COVID-19 patients with preexisting cardiovascular diseases or with cardiovascular complications have showed a higher risk of mortality. The main cardiovascular complications of COVID-19 include acute cardiac injury, acute myocardial infarction, myocarditis, arrhythmia, heart failure, shock, and venous thromboembolism/pulmonary embolism. COVID-19 could cause cardiovascular complications or deterioration of coexisting cardiovascular diseases through direct or indirect mechanisms, including viral toxicity, dysregulation of the renin–angiotensin–aldosterone system, endothelial cell damage and thromboinflammation, cytokine storm, and demand-supply mismatch of oxygen. This study systematically reviews cardiovascular manifestations, histopathology, and mechanisms of COVID-19, to help formulate future research goals and facilitate the development of therapeutic management strategies.
To evaluate the feasibility and clinical efficacy of percutaneous endoscopic lumbar discectomy (PELD) for cauda equina syndrome (CES) caused by disc herniation. 16 patients with CES caused by LDH at the early and middle stages of Shi's classification were selected as the objects of study, who underwent PELD. Clinical outcomes were assessed using the Macnab criteria and the visual analogue scale (VAS). The VAS for leg pain and back pain significantly decreased from preoperative scores of 7.67 ± 1.23 and 7.52 ± 1.42, respectively, to postoperative scores of 1.71 ± 0.53 and 3.18 ± 0.72. Thirteen patients showed favorable results. Complications included one patient of motor weakness, and one patient developed an ipsilateral recurrent herniation who finally acquired satisfactory result after reoperation. Hence, PELD could be used as an alternative surgical method for the treatment of CES in properly selected cases and appropriate patient selection and a reasonable surgical approach will give rise to better outcomes.
Background: Frailty is common and associated with poorer outcomes in the elderly, but its prognostic value in acute coronary syndromes (ACS) requires clarification. We thus undertook a systematic review and meta-analysis to evaluate the relationship between frailty and poor prognosis in patients with ACS. Methods: We systematically searched PubMed, Embase to find literatures which studied the prognostic value of frailty in elderly patients with ACS. Our main endpoints were the all-cause mortality, cardiovascular disease (CVD), major bleeding and readmissions. We pooled studies using random-effect generic inverse variance method, and conducted three pre-specified subgroup analyses. Results: Of 1216 identified studies, 15 studies were included in our analysis. Compared with the normal group, frailty (HR = 2.65; 95%CI: 1.81-3.89, I 2 = 60.2%) and pre-frailty (HR = 1.41; 95%CI: 1.19-1.66, I 2 = 0%) were characterized by a higher risk of mortality after adjustment. Frailty also was associated with increased risk of any-type CVD, major bleeding and hospital readmissions in elderly patients with ACS. The pooled effect sizes in frail patients were 1.54 (95%CI: 1.32-1.79), 1.51 (95%CI: 1.14-1.99) and 1.51 (95%CI: 1.09-2.10). Conclusions: Frailty provides quantifiable and significant prognostic value for mortality and adverse events in elderly ACS patients, helping doctors to appraise the comprehensive prognosis risk and to applicate appropriate management strategies.
Stem cells therapy has been suggested as a promising option for the treatment of acute kidney injury (AKI). This study was performed to compare the abilities of xenogenic transplantation of human adipose stromal vascular fraction (SVF) and adipose-derived mesenchymal stem cells (AdMSCs) to facilitate the recovery of renal function and structure in a rat model of ischemia/reperfusion (IR) induced AKI. SVF or AdMSCs were transplanted to the injured kidney through intra-parenchymal injection. Significantly improved renal function and reduced tubular injury were observed in SVF and AdMSCs groups. Administration of SVF or AdMSCs contributed to significantly improved cell proliferation and markedly reduced cell apoptosis in parallel with reduced microvascular rarefaction in injured kidney. IR injury resulted in higher levels of inflammatory cytokines, whereas xenogenic transplantation of SVF or AdMSCs reduced but not induced inflammatory cytokines expression. Additionally, in vitro study showed that administration of SVF or AdMSCs could also significantly promote the proliferation and survival of renal tubular epithelial cells underwent hypoxia/reoxygenation injury through secreting various growth factors. However, cell proliferation was significantly promoted in SVF group than in AdMSCs group. In conclusion, our study demonstrated that administration of SVF or AdMSCs was equally effective in attenuating acute renal IR injury.
Bladder cancer ranks the second most common genitourinary tract cancer, and muscle-invasive bladder cancer (MIBC) accounts for approximately 25 % of all bladder cancer cases with high mortality. In the current study, with a total of 202 treatment-naïve primary MIBC patients identified from The Cancer Genome Atlas dataset, we comprehensively analyzed the genome-wide microRNA (miRNA) expression profiles in MIBC, with the aim to investigate the relationship of miRNA expression with the progression and prognosis of MIBC, and generate a miRNA signature of prognostic capabilities. In the progression-related miRNA profiles, a total of 47, 16, 3, and 84 miRNAs were selected for pathologic T, N, M, and histologic grade, respectively. Of the eight most important progression-related miRNAs, four (let-7c, mir-125b-1, mir-193a, and mir-99a) were significantly associated with survival of patients with MIBC. Finally, a four-miRNA signature was generated and proven as a promising prognostic parameter. In summary, this study identified the specific miRNAs associated with the progression and aggressiveness of MIBC and a four-miRNA signature as a promising prognostic parameter of MIBC.
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