IntroductionObservational data have suggested that statin therapy may reduce mortality in patients with infection and sepsis; however, results from randomized studies are contradictory and do not support the use of statins in this context. Here, we performed a meta-analysis to investigate the effects of statin therapy on mortality from infection and sepsis.MethodsWe searched electronic databases (PubMed and Embase) for articles published before November 2013. Randomized or observational studies reporting the effects of statin therapy on mortality in patients with infection or sepsis were eligible. Randomized and observational studies were separately pooled with relative risks (RRs) and random-effects models.ResultsWe examined 5 randomized controlled trials with 867 patients and 27 observational studies with 337,648 patients. Among the randomized controlled trials, statins did not significantly decrease in-hospital mortality (RR, 0.98; 95% confidence interval (CI), 0.73 to 1.33) or 28-day mortality (RR, 0.93; 95% CI, 0.46 to 1.89). However, observational studies indicated that statins were associated with a significant decrease in mortality with adjusted data (RR, 0.65; 95% CI, 0.57 to 0.75) or unadjusted data (RR, 0.74; 95% CI, 0.59 to 0.94).ConclusionsLimited evidence suggests that statins may not be associated with a significant reduction in mortality from infection and sepsis. Although meta-analysis from observational studies showed that the use of statins was associated with a survival advantage, these outcomes were limited by high heterogeneity and possible bias in the data. Therefore, we should be cautious about the use of statins in infection and sepsis.

BackgroundIntra-aortic balloon pumps (IABP) have generally been used for patients undergoing high-risk mechanical coronary revascularization. However, there is still insufficient evidence to determine whether they can improve outcomes in reperfusion therapy patients, mainly by percutaneous coronary intervention (PCI) with stenting or coronary artery bypass graft (CABG). This study was designed to determine the difference between high-risk mechanical coronary revascularization with and without IABPs on mortality, by performing a meta-analysis on randomized controlled trials of the current era.MethodsPubmed and Embase databases were searched from inception to May 2015. Unpublished data were obtained from the investigators. Randomized clinical trials of IABP and non-IABP in high-risk coronary revascularization procedures (PCI or CABG) were included. In the case of PCI procedures, stents should be used in more than 80% of patients. Numbers of events at the short-term and long-term follow-up were extracted.ResultsA total of 12 randomized trials enrolling 2155 patients were included. IABPs did not significantly decrease short-term mortality (relative risk (RR) 0.66; 95% CI, 0.42–1.01), or long-term mortality (RR 0.79; 95% CI, 0.47–1.35), with low heterogeneity across the studies. The findings remained stable in patients with acute myocardial infarction with or without cardiogenic shock. But in high-risk CABG patients, IABP was associated with reduced mortality (71 events in 846 patients; RR 0.40; 95%CI 0.25–0.67).ConclusionIn patients undergoing high-risk coronary revascularization, IABP did not significantly decrease mortality. But high-risk CABG patients may be benefit from IABP. Rigorous criteria should be applied to the use of IABPs.

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.

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: Aortic sinus aneurysms are congenital malformations that include left, right, and non-coronary sinus aneurysms. Rupture of non-coronary sinus aneurysms is rare; however, the scope of complications may not be fully understood due to the rarity of this situation. This report presents a rare case of multiple organ dysfunction caused by a ruptured non-coronary sinus aneurysm. To the best of our knowledge, no relevant report has been published on aortic sinus aneurysms that lead to multiple organ dysfunction. Case report: A 26-year-old woman presented with cough, sputum, nausea, and vomiting over three days. Computed tomography revealed thickening of the right lung texture and right pleural effusion. No obvious abnormality was found on cardiac ultrasound. After admission, the patient's symptoms worsened, and her heart, liver, and kidney functions gradually deteriorated. After a physical examination and cardiac ultrasound examination, it was discovered that the aorta had a non-coronary sinus rupture that entered the right atrium. On the basis of these findings, we surgically repaired the aortic sinus, resulting in the patient's dramatic recovery. The heart, liver, and kidney functions dramatically improved. Conclusion: A ruptured aortic sinus aneurysm can induce heart, liver, and kidney dysfunction or even failure, and this multi-organ dysfunction can be alleviated by repairing the ruptured aortic sinus aneurysm. After a ruptured aortic sinus aneurysm has been identified, surgery should be performed as soon as possible to prevent further complications.