Research progress of NLRP3 inflammasome in the treatment of uveitis / 国际眼科杂志(Guoji Yanke Zazhi)

The NLRP3 inflammasome is a cellular multimeric protein complex that plays a crucial role in inflammation and immune responses. It consists of three main components: Nod-like receptor protein 3(NLRP3), apoptosis-associated speck-like protein containing(ASC)and cysteine protease 1(caspase-1). Uveitis is a broad term encompassing a range of inflammatory diseases that primarily affect the iris, ciliary body, vitreous, retina and choroid. It is considered a major cause of blindness globally. Numerous studies have demonstrated the involvement of NLRP3 inflammasome in the onset and progression of uveitis, indicating its potential as a significant therapeutic target for uveitis in the future. This article provides an overview of the structure, biological functions and activation pathways of the NLRP3 inflammasome, as well as the current research progress on its association with different types of uveitis. Additionally, it discusses the application potential of the NLRP3 inflammasome in the treatment of uveitis.

Mid-term clinical outcome analysis of aortic valve repair for rheumatic aortic valve disease / 中华胸心血管外科杂志

Objective:To evaluate the mid-term outcomes of patients with rheumatic heart disease who underwent aortic valve repair surgery in a prospective cohort.Methods:From January 2016 to December 2020, a total of 54 patients with rheumatic heart disease underwent aortic valve repair surgery in Beijing Anzhen Hospital, with an average age of (50.61±13.29) years, including 29 females (53.7%). There were 31 patients (57.4%) had pure aortic insufficiency, 2 patients (3.7%) had pure aortic stenosis and 21 patients (38.9%) had mixed lesion. During the same period, 43 patients (80.0%) underwent mitral valve surgery, 36 patients (66.7%) underwent tricuspid valve surgery, and 20 patients (37.0%) underwent atrial fibrillation radiofrequency ablation.The follow-up period was from 1 month to 61 months (median follow-up was 25 months). Paired rank-sum test was used to compare the differences in continuous variables among subjects, and Kaplan- Meier method was used to analyze the clinical outcomes during the follow-up period. Results:Proportion of moderate and severe aortic regurgitation Preoperatively was higher than that of discharge data, aortic valve orifice maximum velocity and left ventricular end-diastolic diameter were significantly lower than discharge data (all P<0.05). The 5-year survival rate was (96.1±2.7)% (2 patients died). The 5-year freedom from reoperation after aortic valve repair was (89.5±4.5)%(5 patients underwent redo surgery). The 5-year freedom from valvular-related complications was (91.3±4.2)%(3 patients suffered from complications). Conclusion:Aortic valve repair surgery for rheumatic aortic valve disease is feasible and has excellent early and mid-term results, it can be a reliable treatment option.

Establishment of screening models for nonalcoholic fatty liver disease in the adult Blang population / 临床肝胆病杂志

Objective To establish simple screening models for nonalcoholic fatty liver disease (NAFLD) in the adult Blang population. Methods Based on the survey data of metabolic diseases in the Blang people aged 18 years or above in 2017, 2993 respondents were stratified by sex and age (at an interval of 5 years) and then randomly divided into modeling group with 1497 respondents and validation group with 1496 respondents. Related information was collected, including demographic data, smoking, drinking, family history of diseases and personal medical history, body height, body weight, waist circumference, and blood pressure, and related markers were measured, including fasting plasma glucose, 2-hour postprandial plasma glucose or blood glucose at 2 hours after glucose loading, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase. The chi-square test was used for comparison of categorical data between two groups. Logistic regression analysis was used to establish the screening model. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, and negative predictive value were used to evaluate the screening performance of established models versus existing models in the study population, and the DeLong method was used for comparison of AUC. Results Three screening models for NAFLD were established based on physical and biochemical measurements, i.e., simple noninvasive model 1 (age, body mass index, and waist circumference), noninvasive model 2 with the addition of blood pressure, and model 3 with the combination of hematological parameters (diabetes and ALT/AST). In the modeling group, the three models had an AUC of 0.881 (95% confidence interval [ CI ]: 0.864-0.897), 0.892 (95% CI : 0.875-0.907), and 0.894 (95% CI : 0.877-0.909), respectively, and there was a significant difference between model 1 and models 2/3 ( P =0.004 0 and P 0.05). Based on the overall consideration of screening performance, invasiveness, and cost, the simple noninvasive model 1 was considered the optimal screening model for NAFLD in this population. Model 1 had the highest Youden index at the cut-off value of 5 points, and when the score of ≥5 points was selected as the criteria for NAFLD, the model had a sensitivity of 86.5%, a specificity of 79.7%, a positive predictive value of 50.3%, and a negative predictive value of 96.1% in the modeling group and a sensitivity of 85.6%, a specificity of 80.6%, a positive predictive value of 51.7%, and a negative predictive value of 95.8% in the validation group. Conclusion The NAFLD screening models established for the adult Blang population based on age and obesity indicators have relatively higher sensitivity, specificity, and negative predictive value, and this tool is of important practical significance for the intervention of NAFLD and its closely related metabolic diseases in this population.

Video-assisted pulmonary veins isolation versus box-lesion for the lone atrial fibrillation in the mid-term follow-up / 中华胸心血管外科杂志

Objective To compare the mid-term results of video-assisted pulmonary veins isolation and box-lesion for lone atrial fibrillation.Methods Between June 2010 to November 2012,80 lone atrial fibrillation(LAF) patients underwent minimally invasive surgical ablation in Beijing Anzhen Hospital,and all of them received left atrial appendage excision and Marshall ligament break in the surgery.Among them,37 cases were performed two epicardial ablation lines in order to created box-lesion based on PVI(14 paroxysmal AF and 23 persistent AF).Follow-up was finished after discharge.Results Mean follow-up was(18.8 ± 7.4) months,and 2 patients were died with non-cardiac disease.The success rate is 78.8％ (Paroxysmal AF 87.9％;Persistent AF 72.3％).In the paroxysmal AF patients,the success rate for PVI and Box lesion treatment was 84.6％ (11/13) and 92.9％ (13/14),P =0.45;in the persistent AF patients,the success rate for PVI and Box-lesion was 58.3％ (14/24) and 87.5％ (14/16),P =0.04.Conclusion Addition of epicedial ablation lines might increase the cure rate for lone AF therapy,especially for persistent AF.