A novel mitochondrial metabolism-related gene signature for predicting the prognosis of oesophageal squamous cell carcinoma.

Oesophageal squamous cell carcinoma (ESCC) is one of the most lethal cancers worldwide. Due to the important role of mitochondrial metabolism in cancer progression, a clinical prognostic model based on mitochondrial metabolism and clinical features was constructed in this study to predict the prognosis of ESCC. Firstly, the mitochondrial metabolism scores (MMs) were calculated based on 152 mitochondrial metabolism-related genes (MMRGs) by single sample gene set enrichment analysis (ssGSEA). Subsequently, univariate Cox regression and LASSO algorithm were used to identify prognosis-associated MMRG and risk-stratify patients. Functional enrichment, interaction network and immune-related analyses were performed to explore the features differences in patients at different risks. Finally, a prognostic nomogram incorporating clinical factors was constructed to assess the prognosis of ESCC. Our results found there were differences in clinical features between the MMs-high group and the MMs-low group in the TCGA-ESCC dataset (P<0.05). Afterwards, we identified 6 MMRGs (COX10, ACADVL, IDH3B, AKR1A1, LIAS, and NDUFB8) signature that could accurately distinguish high-risk and low-risk ESCC patients. A predictive nomogram that combined the 6 MMRGs with sex and N stage to predict the prognosis of ESCC was constructed, and the areas under the receiver operating characteristic (ROC) curve at 1, 2 and 3 years were 0.948, 0.927 and 0.848, respectively. Finally, we found that COX10, one of 6 MMRGs, could inhibit the malignant progression of ESCC in vitro. In summary, we constructed a clinical prognosis model based on 6 MMRGs and clinical features which can accurately predict the prognosis of ESCC patients.

Safeguarding China's long-term sustainability against systemic disruptors.

China's long-term sustainability faces socioeconomic and environmental uncertainties. We identify five key systemic risk drivers, called disruptors, which could push China into a polycrisis: pandemic disease, ageing and shrinking population, deglobalization, climate change, and biodiversity loss. Using an integrated simulation model, we quantify the effects of these disruptors on the country's long-term sustainability framed by 17 Sustainable Development Goals (SDGs). Here we show that ageing and shrinking population, and climate change would be the two most influential disruptors on China's long-term sustainability. The compound effects of all disruptors could result in up to 2.1 and 7.0 points decline in the China's SDG score by 2030 and 2050, compared to the baseline with no disruptors and no additional sustainability policies. However, an integrated policy portfolio involving investment in education, healthcare, energy transition, water-use efficiency, ecological conservation and restoration could promote resilience against the compound effects and significantly improve China's long-term sustainability.

Pillarurilarenes: Glycoluril-Expanded Pillararenes.

Glycoluril-expanded pillararenes composed of glycoluril and dialkoxybenzene units, namely, pillarurilarenes (PURA), were synthesized through a fragment coupling macrocyclization strategy. Partial replacement of dialkoxybenzene with glycoluril endows PURA with polarized equatorial methine protons for derivatization or CH-anion binding. Crystal structures of pillar[2]uril[4]arene and pillar[1]uril[4]arene containing two glycoluril units and one glycoluril unit, respectively, indicated the inward orientation of the glycoluril unit, as also suggested by 1H nuclear magnetic resonance and density functional theory calculation. This work lays a good foundation for expanding pillararenes using non-aromatic rings.

The Presence of Four Pathogenic Oral Bacterial Species in Six Wild Snake Species from Southern Taiwan: Associated Factors.

The oral cavity of snakes serves as a habitat for various microorganisms, some of which may include potential zoonotic pathogens posing risks to hosts and causing wound infections in snakebite victims. Clinical studies on snakebite cases in Taiwan have identified specific pathogens, such as Enterococcus faecalis (Gram-positive), Morganella morganii, Aeromonas hydrophila, and Pseudomonas aeruginosa (Gram-negative). However, the prevalence of these bacteria in the oral cavity of wild snakes remains largely unknown. This study investigated the occurrence of these bacteria in six wild snake species (Naja atra, Bungarus multicinctus, Trimeresurus stejnegeri, Protobothrops mucrosquamatus, Boiga kraepelini, and Elaphe taeniura friesi) from southern Taiwan, along with factors influencing their presence. Oropharyngeal swab samples were collected from a substantial number of wild-caught snakes (n = 1104), followed by DNA extraction, polymerase chain reaction, and gel electrophoresis. The band positions of samples were compared with positive and negative controls to determine the presence of target bacteria in each sample. The overall occurrence rates were 67.4% for E. faecalis, 31.5% for M. morganii, 8.2% for A. hydrophila, and 7.7% for P. aeruginosa. Among snake species, B. kraepelini exhibited dominance in E. faecalis (93.4%), A. hydrophila (17.1%), and P. aeruginosa (14.5%), while male N. atra showed dominance in M. morganii (51.3%). The occurrence of E. faecalis was lowest in winter. The results of multiple logistic regression analyses suggest that factors such as species, sex, temperature, season, and coexisting pathogens may have a significant impact on the occurrence of target bacteria. These findings have implications for wildlife medicine and snakebite management.

Triphenyl phosphate exposure impairs colorectal health by altering host immunity and colorectal microbiota.

Colorectal diseases such as colorectal cancer (CRC) and inflammatory bowel disease (IBD) have become one of the most common public health concerns worldwide due to the increasing incidence. Environmental factors are one of the important causes of colorectal diseases, as they can affect the intestinal barrier function, immune response and microbiota, causing intestinal inflammation and tumorigenesis. Triphenyl phosphate (TPHP), a widely used organophosphorus flame retardant that can leach and accumulate in various environmental media and biota, can enter the human intestine through drinking water and food. However, the effects of TPHP on colorectal health have not been well understood. In this study, we investigated the adverse influence of TPHP exposure on colorectal cells (in vitro assay) and C57BL/6 mice (in vivo assay), and further explored the potential mechanism underlying the association between TPHP and colorectal disease. We found that TPHP exposure inhibited cell viability, increased apoptosis and caused G1/S cycle arrest of colorectal cells. Moreover, TPHP exposure damaged colorectal tissue structure, changed immune-related gene expression in the colorectal transcriptome, and disrupted the composition of colorectal microbiota. Importantly, we found that TPHP exposure upregulated chemokine CXCL10, which was involved in colorectal diseases. Our study revealed that exposure to TPHP had significant impacts on colorectal health, which may possibly stem from alterations in host immunity and the structure of the colorectal microbial community.

Contrast CT radiomic features add value to prediction of prognosis in adrenal cortical carcinoma.

OBJECTIVE: Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with poor prognosis due to high postoperative recurrence rates. The aim of this study is to develop a contrast CT radiomic feature-based prognosis prediction model for ACC and evaluate its performance by comparison with ENSAT staging system and S-GRAS score. METHODS: Included in this study were 39 ACC patients, from which we extracted 1411 radiomic features. Using cross-validated least absolute shrinkage and selection operator regression (cv-LASSO regression), we generated a radiomic index. Additionally, we further validated the radiomic index using both univariate and multivariate Cox regression analyses. We constructed a radiomic nomogram that incorporated the radiomic signature and compared it with ENSAT stage and S-GRAS score in terms of calibration, discrimination and clinical usefulnes. RESULTS: In this study, the average progression free survival (PFS) of 39 patients was 20.4 (IQR 9.1-60.1) months and the average overall survival (OS) was 57.8 (IQR 32.4-NA). The generated radiomic features were significantly associated with PFS, OS, independent of clinical-pathologic risk factors (HR 0.16, 95%CI 0.02-0.99, p = 0.05; HR 0.20, 95%CI 0.04-1.07, p = 0.06, respectively). The radiomic index, ENSAT stage, resection status, and Ki67% index incorporated nomogram exhibited better performance for both PFS and OS prediction as compared with the S-GRAS and ENSAT nomogram (C-index: 0.75 vs. C-index: 0.68, p = 0.030 and 0.67, p = 0.025; C-index: 0.78 vs. C-index: 0.72, p = 0.003 and 0.73, p = 0.006). Calibration curve analysis showed that the radiomics-based model performs best in predicting the two-year PFS and the three-year OS. Decision curve analysis demonstrated that the radiomic index nomogram outperformed the S-GRAS and ENSAT nomogram in predicting the two-year PFS and the three-year OS. CONCLUSION: The contrast CT radiomic-based nomogram performed better than S-GRAS or ENSAT in predicting PFS and OS in ACC patients.

Changes of serum TSH, FT3, and FT4 levels in infants received surgical correction of congenital heart disease under cardiopulmonary bypass.

OBJECTIVE: This study aimed to explore the fluctuations and clinical relevance of serum thyrotropin (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) levels in infants undergoing surgical correction for congenital heart disease (CHD) using cardiopulmonary bypass (CPB). METHODS: In a retrospective design, 58 infants who underwent CHD surgical correction under CPB between January 2021 and January 2022 at our institution were incorporated. These infants were categorized into two groups: simple CHD (n = 34) and complex CHD (n = 24). TSH, FT3, and FT4 serum concentrations were assessed at four intervals: 24 h pre-surgery (T0) and 24 h (T1), 48 h (T2), and 72 h (T3) post-surgery. RESULTS: The simple CHD group displayed a significantly reduced CPB duration compared to the complex CHD group (P < 0.001). Both groups exhibited a notable decline in serum thyroid hormone concentrations at T1 compared to T0. However, from T1 to T3, an upward trend in hormone levels was observed. By T3, though the levels in both groups had risen notably from T1, they remained significantly diminished from T0 (P < 0.01). In both the simple and complex CHD cohorts, significant fluctuations in thyroid hormone levels (TSH, FT3, FT4) were noted across the different timepoints (T0, T1, T3) (P < 0.01). While no significant disparities were found between the two groups' hormone concentrations at T0 and T1 (P > 0.05), at T2 and T3, the simple CHD group manifested higher TSH, FT3, and FT4 levels compared to the complex CHD group (P < 0.05). CONCLUSIONS: Infants undergoing CHD surgical correction under CPB experience significant declines in TSH, FT3, and FT4 serum levels. The post-surgery thyroid hormone recovery was more pronounced in infants with simple CHD compared to those with complex CHD. As such, vigilant monitoring of thyroid hormone levels during the perioperative phase is imperative, and timely intervention measures should be employed when necessary.

The heterogeneity and clonal evolution analysis of the advanced prostate cancer with castration resistance.

BACKGROUND: Nowadays, the incidence rate of advanced and metastatic prostate cancer at the first time of diagnosis grows higher in China yearly. At present, androgen deprivation therapy (ADT) is the primary treatment of advanced prostate cancer. However, after several years of ADT, most patients will ultimately progress to castration-resistant prostate cancer (CRPC). Previous studies mainly focus on Caucasian and very few on East Asian patients. METHODS: In this study, the pre- and post-ADT tumor samples were collected from five Chinese patients with advanced prostate cancer. The whole-exome sequencing, tumor heterogeneity, and clonal evolution pattern were analyzed. RESULTS: The results showed that the gene mutation pattern and heterogeneity changed significantly after androgen deprivation therapy. Tumor Mutational Burden (TMB) and Copy Number Alteration (CNA) were substantially reduced in the post-treatment group, but the Mutant-allele tumor heterogeneity (MATH), Socio-Demographic Index (SDI), Intratumor heterogeneity (ITH), and weighted Genome Instability Index (wGII) had no significant difference. According to the clone types and characteristics, the presence of main clones in five pre-and post-treatment samples, the clonal evolution pattern can be further classified into two sub-groups (the Homogeneous origin clonal model or the Heterogeneous origin clonal model). The Progression-free survival (PFS) of the patients with the "Homogeneous origin clonal model" was shorter than the "Heterogeneous origin clonal model". The longer PFS might relate to MUC7 and MUC5B mutations repaired. ZNF91 mutation might be responsible for resistance to ADT resistance. CONCLUSION: Our findings revealed potential genetic regulators to predict the castration resistance and provide insights into the castration resistance processes in advanced prostate cancer. The crosstalk between clonal evolution patterns and tumor microenvironment may also play a role in castration resistance. A multicenter-research including larger populations with different background are needed to confirm our conclusion in the future.

Comparisons of the Oral Microbiota from Seven Species of Wild Venomous Snakes in Taiwan Using the High-Throughput Amplicon Sequencing of the Full-Length 16S rRNA Gene.

A venomous snake's oral cavity may harbor pathogenic microorganisms that cause secondary infection at the wound site after being bitten. We collected oral samples from 37 individuals belonging to seven species of wild venomous snakes in Taiwan, including Naja atra (Na), Bungarus multicinctus (Bm), Protobothrops mucrosquamatus (Pm), Trimeresurus stejnegeri (Ts), Daboia siamensis (Ds), Deinagkistrodon acutus (Da), and alpine Trimeresurus gracilis (Tg). Bacterial species were identified using full-length 16S rRNA amplicon sequencing analysis, and this is the first study using this technique to investigate the oral microbiota of multiple Taiwanese snake species. Up to 1064 bacterial species were identified from the snake's oral cavities, with 24 pathogenic and 24 non-pathogenic species among the most abundant ones. The most abundant oral bacterial species detected in our study were different from those found in previous studies, which varied by snake species, collection sites, sampling tissues, culture dependence, and analysis methods. Multivariate analysis revealed that the oral bacterial species compositions in Na, Bm, and Pm each were significantly different from the other species, whereas those among Ts, Ds, Da, and Tg showed fewer differences. Herein, we reveal the microbial diversity in multiple species of wild snakes and provide potential therapeutic implications regarding empiric antibiotic selection for wildlife medicine and snakebite management.

The Association Between Religious Belief and Postoperative Psychological Status and Quality of Life of Parents of Children with Congenital Heart Disease: A Single Center Experience in Southeast China.

This study aimed to investigate the association of religious belief on the postoperative psychological status and quality of life of parents of children with congenital heart disease (CHD). This was a cross-sectional study conducted at a provincial children's hospital in Fujian Province, China. Parents of postoperative children with CHD in the early postoperative period were included in this study between January 2020 and September 2020. The parents were divided into a religious belief group (n = 39) and a nonreligious belief group (n = 42) depending on whether they had religious beliefs. The Religious Coping Questionnaire, WHOQOL-BREF scale, Self-rating depression scale (SDS), and Self-rating anxiety scale (SAS) were used to evaluate psychological status and quality of life. The results showed that the SDS and SAS scores in the religious belief group were significantly lower than those in the nonreligious belief group (P = 0.012 and P = 0.003, respectively). The WHOQOL-BREF scale results showed that the religious belief group's score was significantly higher than those in the nonreligious belief group on the subscale scores of physiology, psychology, social relations, and environment on the WHOQOL-BREF. The total score of quality of life in the religious belief group was significantly higher than that in the nonreligious belief group. Religious belief was associated with lower SDS score (ß = - 0.324, P = 0.005) and SAS score (ß = - 0.245, P = 0.026), while religious belief was positively correlated with the score of WHOQOL-BREF (ß = 0.506, P < 0.001). In this study, we concluded that comparing to those with no religious beliefs, parents with religious belief experienced more positive emotions and higher quality of life when taking care of children in the early postoperative period after congenital heart surgery.

Comparison of partial nephrectomy and radical nephrectomy for cystic renal cell carcinoma: a SEER-based and retrospective study.

Cystic renal cell carcinoma (cRCC) is uncommon and surgical indication remains controversial. We compared radical nephrectomy (RN) with partial nephrectomy (PN) in patients with cRCC using data from the Surveillance, Epidemiology and End Results (SEER) database and a retrospective cohort including 106 cRCC patients hospitalized in Ruijin and Renji Hospitals from 2013 to 2022. The baseline characteristics between RN and PN groups in both cohorts were adjusted by propensity score-matching (PSM). A total of 640 patients were included in the SEER cohort. Before PSM, PN group in the SEER cohort had a lower level of T stage (p < 0.001) and comprised more Caucasians (p < 0.001). After PSM, RN was associated with worse overall survival (p < 0.001) and cancer-specific survival (p = 0.006) in contrast to PN. In the Chinese cohort, 86 patients who underwent PN and 20 patients who underwent RN were finally included. The mean proportions of estimated glomerular filtration rate preserved after RN were worse than PN. Therefore, PN should be preferred in cRCC patients.

Using WeChat to guide preparation before transthoracic echocardiography reduces anxiety and improves satisfaction of parents of infants with congenital heart disease.

OBJECTIVE: To explore the effect of using WeChat to guide preparation before transthoracic echocardiography (TTE) on reducing anxiety and improving the satisfaction of parents of infants with congenital heart disease (CHD). METHODS: This study was a retrospective study conducted in a children's hospital. The clinical data of 44 patients and the anxiety and satisfaction data of their parents who received WeChat guidance were collected between December 2021 and January 2022 (the WeChat group). The corresponding data of 47 patients and their parents who received educational brochure guidance were collected between September 2021 and November 2021 (the routine group). Guidance was used to help the parents prepare for TTE performed by medical professionals. The State-Trait Anxiety Inventory scale and the Patient Satisfaction Questionnaire-18 (PSQ-18) were used. The data of the two groups were compared and analyzed. RESULTS: The comparison of parental anxiety between the two groups showed that the scores of state anxiety and trait anxiety in the WeChat group were significantly lower than those in the routine group (p < 0.05). The comparison of the results of the PSQ-18 showed that the scores for general satisfaction, interpersonal manner, communication, time spent with the physician, and accessibility and convenience in the WeChat group were significantly higher than those in the routine group (p < 0.05). CONCLUSION: Using WeChat to guide preparation before TTE for infants with CHD can effectively reduce the anxiety of their parents and improve their parents' satisfaction with medical treatment.

Association between plasma metal elements and platelet dysfunction in trauma-induced coagulopathy rat model.

BACKGROUND: Disorders of metal elements and platelet dysfunction are common in patients with trauma-induced coagulopathy (TIC). AIM: The aim of this study was to explore the potential role of plasma metal elements in platelet dysfunction in TIC. METHODS: Thirty Sprague-Dawley rats were divided into control, hemorrhage shock (HS) and multiple injury (MI) groups. At timepoints of 0.5 and 3 h after trauma and being documented as HS 0.5 h, HS3 h, MI 0.5 h or MI3 h, blood samples were harvested for inductively coupled plasma mass spectrometer, conventional coagulation function and thromboelastograph. RESULTS: The plasma zinc (Zn), vanadium (V) and cadmium (Ca) decreased initially in HS 0.5 h and recovered slightly in HS3 h, whereas their plasma concentrations continued to decrease from beginning till MI3 h (p < 0.05). In HS, plasma Ca, V and nickel were negatively correlated to the time taken to reach the initial formation (R), whereas R was positively correlated to plasms Zn, V, Ca and selenium in MI (p < 0.05). In MI, plasma Ca was positively correlated to maximum amplitude, and plasma V was positively correlated to platelet count (p < 0.05). CONCLUSION: The plasma concentrations of Zn, V and Ca appeared to contribute to platelet dysfunction in HS 0.5 h, HS3 h, MI 0.5 h and MI3 h, which were trauma type sensitive.

iEnhancer-ELM: improve enhancer identification by extracting position-related multiscale contextual information based on enhancer language models.

Motivation: Enhancers are important cis-regulatory elements that regulate a wide range of biological functions and enhance the transcription of target genes. Although many feature extraction methods have been proposed to improve the performance of enhancer identification, they cannot learn position-related multiscale contextual information from raw DNA sequences. Results: In this article, we propose a novel enhancer identification method (iEnhancer-ELM) based on BERT-like enhancer language models. iEnhancer-ELM tokenizes DNA sequences with multi-scale k-mers and extracts contextual information of different scale k-mers related with their positions via an multi-head attention mechanism. We first evaluate the performance of different scale k-mers, then ensemble them to improve the performance of enhancer identification. The experimental results on two popular benchmark datasets show that our model outperforms state-of-the-art methods. We further illustrate the interpretability of iEnhancer-ELM. For a case study, we discover 30 enhancer motifs via a 3-mer-based model, where 12 of motifs are verified by STREME and JASPAR, demonstrating our model has a potential ability to unveil the biological mechanism of enhancer. Availability and implementation: The models and associated code are available at https://github.com/chen-bioinfo/iEnhancer-ELM. Supplementary information: Supplementary data are available at Bioinformatics Advances online.

Parents' understanding and attitudes toward the use of the WeChat platform for postoperative follow-up management of children with congenital heart disease.

OBJECTIVE: This study aimed to investigate parents' understanding and attitudes toward using the WeChat platform for postoperative follow-up management of children with congenital heart disease (CHD). METHODS: A total of 196 children with CHD were followed up using the WeChat platform. A self-designed questionnaire was administered to their parents at discharge. RESULTS: Only 188 parents completed the questionnaire. One hundred nineteen parents (63.3%) confirmed that they heard about using the WeChat platform for postoperative follow-up, and 104 (87.4%) of them expressed that they were willing to accept the WeChat platform for their follow-up. A total of 42 parents (35.3%) were willing to undergo a follow-up of 1 to 3 months, and 32 (26.8%) were willing to undergo a long-term follow-up. Eighty parents (67.2%) had a positive attitude toward the effect of the WeChat platform on follow-up. Parents in rural areas and those educated at the middle school level or below were more willing to engage with the WeChat platform for postoperative follow-up management (P < 0.05). CONCLUSIONS: Although the WeChat platform is an essential tool for daily communication, its application in postoperative follow-up management is still under study. Most parents who participated in the follow-up study had a positive attitude toward the WeChat platform, especially those in rural areas and with lower education levels.

Evaluation of health-related quality of life in children with postoperative delirium after surgical repair of ventricular septal defect: short- and mid-term follow-up.

BACKGROUND: To investigate health-related quality of life (HRQOL) in children with postoperative delirium (POD) after surgical repair of ventricular septal defects (VSDs). METHODS: A total of 109 patients were enrolled and assigned to the POD group (n = 47) and the non-POD group (n = 62). HRQOL was assessed by the PedsQLTM 3.0 Cardiac Module at discharge, and at the three- and six-month postoperative follow. RESULTS: Significant differences were detected in age, operation time, CPB time, mechanical ventilation duration, and length of ICU stay between the two groups, whereas sex and the VSD size did not significantly differ between groups. In terms of "cardiac heart problems and treatment" and "treatment-II", the HRQOL scores of the non-POD group were significantly better than those of the POD group. In terms of "perceived physical appearance" and "treatment anxiety", the POD group had significantly higher scores than the non-POD group at discharge and at the three-month postoperative follow-up. In terms of "cognitive problems" and "communication", the occurrence of POD still affected HRQOL at three months postoperatively, but the effect was significantly reduced at six months postoperatively. In terms of "total scores", both groups scored increasingly higher over time. The non-POD group had higher scores at discharge and three months postoperatively than the POD group, but no significant difference persisted at six months postoperatively. CONCLUSION: During the follow-up period, the HRQOL of the children with POD after surgical repair of VSD was inferior to that of the children without POD at discharge and three months postoperatively. However, the HRQOL did not differ between the two groups at six months postoperatively.

Postoperative health-related quality of life in children with congenital heart disease: a short-term follow-up study.

OBJECTIVE: This study aimed to explore changes in health-related quality of life in children with congenital heart disease from pre-surgery to 6 months after surgery. METHODS: A total of 87 children aged 2-12 years who underwent cardiac surgery in a provincial hospital in China from January 2021 to June 2021 were selected. After 6 months, the quality of life of all children was retrospectively analyzed. The Chinese version of the Pediatric Quality of Life Inventory 4.0 Scale was used to assess the quality of life of children before and after surgery. RESULTS: Parents of 85 children and 33 children aged 5-12 years completed the questionnaires. After surgical treatment, the quality of life scores reported by parents of children of all ages were significantly higher than those before surgery, the P value < 0.05; the self-evaluated quality of life scores of children of different ages were significantly higher than those before surgery, the P value < 0.05. CONCLUSION: Surgical treatment can improve the health-related quality of life of children with congenital heart disease.

The Value of Myocardial Fibrosis Parameters Derived from Cardiac Magnetic Resonance Imaging in Risk Stratification for Patients with Hypertrophic Cardiomyopathy.

RATIONALE AND OBJECTIVES: The aim of the study was to determine whether myocardial fibrosis parameters of cardiac magnetic resonance imaging (MRI) has added value in the risk stratification of hypertrophic cardiomyopathy (HCM) patients. MATERIALS AND METHODS: In this retrospective study, 108 patients with HCM (mean age ± standard deviation, 55.5 ± 13.4 years) were included from January 2019 to April 2022, and were followed up for 2 years to record sudden cardiac death (SCD) adverse events. All HCM patients underwent cardiac MRI and were divided into a training cohort (n = 81; mean age, 56.1 ± 13.0 years) and a validation cohort (n = 27; mean age, 57.8 ± 13.9 years). According to the presence of SCD risk factors defined by the 2020 AHA/ACC guidelines, HCM patients were classified into low-risk and high-risk groups. Cardiac MRI features, including late gadolinium enhancement (LGE), T1 mapping, and extracellular volume fraction (ECV), were assessed and compared between the two groups. Logistic regression analysis was used to select the optimal predictors of SCD from cardiac MRI features and HCM Risk-SCD score to construct prediction models. Receiver operating curve (ROC) analysis was used to assess the predictive performance of the constructed prediction model. Cox regression analysis was also used to determine the optimal predictors of SCD adverse events. RESULTS: Multivariate logistic analysis showed that the global ECV was the single myocardial fibrosis parameter predictive of the risk of SCD (p < 0.001). The areas under the ROC curves (AUC) of global ECV were higher than those of LGE, global native T1, global postcontrast T1, and HCM Risk-SCD (AUC = 0.85 vs. 0.74, 0.77, 0.63, 0.78). An integrative risk stratification model combining global ECV (odds ratio, 1.36 [95% CI: 1.16-1.60]; p < 0.001) and HCM Risk-SCD score (odds ratio, 1.63 [95% CI: 1.08-2.47]; p < 0.001) achieved an AUC of 0.89 (95% CI: 0.81-0.96) in the training cohort, which was significantly higher than that of HCM Risk-SCD score alone (p = 0.03). The AUC of the integrative model was 0.93 (95% CI: 0.84-1.00) in the validation cohort. Multivariate Cox regression analysis also showed that the global ECV was an independent predictor of SCD adverse events (hazard ratio, 1.27 [95% CI: 1.10-1.47]). CONCLUSION: The ECV derived from cardiac MRI is comparable to the HCM Risk-SCD scale in predicting the SCD risk stratification in patients with HCM.

The effect of applying telehealth education to home care of infants after congenital heart disease surgery.

BACKGROUND: The purpose of this study was to investigate the effect of applying telehealth education to home care of infants after congenital heart disease (CHD) surgery. METHODS: A prospective randomized controlled study was conducted from July 2020 to February 2021 in Fujian Children's Hospital to compare the home care condition of infants after CHD surgery between the intervention group and the control group. RESULTS: At 3 months after discharge, parents' caring ability and CHD knowledge in the intervention group were significantly better than those in the control group and were significantly improved compared with those at discharge time (P < 0.05). The parental care burden in the intervention group was significantly lower than that in the control group and was significantly lower than that at discharge time (P < 0.05). During the follow-up period, the rate of loss of follow-up and complications in the intervention group were significantly lower than those in the control group (P < 0.05). CONCLUSION: Telehealth education via WeChat can effectively improve the knowledge of disease and home care ability of parents of infants after CHD surgery and reduce their home care burden, which can effectively reduce the incidence of complications and lost to follow-up rate after discharge.

Application of High-Frequency Oscillation Ventilation Combined With Volume Guarantee in Preterm Infants With Acute Hypoxic Respiratory Failure After Patent Ductus Arteriosus Ligation.

OBJECTIVE: This study aimed to evaluate the efficacy and safety of high-frequency oscillation ventilation combined with volume guarantee (HFOV-VG) in preterm infants with acute hypoxemic respiratory failure (AHRF) after patent ductus arteriosus ligation. METHODS: We retrospectively analyzed the clinical data of 41 preterm infants, who were ventilated for AHRF after patent ductus arteriosus ligation between January 2020 and January 2022. HFOV alone was used in 20 of the 41 infants, whereas HFOV-VG was used in the other 21 infants. RESULTS: There was no statistically significant difference in the demographic information and baseline characteristics of preterm infants included in the study. The average frequency tidal volume (VThf) of the HFOV-VG group was lower than that of the HFOV group (2.6 ± 0.6 mL versus 1.9 ± 0.3 mL, P < .001). In addition, the incidence of hypocapnia and hypercapnia in infants supported with HFOV-VG was significantly lower (15 versus 8, P < .001; 12 versus 5, P < .001). Furthermore, the duration of invasive ventilation in the HFOV-VG group also was lower than in the HFOV group (3.7 ± 1.2 days versus 2.1 ± 1.0 days, P < .01). CONCLUSION: Compared with HFOV alone, HFOV-VG decreases VThf levels and reduces the incidence of hypercapnia and hypocapnia in preterm infants with acute hypoxic respiratory failure after patent ductus arteriosus ligation.