Different clinical characteristics and outcomes of hypertrophic cardiomyopathy with and without hypertension:seeking the truth

OBJECTIVE To determine the different clinical characteristics and outcomes of hypertrophic cardiomyopathy(HCM)patients with and without hypertension(HT).METHODS A total of 696 HCM patients were included in this study and all HCM diagnoses were confirmed by the genetic test.Patients were analyzed separately in the septal reduction therapy(SRT)cohort and the non-SRT cohort.The primary endpoint was cardiovascular death and the secondary endpoint was all-cause death.Outcome analyses were conducted to evaluate the associations between HT and outcomes in HCM.Medications before enrollment and at discharge were collected in the post-hoc analyses.RESULTS HCM patients without HT were younger,had a lower body mass index,were more likely to have a family history of HCM,and had a smaller left ventricular(LV)end-diastolic diameter than those with HT in both cohorts.A thicker LV wall,a higher level of N-terminal pro-B-type natriuretic peptide,and a higher extent of LV late gadolinium enhancement were additionally observed in patients without HT in the non-SRT cohort.The presence of HT did not alter the distribution pattern of late gadolinium enhancement,as well as the constituent ratio of eight disease-causing sarcomeric gene variants in both cohorts.Outcome analyses showed that in the non-SRT cohort,patients without HT had higher risks of cardiovascular death(HR=2.537,P=0.032)and all-cause death(HR=3.309,P=0.032).While such prognostic divergence was not observed in the SRT cohort.Further post-hoc analyses in the non-SRT cohort found that patients without HT received fewer non-dihydropyridine calcium channel blockers and angiotensinconverting enzyme inhibitors/angiotensin receptor blockers before enrollment and at discharge.CONCLUSIONS HCM patients without HT had worse clinical conditions and higher mortality than patients with HT overall,which may result from active medical therapy in HT patients.Active SRT may have a substantial de-risking effect on patients meeting the indications.

Effects of Da-Cheng-Qi decoction on enteroparalysis and serum inflammatory cytokines in patients with severe acute pancreatitis

Objective: The objective of this study was to investigate the effects of Da-Cheng-Qi decoction (DCQD) on enteroparalysis and levels of the serum inflammatory cytokines C-C motif chemokine ligand 2 (CCL2) and interleukin-8 (IL-8) in patients with severe acute pancreatitis (SAP). Methods: A total of 48 patients diagnosed with SAP who hospitalized in First Affiliated Hospital of Henan Traditional Chinese Medicine University from May 1, 2016 to May 30, 2018 were randomly assigned to the control or treatment groups. Patients in the control group (n = 22) received conventional treatment and those in the treatment group (n = 26) received conventional treatment as well as additional DCQD for 10 days. The duration of abdominal pain and distension, the time when bowel sounds returned to normal, changes in the levels of serum amylase, lipase, C-reactive protein (CRP), CCL2 and IL-8, as well as acute physiology and chronic health evaluation (APACHE)Ⅱ scores of patients on days 1 and 10 were recorded and compared. Results: The duration of abdominal pain and distension, the time when bowel sounds returned to normal, the levels of blood amylase, lipase and CRP, and APACHE Ⅱ scores of patients in the treatment group decreased significantly compared with those of patients in the control group. Though there were no statistical differences in serum CCL2 and IL-8 concentrations on day 1 between patients in these two groups, the levels of serum CCL2 and IL-8 in the treatment group were lower than those in the control group on day 10. Conclusion: DCQD may decrease the levels of CCL2, CRP, and IL-8 in patients with SAP, quickly relieve enteroparalysis, and shorten hospitalization duration.

Environmental factors controlling soil warming and wetting during 2000-2020 in permafrost and non-permafrost regions across the Qinghai-Tibet Plateau

The Qinghai-Tibet Plateau(QTP)has experienced rapid environmental changes,including climate warming and wetting,since the 1980s.These environmental changes significantly impact the shallow soil hydrothermal conditions,which have key roles in land-atmosphere feedback and ecosystem functions.However,the spatial variations and responses of soil hydrothermal conditions to environmental changes over the QTP with permafrost(PF)and seasonal frost(SF)remain unclear.In this study,we investigated the spatial variations in soil temperature(ST)and soil moisture(SM)changes over the QTP from 2000 to 2020 using 99 in-situ sites with observations at 4 depths(i.e.10,40,100 and 200 cm).The main environmental controlling factors were further identified using a calibrated statistical model.Results showed that significant(p<0.05)soil warming occurred at multiple soil layers during 2000-2020 with a wide variation(i.e.0.033-0.039℃ per year on average),whereas the warming rates at PF sites were two times greater than those at SF sites.In addition,the soil wetting rate was high over the SF region,whereas the soil wetting rate was low over the PF region.Aside from air temperature,changes in thawing degree days and solar radiation(Srad)contributed most to soil warming in the PF region,whereas changes in rainfall,Srad and evaporation(EVA)have been identified as the key factors in the SF region.As for soil wetting,changes in snowfall,freezing degree days and vegetation have noticeable nonlinear effects over the PF region,whereas changes in EVA,Srad and rainfall highlighted distinct linear and nonlinear effects in the SF region.These findings enhance our understanding of the hydrothermal impacts of future environmental changes over the QTP.

Machine learning-based predictions of current and future susceptibility to retrogressive thaw slumps across the Northern Hemisphere

Retrogressive thaw slumps(RTSs)caused by the thawing of ground ice on permafrost slopes have dramatically increased and become a common permafrost hazard across the Northern Hemisphere during previous decades.However,a gap remains in our comprehensive understanding of the spatial controlling factors,including the climate and terrain,that are conducive to these RTSs at a global scale.Using machine learning methodologies,we mapped the current and future RTSs susceptibility distributions by incorporating a range of environmental factors and RTSs inventories.We identified freezing-degree days and maximum summer rainfall as the primary environmental factors affecting RTSs susceptibility.The final ensemble susceptibility map suggests that regions with high to very high susceptibility could constitute(11.6±0.78)%of the Northern Hemisphere's permafrost region.When juxtaposed with the current(2000-2020)RTSs susceptibility map,the total area with high to very high susceptibility could witness an increase ranging from(31.7±0.65)%(SSP585)to(51.9±0.73)%(SSP126)by the 2041-2060.The insights gleaned from this study not only offer valuable implications for engineering applications across the Northern Hemisphere,but also provide a long-term insight into the potential change of RTSs in permafrost regions in response to climate change.