In the American Heart Association’s Scientific Sessions 2021, the results of six clinical trials related to cardiovascular surgery were revealed. The PALACS trial demonstrated that posterior left pericardiotomy during open heart surgery was associated with a significant reduction in postoperative atrial fibrillation; the EPICCURE study found that injection of mRNA encoding vascular endothelial growth factor (VEGF-A mRNA) directly into the myocardium of patients undergoing elective coronary artery bypass grafting (CABG) improved patients’ heart function; the VEST trial once again proved the safety and potential value of external stent for vein graft. This article will interpret the above-mentioned three studies.
Periodontal disease is a common chronic infectious disease targeting the connective tissue supporting the dentition. In recent years, the research on periodontal disease and cerebral infarction has been increasing. However, the causal relationship between periodontal disease and cerebral infarction remains unclear. Periodontal disease may be associated with atherosclerosis, which is one of the major causes of cerebral infarction. Regular dental care can reduce the risk of cardiovascular disease. Therefore, investigating the above association and its underlying mechanisms is of great clinical significance, which may help clinicians to make appropriate treatment and prevention measures. In this paper, the research progress and possible mechanism of the relationship between periodontal disease and cerebral infarction were reviewed.
ObjectivesTo systematically review the association between pepper consumption and risk of gastric cancer.MethodsPubMed, EMbase, Web of Science, The Cochrane Library, WanFang Data, VIP and CNKI databases were electronically searched to collect epidemiological studies of evaluating the association between pepper consumption and the risk of gastric cancer from inception to April, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 18 studies involving 17 case-control studies and 1 cohort study with 13 142 participants were included. The studies were divided into quantitative group and non-quantitative group. The results of meta-analysis showed that: ① In quantitative group, medium to heavy pepper consumption was the risk factor of gastric cancer (OR=1.55, 95%CI 1.13 to 2.14, P=0.008). Whereas there was no significant association between low pepper consumption and the risk of gastric cancer (OR=0.63, 95%CI 0.26 to 1.50, P=0.297). ② In the non-quantitative group, pepper consumption was the risk factor of gastric cancer (OR=1.37, 95%CI 1.09 to 1.74, P=0.008). ③ Subgroup analysis results showed that medium to heavy pepper consumption in Asian population had significant association with gastric cancer (OR=2.24, 95%CI 1.88 to 2.67, P=0.005), however, there was no significant association between low pepper consumption and the risk of gastric cancer (OR=0.62, 95%CI 0.33 to 1.18, P=0.144).ConclusionsThe association between pepper consumption and risk of gastric cancer remains unclear, medium to heavy pepper consumption may be related to the risk of gastric cancer, especially in Asian population.
The American Heart Association (AHA) released the 2017 American Heart Association Focused Update on Adult Basic Life Support and Cardiopulmonary Resuscitation Quality (2017 AHA guidelines update) in November 2017. The 2017 AHA guidelines update was updated according to the rules named " the update of the guideline is no longer released every five years, but whenever new evidence is available” in the 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. The updated content in this guideline included five parts: dispatch-assisted cardiopulmonary resuscitation (CPR), bystander CPR, emergency medical services - delivered CRP, CRP for cardiac arrest, and chest compression - to - ventilation ratio. This review will interpret the 2017 AHA guidelines update in detail.
Electrocardiogram (ECG) signals are easily disturbed by internal and external noise, and its morphological characteristics show significant variations for different patients. Even for the same patient, its characteristics are variable under different temporal and physical conditions. Therefore, ECG signal detection and recognition for the heart disease real-time monitoring and diagnosis are still difficult. Based on this, a wavelet self-adaptive threshold denoising combined with deep residual convolutional neural network algorithm was proposed for multiclass arrhythmias recognition. ECG signal filtering was implemented using wavelet adaptive threshold technology. A 20-layer convolutional neural network (CNN) containing multiple residual blocks, namely deep residual convolutional neural network (DR-CNN), was designed for recognition of five types of arrhythmia signals. The DR-CNN constructed by residual block local neural network units alleviated the difficulty of deep network convergence, the difficulty in tuning and so on. It also overcame the degradation problem of the traditional CNN when the network depth was increasing. Furthermore, the batch normalization of each convolution layer improved its convergence. Following the recommendations of the Association for the Advancements of Medical Instrumentation (AAMI), experimental results based on 94 091 2-lead heart beats from the MIT-BIH arrhythmia benchmark database demonstrated that our proposed method achieved the average detection accuracy of 99.034 9%, 99.498 0% and 99.334 7% for multiclass classification, ventricular ectopic beat (Veb) and supra-Veb (Sveb) recognition, respectively. Using the same platform and database, experimental results showed that under the comparable network complexity, our proposed method significantly improved the recognition accuracy, sensitivity and specificity compared to the traditional deep learning networks, such as deep Multilayer Perceptron (MLP), CNN, etc. The DR-CNN algorithm improves the accuracy of the arrhythmia intelligent diagnosis. If it is combined with wearable equipment, internet of things and wireless communication technology, the prevention, monitoring and diagnosis of heart disease can be extended to out-of-hospital scenarios, such as families and nursing homes. Therefore, it will improve the cure rate, and effectively save the medical resources.
In November 2019, the American Heart Association updated guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care. This update is not a comprehensive revision of the 2015 version. The updates for children and newborns mainly include three aspects: ① Pediatric basic life support: A. It is recommended that emergency medical dispatch centers offer dispatcher-assisted CPR instructions for presumed pediatric cardiac arrest. B. It is recommended that emergency dispatchers provide CPR instructions for pediatric cardiac arrest when no bystander CPR is in progress. ② Pediatric advanced life support: A. The bag-mask ventilation is reasonable compared with advanced airway interventions (endotracheal intubation or supraglottic airway) in the management of children during out-of-hospital cardiac arrest (OHCA). B. The extracorporeal CPR may be considered for pediatric patients with cardiac diagnoses who have in-hospital cardiac arrest (IHCA) in settings with existing extracorporeal membrane oxygenation protocols, expertise, and equipment. C. Continuous measurement of core temperature during targeted temperature management is recommended; for infants or children between 24 hours and 18 years of age who remain comatose after OHCA or IHCA, targeted temperature management is recommened. ③ Neonatal resuscitation: A. In term and late-preterm newborns (≥35 weeks of gestation) receiving respiratory support at birth, the initial use of 21% oxygen is reasonable. B. One hundred percent oxygen should not be used to initiate resuscitation because it is associated with excess mortality. C. In preterm newborns (<35 weeks of gestation) receiving respiratory support at birth, it may be reasonable to begin with 21% to 30% oxygen.
ObjectiveTo explore the association between free fatty acid (FFA) and extent of severity of acute coronary syndrome (ACS).
MethodsWe analyzed the clinical data of 93 ACS in-patients treated between July 2014 and May 2015, including 35 with acute ST-elevation myocardial infarction (STEMI), 34 with acute non STEMI (NSTEMI), and 24 with unstable angina (UA). Another 29 in-patients during the same period without coronary heart disease and heart failure and with normal results of electrocardiogram and myocardial damage markers were selected as the control. The statistical analysis of FFA collected within 24 hours after admission was conducted.
ResultsThe FFA in the ACS group[(1.08±0.41) mmol/L] was significantly higher than that in control group[(0.51±0.15) mmol/L] (P < 0.01). The FFA in patients with STEMI, NSTEMI, and UA in ACS group was (1.32±0.38), (1.12±0.35, and (0.67±0.10) mmol/L, respectively; the FFA in STEMI and NSTEMI patients was much higher than that in the UA patients (P < 0.05), and the difference between STEMI and NSTEMI patients was not significant (P > 0.05). There were 58 NSTEMI and UA patients evaluated by Grace risk score, in whom 30 had Grace score≥140 with the FFA of (1.12±0.37) mmol/L and 28 had < 140 with the FFA of (0.73±0.17) mmol/L; the difference was significant (P < 0.05). There were 35 STEMI patients evaluated by Killip grade, in whom 16 were Killip I-II with the FFA of (1.17±0.37) mmol/L, and 19 were Killip III-IV with the FFA of (1.45±0.35) mmol/L; the difference was significant (P < 0.05).
ConclusionElevated plasma FFA could be associated with ischemic risk and extent of severity of ACS.
American Heart Association (AHA) updated the advanced cardiovascular life support use of antiarrhythmic drugs during and immediately after cardiac arrest in the AHA guidelines for cardiopulmonary resuscitation and emergency cardiovascular care in November 2018. Based on the latest progress of relative evidence-based clinical evidence and 2015 AHA guidelines for cardiopulmonary resuscitation and cardiovascular emergency cardiovascular care. This update gave recommends on the use of antiarrhythmic drugs during resuscitation from adult shock-refractory ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT) cardiac arrest and immediately after restoration of spontaneous circulation following shock-refractory VF/pVT cardiac arrest, respectively. This review aims to interpret this update by reviewing the literature and comparing the recommends in this update with other guidelines.
Objective To reveal the association between the single nucleotide polymorphism (SNP) of v-maf musculoaponeurotic fibrosarcoma oncogene homolog B (MAFB) gene rs17820943 locus and non-syndromic cleft l ip with or without cleft palate (NSCL/P) in the southern Chinese Han population. Methods Genotyping of MAFB gene rs17820943 polymorphism was carried out in 300 patients with NSCL/P, 354 normal controls, and an additional 168 case-parent trios with matrix-assisted laser desorption/ionisation time-of-fl ight (MALDI-TOF) mass spectrometry. Then based on the genotypingresults, both a case-control association study and a case-parent trio association study were performed. Results Significant differences were found in the allele and genotype frequencies of rs17820943 locus between case and control groups (Pallele=0.001 and Pgenotype=0.002, respectively). To be specific, the odds radio (OR) values and 95% confidence interval (95%CI) of allele T (frequencies of cases ∶ controls = 0.358 ∶ 0.448) and genotype TT (frequencies of cases ∶ controls = 0.110 ∶ 0.195) were ORT = 0.69 (95%CI: 0.55-0.86) and ORTT = 0.43 (95%CI: 0.26-0.70), respectively. Subsequent case-parent trio analysis also indicated an association between MAFB rs17820943 variant and the risk of NSCL/P (ORT vs. C = 0.55, 95%CI: 0.41-0.75, P value of transmission disequilibrium test was 0.000). Conclusion Polymorphism of MAFB gene rs17820943 locus is associated with NSCL/P in the southern Chinese Han population; MAFB rs17820943 variant may be a susceptible gene of NSCL/P.
The Standards of Medical Care in Diabetes released by the American Diabetes Association (ADA) is one of the most important guidelines for clinicians. Based on the latest evidence of clinical studies, the Standards of Medical Care in Diabetes is annually updated by ADA. The statements of ADA on diagnosis, assessment, and management in diabetes are recommended for clinicians, patients, and researchers. The latest edition of Standards of Medical Care in Diabetes was published in a supplementary issue of Diabetes Care in January 2018. This interpretation will focus on the updated contents and their best evidence and clinical importance in this guideline.
