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Hypertension is a major public health issue worldwide. The imbalance of gut microbiota is thought to play an important role in the pathogenesis of hypertension. The authors conducted the systematic review and meta‐analysis to clarify the relationship between gut microbiota and hypertension through conducting an electronic search in six databases. Our meta‐analysis included 19 studies and the results showed that compared with healthy controls, Shannon significantly decreased in hypertension [SMD = −0.13, 95%CI (−0.22, −0.04), p = .007]; however, Simpson [SMD = −0.01, 95%CI (−0.14, 0.12), p = .87], ACE [SMD = 0.18, 95%CI (−0.06, 0.43), p = .14], and Chao1 [SMD = 0.11, 95%CI (−0.01, 0.23), p = .08] did not differ significantly between hypertension and healthy controls. The F/B ratio significantly increased in hypertension [SMD = 0.84, 95%CI (0.10, 1.58), p = .03]. In addition, Shannon index was negatively correlated with hypertension [r = −0.12, 95%CI (−0.19, −0.05)], but had no significant correlation with SBP [r = 0.10, 95%CI (−0.19, 0.37)] and DBP [r = −0.39, 95%CI (−0.73, 0.12)]. At the phylum level, the relative abundance of Firmicutes [SMD = −0.01, 95%CI (−0.37, 0.34), p = .94], Bacteroidetes [SMD = −0.15, 95%CI (−0.44, 0.14), p = .30], Proteobacteria [SMD = 0.25, 95%CI (−0.01, 0.51), p = .06], and Actinobacteria [SMD = 0.21, 95%CI (−0.11, 0.53), p = .21] did not differ significantly between hypertension and healthy controls. At the genus level, compared with healthy controls, the relative abundance of Faecalibacterium decreased significantly [SMD = −0.16, 95%CI (−0.28, −0.04), p = .01], while the Streptococcus [SMD = 0.20, 95%CI (0.08, 0.32), p = .001] and Enterococcus [SMD = 0.20, 95%CI (0.08, 0.33), p = .002] significantly increased in hypertension. Available evidence suggests that hypertensive patients may have an imbalance of gut microbiota. However, it still needs further validation by large sample size studies of high quality.

Numerous recent studies have found a strong correlation between intestinal flora and the occurrence of hypertension. However, it remains unclear whether fecal microbiota transfer might affect the blood pressure of the host. This study aimed to quantify both associations. An electronic search was conducted in PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang database, Weipu, Embase, and SinoMed to retrieve relevant studies. The final search was completed on August 22, 2022. Two authors independently applied the inclusion criteria, extracted data, and assessed the risk of bias assessment. All data were analyzed using RevMan 5.4. A total of 5 articles were selected for final inclusion. All studies were assessed as having a high risk of bias according to the SYRCLE risk of bias tool. The meta-analysis results showed that transplantation of fecal bacteria from the hypertensive model can significantly improve the host's systolic pressure (MD = 18.37, 95%CI: 9.74~26.99, P<0.001), and diastolic pressure (MD = 17.65, 95%CI: 12.37~22.93, P<0.001). Subgroup analyses revealed that the increase in systolic pressure in the hypertension model subgroup (MD = 29.56, 95%CI = 23.55-35.58, P<0.001) was more pronounced than that in the normotensive model subgroup (MD = 12.48, 95%CI = 3.51-21.45, P<0.001). This meta-analysis suggests a relationship between gut microbiota dysbiosis and increased blood pressure, where transplantation of fecal bacteria from the hypertensive model can cause a significant increase in systolic pressure and diastolic pressure in animal models.

Malnutrition is linked to adverse outcomes in post-cardiac surgery patients. This study investigates the correlation between the Geriatric Nutritional Risk Index (GNRI) and adverse hospital outcomes in patients following cardiac surgery. This retrospective study included elderly patients with heart disease who were admitted to the Department of Cardiology, Fujian Medical University Union Hospital from January 2020 to December 2022. Patients were divided into two groups based on the cut-off value (98 g/dL). Data from 407 patients were assessed, with 278 (68.3%) classified as having nutritional risk and 129 (31.7%) as having no nutritional risk. Notable distinctions were observed in body weight, BMI, and left ventricular ejection fraction ( P  < 0.05). Laboratory indicators indicated lower levels of serum albumin, lymphocytes, red blood cells, hemoglobin, admission blood glucose, and admission triglyceride in the nutritional risk group ( P  < 0.05). Neutrophils and serum creatinine were higher in the nutritional risk group ( P  < 0.05). Poor prognosis was prevalent in the nutrition risk group (64.7%), with higher incidences of adverse outcomes ( P  < 0.05). Univariate and multivariate studies showed that GNRI < 98 g/dL was an independent predictor of postoperative cardiac surgery. Nutritional risk was an important predictor of adverse hospital outcomes after the surgery.

Background Early detection of cognitive dysfunction (POCD) in patients undergoing cardiac surgery may help improve the prognosis and quality of life. Identifying risk factors and clinically relevant factors is critical for prevention and treatment. Methods This study retrospectively selected 305 patients admitted to the cardiac surgery Department of Union Hospital Affiliated with Fujian Medical University from January 2024 to July 2024 as the study objects. The cognitive function of the patients was assessed by the Montreal Cognitive Assessment Scale (MOCA) before and on the 6th day after surgery, and the patients were divided into a cognitive dysfunction group and a non-cognitive dysfunction group. Logistic regression was used to analyze the risk factors of POCD in patients undergoing cardiac surgery. R software was used to construct the nomogram model of POCD in heart patients. Results Logistic regression model was used to screen the included variables, and the final results showed age ( OR  = 2.670, 95%CI 1.675–4.255, P  < 0.001), white blood cell count ( OR  = 1.155, 95%CI 1.050–1.271, P  = 0.009), lymphocytes ( OR  = 2.200, 95%CI 1.512–3.200, P  < 0.001), and hemoglobin ( OR  = 1.020, 95%CI 1.009–1.032, P  < 0.001) were independent risk factors for POCD on day 6 in patients undergoing cardiac surgery. The predicted value of the calibration curve of POCD on the 6th day of cardiac surgery was consistent with the actual value, and the Hosmer–Lemeshow goodness-of-fit test ( χ 2  = 8.73, P  = 0.36 > 0.05) showed good consistency. The area under the ROC curve is 0.80, with a good differentiation and decision curve. Conclusions Age, white blood cell count, lymphocyte, and hemoglobin are independent risk factors for POCD on day 6 of cardiac surgery. The nomogram prediction model constructed in this study has good predictive ability.

The neutrophil percentage to albumin ratio (NPAR) has been associated with prognosis of various cardiovascular diseases, but its role in acute type A aortic dissection (AAAD) mortality remains unclear. The aim of this study was to investigate the relationship between preoperative NPAR and in‐hospital mortality in AAAD patients. Clinical data from patients who underwent AAAD surgery at the Cardiac Medical Center of Fujian Province between January 2020 and April 2024 were retrospectively analyzed. Patients were categorized into three groups based on NPAR tertiles. Univariate and multivariate logistic regression analyses were employed to identify factors contributing to in‐hospital mortality. The predictive performance of NPAR was assessed using ROC curve analysis. The results revealed that out of 813 AAAD patients meeting the inclusion criteria, 137 (16.9%) died in hospital. Multivariate logistic regression analysis indicated that compared to the low tertile group, the odds ratios (95% CI) for in‐hospital mortality in the middle and high tertile groups were (OR 3.041, 95% CI: 1.502–6.158, p = 0.002) and (OR 6.586, 95% CI: 3.324–13.049, p<0.001), respectively. Additionally, cardiopulmonary bypass time (OR 1.010, 95% CI: 1.007‐1.013, p<0.001) and mechanical ventilation time (OR 1.115, 95% CI: 1.082–1.150, p<0.001) were also independently associated with in‐hospital mortality in AAAD patients. The area under the curve for NPAR was 0.708 (95% CI: 0.676–0.739) (p<0.001), with an optimal cut‐off value of 24.105, yielding a sensitivity of 73.7% and a specificity of 64.8%. In conclusion, higher preoperative NPAR may be independently associated with increased in‐hospital mortality, suggesting its potential as a novel indicator for monitoring AAAD patients.

Background Studies suggest that high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV) can prevent reintubation in critically ill patients with a low risk of extubation failure. However, the safety and effectiveness in patients at high risk of extubation failure are still debated. Therefore, we conducted a systematic review and meta-analysis to compare the efficacies of HFNC and NIV in high-risk patients. Methods We searched eight databases (MEDLINE, Cochrane Library, EMBASE, CINAHL Complete, Web of Science, China National Knowledge Infrastructure, Wan-Fang Database, and Chinese Biological Medical Database) with reintubation as a primary outcome measure. The secondary outcomes included mortality, intensive care unit (ICU) length of stay (LOS), incidence of adverse events, and respiratory function indices. Statistical data analysis was performed using RevMan software. Results Thirteen randomized clinical trials (RCTs) with 1457 patients were included. The HFNC and NIV groups showed no differences in reintubation (RR 1.10, 95% CI 0.87–1.40, I 2  = 0%, P  = 0.42), mortality (RR 1.09, 95% CI 0.82–1.46, I 2  = 0%, P  = 0.54), and respiratory function indices (partial pressure of carbon dioxide [PaCO 2 ]: MD − 1.31, 95% CI − 2.76–0.13, I 2  = 81%, P  = 0.07; oxygenation index [P/F]: MD − 2.18, 95% CI − 8.49–4.13, I 2  = 57%, P  = 0.50; respiratory rate [Rr]: MD − 0.50, 95% CI − 1.88–0.88, I 2  = 80%, P  = 0.47). However, HFNC reduced adverse events (abdominal distension: RR 0.09, 95% CI 0.04–0.24, I 2  = 0%, P  < 0.01; aspiration: RR 0.30, 95% CI 0.09–1.07, I 2  = 0%, P  = 0.06; facial injury: RR 0.27, 95% CI 0.09–0.88, I 2  = 0%, P  = 0.03; delirium: RR 0.30, 95%CI 0.07–1.39, I 2  = 0%, P  = 0.12; pulmonary complications: RR 0.67, 95% CI 0.46–0.99, I 2  = 0%, P  = 0.05; intolerance: RR 0.22, 95% CI 0.08–0.57, I 2  = 0%, P  < 0.01) and may have shortened LOS (MD − 1.03, 95% CI − 1.86–− 0.20, I 2  = 93%, P  = 0.02). Subgroup analysis by language, extubation method, NIV parameter settings, and HFNC flow rate revealed higher heterogeneity in LOS, PaCO 2 , and Rr. Conclusions In adult patients at a high risk of extubation failure, HFNC reduced the incidence of adverse events but did not affect reintubation and mortality. Consequently, whether or not HFNC can reduce LOS and improve respiratory function remains inconclusive.

Background The impact of the geriatric nutritional risk index (GNRI) on the prognosis of patients with acute Stanford type A aortic dissection (AAAD) remains unclear. This study sought to explore the predictive value of GNRI for in-hospital mortality in patients with AAAD. Methods We conducted a retrospective analysis of patients who underwent surgery for AAAD from January 2014 to December 2022. Based on the median GNRI score, patients were stratified into high GNRI (> 103.7) and low GNRI (≤ 103.7) groups. Multivariate logistic regression analysis was used to assess the association between GNRI and in-hospital mortality. Results A total of 936 patients were included, with a mean age of 52.7 ± 11.6 years. The mean GNRI was 103.8 ± 11.3, and patients were stratified into low GNRI ( n  = 472, 50.4%) and high GNRI ( n  = 464, 49.6%) groups. The low GNRI group had a significantly higher in-hospital mortality rate than the high GNRI group (23.1% vs. 17.5%, P  = 0.032). Multivariate logistic regression identified GNRI ≤ 103.7 as an independent risk factor for in-hospital mortality (OR = 2.037, 95%CI:1.110–3.740, P  = 0.022). CPB time (OR = 1.005, 95%CI: 1.001–1.009, P  = 0.022), and lactate levels (OR = 1.221, 95%CI: 1.144–1.302, P  < 0.001) were also independent risk factors for in-hospital mortality. The AUC of the logistic model was 0.811. Conclusion The GNRI is a validated nutritional assessment tool, and AAAD patients with a GNRI ≤ 103.7 havesignificantly higher in-hospital mortality rate. These findings highlight the importance of preoperative nutritional assessment and optimization to improve outcomes for AAAD patients.

Objective The aim of this study was to investigate sex-related differences in the clinical characteristics and hospital outcomes of patients undergoing surgery for acute type A aortic dissection (AAAD). Methods This study was a retrospective study. Patients who underwent surgery for AAAD at the Department of Cardiac Surgery, Fujian Medical University Union Hospital, from January 2014 to March 2023 were consecutively included. Data was extracted from electronic medical records. The primary outcome measure was in-hospital mortality, and secondary outcome measures included new-onset postoperative arrhythmia (POA), acute kidney injury (AKI), hepatic dysfunction, neurological complications, gastrointestinal hemorrhage, ICU length of stay, and hospital length of stay. Patients were divided into two groups based on sex, and data analysis was performed using SPSS 25.0 software. Results A total of 1137 subjects were included, with 863 males (75.9%) and 274 females (24.1%). There were statistically significant differences in age and BMI between the two groups ( P  < 0.05). There was no statistically significant difference in the incidence of pain at the onset between the two groups, but chest tightness in females was higher than in males (22.6% vs. 13.8%). Regarding primary outcomes, the in-hospital mortality rate was 11.1% for males and 10.6% for females ( P  = 0.803). There were no statistically significant differences between the groups in ICU days, length of hospitalization, neurological complications, or liver dysfunction ( P  > 0.05). The rate of POA in females was 4.7%, higher than in males (2.2%), but AKI and gastrointestinal hemorrhage were both higher in males than in females ( P  < 0.05). Multivariate analysis showed that age, white blood cell (WBC) counts, lactic acid, operation duration and prolonged mechanical ventilation (PMV) increased the risk of in-hospital mortality in male patients. Hypertension, WBC counts, lactic acid, and PMV increased the risk of in-hospital mortality in female patients. Conclusion Despite significant baseline characteristic differences between male and female AAAD patients, there were no significant differences in onset symptoms. The in-hospital mortality rates were similar between male and female patients, but the risk factors for in-hospital mortality differed.

Aim This study aimed to determine whether family‐centred care (FCC) intervention reduces the ICU delirium prevalence. Design A systematic review and meta‐analysis. Methods The databases, including PubMed, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL Complete, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBMdisc), WANFANG Data and VIP Information, were systematically searched up to 30 November 2021. The search term includes keywords related to intensive care units, delirium and family‐centred care. Meta‐analyses were performed and presented by risk ratio (RR), mean difference (MD) and corresponding 95% confidence intervals (CIs). Results The meta‐analysis results showed that compared with the usual care, FCC intervention has positive effects on reducing ICU delirium prevalence [RR = 0.54, 95% CIs (0.36, 0.81), p < .05]. However, no effect was observed on ICU stays, mechanical ventilation duration and ICU‐acquired infection between the two groups. Conclusions Family‐centred care is an effective intervention to reduce the ICU delirium prevalence. But the result should be treated cautiously as the high levels of heterogeneity, further high‐quality studies are required to determine the effectiveness of FCC intervention in the ICU setting.

To explore whether general self-efficacy can mediate the relationship between social support and quality of life in patients after surgical aortic valve replacement. A cross-sectional design. The final analysis included 283 patients who underwent surgical aortic valve replacement from May 2021 to September 2021. They completed a set of questionnaires, including the Chinese version of the General Self-Efficacy Scale, the Chinese Questionnaire of Quality of life in Patients with Cardiovascular Diseases and the Social Support Rating Scale. The PROCESS Macro in SPSS was used to analyse the mediating effect. Quality of life and all of its dimensions were significantly related to social support and general self-efficacy. A significant indirect effect of social support existed through general self-efficacy in relation to quality of life with the mediation effect ratio of 32.82%.