Clinical Efficacy of Fractional Flow Reserve-Guided Percutaneous Coronary Intervention in Coronary Heart Disease Patients with SYNTAX Score ≥33 and Euro Score ≥6: A Single-Center Retrospective Analysis.

OBJECTIVE: To observe clinical efficacy of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) in coronary heart disease patients with SYNTAX scores (SS) ≥33 and Euro Scores (ES) ≥6 who are unsuitable for or have declined coronary artery bypass graft (CABG). METHODS: A total of 117 patients with SS ≥33 and Euro Score (ES) ≥6 who were unsuitable for and/or who had declined CABG between Jan 2021 and June 2022 were enrolled in this retrospective analysis. All patients accepted optimal medical therapy and some accepted an FFR-guided PCI procedure. Patients who only underwent optimal medical therapy were divided into the optimal medical therapy group (OMT group) and patients who simultaneously underwent FFR-guided PCI procedure were divided into the PCI group in this retrospective analysis. All patients accepted follow-up for at least 12 months after discharge. RESULTS: SS and ES in the two groups were not statistically different (p > 0.05). Patients with chronic total occlusion accounted for a greater proportion in the PCI subgroup (31.3%, 5/16) than in other subgroups. Eighteen (18.6%, 18/97) cases in the PCI group developed major adverse cardiac and cerebrovascular events (MACCEs). There were 12 (60%, 12/20) cases of MACCEs in the OMT group, which was statistically different from the PCI group (p < 0.05). CONCLUSIONS: Based on optimal medical therapy, FFR-guided PCI can still have clinical benefit to coronary artery disease patients with SS ≥33 who were not suitable for CABG.

Evaluation of the potential of chimeric spidroins/poly(L-lactic-co-ε-caprolactone) (PLCL) nanofibrous scaffolds for tissue engineering.

In this study, a novel type of chimeric spider silk proteins (spidroins) NTW1-4CT was blended with poly(L-lactic-co-ε-caprolactone) (PLCL) to obtain nanofibrous scaffolds via electrospinning. Spidroins are composed of a N-terminal module (NT) from major ampullate spidroins, a C-terminal module (CT) from minor ampullate spidroins and 1-4 repeat modules (W) from aciniform spidroins. Physical characteristics and structures of NTW1-4CT/PLCL (25/75, w/w) blend scaffolds were carried out by scanning electron microscope (SEM), water contact angles measurements, Fourier transform infrared (FTIR) spectroscopy and tensile mechanical tests. Results showed that blending with spidroins decreased diameters of nanofibers and increased porosity and wettability of scaffolds. Additionally, chimeric spidroins undergone a similar structural transition in electrospinning process as with the formation process of native and artificial spider silks from other spidroins. With amounts of W modules increasing, the tensile strength and elongation of blend scaffolds were also increased. Particularly, NTW4CT/PLCL (25/75) scaffolds revealed much higher breaking stress than pure PLCL scaffolds. In vitro experiments, human umbilical vein endothelial cells (HUVEC) cultured on NTW4CT/PLCL (25/75) scaffolds displayed significantly higher activity of proliferation and adhesion than on pure PLCL scaffolds. All results suggested that chimeric spidroins/PLCL, especially NTW4CT/PLCL (25/75) blend nanofibrous scaffolds had promising potential for vascular tissue engineering.

Structural characterization and mechanical properties of chimeric Masp1/Flag minispidroins.

Dragline silk has the highest tensile strength among the seven types of spider silks due to its abundant polyalanine motifs. Whereas the flagelliform spider silk is most extensible as its composed spidroin is rich in GPGGX motifs. Most of the spider silk proteins are composed of an extensive repetitive domain flanked by N- and C-terminal domains. To obtain artificial fibers with considerable strength and extensibility, herein a kind of chimeric minispidroins were constructed whose repetitive domain (R) mainly consisted of polyalanine motifs and GPGGX motifs. In our study, NT and CT from Araneus ventricosus MaSp1 were fused with different numbers (1, 4, 8) of repeat domains (R), resulting in three chimeric minispidroins. All these chimeric proteins could form silk-like fibers via manual pulling. As the chimeric spidroin was pulled from the protein solution into fiber by shear forces, the secondary structure transformed from α-helix to ß-sheet. Among the three types of fibers, the average tensile strength of NTR4CT ranked the highest (149 MPa), which could provide outstanding material with better mechanical properties. In addition, NT was fused with CT and repetitive domain R respectively, namely NC and NR proteins. As a result, NC could form fibers that had much lower properties than NTR1CT, indicating that repetitive domain was responsible for the strength and elasticity of the fibers. However, NR did not form silk-like fibers, suggesting that Araneus ventricosus Masp1 CT controlled fiber formation. These results broaden the limited knowledge of chimeric spider silk sequences.

Overseeing health care facilities in Shanghai, China: regulatory regime, activities and challenges of the governmental regulatory system.

BACKGROUND: Government regulation has played a crucial role in ensuring the quality, safety and equity of health care. However, few empirical studies have investigated Chinese governmental oversight of health care facilities in terms of regulatory arrangements and approaches. This study aims to explore the regulatory regime and main activities within the health sector in Shanghai, a city featuring abundant health care resources and a complex medical system, to provide policy implications for better regulation and offer valuable reference for elsewhere in China and other developing countries. METHODS: We explored the structure and main activities of government regulation over health care facilities in Shanghai, compared it with the regulatory system in Hong Kong and Taipei through a literature review and analyzed the data on regulatory activities conducted by the local Health Supervision Agencies using descriptive statistical analysis. The data were collected from the Shanghai Statistical Yearbook 2014-2018 and the centralized data bank of the Shanghai Health Supervision Authority. RESULTS: Shanghai has established a unique governmental regulatory system compared to Hong Kong and Taipei. We found health care facilities in Shanghai underwent less frequent inspections between 2013 and 2017, as average annual inspections at individual facilities decreased from 3.8 to 2.7. The number of annual administrative penalties and notifications issued for accumulating points on local health care facilities' violations decreased by 24.8 and 40.7%, respectively, and complaints against health care facilities decreased by 29.1% during the study period. CONCLUSIONS: The local governmental regulatory system played a vital role in overseeing the health care facilities and ensuring their legal compliance by exerting the various regulatory activities. Both annual administrative penalties and notifications of accumulating points on local health care facilities' violations decreased considerably, with complaints against health care facilities reducing. As our study identified significant challenges, including regulatory fragmentation and no risk-based approach used, we offer recommendations to develop new policies and establish new mechanisms for better regulation.

The atomic-scale structure of LaCrO3-NaTaO3 solid solution photocatalysts with enhanced electron population.

Visible light sensitization of sodium tantalate (NaTaO3), a highly UV-active material, is critical for realizing its practical application in photocatalytic water splitting under solar light. Double doping of a half-filled transition metal together with another metal for cationic charge balance is a promising way of sensitizing NaTaO3 to visible light. One fundamental issue is that the atomic-scale structure of such doubly doped NaTaO3 is not yet fully understood. In this study, we doubly doped NaTaO3 with La3+ and Cr3+ through a solid-state route. The occupation preference of La3+ in a doubly doped system was particularly studied by the extended X-ray absorption fine structure technique. We revealed the substitution of La3+ for Na+, and Cr3+ for Ta5+, forming a LaCrO3-NaTaO3 solid solution. We then showed that doping NaTaO3 with La3+ and Cr3+ appreciably increased the population of electrons photoexcited by either visible light or UV light. Photoactivation of the doubly doped NaTaO3 with visible light produced a population of electrons comparable to that under UV light. The charge compensation scheme of double doping with La3+ and Cr3+ is shown here to be a good option for the sensitization of NaTaO3 to visible light.

Production and Properties of Triple Chimeric Spidroins.

All spider silk proteins (spidroins) are composed of N- and C-terminal domains (NT and CT) that act as regulators of silk solubility and assembly and a central repetitive region, which confers mechanical properties to the fiber. Among the seven types of spider silks, aciniform silk has the highest toughness. Herein, we fused NT and CT domains from major and minor ampullate spidroins (MaSps and MiSps), respectively, to 1-4 repeat domains (W) from another type of spidroin, aciniform spidroin 1(AcSp1). Although the three domains originate from distantly related spidroin types, they keep their respective characteristics in the chimeric spidroins. Furthermore, all chimeric spidroins could form silk-like fibers by manual-drawing. In contrast to fibers made in the same manner from W domains only, NTW1-4CT fibers show superior mechanical properties. Our results suggest that chimeric spidroins with NT, CT, and repeat domains can be designed to form fibers with various mechanical properties.

[Angiotensin II induced cardiac hypertrophy is blocked by PTEN via suppressing Ca2+/Calcineurin pathway].

OBJECTIVE: To investigate the effects of PTEN on Ang II induced cardiomyocyte hypertrophy and subsequent Ca(2+)/Calcineurin pathway changes. METHODS: Primary cultured neonatal rat cardiomyocytes were cultured and were treated with phosphate-buffered saline, empty adenovirus (Ad-GFP), or adenovirus encoding for PTEN (Ad-PTEN-GFP) for 48 h and Ang II (10(-7) mol/L) was added to the medium for another 24 h. Cells were harvested and intracellular Ca(2+) concentration ([Ca(2+)] i) was determined by Fura-2/AM ratio imaging analysis; PTEN, ANF, beta-MHC and CaNAbeta mRNA evaluated with RT-PCR; PTEN and CaNAbeta protein by Western blot; CaN phosphatase activity by CaN detecting kits. RESULTS: PTEN at mRNA and protein levels were significantly higher in Ad-PTEN-GFP treated cardiomyocytes than that of Ad-GFP treated cardiomyocytes. Ang II stimulation upregulated [Ca(2+)] i, CaNAbeta at mRNA and protein levels and CaN phosphatase activity in Ad-GFP treated cardiomyocytes but not in Ad-PTEN-GFP treated cardiomyocytes. CONCLUSIONS: Cardiac hypertrophy induced by Ang II could be blocked by PTEN overexpression via suppressing Ca(2+)/Calcineurin pathway.

[PTEN negatively regulates isoproterenol-induced cardiac hypertrophy and effects of captopril on PTEN expression].

OBJECTIVE: To examine the negative regulation role of PTEN in isoproterenol-induced cardiac hypertrophy by testing the expression of PTEN mRNA and protein and to explore the effects of captopril (Cap) on PTEN expression. METHODS: Twenty four rats were randomly divided into three groups: control group, ISO group, and ISO+Cap group. The following parameters were examined:body weight (BW), heart weight (HW), left ventricular weight (LVW), left ventricular end-diastolic pressure (LVEDP), left ventricular end-systolic pressure (LVESP) and +/- dp/dt(max). The ratio of HW/BW and LVW/BW was calculated. PTEN mRNA and protein were tested by RT-PCR and Western blot, respectively. RESULTS: (1) Compared with the control group, the ratio of HW/BW and LVW/BW, LVEDP and LVESP were all increased in ISO group and ISO+Cap group (P < 0.05), but +/- dp/dt(max) was decreased (P < 0.05); (2) compared with the ISO group, the ratio of HW/BW and LVW/BW, LVEDP, LVESP were all decreased in ISO+Cap group (P < 0.05), but +/- dp/dt(max) was increased (P < 0.05); (3) compared with the control group, PTEN mRNA and protein were up-regulated in ISO group and ISO+Cap group; (4) compared with the ISO group, PTEN mRNA and protein were up-regulated in ISO+Cap group. CONCLUSIONS: PTEN mRNA and protein are up-regulated in isoproterenol-induced cardiac hypertrophy. Captopril can up-regulate PTEN expression in cardiac hypertrophy. There is a negative regulative mechanism in cardiac hypertrophy process, in which PTEN is probably an endogenous negative regulator of cardiac hypertrophy.

[The relationship between expressions of beta1-, beta2-, beta3-adrenoceptor mRNA of myocardium and cardiac function in patients with heart failure].

OBJECTIVE: To investigate the alteration of expressions of beta(1)-, beta(2)-, beta(3)-adrenoceptor mRNA in human myocardial tissue and the relation between their expressions and cardiac function in patient with heart failure. METHODS: The mRNA expressions of beta(1)-, beta(2)- and beta(3)-adrenergic receptors in myocardial tissue were analyzed by using the reverse transcriptase-polymerase chain reaction in 24 patients with heart failure of valvular heart disease and 5 control subjects. RESULTS: Beta(1)-adrenergic receptor mRNA expressions in myocardium were significantly lower in patients with heart failure than those in control subjects, and progressively reduced with aggravation of heart function. By contrast, beta(3)-adrenoceptor mRNA expressions were significantly higher in patients with heart failure than those in controls, and progressively elevated with aggravation of cardiac function. No difference was observed in beta(2)-adrenergic receptor among all groups. CONCLUSION: The changes of beta-adrenergic receptor mRNA expression are associated with the severity of heart failure.