Metal–organic frameworks (MOFs) with intrinsically porous structures and well‐dispersed metal sites are promising candidates for electrocatalysis; however, the catalytic efficiencies of most MOFs are significantly limited by their impertinent adsorption/desorption energy of intermediates formed during electrocatalysis and very low electrical conductivity. Herein, Co is introduced into conductive Cu‐catecholate (Cu‐CAT) nanorod arrays directly grown on a flexible carbon cloth for hydrogen evolution reaction (HER). Electrochemical results show that the Co‐incorporated Cu‐CAT nanorod arrays only need 52 and 143 mV overpotentials to drive a current density of 10 mA cm−2 in alkaline and neutral media for HER, respectively, much lower than most of the reported non‐noble metal‐based electrocatalysts and comparable to the benchmark Pt/C electrocatalyst. Density functional theory calculations show that the introduction of Co can optimize the adsorption energy of hydrogen (ΔGH*) of Cu sites, almost close to that of Pt (111). Furthermore, the adsorption energy of water (ΔEH2O) of Co sites in the CuCo‐CAT is significantly lower than that of Cu sites upon coupling Cu with Co, effectively accelerating the Volmer step in the HER process. The findings, synergistic effect of bimetals, open a new avenue for the rational design of highly efficient MOF‐based electrocatalysts.

ObjectivesTo explore assessment of supra‐annular structure for self‐expanding transcatheter heart valve (THV) size selection in patients with bicuspid aortic stenosis (AS).BackgroundAnnulus‐based device selection from CT measurement is the standard sizing strategy for tricuspid aortic valve before transcatheter aortic valve replacement (TAVR). Because of supra‐annular deformity, device selection for bicuspid AS has not been systemically studied.MethodsTwelve patients with bicuspid AS who underwent TAVR with self‐expanding THVs were included in this study. To assess supra‐annular structure, sequential balloon aortic valvuloplasty was performed in every 2 mm increments until waist sign occurred with less than mild regurgitation. Procedural results and 30 day follow‐up outcomes were analyzed.ResultsSeven patients (58.3%) with 18 mm; three patients (25%) with sequential 18 mm, 20 mm; and only two patients (16.7%) with sequential 18 mm, 20 mm, and 22 mm balloon sizing were performed, respectively. According to the results of supra‐annular assessment, a smaller device size (91.7%) was selected in all but one patient compared with annulus based sizing strategy, and the outcomes were satisfactory with 100% procedural success. No mortality and 1 minor stroke were observed at 30 d follow‐up. The percentage of NYHA III/IV decreased from 83.3% (9/12) to 16.7% (2/12). No new permanent pacemaker implantation and no moderate or severe paravalvular leakage were found.ConclusionsA supra‐annular structure based sizing strategy is feasible for TAVR in patients with bicuspid AS.

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Abstract:Objective: The purpose of this study is to evaluate the safety and efficacy of transcatheter aortic valve implantation (TAVI) in patients with a severe stenotic bicuspid aortic valve (BAV) in a Chinese population. While several groups have reported the feasibility, efficacy, and safety of TAVI for patients with a BAV, worldwide experience of the technique is still limited, especially in China. Methods: From March 2013 to November 2014, high surgical risk or inoperable patients with symptomatic severe aortic stenosis (AS) who had undergone TAVI at our institution were selected for inclusion in our study. Results were compared between a BAV group and a tricuspid aortic valve (TAV) group. Results: Forty patients were included in this study, 15 (37.5%) of whom were identified as having a BAV. In the BAV group, the aortic valve area was smaller ((0.47±0.13) vs. (0.59±0.14) cm 2 ), the ascending aortic diameter was larger ((40.4±4.4) vs. (36.4±4.3) mm), and the concomitant aortic regurgitation was lower. No significant differences were found between the groups in the other baseline characteristics. No differences were observed either in the choice of access or valve size. The procedural success achieved in this study was 100%. There were no differences between groups in device success (86.7% vs. 88.0%), 30-d mortality (6.7% vs. 8.0%), or 30-d combined end point (13.3% vs. 12.0%). The incidences of new pacemaker implantation, paravalvular regurgitation and other complications, recovery of left ventricle ejection fraction and heart function were similar in both groups. Conclusions: Patients with a severely stenotic BAV can be treated with TAVI, and their condition after treatment should be similar to that of people with a TAV.

BackgroundAccurate and early prognosis of disease is essential to clinical decision making, particularly in diseases, such as HCC, that are typically diagnosed at a late stage in the course of disease and therefore carry a poor prognosis. CDCA5 is a cell cycle regulatory protein that has shown prognostic value in several cancers.MethodsWe retrospectively evaluated 178 patients with HCC treated with curative liver resection between September 2009 and September 2012 at Nanchong Central Hospital in Nanchong, Sichuan Province, China. Patients were screened for their CDCA5 expression levels and assigned to either the high or low expression group. Patient demographics, comorbidities, clinicopathologic data, such as tumor microvascular invasion status and size, and long-term outcomes were compared between the two groups. The effect of CDCA5 on the proliferation of liver cancer cells was analyzed using in vitro and in vivo assays.ResultsThe present study found that increased CDCA5 expression was associated with increased tumor diameter and microvascular invasion in HCC. It was also found that CDCA5 overexpression may be associated with liver cancer cells. Additionally, this study confirmed that CDCA5 expression was increased in HCC tissue versus normal liver tissue, that CDCA5 expression was associated with decreased survival and that CDCA5 knockdown using shRNA led to cell cycle arrest in the G2/M phase.ConclusionsThese findings suggest that CDCA5 expression is associated with poor prognosis in patients with hepatocellular carcinoma.

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OPN may occur as a manifestation of BD and, in non-Western countries, this may be more common than the idiopathic variety. In contrast to idiopathic cases, OPN in BD is more likely to demonstrate initial rapid progression of visual loss and more severe loss at presentation. Patients show less recovery of vision in response to corticosteroids but carry a lower rate of subsequent relapse. Patients with OPN should be specifically questioned regarding symptoms of BD.

Far less attention has been paid to the prognostic effect of right‐side heart disease on outcomes after transcatheter aortic valve replacement (TAVR) when compared with the left side. Therefore, we performed a systematic review and meta‐analysis on the impact of tricuspid regurgitation (TR) and right ventricular (RV) dysfunction on outcomes after TAVR. We hypothesized that TR and RV dysfunction may have a deleterious effect on outcomes after TAVR. Article revealing the prognostic effect of TR and RV dysfunction on outcomes after TAVR were being integrated. Random or fixed effect model was adopted in accordance with the heterogeneity. There were nine studies with a total of 6466 patients enrolled after a comprehensive literature search of the MEDLINE/PubMed, EMBASE, ISI Web of Science, and Cochrane databases. The overall analysis revealed that moderate or severe TR at baseline increased all‐cause mortality after TAVR (HR = 1.79, CI 95% 1.52‐2.11, P < 0.001). Both baseline RV dysfunction (HR = 1.53, CI 95% 1.27‐1.83, P < 0.001) and presence of RV dilation (HR = 1.83, CI 95% 1.47‐2.27, P < 0.001) were associated with all‐cause mortality. Both baseline moderate or severe TR and RV dysfunction worsen prognosis after TAVR and careful assessment of right heart function should be done for clinical decision by the heart team before the TAVR procedure.