To examine the association of early central venous pressure (ECVP) measurement with 28-day mortality in critically ill elderly patients. We used the Medical Information Mart for Intensive Care database to identify critically ill elderly patients. Multivariable logistic regression was used to control confounding effects and characterize the association between ECVP measurement and 28-day mortality. Propensity score matching and propensity score-based inverse probability of treatment weighting were employed to assess the robustness of our findings. 21,781 patients were included in our study, of which 2860 underwent central venous pressure measurement within 24 hours of intensive care unit admission (ECVP group). ECVP measurement was associated with lower 28-day mortality (odds ratio = 0.73, 95% Confidence Interval 0.634-0.84, P < .001). The ECVP group's in-hospital mortality and 1-year mortality were also significantly lower than those of the non-ECVP group. The ECVP patients had significantly shorter duration of intensive care unit stay and hospital stay. The ECVP patients received more intravenous fluid. The duration of mechanical ventilation and vasopressor use among ECVP patients was also shorter. The ECVP group lactate increase was significantly lower than the non-ECVP group. The mediating effect of lactate change was significant (P = .014 for the average causal mediation effect). ECVP measurement is associated with a decreased risk of 28-day mortality, and serum lactate change may proportionally mediate this beneficial effect.

Objective:This study aimed to characterize serum metabolic profiles in hypertensive patients and investigate the regulatory role of tryptophan metabolism. Methods:We employed an integrated metabolomics strategy that combined non-targeted screening with targeted validation. From November 2022 to November 2023, we enrolled 25 newly diagnosed, treatment-naïve hypertensive patients and 25 age- and sex-matched healthy controls (1:1 ratio) from a local Shanghai hospital, together with their clinical baseline data. Non-targeted metabolomics, combined with Principal Component Analysis (PCA) and Orthogonal Partial Least Squares Discriminant Analysis (OPLS-DA) were used to identify differential metabolic pathways. Subsequent targeted metabolomics analysis was conducted to quantify key molecules involved in the tryptophan metabolic pathway. Results:Non-targeted metabolomics revealed 2,931 metabolites, with 759 showing differential expression (296 up-regulated and 463 down-regulated), emphasizing tryptophan metabolism as the central dysfunctional pathway. Targeted validation confirmed abnormalities in three branches of tryptophan metabolism: 5-hydroxytryptamine (5-HT) was down-regulated by 30% (Fold change = 0.69, P = 0.002), while five metabolites, such as 5-HT acid (Fold change = 1.33, P = 0.002) and kynurenine (Fold change = 1.35, P = 0.004), exhibited significant up-regulation (all P < 0.05). Network pharmacology analysis indicated strong binding affinities between tryptamine metabolites (Serotonin and L-5-Hydroxytryptophan), kynurenine metabolites (3-Hydroxykynurenine and Kynurenine), and indole metabolites (Hydroxyindoleacetic acid and Indolelactic acid) with their respective targets SLC6A4, KYNU, and SLC6A2. Conclusion:Dysregulation of the tryptophan metabolic network-characterized by kynurenine pathway activation, 5-HT pathway inhibition, and microbial-indole pathway imbalance-is a key pathological mechanism in hypertension. These key molecules regulate targets such as SLC6A4, KYNU, and SLC6A2, potentially offering mechanistic insights for future precision intervention studies.

This study investigated the chemical profile and therapeutic mechanisms of the Yishen Ningxin Formula (YSNXF) in treating hypertension comorbid with insomnia through an integrated approach involving UPLC-QE-MS/MS, network pharmacology, and molecular docking. Chemical profiling identified a total of 870 components within YSNXF, with 13 compounds confirmed as blood-entering components in rat plasma, corresponding to 133 potential targets. Intersection analysis with disease-related targets revealed 46 core targets, notably ACE, HTR2A, HTR2B, and HTR1A. Network pharmacology and enrichment analyses indicated that key bioactive components-including hirsutine, geissoschizine methyl ether, hypaphorine, and N-acetylleucine-exert their effects via critical pathways such as the renin-angiotensin system, neuroactive ligand-receptor interactions, and serotonergic synapses. Molecular docking further validated the strong binding affinities of geissoschizine methyl ether and hypaphorine to the identified core targets. These findings suggest that YSNXF alleviates hypertension and insomnia through a multi-component, multi-target, and multi-pathway synergistic mechanism, highlighting geissoschizine methyl ether and hypaphorine as pivotal active constituents for further pharmacological validation.

Pathological cardiac hypertrophy is a major contributor to heart failure (HF), resulting in high mortality rates worldwide; therefore, identifying key molecules in pathological cardiac hypertrophy is of critical importance for preventing or reversing HF. Tripartite motif 38 (Trim38) is an E3 ubiquitin ligase that serves a pivotal role in various diseases. The present study aimed to elucidate the regulatory role of Trim38 in pressure overload‑induced pathological cardiac hypertrophy and to explore its underlying molecular mechanisms. The expression of Trim38 was decreased in hypertrophic heart tissues from a murine model of transverse aortic constriction (TAC) and in neonatal rat cardiomyocytes (NRCMs) treated with phenylephrine (PE). Furthermore, Trim38 knockout (Trim38‑KO) aggravated cardiac hypertrophy after TAC, and Trim38 knockdown in cardiomyocytes increased cell cross section area, and upregulated the expression of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) following treatment with PE. Ubiquitinomics analysis revealed that the MAPK signaling pathway was regulated by Trim38. Furthermore, western blotting confirmed that Trim38‑KO activated TAK1 and JNK/P38. By contrast, Trim38 overexpression in NRCMs suppressed the JNK/P38 signaling pathway and inhibited the phosphorylation of TAK1. Furthermore, Trim38 knockdown resulted in a marked enhancement of TAK1 phosphorylation, concomitant with an augmentation of cardiomyocyte area and a significant upregulation of the hypertrophic biomarkers ANP and BNP. By contrast, infection with an adenovirus containing dominant‑negative TAK1 inhibited TAK1 activity, which attenuated Trim38 knockdown‑induced cardiomyocyte hypertrophy, confirming that TAK1 is a key molecule involved in the protective effects of Trim38 on cardiomyocytes. In conclusion, to the best of our knowledge, the present study is the first to reveal that Trim38 confers protection against pathological cardiac hypertrophy by inhibiting the TAK1/JNK/P38 signaling pathway; therefore, Trim38 may be a promising target for treating cardiac hypertrophy.

BackgroundOpen heart surgery (OHS) is crucial for treating cardiovascular diseases, but postoperative delirium (POD) is a common and challenging complication. Existing POD prognostic indicators have limitations in clinical application. The relationship between AG and POD in OHS patients remains unclear.MethodsData from the MIMIC-IV database were used. Patients aged 18 or older who underwent OHS, were admitted to the ICU post-surgery, and had an AG test within the first 24 h after surgery were included. The maximum AG value within 24 h after surgery was the exposure variable, and POD occurrence was the primary outcome. Multivariable logistic regression was applied to explore the relationship between AG and POD. A restricted cubic spline regression model (RCSRM) was used to analyze the correlation shape, and subgroup and interaction analyses were performed. Causal mediation analysis (CMA) was conducted to explore the mediating role of ICU length of stay (LOS) in the relationship between AG and POD.ResultsWe included 6,429 patients. The overall POD incidence was 13%. Multivariable logistic regressions showed that AG was significantly associated with POD (OR = 1.686, 95% CI: 1.348–2.113, P < 0.001 for group 2; OR = 1.54, 95% CI: 1.161–2.037, P = 0.003 for group 3; OR = 2.005, 95% CI: 1.574–2.558, P < 0.001 for group 4; P for trend <0.001) and ICU LOS (OR = 1.256, 95% CI: 1.066–1.48, P = 0.007 for group 2; OR = 1.281, 95% CI: 1.033–1.585, P = 0.023 for group 3; OR = 1.595, 95% CI: 1.32–1.928, P < 0.001 for group 4). The RCSRM revealed a non-linear relationship between AG and POD (P-overall <0.001, P for non-linear = 0.042). No multiplicative or additive interactions were detected between AG and any subgroup. CMA indicated that ICU LOS mediated 5.392% (95% CI: 0.483%–11.98%; P = 0.034) of the effect of AG on POD.ConclusionAn elevated AG level within the first 24 h after OHS is significantly associated with an increased risk of POD, and the relationship shows a tendency toward non-linearity. ICU LOS may proportionally mediate the impact of AG on POD development.

This study investigated the association between serum small peptides and arteriosclerosis (AS) in hypertensive patients. Sixty hypertensive patients (with and without AS) and 30 healthy individuals were enrolled. Untargeted metabolomics identified 120 peptides in AS patients, 136 in hypertensive patients, and 59 shared peptides. LASSO regression identified key peptides differentiating hypertensive patients with AS from those without. Peptides like Thr-Ile, Phe-Asp-Lys, and Lys-Ile-Val-Lys were upregulated in AS, while others like Gln-Glu and Lys-Lys were higher in non-AS patients. The diagnostic model showed AUCs of 0.896 for AS and 0.909 for non-AS. Elevated levels of Lys-Ile-Val-Lys and Phe-Asp-Lys were linked to increased carotid intima-media thickness, indicating higher AS risk. This study successfully identified the specific small peptides in hypertensive patients with AS using untargeted metabolomics. These peptides were significantly upregulated in the hypertension with AS group, highlighting their potential as early biomarkers.

Serum phosphate levels are strongly correlated with the prognosis of septic patients. However, previous studies have concentrated on individual phosphate levels, and the relationship between change trends in serum phosphate levels and in-hospital mortality has seldom been reported. We aimed to investigate whether the level and change trends of serum phosphate were associated with in-hospital mortality. We classified patients using k-means clustering analysis into clusters with changes in serum phosphate levels and used logistic regressions to explore the relationships between different clusters and in-hospital mortality, taking the cluster with the smallest change as a reference. Restricted cubic spline regression was used to examine the shape of the correlation between changes in serum phosphate levels and in-hospital mortality. Subgroup analyses and interaction analyses were performed to discover potential impact factors. A total of 1810 (21.1%) of 8586 participants died during their hospital stay. After adjustment for baseline variables, cluster 2 (OR 1.303, 95% CI 1.101–1.542, p = 0.002), cluster 3 (OR 1.348, 95% CI 1.158–1.57, p < 0.001), cluster 4 (OR 1.652, 95% CI 1.225–2.222, p = 0.001) and cluster 5 (OR 2.745, 95% CI 2.212–3.407, p < 0.001) remained associated with significantly increased mortality. The changes in serum phosphate levels and in-hospital mortality were linear according to restricted cubic spline regression. According to the subgroup analyses, the ORs of the female subgroup and mechanical ventilation subgroup were lower than those of their counterparts across all clusters. Multiplicative and additive interactions were detected between phosphate clusters and mechanical ventilation. First, a high and unstable serum phosphate level is associated with increased mortality in septic patients. Second, for those with elevated phosphate levels, treatments to lower serum phosphate may reduce mortality in septic patients. Third, an increasing trend in phosphate levels may be more important than a high level in predicting poor prognosis in septic patients.

Background This study assessed the medical effectiveness and cost-effectiveness of a multidisciplinary team (MDT)-based interventional follow-up in managing hypertension, thereby serving as an evidence base for decision-making in disease prevention and control for community residents. Methods We randomly assigned 5,676 community residents in Shanghai’s Changning District to the intervention or the control group and followed them up for two years. Results The mean BP of the intervention group decreased from 132.28/79.55 mmHg to 130.73/77.62 mmHg after the follow-up. The prevalence of hypertension in the intervention group (86.1%, n = 2,450) was lower than in the control group (89.8%, n = 2,510) (odds ratio (OR) = 1.30, 95% confidence interval (CI): 1.09–1.58, P = 0.004). The ICER of the intervention group was ¥6,837 ($989.135, £792.135) in cost analysis, with the threshold of cost-effectiveness set as the incremental costs per QALY, which was 0.63 times China’s 2017 GDP (gross domestic product) per capita (¥59,960). Additionally, the incremental costs of the intervention group totaled ¥5,128.394 with a QALY value of 2.018, while those of the control group were ¥4,855.406 with a QALY value of 1.978. The ICER of ¥6,837/QALY in the intervention group was far less than 0.63 times China’s 2017GDP per capita (¥59,960), suggesting the economic feasibility of the interventional strategy. Conclusions The MDT-based intervention is a highly cost-effective strategy, and it effectively reduces the prevalence of hypertension in community residents, the occurrence of MACEs, and the mortality rate from CVDs while providing scientific medication guidance. Trial registration: item number 134119b2200.

Objectives The aim of this study was to understand the prevalence of chronic venous disease (CVD) of lower limbs in young men at high-altitude in Xizang, and to provide prevention measures. Methods The convenient sampling method was used to conduct a questionnaire survey among males aged 18 to 40 above an altitude of 3000 meters in Xizang in April 2023. The contents of the questionnaire included basic information, symptoms of CVD of lower limbs, protection status and training needs. Multivariate logistic regression model was calculated to evaluate the risk factors for CVD. Results A total of 350 survey questionnaires were received, and 326 valid samples were collected. The prevalence of CVD of lower limbs (C1-C6) was 37.42% (95%CI: 32.17%–42.68%), the ratio of C0 to C5 were 62.58%, 27.30%, 3.07%, 4.60%, 2.15% and 0.31%, respectively, no one reached C6. The top three symptoms of CVD were lower limb fatigue (18.10%), heaviness (15.34%) and pain (13.19%). 46.01% of respondents were unaware of CVD, and 12.88% of respondents did not have any protective measures of CVD. Multivariate logistic regression showed that age (OR = 1.076, 95%CI: 1.018–1.137, p = .009), preference for spicy food (OR = 1.747, 95%CI: 1.083–2.818, p = .022), unbalanced diet (OR = 1.877, 95%CI: 1.049–3.358, p = .034) and physical exercise (OR 0.610, 95%CI: 0.377–0.986, p = .044) were the independent risk factors for CVD. Conclusions This study provided data on the prevalence of CVD in young men at high-altitude and the risk factors for CVD. The findings of this study may facilitate the development of individualized clinical assessments and targeted prevention programs.

Concurrent chemoradiotherapy (CRT) is the standard treatment for new diagnosis locally advanced cervical cancer (LACC). However, local recurrence and distant metastasis are the main modes of CRT failure in LACC, especially for the patient with high risk such as stage IIIA ∼IVA, tumour with large masses (>4cm) or regional lymph node metastasis. Here is a prospective, single-arm, phase II study aims to evaluate the efficacy and safety of tislelizumab (anti-pd-1 antibodies) combined with concurrent chemoradiotherapy for high risk LACC. Eligible patients were age 18-75 years with ECOG PS 0-1, histologically confirmed cervical cancer with 2018 FIGO stage IIIA, IIIB, IVA or cervical tumors > 4cm with regional lymph node metastasis, or paracervical invasion with regional lymph node metastasis, and without received prior systemic therapy, surgery or radiation. All patients received CRT combined with tislelizumab 200mg Q3W for 1 year or until disease progression or intolerable toxicity. The CRT includes at least 4 cycles of cisplatin 40mg/m2/W + EBRT 45∼50Gy/25f then BT 28∼30Gy/4∼5f. The primary endpoint was tumor regression ratio after EBRT. Secondary endpoints were 3-month and 6-month ORR after CRT, 1-year and 3-year OS and PFS, safety. Until Feb,28, 2024, 30 patients were enrolled. 25 patients completed CRT and were available for evaluation. The median age was 59 years (range 40-75). The tumor regression ratio after EBRT was 90.6%. The 3 and 6-months ORR after CRT were 100% and 100%. The 1-year PFS rate was 100%. The main adverse effect was neutropenia including 36% for grades 3-4 and 20% for grades 1-2. Radiation enteritis incidence was 64% and were grade 1-2. Other adverse effect such as nausea, vomiting, and dizziness occurred during CRT and could be alleviated after symptomatic treatment. No immune-related adverse events were observed. Our results suggest that Tislelizumab combined with concurrent chemoradiotherapy showed valuable antitumor activity and controllable safety in high risk LACC. The combination regimens can be one of the treatment options for these patients.

The integration of regional medical centers and community health service centers is an effective way to improve the professional ability of general practitioners in post-practice training. Its major advantage lies in the establishment of a regional general practitioner ability improvement system integrating assessment, practice and teaching under the unified health administrative department. This article introduces the path of general practitioner post-training developed by Shanghai Tongren Hospital in forms of a regional medical center combined with the community health service center under the "integrated dual-drives" model, which was carried out in Shanghai Changning District; and its preliminary accomplishment is also discussed. It may provide reference for regional medical centers to improve the ability of general practitioners through practice-driven and teaching-driven.

Objective:To construct an evaluation scale for post competence of family doctors based on knowledge-skill-management model.Methods:The evaluation dimensions and indicators for post competency of family doctors were preliminarily developed through literature review, internal group meeting and brainstorming, and in-depth interviews of experts. And 16 experts in the fields of general practice and health management were invited for 2 rounds of Delphi consultation from December 2020 to April 2021. A competency evaluation scale for family doctors based on the dimensions of knowledge, skills and management was finally constructed.Results:The age of the experts was (47.9±7.3) years with a working experience of (24.6±7.8) years. The Cronbach′s α of the questionnaires was 0.891 and the KMO was 0.844. The positive coefficients for 2 rounds of expert consultation were 100%; the familiarity level of experts was 0.86 and authority level was 0.89 in the first round consultation, and those were 0.84 and 0.90 in the second round consultation. After 2 rounds of consultation, the coordination coefficient of expert opinions in the knowledge and skill dimensions was>0.5, and that in the management dimension and overall evaluation system was>0.3. After discussion 2 indicators were deleted in the first round of consultation. The finally constructed family doctor post competency evaluation scale included 3 dimensions, 8 secondary indicators and 61 tertiary indicators. Conclusion:Through the Delphi consultation, we have successfully constructed an evaluation scale for post competence of family doctors based on the three dimensions of knowledge, skills and management.

Objective:To analyze the clinical knowledge and training needs of general practitioners from subjective perception and objective assessment, and to analyze their relationship.Methods:A survey was conducted among general practitioners from community health service centers in Shanghai Changning district from September to December 2020. Based on the general practitioner competency indicator system designed by the project team, 17 clinical knowledge competency evaluation indicators were developed through expert consultation, and used for subjective perception and objective assessment of clinical knowledge and learning needs among general practitioners. The influencing factors of objective assessment scores were analyzed, and the relationship between subjective perception and objective assessment scores was analyzed using the four quadrant method.Results:A total of 136 general practitioners participated in the study with the mean age of (39.25±5.90) years, most of whom were attending physician (67.65%, 92/136) and had undergraduate education (88.20%, 122/136). The average daily application frequency score was (1.55±0.21), and the training needs score was (1.65±0.09) for 17 clinical knowledge items; the average objective evaluation score was (74.21±14.0) points. The older the age ( OR=1.25, 95% CI:1.14-1.37), the higher the educational level ( OR=2.11, 95% CI:1.57-2.83), and the longer the working years ( OR=1.16, 95% CI:1.04-1.30) were significantly correlated with the higher objective evaluation scores (all P<0.05). The objective evaluation scores of endocrine diseases such as diabetes, cerebrovascular diseases and respiratory diseases are the highest, and the daily application frequency and learning needs are high (the first quadrant); The objective evaluation scores of common orthopedic diseases, common psychological diseases, and planned immunity indicators were relatively low, but their daily application frequency and learning needs were relatively high (second quadrant). The objective evaluation scores of indicators such as common malignant tumors, common dermatology diseases and health problems, and common ENT diseases were low, and the daily application frequency and learning needs were also low (the third quadrant). The objective evaluation scores of indicators such as hospice and palliative care are relatively high, but their daily application frequency and training needs are relatively low (listed in the fourth quadrant). Conclusions:The clinical knowledge levels of general practitioners are correlated with age, education level, and years of practice. There is a certain overlap between the objective evaluation results of clinical knowledge and the frequency of knowledge usage and training needs of general practitioners, and a targeted training mechanism should be established.

Purpose: We aimed to analyze the optimal timing of enteral nutrition (EN) in the treatment of sepsis and its effect on sepsis -asso-ciated acute kidney injury (SA-AKI.)Materials and Methods: The MIMIC-III database was employed to identify patients with sepsis who had received EN. With AKI as the primary outcome variable, receiver operating characteristic (ROC) curves were utilized to calculate the optimal cut-off time of early EN (EEN). Propensity score matching (PSM) was employed to control confounding effects. Logistic regressions and propen-sity score-based inverse probability of treatment weighting were utilized to assess the robustness of our findings. Comparisons within the EEN group were performed.Results: 2364 patients were included in our study. With 53 hours after intensive care units (ICU) admission as the cut-off time of EEN according to the ROC curve, 1212 patients were assigned to the EEN group and the other 1152 to the delayed EN group. The risk of SA-AKI was reduced in the EEN group (odds ratio 0.319, 95% confidence interval 0.245-0.413, p<0.001). The EEN patients re-ceived fewer volumes (mL) of intravenous fluid (IVF) during their ICU stay (3750 mL vs. 5513.23 mL, p<0.001). The mediating ef-fect of IVF was significant (p<0.001 for the average causal mediation effect). No significant differences were found within the EEN group (0-48 hours vs. 48-53 hours), except that patients initiating EN within 48 hours spent fewer days in ICU and hospital.Conclusion: EEN is associated with decreased risk of SA-AKI, and this beneficial effect may be proportionally mediated by IVF volume.

Total anomalous pulmonary venous connection (TAPVC) is a rare congenital heart disease, with which some patients suffer from postoperative pulmonary venous obstruction (PPVO), requiring particular follow-up strategies and treatments. PPVO prediction has important clinical significance, while building a PPVO prediction model is challenging due to limited data and class imbalance distribution. Inspired by the anatomical evidence of PPVO, which is related to the structure of the left atrium (LA) and pulmonary vein (PV), we design an effective multi-task network for PPVO classification. The proposed method incorporates clinical priors and merits of the segmentation-based network into the classification task. The features learned from segmenting LA and PV are concatenated into the PPVO classification branch to constrain the learning of discriminative features. Anatomical-guided attention is applied in the aggregation of these features to restrict them focusing on TAPVC-related regions. To deal with the imbalance classification problem of PPVO, a novel classification loss derived by masked class activation map (MCAM) is designed to improve the classification performance. Computed tomography angiography (CTA) images of 146 patients diagnosed with supracardiac TAPVC in Shanghai Children's Medical Center and Guangdong Provincial People's Hospital were enrolled in this work. The comprehensive experiments demonstrate the effectiveness and generalization of our proposed method. The automatic PPVO prediction model shows the potential application in helping clinicians develop follow-up strategies, thereby improving the survival rate of TAPVC patients.

The life-threatening adverse effects of doxorubicin (Dox) caused by its cardiotoxic properties limit its clinical application. DDX3X has been shown to participate in a variety of physiological processes, and it acts as a regulator of Wnt/β-catenin signaling. However, the role of DDX3X in Dox-induced cardiotoxicity (DIC) remains unclear. In this study, we found that DDX3X expression was significantly decreased in H9c2 cardiomyocytes treated with Dox. Ddx3x knockdown and RK-33 (DDX3X ATPase activity inhibitor) pretreatment exacerbated cardiomyocyte apoptosis and mitochondrial dysfunction induced by Dox treatment. In contrast, Ddx3x overexpression ameliorated the DIC response. Moreover, Wnt/β-catenin signaling in cardiomyocytes treated with Dox was suppressed, but this suppression was reversed by Ddx3x overexpression. Overall, this study demonstrated that DDX3X plays a protective role in DIC by activating Wnt/β-catenin signaling.

Angiotensin II (AngII) is involved in the pathogenesis of hypertensive artery remodeling by inducing a phenotypic switch in vascular smooth muscle cells [Gly14]-Humanin (HNG), a humanin analogue, exerts potent cytoprotective effects both in vitro and in vivo. This study aimed to investigate the effects of HNG on an AngII-induced phenotypic switch in VSMCs and the potential mechanisms underlying these effects. The roles of [Gly14]-Humanin in AngII-stimulated VSMCs proliferation and migration was detected by CCK-8 assay, Cell cycle analysis, wound healing assay, trsnswell assay and western blot. The mechanism by which [Gly14]-Humanin regulates VSMC phenotypic switch was determined by intracellular oxidative stress detection, transcriptomic analysis and qRT-PCR. The results showed that HNG inhibited AngII-induced VSMC proliferation and migration and maintained a stable VSMC contractile phenotype. In addition, HNG reduced the level of AngII-induced oxidative stress in vascular smooth muscle cells. This process could be accomplished by inhibiting nicotinamide adenine dinucleotide phosphate oxidase activity. In conclusion, the results suggested that HNG ameliorated intracellular oxidative stress by inhibiting NAD(P)H oxidase activity, thereby suppressing the AngII-induced VSMC phenotype switch. Thus, HNG is a potential drug to ameliorate artery remodeling in hypertension.

脑梗、心梗、肺栓塞……在这些凶险疾病的背后,都有一个杀手——血栓.它就像是"拦路虎",会阻塞血液流通,堵住生命要道.血栓性疾病包括动脉血栓和静脉血栓,前者多发生在心脏和大脑,后者易出现在下肢和肺部,两者都可谓"潜伏高手",不易被发现.所以,如果出现以下状况就要当心了.

线粒体源性肽(MDP)是由线粒体DNA编码的一系列内源性分泌性多肽,其中Humanin是最早发现的MDP.Humanin广泛分布于心脏、血管壁、肾脏、骨骼肌和结肠等组织中,在体内和体外均表现出抗氧化应激、抗凋亡、抗炎性反应的作用.Humanin在心血管疾病的发生发展中具有重要作用,该文介绍Humanin及其修饰物在动脉粥样硬化、心肌缺血再灌注损伤、心肌纤维化、冠脉微循环障碍中的保护作用及可能机制.

Total anomalous pulmonary venous connection (TAPVC) is a rare but mortal congenital heart disease in children and can be repaired by surgical operations. However, some patients may suffer from pulmonary venous obstruction (PVO) after surgery with insufficient blood supply, necessitating special follow-up strategy and treatment. Therefore, it is a clinically important yet challenging problem to predict such patients before surgery. In this paper, we address this issue and propose a computational framework to determine the risk factors for postoperative PVO (PPVO) from computed tomography angiography (CTA) images and build the PPVO risk prediction model. From clinical experiences, such risk factors are likely from the left atrium (LA) and pulmonary vein (PV) of the patient. Thus, 3D models of LA and PV are first reconstructed from low-dose CTA images. Then, a feature pool is built by computing different morphological features from 3D models of LA and PV, and the coupling spatial features of LA and PV. Finally, four risk factors are identified from the feature pool using the machine learning techniques, followed by a risk prediction model. As a result, not only PPVO patients can be effectively predicted but also qualitative risk factors reported in the literature can now be quantified. Finally, the risk prediction model is evaluated on two independent clinical datasets from two hospitals. The model can achieve the AUC values of 0.88 and 0.87 respectively, demonstrating its effectiveness in risk prediction.