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Long-term outcomes of titanium-nitride-oxide coated stents and drug-eluting stents in acute coronary syndrome:A systematic review and meta-analysis

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World Journal of Cardiology 2024年第5期16卷 293-305页

作者： Muhammad Ahmed Ali Fahim Afia Salman Hira Anas Khan Syed Muhammad Hasan Muskan FatimaBhojani Sarah Aslam Amna Zia Ul Haq Vishal Reddy Bejugam Beena Muntaha Nasir Wajiha Gul Abdul Moeed Abdelrahman S Abdalla Muhammad Majid Muhammad Sohaib Asghar Md Al Hasibuzzaman Department of Internal Medicine Dow University of Health SciencesKarachi 74200Pakistan Department of Internal Medicine North Central Bronx HospitalBronxNY 10467United States Department of Urology Center for Academic MedicineStanford University School of MedicinePalo AltoCA 33872United States Department of cardiovascular Imaging Cleveland ClinicClevelandOH 44195United States Division of Nephrology and Hypertension Mayo Clinic RochesterRochesterMN 55905United States institute of Nutrition and Food Science University of DhakaDhaka 1000Bangladesh

BACKGROUND In severe cases of coronary artery disease,percutaneous coronary intervention provide promising results.The stent used could be a drug-eluting stent(DES)or a titanium-nitride-oxide coated stent(TiNOS).AIM To compare the 5-year effectiveness and safety of the two stent types.METHODS The following systematic review and meta-analysis was conducted in accordance with the preferred reporting items for systematic reviews and meta-analysis guidelines,and PubMed/MEDLINE,Scopus,and Cochrane Central were searched from inception till August 2023.Primary outcomes were major adverse cardiac events(MACE),cardiac death,myocardial infarction(MI),cardiac death or MI,and ischemia-driven total lesion revascularization(ID-TLR).RESULTS Four randomized controlled trials(RCT),which analyzed a sum total of 3045 patients with acute coronary syndrome(ACS)after a median follow-up time of 5 years were included.Though statistically insignificant,an increase in the ID-TLR was observed in patients receiving TiNOSs vs DESs.In addition,MI,cardiac death and MI,and definite stent thrombosis(DST)were significantly decreased in the TiNOS arm.Baseline analysis revealed no significant results with meta-regression presenting non-ST elevated MI(NSTEMI)as a statistically significant covariate in the outcome of MACE.CONCLUSION TiNOS was found to be superior to DES in terms of MI,cardiac death or MI,and DST outcomes,however,the effect of the two stent types on ID-TLR and MACE was not significant.A greater number of studies are required to establish an accurate comparison of patient outcomes in TiNOS and DES.

关键词： Stents Drug-eluting Major adverse cardiac events All-cause death Meta-analysis

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Risk factors associated with hepatic dysfunction after Sun's procedure for type A aortic dissection

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South China Journal of Cardiology 2024年第2期 99-108页

作者：胡皓昀吴丽周勘朱平 Guangdong Medical University Guangdong cardiovascular institute Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University

Background Type A aortic dissection, as a cardiovascular emergency, is best treated with early surgical intervention. With advancements in surgical techniques and perioperative management, the clinical cure rate of surgery has significantly improved. However, the probability of postoperative complications remains high, among which postoperative hepatic dysfunction is one of the common and serious complications affecting prognosis. The purpose of this study was to explore the risk factors associated with postoperative hepatic dysfunction in patients with type A aortic dissection, hoping to identify high-risk patients early, prevent postoperative hepatic dysfunction, and improve patient prognosis. Methods A retrospective analysis was conducted on patients diagnosed with stanford type A aortic dissection and treated with Sun's procedure at Guangdong Provincial People's Hospital from January 1, 2021, to October 1, 2022. The Model for End-Stage Liver Disease excluding International Normalized Ratio(MELD-XI) score was used as the evaluation index for postoperative hepatic dysfunction(HD). MELD-XI scores from postoperative day 1 to 7 were collected. Statistical methods were employed to analyze the perioperative clinical data of the two groups of patients. Variables with statistical significance in univariate analysis were included in multivariate logistic regression analysis to identify independent risk factors associated with postoperative HD. Results A total of 241 patients diagnosed with stanford type A aortic dissection and hospitalized for Sun ' s procedure treatment were selected using specific inclusion and exclusion criteria. All patients were divided into HD group(MELD-XI score ≥12, n=108) and normal group(MELD-XI score <12, n=133), with a postoperative HD incidence rate of 44.81%. There were statistically significant differences(P<0.05) between the two groups in terms of whether the surgery was emergency, gender distribution, preoperative level of white blood cell count, alanine aminotransferase, aspartate ami

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MXene‑Graphene Composites:A Perspective on Biomedical Potentials

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Nano-Micro Letters 2022年第8期14卷 112-123页

作者： Ebrahim Mostafavi Siavash Iravani stanford cardiovascular institute Stanford University School of MedicineStanfordCA 94305USA Department of Medicine Stanford University School of MedicineStanfordCA 94305USA Faculty of Pharmacy and Pharmaceutical Sciences Isfahan University of Medical SciencesIsfahanIran

MXenes,transition metal carbides and nitrides with graphene-like structures,have received considerable attention since their first discovery.On the other hand,Graphene has been extensively used in biomedical and medicinal applications.MXene and graphene,both as promising candidates of two-dimensional materials,have shown to possess high potential in future biomedical applications due to their unique physicochemical properties such as superior electrical conductivity,high biocompatibility,large surface area,optical and magnetic features,and extraordinary thermal and mechanical properties.These special structural,functional,and biological characteristics suggest that the hybrid/composite structure of MXene and graphene would be able to meet many unmet needs in different fields;particularly in medicine and biomedical engineering,where high-performance mechanical,electrical,thermal,magnetic,and optical requirements are necessary.However,the hybridization and surface functionalization should be further explored to obtain biocompatible composites/platforms with unique physicochemical properties,high stability,and multifunctionality.In addition,toxicological and long-term biosafety assessments and clinical translation evaluations should be given high priority in research.Although very limited studies have revealed the excellent potentials of MXene/graphene in biomedicine,the next steps should be toward the extensive research and detailed analysis in optimizing the properties and improving their functionality with a clinical and industrial outlook.Herein,different synthesis/fabrication methods and performances of MXene/graphene composites are discussed for potential biomedical applications.The potential toxicological effects of these composites on human cells and tissues are also covered,and future perspectives toward more successful translational applications are presented.The current state-of-the-art biotechnological advances in the use of MXene-Graphene composites,as well as their developmental challenges and future p

关键词： Graphene MXene Composites Hybrid structures Biocompatibility Cancer theranostics Biomedical engineering

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Application of multi-planar reconstruction technique in endovascular repair of aortic dissection

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World Journal of Clinical Cases 2024年第17期12卷 2989-2994页

作者： Guo-Jie Li Ming-Xian Zhao Department of Vascular Surgery Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist HospitalXining 810000Qinghai ProvinceChina

BACKGROUND Endovascular repair of aortic dissection is an effective method commonly used in the treatment of stanford type B aortic dissection.Stent placement during the operation was one-time and could not be repeatedly adjusted during the operation.Therefore,it is of great significance for cardiovascular physicians to fully understand the branch status,position,angle,and other information regarding aortic arch dissection before surgery.AIM To provide more references for clinical cardiovascular physicians to develop treatment plans.METHODS Data from 153 patients who underwent endovascular repair of aortic dissection at our hospital between January 2021 and December 2022 were retrospectively collected.All patients underwent multi-slice spiral computed tomography angiography.Based on distinct post-image processing techniques,the patients were categorized into three groups:Multiplanar reconstruction(MPR)(n=55),volume reconstruction(VR)(n=46),and maximum intensity projection(MIP)(n=52).The detection rate of aortic rupture,accuracy of the DeBakey classification,rotation,and tilt angles of the C-arm during the procedure,dispersion after stent release,and the incidence of late complications were recorded and compared.RESULTS The detection rates of interlayer rupture in the MPR and VR groups were significantly higher than that in the MIP group(P0.05).The scatter rate of markers and the incidence of complications in the MPR group were significantly lower than those in the VR and MIP groups(P<0.05).CONCLUSION The application of MPR in the endovascular repair of aortic dissection has improved the detection rate of dissection rupture,the accuracy of anatomical classification,and safety.

关键词： Multiplanar reconstruction Endovascular repair of aortic dissection Image-processing technology Rate of aortic rupture Volume reconstruction

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From hardware store to hospital:a COVID-19-inspired,cost-effective,open-source,in vivo-validated ventilator for use in resource-scarce regions

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Bio-Design and Manufacturing 2022年第1期5卷 133-140页

作者： Matthew H.Park Yuanjia Zhu Hanjay Wang Nicholas ATran Jinsuh Jung Michael JPaulsen Annabel M.Imbrie‑Moore Samuel Baker Robert Wilkerson Mateo Marin‑Cuartas Danielle M.Mullis Y.Joseph Woo Department of Cardiothoracic Surgery Stanford UniversityFalk Cardiovascular Research Building CV-235300 Pasteur DriveStanfordCA 94305-5407USA Department of Mechanical Engineering Stanford UniversityStanfordCAUSA Department of Bioengineering Stanford UniversityStanfordCAUSA Department of Comparative Medicine Stanford UniversityStanfordCAUSA University Department of Cardiac Surgery Leipzig Heart CenterLeipzigGermany

Resource-scarce regions with serious COVID-19 outbreaks do not have enough ventilators to support critically ill patients,and these shortages are especially devastating in developing countries.To help alleviate this strain,we have designed and tested the accessible low-barrier in vivo-validated economical ventilator(ALIVE Vent),a COVID-19-inspired,cost-effective,open-source,in vivo-validated solution made from commercially available components.The ALIVE Vent operates using compressed oxygen and air to drive inspiration,while two solenoid valves ensure one-way flow and precise cycle timing.The device was functionally tested and profiled using a variable resistance and compliance artificial lung and validated in anesthetized large animals.Our functional test results revealed its effective operation under a wide variety of ventilation conditions defined by the American Association of Respiratory Care guidelines for ventilator stockpiling.The large animal test showed that our ventilator performed similarly if not better than a standard ventilator in maintaining optimal ventilation status.The FiO2,respiratory rate,inspiratory to expiratory time ratio,positive-end expiratory pressure,and peak inspiratory pressure were successfully maintained within normal,clinically validated ranges,and the animals were recovered without any complications.In regions with limited access to ventilators,the ALIVE Vent can help alleviate shortages,and we have ensured that all used materials are publicly available.While this pandemic has elucidated enormous global inequalities in healthcare,innovative,cost-effective solutions aimed at reducing socio-economic barriers,such as the ALIVE Vent,can help enable access to prompt healthcare and life saving technology on a global scale and beyond COVID-19.

关键词： COVID-19 Ventilator Open-source

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SARS-CoV-2 getting into the brain;neurological phenotype of COVID-19,and management by nano-biotechnology

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Neural Regeneration Research 2023年第3期18卷 519-520页

作者： Małgorzata Kujawska Ebrahim Mostafavi Ajeet Kaushik Department of Toxicology Poznan University of Medical SciencesPoznańPoland stanford cardiovascular institute/Department of Medicine Stanford University School of MedicineStanfordCAUSA NanoBioTech Laboratory Health Systems EngineeringDepartment of Natural SciencesFlorida Polytechnic UniversityLakelandFLUSA

Human coronavirus infection getting into the brain:By February 2022,the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection,causing the coronavirus disease 2019(COVID-19)outbreak,has infected around 415 million people,and caused~5.8 million deaths worldwide(WHO,https://covid19.***.int/).As SARS-CoV-2 replicates during the infection,it undergoes genetic mutation to generate variants with varying characteristics and mutation frequencies.The emerging,over time,new variants that differ with transmissibility,immunity,and infection severity pose continuous challenges to established COVID-19 management strategies and regulations.Several SARS-CoV-2 variants such as Omicron(B.1.1.529),Delta(B.1.617.2),UK(B.1.17),South Africa(B.1.351),Brazil(P.1),and New York B.1.525-B.1.526 were detected worldwide and accelerated severity of COVID-19 pandemic(Figure 1A;McQuaid et al.,2021).

关键词： immunity Figure getting

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An extracellular matrix paradox in myocardial scar formation

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Signal Transduction and Targeted Therapy 2020年第1期5卷 1139-1140页

作者： Sangkyun Cho David T.Paik Joseph C.Wu stanford cardiovascular institute Stanford University School of MedicineStanfordCAUSA Department of Medicine Division of Cardiovascular MedicineStanford University School of MedicineStanfordCAUSA Department of Radiology Stanford University School of MedicineStanfordCAUSA

In a recent article in Cell,Yokota et al.1 demonstrate that type V collagen,a minor component of the cardiac extracellular matrix,plays a paradoxical role in limiting scar size after myocardial infarction by altering the mechanical properties of the developing scar tissue and by regulating integrindependent activation of cardiac fibroblasts(Fig.1).

关键词： scar al cardiac

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To manage long COVID by selective SARS-CoV-2 infection biosensing

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The Innovation 2022年第5期3卷 9-10页

作者： Ajeet Kaushik Ebrahim Mostafavi NanoBiotech Laboratory Department of Environmental EngineeringFlorida Polytechnic UniversityLakelandFLUSA stanford cardiovascular institute Stanford University School of MedicineStanfordCA 94305USA Department of Medicine Stanford University School of MedicineStanfordCA 94305USA

According to the National institutes of Health(NIH),the initiative of The Rapid Acceleration of Diagnostics Tech and Advanced Technology Platforms(RADxTech/ATP)program was established to promote research and development(R&D)in the field of investigating selective,sensitive,and affordable sensing technologies for coronavirus disease 2019(COVID-19)diagnostics.This is a goaloriented approach toward point-of-care testing(POCT)and severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection management applications.Till May 2022,RADxTech/ATP has been involved in 1.9 billion tests production,44 FDA authorized tests,first over-the-counter test for POCT and home-based testing,and>100 companies dedicated to smart sensor development(https://www.***.nih.gov/covid-19/radx-tech-program/radx-tech-dashboard).Despite such outstanding growth,COVID-19 management is far from in control due to SARS-CoV-2 mutations,virus presence in life systems(including human-to-human transmission,water,food,animal,and air[mainly indoor premises])。

关键词： POCT infection acute

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Kunming mouse strain is less susceptible to elastase-induced abdominal aortic aneurysms

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Animal Models and Experimental Medicine 2022年第1期5卷 72-80页

作者： Haole Liu Kangli Tian Congcong Xia Panpan Wei Boyu Xu Weilai Fu Yankui Li Yafeng Li Liang Bai Rong Wang Weirong Wang Baohui Xu Enqi Liu Sihai Zhao institute of cardiovascular Science School of Basic Medical SciencesXi'an Jiaotong University Health Science CenterXi'anChina Laboratory Animal Center Xi'an Jiaotong UniversityXi'anChina Department of Vascular Surgery The Second Hospital of Tianjin Medical UniversityTianjinChina Pain Rehabilitation Department of TCM Orthopedic Center Xi'an Honghui HospitalXi'anChina Department of Vascular Surgery Stanford University School of MedicineStanfordCaliforniaUSA

Background:Porcine pancreatic elastase(PPE)is successfully used to induce abdominal aortic aneurysm(AAA)in mice.However,differences between mouse strains in susceptibility to PPE induction have been reported.Kunming mouse is one of the most frequently used strains in China but whether it is suitable for induction of AAA by PPE application remains unclear.Methods:PPE infusion(1.5 units/ml)in temporary controlled aorta was performed to induce AAAs in both C57BL/6J and Kunming mice.Phosphatebuffered saline(PBS)application was used as vehicle control.The aorta diameters of all mice were measured at days 0 and 14 after surgery to evaluate the AAA formation.Results:After 14 days of PPE or PBS infusion,all mice were sacrificed and aorta tissues were collected for histological staining analysis.At the 14th day after infusion,PPE successfully induced aortic dilation in Kunming mice and typical AAA in C57BL/6J mice.The aorta diameter increased by 0.23 mm in Kunming mice after PPE infusion,while it was 0.72 mm in the C57BL/6J strain.PPE induced mild elastin degradation,smooth muscle cell(SMC)depletion and mural leucocyte infiltration in Kunming mice,but in PPE-sensitive C57BL/6J mice,it induced total loss of SMCs,elastin disappearance and diffused infiltrated leucocytes in aortic aneurysmal segments.The effects of PPE in inducing angiogenesis and upregulating matrix metalloproteinase 2 and 9 expression in Kunming mice were also weaker than that in C57BL/6J mice.Conclusion:At the reported dose of PPE,Kunming mouse is not as susceptible to AAA formation as C57BL/6J mice.The failure of PPE to induce AAA formation in Kunming mice may be associated to its inability to boost a strong inflammatory response.

关键词： abdominal aortic aneurysms C57BL/6J histology Kunming strain

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Cardiorespiratory fitness,white blood cell count,and mortality in men and women

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Journal of Sport and Health Science 2022年第5期11卷 605-612页

作者： Stephen W.Farrell David Leonard Kerem Shuval Laura F.DeFina Carolyn E.Barlow Andjelka Pavlovic William L.Haskell Research Division The Cooper InstituteDallasTX 75230USA Department of Medicine Stanford UniversityPalo AltoCA 94305USA

Background:We examined the associations of cardiorespiratory fitness(CRF) and white blood cell count(WBC) with mortality outcomes.Methods: A total of 52,056 apparently healthy adults completed a comprehensive health examination,including a maximal treadmill test and blood chemistry analyses.CRF was categorized as high,moderate,or low by age and sex;WBC was categorized as sex-specific quartiles.Results:During 17.8± 9.5 years(mean± SD) of follow-up,a total of 4088 deaths occurred.When regressed jointly,significantly decreased allcause mortality across CRF categories was observed within each quartile of WBC in men.Within WBC Quartile 1,all-cause mortality hazard ratios(HRs) with a 95% confidence interval(95%CI) were 1.0(referent),1.29(95%CI:1.06-1.57),and 2.03(95%CI:1.42-2.92) for high,moderate,and low CRF categories,respectively(p for trend cardiovascular disease(CVD) mortality within Quartile 1(p for trend=0.743),there were also similar trends across CRF categories within WBC quartiles in men for both CVD and cancer mortality(p for trend <0.01 for all).For women,there were no significant trends across CRF categories for mortality outcomes within Quartiles 1-3.However,we observed significantly decreased all-cause mortality across CRF categories within WBC Quartile 4(HR=1.05(95%CI:0.76-1.44),HR=1.63(95%CI:1.20-2.21),and HR=1.87(95%CI:1.29-2.69) for high,moderate,and low CRF,respectively(p for trend=0.002)).Similar trends in women were observed for CVD and cancer mortality within WBC Quartile 4 only.Conclusion:There are strong joint associations between CRF,WBC,and all-cause,CVD,and cancer mortality in men;these associations are less consistent in women.

关键词： Complete blood count Epidemiology Inflammation Physical fitness

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