OBJECTIVE:The purpose of this study was to assess the safety and efficacy of aortic cannulation in comparison with right axillary artery (RAX) cannulation. METHODS:Between 2018 and 2023, 267 and 364 patients underwent aortic or axillary cannulation for aortic repair for acute type A aortic dissection (ATAAD), respectively. Clinical features and outcomes were compared after inverse probability of treatment weighting was stabilized. RESULTS:In the original cohort, patients in the aortic group had higher incidences of innominate artery (IA) dissection (59.6% vs. 45.1%, p<0.001), RAX dissection (13.9% vs. 4.7%, p<0.001), and right common carotid artery (RCCA) dissection (42.7% vs. 13.7%, p<0.001). After weighting, baseline characteristics were well balanced, resulting in a pseudo-cohort of aortic (n=265) vs. RAX (n=357) patients. Aortic cannulation was associated with a lower rate of cannulation-related complications (0.4% vs. 3.5%, p=0.011). In-hospital mortality (8.3% vs. 6.1%, p=0.346) and stroke rates (4.1% vs. 5.8%, p=0.383) were comparable between groups. The aortic group experienced lower rates of reoperation for bleeding (8.0% vs. 2.3%, p=0.001) and extracorporeal membrane oxygenation use (5.0% vs. 2.0%, p=0.046). Mid-term survival did not differ significantly before (p=0.849) or after weight stabilization (p=0.345). CONCLUSION:Direct aortic cannulation in ATAAD provides in-hospital and mid-term outcomes that are not statistically different from those with axillary cannulation. Aortic cannulation offers an alternative to axillary cannulation, especially for patients with IA/RAX/RCCA dissection.

Background:The presence of a small aortic annulus (SAA) in patients undergoing aortic valve replacement (AVR) remains a clinical challenge in cardiac surgery. Continuous suture technique (CST) has been considered to allow implantation of relatively larger prostheses compared with interrupted pledgeted suture (IPS). This study aimed to compare early clinical outcomes of CST versus IPS in patients with SAA who underwent surgical AVR. Methods:Between 2023 to 2025, 250 patients who received surgical AVR with implanted prostheses size <23 mm at our department were enrolled for retrospective analysis: 99 in the CST group and 151 in the IPS group. Early clinical outcomes were analyzed using propensity score matching, with postoperative peak aortic velocity as the primary endpoint. Results:The CST group exhibited comparable early clinical outcomes to the IPS group, with no postoperative paravalvular leak observed. Shorter surgery time (P=0.03) and cross-clamp time (P=0.045) were shown in the raw CST group; this advantage also reached a significant difference in the isolated AVR subgroup analysis. Our cohort presented that AVR with CST was associated with significantly lower peak aortic velocity compared with IPS in both raw cohort {2.0 [interquartile range (IQR), 1.7-2.2] vs. 2.2 (IQR, 2.0-2.6) m/s; P<0.001} and propensity-matched analyses (P=0.03). Multivariable linear regression also confirmed CST as an independent predictor of reduced postoperative peak aortic velocity (coefficient -0.192; 95% confidence interval, -0.292 to -0.092; P<0.001). Conclusions:The treatment with CST in AVR could be a valid and well-promoted alternative strategy for patients with SAA and showed a trend toward better hemodynamic performance compared to the traditional IPS approach.

ABSTRACT Low‐temperature operation of aqueous zinc batteries is fundamentally limited by electrolyte freezing and sluggish interfacial kinetics, originating from strong ion‐solvent interactions. Here, we report a steric‐regulated weakly solvating hydrogel electrolyte enabled by network‐anchored fluorinated Zr‐based metal–organic polyhedra (MOPs). The rigid, hydrophobic nanocage architecture simultaneously anchors Zn 2+ through coordination and sterically excludes active water molecules, thereby diluting the local electrostatic field, lowering the desolvation barrier, and disrupting extended hydrogen‐bond networks to suppress ice crystallization. As a result, Zn||Zn symmetric cells cycle stably for over 3700 h at −40°C, while Zn||MnHCF full cells deliver 65.8 mAh g −1 at −20°C with 82% capacity retention after 350 cycles, and still maintain 24.6 mAh g −1 at −40°C. Spectroscopic, electrochemical, and theoretical analyses reveal that Zr‐based MOPs reconstruct the Zn 2+ solvation shell into a spatially expanded, weakly bound structure that accelerates charge transfer and suppresses parasitic reactions. This work establishes a steric‐architecture design paradigm for engineering weakly solvating electrolytes, offering a robust strategy for aqueous batteries operating under extreme low‐temperature conditions.

Myocardial fibrosis, driven by fibroblast activation following myocardial infarction (MI), represents a significant pathological process contributing to heart failure progression. Interleukin-11 (IL-11) is recognized as a key mediator in fibrotic pathologies across multiple organs, including the heart. This study demonstrates consistent and specific upregulation of IL-11 expression in a mouse MI model. A single intrapericardial injection of the IL-11-blocking antibody hIL-11 MAB resulted in a modest attenuation of post-MI fibrosis. Subsequently, encapsulation of hIL-11 MAB within reactive oxygen species (ROS)-sensitive hydrogels significantly prolonged drug retention at the injury site, leading to markedly improved therapeutic efficacy. Hydrogel-delivered hIL-11 MAB effectively preserved cardiac structure and function by reducing scar fibrosis, specifically decreasing scar thickness and marginal zone area. IL-11 blockade mediated reduced collagen deposition and enhanced left ventricular contractility, concomitant with a decrease in fibrotic tissue stiffness. These findings provide compelling evidence supporting IL-11 as a therapeutic target for myocardial fibrosis and highlight a novel delivery strategy for developing improved anti-fibrotic interventions.

Biomass-derived hard carbon has emerged as a research hotspot of common concern in academic/industrial circles in the field of sodium-ion battery (SIBs) anode materials due to its low cost and wide availability. However, the core bottleneck of poor rate performance and fast-charging capability severely hinders the practical commercialization process of SIBs. In this work, Juncus effusus is employed as the precursor to develop an acid-free, eco-friendly fabrication route toward high-performance hard carbon anodes. Efficient synergistic modulation of interlayer spacing and defect configuration enables the rational establishment of a capacitance-dominated sodium-storage mechanism. This structural engineering substantially accelerates sodium-ion storage kinetics, endowing the material with exceptional cycling stability under ultrahigh-rate conditions. The optimized hard carbon delivers superior fast-charging capability: it achieves a reversible specific capacity of 169.01 mAh g-1 at 5 A g-1, while maintaining 80.27 mAh g-1 after 800 long-term cycles at an ultrahigh current density of 10 A g-1, corresponding to a remarkable capacity retention of 77.6%. This study not only confirms the great application potential of Juncus effusus as a precursor for high-performance SIBs anodes, but also clarifies the key enabling role of the capacitance-dominated sodium storage mechanism in the high-rate performance of hard carbon. It lays a solid foundation for the large-scale, green preparation and commercial application of low-cost biomass-derived hard carbon anodes, and meanwhile provides a new idea for the high-value utilization of biomass resources.

High-concentration electrolytes (HCEs) face inherent challenges such as high viscosity and diminished ionic conductivity caused by the formation of three-dimensional (3D) anion networks, which limit their practical applications. In this study, it is demonstrated that encapsulating HCEs within metal-organic frameworks (MOFs) effectively disrupts these 3-D networks, resulting in significantly enhanced ionic conductivity. Raman spectroscopy, nuclear magnetic resonance (NMR), and molecular dynamics (MD) simulations reveal a significant reduction in aggregates (AGGs)-state anion within MOF-confined electrolytes, confirming the reconstruction of the solvation environment. The MOF-engineered electrolytes promote uniform lithium deposition and enable LiFePO4||Li (LFP||Li) batteries to achieve stable cycling for over 400 cycles with minimal capacity decay. Remarkably, these batteries maintain stability at elevated temperatures and sustain the performance at 90 °C. By addressing the fundamental limitations of HCEs through nanoconfinement in MOFs, this work establishes an effective strategy for developing high-performance and robust energy storage systems.

Background: This study aimed to evaluate the perioperative outcomes of concomitant coronary artery bypass grafting (CABG) in patients undergoing surgical repair for acute type A aortic dissection (ATAAD) and to assess the impact of CABG on mortality and complications. Methods: A retrospective analysis was conducted on 1198 ATAAD patients who underwent surgical treatment at our center between January 2016 and December 2022. Patients were categorized into CABG and non-CABG groups. Preoperative characteristics, surgical data, and perioperative outcomes were collected and analyzed. Results: A total of 1198 patients underwent surgical treatment in this study, of whom 979 (81.7%) were male. The mean age was 51.7 ± 11.5 years. Among these patients, 91 (7.6%) underwent concomitant CABG. Patients in the CABG group had significantly higher incidences of chronic coronary artery disease (58.2% vs. 22.6%, p < 0.001), acute myocardial infarction (59.3% vs. 9.5%, p < 0.001), and neurological events (28.6% vs. 18.2%, p = 0.016) compared to the non-CABG group before surgery. Among all patients who underwent surgical treatment, 96 (8.0%) experienced perioperative death. The perioperative mortality rate was significantly higher in the CABG group (39.6% vs. 5.4%, p < 0.001). Patients in the CABG group also had higher rates of postoperative complications, including heart failure, neurological events, continuous renal replacement therapy (CRRT), re-exploration for bleeding, multiple organ dysfunction syndrome (MODS), and need for extracorporeal membrane oxygenation (ECMO) support (all p-values < 0.001). Compared to patients without concomitant CABG, those undergoing CABG had a much higher rate of mortality (Odds Ratio = 2.729, 95% CI = 1.282–5.812, p = 0.009). Conclusions: Concomitant CABG in ATAAD patients was significantly associated with higher perioperative mortality and complication rates.

Acute myocardial infarction (AMI) triggers a sterile inflammatory response that drives adverse cardiac remodeling and progressive tissue injury. While interleukin-1β (IL-1β) is a recognized mediator of post-ischemic inflammation, its clinical targeting in myocardial infarction remains limited, and the underlying cardioprotective mechanisms are incompletely understood. We therefore engineered three humanized anti-IL-1β nanobodies (KD: 29.23-43.09 nM) by grafting complementarity-determining regions (CDRs) from monoclonal antibodies onto a humanized VHH scaffold, followed by structural alignment and affinity optimization. The lead candidate, 5MVZ-VHH, was assessed in a C57BL/6J mouse model of MI. Administration of 5MVZ-VHH significantly reduced systemic inflammation, as reflected by lower levels of IL-1β, TNF-α, and CXCL-10 (p < 0.05), while increasing the anti-inflammatory cytokine IL-10 (p < 0.0001). Furthermore, 5MVZ-VHH strongly suppressed apoptosis in the infarcted myocardium, as indicated by diminished caspase-3 cleavage and fewer TUNEL-positive nuclei (p < 0.01). Echocardiography and Masson's trichrome staining demonstrated improved cardiac function and attenuated fibrotic remodeling, consistent with the inhibition of IL-1β-mediated signaling. Mechanistically, 5MVZ-VHH not only enhanced angiogenesis, evidenced by elevated CD31+/α-SMA+ vessel density (p < 0.05), but also promoted macrophage polarization toward an M2-reparative phenotype (CD68+/CD206+, p < 0.01) through activation of the IL-10/STAT3 axis. Transcriptomic profiling identified 2957 differentially expressed genes (FDR < 0.05), and functional enrichment analysis indicated that IL-1β neutralization restored oxidative phosphorylation and modulated TNF and cAMP signaling pathways. Collectively, these findings show that 5MVZ-VHH confers cardioprotection via multimodal mechanisms involving coordinated inflammation suppression, apoptosis inhibition, and metabolic reprogramming, supporting its therapeutic potential for ischemic heart disease.

Coronary endarterectomy combined with coronary artery bypass grafting (CE-CABG) effectively achieves coronary revascularization in patients with diffuse atherosclerotic coronary artery disease (CAD). However, the loss of the subendothelial tissue at the CE-CABG coronary artery accelerates local thrombosis, leading to CE-CABG graft failure. Dual antiplatelet therapy (DAT) and warfarin plus aspirin (WPA) are the two most common anticoagulation strategies post CE-CABG. This retrospective study compares the clinical outcomes and graft failure rates associated with these two approaches. This study is a retrospective cohort study. Between July 2016 and April 2024, 102 patients with diffuse CAD underwent CE-CABG. Six patients were excluded. In total, 96 patients (mean age 59.8 ± 7.7 years) enrolled in the study (43 in DAT group and 53 in WPA group). The DAT group received aspirin (100 mg, qd) and clopidogrel (75 mg, qd) for 1 year postoperatively, transitioning to aspirin (100 mg, qd) after 1 year. The WPA group received warfarin (international normalized ratio, INR remained at 1.8–2.5) and aspirin (100 mg, qd) for 3 months postoperatively, followed by DAT after 3 months, changed to aspirin monotherapy after 1 year. The primary endpoint was graft failure of the CE-CABG graft. Four patients died during the perioperative period (1 in DAT group, 3 in WPA group), resulting in an overall perioperative mortality rate of 4.2

Zn batteries emerge as a promising class of energy storage devices with high energy density, low cost and high safety. Nonaqueous Zn electrolytes offer high interfacial stability yet suffer from sluggish interfacial charge transfer kinetics. Here, we report an eccentric Zn2+ solvation structure enabled by metal-organic polyhedrons (MOPs) in nonaqueous colloidal electrolytes, which facilitates charge transfer at electrode-electrolyte interface. The resultant Zn2+(ZrT)(DMF)(1) solvation structure features a large solvation sheath and a small ion-to-electrode distance, thus reducing the energy required for reorganizing the solvation sheath to accept electron. As a result, the MOPs-modulated colloidal electrolyte enables Zn anode with supreme stability for over 1200 h at 8 mA cm(-2) and 270 h at 12 mA cm(-2), along with high coulombic efficiency (similar to 99.8 % over 1000 cycles), notably exceeding the performance of conventional aqueous and nonaqueous electrolytes. The design principle of solvation sheath might be broadly applicable to other high-valence metal cation batteries.

The cardiac microenvironment profoundly restricts the efficacy of myocardial regeneration tactics for the treatment of myocardial infarction (MI). A prospective approach for MI therapeutics encompasses the combined strategy of scavenging reactive oxygen species (ROS) to alleviate oxidative stress injury and facilitating macrophage polarization towards the regenerative M2 phenotype. In this investigation, we fabricated a ROSsensitive hydrogel engineered to deliver our previously engineered IL-1(3-VHH for myocardial restoration. In mouse and rat models of myocardial infarction, the therapeutic gel was injected into the pericardial cavity, effectively disseminated over the heart surface, forming an in situ epicardial patch. The IL-1(3-VHH released from the hydrogel exhibited penetrative potential into the myocardium. Our results imply that this infarct-targeting gel can adhere to the damaged cardiac tissue and augment the quantity of anti-IL-1(3 antibodies. Moreover, the anti-IL-1(3 hydrogel safeguards cardiomyocytes from apoptosis by neutralizing IL-1(3 and inducing M2-type polarization within the myocardial infarction regions, thereby facilitating therapeutic cardiac repair. Our results emphasize the effectiveness of this synergistic comprehensive treatment modality in the management of MI and showcase its considerable potential for promoting recovery in infarcted hearts.

Diabetic peripheral neuropathy (DPN), a prevalent complication of diabetes, caused a significant morbidity and posed a heavy burden on society. Considering the lack of disease models in vitro for DPN and the advantages of 3D bioprinting in disease modeling, we employed 3D bioprinting technology based on GelMA hydrogel to construct neurovascular units to mimic peripheral nerves and vessels in vitro, further we built the pathological microenvironment characteristic of DPN when the treatment of high glucose in these units. Our 3D disease models closely recapitulated in vivo pathological conditions, including oxidative stress and inflammatory responses, which are key hallmarks of DPN. Then we explored the effects of cholesterol on DPN progression using our disease models in vitro. Moreover, the results of RNA-seq analysis revealed that cholesterol stimulation promoted neuron death and inhibited angiogenesis, thereby accelerating the progression of DPN. We identified Fos as a potential therapeutic target, given its role in regulating reactive oxygen species (ROS), neuron death, and transcriptional activity. This study provides valuable insights into the molecular mechanisms underlying the interaction between cholesterol and DPN, and highlights the potential for targeting cholesterol metabolism in the treatment of DPN.

OBJECTIVES:In this study, we aimed to assess 18fluorodeoxyglucose (18F-FDG) uptake in patients with type A aortic intramural haematoma (IMH) to establish its association with disease progression. METHODS:Patients with type A IMH receiving medical management were included. After the patient agreed to participate, 18F-FDG PET/CT was performed. The aortic 18F-FDG uptake was measured in standardized uptake value (SUV). The primary outcome was disease progression, which was defined as a condition requiring aortic intervention. The median follow-up was calculated by the inverse Kaplan-Meier method. RESULTS:A total of 32 patients were included in this study. During a median follow-up of 28.3 months (95% CI, 4.8-51.7), 14 events occurred in 14 patients (43.8%). Patients with disease progression had significantly higher SUVmax compared to the stable group (4.9 [SD:1.1] vs 3.5 [SD:1.0], P = .001). ROC curve analysis revealed that an SUVmax cut-off of 4.25 had a sensitivity of 78.6% and specificity of 77.8% for predicting disease progression, with an area under the curve (AUC) of 0.806 (95% CI, 0.653-0.958). The 2-year progression-free survival rates for the SUVmax increased (>4.25) and non-increased (≤4.25) were 20.7% and 75.0% (P = .019), respectively. CONCLUSIONS:Increased aortic 18F-FDG uptake was associated with high risk for adverse aortic events in type A IMH. The SUVmax of 18F-FDG should be considered in the risk stratification and management of these patients.

Hydrogen (H2) has emerged as a highly promising energy carrier owing to its remarkable energy density and carbon emission-free properties. However, the widespread application of H2 fuel has been limited by the difficulty of storage. In this work, spontaneous electrochemical hydrogen production is demonstrated using hydrazine (N2H4) as a liquid hydrogen storage medium and enabled by a highly active Co catalyst for hydrazine electrooxidation reaction (HzOR). The HzOR electrocatalyst is developed by a self-limited growth of Co nanoparticles from a Co-based zeolitic imidazolate framework (ZIF), exhibiting abundant defective surface atoms as active sites for HzOR. Notably, these self-limited Co nanoparticles exhibit remarkable HzOR activity with a negative working potential of -0.1 V (at 10 mA cm-2) in 0.1 m N2H4/1 m KOH electrolyte. Density functional theory (DFT) calculations are employed to validate the superior performance of low-coordinated Co active sites in facilitating HzOR. By taking advantage of the potential difference between HzOR and the hydrogen evolution reaction (HER), a novel HzOR||HER electrochemical system is developed to spontaneously produce H2 without external energy input. Overall, the work offers valuable guidance for developing active HzOR catalyst. The novel HzOR||HER electrochemical system represents a promising and innovative solution for energy-efficient hydrogen production.

The cardiac microenvironment profoundly restricts the efficacy of myocardial regeneration tactics for the treatment of myocardial infarction (MI). A prospective approach for MI therapeutics encompasses the combined strategy of scavenging reactive oxygen species (ROS) to alleviate oxidative stress injury and facilitating macrophage polarization towards the regenerative M2 phenotype. In this investigation, we fabricated a ROS-sensitive hydrogel engineered to deliver our previously engineered IL-1β-VHH for myocardial restoration. In mouse and rat models of myocardial infarction, the therapeutic gel was injected into the pericardial cavity, effectively disseminated over the heart surface, forming an in situ epicardial patch. The IL-1β-VHH released from the hydrogel exhibited penetrative potential into the myocardium. Our results imply that this infarct-targeting gel can adhere to the damaged cardiac tissue and augment the quantity of anti-IL-1β antibodies. Moreover, the anti-IL-1β hydrogel safeguards cardiomyocytes from apoptosis by neutralizing IL-1β and inducing M2-type polarization within the myocardial infarction regions, thereby facilitating therapeutic cardiac repair. Our results emphasize the effectiveness of this synergistic comprehensive treatment modality in the management of MI and showcase its considerable potential for promoting recovery in infarcted hearts.

Highlights Janus quasi-solid electrolyte membranes with asymmetric porous structure were constructed, showing a high σ Li+ of 1.5 × 10 -4 S cm -1 and a high t + of 0.71. The solvation structures and ion transport dynamics in nanopores have been deciphered, manifesting a concentrated electrolyte-like structure and regulated transport behaviors. Quasi-solid NCM 622||Li cells have been demonstrated to stably cycle for 200 cycles at 1 C, and pouch cell has shown high tolerance for abuse.

To enable the practical application of lithium metal batteries, it is crucial to address the challenges of dendrite growth and volume expansion in lithium metal anodes. A 3D framework offers an effective solution to regulate the lithium plating/stripping process. In this work, we present a 3D mixed ion-electron conducting (MIEC) framework as a lithium metal anode, achieved by conformally coating carbon nanotubes (CNTs) onto Li0.5La0.5TiO3 (LLTO) particles. The synergy between LLTO's lithiophilicity and CNTs' high electron conductivity ensures uniform lithium deposition and mitigates volume changes, thereby enhancing the electrochemical performance. As a result, the LLTO@CNT anode demonstrates a high coulombic efficiency of 99.24% for 400 cycles at 1 mA cm-2 in a half-cell, along with excellent cycling stability and prolonged lifespan.

Metal-organic frameworks have emerged as a promising class of solid electrolytes for Li batteries. However, previous efforts to enhance Li-ion conductivity exclusively rely on the incorporation of solvents/salts and modifications of the rigid frameworks. In this study, we demonstrate metal-organic solid electrolytes with superionic conductivity by grafting hemilabile anionic chains with segmental motions in the pore channels of an Al-based metal-organic framework. High room-temperature ionic conductivity of 1.4x10(-5) and 1.1x10(-3) S cm(-1) have been achieved under solvent-free and lean-solvent conditions, respectively. Solid-state nuclear magnetic resonance analysis reveals the localized molecular rotation and vibration of the anionic chains within in the rigid framework. Such segmental molecular dynamics would build Li transport highways and facilitate the Li-ion transport even without solvent. The metal-organic solid electrolyte shows excellent stability against Li metal anode, and the as-developed Li-metal batteries exhibit remarkable rate performance up to 4 C and long lifespan over 300 cycles. This work sheds light on the design principles of advanced metal-organic solid electrolytes for solid-state Li batteries.