related parvovirus isolated from domesticated partridge duck. Recombination is evident in the evolution of NGPV, and as such, the use of live attenuated vaccines for NGPV requires further study.

Summary Urbanization is a pressing challenge for earth’s humans because it is changing not only natural environments but also agricultural lands. Yet, the consequences of cropland loss on pest insect populations that largely depend on these habitats remain largely unclear. We used a 17-year data set to investigate the dynamics of three moth pest species (i.e., striped stem borer, yellow stem borer, and pink stem borer) and their driving forces across the largest mega-urban region of China. Total abundance of three pest species is declined by about 80%, which was strongly associated with cropland loss during rapid urbanization. Our findings indicate that not only the increasing conversion of natural areas to human-dominated landscapes but also that of agricultural lands to urban landscapes can be critical to insect populations. It is therefore essential to monitor and understand the insect dynamics in rapidly urbanizing regions, which are currently found in many developing countries worldwide., Graphical abstract, Highlights • Urbanization has worldwide dramatic impacts on the earth's insects • Its relation to declining farmland pest insect populations remains greatly understudied • Consistent moth population decline coincided with a rapid process of urbanization • About 80% of such decline was due to loss of agricultural land, Ecology; Entomology; Agricultural science; Economic entomology

Resveratrol, a natural antioxidant, anti-inflammatory plant extract, was found to have a protective effect in poultry subjected to heat stress. In this study, we strove to characterize resveratrol on intestinal of duck exposed to acute heat stress and investigate the underlying mechanism. A total of 120 Shan-ma ducks (60 days old) were randomly divided into 2 groups. The control group was fed a basal diet, and the resveratrol group was fed a basal diet supplemented with 400 mg/kg resveratrol. Animals in 2 groups were kept at a temperature of 24°C ± 2°C for 15 d. Then, animals of both groups were placed in an artificial climate room at 39°C. Twelve ducks of each group were sacrificed for sampling at 0, 30, and 60 min, respectively. Results indicated that resveratrol increased the ratio of villus height to crypt depth, increased the number of goblet cells, and reduced the histopathological damage of jejunum caused by acute heat stress. Furthermore, the gene expression of heat shock proteins (HSP60, HSP70, and HSP90) and tight junction proteins (CLDN1 and OCLN) was significantly increased in the resveratrol group compared to that in the control groups. Simultaneously, resveratrol significantly activated the SIRT1-NRF1/NRF2 signaling pathways, improved ATP level of jejunum, and increased SOD and CAT antioxidant enzymes activities. In addition, we found that the NF-κB/NLRP3 inflammasome signaling pathways were repressed under acute heat stress. Meanwhile, supplement resveratrol further inhibited the NLRP3 inflammasome pathway, decreased protein level of NLRP3 and caspase1 p20, reduced the secretion of IL-1β. Taken together, our results indicate that resveratrol against the oxidative damage and inflammation injury in duck jejunum induced by heat stress via active SIRT1 signaling pathways.

The mechanisms by which GnIH regulates the steroid synthesis pathway in duck granulosa cells remain poorly understood. In this study, we measured steroid hormone secretion by ELISA and reproduction-associated gene expression by quantitative real-time Polymerase Chain Reaction (qPCR) in duck granulosa cells treated with different concentrations of GnIH (0, 0.1, 1, 10, and 100 ng/mL) for 24 h. The genome-wide expression profiles of GnIH-treated cells (0 and 10 ng/mL) were evaluated by high-throughput RNA sequencing. Compared with untreated cells, the secretion of the steroid hormones E2, E1, P4, and T was downregulated, with that of E1 and P4 reaching statistical significance (P

Urbanization is a pressing challenge for earth's human because it is transforming and fragmenting not only natural environments, but also rural lands. Yet, the consequences of rural land-use change on insect populations that depend on these habitats remain largely unclear. We used a 17-year data set to investigate the dynamics of three dominant native farmland moths and its driving forces across the largest megaurban region of China. Total moth abundance declined by about 80%, which was strongly associated with loss and fragmentation of croplands during rapid urbanization. Our findings indicate that urbanization, through loss of traditional agricultural lands, can be a further threat to insect populations. It is therefore really critical to monitor and understand the agrobiodiversity dynamics in rapidly urbanizing regions, which are currently found in many developing countries worldwide.

Granulosa cells (GCs) play an important role in the development of follicles. In this study, we investigate the impact of heat stress at 41°C and 43°C on duck GCs' proliferation and steroids secretion. And, the transcriptomic responses to heat treatment were examined using RNA-sequencing analysis. Digital gene expression profiling was used to screen and identify differentially expressed genes (fold change ≥ 2 and Q value

Compatibility investigations are vital but also the most difficult aspect of traditional Chinese medicine (TCM) prescriptions. Previous researches have demonstrated that Xiaoyaosan (XYS) is an effective treatment for depression. However, the compatibility rules of XYS and the underlying mechanisms remain unclear. Herein, we combined network pharmacology and serum metabolomics to investigate the scientific connotations and the compatibility effects of XYS. First, the Traditional Chinese Medicine Systems Pharmacology (TCMSP) and the GeneCards databases were applied to identify the chemical components and the putative targets of XYS, and its efficacy groups. We then analyzed the herb-component-target pathways and constructed PPI networks. Potential pathways were determined by gene ontology (GO) and pathway enrichment analyses. Additionally, a chronic unpredictable mild stress (CUMS) model was applied on rats. A proton nuclear magnetic resonance spectrometry (1H NMR) based serum metabolomics was then used to identify potential metabolites and the corresponding pathways that were involved in depression and the potential anti-depression effects of XYS and its efficacy groups. A total of 121 components of XYS and 111 targets were associated with depression. Additionally, we screened 105 targets of 24 components in Shugan (SG) group and 106 targets of 95 components in Jianpi (JP) group. 13 targets were common to all three groups. Protein-protein interaction network analysis showed that Caspase-3 and Nitric oxide synthase-3 were nodes that overlapped with proteins known to be associated with depression. Pathway enrichment analysis further indicated that the putative targets of XYS and its efficacy groups mostly participated in pathways associated with cancer. Also, XYS and its efficacy groups significantly reversed abnormalities of serum metabolites and metabolic pathways, but to different degrees. Overall, different efficacy groups of XYS exhibit synergistic anti-depression effects and contribute to the whole prescription against depression. This study shows that the combination of network pharmacology and metabolomics is an effective approach to demonstrate scientific connotations and compatibility of TCMs from a holistic perspective.

Traditional Chinese medicines (TCMs) have attracted more attentions in the treatment of depression. Xiaoyaosan (XYS), a classic anti-depression TCM prescription, contains eight herbs. However, the compatibility effects of XYS in modern pharmacology need to be investigated in depth. In this study, the chronic unpredictable mild stress (CUMS) depression-like model was constructed. Afterwards, XYS was divided into the Shugan and the Jianpi groups according to the research strategy ofefficacy groups. Meanwhile, a proton nuclear magnetic resonance spectrometry (1H NMR) based serum metabolomics was applied. XYS and its efficacy groups significantly regulated the abnormal levels of differential metabolites related to depression, but to different degrees. Metabolic profiling by orthogonal partial least squares discriminant analysis showed that XYS at high dose (XH) exhibited the strongest effects than other treatment groups. Ten metabolites related to depression were identified as differential metabolites. Besides, relative distance (Rd) was calculated to quantitatively evaluate the effects. We found that XH group had the highest Rd value. Moreover, among the five metabolic pathways of depression, XYS and Jianpi groups significantly regulated all pathways while Shugan group regulated four pathways. These findings lay a solid foundation for comprehensively and deeply understanding the compatibility effects of XYS against depression.

Background Contemporary heart failure medications have led to considerable improvement in the survival of patients with heart failure. However, limited evidence is available regarding the effect of those medications in patients with idiopathic dilated cardiomyopathy (IDCM), particularly in China. We sought to analyze the trends in clinical characteristics and the prescription rate of recommended therapies and its prognostic impact in patients with IDCM. Methods From 2009 to 2016, 1441 consecutive patients (age: 55±14 years, 68% men, LVEF: 33% ± 12%) fulfilling World Health Organization criteria for IDCM were enrolled in the current retrospective cohort study. Temporal trends of baseline clinical characteristics, treatment and prognosis were analyzed, and potential influential factors were explored. Results Rates of patients receiving angiotensin-converting enzyme inhibitors/angiotensin II receptors blockers, β-blockers, aldosterone receptor antagonists and diuretics increased from 55%, 45%, 58%, 51% in 2009 to 67%, 69%, 71%, 64% in 2016, respectively (P < 0.05); whereas, the proportion of patients receiving digoxin decreased from 39% in 2009 to 28% in 2016 (P < 0.05). The overall proportion of patients with optimal guideline-directed medical therapy (GDMT) was 44.6%; however, that rate increased from 33% in 2009 to 41%, 49% and 56% in 2012, 2014 and 2016 respectively (P < 0.05). Patients with optimal GDMT had a better outcome than those without, but there was no temporal trend toward improvement in the overall long-term prognosis of IDCM patients with the years. There was a trend towards admission of patients with milder disease and toward increased admission to a cardiology ward with the years. Conclusions An improvement in prescription rates of guideline-recommended medications in IDCM patients was observed. However, it remains suboptimal, and there is still some room for improvement. The prognosis of patients with optimal GDMT was better than those without. Moreover, the following patient category also had an improved prognosis: patients with LVEF ≥ 40%, with device therapy, and those admitted to a cardiology ward.

Background The relationship between renal function and outcomes among patients with hypertrophic cardiomyopathy (HCM) remains undefined. We sought to investigate the prevalence of renal dysfunction and its prognostic value in HCM patients. Methods A total of 581 patients with HCM were consecutively recruited. The chronic kidney disease epidemiology equation was used to estimate the glomerular filtration rate (eGFR). Patients were divided into 2 eGFR categories: ≥60 or Results The proportions of eGFR 60–90 ml/min/1.73 m2 and Conclusions Renal dysfunction is a common comorbidity in HCM. Renal function is an independent predictor of outcomes in patients with HCM. These findings highlight the clinical importance of renal dysfunction in HCM.

Few data are available regarding the prevalence and clinical significance of right ventricular systolic dysfunction (RVSD) in hypertrophic cardiomyopathy (HC) patients. This study aimed to evaluate right ventricular (RV) systolic function by cardiovascular magnetic resonance and explore the prevalence and prognostic significance of RVSD in HC patients. A total of 226 patients with HC assessed by cardiovascular magnetic resonance were included in this retrospective study. RVSD was defined by RV ejection fraction (RVEF) ≤45% and was present in 26 (11.5%) patients. Association between RVSD, clinical characteristics, and outcomes were analyzed. RVEF was significantly lower in patients with RVSD than without RVSD (36.2 ± 7.0% vs 60.5 ± 7.4%, p0.001). There was a positive correlation between RVEF and left ventricular ejection fraction (r = 0.45; p0.001). During a mean follow-up of 30.5 ± 23.9 months, there were 22 (9.7 %) all-cause mortality, including 12 (5.3%) cardiovascular death. Kaplan-Meier analysis showed a significantly higher risk for cardiovascular mortality in patients with RVSD (p = 0.026), but no significant difference in all-cause mortality (p = 0.118) and heart failure related rehospitalization (p = 0.485). On multivariate Cox regression analysis, RVSD (hazard ratio 5.36; confidence interval 1.39 to 20.77; p = 0.015) and RVEF (hazard ratio 0.94; confidence interval 0.89 to 0.98; p = 0.011) were independent predictors of cardiovascular mortality. In conclusion, RVSD is a common phenotype and a strong independent predictor of cardiovascular mortality in HC patients.

Tremendous effort has been invested in reducing the prevalence of atherosclerotic cardiovascular disease (ASCVD) in China. Meanwhile, accumulating evidence has emerged to show the benefits of statins in the prevention of cardiovascular disease. The present study investigated the change trends of statins prescription at discharge among patients with ASCVD in recent years, differences across subtypes of ASCVD, and associated factors. The study included 51,972 patients with a discharge diagnosis of ASCVD who were hospitalized in West China Hospital from 2008 to 2014. Trends of statins prescription rates between subtypes of ASCVD were compared and potential influential factors were explored. The overall statins prescription rate in patients with ASCVD was 58.8%. Adjusted odds ratios (ORs) of increase in prescription rate per year were 1.15 (95% CI 1.13-1.17, p

Gender plays a crucial role in the prevalence, clinical presentation, management and outcomes of various cardiovascular diseases. The aim of this study was to evaluate the impact of gender on clinical manifestations and outcomes in the Chinese patients with hypertrophic cardiomyopathy (HCM).We evaluated 576 Chinese patients (316 males) who were diagnosed with HCM at West China Hospital from 2008 to 2016 and followed over 3.2 ± 2.3 years.Compared to male patients, female patients were older (57.2 ± 16.7 years vs. 53.0 ± 15.7 years, P = 0.002) and more symptomatic [New York Heart Association class III-IV symptoms 46.9% vs. 30.7%, P0.001] at the time of diagnosis, and had higher left ventricular outflow tract gradient at rest [33 (12-58) mmHg vs. 24 (8-42) mmHg, P = 0.007]. During the follow-up period, survival analysis showed no significant differences in the incidences of all-cause mortality (P = 0.657) and cardiovascular mortality (P = 0.214) but the rate of rehospitalization due to heart failure was higher in females than in males (P = 0.015). Multivariable Cox analysis showed that left ventricular ejection fraction (hazard ratio [HR], 0.96 [95% confidence interval [CI], 0.94-0.99]; P = 0.003) and New York Heart Association class III-IV (HR, 2.86 [95% CI, 1.38-5.94]; P = 0.005) were independently associated with cardiovascular mortality.Compared to males, females were older and more symptomatic at presentation, and had higher risk of progression to heart failure in Chinese HCM patients but there were no differences in cardiovascular mortality.

This study aimed to demonstrate the scientific connotations and compatibility effects of Xiaoyaosan (XYS) based on the theory of “Treating Diseases via Regulating the Liver’s Function” by hepatic metabolomics. XYS was divided into two efficacy groups, i.e. the Shugan (SG) and the Jianpi (JP) groups, according to the strategy of “Efficacy Compositions”. The chronic unpredictable mild stress (CUMS) depression model was constructed. A 1H NMR-based hepatic metabolomics approach coupled with multivariate data (MVD) analysis was performed. Meanwhile, relative distance (RD) and Efficacy Index (EI) were calculated. XYS and its efficacy groups significantly reversed the abnormality of behavior and hepatic metabolomics of depression rats, but to different degrees. The results of ethology and metabolomics showed the same order, i.e. XYS > JP > SG. Two metabolites, i.e. tyrosine and malate, were regulated by all the treatment groups. Four metabolites were significantly regulated only by XYS group. Of note, the results showed the two efficacy groups of XYS exhibited synergistic anti-depression effects, and glutamate, malate and taurine could be the key hepatic metabolites for these synergistic effects. The current study not only complements and consummates the mechanisms of depression and the anti-depression effects of XYS from the perspective of hepatic metabolomics, but also lays a solid foundation for comprehensively and deeply understanding the compatibility effects of XYS against depression, especially from the points of view of compatibility in Traditional Chinese medicine (TCM) theory and synergism in modern medicine theory.

Few studies to date address the predictive ability of CHA2DS2-VASc and R2CHADS2 in CAD patients. Our aim is to investigate the prognostic performance of CHADS2, CHA2DS2-VASc and R2CHADS2 scores in patients with coronary artery disease (CAD). Angiographically obstructive CAD patients were enrolled. The prognostic performance of the three risk scores was evaluated using Cox hazards models. In addition, we compared their predictive values by calculating C statistics, net reclassification improvement (NRI) and integrated discrimination improvement (IDI). The endpoints are death from any cause and cardiovascular death. Of 3295 subjects with CAD, the mean CHADS2, CHA2DS2-VASc and R2CHADS2 scores are 1.2 ± 1.0, 2.4 ± 1.4, and 1.6 ± 1.4, respectively. The CHADS2-guided risk classification is markedly distinct from CHA2DS-2-VASc- and R2CHADS2-guided ones. Over a median follow-up of 24 months, a total of 290 (rate 4.00/100 person-year) deaths occurred, and 163 (rate 2.2/100 person-year) were attributed to cardiovascular deaths. Event rates increase by CHADS2, CHA2DS2-VASc and R2CHADS2 (P for trend

Fibrinogen (Fib) is considered to be a potential risk factor for the prognosis of patients with acute coronary syndrome (ACS), but it is unclear whether Fib level have synergistic effects to enhance the prognostic value of the GRACE score in patients with ACS. A retrospective analysis was conducted from a single registered database. 2253 consecutive patients with ACS confirmed by coronary angiography were enrolled and were grouped into 3 categories by the tertiles of admission plasma Fib levels. The end points were all-cause mortality and cardiac mortality. The mean follow-up time was 27.2 ± 13.1 months and death events occurred in 223 cases and cardiac death events occurred in 130 cases. Cumulative survival curves indicated that the risk of all-cause death increased with increasing Fib level (mortality rates for Tertile 1 vs. Tertile 2 vs. Tertile 3 = 6.6% vs. 10.8 %vs. 12.3%, p < 0.001). Cox multivariate regression analysis indicated that compared with other traditional risk factors, plasma Fib level is independently correlated with all-cause death (HR 1.33, 95% CI 1.04-1.70). However, incorporating elevated Fib level into the GRACE model did not significantly increase the predictive value of the GRACE score; for instance, AUC only increased from 0.703 to 0.713 (p = 0.765). In conclusion, Fib level at admission was independently associated with death risk among Chinese patients with ACS. However, the incorporation of Fib level at admission into the GRACE score did not improve this score's predictive value for death risk among these patients.

There is a controversy surrounding the correlation between fibrinogen (Fib) level and prognosis of coronary artery disease (CAD). We try to investigate the role of the subtypes of CAD in this controversy.A retrospective analysis was conducted from a single center CAD registered database. 3020 consecutive patients with CAD confirmed by coronary angiography were enrolled. The end points were all-cause mortality.The mean follow-up time was 27.2±13.1months and death events occurred in 258 cases. Mortality rates for patients with CAD and those in the stable coronary artery disease (SCAD) and unstable angina pectoris (UAP) groups exhibited an overall rising trend as Fib levels increased (log rank test, all p0.05). However, similar trends were not detected in patients with acute myocardial infarction (AMI). The results of a Cox proportional-hazards regression analysis showed that Fib level was independently correlated with the risk of death in patients with CAD as well as those in the SCAD and UAP groups (CAD, HR 1.40, CI 1.16-1.68; SCAD, HR 1.86, CI 1.24-2.79; UAP, HR 1.42, CI 1.06-1.90). In the AMI group, however, no independent correlation was observed between Fib level and mortality.The different proportions of subtypes of CAD affected the correlation between Fib level and the clinical prognosis of patients with CAD. This is maybe a clue to explain the controversy.

Currently, there are no studies addressing the influence of age on the prognostic information of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in Asian population with acute coronary syndrome (ACS). The purpose of this study was to investigate the prognostic performance of NT-proBNP in Chinese patients with ACS across different age groups. A total of 1512 ACS patients with venous blood NT-proBNP measured were enrolled. Patients were divided into tertiles based on their ages (

We present a case of aortic coarctation combined with ascending-descending aorta dilatation and concomitant aortic valve regurgitation. The technique involved using endovascular stenting, a two-stage balloon dilation procedure post-stent implantation and a Bentall procedure.

Objective To analyze the current usage of optimal medical therapy (OMT), influencing factors, and the predictive value of OMT for all-cause mortality in coronary artery disease (CAD) patients with different subgroups. Methods A total of 3176 CAD patients confirmed by coronary angiography were included. OMT was defined as the combination of anti-platelet drugs, statins, beta blockers, and angiotensin converting enzyme inhibitors or angiotensin receptor blockers. Factors for OMT and its prognostic value were analyzed in CAD patients across different subgroups. Results Out of 3176 patients, only 39.8% (n = 1265) were on OMT at discharge. Factors associated with OMT at discharge were pre-admission OMT and discharge department. All-cause mortality occurred in 6.8% (n = 217) of patients. Multivariate analyses indicated that OMT was significantly associated with reduced all-cause mortality (HR: 0.65, 95% CI: 0.45–0.95; P = 0.025). Sub-group analyses indicate that male acute coronary syndrome (ACS) patients were more likely to receive survival benefits with OMT at discharge. The positive impact of OMT at discharge was more apparent after 24 months, regardless of revascularization therapy. Four-drug combination of OMT was superior to 3-drug combination therapy in ACS patients but not in stable patients. Conclusions OMT was associated with significant improvement in survival in patients with CAD. The positive impact of OMT was distinct in the CAD patients with different characteristics.

OBJECTIVES Our aim was to investigate whether the presence of metabolic syndrome (MetS) and diabetes mellitus (DM) influenced the N-terminal pro-B-type natriuretic peptide (NT-proBNP) level and its prognostic performance in coronary artery disease (CAD). PATIENTS AND METHODS The present study enrolled a total of 1638 CAD patients. Multivariate regression analyses were carried out to relate NT-proBNP to metabolic components, nondiabetic MetS, DM, and MetS score. Furthermore, we examined the prognostic performance of NT-proBNP in patients with non-MetS, nondiabetic MetS, and DM. RESULTS NT-proBNP levels correlated inversely with BMI (β=-0.11, P=0.003) and correlated positively with fasting glucose (β=0.12, P=0.001). There were no significant relationships of NT-proBNP with other metabolic parameters. Compared with non-MetS, the presence of DM significantly increased NT-proBNP levels (P=0.004), whereas nondiabetic MetS did not influence NT-proBNP levels (P=0.954). During the median follow-up of 21 months, 109 all-cause deaths occurred. NT-proBNP levels independently predicted all-cause deaths irrespective of the presence of nondiabetic MetS and DM (Pinteraction=0.43). CONCLUSION DM, but not nondiabetic MetS, is associated with higher NT-proBNP levels. NT-proBNP can still predict death in patients with CAD, even with the confounding effect of MetS and diabetes.

Few studies to date address the predictive ability of CHA

Background Whether body composition is associated with the N-terminal pro-B-type natriuretic peptide (NT-proBNP) level and its prognostic performance in acute coronary syndrome (ACS) remains unknown. We aimed to investigate the influence of body composition on the NT-proBNP level and its prognostic performance among ACS patients. Methods In total, 1623 ACS patients with NT-proBNP data were enrolled. Percent body fat and lean mass index were estimated using the Clínica Universidad de Navarra—Body Adiposity Estimator equation. Patients were divided into three groups according to the tertiles of sex-specific body mass index, percent body fat, or lean mass index. The endpoints were death from any cause and cardiovascular death. Results Body mass index was inversely correlated with NT-proBNP levels (β = −0.036, P = 0.003). Lean mass index, but not percent body fat, was inversely associated with NT-proBNP levels (β of lean mass index = −0.692, P = 0.002). During a median follow-up of 23 months, 161 all-cause deaths occurred, and of these, 93 (57.8 %) were attributed to cardiovascular causes. Multivariate Cox analysis showed that the NT-proBNP level independently predicted all-cause mortality or cardiovascular death in the lower body mass index, lean mass index, and percent body fat groups. However, the prognostic performance of NT-proBNP was attenuated in patients with high body mass index, lean mass index, and percent body fat. In the subgroup of patients with diabetes, inverse associations between NT-proBNP levels and body mass index or body composition were not observed. In addition, the negative influence of high body mass index and body composition on the prognostic performance of the NT-proBNP level appeared to be attenuated. Conclusions Body mass index and lean mass index, but not percent body fat, are inversely associated with NT-proBNP levels. The prognostic performance of this biomarker may be compromised in patients with high body mass index, percent body fat, or lean mass index. Additionally, the influence of body composition on the NT-proBNP level and its prognostic performance might be attenuated in diabetic patients with ACS.

Our aim was to illustrate the effect of higher activated clotting time (ACT) values versus lower ACT values on thrombotic or hemorrhagic events in coronary atherosclerotic heart disease (CHD) patients undergoing percutaneous coronary intervention (PCI). PubMed, Embase, Web of Science, and Cochrane Library were searched. Observational studies assessing ACT related major adverse cardiac event (MACE) and major bleeding were included. Studies were allocated into three groups. Group 1 included studies with low percentage of participants prescribed with glycoprotein IIb/IIIa inhibitors ([GPI] ≤30%), Group 2 with high percentage of participants prescribed with GPI (>30%), and Group 3 with routine direct thrombin inhibitors (DTI) prescription. The cutoff is designed as 300s (290-310s) for Group 1, and 250s (240-260s) for Group 2. With regard to MACE and major bleeding in Group 1, there was no significant difference between higher ACT values and lower ACT values (risk ratio [RR] for MACE, 1.16, 95% confidence interval [CI], 0.65-2.05, p=0.62, I(2)=94%, RR for major bleeding, 0.96, 95% CI, 0.66-1.40, p=0.83, I(2)=0%). Likewise, no significant difference was found in Group 2 between higher ACT values and lower ACT values (RR for MACE, 1.15, 95% CI, 0.97-1.35, p=0.10, I(2)=0%, RR for major bleeding, 0.85, 95% CI, 0.45-1.60, p=0.61, I(2)=83%). In conclusion, ACT may not have a substantial effect on thrombotic or hemorrhagic complications. Under current clinical practice, target ACT may be higher than what is necessary to prevent thrombotic events. We may achieve a relative low ACT level to preserve efficacy and enhance safety.

The aim of this study was to determine whether theEscherichia coli(EPEC) attached to cells by the TLR4. A fusion between gene encoding fluoresce-enhanced green fluorescent protein (EGFP) and Toll like receptor 4 (TLR4) was constructed and expressed inEscherichia coli. Then the pEGFP-N1-TLR4 fusion expression vector was transfected into HT-29 cells. The green fluoresce was observed at the plasma membrane of HT-29 cells under inverted fluorescent microscopes. In addition, the FITC stained EPEC was also observed adherence to the TLR4 of HT-29 cells.The results indicated that the EPEC adhered to cells by bonding to TLR4 protein. It is the first time that the TLR4 has been explained as an adhesion receptor.

Bisphosphonates have shown potential to inhibit atherosclerosis in animal experiments; however, whether bisphosphonates therapy lowers the risk of incidence of myocardial infarction (MI) is debated. We performed the meta-analysis and trial sequential analysis (TSA) to investigate the relation between bisphosphonates therapy and incident MI.Pubmed and Embase databases were systematically searched in April 2015 to identify studies, which compared the incidence of MI in subjects receiving bisphosphonates with that in subjects not receiving the agents. Meta-analysis was conducted using random effects model in consideration of statistical heterogeneity between studies. Reliability of the results from meta-analysis was examined using TSA.Six observational studies (n = 440261) and 3 randomized control trials (RCTs, n = 11,024) met the eligible criteria. In the pooled analysis of observational studies, bisphosphonates therapy was not associated with reduced risk of MI either using unadjusted estimates (relative risk 0.93, 95% confidence interval (CI), 0.75-1.15) or estimates adjusted for confounding factors (hazard ratio 1.01, 95% CI, 0.84-1.21). Furthermore, hazard of incident MI did not differ between alendronate users and nonusers. TSA showed that evidence from observational studies firmly precluded the association between bisphosphonates and incident MI. Pooled analysis of RCTs also suggested no benefits of decrease in incident MI associated with bisphosphonates therapy (relative risk 1.05, 95% CI, 0.53-2.09). However, TSA demonstrated that evidence from RCTs was insufficient to draw a conclusion.Despite the encouraging findings from animal studies, bisphosphonates therapy is not associated with reduced risk of MI.

The aim of the present review was to investigate the association between the use of oral β-blockers and prognosis in patients with acute myocardial infarction (AMI) who underwent percutaneous coronary intervention (PCI) treatment. A systematic literature search was conducted in Pubmed (from inception to September 27, 2014) and Embase (Ovid SP, from 1974 to September 29, 2014) to identify studies that compared the outcome of patients with AMI taking oral β-blockers with that of patients not taking after PCI. Systematic review and meta-analysis were performed with random-effects model or fixed-effects model. Ten observational studies with a total of 40,873 patients were included. Use of β-blockers was associated with a reduced risk of all-cause death (unadjusted relative risk 0.58, 95% confidential interval 0.48 to 0.71; adjusted hazard ratio 0.76, 95% confidential interval 0.62 to 0.94). The potential benefit of β-blockers in preventing all-cause death was not similar in all population but was restricted to those with reduced ejection fraction, with low use proportion of other secondary prevention drugs or with non–ST-segment elevation myocardial infarction. The association between the use of β-blockers and improved survival rate was significant in ≤1-year follow-up duration. Rates of cardiac death, myocardial infarction, and heart failure readmission in patients using β-blockers were not significantly different from those in patients without β-blocker therapy. In conclusion, there is lack of evidence to support routine use of β-blockers in all patients with AMI who underwent PCI. Further trials are urgently needed to address the issue.

Background TAVR is a rapidly spreading treatment option for severe aortic valve stenosis. Significant coronary artery disease (CAD) is present in 40% to 75% of patients undergoing TAVR. However, when to treat the concomitant coronary artery lesions is controversial. Methods This is a systematic review comparing concomitant PCI and TAVR versus staged PCI and TAVR. The OVID database was systematically searched for studies reporting PCI in patients undergoing TAVR. A random effects model was used to calculate the pooled odds ratio (OR) with 95% confidence intervals. Results Four observational studies and a total of 209 patients were included in this analysis. Overall 30-day mortality was similar between concomitant PCI and TAVR versus staged PCI and TAVR [OR: 1.47 (0.47-4.62); P = .51], renal failure was not significantly different between both groups [OR: 3.22 (0.61-17.12); P = .17], periprocedural myocardial infarction was not different between the 2 groups [OR: 1.44 (0.12-16.94); P = .77], life-threatening bleeding did not differ between both groups [OR: 0.45 (0.11-1.87); P = .27], and major stroke also was not significantly different [OR: 3.41 (0.16-74.2); P = .44]. Conclusion These data did not show a significant difference in short-term outcomes between concomitant PCI and TAVR versus staged PCI and TAVR.

Rationale: Coarctation of aorta in adulthood is usually complicated by other cardiovascular anomalies, posing great technical challenge for intervention. Patient concerns: Here, we report an extremely rare case of aortic arch coarctation combined with a poststenotic biloculated calcified aneurysm and hypoplastic left subclavian artery. Interventions: First, an extra-anatomic bypass was established, along with narrowing of aorta just proximal and distal to the aneurysm. While the bypass graft significantly relieved trans-coarctation gradient, the latter procedure decreased intra-aneurysm pressure and created landing zones for aneurysm occlusion. Six months later, 2 muscular ventricular septal defect occluders were deployed at the proximal and distal orifice of the aneurysm. Outcomes: Follow-up computed tomography angiography confirmed the absence of contrast leakage into aneurysm. Conclusions: A 2-stage hybrid approach described here appears to be feasible, safe, and associated with favorable clinical outcomes in the treatment of complicated aortic coarctation and poststenotic aneurysm.

Rationale Ventricular double rupture (VDR) is a rare but lethal mechanical complication of acute myocardial infarction (AMI). The early identification and timely treatment of VDR remain challenging problems. We present a case of AMI with VDR and briefly review the characteristics and prognosis of this life-threatening disease. Patient concerns and diagnoses A 77-year-old male presented to our hospital with a 4-day history of severe dizziness, mild chest tightness, and dyspnea. An inferior AMI was diagnosed. Interventions and outcomes On the second hospital day, hypotension and a new cardiac murmur was found. The emergency echocardiographic study disclosed a ventricular septal defect. Soon after that the patient suddenly died of ventricular free-wall rupture. Lessons In patients with AMI complicated by a septal perforation in the apical region, close to the septum-free wall junction, special attention should be paid to the great risk of VDR. Other high risk factors included advanced age, delayed reperfusion, and inferior infarction. Sufficient evaluation of the risk factors, close monitoring of vital signs, early identification of the specific symptoms, and timely treatment are the key points for the effective prediction and prevention of VDR.

Chaos control in Random Boolean networks is implemented by freezing part of the network to drive it from chaotic to ordered phase. However, controlled nodes are only viewed as passive blocks to prevent perturbation spread. This paper proposes a new control method in which controlled nodes can exert an active impact on the network. Controlled nodes and frozen values are deliberately selected according to the information of connection and Boolean functions. Simulation results show that the number of nodes needed to achieve control is largely reduced compared to previous method. Theoretical analysis is also given to estimate the least fraction of nodes needed to achieve control., 10 pages, 2 figures

To investigate the effect of hydrogen sulfide (H2S) on artherosclerosis (AS) and its mechanism in rats.125 healthy male SD rats of the weight (210 +/- 10) g were randomly divided into 5 groups: control group, AS model group, AS + low-dose NaHS (2.8 micromol/(kg x d)) group, AS+ middle-dose (14 micromol/(kg x d)) NaHS group, AS+ high-dose NaHS (28 micromol/(kg x d)) group. The atherosclerotic model was established by feeding high grease food and injecting large doses of VitD3. The rats were using NaHS by peritoneal injection for 12 weeks. 5 rats were executed in each group before the experiment and in the weeks of 3, 6, 9, 12 after the experiment, respeotively. The blood fat was analyzed by automatic biochemistry analysator. H2S content in serum was detected by the method of deproteinization. The pathological damage of vessels was observed and scored by HE stain. The expression of VEGF in the vessel tissue was detected by immunohistochemistry staining.Compared with the control group at contemporaneity, both serumal triglyceride (TG) and cholesterol (TC) increased significantly in the AS model group after rat feeded 3, 6, 9, 12 weeks, and scores of the artery pathological damage also increased obviously from the 6th week to the 12th week (P0.01), as well as artherosclerosis plaque appeared, displaying as lipid plaque in the positive part. The serumal H2S concentration decreased obviously, from (44.98 +/- 2.06) micromol/L of before feeding to (38.56 +/- 2.26), (32.96 +/- 2.38), (28.63 +/- 0.92), (23.55 +/- 0.92) nnol/L of after feeding 3, 6, 9, and 12 weeks, respectively, and lower than that of control at contemporaneity (44.72 +/- 0.85), (43.71 +/- 0.59), (41.96 +/- 0.97), (39.87 +/- 1.25) micromol/L, respectively ( P0.01), and VEGF expression of the vascular tissue also increased (P0.01). Compared with the AS model group, all of above indexes in rat of the low-dose of NaHS group did not appear any obvious change. The serumal H2S concentration in rat of the middle-dose NaHS began increase at the 6 week after rat feeded (36.13 +/- 0.3 vs. 32.96 +/- 2.38 micronol/L, P0.05), and continuously increased at the 9th and the 12th week (33.07 +/- 1.14 vs. 28.63 +/- 0.92 micromol/L, 30.16 +/- 0.2 vs. 23.55 +/- 0.92 micromol/L; P0.01, respectively). The serumal H2S concentration in high-dose NaHS groups, increased from the 3th to the 12th week (41.25 +/- 0.80, 38.71 +/- 0.46, 35.31 +/- 0.62, 33.38 +/- 0.78 micromol/L, respectively, P0.01). The rat serumal TC in both middle and high-dose NaHS groups, decreased from the 3th to the 12th week (P0.01), and TG began decrease from the 3th and the 6th week to the 12th week after rat feeded, respectively (P0.05, P0.01). Both of the pathological damage scores and the expression of VEGF decrease from the 6th week to the 12th week (P0.05). The correlation analysis showed that H2S in serum had a negative correlation with both pathological damage scores (r = -0.917, P0.01) and the expression of VEGF (r = -0. 885, P0.01). But it had no obvious correlation with serumal TG and TC.The formation and development of artherosclerosis has a close correlation with the depressing of endogenous H2S. Administration of exogenous H2S could raise the H2S concentration of serum in artherosclerosis, which might improve the damage of vessels and inhibit the expression of VEGF.

The present study was aimed to study the effect of hydrogen sulfide (H(2)S) on rat myocardial ischemia/reperfusion (I/R) injury and whether the effect is mediated by c-Fos protein expression. Male Sprague-Dawley rats were randomly divided into 4 groups:sham treatment; I/R group: the rat anterior descending branch of left coronary artery was occluded for 30 min and then released to allow reperfusion for 60 min; NaHS (exogenous H(2)S donor) groups: the rats were pretreated with NaHS at 2.8 μmol/kg body weight and 14 μmol/kg body weight (i.v.), respectively, before I/R treatment. Hemodynamics (LVSP, LV±dp/dt(max)) and electrocardiogram (ECG, lead II) were monitored continuously with multi-channel physiological signal analysis system after reperfusion. Myocardial infarct size was measured using triphenyltetrazolium chloride (TTC) staining. H(2)S concentration in the plasma was determined with a spectrophotometer. Morphological and ultrastructural changes in myocardial tissue were evaluated by HE staining and by a transmission electron microscope. The evaluation of c-Fos protein expression in myocardial tissue was performed by immunohistological staining. The results showed that H(2)S concentration in rat plasma in I/R group was significantly decreased compared with that in the control group [(30.32±5.26) vs (58.28±7.86) μmol/L, P0.05]. NaHS at 2.8 and 14 μmol/kg body weight reduced the changes in LVSP, LV±dp/dt(max) in rat myocardium induced by I/R injury. The values of LVSP, +dp/dt(max) and -dp/dt(max) at 60 min during myocardial reperfusion were enhanced from (75.93±1.10)%, (66.27±4.78)% and (66.01±4.79)% in I/R group to (84.34±2.24)%, (76.38±1.93)% and (75.47±5.29)% in 2.8 μmol/kg body weight NaHS group (P0.05, P0.01, n=6), (88.40±2.88)%, (80.10±2.09)% and (80.48±6.20)% in 14 μmol/kg body weight NaHS group (P0.01, n=6), respectively. Compared with that in 2.8 μmol/kg body weight NaHS group, the enhancing effect was more prominent in 14 μmol/kg body weight NaHS group. NaHS at 14 μmol/kg body weight markedly alleviated the injury in morphological changes and decreased c-Fos protein expression in myocardial tissue compared with that in I/R group (0.20±0.06 vs 0.32±0.10, P0.05). These results suggest that H(2)S protects myocardium against I/R injury and this protective effect may be related to the down-regulation of c-Fos protein expression.

The purpose of this study was to discuss the present situation of discharge medications in coronary artery disease (CAD) patients with different levels of renal function and assess the potential impact of these medications on the prognosis of this patient population. A retrospective cohort study was conducted. From July 2008 to Jan 2012, consecutive patients with CAD confirmed by coronary angiography of West China Hospital were enrolled and were grouped into 3 estimated glomerular filtration rate (eGFR) categories: ≥60, 30 to 60, and