Retrospective study on the short-term efficacy of different doses of Spironolactone in patients with heart failure of ischemic cardiomyopath and the influence of ventricular remodeling markers.

OBJECTIVE: To evaluate the impact of varying dosages of Spironolactone on the short-term effectiveness and ventricular remodeling indicators in patients with Heart Failure of Ischemic Cardiomyopathy (HFIC). METHODS: A cohort of 141 HFIC patients, admitted to our hospital between October 2018 and February 2023, were enrolled for this study. Alongside the standard treatment for Chronic Congestive Heart Failure (CHF), these patients were randomly assigned to either a low-dose (20 mg/d, N=70) or a high-dose (60 mg/d, N=71) Spironolactone group. After four weeks, various parameters were assessed and compared within each group before and after the treatment. These parameters included echocardiographic indices (LVEF, LVESD, LVEDD, LVESV, and LVEDV), New York Heart Association (NYHA) cardiac function classification, ventricular remodeling markers (hs-CRP, TNF-α, NT-pro BNP, Gal-3, MMP-9, and TIMP-4), and the Six Minute Walk Distance (6MWD). RESULTS: Both low-dose and high-dose Spironolactone significantly improved LVEF and 6MWD in HFIC patients (P<0.05), as well as markedly reduced LVESD, LVEDD, LVESV, LVEDV, and NYHA cardiac function grades (P<0.05). The high-dose group exhibited the most pronounced improvements (P<0.05). High-dose Spironolactone was more effective in improving the clinical and total effective rate compared to the low-dose, significantly reducing treatment inefficacy (P<0.05). Both dosages significantly increased serum potassium levels within normal ranges. They also improved the expression of ventricular remodeling markers (hs-CRP, TNF-α, NT-pro BNP, Gal-3, MMP-9, and TIMP-4) in HFIC patients, with the high-dose group showing the most significant results (P<0.05). CONCLUSION: High-dose Spironolactone (60 mg/d) demonstrates superior efficacy over the low-dose (20 mg/d) in rapidly diminishing ventricular remodeling damage and enhancing cardiac function and clinical symptoms in HFIC patients over a short duration.

Giant thoracic hematoma post-transradial coronary angiography: a case report and review of the literature.

BACKGROUND: Although there are cardiac interventional procedures, certain transradial access complications might be life-threatening. CASE PRESENTATION: A 67-year-old male was admitted for coronary angiography due to chest tightness and shortness of breath on exertion. Hours after the right transradial access angiography, the patients complained the right side of chest pain. Emergent chest X-ray revealed a giant mass in the right chest. The right radial artery was reaccessed and subsequent arteriograms confirmed that the presence of a rupture of the branch of right internal mammary artery. Simultaneously, a microcoil was implanted to seal the perforation. The perforation caused a thoracic hematoma measuring 13.8 cm × 6.7 cm, along with a decrease in hemoglobin concentration from 14.1 g/dL to a minimum of 7.8 g/dL. Additionally, the drainage of the hematoma and red blood cells transfusion were carried out. Further, the patient underwent ascending aortic replacement, aortic valve replacement, mitral valve replacement, and thoracic hematoma removal. Postoperative echocardiography showed that the prosthetic valves were properly positioned and functioning normally. The patient recovered well after the surgery and remained event-free during the latest 14moth follow-up period. CONCLUSIONS: Vascular perforation and subsequent hematoma might occur due to guidewire maneuvering during transradial approach. Awareness of prevention, early recognition and management of access complications may help reduce the occurrence and severity of complications related to the transradial approach.

Effects of depressive symptoms on osteoporotic bone metabolism and prognosis of joint replacement surgery in elderly male patients with femoral neck fracture.

OBJECTIVE: To investigate the effect of depressive symptoms on osteoporotic bone metabolism and prognosis of joint replacement surgery in elderly male patients with femoral neck fractures. METHOD: 102 elderly male patients with femoral neck fractures hospitalized in the Beijing Hospital from January 2017 to January 2019 were included. The patients with femoral neck fractures were divided into the depression group and the control group. The observation indicators included: bone mineral density, serum alkaline phosphatase, serum calcium, serum phosphorus, 25-hydroxy-vitamin D, osteocalcin, Type I procollagen amino-terminal propeptide, serum ß-isomer of C-terminal telopeptide of type I collagen, hip function scores, and pain visual analogue scale at pre- and post-operative examinations. RESULTS: The BMD was significantly lower in the depressed group than in the control group [either for lumbar spine or hip, P < 0.05]. Serum 25-(OH)-D levels and serum OC levels were lower (both P < 0.05) in the depression group, while serum -CTX levels were higher in the depression group than in the control group (P < 0.05). Depression severity (GDS score) was negatively correlated with BMD (r = -0.456, P < 0.05), 25(OH)D (r = -0.546, P < 0.05), and OC (r = -0.215, P < 0.05), while positively correlated with ß-CTX (r = 0.372, P < 0.05). The Harris scores of the depression group were lower than the control group (P < 0.001). In the control group, VAS scores decrease at 12 months postoperatively while in the depressed group, VAS scores increased (P < 0.001). CONCLUSION: Depression is a risk factor for low bone mineral density and fracture, and adversely affects functional recovery and pain relief after artificial femoral head replacement. Special care should be taken for those patients with depressive symptoms in orthopedic practice.

Comparison Between Fusion and Non-Fusion Surgery for Lumbar Spinal Stenosis: A Meta-analysis.

INTRODUCTION: A large number of studies have shown that, for severe lumbar spinal stenosis, decompression surgery can often obtain better results than non-surgical treatment. However, whether the lumbar spine is fixed after decompression is still controversial. The results of biomechanical studies indicate that there is a correlation between the range of decompression and postoperative spinal instability. METHODS: The multiple databases like Pubmed, Embase, Cochrane databases and China National Knowledge database were used to search for the relevant studies, and full-text articles involved in the evaluation of fusion and nonfusion surgery for lumbar spinal stenosis. Review Manager 5.2 was adopted to estimate the effects of the results among selected articles. Forest plots, sensitivity analysis and bias analysis for the articles included were also conducted. RESULTS: A total of nine relevant studies were eventually satisfied the included criteria. There were significant differences in length of stay [mean difference (MD) = 3.04, 95% CI (2.00, 4.08), P < 0.000]1), but there were no differences in Oswestry Disability Index (ODI score) [MD = - 1.14, 95% CI (- 2.92, 0.63), P = 0.21; I2 = 87%] and complications [RR = 1 with 95% CI (0.69, 1.46), P value of overall effect was 0.98]. The study was robust and limited publication bias was observed in this study. CONCLUSION: Our research supported that fusion and nonfusion surgeries had no differences in clinical effects and complications for lumbar spinal stenosis, while fusion surgery involved a longer length of stay than nonfusion surgery.

Electrochemiluminescence resonance energy transfer immunoassay for alkaline phosphatase using p-nitrophenyl phosphate as substrate.

A sensitive electrochemiluminescent immunoassay for alkaline phosphatase (ALP) using p-nitrophenyl phosphate (PNPP) as substrate based on the electrochemiluminescence resonance energy transfer (ECRET) is developed. Luminol-doped silica nanoparticles (luminol-SiNPs) are prepared by water/oil (W/O) microemulsion method. PNPP convertes to p-nitrophenol (PNP) in the presence of ALP, which results in the absorption peak shifting from 360 nm to 450 nm. Herein the spectral overlap between absorption spectrum of PNP and electrochemiluminescence (ECL) spectrum of luminol-SiNPs (425 nm) makes energy transfer occur from luminol-SiNPs to PNP. In the optimized conditions, a linear relationship was obtained using this ECRET method at the concentration of ALP from 5 to 50 U/L (r = 0.9905) and with the limit of detection (LOD) of 0.8 U/L. This ECRET method exhibits sufficient specificity for ALP over other enzymes such as horseradish peroxidase, trypsin and lysozyme.

Interleukin-6 serum concentration in the elderly undergoing total knee arthroplasty: A potential predictor of the early postoperative knee joint range of motion.

PURPOSE: To analyze the relevance between serum IL-6 with the early postoperative (post-op) knee joint range of motion (ROM) in the elderly undergoing total knee arthroplasty (TKA). To evaluate the factors affecting early post-op knee joint ROM in the elderly after TKA. METHODS: One hundred and forty-three patients undergoing TKA were included. The patients' general data, perioperative knee joint ROM and serum IL-6, pre-op HSS, WOMAC, SF-36 scores and Wells scores were collected. Repeated data variance analyses were performed to analyze the relevance between serum IL-6 with post-op knee joint ROM. Correlative regression and regression analysis were performed to evaluate the multiple factors affecting knee joint ROM in the elderly undergoing TKA. RESULTS: The 2-week-post-op (2w-post-op) knee joint ROM was significantly higher in the low IL-6 serum concentration group (< 46.45 ng/L) than in the high group (⩾ 46.45 ng/L) (97.78 ± 7.44∘VS 91.85 ± 7.42∘, F= 16.860, P= 0.000). A significant negative correlation was found between 1d-post-op serum IL-6 concentration with 2w-post-op knee joint ROM (R=-0.513, P= 0.000). The factors influencing the 2w-post-op knee joint ROM included pre-op HSS scores, pre-op WOMAC scores and whether to retain PCL (posterior cruciate ligament) (R2= 0.451, P= 0.009). CONCLUSION: A higher 1d-post-op IL-6 serum concentration indicated a lower knee joint ROM in the elderly two weeks after TKA.

Fluorescence detection of protamine, heparin and heparinase II based on a novel AIE molecule with four carboxyl.

In this research, a new DSA (Distyryl-anthracene) derivative with four carboxyl groups was designed and synthesized. This molecule exhibits aggregation-induced emission property (AIE). With the AIE character, a convenient and sensitive fluorescent probe for the detection of protamine, heparin and heparinase has been developed. The protamine can directly induce the aggregation of probe, which caused by electrostatic attraction. In this way, the turn-on detection of protamine is achieved, and the detection limit is as low as 30 ng mL-1. When heparin appears, the probes will be redisperse in solution, which causes a decrease in fluorescence intensity. Besides, this method also shows good selectivity and sensitivity, and the linear range of heparin is from 0.08 to 8 µg mL-1 with detection limit of 37 ng mL-1. After hydrolyzing heparin by heparinase, the probes rebind with protamine and the fluorescence enhance. The fluorescence enhancement was linearly related to the concentration of heparinase in the range of 0.02-2.0 µg mL-1 and detection limit as low as 143.7 ng mL-1. In addition, the results exhibited that the recovery percentage of heparinase in bovine samples reached to 96-101%.

Electrochemiluminescence "turn-off" detection of curcumin via energy transfer using luminol-doped silica nanoparticles.

A method is presented for electrochemiluminescent (ECL) detection of the food additive curcumin via an energy transfer strategy and by using luminol-doped silica nanoparticles (luminol-NPs). The ECL emission of the luminol-NPs (peaking at 425 nm) is reduced in the presence of curcumin due to spectral overlap. The assay can be performed within 1 min, response is linear in the 0.1 to 100 µM curcumin concentration range, and the limit of detection is 32 nM. The method is selective over many ions, adenosine triphosphate, ascorbic acid, cysteine and folic acid. It was successfully applied to the determination of curcumin in spiked human serum and urine. The average recoveries range from 99.0 to 102.6%. Graphical abstract Electrochemiluminescence (ECL) "turn-off" detection of curcumin at levels as low as 32 nM via energy transfer using luminol-doped silica nanoparticles. No hydrogen peroxide (H2O2) is used in ECL detection which makes the luminol-NPs ECL system more stable than the conventional luminol-H2O2 ECL system.

Water-dispersed fluorescent silicon nanodots as probes for fluorometric determination of picric acid via energy transfer.

Water-dispersed fluorescent silicon nanodots (SiNDs) were synthesized by a one-pot hydrothermal method starting from tetraethyl orthosilicate (TEOS) as silicon source and trisodium citrate as reducing reagent. The method is simple and convenient. The SiNDs, with excitation/emission peaks at 347/440 nm and with fluorescence quantum yield of 18% are shown to be viable fluorescent probes for picric acid (PA). The SiNDs strongly bind PA, and their blue fluorescence is quenched. The distance between the donor and acceptor (R0 value) is calculated from fluorescence data to be 2.1 nm. A fluorometric method was worked out that has a linear response in the 8 nM to 50 µM PA concentration range and a 0.92 nM limit of detection. The method has a fast response (2 min) and is well selective over other nitroaromatic compounds and metal ions. The average recoveries from spiked lake water samples ranged between 98.4 and 100.8%. Graphical abstract Water-dispersed fluorescent silicon nanodots (SiNDs) are synthesized using tetraethyl orthosilicate (TEOS) and trisodium citrate. Based on spectral overlap of fluorescent spectrum of SiNDs and absorption spectrum of picric acid (PA), fluorometric determination of PA at concentrations as low as 0.92 nM is achieved.