Prenatal exposure to LPS activates the intrarenal RAS but not the circulating RAS and thus induces increases in blood pressure in adult offspring; however, ADSCs treatment attenuates the blood pressure increases resulting from LPS exposure and also ameliorates the other phenotypic changes induced by LPS treatment by inhibiting intrarenal RAS activation.

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Purpose: The purpose of this study was to investigate the associated between serum total bilirubin (STB) levels and long-term outcomes in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI).Methods: A total of 1,273 consecutive patients were enrolled. Patients were grouped according to their baseline STB levels: Group 1 (STB < 3.4 μmol/L), Group 2 (3.4 μmol/L ≤ STB ≤ 10.3 μmol/L), Group 3 (10.3 μmol/L < STB ≤ 17.1 μmol/L), and Group 4 (STB > 17.1 μmol/L) and the rate of major adverse cardiovascular events (MACE) was determinedResults: A total of 1,152 patients were successfully followed up (90.5%) for a mean period of 30 ± 5 months, including 187 patients experiencing a major adverse cardiovascular event (MACE: death from any cause, myocardial infarction, repeat revascularization or readmission). The MACE rate in Groups 3 and 4 was lower than in Groups 1 and 2 (P < 0.01). After adjusted the confounding factors with Cox regression analysis, the MACE rates in Groups 2-4 were still lower than in Group 1 (Group 2, RR=0.293, 95% CI 0.167-0.517, P<0.01; Group 3, RR=0.142, 95% CI 0.065-0.312, P<0.01; Group 4, RR=0.134, 95% CI 0.071-0.252, P<0.01). The cumulative survival rates of Groups 3 and 4 were higher than that of Groups 1and 2 (P<0.01).Conclusions: High STB concentration is associated with lower MACE in patients with ACS after PCI.

BACKGROUND: There are confl icting results regarding whether corticosteroids have better effi cacy than placebo in acute respiratory distress syndrome (ARDS) patients. Therefore, we aim to further evaluate the effi cacy and safety of corticosteroids in adult ARDS patients. METHODS:The databases, including Medline, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, were searched from their inception to May 2, 2020. Randomized controlled trials (RCTs) and observational cohort studies were selected to assess the use of corticosteroids in adult ARDS patients. The quality of the results was judged by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The inverse-variance method with random or fixed effects modeling was used to compute pooled odds ratio (OR), standardized mean diff erence (SMD), and their 95% confi dence interval (CI). RESULTS:Eight eligible RCTs and six cohort studies were included. The use of corticosteroids was associated with reduced mortality (OR 0.57, 95% CI 0.43-0.76, I 2 =35.1%, P=0.148) in ARDS patients, and the result was confirmed in the included cohort studies (OR 0.51, 95% CI 0.27-0.95, I 2 =66.7%, P=0.010). The subgroup analysis stratified by the initiation time and duration of corticosteroid use showed that early ARDS and prolonged corticosteroid use had signifi cant survival benefits in the RCTs. The low-dose corticosteroid use was also associated with significantly more ventilator-free days and a reduced rate of new infections in ARDS patients. CONCLUSIONS:The low-dose corticosteroid therapy may be safe and reduce mortality, especially in patients with prolonged treatment and early ARDS.