Safety and efficacy of PCSK9 inhibitor (evolocumab) in patients with non-ST segment elevation acute coronary syndrome and non-culprit artery critical lesions: a randomised controlled trial protocol (SPECIAL study).

INTRODUCTION: Patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS) and concomitant multivessel coronary artery disease (CAD) are considered patients with extremely high-risk atherosclerotic cardiovascular disease (ASCVD), and current guidelines specify a lower low-density lipoprotein cholesterol (LDL-C) target for this population. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been shown to effectively reduce LDL-C levels on a statin background. Additionally, several studies have confirmed the role of PCSK9 inhibitors in plaque regression and reducing residual cardiovascular risk in patients with ACS. However, those studies included coronary lesions with a degree of stenosis <50%. Whether the application of PCSK9 inhibitors in patients with NSTE-ACS with non-culprit artery critical lesions (stenosis degree between 50% and 75%) has a similar effect on plaque regression and improvement of cardiovascular outcomes remains unknown, with a lack of relevant research. This study aims to further investigate the safety and efficacy of evolocumab in patients with NSTE-ACS and concomitant multivessel CAD (non-culprit artery stenosis between 50% and 75%). METHODS AND ANALYSIS: In this single-centre clinical randomised controlled trial, 122 patients with NSTE-ACS and concomitant multivessel CAD (non-culprit artery stenosis between 50% and 75%) will be randomly assigned to either the evolocumab treatment group or the standard treatment group after completing culprit vessel revascularisation. The evolocumab treatment group will receive evolocumab in addition to statin therapy, while the standard treatment group will receive standard statin therapy. At baseline and week 50, patients in the evolocumab treatment group will undergo coronary angiography and OCT imaging to visualise pre-existing non-lesional vessels. The primary end point is the absolute change in average minimum fibrous cap thickness (FCT) from baseline to week 50. Secondary end points include changes in plaque lipid arc, lipid length, macrophage grading, lipid levels and major adverse cardiovascular events during the 1-year follow-up period. ETHICS AND DISSEMINATION: Ethics: this study will adhere to the principles outlined in the Helsinki Declaration and other applicable ethical guidelines. This study protocol has received approval from the Medical Research Ethics Committee of the First Affiliated Hospital of the University of Science and Technology of China (Anhui Provincial Hospital), with approval number 2022-ky214. DISSEMINATION: we plan to disseminate the findings of this study through various channels. This includes publication in peer-reviewed academic journals, presentation at relevant academic conferences and communication to the public, policymakers and healthcare professionals. We will also share updates on the research progress through social media and other online platforms to facilitate the exchange and application of scientific knowledge. Efforts will be made to ensure widespread dissemination of the research results and to have a positive impact on society. TRIAL REGISTRATION NUMBER: ChiCTR2200066675.

Giant Iontronic Flexoelectricity in Soft Hydrogels Induced by Tunable Biomimetic Ion Polarization.

Flexoelectricity features the strain gradient-induced mechanoelectric conversion using materials not limited by their crystalline symmetry, but state-of-the-art flexoelectric materials exhibit very small flexoelectric coefficients and are too brittle to withstand large deformations. Here, inspired by the ion polarization in living organisms, this paper reports the giant iontronic flexoelectricity of soft hydrogels where the ion polarization is attributed to the different transfer rates of cations and anions under bending deformations. The flexoelectricity is found to be easily regulated by the types of anion-cation pairs and polymer networks in the hydrogel. A polyacrylamide hydrogel with 1 m NaCl achieves a record-high flexoelectric coefficient of ≈1160 µC m-1, which can even be improved to ≈2340 µC m-1 by synergizing with the effects of ion pairs and extra polycation chains. Furthermore, the hydrogel as flexoelectric materials can withstand larger bending deformations to obtain higher polarization charges owing to its intrinsic low modulus and high elasticity. A soft flexoelectric sensor is then demonstrated for object recognition by robotic hands. The findings greatly broaden the flexoelectricity to soft, biomimetic, and biocompatible materials and applications.

Tracing Immunological Interaction in Trimethylamine N-Oxide Hydrogel-Derived Zwitterionic Microenvironment During Promoted Diabetic Wound Regeneration.

The diabetic wound healing is challenging due to the sabotaged delicate balance of immune regulation via an undetermined pathophysiological mechanism, so it is crucial to decipher multicellular signatures underlying diabetic wound healing and seek therapeutic strategies. Here, this work develops a strategy using novel trimethylamine N-oxide (TMAO)-derived zwitterionic hydrogel to promote diabetic wound healing, and explore the multi-cellular ecosystem around zwitterionic hydrogel, mapping out an overview of different cells in the zwitterionic microenvironment by single-cell RNA sequencing. The diverse cellular heterogeneity is revealed, highlighting the critical role of macrophage and neutrophils in managing diabetic wound healing. It is found that polyzwitterionic hydrogel can upregulate Ccl3+ macrophages and downregulate S100a9+ neutrophils and facilitate their interactions compared with polyanionic and polycationic hydrogels, validating the underlying effect of zwitterionic microenvironment on the activation of adaptive immune system. Moreover, zwitterionic hydrogel inhibits the formation of neutrophil extracellular traps (NETs) and promotes angiogenesis, thus improving diabetic wound healing. These findings expand the horizons of the sophisticated orchestration of immune systems in zwitterion-directed diabetic wound repair and uncover new strategies of novel immunoregulatory biomaterials.

Preserving shape details of pulse signals for video-based blood pressure estimation.

In recent years, imaging photoplethysmograph (iPPG) pulse signals have been widely used in the research of non-contact blood pressure (BP) estimation, in which BP estimation based on pulse features is the main research direction. Pulse features are directly related to the shape of pulse signals while iPPG pulse signals are easily disturbed during the extraction process. To mitigate the impact of pulse feature distortion on BP estimation, it is necessary to eliminate interference while retaining valuable shape details in the iPPG pulse signal. Contact photoplethysmograph (cPPG) pulse signals measured at rest can be considered as the undisturbed reference signal. Transforming the iPPG pulse signal to the corresponding cPPG pulse signal is a method to ensure the effectiveness of shape details. However, achieving the required shape accuracy through direct transformation from iPPG to the corresponding cPPG pulse signals is challenging. We propose a method to mitigate this challenge by replacing the reference signal with an average cardiac cycle (ACC) signal, which can approximately represent the shape information of all cardiac cycles in a short time. A neural network using multi-scale convolution and self-attention mechanisms is developed for this transformation. Our method demonstrates a significant improvement in the maximal information coefficient (MIC) between pulse features and BP values, indicating a stronger correlation. Moreover, pulse signals transformed by our method exhibit enhanced performance in BP estimation using different model types. Experiments are conducted on a real-world database with 491 subjects in the hospital, averaging 60 years of age.

Electronic Structure Regulated Nickel-Cobalt Bimetal Phosphide Nanoneedles for Efficient Overall Water Splitting.

Transition metal phosphides (TMPs) have been widely studied for water decomposition for their monocatalytic property for anodic or cathodic reactions. However, their bifunctional catalytic activity still remains a major challenge. Herein, hexagonal nickel-cobalt bimetallic phosphide nanoneedles with 1-3 µm length and 15-30 nm diameter supported on NF (NixCo2-xP NDs/NF) with adjusted electron structure have been successfully prepared. The overall alkaline water electrolyzer composed of the optimal anode (Ni0.67Co1.33P NDs/NF) and cathode (Ni1.01Co0.99P NDs/NF) provide 100 mA cm-2 at 1.62 V. Gibbs Free Energy for reaction paths proves that the active site in the hydrogen evolution reaction (HER) is Ni and the oxygen evolution reaction (OER) is Co in NixCo2-xP, respectively. In the HER process, Co-doping can result in an apparent accumulation of charge around Ni active sites in favor of promoting HER activity of Ni sites, and ΔGH* of 0.19 eV is achieved. In the OER process, the abundant electron transfer around Co-active sites results in the excellent ability to adsorb and desorb *O and *OOH intermediates and an effectively reduced ∆GRDS of 0.37 eV. This research explains the regulation of electronic structure change on the active sites of bimetallic materials and provides an effective way to design a stable and effective electrocatalytic decomposition of alkaline water.

PFDNet: A Pulse Feature Disentanglement Network for Atrial Fibrillation Screening From Facial Videos.

Video-based Photoplethysmography (VPPG) can identify arrhythmic pulses during atrial fibrillation (AF) from facial videos, providing a convenient and cost-effective way to screen for occult AF. However, facial motions in videos always distort VPPG pulse signals and thus lead to the false detection of AF. Photoplethysmography (PPG) pulse signals offer a possible solution to this problem due to the high quality and resemblance to VPPG pulse signals. Given this, a pulse feature disentanglement network (PFDNet) is proposed to discover the common features of VPPG and PPG pulse signals for AF detection. Taking a VPPG pulse signal and a synchronous PPG pulse signal as inputs, PFDNet is pre-trained to extract the motion-robust features that the two signals share. The pre-trained feature extractor of the VPPG pulse signal is then connected to an AF classifier, forming a VPPG-driven AF detector after joint fine-tuning. PFDNet has been tested on 1440 facial videos of 240 subjects (50% AF absence and 50% AF presence). It achieves a Cohen's Kappa value of 0.875 (95% confidence interval: 0.840-0.910, P<0.001) on the video samples with typical facial motions, which is 6.8% higher than that of the state-of-the-art method. PFDNet shows significant robustness to motion interference in the video-based AF detection task, promoting the development of opportunistic screening for AF in the community.

Impact of Bivalirudin on Patients with Acute Coronary Syndrome Undergoing Rotational Atherectomy in Real-Life Setting: A Retrospective Cohort Study.

BACKGROUND: No evidence exists on the impact of bivalirudin in patients with the acute coronary syndrome undergoing rotational atherectomy. This study aimed to evaluate the impact of bivalirudin on patients with acute coronary syndrome undergoing rotational atherectomy. METHODS: This was a retrospective cohort study conducted in our hospital between January 2017 and December 2019. The study included patients with acute coronary syndrome undergoing rotational atherectomy. Furthermore, 2 cohorts were included in this study (bivalirudin cohort and control cohort unfractionated heparin). The primary end-point was in-hospital net adverse clinical events. The secondary endpoint was all-cause mortality at 23 months. RESULTS: The study included 157 patients with 33 (21.0%) in the bivalirudin cohort and 124 (79.0%) in the control cohort. Net adverse clinical events during hospitalization in the bivalirudin cohort were higher than that in the control cohort [9 (27.3%) vs. 14 (11.3%), P = .021]. However, there was no significant difference in all-cause mortality at 23 months between the 2 cohorts [25 (20.2%) vs. 10 (30.3%), P =.214]. After adjusting for potential confounders, the usage of bivalirudin was not associated with net adverse clinical event (odds ratio = 0.90; 95% CI: 0.18-4.45; P =.890), and the hazard ratio for all-cause mortality at 23 months was 1.01 (95% CI: 0.33-3.15; P =.983). CONCLUSION: Bivalirudin appears to exhibit a similar impact as unfractionated heparin on patients with acute coronary syndrome undergoing rotational atherectomy in real-life setting.

Nonepitaxial Electrodeposition of (002)-Textured Zn Anode on Textureless Substrates for Dendrite-Free and Hydrogen Evolution-Suppressed Zn Batteries.

Nontoxic and safe aqueous Zn batteries are largely restricted by the detrimental dendrite growth and hydrogen evolution of Zn metal anode. The (002)-textured Zn electrodeposition, demonstrated as an effective approach for solving these issues, is nevertheless achieved mainly by epitaxial or hetero-epitaxial deposition of Zn on pre-textured substrates. Herein, the electrodeposition of (002)-textured and compact Zn on textureless substrates (commercial Zn, Cu, and Ti foils) at a medium-high galvanostatic current density is reported. According to the systematic investigations on Zn nucleation and growth behaviors, this is ascribed to two reasons: i) the promoted nonepitaxial nucleation of fine horizontal (002) nuclei at increased overpotential and ii) the competitive growth advantages of (002)-orientated nuclei. The resulting freestanding (002)-textured Zn film exhibits significantly suppressed hydrogen evolution and prolonged Zn plating-stripping cycling life, achieving over 2100 mAh cm-2 cumulative capacity under a current density of 10 mA cm-2 and a high depth of discharge (DOD) of 45.5%. Therefore, this study provides both fundamental and practical insights into long-life Zn metal batteries.

Suppressing the Exacerbated Hydrogen Evolution of Porous Zn Anode with an Artificial Solid-Electrolyte Interphase Layer.

Rechargeable Zn batteries are widely studied as aqueous, safe, and environmentally friendly alternatives to Li-ion batteries. The 3D porous Zn anode has been extensively reported for suppressing Zn dendrite growth and accelerating the electrode kinetics. However, we demonstrate herein that the undesirable hydrogen evolution reaction (HER) is also exacerbated for porous Zn electrode. Therefore, a polytetrafluoroethylene (PTFE) coating is further applied on the porous Zn serving as the artificial solid-electrolyte interphase (SEI), which is demonstrated to effectively inhibit the hydrogen evolution and maintain the Zn plating kinetics. By utilizing the synergistic effects of the porous morphology and artificial SEI layer, better performances are obtained over porous Zn or bare Zn foil, including dendrite-free Zn plating/stripping up to 2000 h at 2 mA cm-2 and extended cycling in the Zn||V2O5 cell. This work suggests two complementary strategies for achieving simultaneously dendrite-free and side-reaction-suppressed Zn batteries.

Rapid Determination of Cellulose and Hemicellulose Contents in Corn Stover Using Near-Infrared Spectroscopy Combined with Wavelength Selection.

The contents of cellulose and hemicellulose (C and H) in corn stover (CS) have an important influence on its biochemical transformation and utilization. To rapidly detect the C and H contents in CS by near-infrared spectroscopy (NIRS), the characteristic wavelength selection algorithms of backward partial least squares (BIPLS), competitive adaptive reweighted sampling (CARS), BIPLS combined with CARS, BIPLS combined with a genetic simulated annealing algorithm (GSA), and CARS combined with a GSA were used to select the wavelength variables (WVs) for C and H, and the corresponding regression correction models were established. The results showed that five wavelength selection algorithms could effectively eliminate irrelevant redundant WVs, and their modeling performance was significantly superior to that of the full spectrum. Through comparison and analysis, it was found that CARS combined with GSA had the best comprehensive performance; the predictive root mean squared errors of the C and H regression model were 0.786% and 0.893%, and the residual predictive deviations were 3.815 and 12.435, respectively. The wavelength selection algorithm could effectively improve the accuracy of the quantitative analysis of C and H contents in CS by NIRS, providing theoretical support for the research and development of related online detection equipment.

Bioinspired soft electroreceptors for artificial precontact somatosensation.

Artificial haptic sensors form the basis of touch-based human-interfaced applications. However, they are unable to respond to remote events before physical contact. Some elasmobranch fishes, such as seawater sharks, use electroreception somatosensory system for remote environmental perception. Inspired by this ability, we design a soft artificial electroreceptor for sensing approaching targets. The electroreceptor, enabled by an elastomeric electret, is capable of encoding environmental precontact information into a series of voltage pulses functioning as unique precontact human interfaces. Electroceptor applications are demonstrated in a prewarning system, robotic control, game operation, and three-dimensional object recognition. These capabilities in perceiving proximal precontact events can lenrich the functionalities and applications of human-interfaced electronics.

VidAF: A Motion-Robust Model for Atrial Fibrillation Screening From Facial Videos.

Atrial fibrillation (AF) is the most common arrhythmia, but an estimated 30% of patients with AF are unaware of their conditions. The purpose of this work is to design a model for AF screening from facial videos, with a focus on addressing typical motion disturbances in our real life, such as head movements and expression changes. This model detects a pulse signal from the skin color changes in a facial video by a convolution neural network, incorporating a phase-driven attention mechanism to suppress motion signals in the space domain. It then encodes the pulse signal into discriminative features for AF classification by a coding neural network, using a de-noise coding strategy to improve the robustness of the features to motion signals in the time domain. The proposed model was tested on a dataset containing 1200 samples of 100 AF patients and 100 non-AF subjects. Experimental results demonstrated that VidAF had significant robustness to facial motions, predicting clean pulse signals with the mean absolute error of inter-pulse intervals less than 100 milliseconds. Besides, the model achieved promising performance in AF identification, showing an accuracy of more than 90% in multiple challenging scenarios. VidAF provides a more convenient and cost-effective approach for opportunistic AF screening in the community.

Application of serum exosomal hypoxia-inducible factor-1 alpha (HIF-1α) as potential circulating biomarker for bacterial peritonitis.

Bacterial peritonitis is a severe disease that diagnosis remains challenging for clinicians. Measuring biomarkers might be a rapid diagnostic method. The objective of this study was to analyze and evaluate the dynamic changes in HIF-1α concentration in serum exosomes during bacterial peritonitis. The pre-clinical application value of serum exosomal HIF-1α was evaluated via imipenem and cilastatin sodium (ICS) intervention in the bacterial peritonitis model. The new colorimetric method to quantitate dynamic expression changes of HIF-1α in serum exosomes during bacterial peritonitis was established by our team via using the gold seed-coated with aptamer-functionalized Au @ Au core-shell peroxidase mimic. The typical inflammatory cytokines of bacterial peritonitis were also measured. Following intramuscular administration with ICS, In-Vivo Xtreme imaging system was used to visualize abdominal infection extent. Meanwhile, HIF-1α concentration in rat serum exosomes and pro-inflammatory factors levels in serum were detected. The serum typical inflammatory cytokines levels were elevated in GFP-labeled E.coli induced bacterial peritonitis. The serum exosomal HIF-1α levels clearly increased at 12 h, reached the peak during 24-48 h, and then gradually decreased at 72 h. Following intramuscular administration with ICS, the abdominal infection extent, HIF-1α concentration in serum exosomes, and the serum pro-inflammatory factors levels were reduced at 24 h in GFP-labeled E. coli induced bacterial peritonitis model. The serum exosomal HIF-1α can be used as a biomarker in the early stage of bacterial peritonitis, which might provide the basic research in the pre-clinical for further predicting and monitoring the pathological process of bacterial peritonitis.

Electricity Generation and Self-Powered Sensing Enabled by Dynamic Electric Double Layer at Hydrogel-Dielectric Elastomer Interfaces.

The electric double layer (EDL) at liquid-solid interfaces is fundamental to many research areas ranging from electrochemistry and microfluidics to colloidal chemistry. Here, we demonstrate the electricity generation by mechanically modulating the EDL at the hydrogel-dielectric polymer interfaces. It is found that contact electrification between the hydrogel and the dielectric polymer could charge the dielectric polymer surface at first; the mechanical deformation of the pyramid-shaped hydrogel results in the periodic variation of the EDL area and capacitance, which then induces an alternative current in the external circuits. This mechano-to-electrical energy conversion mechanism is then utilized to construct soft stretchable self-powered pressure sensors by designing dynamic EDL at hydrogel-dielectric elastomer interfaces. The sensitivity is optimized to 1.40 kPa-1 in the low-pressure range of 31-300 Pa by increasing the elastomer roughness. Its antifreeze performance is also improved by adding ethylene glycol into the hydrogel. The capability in detecting subtle human activities is further demonstrated. This mechano-electrical energy conversion and the corresponding self-powered sensor can be widely applied in future soft electronics.

Rapid detection of cellulose and hemicellulose contents of corn stover based on near-infrared spectroscopy combined with chemometrics.

The feasibility of near-infrared spectroscopy (NIRS) combined with chemometrics for the rapid detection of the cellulose and hemicellulose contents in corn stover is discussed. Competitive adaptive reweighted sampling (CARS) and genetic simulated annealing algorithm (GSA) were combined (CARS-GSA) to select the characteristic wavelengths of cellulose and hemicellulose and to reduce the dimensionality and multicollinearity of the NIRS data. The whole spectra contained 1845 wavelength variables. After CARS-GSA optimization, the number of characteristic wavelengths of cellulose (hemicellulose) was reduced to 152 (260), accounting for 8.24% (14.09%) of all wavelengths. The coefficients of determination of the regression models for predicting the cellulose and hemicellulose contents were 0.968 and 0.996, the root mean square errors of prediction (RMSEPs) were 0.683 and 0.648, and the residual predictive deviations (RPDs) were 5.213 and 16.499, respectively. The RMSEP of the cellulose and hemicellulose regression models was 0.152 and 0.190 lower for CARS-GSA than for the full-spectrum, and the RPD was increased by 0.949 and 3.47, respectively. The results showed that the CARS-GSA model substantially reduced the number of characteristic wavelengths and significantly improved the predictive ability of the regression model.

Oligosaccharides from Polygonatum Cyrtonema Hua: Structural characterization and treatment of LPS-induced peritonitis in mice.

Fructooligosaccharide was isolated from Polygonatum Cyrtonema Hua (PFOS) for the first time. Structure characterized using FT-IR, MALDI-TOF-MS, NMR, AFM, and TEM, indicated that PFOS was graminan-type fructan with a degree of polymerization ranging from 5 to 10. A murine model of lipopolysaccharide (LPS)-induced peritonitis was used to evaluate the in vivo anti-inflammatory and lung protective efficacy of PFOS. The result shown that pretreatment with PFOS (1.0 mg/mL) in peritonitis-induced mice could significantly inhibit the level of pro-inflammatory cytokines (TNF-α, IL-1ß) in serum (P < 0.001), increase mice survival rate from 12.5 % to 54 % (P < 0.05), and alleviated lung injury through ameliorating the damage of the pulmonary cellular architecture and reducing inflammatory monocyte accumulation in lung tissue. This effect of oligosaccharides could explain the traditional usage of P. cyrtonema as a tonic medicine for respiratory problems and it could be used as a potential natural ingredient with anti-inflammatory activity.

Ultra-stretchable and healable hydrogel-based triboelectric nanogenerators for energy harvesting and self-powered sensing.

The next-generation multifunctional soft electronic devices require the development of energy devices possessing comparable functions. In this work, an ultra-stretchable and healable hydrogel-based triboelectric nanogenerator (TENG) is prepared for mechanical energy harvesting and self-powered sensing. An ionic conductive hydrogel was developed with graphene oxide and Laponite. as the physical cross-linking points, exhibiting high stretchability (∼1356%) and healable capability. When using the hydrogel as the electrode, the TENG can operate normally at 900% tensile strain, while the electrical output of the TENG can fully recover to the initial value after healing the damage. This hydrogel-based TENG is demonstrated to power wearable electronics, and is used as a self-powered sensor for human motion monitoring and pressure sensing. Our work shows opportunities for multifunctional power sources and potential applications in wearable electronics.

Predictive value of ACEF score for clinical prognosis of elderly patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention.

BACKGROUND: To investigate the predictive value of the age, creatinine, and ejection fraction (ACEF) score for cardiac death in patients aged ≥75 years diagnosed with acute ST-segment elevation myocardial infarction (STEMI) at 1 month and 1 year after emergency percutaneous coronary intervention (PCI). METHODS: A total of 360 patients with STEMI undergoing emergency PCI in the Department of Cardiology of Anhui Provincial Hospital from January 2013 to April 2018 were consecutively recruited. The primary endpoint event was cardiac death at postoperative 1 month and 1 year. The ROC curve was utilized to evaluate ACEF scoring system and predict cardiac death rate. RESULTS: According to ACEF score upon admission, 360 patients were divided into low-to-intermediate risk group (n=80) with ACEF score of 0.99-1.27 (1.18±0.07) and high-risk group (n=280) with ACEF score of 1.28-4.14 (1.83±0.51). The age, left ventricular ejection fraction (LVEF), estimated glomerular filtration rate (eGFR), heart rate and the proportion of complete revascularization in the high-risk group were significantly higher than those in low-to-intermediate risk group (all P<0.05). The area under ROC curve for ACEF scoring system to predict cardiac death at 1 month and 1 year following PCI was 0.809 and 0.763, respectively. CONCLUSIONS: ACEF value upon admission can predict the cardiac death rate at 1 month and 1 year after emergency PCI in STEMI patients aged ≥75 years old.

Circ-HIPK2 Accelerates Cell Apoptosis and Autophagy in Myocardial Oxidative Injury by Sponging miR-485-5p and Targeting ATG101.

Myocardial injury has been deemed as a major cause of heart diseases including myocarditis and coronary heart disease, which have brought multiple mortalities globally. Long non-coding RNAs (lncRNAs) are widely recognized in diverse diseases. However, the role of circular RNA HIPK2 (circ-HIPK2) remains unclear in myocardial injury induced by H2O2. We attempted to investigate the probable role of circ-HIPK2 in myocardial injury induced by H2O2. This study discovered that the treatment of H2O2 inhibited cell proliferation but boosted cell apoptosis and autophagy. ATG101 was upregulated in primary mouse neonatal cardiomyocytes under H2O2 treatment. ATG101 knockdown promoted proliferation and limited apoptosis by attenuating autophagy in H2O2-injured mouse neonatal cardiomyocytes. Furthermore, miR-485-5p was validated to combine with ATG101 and circ-HIPK2, and circ-HIPK2 positively regulated ATG101 expression by sponging miR-485-5p. At last, silenced circ-HIPK2 mediated the promotion of cell proliferation, and repression of cell apoptosis was restored by ATG101 amplification. In a word, circ-HIPK2 facilitates autophagy to accelerate cell apoptosis and cell death in H2O2-caused myocardial oxidative injury through the miR-485-5p/ATG101 pathway, indicating a novel therapeutic target point for patients with myocardial injury.

Efficacy and safety of bivalirudin application during primary percutaneous coronary intervention in older patients with acute ST-segment elevation myocardial infarction.

OBJECTIVE: ST-segment elevation myocardial infarction (STEMI) is the most serious type of acute coronary syndrome. This study aimed to investigate the efficacy and safety of bivalirudin application during primary percutaneous coronary intervention (PPCI) in older patients with acute STEMI. METHODS: A total of 672 older patients with STEMI (>75 years) who underwent PPCI were studied. The primary endpoints were 30-day net adverse clinical events (NACEs) post-emergency percutaneous coronary intervention, including major adverse cardiac and cerebrovascular events (MACCEs) and Bleeding Academic Research Consortium grades 2 to 5 (BARC 2-5) bleeding events. RESULTS: The incidence of NACEs and BARC 2-5 bleeding events in the bivalirudin group was significantly lower than that in the unfractionated heparin group. Multivariate Cox regression analysis showed that bivalirudin significantly reduced 30-day NACEs (odds ratio: 0.700, 95% confidence interval: 0.492-0.995) and BARC 2-5 bleeding events (odds ratio: 0.561, 95% confidence interval: 0.343-0.918). At 1-year follow-up, these results were similar. CONCLUSIONS: Bivalirudin can be safely and effectively used during PPCI in older patients with STEMI. Bivalirudin reduces the risks of NACEs and bleeding within 30 days after PPCI, without increasing the risks of MACCEs and stent thrombosis compared with heparin.