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Birth weight,ideal cardiovascular health metrics in adulthood,and incident cardiovascular disease

Chinese medical Journal 2024年第10期137卷 1160-1168页

作者： Ying sun Bin Wang Yuefeng Yu Yuying Wang Xiao Tan Jihui Zhang Lu Qi Yingli Lu Ningjian Wang Department of Endocrinology and Metabolism Institute of Endocrinology and MetabolismShanghai Ninth People’s HospitalShanghai Jiao Tong University School of MedicineShanghai 200011China school of Public Health Zhejiang UniversityHangzhouZhejiang 310058China Department of medical sciences Uppsala UniversityUppsala 75105Sweden center for sleep and Circadian Medicine The Affiliated Brain Hospital of Guangzhou Medical UniversityGuangzhouGuangdong 510370China Department of Epidemiology School of Public Health and Tropical MedicineTulane UniversityNew OrleansLA 70118USA Department of Nutrition Harvard T.H.Chan School of Public HealthBostonMA 02138USA Channing Division of Network Medicine Department of MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonMA 02138USA

Background:Prenatal and postnatal factors may have joint effects on cardiovascular health,and we aimed to assess the joint association of birth weight and ideal cardiovascular health metrics(ICVHMs)prospectively in adulthood with incident cardiovascular disease(CVD).Methods:In the UK Biobank,227,833 participants with data on ICVHM components and birth weight and without CVD at baseline were *** ICVHMs included smoking,body mass index,physical activity,diet information,total cholesterol,blood pressure,and hemoglobin *** Cox proportional hazards model was used to estimate the hazard ratios(HRs)and 95%confidence intervals(CIs)in men and ***:Over a median follow-up period of 13.0 years(2,831,236 person-years),we documented 17,477 patients with incident *** with participants with birth weights of 2.5-4.0 kg,the HRs(95%CIs)of CVD among those with low birth weights was 1.08(1.00-1.16)in men and 1.23(1.16-1.31)in *** association between having a birth weightsk in men was more prominent for those ageds than for those of older age(P for interaction=0.026).Lower birth weight and non-ideal cardiovascular health metrics were jointly related to an increased risk of *** with birth weightss score 0-1 had the highest risk of incident CVD(HR[95%CI]:3.93[3.01-5.13]in men;4.24[3.33-5.40]in women).The joint effect(HR[95%CI]:1.36[1.17-1.58])could be decomposed into 24.7%(95%CI:15.0%-34.4%)for a lower birth weight,64.7%(95%CI:56.7%-72.6%)for a lower ICVHM score,and 10.6%(95%CI:2.7%-18.6%)for their additive interaction in ***:Birth weight and ICVHMs were jointly related to CVD *** a normal birth weight and ideal ICVHMs may reduce the risk of CVD,and a simultaneous improvement of both prenatal and postnatal factors could further prevent additional cases in women.

关键词： Birth weight Health metrics Cardiovascular disease Adult stroke Coronary heart disease

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safety of high-carbohydrate fluid diet 2 h versus overnight fasting before non-emergency endoscopic retrograde cholangiopancreatography:A single-blind,multicenter,randomized controlled trial

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Chinese medical Journal 2024年第12期137卷 1437-1446页

作者： Wenbo Meng Joseph W.Leung Zhenyu Wang Qiyong Li Leida Zhang Kai Zhang Xuefeng Wang Meng Wang Qi Wang Yingmei shao Jijun Zhang Ping Yue Lei Zhang Kexiang Zhu Xiaoliang Zhu Hui Zhang senlin Hou Kailin Cai Hao sun Ping Xue Wei Liu Haiping Wang Li Zhang songming Ding Zhiqing Yang Ming Zhang Hao Weng QingyuanWu Bendong Chen Tiemin Jiang Yingkai Wang Lichao Zhang Ke Wu Xue Yang Zilong Wen Chun Liu LongMiao Zhengfeng Wang Jiajia Li Xiaowen Yan Fangzhao Wang Lingen Zhang Mingzhen Bai Ningning Mi XianzhuoZhang Wence Zhou Jinqiu Yuan Azumi suzuki Kiyohito Tanaka Jiankang Liu Ula Nur Elisabete Weiderpass Xun Li Department of General surgery The First Hospital of Lanzhou UniversityLanzhouGansu 730000China Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province LanzhouGansu 730000China Division of Gastroenterology and Hepatology UC Davis Medical CenterSacramentoCA 95816USA Department of Minimally Invasive surgery Tianjin Nankai HospitalTianjin 300100China Division of Hepatobiliary and Pancreatic surgery Department of SurgeryShulan(Hangzhou)Hospital Affiliated to Zhejiang Shuren UniversityHangzhouZhejiang 310000China Department of Hepatobiliary surgery Southwest HospitalArmy Medical UniversityChongqing 400000China Hepatobiliary surgery Department Shandong Provincial Third HospitalJinanShandong 250000China Department of General surgery Xinhua HospitalAffiliated to Shanghai Jiao Tong University School of MedicineShanghai Key Laboratory of Biliary Tract Disease ResearchShanghai 200000China Department of Hepatobiliary and Pancreatic surgery The First Hospital of Jilin UniversityChangchunJilin 130000China Department of Hepatobiliary surgery The General Hospital of Ningxia Medical UniversityYinchuanNingxia 750000China Department of Hepatobiliary&Hydatid Digestive and Vascular Surgery CenterXinjiang Key Laboratory of Echinococcosis and Liver Surgery ResearchThe First Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjiang 830000China Department of Hepatobiliary and Pancreatic surgery The First Hospital of Shanxi Medical UniversityTaiyuanShanxi 030000China Department of General surgery The Second Hospital of Lanzhou UniversityLanzhouGansu 730000China Department of Biliopancreatic Endoscopic surgery The Second Hospital of Hebei Medical UniversityShijiazhuangHebei 050000China Gastrointestinal surgery Department Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430000China Department of Hepatobiliary surgery The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anShaanxi 710000China Depart

Background:Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography(ERCP),the benefits and safety of high-carbohydrate fluid diet(CFD)intake 2 h before ERCP remain *** study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’***:This prospective,multicenter,randomized controlled trial involved 15 tertiary ERCP centers.A total of 1330 patients were randomized into CFD group(n=665)and fasting group(n=665).The CFD group received 400 mL of maltodextrin orally 2 h before ERCP,while the control group abstained from food/water overnight(>6 h)before *** ERCP procedures were performed using deep sedation with intravenous *** investigators were blinded but not the *** primary outcomes included postoperative fatigue and abdominal pain score,and the secondary outcomes included complications and changes in metabolic *** outcomes were analyzed according to a modified intention-to-treat ***:The post-ERCP fatigue scores were significantly lower at 4 h(4.1±2.6 vs.4.8±2.8,t=4.23,Ps.3.4±2.4,t=7.94,Pst-squares mean differences of 0.48(95%confidence interval[CI]:0.26-0.71,Pscores(2.1±1.7 vs.2.2±1.7,t=2.60,P=0.009,with a least-squares mean difference of 0.21[95%CI:0.05-0.37])and positive urine ketone levels(7.7%[39/509]vs.15.4%[82/533],χ^(2)=15.13,Psignificantly less cholangitis(2.1%[13/634]vs.4.0%[26/658],χ^(2)=3.99,P=0.046)but not pancreatitis(5.5%[35/634]vs.6.5%[43/658],χ^(2)=0.59,P=0.444).subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla(odds ratio[OR]:0.61,95%CI:0.39-0.95,P=0.028)in the multivariable ***:Ingesting 400 mL of CFD 2 h before ERCP is safe,with a reduction in post-ERCP fatigue,

关键词： Endoscopic retrograde cholangiopancreatography ERCP Carbohydrate Fasting safety Complications Enhanced recovery after surgery Randomized controlled trial

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Linking the Paul Coverdell National Acute stroke Program to commercial claims to establish a framework for real-world longitudinal stroke research

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stroke & vascular Neurology 2022年第2期7卷 114-123页

作者： Elisabetta Patorno sebastian schneeweiss Mary G George Xin Tong Jessica M Franklin Ajinkya Pawar Helen Mogun Lidia M V R Moura Lee H schwamm Division of Pharmacoepidemiology and Pharmacoeconomics Department of MedicineBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA Division for heart Disease and stroke Prevention NCCDPHPCenters for Disease Control and PreventionAtlantaGeorgiaUSA Epilepsy and Neurophysiology Division Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA Fireman vascular center and stroke Division Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA

Background Non-interventional large-scale research on real-world patients who had a stroke requires the use of multiple data sources ensuring access to longitudinal data from large populations with clinically-detailed *** sought to establish a framework for longitudinal research on patients hospitalised with stroke by linking information-rich,deidentified inpatient data from the Paul Coverdell National Acute stroke Program(PCNAsP)to commercial and Medicare Advantage longitudinal claims *** All stroke admissions in PCNAsP between 2008 and 2015 were evaluated for linkage to longitudinal claims from a commercial insurer using an algorithm based on six available common data fields(patient age,gender,admission date,discharge date,discharge diagnosis and state)and a hospital *** evaluated the linkage quality(via the percentage of unique records in the linked dataset)and the representativeness of the linked *** also described medical history,stroke severity and patterns of medication use among the PCNAsP-claims linked *** The linkage produced uniqueness equal to 99.1%.We identified 5644 linked and 98896 unlinked patients who had an ischaemic stroke hospitalisation in claims *** patients were younger than unlinked(69.7 vs 72.5 years),but otherwise similar by medical history,prestroke medication use or lab *** severity was mild and most patients were discharged *** and discharge use of antihypertensive and statins in the PCNAsP were greater than their use as measured by filled prescriptions in *** High-quality linkage between the PCNAsP and commercial claims data is *** linkage identified differences between reported or recommended versus actual out-of-hospital medication utilisation,highlighting the importance of longitudinal data availability for research aimed to improve the care of patients who had a stroke.

关键词： linkage claims younger

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Pre-Lung transplant reflux testing demonstrates high prevalence of gastroesophageal reflux in cystic fibrosis and reduces chronic rejection risk

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World Journal of Transplantation 2023年第4期13卷 138-146页

作者： Wai-Kit Lo Ryan Flanagan Nirmal sharma Hilary J Goldberg Walter W Chan Division of Gastroenterology Hepatology and EndoscopyBrigham and Women's HospitalHarvard Medical SchoolBostonMA Division of Pulmonary and Critical Care Medicine Brigham and Women's HospitalHarvard Medical SchoolBostonMA 02115United States

BACKGROUND Gastroesophageal reflux(GER)has been associated with poor outcomes after lung transplantation for chronic lung disease,including increased risk of chronic *** is common in cystic fibrosis(CF),but factors influencing the likelihood of pre-transplant pH testing,and the impact of testing on clinical management and transplant outcomes in patients with CF are *** To evaluate the role of pre-transplant reflux testing in the evaluation of lung transplant candidates with *** This was a retrospective study from 2007-2019 at a tertiary medical center that included all patients with CF undergoing lung *** with pretransplant anti-reflux surgery were *** characteristics(age at transplantation,gender,race,body mass index),self-reported GER symptoms prior to transplantation,and pre-transplant cardiopulmonary testing results,were *** testing consisted of either 24-h pH-or combined multichannel intraluminal impedance and pH ***-transplant care included a standard immunosuppressive regimen,and regular surveillance bronchoscopy and pulmonary spirometry in accordance with institutional practice as well as in symptomatic *** primary outcome of chronic lung allograft dysfunction(CLAD)was defined clinically and histologically per International society of heart and Lung Transplantation *** analysis was performed with Fisher’s exact test to assess differences between cohorts,and time-to-event Cox proportional hazards *** After applying inclusion and exclusion criteria,a total of 60 patients were included in the *** all CF patients,41(68.3%)completed reflux monitoring as part of pre-lung transplant *** evidence of pathologic reflux,defined as acid exposure time>4%,was found in 24 subjects,representing 58%of the tested *** patients with pre-transplant reflux testing were older(35.8 vs 30.1 years,P=0.01)and more commonly reported typical

关键词： Cystic fibrosis Gastroesophageal reflux Lung transplantation pH monitoring

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What do the recent American heart Association/American College of Cardiology Foundation Clinical Practice Guidelines tell us about the evolving management of coronary heart disease in older adults?

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Journal of Geriatric Cardiology 2013年第2期10卷 123-128页

作者： Daniel Forman Nanette K Wenger harvard medical school Brigham and Women's Hospital Boston MA 02115USA Emory University school of Medicine Emory Heart and Vascular Center Atlanta GA 30303 USA

Biological aging predisposes older adults to increased cardiovascular disease (CHD) and greater disease complexity. Given the high age-related prevalence of CHDand age-related compounding factors, the recently updatedAmerican heartAssociation/American College of Cardiology Foundation CHD-related guidelines increased their focus on older patients. These guidelines are predominately evidence-based (using data from quality randomized clinical trials) and are organized to delineate medications and procedures that best treat particular cardiovascular *** such rationale and thought work well in young and middle aged adults, they become problematic in patientswho are very old. Data pertaining to adults aged ≥80 are virtually absent from most randomized clinical trials, and even in the instances when very old patients were included, eligibility criteria typically excluded candidates with co-morbidities and complexities of customary CHD patients. While medications and interventions yielding benefit in clinical trials should theoretically produce the greatest benefits for patients with high intrinsic risk, age-related cardiovascular complexities also increase iatrogenic risks. Navigating between the potential for high benefit and high risk in “evidence-based”cardiovascular management remains a key Geriatric Cardiology challenge. In this review we consider the expanded Geriatric Cardiology content of current guidelines, acknowledging both the progress that has been made, as well as the work that still needs to be accomplished to truly address the patient-centered priorities of older CHDpatients.

关键词： Cardiovascular disease Elderly patient Guidelines

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Emerging vaccine nanotechnology: From defense against infection to sniping cancer

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Acta Pharmaceutica sinica B 2022年第5期12卷 2206-2223页

作者： Chan Feng Yongjiang Li Bijan Emiliano Ferdows Dylan Neal Patel Jiang Ouyang Zhongmin Tang Na Kong Enguo Chen Wei Tao Department of Respiratory Medicine Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China center for Nanomedicine and Department of Anesthesiology Brigham and Women’s HospitalHarvard Medical SchoolBostonMA 02115USA Cancer center Zhejiang UniversityHangzhou 310058China Department of Pharmacy the Second Xiangya Hospital of Central South UniversityChangsha 410011China

Looking retrospectively at the development of humanity, vaccination is an unprecedented medical landmark that saves lives by harnessing the human immune system. During the ongoing coronavirus disease 2019(COVID-19) pandemic, vaccination is still the most effective defense modality. The successful clinical application of the lipid nanoparticle-based Pfizer/BioNTech and Moderna mRNA COVID-19 vaccines highlights promising future of nanotechnology in vaccine development. Compared with conventional vaccines, nanovaccines are supposed to have advantages in lymph node accumulation,antigen assembly, and antigen presentation;they also have, unique pathogen biomimicry properties because of well-organized combination of multiple immune factors. Beyond infectious diseases, vaccine nanotechnology also exhibits considerable potential for cancer treatment. The ultimate goal of cancer vaccines is to fully mobilize the potency of the immune system as a living therapeutic to recognize tumor antigens and eliminate tumor cells, and nanotechnologies have the requisite properties to realize this *** this review, we summarize the recent advances in vaccine nanotechnology from infectious disease prevention to cancer immunotherapy and highlight the different types of materials, mechanisms, administration methods, as well as future perspectives.

关键词： Vaccine Nanotechnology Infection Cancer Nanovaccines Vaccination Diseases prevention Immunotherapy

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A multifunctional nanotheranostic agent potentiates erlotinib to EGFR wild-type non-small cell lung cancer

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Bioactive Materials 2022年第7期7卷 312-323页

作者： Duo Wang Jun Zhou Weimin Fang Cuiqing Huang Zerong Chen Meng Fan Ming-Rong Zhang Zeyu Xiao Kuan Hu Liangping Luo medical Imaging center The First Affiliated Hospital of Jinan UniversityGuangzhou510632PR China The Guangzhou Key Laboratory of Molecular and Functional Imaging for Clinical Translation Jinan UniversityGuangzhou510632PR China Department of Advanced Nuclear Medicine sciences Institute of Quantum Medical ScienceNational Institutes for Quantum and Radiological Science and TechnologyChiba263-8555Japan center for Nanomedicine and Department of Anesthesiology Brigham and Women’s HospitalHarvard Medical SchoolBostonMA02115USA

Epidermal growth factor receptor(EGFR)tyrosine kinase inhibitors(TKI),such as Erlotinib,have demonstrated remarkable efficacy in the treatment of non-small cell lung cancer(NsCLC)patients with mutated ***,the efficacy of EGFR-TKIs in wild-type(wt)EGFR tumours has been shown to be *** that can sensitize Erlotinib to EGFR wild-type NsCLC remain ***,we developed a multifunctional superparamagnetic nanotheranostic agent as a novel strategy to potentiate Erlotinib to EGFR-wt *** results demonstrate that the nanoparticles can co-escort Erlotinib and a vascular epithermal growth factor(VEGF)inhibitor,Bevacizumab(Bev),to EGFR-wt *** nanotheranostic agent exhibits remarkable effects as an inhibitor of EGFR-wt tumour ***,Bev normalizes the tumour embedded vessels,further promoting the therapeutic efficacy of *** addition,the tumour engagement of the nanoparticles and the vascular normalization could be tracked by magnetic resonance imaging(MRI).Collectively,our study,for the first time,demonstrated that elaborated nanoparticles could be employed as a robust tool to potentiate Erlotinib to EGFR-wt NsCLC,paving the way for imaging-guided nanotheranostics for refractory NsCLCs expressing EGFR wild-type genes.

关键词： Non-small cell lung cancer EGFR wild-Type superparamagnetic iron oxide Erlotinib Bevacizumab Tumour vascular normalization

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heart rate response and recovery during exercise predict future delirium risk——A prospective cohort study in middle-to older-aged adults

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Journal of sport and Health science 2023年第3期12卷 312-323页

作者： Lei Gao Aden Gaba Peng Li Richa saxena Frank A.J.Lscheer Oluwaseun Akeju Martin K.Rutter Kun Hu Department of Anesthesia Critical Care and Pain MedicineMassachusetts General HospitalHarvard Medical SchoolBostonMA 02114USA medical Biodynamics Program Brigham and Women's HospitalBostonMA 02115USA Division of sleep Medicine Harvard Medical SchoolBostonMA 02115USA Broad Institute of Massachusetts Institute of Technology and harvard CambridgeMA 02142USA center for Genomic Medicine Massachusetts General HospitalBostonMA 02114USA Division of Diabetes Endocrinology and GastroenterologySchool of Medical SciencesFaculty of BiologyMedicine and HealthManchester Academic Health Science CentreUniversity of ManchesterManchester M139PLUK Diabetes Endocrinology and Metabolism CentreManchester University National Health Service Foundation TrustManchester M139WLUK

Background:Delirium is a neurocognitive disorder characterized by an abrupt decline in attention,awareness,and cognition after surgical/illness-induced stressors on the *** is now an increasing focus on how cardiovascular health interacts with neurocognitive disorders given their overlapping risk factors and links to subsequent dementia and *** common indicator for cardiovascular health is the heart rate response/recovery(HRR)to exercise,but how this relates to future delirium is ***:Electrocardiogram data were examined in 38,740 middle-to older-aged UK Biobank participants(mean age=58.1 years,range:40-72 years;47.3%males)who completed a standardized submaximal exercise stress test(15-s baseline,6-min exercise,and 1-min recovery)and required hospitalization during *** HRR index was derived as the product of the heart rate(HR)responses during exercise(peak/resting HRs)and recovery(peak/recovery HRs)and categorized into low/average/high groups as the bottom quartile/middle 2 quartiles/top quartile,*** between 3 HRR groups and new-onset delirium were investigated using Cox proportional hazards models and a2-year landmark analysis to minimize reverse *** factors,lifestyle factors/physical activity,cardiovascular risk,comorbidities,cognition,and maximal workload achieved were included as ***:During a median follow-up period of 11 years,348 participants(9/1000)newly developed *** with the high HRR group(16/1000),the risk for delirium was almost doubled in those with low HRR(hazard ratio=1.90,95%)confidence interval(95%CI):1.30-2.79,p=0.001)and average HRR(hazard ratio=1.54,95%CI:1.07-2.22,p=0.020)).Low HRR was equivalent to being 6 years older,a current smoker,or>3 additional cardiovascular disease *** were robust in sensitivity analysis,but the risk appeared larger in those with better cognition and when only postoperative delirium was considered(n=1

关键词： Brain health Delirium Exercise stress test UK Biobank

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A facile and general method for synthesis of antibiotic-free protein-based hydrogel:Wound dressing for the eradication of drug-resistant bacteria and biofilms

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Bioactive Materials 2022年第12期7卷 446-458页

作者： Jiang Ouyang Qingyue Bu Na Tao Mingkai Chen Haijun Liu Jun Zhou Jinggong Liu Bo Deng Na Kong Xingcai Zhang Tianfeng Chen Yihai Cao Wei Tao The First Affiliated hospital Department of ChemistryJinan UniversityGuangzhou510632China center for Nanomedicine and Department of Anesthesiology Brigham and Women’s HospitalHarvard Medical SchoolBostonMA02115USA John A.Paulson school of Engineering and Applied sciences Harvard UniversityCambridgeMA02138USA College of Chemistry and Chemical Engineering Central South UniversityChangshaHunan410083China The second Affiliated hospital of Guangzhou University of Chinese Medicine Guangdong Provincial Academy of Chinese Medical SciencesGuangzhou510006China Department of Microbiology Tumor and Cell BiologyKarolinska InstituteStockholm17177Sweden

Antibacterial protein hydrogels are receiving increasing attention in the aspect of bacteria-infected-wound healing. However, bacterial drug resistance and biofilm infections lead to hard healing of wounds, thus the construction of biological agents that can overcome these issues is essential. Here, a simple and universal method to construct antibiotic-free protein hydrogel with excellent biocompatibility and superior antibacterial activity against drug-resistant bacteria and biofilms was developed. The green industrial microbicide tetrakis (hydroxymethyl) phosphonium sulfate (THPs) as cross-linking agent can be quickly cross-linked with model protein bovine serum albumin (BsA) to form antibacterial hydrogel through simple mixing without any other initiators, subsequently promoting drug-resistance bacteria-infected wound healing. This simple gelatinization strategy allows at least ten different proteins to form hydrogels (e.g. BsA, human serum albumin (HsA), egg albumin, chymotrypsin, trypsin, lysozyme, transferrin, myohemoglobin, hemoglobin, and phycocyanin) under the same conditions, showing prominent universality. Furthermore, drug-resistance bacteria and biofilm could be efficiently destroyed by the representative BsA hydrogel (B-Hydrogel) with antibacterial activity, overcoming biofilm-induced bacterial resistance. The in vivo study demonstrated that the B-Hydrogel as wound dressing can promote reepithelization to accelerate the healing of methicillin-resistant staphylococcus aureus (MRsA)-infected skin wounds without inducing significant side-effect. This readily accessible antibiotic-free protein-based hydrogel not only opens an avenue to provide a facile, feasible and general gelation strategy, but also exhibits promising application in hospital and community MRsA disinfection and treatment.

关键词： THPs Protein hydrogel Bacterial resistance Anti-Biofilm Wound dressing

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COVID-19,the Pandemic of the Century and Its Impact on Cardiovascular Diseases

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Cardiology Discovery 2021年第4期1卷 233-258页

作者： Yuanyuan Zhang Mingjie Wang Xian Zhang Tianxiao Liu Peter Libby Guo-Ping shi Department of Medicine Brigham and Women’s Hospital and Harvard Medical SchoolBostonMassachusetts 02115USA

COVID-19 caused by severe acute respiratory syndrome coronavirus 2(sARs-CoV-2)infection likely ranks among the deadliest diseases in human *** with other coronaviruses,sARs-CoV-2 infection damages not only the lungs but also the heart and many other organs that express angiotensin-converting enzyme 2(ACE2),a receptor for ***-19 has upended lives *** behaviors have been altered such that they favor metabolic and cardiovascular complications,while patients have avoided hospital visits because of limited resources and the fear of infection,thereby increasing out-hospital mortality due to delayed diagnosis and *** observations show that sex,age,and race all influence the risk for sARs-CoV-2 infection,as do hypertension,obesity,and pre-existing cardiovascular *** hospitalized COVID-19 patients suffer cardiac injury,acute coronary syndromes,or cardiac ***-CoV-2 infection may lead to cardiomyocyte apoptosis and necrosis,endothelial cell damage and dysfunction,oxidative stress and reactive oxygen species production,vasoconstriction,fibrotic and thrombotic protein expression,vascular permeability and microvascular dysfunction,heart inflammatory cell accumulation and activation,and a cytokine *** data indicate that COVID-19 patients with cardiovascular diseases should not discontinue many existing cardiovascular therapies such as ACE inhibitors,angiotensin receptor blockers,steroids,aspirin,statins,and PCsK9 *** review aims to furnish a framework relating to COVID-19 and cardiovascular pathophysiology.

关键词： COVID-19 severe acute respiratory syndrome coronavirus 2 Cardiovascular disease Angiotensin-converting enzyme 2 Hypertension Risk factor

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