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It is noteworthy that prolonged cardiac structural changes and excessive fibrosis caused by myocardial infarction (MI) seriously interfere with the treatment of heart failure in clinical practice. Currently, there are no effective and practical means of either prevention or treatment. Thus, novel therapeutic approaches are critical for the long‐term quality of life of individuals with myocardial ischaemia. Herein, we aimed to explore the protective effect of H2, a novel gas signal molecule with anti‐oxidative stress and anti‐inflammatory effects, on cardiac remodelling and fibrosis in MI rats, and to explore its possible mechanism. First, we successfully established MI model rats, which were then exposed to H2 inhalation with 2% concentration for 28 days (3 hours/day). The results showed that hydrogen gas can significantly improve cardiac function and reduce the area of cardiac fibrosis. In vitro experiments further proved that H2 can reduce the hypoxia‐induced damage to cardiomyocytes and alleviate angiotensin II‐induced migration and activation of cardiac fibroblasts. In conclusion, herein, we illustrated for the first time that inhalation of H2 ameliorates myocardial infarction‐induced cardiac remodelling and fibrosis in MI rats and exert its protective effect mainly through inhibiting NLRP3‐mediated pyroptosis.

Background To define how the incidence of peripheral arterial disease (PAD) in chronic kidney disease (CKD) differs according to sex and age. Methods and Results The Chronic Renal Insufficiency Cohort (CRIC) is a multi-center, prospective cohort study of CKD participants. Fine and Gray methods were used to determine the cumulative incidence of PAD, defined by an ankle brachial index (ABI) < 0.90 or a confirmed PAD event, with death as a competing event. Adjusted subdistribution hazard ratios from the Fine and Gray model determined the risk of PAD according to sex. A priori, we hypothesized that the relationship between sex and cumulative incidence of PAD differed according to age. The mean age of the 3,174 participants in this study was 56.6 years and consisted of 55% males. Over a median follow-up of 5.9 years, 17.8% developed PAD, 13.0% were lost to followup and 11.1% died. Females had a 1.53-fold greater adjusted PAD risk compared to men (95% CI 1.27-1.84, p<0.001). These sex-related differences in PAD risk also differed by age (p=0.013). Women, compared to men, were at a markedly increased risk for PAD at younger ages; however, at ages greater than 70 years, the risk was similar across both sexes. Older men had a substantially greater PAD risk compared to younger men. In women, PAD risk did not vary with age. Conclusions Females with CKD have a higher PAD risk compared to males at younger ages. There is an important need to improve our understanding of the biological and clinical basis for these differences.

Background. It was unknown whether surgery for primary tumor would affect the occurrence of local symptoms caused by tumor progression in patients with de novo stage IV breast cancer (BC). Our work attempted to probe the effect of local resection on controlling local symptoms and improving the quality of life in de novo stage IV BC patients. Methods. Our study included patients presenting with de novo stage IV BC at the Cancer Hospital of the Chinese Academy of Medical Sciences from January 2008 to December 2014. In this study, we defined a new term called ''local progress/recurrence of symptoms'' (LPRS) to refer to the local problems caused by tumor progression/ recurrence. All the patients were grouped into surgery and non-surgery groups. The characteristics of the two groups were analyzed by Chi square and Fisher's test. Univariate and multivariate Cox regression models were designed to evaluate independent prognostic factors. Results. This study contained 177 patients. The follow-up deadline was April 1, 2019. The median follow-up time was 33 months (range 1-135 months). In included patients, 77 (43.5%) underwent surgery for primary tumors. Primary tumor surgery could reduce the occurrence of LPRS (relative risk/risk ratio (RR = 0.440; 95% CI 0.227-0.852; p = 0.015)) and patients without LPRS had longer OS (45 months vs 29 months, p \ 0.001). In addition, patients who had only one symptom had better OS than those who had two or three symptoms (p = 0.0175). Conclusions. The quality of life in patients with de novo stage IV breast cancer can be improved by reducing the incidence of local symptoms through primary tumor surgery. Keywords De novo stage IV breast cancer Á Local symptoms Á Primary tumor surgery Á Quality of life Á Survival Abbreviations BC Breast cancer LPRS Progress/recurrence symptoms OS Overall survival LPFS Local progression-free survival AJCC American Joint Committee on Cancer CR Complete response PR Partial response Generally, 3-5% of breast cancer (BC) patients in China are initially diagnosed as de novo stage IV BC. 1 The standard therapeutic approach was systemic therapy, especially chemotherapy. 2 Along with improvement of systemic treatment, which had prominently prolonged survival of patients, the effect of primary tumor surgery on de novo stage IV BC has gradually become a hot topic. 3

Background: Sepsis causes varying degrees of thrombocytopenia that are closely related to the likelihood of patient mortality. This study analysed the effect of recombinant human thrombopoietin (rhTPO) on the platelet count in critically ill patients with sepsis-associated thrombocytopenia and provided a reference for its treatment. Material/methods: The study was a retrospective analysis of the clinical data of patients. Patients were divided into an rhTPO group and control group according to rhTPO use during treatment. Demographical and clinical data (age, sex, history of hypertension, diabetes, platelet counts, mortality rate, etc.) of the patients were collected and analysed using statistical software; p < 0.05 was considered statistically significant. Results: Of 213 patients, 84 constituted the rhTPO group and 129 constituted the control group. The increase in platelet counts was significantly higher in the rhTPO group than in the control group on the third day (43.01 AE 18.23 Â 10 9 /L vs. 36.31 AE 14.17 Â 10 9 /L, p = 0.003), fifth day (71.51 AE 39.59 Â 10 9 /L vs. 42.95 AE 20.48 Â 10 9 /L, p < 0.001) and seventh day (115.36 AE 69.41 Â 10 9 /L vs. 62.54 AE 42.70 Â 10 9 /L, p < 0.001). Further statistical analysis of the data of patients with platelet counts 30 Â 10 9 /L and >30 Â 10 9 /L and APACHE II scores >15 and 15 at the time of diagnosis showed that the increase in platelet counts in the rhTPO group was greater. There was no significant between-group difference in volume of platelet transfusions (rhTPO group 15.42 AE 17.20 vs. control group 10.93 AE 17.48, p = 0.068). The cost of ICU treatment in patients with rhTPO was higher (RMB 126,936.21 AE 86,548.27 vs. 101,685.28 AE 77,291.75, p = 0.027); however, the ICU stay time was shorter (9.20 AE 5.38 vs. 10.88 AE 6.82, p = 0.047). There was no significant difference in 28-day mortality (rhTPO group: 25.0% vs. control group: 34.1%, p = 0.158) between the two groups. Conclusion: For patients with severe thrombocytopenia or severe sepsis, rhTPO was efficacious in increasing their platelet counts, resulting in a shorter ICU stay time.

Graphite phase carbon nitride (g-CN) composite structure materials, as a kind of stable compound with graphite-like structure, has attracted more and more attention due to its excellent properties, such as being able to absorb solar energy, stable chemical and optical properties and having a suitable oxidation potential. However, its application in the field of photocatalysis is limited by its small specific surface area and poor dispersibility. To solve this problem, ultra-thin g-CN nanosheets are often prepared using peeling methods. In this paper, the current status and mechanism of thermal oxidation peeling, ultrasound-assisted liquid-phase peeling and acid-base chemical peeling are reviewed in detail. In addition, the future research directions of ultra-thin graphite-like carbon nitride nanosheets are discussed.

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