BACKGROUND Increased lipoprotein(a)[lp(a)]has proinflammatory effects,which increase the risk of coronary artery disease.However,the association between lp(a)variability and follow-up C-reactive protein(CRP)level in p...BACKGROUND Increased lipoprotein(a)[lp(a)]has proinflammatory effects,which increase the risk of coronary artery disease.However,the association between lp(a)variability and follow-up C-reactive protein(CRP)level in patients undergoing percutaneous coronary intervention(PCI)has not been investigated.AIM To explore the association between lp(a)variability and mean CRP levels within the 1st year post-PCI.METHODS Results of lp(a)and CRP measurements from at least three follow-up visits of patients who had received PCI were retrospectively analyzed.Standard deviation(SD),coefficient of variation(CV),and variability independent of the mean(VIM)are presented for the variability for lp(a)and linear regression analysis was conducted to correlate lp(a)variability and mean follow-up CRP level.The relationship of lp(a)variability and inflammation status was analyzed by restricted cubic spline analysis.Finally,exploratory analysis was performed to test the consistency of results in different populations.RESULTS A total of 2712 patients were enrolled.Patients with higher variability of lp(a)had a higher level of mean follow-up CRP(P<0.001).lp(a)variability was positively correlated with the mean follow-up CRP(SD:β=0.023,P<0.001;CV:β=0.929,P<0.001;VIM:β=1.648,P<0.001)by multivariable linear regression analysis.Exploratory analysis showed that the positive association remained consistent in most subpopulations.CONCLUSION Lp(a)variability correlated with mean follow-up CRP level and high variability could be considered an independent risk factor for increased post-PCI CRP level.展开更多
BACKGROUND Down syndrome,also known as trisomy 21 syndrome,is commonly associated with congenital heart disease,and can often result in early formation of pulmonary hypertension.The development of pulmonary hypertensi...BACKGROUND Down syndrome,also known as trisomy 21 syndrome,is commonly associated with congenital heart disease,and can often result in early formation of pulmonary hypertension.The development of pulmonary hypertension can result from factors such as intracardiac and macrovascular shunts,and upper airway obstruction or hypoplasia of lung tissue.Individuals with Down syndrome and congenital heart disease have a significantly lower average life expectancy,with surgical intervention being the most viable treatment option to improve longevity.CASE SUMMARY We report the case of a 13-year-old boy with Down syndrome presenting with atrial septal defect and patent ductus arteriosus along with severe pulmonary hypertension.The electrocardiogram shows sinus rhythm and right ventricular hypertrophy.The echocardiogram shows an atrial septal defect with interrupted echo in the interatrial septum,measuring 0.813 cm in length.The patient was initially refused to be offered surgical treatment by many hospitals due to the high surgical risk and pulmonary artery resistance.After discussing the patient’s diagnosis and treatment options,we ultimately recommended surgical treatment.However,the patient and their family declined this recommendation and chose to be discharged.During the follow-up period of 6 mo,there were no significant improvements or deteriorations in the patient’s condition.CONCLUSION In conclusion,this case highlights the challenges faced by individuals with Down syndrome and congenital heart disease complicated by severe pulmonary hypertension.Timely intervention and a multidisciplinary approach are crucial for improving prognosis and life expectancy.Further research is needed to enhance our understanding and develop effective interventions for this popula-tion.Core Tip:This case study presents a 13-year-old boy diagnosed with Down syndrome alongside atrial septal defect,patent ductus arteriosus,and severe pulmonary hypertension.A complex condition initially met with surgical treatment denial due to high risks,highlights the significant challenges faced by individuals with Down syndrome and congenital heart disease.This case highlights the discussion and educational value surrounding the decision to undergo surgery in complex congenital heart diseases.The educational value lies in the diagnostic and therapeutic approaches demonstrated by our team.Due to the relatively common occurrence of this case in the field of cardiology,our decision-making process holds significant value and applicability.展开更多
Peptide drugs are known for their high biological safety.However,compared with small molecule drugs,peptide drugs are easily oxidized and hydrolyzed as well as short in half-life.Herein,inspired by the long circulatio...Peptide drugs are known for their high biological safety.However,compared with small molecule drugs,peptide drugs are easily oxidized and hydrolyzed as well as short in half-life.Herein,inspired by the long circulation of albumin in blood,we screened albumin binding peptides(ABPs)from a one-bead one-compound(OBOC)peptide library to increase the half-life of peptide drugs.Beads displaying random peptides were screened using fluorescent labeled human serum albumin.Fluorescent beads with specific binding to albumin were isolated for sequencing.The selected ABPs can effectively bind to albumin,thus possessing the long circulation of albumin.The dissociation constant(K_(D))of ABPs to albumin is up to 1×10^(-8)mol/L.Once one of ABPs(ABP2)was coupled to triptorelin,the circulation half-life of triptorelin in mice was significantly prolonged to 263.50 h much longer than that of triptorelin alone(179.07 h).In addition,the combination therapy using ABP-conjugated triptorelin and doxorubicin(DOX)can effectively inhibit the proliferation of tumor cells in mice.The OBOC screening strategy and resulting ABPs showed great potential for enhancing the delivery efficiency of peptide drugs.展开更多
文摘BACKGROUND Increased lipoprotein(a)[lp(a)]has proinflammatory effects,which increase the risk of coronary artery disease.However,the association between lp(a)variability and follow-up C-reactive protein(CRP)level in patients undergoing percutaneous coronary intervention(PCI)has not been investigated.AIM To explore the association between lp(a)variability and mean CRP levels within the 1st year post-PCI.METHODS Results of lp(a)and CRP measurements from at least three follow-up visits of patients who had received PCI were retrospectively analyzed.Standard deviation(SD),coefficient of variation(CV),and variability independent of the mean(VIM)are presented for the variability for lp(a)and linear regression analysis was conducted to correlate lp(a)variability and mean follow-up CRP level.The relationship of lp(a)variability and inflammation status was analyzed by restricted cubic spline analysis.Finally,exploratory analysis was performed to test the consistency of results in different populations.RESULTS A total of 2712 patients were enrolled.Patients with higher variability of lp(a)had a higher level of mean follow-up CRP(P<0.001).lp(a)variability was positively correlated with the mean follow-up CRP(SD:β=0.023,P<0.001;CV:β=0.929,P<0.001;VIM:β=1.648,P<0.001)by multivariable linear regression analysis.Exploratory analysis showed that the positive association remained consistent in most subpopulations.CONCLUSION Lp(a)variability correlated with mean follow-up CRP level and high variability could be considered an independent risk factor for increased post-PCI CRP level.
文摘BACKGROUND Down syndrome,also known as trisomy 21 syndrome,is commonly associated with congenital heart disease,and can often result in early formation of pulmonary hypertension.The development of pulmonary hypertension can result from factors such as intracardiac and macrovascular shunts,and upper airway obstruction or hypoplasia of lung tissue.Individuals with Down syndrome and congenital heart disease have a significantly lower average life expectancy,with surgical intervention being the most viable treatment option to improve longevity.CASE SUMMARY We report the case of a 13-year-old boy with Down syndrome presenting with atrial septal defect and patent ductus arteriosus along with severe pulmonary hypertension.The electrocardiogram shows sinus rhythm and right ventricular hypertrophy.The echocardiogram shows an atrial septal defect with interrupted echo in the interatrial septum,measuring 0.813 cm in length.The patient was initially refused to be offered surgical treatment by many hospitals due to the high surgical risk and pulmonary artery resistance.After discussing the patient’s diagnosis and treatment options,we ultimately recommended surgical treatment.However,the patient and their family declined this recommendation and chose to be discharged.During the follow-up period of 6 mo,there were no significant improvements or deteriorations in the patient’s condition.CONCLUSION In conclusion,this case highlights the challenges faced by individuals with Down syndrome and congenital heart disease complicated by severe pulmonary hypertension.Timely intervention and a multidisciplinary approach are crucial for improving prognosis and life expectancy.Further research is needed to enhance our understanding and develop effective interventions for this popula-tion.Core Tip:This case study presents a 13-year-old boy diagnosed with Down syndrome alongside atrial septal defect,patent ductus arteriosus,and severe pulmonary hypertension.A complex condition initially met with surgical treatment denial due to high risks,highlights the significant challenges faced by individuals with Down syndrome and congenital heart disease.This case highlights the discussion and educational value surrounding the decision to undergo surgery in complex congenital heart diseases.The educational value lies in the diagnostic and therapeutic approaches demonstrated by our team.Due to the relatively common occurrence of this case in the field of cardiology,our decision-making process holds significant value and applicability.
基金supported by National Natural Science Foundation of China(Nos.51890891,51890894,52073027,and 51773017)National Key R&D Program of China(No.2018YFE0205400)the Fundamental Research Funds for the Central Universities(No.FRFDF-19–001)。
文摘Peptide drugs are known for their high biological safety.However,compared with small molecule drugs,peptide drugs are easily oxidized and hydrolyzed as well as short in half-life.Herein,inspired by the long circulation of albumin in blood,we screened albumin binding peptides(ABPs)from a one-bead one-compound(OBOC)peptide library to increase the half-life of peptide drugs.Beads displaying random peptides were screened using fluorescent labeled human serum albumin.Fluorescent beads with specific binding to albumin were isolated for sequencing.The selected ABPs can effectively bind to albumin,thus possessing the long circulation of albumin.The dissociation constant(K_(D))of ABPs to albumin is up to 1×10^(-8)mol/L.Once one of ABPs(ABP2)was coupled to triptorelin,the circulation half-life of triptorelin in mice was significantly prolonged to 263.50 h much longer than that of triptorelin alone(179.07 h).In addition,the combination therapy using ABP-conjugated triptorelin and doxorubicin(DOX)can effectively inhibit the proliferation of tumor cells in mice.The OBOC screening strategy and resulting ABPs showed great potential for enhancing the delivery efficiency of peptide drugs.
