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Enhanced diagnostic workup increases pathological findings in patients with acute ischaemic stroke:results of the prospective HEBRAS study

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Stroke & Vascular Neurology 2024年第2期9卷 145-152,I0414-I0425页

作者： Simon Hellwig Thomas Krause Jan F Scheitz Juliane Herm Ulrike Grittner Nadja Jauert Jochen B Fiebach Mario Kasner Wolfram Doehner Matthias Endres Rolf Wachter Thomas Elgeti Christian H Nolte Karl Georg Haeusler Department of Neurology with Experimental Neurology Charité-Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt-Universität zu BerlinBerlinGermany Center for Stroke Research Berlin BerlinGermany Berlin Institute of Health at Charité–Universitätsmedizin Berlin BIH Biomedical Innovation AcademyBerlinGermany Department of Neurology Jüdisches Krankenhaus BerlinBerlinGermany German Center for Cardiovascular Diseases(DZHK) Partner Site BerlinBerlinGermany Institute of Biometry and Clinical Epidemiology Charité-Universitätsmedizin BerlinBerlinGermany BIH Center for Regenerative Therapies(BCRT) Berlin Institute of Health at Charité–Universitätsmedizin BerlinBerlinGermany Department of cardiology Charité-Universitätsmedizin BerlinBerlinGermany Department of cardiology Campus Benjamin FranklinCharité-Universitätsmedizin BerlinBerlinGermany German Center for Neurodegenerative Diseases(DZNE) Partner Site BerlinBerlinGermany Department of cardiology University Hospital LeipzigLeipzigGermany Department of Radiology Charité-Universitätsmedizin BerlinBerlinGermany Department of Neurology University Hospital WürzburgWürzburgGermany

Background Stroke aetiology remains cryptogenic in a relevant proportion of patients with acute ischaemic stroke(AIS).We assessed whether enhanced diagnostic workup after AIS yields a higher rate of prespecified pathological findings compared with routine diagnostic care *** Hospitalised patients with AIS were prospectively enrolled in the investigator-initiated observational HEart and BRain Interfaces in Acute Ischaemic Stroke(HEBRAS)study at the Charité,Berlin,*** with AIS without known atrial fibrillation(AF)underwent cardiovascular MR imaging(CMR),MR-angiography of the aortic arch and prolonged Holter-ECG monitoring on top of routine diagnostic *** Among 356 patients with AIS(mean age 66 years,37.6%female),enhanced workup yielded a higher rate of prespecified pathological findings compared with routine care(17.7%vs 5.3%;p<0.001).Consequently,fewer patients were classified as cryptogenic after enhanced diagnostic workup(38.5%vs 45.5%,p<0.001).Routine care included echocardiography in 228(64.0%)*** was successfully performed in 292(82.0%)patients and revealed more often a prespecified pathological finding compared with routine echocardiography(16.1%vs 5.3%).Furthermore,study-related ECG monitoring(median duration 162 hours(IQR 98–210))detected AF in 16(4.5%)patients,while routine monitoring(median duration 51 hours(IQR 34–74))detected AF in seven(2.0%)*** Enhanced diagnostic workup revealed a higher rate of prespecified pathological findings in patients with AIS compared with routine diagnostic care and significantly reduced the proportion of patients with cryptogenic *** registration number NCT02142413.

关键词： routine patients prospective

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Glucagon-like peptide-1 receptor agonists:Exploring the mechanisms from glycemic control to treatment of multisystemic diseases

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World Journal of Gastroenterology 2024年第36期30卷 4036-4043页

作者： Mo-Wei Kong Yang Yu Ying Wan Yu Gao Chun-Xiang Zhang Department of cardiology Southwest Medical UniversityLuzhou 646000Sichuan ProvinceChina School of Basic Medical Sciences Southwest Medical UniversityLuzhou 646000Sichuan ProvinceChina Department of Endocrinology The Affiliated Hospital of Chengde Medical CollegeChengde 067000Hebei ProvinceChina Department of cardiology The Affiliated Hospital of Southwest Medical UniversityLuzhou 646000Sichuan ProvinceChina Key Laboratory of Medical Electrophysiology Ministry of EducationInstitute of Cardiovascular ResearchBasic Medicine Research Innovation Center for Cardiometabolic DiseasesMinistry of EducationNucleic Acid Medicine of Luzhou Key LaboratorySouthwest Medical UniversityLuzhou 646000Sichuan ProvinceChina

This editorial takes a deeper look at the insights provided by Soresi and Giannitrapani,which examined the therapeutic potential of glucagon-like peptide-1 receptor agonists(GLP-1RAs)for metabolic dysfunction-associated fatty liver *** provide supplementary insights to their research,highlighting the broader systemic implications of GLP-1RAs,synthesizing the current understanding of their mechanisms and the trajectory of research in this ***-1RAs are revolutionizing the treatment of type 2 diabetes mellitus and *** glycemic control,GLP-1RAs demonstrate cardiovascular and renal protective effects,offering potential in managing diabetic kidney disease alongside renin–angiotensin–aldosterone system *** role in bone metabolism hints at benefits for diabetic osteoporosis,while the neuroprotective properties of GLP-1RAs show promise in Alzheimer's disease treatment by modulating neuronal insulin ***,they improve hormonal and metabolic profiles in polycystic ovary *** editorial highlights the multifaceted mechanisms of GLP-1RAs,emphasizing the need for ongoing research to fully realize their therapeutic potential across a range of multisystemic diseases.

关键词： Glucagon-like peptide-1 receptor agonists Glycemic control Multisystem diseases Mechanism of action Cardiovascular protection Renal disease Bone metabolism Non-alcoholic fatty liver disease Neuroprotection Polycystic ovary syndrome

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Subclinical impairment of left ventricular myocardium function in type 2 diabetes mellitus patients with or without hypertension

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World Journal of Diabetes 2024年第6期15卷 1272-1279页

作者： Zeng-Guang Chen Guang-An Li Jun Huang Li Fan Department of cardiology The Affiliated Changzhou Second People’s Hospital with Nanjing Medical UniversityChangzhou 213000Jiangsu ProvinceChina Department of Echocardiography The Affiliated Changzhou Second People’s Hospital with Nanjing Medical UniversityChangzhou 213000Jiangsu ProvinceChina

BACKGROUND Cardiovascular disease has been the leading cause of morbidity and mortality for type 2 diabetes mellitus(T2DM)patients over the last *** To determine whether layer-specific global longitudinal strain(GLS)combined with peak strain dispersion(PSD)can be used to assess left ventricle(LV)myocardium systolic dysfunction in T2DM patients or without hypertension(HP).METHODS We enrolled 97 T2DM patients,70 T2DM+HP patients and 101 healthy ***-specific GLS and PSD were calculated by EchoPAC software in apical three-,four-and two-chamber *** of the epimyocardial,middle-layer and endomyocardial(GLSepi,GLSmid,and GLSendo)were measured and *** operating characteristic analysis was performed to detect LV myocardium systolic dysfunction in T2DM *** There were significant differences in GLSepi,GLSmid,GLSendo,and PSD between healthy subjects,T2DM patients and T2DM patients with HP(PT2DM patients>T2DM with HP patients in the absolute values of GLSepi,GLSmid and GLSendo(P<0.001),while PSD was ranked healthy subjects

关键词： Type 2 diabetes mellitus Hypertension Speckle tracking echocardiography Global longitudinal strain Peak strain dispersion

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Cellular senescence-driven transcriptional reprogramming of the MAFB/NOTCH3 axis activates the PI3K/AKT pathway and promotes osteosarcoma progression

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Genes & Diseases 2024年第2期11卷 952-963页

作者： Zhenhao Zhang Doudou Jing Baijun Xuan Zhicai Zhang Wei Wu Zengwu Shao Department of Orthopedics Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430022China Department of Orthopedics The Second Hospital of Shanxi Medical UniversityTaiyuanShanxi 030001China Department of cardiology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430022China

Osteosarcoma is the most common primary malignancy of bones and primarily occurs in adolescents and young ***,a second smaller peak of osteosarcoma incidence was reported in the elderly aged more than *** patients with osteosarcoma exhibit different characteristics compared to young patients,which usually results in a poor *** mechanism underlying osteosarcoma development in elderly patients is intriguing and of significant value in clinical *** cells can accelerate tumor progression by metabolic *** research has shown that methylmalonic acid(MMA)was significantly up-regulated in the serum of older individuals and played a central role in the development of aggressive *** found that the significant accumulation of MMA in elderly patients imparted proliferative potential to osteosarcoma *** expression of MAFB was excessively up-regulated in osteosarcoma specimens and was further enhanced in response to MMA accumulation as the patient ***,we first confirmed a novel molecular mechanism between cellular senescence and cancer,in which the MMA-driven transcriptional reprogramming of the MAFB-NOTCH3 axis accelerated osteosarcoma progression via the activation of PI3K-AKT ***,the down-regulation of the MAFB-NOTCH3 axis increased the sensitivity and effect of AKT inhibitors in osteosarcoma through significant inhibition of AKT *** conclusion,we confirmed that MAFB is a novel age-dependent biomarker for osteosarcoma,and targeting the MAFB-NOTCH3 axis in combination with AKT inhibition can serve as a novel therapeutic strategy for elderly patients with osteosarcoma in experimental and clinical trials.

关键词： Cellular senescence Elderly patients MAFB-NOTCH3axis Methylmalonic acid Osteosarcoma PI3K-AKTpathway

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Treg Immunomodulation Contributes to the Anti-atherosclerotic Effects of Huxin Formula in ApoE^(-/-)Mice

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Chinese Journal of Integrative Medicine 2024年第10期30卷 896-905页

作者： OU Xiao-min CAI Jing HU Xiao-yue ZENG Qiao-huang LAN Tao-hua JIANG Wei The Second Clinical College of Guangzhou University of Chinese Medicine Guangzhou510405China Department of cardiology Guangdong Provincial Hospital of Chinese Medicinethe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou510020China Guangdong Provincial Key Laboratory of Chinese Medicine for Prevention and Treatment of Refractory Chronic Diseases Guangzhou510020China

Objective:To explore the effects of Huxin formula(HXF)in curtailing atherosclerosis and its underlying ***:According to random number table method,24 specific pathogen free male ApoE^(-/-)mice were randomly divided into model group,HXF low-dose(HXF-L)group(8.4 g/kg daily),HXF high-dose(HXF-H)group(16.8 g/kg daily),and pravastatin(8 mg/kg daily)group in ExperimentⅠ(n=6 per group).C57BL/6J mice served as the control group(n=6).ApoE^(-/-)mice in HXF-L,HXF-H,pravastatin groups were fed a Western diet and administered continuously by gavage for 12 weeks,while C57BL/6J mice in the control group were fed conventional lab mouse chow for 12 ***,Tregs were depleted by weekly intraperitoneal injection of purified anti-mouse CD25 antibody(PC61,250μg per mouse)for 4 weeks in ExperimentⅡ(n=6 per group).Oil Red O and Masson staining were used to evaluate the plaque area and aortic root *** CD4^(+)CD25^(+)Foxp3^(+)Treg counts in the lymph nodes and spleen cells were detected using flow cytometric *** transforming growth factor-β1(TGF-β1),interleukin(IL)-10,and IL-6 serum levels were examined by MILLIPLEX?MAP *** real-time reverse transcription PCR(qRT-PCR)and Western blot were utilized to assess the expression of TGF-βmRNA and protein in the *** expression of CD4^(+)T lymphocytes,macrophages and smooth muscle cells in the aortic root were detected by immunofluorescence ***:HXF reduced plaque area in ApoE^(-/-)mice(P0.05).Also,HXF upregulated the expression of TGF-βmRNA and protein in the aorta(P<0.05).Additionally,HXF attenuated CD4^(+)T lymphocytes,macrophages and smooth muscle cells in aortic root plaque(P<0.01).Furthermore,the depletion of Tregs with CD25

关键词： atherosclerosis Huxin Formula Tregs immune responses inflammation

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Endovascular embolization by a magnetic microfiberbot

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National Science Review 2024年第5期11卷 95-96页

作者： Shuning Zhang Wenlong Yang Junbo Ge Department of cardiology Zhongshan HospitalFudan University Shanghai Institute of Cardiovascular Diseases Key Laboratory of Viral Heart Diseases National Health Commission Key Laboratory of Viral Heart Diseases Chinese Academy of Medical Sciences National Clinical Research Center for Interventional Medicine Institutes of Biomedical Sciences Fudan University

The evolving landscape of embolization therapy for treating cerebral aneurysms and brain tumors represents a pivotal stride towards enhancing the efficacy and safety of minimally invasive treatments [1]. Conventional endovascular embolization methods [2], characterized by the manual maneuvering of catheters through the vascular system, present notable limitations in steerability and precision, compounded by the potential health risks associated with prolonged exposure to radiation for surgeons.

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Oral anti-coagulants use in Chinese hospitalized patients with atrial fibrillation

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Chinese Medical Journal 2024年第2期137卷 172-180页

作者： Jing Lin Deyong Long Chenxi Jiang Caihua Sang Ribo Tang Songnan Li Wei Wang Xueyuan Guo Man Ning Zhaoqing Sun Na Yang Yongchen Hao Jun Liu Jing Liu Xin Du Louise Morgan Gregg C.Fonarow Sidney C.Smith Jr Gregory Y.H.Lip Dong Zhao Jianzeng Dong Changsheng Ma On behalf of CCC-AF investigators Department of cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China National Clinical Research Center for Cardiovascular Diseases Beijing 100029 China Department of Epidemiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of HeartLung and Blood Vessel DiseasesBeijing 100029China International Quality Improvement Department American Heart AssociationDallasTX 07076USA Division of cardiology Geffen School of Medicine at University of CaliforniaLos Angeles CA 90024USA Division of cardiology University of North CarolinaChapel HillNC 27599USA Department of cardiology Liverpool Centre for Cardiovascular ScienceUniversity of Liverpool and Liverpool Heart&Chest HospitalLiverpool L143PEUK Department of Clinical Medicine Aalborg UniversityAalborg 9000Denmark 不详

Background:Oral anti-coagulants(OAC)are the intervention for the prevention of stroke,which consistently improve clinical outcomes and survival among patients with atrial fibrillation(AF).The main purpose of this study is to identify problems in OAC utilization among hospitalized patients with AF in ***:Using data from the Improving Care for Cardiovascular Disease in China-Atrial Fibrillation(CCC-AF)registry,guideline-recommended OAC use in eligible patients was ***:A total of 52,530 patients with non-valvular AF were enrolled from February 2015 to December 2019,of whom 38,203 were at a high risk of stroke,9717 were at a moderate risk,and 4610 were at a low *** admission,only 20.0%(6075/30,420)of patients with a diagnosed AF and a high risk of stroke were taking *** use of pre-hospital OAC on admission was associated with a lower risk of new-onset ischemic stroke/transient ischemic attack among the diagnosed AF population(adjusted odds ratio:0.54,95%confidence interval:0.43-0.68;P70%of AF patients were at a high risk of *** poor performance on guideline-recommended OAC use was found in this study,over time the CCC-AF project has made progress in stroke prevention in the Chinese AF ***

关键词： Atrial fibrillation Oral anti-coagulants OAC Stroke prevention Contraindication

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COVID-19 and cardiac complications:Myocarditis and multisystem inflammatory syndrome in children

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World Journal of cardiology 2024年第5期16卷 260-268页

作者： Muhammed Gunes Oner Ozdemir Department of Pediatric cardiology Research and Training Hospital of SakaryaAdapazarı54100SakaryaTürkiye Department of Pediatric Allergy and Immunology Research and Training Hospital of SakaryaSakarya University Medical FacultyAdapazarı54100SakaryaTürkiye

Coronavirus is an important pathogen causing disease in humans and *** the end of 2019,an investigation into an increase in pneumonia cases in Wuhan,Hubei Province,China,found that the cause was a new *** disease,which spread rapidly across China and caused an outbreak worldwide,resulted in a *** this virus has previously been referred to as 2019-nCoV,which causes coronavirus disease 2019(COVID-19),later it was named severe acute respiratory syndrome coronavirus *** were usually asymptomatic and rarely severely *** April 2020,reports from the United Kingdom indicated that children may have Kawasaki disease or a clinical condition similar to toxic shock *** clinical picture was later defined as multisystem inflammatory syndrome in *** then,similarly affected children as well as cases with other cardiac complications have been reported in other parts of the *** this review,we aimed to evaluate COVID-19 in terms of cardiac involvement by reviewing the literature.

关键词： COVID-19 Cardiac complication Myocarditis Multisystem inflammatory syndrome in children SARS-CoV-2

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Efficacy and safety of Yangxinshi tablet for chronic heart failure:A systematic review and meta-analysis

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World Journal of Clinical Cases 2024年第13期12卷 2218-2230页

作者： Sheng-Hua Lu Yun-Feng Yu Si-Si Dai Ya-Qi Hu Jian-He Liu The First Clinical College of Chinese Medicine Hunan University of Chinese MedicineChangsha 410007Hunan ProvinceChina Branch of National Clinical Research Center for Chinese Medicine cardiology The First Hospital of Hunan University of Chinese MedicineChangsha 410007Hunan ProvinceChina

BACKGROUND The specific benefits of Yangxinshi tablet(YXST)in the treating chronic heart failure(CHF)remain *** To systematically evaluate the efficacy and safety of YXST in the treatment of *** Randomized controlled trials(RCTs)investigating YXST for CHF treatment were retrieved from eight public databases up to November ***-analyses of the included clinical studies were conducted using Review Manager *** Twenty RCTs and 1845 patients were *** meta-analysis results showed that the YXST combination group,compared to the conventional drug group,significantly increased the clinical efficacy rate by 23%[relative risk(RR)=1.23,95%CI:1.17-1.29],(P<0.00001),left ventricular ejection fraction by 6.69%[mean difference(MD)=6.69,95%CI:4.42-8.95,P<0.00001]and 6-min walk test by 49.82 m(MD=49.82,95%C:38.84-60.80,P<0.00001),and reduced N-terminal pro-Btype natriuretic peptide by 1.03 ng/L[standardized MD(SMD)=-1.03,95%CI:-1.32 to-0.74,P<0.00001],brain natriuretic peptide by 80.95 ng/L(MD=-80.95,95%CI:-143.31 to-18.59,P=0.01),left ventricular end-diastolic diameter by 3.92 mm(MD=-3.92,95%CI:-5.06 to-2.78,P<0.00001),and left ventricular endsystolic diameter by 4.34 mm(MD=-4.34,95%CI:-6.22 to-2.47,P<0.00001).Regarding safety,neither group reported any serious adverse events during treatment(RR=0.54,95%CI:0.15-1.90,P=0.33).In addition,Egger's test results indicated no significant publication bias(P=0.557).CONCLUSION YXST effectively improves clinical symptoms and cardiac function in patients with CHF while maintaining a favorable safety profile,suggesting its potential as a therapeutic strategy for CHF.

关键词： Yangxinshi tablet Chronic heart failure Cardiac function Systematic evaluation Meta-analysis

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The diagnostic yield for computed tomography pulmonary angiography in patients with anticoagulation

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World Journal of Emergency Medicine 2024年第4期15卷 251-255页

作者： Payush Chatta Brian Diep Jakrin Kewcharoen Daniel Rossie Cory Toomasian Purvi Parwani Dmitry Abramov Department of Medicine Division of CardiologyLoma Linda University Medical CenterLoma LindaCA 92374USA Department of Medicine Loma Linda University Medical CenterLoma LindaCA 92374USA Department of Emergency Medicine Loma Linda University Medical CenterLoma LindaCA 92374USA

BACKGROUND:Patients who present to the emergency department(ED)for suspected pulmonary embolism(PE)are often on active oral anticoagulation(AC).However,the diagnostic yield of computed tomography pulmonary angiography(CTPA)in screening for PE in patients who present on AC has not been well *** aim to investigate the diagnostic yield of CTPA in diagnosing PE depending on AC ***:We reviewed and analyzed the electronic medical records of patients who underwent CTPA for PE at a university hospital ED from June 1,2019,to March 25,*** outcome was the incidence of PE on CTPA depending on baseline AC status and indication for ***:Of 2,846 patients,242 were on AC for a history of venous thromboembolism(VTE),210 were on AC for other indications,and 2,394 were not on *** incidence of PE on CTPA was significantly lower in patients on AC for other indications(5.7%)when compared to patients on AC for prior VTE(24.3%)and patients not on AC at presentation(9.8%)(P<0.001).In multivariable analysis among the whole cohort,AC was associated with a positive CTPA(odds ratio[OR]0.26,95%confidence interval[CI]:0.15-0.45,P<0.001).CONCLUSION:The incidence of PE among patients undergoing CTPA in the ED is lower in patients previously on AC for indications other than VTE when compared to those not on AC or those on AC for history of *** status and indication for AC may affect pre-test probability of a positive CTPA,and AC status therefore warrants consideration as part of future diagnostic algorithms among patients with suspected PE.

关键词： Pulmonary embolism Computed tomography pulmonary angiography Emergency department Anticoagulation

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