MiRNA let-7d-5p Alleviates Inflammatory Responses by Targeting Map3k1 and Inactivating ERK/p38 MAPK Signaling in Microglia.

Alzheimer's disease (AD) is the most common form of dementia. Aberrant regulation of microRNAs (miRNAs) has been implicated in the pathogenesis of AD. In a large case-control study recruiting 208 patients with AD and 205 elderly control subjects, miRNA-let-7d-5p attracted our attention for its downregulated level in patients with AD. However, the biological functions of let-7d-5p in AD pathogenesis have not been investigated. This study emphasized the functions and mechanisms of let-7d-5p in the pathogenesis of AD. Mouse microglial BV2 cells treated with amyloid-ß (Aß)1-42 were used as in vitro AD inflammation models. We reported that let-7d-5p was downregulated in Aß1-42-stimulated BV2 cells, and upregulation of let-7d-5p promoted the transversion of microglial cells from Ml phenotype to M2 phenotype. Then, the binding relationship between let-7d-5p and Map3k1 was verified by luciferase reporter assays. Mechanistically, let-7d-5p could target Map3k1 3'UTR to inactivate ERK/p38 MAPK signaling. Therefore, it was suggested that let-7d-5p might be a novel modulator of microglial neuroinflammation and serve as a novel target for diagnosis and treatment of AD.

Ordering Bimetallic Cu-Pd Catalysts onto Orderly Mesoporous SrTiO3-Crystal Nanotubular Networks for Efficient Carbon Dioxide Photoreduction.

Artificial photosynthesis of fuels has garnered significant attention, with SrTiO3 emerging as a potential candidate for photocatalysis due to its exceptional physicochemical properties. However, selectively converting CO2 into fuels with desired reaction products remains a grand challenge. Herein, we design an updated method via an aging strategy based on the electrospinning technique to synthesize a single-crystalline Al-doped SrTiO3 nanotubular networks with self-assembled orderly mesopores, further modified by Cu-Pd alloy. It exhibits both high crystallinity and superior cross-linked mesoporous structures, effectively facilitating charge carrier transfer, photon utilization, and mass transfer, with a remarkable enhancement from 0.025 mmol·h-1·m-2 to 1.090 mmol·h-1·m-2 in the CO production rate. Meanwhile, the ordered arrangement of Cu and Pd atoms on the (111) surface can promote the rate-determining step (*CO2 to *COOH), which is also responsible for its good activity. The presence of CuO in the reaction confers a significant advantage for CO desorption, leading to a remarkable CO selectivity of 95.54%. This work highlights new insights into developing advanced heterogeneous photocatalysts.

Recent progresses in gut microbiome mediates obstructive sleep apnea-induced cardiovascular diseases.

Obstructive sleep apnea (OSA) is a multifactorial sleep disorder with a high prevalence in the general population. OSA is associated with an increased risk of developing cardiovascular diseases (CVDs), particularly hypertension, and is linked to worse outcomes. Although the correlation between OSA and CVDs is firmly established, the mechanisms are poorly understood. Continuous positive airway pressure is primary treatment for OSA reducing cardiovascular risk effectively, while is limited by inadequate compliance. Moreover, alternative treatments for cardiovascular complications in OSA are currently not available. Recently, there has been considerable attention on the significant correlation between gut microbiome and pathophysiological changes in OSA. Furthermore, gut microbiome has a significant impact on the cardiovascular complications that arise from OSA. Nevertheless, a detailed understanding of this association is lacking. This review examines recent advancements to clarify the link between the gut microbiome, OSA, and OSA-related CVDs, with a specific focus on hypertension, and also explores potential health advantages of adjuvant therapy that targets the gut microbiome in OSA.

[Expert consensus on integrated traditional Chinese and western medicine diagnosis and treatment for osteoporotic fractures].

Osteoporotic fractures represent the most severe complications of osteoporosis,characterized by insidious onset,high mortality and disability rates,and a steadily increasing incidence,imposing a significant socioeconomic burden. Western medicine has advantages in diagnosis and surgical interventions,while traditional Chinese medicine excels in holistic management and the restoration of bodily equilibrium. The integration of both traditional Chinese medicine (TCM) and western medicine emerges as an effective therapeutic strategy for osteoporotic fractures. In order to propagate the concept of integrated diagnosis and treatment,foster the advancement of integrated medical techniques for osteoporotic fractures,and establish standardized and normative protocols for disease prevention,diagnosis,and treatment,a consensus expert group,led by Geriatric Branch of Chinese Geriatrics Society,the Young Osteoporosis Group of Orthopedics Branch of Chinese Medical Association,Osteoporosis Group of Orthopedics Branch of Chinese Physician Association,and Osteoporosis Professional Committee of the Shanghai Society of Integrated Traditional Chinese and Western Medicine,was established. This group engaged in deliberations and formulated the "Expert Consensus on Integrated Traditional Chinese and Western Medicine Diagnosis and Treatment of Osteoporotic Fractures" elucidating the concept of integrated medicine and offering recommendations in the domains of prevention,diagnosis,and treatment,with the aspiration of ameliorating the prognosis of osteoporotic fractures and enhancing the quality of life for these patients.

Short-term effects of cupping and scraping therapy for chronic nonspecific low-back pain: A prospective, multicenter randomized trial.

BACKGROUND: As one of the most common musculoskeletal ailments, chronic nonspecific low-back pain (CNLBP) causes persistent disability and substantial medical expenses. Epidemiological evidence shows that the incidence rate of CNLBP in young and middle-aged people who are demanded rapidly recovery and social contribution is rising. Recent guidelines indicate a reduced role for medicines in the management of CNLBP. OBJECTIVE: The present study investigates the short-term effects of cupping and scraping therapy using a medicated balm, compared to nonsteroidal anti-inflammatory drug (NSAID) with a capsaicin plaster, in the treatment of CNLBP. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: We designed a prospective multicenter randomized clinical trial enrolling patients from January 1, 2022 to December 31, 2022. A total of 156 patients with CNLBP were randomized into two parallel groups. Diclofenac sodium-sustained release tablets were administered orally to participants in the control group for one week while a capsaicin plaster was applied externally. Patients in the test group were treated with cupping and scraping using a medical device and medicated balm. MAIN OUTCOME MEASURES: Primary outcome was pain recorded using the visual analogue scale (VAS). Two secondary outcomes were recorded using the Japanese Orthopedic Association low-back pain scale (JOA) and the traditional Chinese medicine (TCM) syndrome integral scale (TCMS) as assessment tools. RESULTS: Between baseline and postintervention, all changes in outcome metric scales were statistically significant (P < 0.001). Compared to the control group, patients in the test group had a significantly greater treatment effect in all outcome variables, as indicated by lower VAS and TCMS scores and higher JOA scores, after the one-week intervention period (P < 0.001). Further, according to the findings of multivariate linear regression analysis, the participants' pain (VAS score) was related to their marital status, age, smoking habits and body mass index. No adverse reactions were reported for any participants in this trial. CONCLUSION: The effectiveness of TCM combined with the new physiotherapy tool is superior to that of NSAID combined with topical plasters, regarding to pain intensity, TCM symptoms and quality of life. The TCM plus physiotherapy also showed more stable and long-lasting therapeutic effects. TRIAL REGISTRATION: This study was registered at Chinese Clinical Trial Registry (ChiCTR2200055655). Please cite this article as: He JY, Tu XY, Yin ZF, Mu H, Luo MJ, Chen XY, Cai WB, Zhao X, Peng C, Fang FF, Lü C, Li B. Short-term effects of cupping and scraping therapy for chronic nonspecific low-back pain: A prospective, multicenter randomized trial. J Integr Med. 2024; 22(1): 39-45.

Enhancing emotion recognition in young autistic children with or without attention-deficit/hyperactivity disorder in Hong Kong using a Chinese App version of The Transporters.

TRIAL REGISTRATION: This study was registered with the German Clinical Trials Register - Deutschen Register Klinischer Studien (DRKS) on 23 December 2018. The Trial Registration Number (TRN) is DRKS00016506. LAY ABSTRACT: The Transporters App is an intervention programme with 15 animated episodes that teach emotion recognition skills to autistic children between 4 and 6 years of age. Each episode contains a story depicting social interactions between characters in the form of a vehicle, with human faces grafted on to each of them. Each episode teaches a specific emotion in a story context. Autistic children watched at least three episodes at home for about 15 min daily for a month, with parental guidance. Its automated, home-based format is cost-saving and readily accessible. This study translated The Transporters to a Cantonese-Chinese version. Results showed a significant improvement in emotion recognition following viewing The Transporters in a group of Hong Kong Chinese autistic children, between 4 and 6 years of age, with and without attention-deficit/hyperactivity disorder (n = 48) relative to a control group (n = 24). A non-autistic group (n = 23) showed that the autistic children scored lower in emotion recognition pre-intervention. Post-intervention, the autistic children had improved in emotion recognition to the level of the non-autistic children. The autistic children in the intervention groups also generalized their learning to novel situations/characters not taught within The Transporters. There was no dosage effect, with the standard recommended number of episodes viewed being sufficient to achieve significant improvement. This study confirms the effectiveness of The Transporters for Chinese autistic children and contributes to the literature/practice by expanding the range of applicability of The Transporters to autistic children with attention-deficit/hyperactivity disorder, which is important given the high rate of co-occurrence between autism and attention-deficit/hyperactivity disorder.

Changes in the posterior segment of the eye after an episode of acute ocular hypertension / 国际眼科杂志(Guoji Yanke Zazhi)

Rapidly increasing intraocular pressure(IOP)is a typical manifestation of acute angle-closure glaucoma and an important cause of ocular tissue damage, vision loss and even blindness in glaucoma patients. The sharp increase of intraocular pressure in a short period of time in acute angle-closure glaucoma will cause characteristic damage to the structure and function of retina, choroid and optic nerve. Currently, the diagnosis and evaluation of the course of glaucoma is largely dependent on the state of high IOP, changes in the optic nerve and visual field damage, but irreversible damage to the fundus has already been made in glaucoma patients by this time. The microstructural changes in the posterior segment of the eye are more sensitive to high IOP and often appear before optic nerve and visual field damage, which can indicate the damage of high IOP to the eye earlier. Through the evaluation of the imaging characteristics of the posterior segment of the eye, the morphological characteristics that affect the prognosis of glaucoma can be explored, which is clinically important for the early diagnosis of glaucoma.

Progress in the effect of blood indicators on retinopathy of prematurity / 国际眼科杂志(Guoji Yanke Zazhi)

Retinopathy of prematurity(ROP), an abnormal vascular proliferative retinopathy of prematurity, is a serious condition that can lead to retinal detachment or blindness. With the development of neonatal medicine, the survival rate of low birth weight and low gestational age infants has been increasing, as well as the incidence of ROP. Therefore, studying ROP's pathogenesis and influencing factors is of great clinical importance. Numerous studies have been conducted on the risk factors for ROP, including gestational age, oxygen intake, mode of delivery, neonatal bronchopulmonary dysplasia, and the use of surfactants. At present, it is widely accepted both at home and abroad that preterm birth, low birth weight, and high oxygen concentration after birth are independent risk factors for ROP. In recent years, more and more scholars have found that abnormalities in blood indicators in preterm infants may be associated with the development of ROP. This article reviews the effects of platelets, haemoglobin, blood glucose, inflammatory cells, and lipids on ROP, providing a reference for identifying and preventing risk factors for ROP.

Experimental Study on Gas-Solid Two-Phase Flow Characteristics of a Vertical Cyclone Combustor System.

According to the design and operational parameters of the cyclone liquid slag-discharging boiler, an experimental platform for the cyclone burner was designed and constructed in a cold state based on the principle of similarity. The experimental study investigated the effects of parameters, such as swirl-vane angles, coal concentration, operating parameters, and particle size, on the flow distribution and vertical riser resistance characteristics of the vertical cyclone burner. The results showed that there were differences in flow distribution among the cyclone burners, and the most uniform flow distribution was achieved when the swirl-vane angle of the primary air was 30°. The concentration of pulverized coal significantly influenced the pressure drop in the vertical ascending section, which increased with higher concentrations of pulverized coal. When the concentration of pulverized coal remains constant, the pipeline pressure drop is minimized at a primary air velocity of 7.5 m/s. As the secondary wind speed increased, the pressure drop consistently rose; when the secondary wind speed is 22 m/s, the pressure drop of the pipeline is the maximum; however, excessively high secondary wind speeds were found to be detrimental to the formation of an optimal aerodynamic field in the burner. Furthermore, when the pulverized coal concentration was held constant, materials with larger particle sizes exhibited the highest pressure drop. When the particle size increases from 50 to 150 µm, the pressure drop of the vertical riser segment also increases. Finally, based on the Barth additional pressure drop theory, the pressure drop formula of the vertical riser is fitted by a dimensional analysis method, and the correlation formula of the pressure drop test of gas-solid two-phase flow in the vertical riser is obtained.

Carbazole and tetrahydro-carboline derivatives as dopamine D3 receptor antagonists with the multiple antipsychotic-like properties.

Dopamine D3 receptor (D3R) is implicated in multiple psychotic symptoms. Increasing the D3R selectivity over dopamine D2 receptor (D2R) would facilitate the antipsychotic treatments. Herein, novel carbazole and tetrahydro-carboline derivatives were reported as D3R selective ligands. Through a structure-based virtual screen, ZLG-25 (D3R Ki = 685 nmol/L; D2R Ki > 10,000 nmol/L) was identified as a novel D3R selective bitopic ligand with a carbazole scaffold. Scaffolds hopping led to the discovery of novel D3R-selective analogs with tetrahydro-ß-carboline or tetrahydro-γ-carboline core. Further functional studies showed that most derivatives acted as hD3R-selective antagonists. Several lead compounds could dose-dependently inhibit the MK-801-induced hyperactivity. Additional investigation revealed that 23j and 36b could decrease the apomorphine-induced climbing without cataleptic reaction. Furthermore, 36b demonstrated unusual antidepressant-like activity in the forced swimming tests and the tail suspension tests, and alleviated the MK-801-induced disruption of novel object recognition in mice. Additionally, preliminary studies confirmed the favorable PK/PD profiles, no weight gain and limited serum prolactin levels in mice. These results revealed that 36b provided potential opportunities to new antipsychotic drugs with the multiple antipsychotic-like properties.

Non-Lignin Constructing the Gas-Solid Interface for Enhancing the Photothermal Catalytic Water Vapor Splitting.

The progress of solar-driven water-splitting technology has been impeded by the limited light response capability of semiconductor materials. Despite attempts to leverage nearly 50% of infrared radiation for photothermal synergy and catalytic reaction enhancement, heat loss during liquid phase reactions results in low energy conversion efficiency. Here, the photothermally driven catalytic water-splitting system, which designs K-SrTiO3 -loaded TiN silica wool at the water-air interface. Photocatalytic tests and density functional theory calculations demonstrate that the thermal effect transforms liquid water into water vapor, thereby reducing the reaction free energy of catalysts and improving the transmission rate of catalytic products. Hence, the hydrogen evolution rate reaches 275.46 mmol m-2  h-1 , and the solar-to-hydrogen (STH) efficiency is 1.81% under 1 sun irradiation in this gas-solid system, which is more than twice that of liquid water splitting. This novel photothermal catalytic pathway, which involves a coupled reaction of water evaporation and water splitting, is anticipated to broaden the utilization range of the solar spectrum and significantly enhance the conversion efficiency of STH.

Integrated Coupling Utilization of the Solar Full Spectrum for Promoting Water Splitting Activity over a CIZS Semiconductor.

Most of the existing photocatalysts can only use ultraviolet light and part of visible light, so broadening the spectrum response range and realizing the full spectrum coverage are key measures to improve the solar-to-hydrogen (STH) efficiency of photocatalytic water splitting. A spatially separated photothermal coupled photocatalytic (PTC) reaction system was designed using carbonized melamine foam (C-MF) as a substrate to absorb visible and infrared light and Cu0.04In0.25ZnSy@Ru (CIZS@Ru) as a photocatalyst to absorb UV-visible light (UV-vis). By comparing the three modes of bottom, liquid level, and self-floating, it is found that the surface temperature of the system has a significant effect on the hydrogen evolution activity. The monochromatic light and activation energy experiments verify that the enhancement of photocatalytic activity comes from the strengthened photothermal effect of the substrate. Combined with theoretical calculations, it is further confirmed that the introduction of photothermal materials provides additional kinetic energy for carrier transmission and promotes directional carrier transmission efficiency. Based on the photoenergy-thermal integrated catalytic strategy, the hydrogen production rate reaches 603 mmol h-1 m-2. The structural design of photocatalysis has potential application in the field of photoenergy-fuel conversion.

hsa_circ_0006916 Exerts Effect on Amyloid Beta-Induced Neuron Injury by Targeting miR-217/HOMER1.

OBJECTIVE: Circular RNAs (circRNAs) are rich in miRNA-binding sites, which serve as miRNA sponges or competitive endogenous RNAs (ceRNAs). In the central nervous system, circRNAs are relevant to many neurological disorders including Alzheimer's disease (AD). Dementia associated with AD is correlated with the conversion of the ß-Amyloid (Aß) peptides from soluble monomers to aggregated oligomers and insoluble fibrils. Downregulation of circHOMER1 (circ_0006916) expression level is observed in AD female cases. Thus, this study investigates whether circHOMER1 prevents fibrillar Aß (fAß)-induced cell damage. METHODS: The levels of sAß42 in cerebrospinal fluid (CSF) of amyloid-positive normal cognition (NC) individuals, mild cognitive impairment (MCI) individuals, and AD patients were measured. For in vitro studies, the SH-SY5Y cells were treated with 10 µM of fAß42 or soluble Aß42 (sAß42). RNase R treatment and actinomycin D treatment were used to identify the characteristics of circHOMER1. Gene expression was measured by RT-qPCR. Protein levels were measured using western blotting. Cell viability and apoptosis were estimated by MTT assays and flow cytometry. The binding relationship of miR-217 and circHOMER1 (HOMER1) was verified by luciferase reporter assays. RESULTS: CircHOMER1 was more stable in SH-SY5Y cells than linear HOMER1. CircHOMER1 upregulation ameliorates the fAß42-induced cell apoptosis and circHOMER1 downregulation reversed the anti-apoptotic roles of sAß42. Mechanistically, miR-217 interacted with circHOMER1 (HOMER1). Moreover, miR-217 upregulation or HOMER1 downregulation exacerbates the fAß42-induced cell damage. CONCLUSIONS: CircHOMER1 (hsa_circ_0006916) ameliorates the fAß42-induced cell injury via the miR-217/HOMER1 axis.

Trace Cu+-dominated band structure engineering in CuxIn0.25ZnSy for promoting photocatalytic H2 evolution.

As an attractive semiconductor photocatalyst, (CuInS2)x-(ZnS)y has been intensively studied in photocatalysis, due to its unique layered structure and stability. Here, we synthesized a series of CuxIn0.25ZnSy photocatalysts with different trace Cu+-dominated ratios. The results show that doping with Cu+ ions leads to an increase in the valence state of In and the formation of a distorted S structure, simultaneously inducing a decrease in the semiconductor bandgap. When the doping amount of Cu+ ions is 0.04 atomic ratio to Zn, the optimized Cu0.04In0.25ZnSy photocatalyst with a bandgap of 2.16 eV shows the highest catalytic hydrogen evolution activity (191.4 µmol.h-1). Subsequently, among the common cocatalysts, Rh loaded Cu0.04In0.25ZnSy gives the highest activity of 1189.8 µmol·h-1, corresponding to an apparent quantum efficiency of 49.11 % at 420 nm. Moreover, the internal mechanism of photogenerated carrier transfer between semiconductors and different cocatalysts is analyzed by the band bending phenomenon.

The structure-based optimization of 3-substituted indolin-2-one derivatives as potent and isoform-selective c-Jun N-terminal kinase 3 (JNK3) inhibitors and biological evaluation.

An indolin-2-(4-thiazolidinone) scaffold was previously shown to be a novel chemotype for JNK3 inhibition. However, more in vivo applications were limited due to the unconfirmed configuration and poor physicochemical properties. Here, the indolin-2-(4-thiazolidinone) scaffold validated the absolute configuration; substituents on the scaffold were optimized. Extensive structure activity relationship (SAR) studies were performed using kinase activity assays, thus leading to potent and highly selective JNK3 inhibitors with neuroprotective activity and good oral bioavailability. One lead compound, A53, was a potent and selective JNK3 inhibitor (IC50 = 78 nM) that had significant inhibition (>80% at 1 µM) to only JNK3 in a 398-kinase panel. A53 had low inhibition against JNK3 and high stability (t1/2(α) = 0.98 h, t1/2(ß) = 2.74 h) during oral administration. A modeling study of A53 in human JNK3 showed that the indolin-2-(4-thiazolidinone)-based JNK3 inhibitor with a 5-position-substituted hydrophilic group offered improved kinase inhibition.

Nitrogen dioxide detection using tandem integrating spheres as a gas absorption cell based on gas absorption spectroscopy.

This paper presents a nitrogen dioxide detection device based on gas absorption spectroscopy by connecting two integrating spheres as a gas cell, observing the feasibility of the tandem integrating spheres as a gas cell, and taking a single integrating sphere as a gas cell for comparison experiments. Theoretical knowledge of the effective path length of tandem integrating spheres was established, and the theoretical derivation was further verified by experiments investigating the relationship between absorbance and gas concentration. This work makes it possible to develop a gas sensor that can reduce the volume of the gas cell and keep the effective optical path length unreduced.

A longitudinal study of perinatal depression and the risk role of cognitive fusion and perceived stress on postpartum depression.

AIMS AND OBJECTIVES: To explore fluctuations in perinatal depression based on physiological, psychological and interpersonal dimensions to analyse risk factors across three time points: in the third trimester and at weeks 1 and 6 postpartum. BACKGROUND: Pregnant women experience depression at multiple time points and require screening. Studies have shown protective and negative factors related to postpartum depression. Cognitive fusion refers to an individual's emotions and behaviours that are regulated and influenced by that individual's own cognitive overregulation, especially when facing stress. This is an important psychological factor related to depression, but little is known about it in pregnant women. DESIGN: A longitudinal study was conducted from June 2019-July 2020, and the findings are reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. METHODS: Pregnant women (n = 207) were recruited, and a questionnaire survey was performed at 32-34 weeks of pregnancy and at weeks 1 and 6 postpartum. Repeated-measures analysis of variance was performed to analyse the changes in depression over time. Regression analysis and linear mixed modelling were used to identify risk factors. Pearson's correlation analysis was performed to analyse the relationships between variables. RESULTS: Of the pregnant women, 36.70% experienced antenatal depression and prolonged depression with the onset of postpartum depression (12.21%). Some depressive moods disappeared spontaneously after delivery (47.37%). Perceived stress was the highest risk predictor of postpartum depression (ß = 0.332), followed by cognitive fusion (ß = 0.178), which remained stable over time and might have been positively related to having a vulnerable personality (0.2 < r < 0.4). Social support plays a positive role in lowering postpartum depression (ß = -0.027). CONCLUSIONS: Changes in depression were influenced by multiple factors with stability and predictability across time. Psychological dimensions, such as perceived stress and cognitive fusion, are risk factors for developing postpartum depression and antenatal depression. RELEVANCE TO CLINICAL PRACTICE: Pregnant women can be divided into depressive cohorts according to screening at different time points to provide targeted interventions.

Novel Loss of Function (G15D) Mutation on RAC2 in a Family with Combined Immunodeficiency and Increased Levels of Immunoglobulin G, A, and E.

Ras-related C3 botulinum toxin substrate 2 (RAC2) is a small guanine nucleotide binding molecule that is exclusively expressed in hematopoietic cell lineages as a switcher. Based on in vivo and/or in vitro model experiments, RAC2 plays important roles in different cells through proliferation, secretion, and phagocytosis. It also performs a suppressing function in immunoglobulin (Ig) switching in Rac2-/- animals or cells. Several RAC2 natural mutations have been described in patients with primary immunodeficiency. RAC2 mutations can be classified into loss-of-function inactivating (LoF-I) and gain-of-function activating mutations according to their functional effects. Only two LoF-I mutations on RAC2 have been reported, including a dominant D57N mutation in several cases that exhibit granulocyte function defects and a recessive D56X mutation in cases with common variable immunodeficiency. Regardless of the type of mutation, most of the reported RAC2 mutant cases have shown reduced IgG, IgA, and IgM levels. Herein, we report on a family with three members that suffer from persistent HPV infection, recurrent respiratory infections, bronchiectasis, and autoimmune disease. The immunologic profile suggests that the family was affected by combined immunodeficiency (CID) with increased serum levels of IgG, IgA, and IgE. Exome sequencing identified a de novo RAC2 mutation (c.44G > A/p.G15D) that was co-segregated with the disease in the family. Gene functional experiments identified that such mutation results in reduced guanosine triphosphate binding activity and RAC2 protein expression. In patients' lymphocytes, impaired aggregation and proliferation effects, decreased mitochondrial membrane potential, and increased levels of cell apoptosis were observed, although no functional abnormalities were detected in neutrophils. To our knowledge, this study was the first to identify a LoF-I mutation of RAC2 affecting lymphocyte function that consequently led to CID and increased levels of serum IgG, IgE, and IgA. This study presents a novel subtype of RAC2-related immune disorder.

Meta-analysis and GRADE evaluation of Guanxinning Tablets in treatment of angina pectoris of coronary heart disease / 中国中药杂志

This study aims to evaluate the efficacy and safety of Guanxinning Tablets+conventional western medicine in the treatment of angina pectoris of coronary heart disease, and provide evidence-based references for clinical medication. Retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Cochrane Library, randomized controlled trial(RCT) about Guanxinning Tablets for the treatment of angina pectoris of coronary heart disease from the inception to April 2022 were collected. After literature screening and data extraction, the bias risk assessment tool recommended by the Cochrane evaluation manual handbook 5.1.0 was used to evaluate the quality of the included literature, and RevMan 5.3 and Stata 14.0 were used for Meta-analysis. Eighteen RCTs were finally included, involving 2 281 patients. Meta-analysis showed that, compared with conventional western medicine treatment alone, Guanxinning Tablets+conventional western medicine significantly improved angina pectoris efficacy(RR=1.33, 95%CI[1.13, 1.57], P=0.000 8), electrocardiogram efficacy(RR=1.32, 95%CI[1.02, 1.71], P=0.03), and exercise duration(MD=59.53, 95%CI[39.16, 79.90], P<0.000 01) and reduced the incidence of cardiovascular events(MACE)(RR=0.43, 95%CI[0.30, 0.61], P<0.000 01), high sensitivity C-reactive protein(hs-CRP)(MD=-2.75, 95%CI[-3.71,-1.79], P<0.000 01), and endothelin-1(ET-1) levels(MD=-9.34, 95%CI[-11.36,-7.32], P<0.000 01). There was no statistically significant difference in the incidence of adverse reactions between two groups(RR=0.91, 95%CI[0.68, 1.22], P=0.52). Subgroup analysis showed that Guanxinning Tablets may have better short-term efficacy(less than 6 months) in the treatment of heart-blood stasis syndrome. GRADE grading showed that angina pectoris efficacy, electrocardiogram efficacy, MACE, and ET-1 were in the medium grade, hs-CRP and adverse reactions were in the low grade, and exercise duration was in the extremely low grade. In conclusion, the efficacy of Guanxinning Tablets+conventional western medicine is better than conventional western medicine treatment alone, with good safety. Therefore, it is recommended for the short-term treatment of patients with heart-blood stasis syndrome. However, the evidence quality of some results is low, and more rigo-rous RCT is still needed to enhance the reliability of evidence.

Thirty-day outcomes of in-hospital multi-vessel versus culprit-only revascularization strategy for ST-segment elevation myocardial infarction with multivessel coronary disease / 老年心脏病学杂志（英文版）

BACKGROUND@#Many studies have demonstrated the benefit of complete multivessel revascularization versus culprit-only intervention in patients of ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease. However, only a few single-center retrospective studies were performed on small Chinese cohorts. Our study aims to demonstrate the advantage of multivessel percutaneous intervention (PCI) strategy on 30-day in-hospital outcomes to patients with STEMI and multivessel disease in larger Chinese population.@*METHODS@#From the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome (CCC-ACS) project, 5935 patients with STEMI and multivessel disease undergoing PCI and hospitalized for fewer than 30 days were analyzed. After 5: 1 propensity score matching, 3577 patients with culprit-only PCI and 877 with in-hospital multivessel PCI were included. The primary outcome was major adverse cardiovascular and cerebrovascular event (MACCE), defined as a composite of myocardial infarction, all-cause death, stent thrombosis, heart failure, and stroke.@*RESULTS@#Multivariable logistic regression analysis revealed that in-hospital multivessel PCI was associated with lower risk of 30-day MACCE (adjusted OR = 0.75, 95% CI: 0.57-0.98, P = 0.032) than culprit-only PCI and conferred no increased risk of all-cause death, myocardial infarction, stent thrombosis, stroke, or bleeding. Subgroup analysis showed that MACCE reduction was observed more often from patients with trans-femoral access (OR = 0.34, 95% CI: 0.15-0.74) than with trans-radial access (OR = 0.87, 95% CI: 0.66-1.16, P for interaction = 0.017).@*CONCLUSIONS@#The in-hospital multivessel PCI strategy was associated with a lower risk of 30-day MACCE than culprit-only PCI in patients with STEMI and multivessel coronary artery disease.