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

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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

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

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

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

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

Therapeutic uses of animal biles in traditional Chinese medicine:An ethnopharmacological,biophysical chemical and medicinal review

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World Journal of Gastroenterology 2014年第29期20卷 9952-9975页

作者： David Q-H Wang Martin C Carey Gastroenterology Division Department of MedicineBrigham and Women’s HospitalHarvard Medical School and Harvard Digestive Diseases Center Liver center and Gastroenterology Division Department of MedicineBeth Israel Deaconess Medical CenterHarvard Medical School and Harvard Digestive Diseases Center Division of Gastroenterology and Hepatology Department of Internal MedicineEdward Doisy Research CenterSaint Louis University School of Medicine

Forty-four different animal biles obtained from both invertebrates and vertebrates (including human bile) have been used for centuries for a host of maladies in traditional Chinese medicine (TCM) beginning with dog, ox and common carp biles approximately in the Zhou dynasty (c. 1046-256 BCE). Overall, different animal biles were prescribed principally for the treatment of liver, biliary, skin (including burns), gynecological and heart diseases, as well as diseases of the eyes, ears, nose, mouth and throat. We present an informed opinion of the clinical efficacy of the medicinal uses of the different animal biles based on their presently known principal chemical components which are mostly steroidal detergent-like molecules and the membrane lipids such as unesterified cholesterol and mixed phosphatidylcholines and sometimes sphingomyelin, as well as containing lipopigments derived from heme principally bilirubin glucuronides. All of the available information on the ethnopharmacological uses of biles in TCM were collated from the rich collection of ancient Chinese books on materia medica held in libraries in China and United states and the composition of various animal biles was based on rigorous separatory and advanced chemical identification techniques published since the mid-20sup>thsup> century collected via library (harvard’s Countway Library) and electronic searches (PubMed and Google scholar). Our analysis of ethnomedical data and information on biliary chemistry shows that specific bile salts, as well as the common bile pigment bilirubin and its glucuronides plus the minor components of bile such as vitamins A, D, E, K, as well as melatonin (N-acetyl-5-methoxytryptamine) are salutary in improving liver function, dissolving gallstones, inhibiting bacterial and viral multiplication, promoting cardiac chronotropsim, as well as exhibiting anti-inflammatory, anti-pyretic, anti-oxidant, sedative, anti-convulsive, anti-allergic, anti-congestive, anti-diabe

关键词： Bile acids Bile pigments Bilirubinates Liquid crystals Materia medica Mixed micelles Bear bile Ox gallstones Paleo-pharmacology Phospholipids

Generation of dynamically perfused functional vascular network system within hydrogel using3D bio-printing technology

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医用生物力学 2013年第S1期28卷 9-11页

作者： Vivian K.Lee seung-schik Yoo Peter Vincent Guohao Dai Department of Biomedical Engineering Rensselaer Polytechnic Institute Department of Radiology Brigham and Women's HospitalHarvard Medical School center for Cardiovascular sciences Albany Medical College

Introduction:3D bio-printing technology[1-3]（Figure 1）capable of dispensing live cells,soluble factors,and phase-changing hydrogel in a desired pattern,has great potential in creating 3D ***,maintaining the viabilit... 详细信息

Introduction:3D bio-printing technologysup>[1-3]sup>（Figure 1）capable of dispensing live cells,soluble factors,and phase-changing hydrogel in a desired pattern,has great potential in creating 3D ***,maintaining the viability of a thick tissue structure during tissue growth and maturation is challenging due to lack of adequate vascular *** a simple tissue model with

关键词： hydrogel printing perfusion dynamically challenging viability maintaining desired thick capable

Giant idiopathic renal arteriovenous fistula managed by coils and amplatzer device:Case report and literature review

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World Journal of Clinical Cases 2016年第11期4卷 364-368页

作者： Prashant Nagpal Girish Bathla sachin s saboo Ashish Khandelwal Abhishek Goyal Frank J Rybicki Michael L steigner Department of Radiology University of Iowa Hospitals and Clinics Department of Radiology Brigham and Women’s HospitalHarvard Medical School Department of Radiology Cardiothoracic ImagingUT Southwestern Medical Center Department of Internal Medicine Westchester Medical CenterNew York Medical College

An idiopathic renal arteriovenous(AV) fistula is a rare malformation of the kidney that may present insidiously with heart failure or *** treatment may be challenging due to large fistula size that may limit endovascular *** authors report a case of an 85-year-old Caucasian woman who presented with acute heart failure and was found to have a right renal AV *** she had no prior history of renal intervention or trauma,a diagnosis of idiopathic renal AV fistula was *** was managed by endoluminal occlusion using multiple stainless steel coils and Amplatzer vascular plug II *** follow-up computed tomography showed complete occlusion of the *** report highlights the late presentation of this rare disease and presents the utility of the combination of coils and Amplatzer device for management of a large *** also reiterates that even if large,these fistulas can be managed by endovascular occlusion.

关键词： heart failure Idiopathic Arteriovenous fistula Endovascular management Amplatzer device

Black Phosphorus in Biological Applications:Evolutionary Journey from Monoelemental Materials to Composite Materials

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Accounts of Materials Research 2021年第7期2卷 489-500页

作者： Jiang Ouyang Chan Feng Xingcai Zhang Na Kong Wei Tao center for Nanomedicine and Department of Anesthesiology Brigham and Women’s HospitalHarvard Medical SchoolBostonMassachusetts 02115United States John A.Paulson school of Engineering and Applied sciences Harvard UniversityCambridgeMassachusetts 02138United States

CONsPECTUs:Understanding the evolutionary journey of monoelemental black phosphorus(BP)to BP-based composites plays a crucial role in expanding and advancing the development of BP in biological *** of its exceptional unique structure and superior biological properties,BP has been extensively developed into various nanomaterials for different biological ***,the performance of BP alone cannot completely meet some specific requirements,and one possible route to harnessing its unique properties for different biological applications is to incorporate BP with a specific material to obtain an on-demand composite *** manufacturing of such high-performance composites requires not only a full understanding of the structure and features of BP so that it could be perfectly incorporated with other materials or homogeneously distributed into various matrixes but also a clear biological effect of BP in different biological ***,we summarize our recent work on BP-based high-performance composites for different biological applications,aiming to uncover(i)the evolutionary journey of BP from monoelemental materials to composite materials in biological applications and(ii)the interaction between BP and biological *** the emergence of BP,BP-based materials have shown a prominent potential for technological applications as well as plenty of unexplored fundamental *** particular,with the unlimited potential of BP in biological fields,it is desirable to take advantage of the useful performance of BP in composites through the combination of various functional materials for broadening its ***,how to design and synthesize a BP-based composite with some specific performance remains a huge challenge due to the lack of an in-depth understanding of the interaction among BP,functional adjuvants,and physiological ***-based nanosheets can selectively kill tumor cells via a reactive oxygen species

关键词： composites composite interaction