The efficacy of different types of cerebral embolic protection device during transcatheter aortic valve implantation: a meta-analysis

AimsPerioperative stroke remains a devastating complication after transcatheter aortic valve implantation (TAVI), and using a cerebral embolic protection device (CEPD) during TAVI may reduce the occurrence of stroke according to some studies. Therefore, we conducted this meta-analysis to determine whether CEPD should be routinely used during TAVI.Methods and resultsThe inclusion criteria for this study were randomized controlled trials (RCTs) that examined the outcome of stroke with or without CEPD during TAVI, with a minimum follow-up period of 30 days. The primary endpoint was the occurrence of stroke (including both cerebrovascular accidents and death due to cerebrovascular accidents). The risk of stroke was lower in the CEPD group: RR 0.68, 95% CI 0.49–0.96, p = 0.03, I2 = 0%. A subgroup analysis was conducted according to the type of CEPD. The risk of stroke was lower in the I&LCCA (filter cover the innominate and the left common carotid arteries) type CEPD group: RR 0.66, 95% CI 0.49–0.96, p = 0.03, I2 = 36%. However, there was no statistically significant difference in the risk of stroke in the TMCA [filter cover the three major cerebral arteries (innominate, left common carotid, and subclavian arteries)] type CEPD group: RR 0.81, 95% CI 0.36–1.80, p = 0.60, I2 = 0%.ConclusionsIn this meta-analysis, the I&LCCA-type CEPD can reduce the risk of stroke within 30 days following TAVI, but the TMCA type cannot

A Robust Nanoparticle Platform for RNA Interference in Macrophages to Suppress Tumor Cell Migration

Macrophages are one of the most abundant immune cells in the solid tumor and their increased density is associated with the specific pathological features of cancers, including invasiveness, metastasis, immunosuppression, neovascularization, and poor response to therapy. Therefore, reprogramming macrophage behavior is emerging as a promising therapeutic modality for cancer treatment. RNA interference (RNAi) technology is one of the powerful strategies for the regulation of macrophage activities by silencing specific genes. However, as polyanionic biomacromolecules, RNAi therapeutics such as small interfering RNA (siRNA) cannot readily cross cell membrane and thus specific delivery vehicles are required to facilitate the cytosolic siRNA delivery. Herein, we developed a robust nanoparticle (NP) platform for efficient siRNA delivery and gene silencing in macrophages. This NP platform is composed of biodegradable poly (ethylene glycol)-b-poly (-caprolactone) (PEG-b-PCL), poly (-caprolactone)-b-poly (2-aminoethyl ethylene phosphate) (PCL-b-PPEEA), and PCL homopolymer. We chose CC-chemokine ligand 18 (CCL-18) as a proof of concept therapeutic target and our results demonstrate that the CCL-18 silencing in macrophages can significantly inhibit the migration of breast cancer cells. The successful regulation of the macrophage behavior demonstrated herein shows great potential as an effective strategy for cancer therapy

Sutureless technique versus conventional surgery in the primary treatment of total anomalous pulmonary venous connection: a systematic review and meta-analysis

Abstract Backgroud A meta-analysis was performed to compare the differences in outcomes between sutureless technique and conventional surgery for primary repair of Total Anomalous Pulmonary Venous Connection(TAPVC). Methods Electronic databases, including PubMed, EMbase, Medline, CNKI, Wanfang Data and Weipu Data were searched systematically for the literature aimed mainly at comparing the therapeutic effects for primary repair of TAPVC administered by sutureless technique and conventional surgery. Corresponding data sets were extracted and two reviewers independently assessed the methodological quality. Results Seven studies meeting the inclusion criteria were included, involving a total of 1293 subjects. It was observed that sutureless technique entailed a lower occurrence rate of post-operative Pulmonary Veins Obstruction (PVO) (OR, 0.52 95%CI, 0.32–0.86; P = 0.01) and re-operation due to PVO (OR, 0.28;95%CI, 0.09–0.87; P = 0.03). However, meta-analyses of hospitalization time (WMD, 5.92; 95%CI, − 7.97-19.80; P = 0.40) and post-operative mortality (OR, 0.65; 95%CI, 0.41–1.04; P = 0.07) showed no significant differences between sutureless technique and conventional surgery. Meta-analysis of Cardiopulmonary Bypass (CPB) time and aortic cross-clamp time also showed no significant differences between the two surgical approaches (WMD, 5.07; 95%CI, − 9.29-19.42; P = 0.49); (WMD, 5.73; 95%CI, − 7.76-19.23; P = 0.40), but the result remained inconclusive due to pooling result changes after sensitivity analysis. Conclusions Compared with conventional surgery, a lower occurrence rate of post-operative PVO and re-operation due to PVO were associated with sutureless technique. Meanwhile, hospitalization time and post-operative mortality were not statistically different between the two surgical approaches. Pooling result of CPB and aortic cross-clamp time between the two groups remained inconclusive

Prompt Graft Cooling Enhances Cardioprotection during Heart Transplantation Procedures through the Regulation of Mitophagy

A complete and prompt cardiac arrest using a cold cardioplegic solution is routinely used in heart transplantation to protect the graft function. However, warm ischemic time is still inevitable during the procedure to isolate donor hearts in the clinical setting. Our knowledge of the mechanism changes prevented by cold storage, and how warm ischemia damages donor hearts, is extremely poor. The potential consequences of this inevitable warm ischemic time to grafts, and the underlying potential protective mechanism of prompt graft cooling, have been studied in order to explore an advanced graft protection strategy. To this end, a surgical procedure, including 10–15 min warm ischemic time during procurement, was performed in mouse models to mimic the clinical situation (Group I), and compared to a group of mice that had the procurement performed with prompt cooling procedures (Group II). The myocardial morphologic changes (including ultrastructure) were then assessed by electron and optical microscopy after 6 h of cold preservation. Furthermore, syngeneic heart transplantation was performed after 6 h of cold preservation to measure the graft heart function. An electron microscopy showed extensive damage, including hypercontracted myofibers with contraction bands, and damaged mitochondria that released mitochondrial contents in Group I mice, while similar patterns of damage were not observed in the mice from Group II. The results from both the electron microscopy and immunoblotting verified that cardiac mitophagy (protective mitochondrial autophagy) was present in the mice from Group II, but was absent in the mice from Group I. Moreover, the mice from Group II demonstrated faster rebeating times and higher beating scores, as compared to the mice from Group I. The pressure catheter system results indicated that the graft heart function was significantly more improved in the mice from Group II than in those from Group I, as demonstrated by the left ventricle systolic pressure (31.96 ± 6.54 vs. 26.12 ± 8.87 mmHg), the +dp/dt (815.6 ± 215.4 vs. 693.9 ± 153.8 mmHg/s), and the -dp/dt: (492.4 ± 92.98 vs. 418.5 ± 118.9 mmHg/s). In conclusion, the warm ischemic time during the procedure impaired the graft function and destroyed the activation of mitophagy. Thus, appropriate mitophagy activation has emerged as a promising therapeutic target that may be essential for graft protection and functional improvement during heart transplantation

Comparison of day surgery between varicose veins with and without superficial venous thrombosis below knee: a propensity score-matched analysis

Abstract Objectives Development of endovenous treatment and sclerotherapy technology makes it feasible for clinicians to treat varicose veins (VV) through day surgery (DS). Superficial venous thrombosis (SVT) of lower extremities is a common complication of VV. This study aimed to investigate whether the existence of SVT below knee affect the safety and efficacy of DS for VV patients. Methods This is a single-center retrospective study. Clinical data of 593 VV patients was retrospectively analyzed. Raw data were matched by the using of propensity score matching model. Operation time, technical failure, postoperative DVT, skin burns, saphenous nerve injury, subcutaneous induration, and bleeding were compared between the groups. Also, we compared VV recurrence, SVT formation, DVT events and the change of VCSS score with 12 months. Results Fifty-nine patients complicated with SVT below knee were matched with 118 patients had VV only. Perioperative and follow-up outcomes were similar in both groups except for the number of incisions (median = 6 [5, 7] VS median = 4 [4, 5], P < 0.001). Both groups experienced a great decrease in VCSS score. Conclusion We systematically compared the clinical outcomes of DS in VV patients. Our results indicate DS is safe and effective for patients with VV, whether accompanied by SVT below the knee. Trial registration The ClinicalTrials.gov identifier for this trial is NCT05380895 (retrospectively registered)

Additional file 1 of Spatiotemporal distribution of migraine in China: analyses based on baidu index

Supplementary Material

Physicochemical Characterization and Chemical Reactivity of Biochar from Pyrolysis of Dried Distiller’s Grains with Solubles (DDGs)

Biomass utilization has attracted great attention for decades, and the dried distiller’s grains with solubles (DDGs) is an important source which is the by-product of brewing industries, as fermented from raw biomass such as rice, wheat and sorghum. Currently, there are a few studies on the kinetics and thermodynamics of distiller’s grains biomass. Therefore, the physicochemical characterization, kinetic and thermodynamic analyses of DDGs and DDGs-biochar were studied. The characterization results confirmed that DDGs had high volatile matter (81.6%) and higher heating value (21.3 MJ kg−1). The pyrolysis kinetics of DDGs and DDGs-biochar at four heating rates of 5, 10, 20 and 40 K min−1 were investigated by non-isothermal thermogravimetric analysis. The isoconversional method such as Kissinger-Akahira-Sunose (KAS), analysis showed that the effective activation energy varied with the change in the conversion rates. For DDGs, it was 122–159 kJ mol−1 (α: 0.1–0.2), 160 ± 6.20 kJ mol−1 (α: 0.20–0.75) and 179–194 kJ mol−1 (α > 0.75), corresponded to thermal decomposition of hemicellulose, cellulose and part of lignin, and remaining lignin respectively; as to combustion of DDGs-biochar, it was 152 to 60.1 kJ mol−1 (α: 0.1–0.9) indicated that some of the more complicated structures in DDGs had been carbonized, making as-obtained biochar easier to burn owing to the lower activation energy. The changes in enthalpy, Gibbs free energy and entropy of DDGs and DDGs-biochar were calculated, and the results were helpful to evaluate the conversion efficiency and technical feasibility of DDGs pyrolysis and DDGs-biochar combustion processes.</p

LncRNA Expression Profile of Human Thoracic Aortic Dissection by High-Throughput Sequencing

Background/Aims: In this study, the long non-coding RNA (lncRNA) expression profile in human thoracic aortic dissection (TAD), a highly lethal cardiovascular disease, was investigated. Methods: Human TAD (n=3) and normal aortic tissues (NA) (n=3) were examined by high-throughput sequencing. Bioinformatics analyses were performed to predict the roles of aberrantly expressed lncRNAs. Quantitative real-time polymerase chain reaction (qRT-PCR) was applied to validate the results. Results: A total of 269 lncRNAs (159 up-regulated and 110 down-regulated) and 2, 255 mRNAs (1 294 up-regulated and 961 down-regulated) were aberrantly expressed in human TAD (fold-change&#x3e; 1.5, P&#x3c; 0.05). QRT-PCR results of five dysregulated genes were consistent with HTS data. A lncRNA-mRNA coexpression analysis showed positive correlations between the up-regulated lncRNA (ENSG00000269936) and its adjacent up-regulated mRNA (MAP2K6, R=0.940, P&#x3c; 0.01), and between the down-regulated lncRNA_1421 and its down-regulated mRNAs (FBLN5, R=0.950, P&#x3c; 0.01; ACTA2, R=0.96, P&#x3c; 0.01; TIMP3, R=0.96, P&#x3c; 0.05). The lncRNA-miRNA-mRNA network indicated that the up-regulated lncRNA XIST and p21 had similar sequences targeted by has-miR-17-5p. The results of luciferase assay and fluorescence immuno-cytochemistry were consistent with that. And qRT-PCR results showed that lncRNA XIST and p21 were expressed at a higher level and has-miR-17-5p was expressed at a lower level in TAD than in NA. The predicted binding motifs of three up-regulated lncRNAs (ENSG00000248508, ENSG00000226530, and EG00000259719) were correlated with up-regulated RUNX1 (R=0.982, P&#x3c; 0.001; R=0.967, P&#x3c; 0.01; R=0.960, P&#x3c; 0.01, respectively). Conclusions: Our study revealed a set of dysregulated lncRNAs and predicted their multiple potential functions in human TAD. These findings suggest that lncRNAs are novel potential therapeutic targets for human TAD

ZBTB20 Positively Regulates Oxidative Stress, Mitochondrial Fission, and Inflammatory Responses of ox-LDL-Induced Macrophages in Atherosclerosis

Atherosclerosis (AS) is one of the most serious and common cardiovascular diseases affecting human health. AS is featured by the accumulation of plaques in vessel walls. The pathophysiology of AS is relevant in the low-density lipoprotein (LDL) uptake by macrophages, as well as the conversion of macrophages to foam cells. However, the mechanisms about how macrophages regulate AS have not been fully elucidated. In this study, we aimed to illuminate the roles of ZBTB20 and to excavate the underlying regulative mechanisms of ZBTB20 in AS. The microarray analysis revealed that ZBTB20 was a hub gene in the oxidative stress and inflammatory responses induced by oxidized LDL (ox-LDL) in AS. Correspondingly, our validation studies showed that ZBTB20 increased in either the human atherosclerotic lesion or the ox-LDL-stimulated macrophages. Moreover, the knockdown of ZBTB20 decreased M1 polarization, suppressed the proinflammatory factors, inhibited mitochondrial fission, and reduced the oxidative stress level of macrophages induced by ox-LDL. The mechanistic studies revealed that the ZBTB20 knockdown suppressed NF-κB/MAPK activation and attenuated the mitochondrial fission possibly via regulating the nucleus translocation of NRF2, a pivotal transcription factor on redox homeostasis. Our in vivo studies showed that the sh-ZBTB20 adenovirus injection could reduce the progression of AS in apolipoprotein E-deficient (ApoE-/-) mice. All in all, these results suggested that ZBTB20 positively regulated the oxidative stress level, mitochondrial fission, and inflammatory responses of macrophages induced by ox-LDL, and the knockdown of ZBTB20 could attenuate the development of AS in ApoE-/- mice