A pomegranate seed-structured nanozyme-based colorimetric immunoassay for highly sensitive and specific biosensing of Staphylococcus aureus.

Staphylococcus aureus (S. aureus) infections are a serious threat to human health. The development of rapid and sensitive detection methods for pathogenic bacteria is crucial for accurate drug administration. In this research, by combining the advantages of enzyme-linked immunosorbent assay (ELISA), we synthesized nanozymes with high catalytic performance, namely pomegranate seed-structured bimetallic gold-platinum nanomaterials (Ps-PtAu NPs), which can catalyze a colorless TMB substrate into oxidized TMB (oxTMB) with blue color to achieve colorimetric analysis of S. aureus. Under the optimal conditions, the proposed biosensor could quantitatively detect S. aureus at levels ranging from 1.0 × 101 to 1.0 × 106 CFU mL-1 with a limit of detection (LOD) of 3.9 CFU mL-1. Then, an integrated color picker APP on a smartphone enables on-site point-of-care testing (POCT) of S. aureus with LOD as low as 1 CFU mL-1. Meanwhile, the proposed biosensor is successfully applied to the detection of S. aureus in clinical samples with high sensitivity and specificity.

Doppler Echocardiography Combined with NTproBNP/BNP in the Diagnosis of Pulmonary Artery Hypertension Associated with Congenital Heart Disease.

Background: Pulmonary artery hypertension (PAH) is a common complication of congenital heart disease (CHD) and is associated with worse outcomes and increased mortality. The Doppler echocardiography (DE) is a commonly used imaging tool for both diagnosis and follow-up examination of PAH. Here is to evaluate the diagnostic performance of DE combined with NTproBNP/BNP as screening strategy in PAH patients with CHD. Methods: A retrospective study in 64 patients with CHD has been carried out to compare estimate pulmonary artery systolic pressure (PASP) measured with DE to that measured with right heart catheterization (RHC). The Pearson correlation analyses were used to calculate the correlation coefficients between RHC and DE. The Bland-Altman analyses were carried out to assess the agreement between the two methods. ROC analyses were used to evaluate the diagnostic performance of DE, NTproBNP/BNP, and DE combined with NTproBNP/BNP. Results: Our data have demonstrated that a mild correlation (r = 0.4401, P < 0.01) was observed between PASP (78.1 ± 29.0 mmHg) measured during RHC and PASP (74.9 ± 19.7 mmHg) as estimated using DE. The Bland-Altman analysis demonstrated that the bias for DE PASP estimates was 3.2 mmHg with 95% limits of agreement ranging from -49.53 to 55.90 mmHg. The results of DE showed an AUC of 0.848 (95% CI = 0.666-1; P < 0.001), the sensitivity of which was 98.3% and the specificity was 77.8%. The AUC of NTproBNP/BNP for the identification of PAH was 0.804 (95% CI = 0.651-0.956; P < 0.001), the sensitivity of which was 81.4% and the specificity was 87.5%. The AUC of DE combined with NTproBNP/BNP was 0.857 (95% CI = 0.676-1; P < 0.001), of which sensitivity was 100% and specificity was 77.8%. The positive predictive value (PPV) and negative predictive value (NPV) were 96.6% and 100%, respectively. Conclusions: Our study shows that the Doppler echocardiography combined with NTproBNP/BNP has better diagnostic performance in pulmonary artery hypertension associated with congenital heart disease, especially when DE negative screening in PAH patients.

Prediction of Acute Kidney Injury for Acute Type A Aortic Dissection Patients Who Underwent Sun's Procedure by a Perioperative Nomogram.

INTRODUCTION: Postoperative acute kidney injury (AKI) occurs in 20-40% of acute type A aortic dissection (ATAAD) patients undergoing cardiac surgery. A predictive model could be developed to assess the probability of AKI in patients with ATAAD before and after cardiac surgery in a timely manner. METHODS: This retrospective study enrolled a total of 224 patients with ATAAD. Patients were subjected to total arch replacement using a tetrafurcate graft with stented elephant trunk implantation according to Sun's procedure. Statistical comparison for the collected data was done with Student's t test or Mann-Whitney U test (continuous variables) and χ2 test (categorical variables). The independent predictors were screened by multivariate logistic regression analysis and then incorporated into a nomogram. The reliability of cardiac surgery-associated AKI (CSA-AKI) models was evaluated using the area under the receiver operating characteristic curve (AUC). RESULTS: This study enrolled 224 ATAAD patients, including 53 patients with AKI and 171 patients without AKI. The incidence of ATAAD-induced AKI in the cohort was 23.66%. The screened predictors for AKI include iliac artery involvement, creatinine, D-dimer, autotransfusion, platelet-rich plasma reinfusion, nasal temperature, red blood cells, fresh frozen plasma, drainage, and mechanical ventilation. The calculated AUC values for model 1, model 2, model 3, and model 4 were 0.710, 0.777, 0.827, and 0.848, respectively. Model 4 was optimum for AKI risk scoring compared with model 1, model 2, and model 3. CONCLUSIONS: AKI prediction models were established for ATAAD patients using preoperative, intraoperative, and postoperative information. Particularly, model 4 shows superiority in risk prediction for CSA-AKI.

Development and evaluation of an early death risk prediction model after acute type A aortic dissection.

BACKGROUND: The purpose of the study was to assess the relationship between preoperative laboratory examination, clinical imaging data, and postoperative death of patients with acute type A aortic dissection (ATAAD) and to establish a prediction model of hospital death risk after the operation. METHODS: A total of 224 cases of acute Standford A aortic dissection were treated by total arch replacement using a tetrafurcate graft with stented elephant trunk implantation in Tianjin Chest Hospital. Based on preoperative laboratory examination and clinical imaging data of patients with ATAAD, the independent risk factors of postoperative hospital death were obtained using logistic analysis, and a risk prediction model of postoperative hospital death was developed. RESULTS: Independent risk factors of postoperative death in patients with ATAAD were: body mass index (BMI), preoperative neutrophil to lymphocyte ratio (NLR), mean platelet volume (MPV), creatinine (Cr), D-dimer, high-sensitive cardiac troponin T (hs-CTnT), apolipoprotein A1, left subclavian artery involvement, and iliac artery involvement. The regression equation of postoperative death risk was: logitP1 = -9.584 + 1.060 × NLR + 1.586 × MPV + 1.009 × Cr + 1.067 × D-dimer + 2.023 × hs-CTnT; the regression equation of postoperative death risk was: logitP2 = -3.296 + 3.242 × left subclavian artery involved + 4.564 × iliac artery involved; the regression equation of postoperative death risk was: logitP3 = -12.864 + 1.149 × BMI + 4.731 × left subclavian artery involved + 4.150 × iliac artery involved + 1.064 × NLR + 1.011 × Cr + 1.084 × D-dimer + 2.242 × hs-CTnT + 3.233 × apolipoprotein A1. CONCLUSIONS: BMI, NLR, MPV, Cr, D-dimer, hs-CTnT, apolipoprotein A1, left subclavian artery involvement and iliac artery involvement can affect the hospital mortality rate of aortic dissection undergoing Sun's operation to varying degrees, which may be helpful to guide the design of the perioperative treatment strategy.

Totally thoracoscopic surgery for treating left atrial myxoma.

ABSTRACT: We aimed to summarize the experience of totally thoracoscopic surgery for left atrial myxoma, together with analyzing the safety and feasibility. We retrospectively analyzed the clinical data of 15 patients with left atrial myxoma admitted to our hospital from October 2016 to October 2018. The auxiliary hole was located at the midline of the 5th intercostal space of the right chest. The endoscope hole was located at the front position of the fourth intercostal space. Specimens were sent to the pathology department for pathological examination. All the procedures were completed successfully. Extracorporeal circulation time was 46.5 ±â€Š18.6 minute, cross-clamping time was 20.6 ±â€Š6.7 minute, thoracic drainage fluid was 89+60.2 ml, ventilator assist time was 4.3 ±â€Š2.6 hour, intensive care unit stay time was 14.5 ±â€Š4.2 hour, the average postoperative hospital stay was 5.2 ±â€Š1.2 day. There was no death, or red blood cell transfusion during and after surgery. No postoperative complications were reported by the patients. No recurrence of myxoma, residual shunt in the atrial septum and valvular lesions were found after 3months of postoperative cardiac ultrasound examination. Total thoracoscopic surgery for left atrial myxoma was less invasive with satisfactory cosmetic appearance with feasibility and safety. Besides, it caused no serious complications.

Myricetin ameliorates ox-LDL-induced HUVECs apoptosis and inflammation via lncRNA GAS5 upregulating the expression of miR-29a-3p.

Oxidized low-density lipoprotein (ox-LDL)-induced endothelial cell dysfunction is a significant event in the progression of atherosclerosis. Even Myricetin (Myr) has been exhibited strong antioxidant potency, the effect on atherosclerosis is still elusive. HUVECs were subjected to ox-LDL, before which cells were preconditioned with Myr. Cell Counting Kit-8 assay, flow cytometry, quantitative real-time polymerase chain reaction and Western blot were carried out to assess the impacts of ox-LDL and Myr on HUVECs. The expression of EndMT markers was determined by Western blot analysis and immunocytochemistry. In addition, the relationship of GAS5 and miR-29a-3p was evaluated by RNA Fluorescent in Situ Hybridization and RNA immunoprecipitation assay. Myr preconditioning prevented ox-LDL-induced apoptosis, inflammatory response, and EndMT. GAS5 was upregulated in response to ox-LDL while it was down-regulated by Myr preconditioning. GAS5 over-expression attenuates Myr protective effects against ox-LDL-mediated HUVEC injury. Besides, miR-29a-3p is a target of GAS5 and down-regulated miR-29a-3p could further reduce the effects of GAS5 in ox-LDL-mediated HUVEC. Furthermore, Myr inactivated the TLR4/NF-κB signalling pathway in ox-LDL-treated HUVEC by down-regulating GAS5 or upregulating miR-26a-5p. Myr possessed an anti-inflammatory and anti-EndMT function against ox-LDL-induced HUVEC injury by regulating the GAS5/miR-29a-3p, indicating that Myr may have an important therapeutic function for atherosclerosis.

BAPN-induced rodent model of aortic dissecting aneurysm and related complications.

BACKGROUND: The aim of this study was to investigate the effects of beta-aminopropionitrile (BAPN) on the arterial walls of rodents, and to analyze the gross or pathological changes of arterial and other tissues of rodents treated with BAPN at different concentrations or doses. METHODS: Eighteen SPF SD rats (4-5-week old) were divided into three groups: SD-0.2 (Group A), SD-0.4 (Group B), and SD-0.6 (Group C). The groups A, B and C were given 0.2%, 0.4%, and 0.6% BAPN solution, respectively, as drinking water for seven weeks. Forty SPF C57BL/6 mice (3-week old) were randomly divided into four groups: C57-0.2 (Group D), C57-0.4 (Group E), C57-0.6 (Group F) and the control group and given 0.2%, 0.4%, or 0.6% BAPN or distilled water as drinking water, respectively, for seven weeks. All experimental animals were free to drink water. The aortas were dissected and visually examined. At the same time, hematoxylin and eosin (HE) staining was performed in aorta tissue. The vascular diameter and area of the middle membrane were measured with IPP (Image-Pro Plus 6.0). RESULTS: BAPN treatment significantly affected the water intake and weight gain of rats and mice. BAPN also caused thickening of the membrane in the aortas of rats and mice, and irregularity in the arrangement of elastic fibers. These pathological changes are similar to the pathological changes observed in human aneurysms. The incidence of dissecting aneurysm in C57 mice was higher than that of Sprague Dawley (SD) rats. CONCLUSIONS: BAPN at a concentration of 0.4% was feasible to produce an animal model of dissecting aneurysm. In SD rats, the rate of pathological changes and other complications, such as intestinal rupture and scoliosis, was higher than the rates of dissecting aneurysm.

CDR1as/miR-7/CKAP4 axis contributes to the pathogenesis of abdominal aortic aneurysm by regulating the proliferation and apoptosis of primary vascular smooth muscle cells.

Abdominal aortic aneurysm (AAA) is characterized as dilation of the aortic wall. Dysregulation of vascular smooth muscle cells (VSMCs) can contribute to the development of this phenotype. Circular RNAs and microRNAs (miRNAs) can regulate the proliferation and apoptosis of VSMCs. This present study aimed to identify the mechanisms of action behind the regulation of cerebellar degeneration-related protein 1 antisense RNA (CDR1as)/miRNA (miR)-7 in VSMCs. The expression levels of miR-7 were upregulated, whereas the levels of CDR1as and cytoskeleton-associated protein 4 (CKAP4) were downregulated in aortic specimens obtained from 10 patients who underwent surgery for AAA compared with aortic specimens from 10 control patients who underwent coronary artery bypass surgery. The molecular mechanism of action of CDR1as/miR-7 was investigated in primary VSMCs. The results of Cell Counting kit-8 and cell growth curve assays revealed that overexpression of CDR1as and knockdown of miR-7, increased VSMC proliferation, whereas knockdown of CDR1as and overexpression of miR-7 suppressed VSMC proliferation. In addition, overexpression of CDR1as and knockdown of miR-7, suppressed apoptosis in VSMCs, indicated by the decreased levels of reactive oxygen species (ROS) and lactate dehydrogenase (LDH) activity, whereas knockdown of CDR1as and overexpression of miR-7 exhibited the opposite effects. The results of luciferase reporter and biotin pull-down assays confirmed that CDR1as directly bound to miR-7 and suppressed its expression. Additionally, the CDR1as-induced proliferation and suppressed apoptosis was reversed by the overexpression of miR-7. Furthermore, luciferase reporter, reverse transcription-quantitative PCR and western blot assays revealed that miR-7 directly targeted CKAP4 and suppressed its expression. Additionally, the miR-7-suppressed proliferation and increased ROS and LDH activity were reversed by the overexpression of CKAP4. CDR1as also decreased caspase 3/7 activity, which was reversed by miR-7 mimics. miR-7 increased the activity of caspase 3/7, which was again reversed by the overexpression of CKAP4. Therefore, CDR1as, miR-7 and CKAP4 may act in the same pathway to regulate VSMC proliferation and apoptosis.

Total thoracoscopic surgery for biatrial cardiac myxoma: a case report.

Myxoma is the most common type of benign cardiac tumor in adults. Myxoma can occur anywhere in the heart. The left atrium is the most frequent site of origin, specifically located on the left atrium side of the fossa oval in the atrial septum, followed by the right atrium, the right ventricle and left ventricle. But biatrial myxoma is extremely rare. Thoracoscopic resection of myxoma has become more common, but there are few reports on thoracoscopic surgery for biatrial myxoma. We present a case of a 72-year-old woman with biatrial myxoma, who presented with intermittent dyspnea for one week. Echocardiography revealed a medium echo in both the left and right atrium and was connected via the atrial septum. Computed tomography revealed a hypointense mass in both atria. Thoracoscopic resection successfully removed the tumors, and histological examination confirmed the diagnosis. Also, the patient was discharged six days after surgery. There was no evidence of tumor recurrence during the one-year follow-up period. Biatrial myxoma is rare. Surgical resection is the primary method for myxoma. Compared with the traditional medium thoracotomy, thoracoscopic surgery for myxoma has the following advantages: less trauma, keeping the integrity of the sternum, less bleeding, faster postoperative recovery, etc. Total thoracoscopic surgery for biatrial myxomas is effective and safe.

Endovascular graft exclusion for treating Stanford type B acute aortic dissection in aged population.

The aim of this study was to investigate the efficiency of endovascular graft exclusion for treating Stanford type B acute aortic dissection (AAD) in aged population.Forty-six consecutive patients aged ≥65 years with Stanford type B AAD underwent endovascular therapy in Tianjin Chest Hospital between 2010and 2015 were included in this study. All patients received echocardiography, contrast-enhanced CT, hepatic and renal functions tests, and the blood and urine routine examinations. After the procedure, annual review of the whole aortic computed tomography (CT) was performed for all patients before discharge, as well as 3 months, 6 months and12 months after surgery. All patients were followed up until December, 2015. The outcomes of the whole aortic CT and survival rate were analyzed.Five patients (10.87%) died. Among the 5 cases, 2 showed perioperative death induced by cerebral infarction, 1 died because of newly developed AD 8 months after surgery, and 2 died because of acute myocardial infarction (n = 1) and renal/cardiac failure (n = 1). The other 41 patients (89.13%) were symptom-free with satisfactory conditions.Endovascular stent-graft placement was effective for treating the senior patients with Stanford type B AAD.

The significance of natriuretic peptide in treatment of pulmonary hypertension after mitral valve replacement.

OBJECTIVES: To compare the therapeutic efficacy of recombinant human brain natriuretic peptide and prostaglandin E1 in the treatment of pulmonary hypertension after mitral valve replacement. METHODS: Sixty patients with postoperative pulmonary hypertension were divided randomly into 3 groups that received saline, prostaglandin E1, and natriuretic peptide infusions for 12 hours each. The hemodynamics data were monitored consecutively, and the levels of thromboxane A2 and cyclic guanosine monophosphate were detected pretreatment, after treatment, and 1 week after surgery. RESULTS: The arterial pressure, pulmonary arterial pressure, and pulmonary capillary wedge pressure decreased 1 hour after prostaglandin E1 treatment and rebounded after treatment discontinuation. The pulmonary arterial pressure and pulmonary capillary wedge pressure in the natriuretic peptide group decreased 3 hours after treatment; pulmonary arterial pressure decreased less than that of the prostaglandin group, and there was no evidence of hemodynamic rebound after treatment discontinuation. The natriuretic peptide had no significant effects on arterial pressure. In both the prostaglandin and natriuretic peptide groups, cyclic guanosine monophosphate increased after the treatment, which was even higher in the latter group. Prostaglandin E1 could lead to the decrease of thromboxane A2, which was not seen in the natriuretic peptide group. CONCLUSIONS: Both brain natriuretic peptide and prostaglandin E1 can effectively reduce pulmonary hypertension; however, natriuretic peptide has a slower and milder efficacy. The effects of these 2 drugs in reducing the pulmonary arterial pressure may be mediated through different pathways.