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BackgroundOver the past three decades, significant disparities in the global burden of cardiovascular disease (CVD) have been observed, particularly CVD attributed to secondhand smoke. However, a comprehensive understanding of global trends and their interaction with secondhand smoke remains inadequate.MethodsUsing Global Burden of Disease data (1990–2019), an age-period-cohort analysis examined temporal trends in CVD mortality among secondhand smoke-exposed populations, considering age, period and cohort interactions.ResultsOver the 30-year period, the global number of CVD deaths attributed to secondhand smoke increased substantially, from 432.6 thousand in 1990 (95% UI: 357.4–508.3) to 598.5 thousand in 2019 (95% UI: 489.7–713.5), representing a 38.4% increase (95% UI: 26.8%–49.5%). In 2019, CVD accounted for 45.9% of all deaths attributable to secondhand smoke among both sexes globally. Among these CVD deaths, ischaemic heart disease predominated, accounting for 66.4% of cases, compared with stroke. The distribution by sex revealed a slightly lower percentage of males (46.5%) than females (53.5%). Age-period-cohort models show overall global decline in CVD mortality due to secondhand smoke over 30 years, with regional, sex and subtype variations. Notably, a higher Sociodemographic Index (SDI) correlated with a greater reduction in mortality, exhibiting a significant 39.1% decrease in high SDI areas (95% UI: 35.6%–42.3%), in stark contrast to the minimal change observed in low SDI areas (0.1%, 95% UI: −52.4%–62.2%).ConclusionsThis study highlights the importance of considering secondhand smoke as a modifiable CVD risk. Further research is needed to understand disparities in CVD burden across development levels, sexes and subtypes.

Objective The objective of this study was to assess the feasibility of percutaneous balloon pulmonary valvuloplasty (PBPV) under echocardiographic guidance only. Setting PBPV has become the preferred choice for pulmonary valve stenosis (PS). We report the first-in-human successful PBPV under only echocardiography guidance for isolated PS. Methods From March 2013 to December 2014, 34 patients with congenital PS underwent PBPV with echocardiography as the only imaging modality in the ordinary operation room or catheter lab. Outpatient follow-up including chest radiography, electrocardiography, and transthoracic echocardiography (TTE) was conducted at 1, 3, 6, and 12 months. Results All 34 patients successfully underwent PBPV under echocardiography guidance without radiation and contrast agent. The pulmonic transvalvular pressure gradient dropped from 62.8±10.1 mm Hg to 14.7±4.2 mm Hg measured on catheterization (P<.05). The balloon diameter/pulmonary annulus diameter ratio was 1.34±0.07. Slight regurgitation of the pulmonary valve occurred in five patients and mild pulmonary regurgitation occurred in one patients. The pulmonic transvalvular pressure gradient measured on TTE 12 months after the procedure was 14.1±4.6 mm Hg. No pericardial effusion and peripheral vascular complications occurred. Conclusion This study demonstrated that PBPV can be successfully performed under only echocardiography guidance and appears safe and effective while avoiding radiation and contrast agent use.

ObjectiveComprehensive data and analyses on cardiovascular research could clarify recent research trends for the academic community and facilitate policy development. We examined publications and reference data to identify research topics, trends and interdisciplinarity for cardiovascular disease (CVD).MethodsWe extracted and clustered text fragments from the titles and abstracts of 2 512 445 publications using artificial intelligence techniques, including natural language processing (NLP) for semantic analysis. Cardiovascular experts identified topics and document clusters based on the output of those semiautomatic methods. We also applied machine learning algorithms to predict the trends over the next 5 years in each field. We examined the crossover between the two cluster groups using citation relationships in the documents.ResultsResearch in clinical studies showed the most notable increase; that was followed by research in population and basic studies. The research hotspots were minimally invasive treatments for valve disease, circulatory haemodynamics, and prevention and control of hypertension. The fastest-growing topics were health monitoring, evidence-based medicine and immunotherapy. We found extensive crossover relationships among document clusters for the periods of 2017–2018 and 2020–2021.ConclusionsThis study provides valuable insights into the research hotspots for cardiovascular research, including an increasing emphasis on early disease detection and prevention, exploration of minimally invasive treatments and assessment of risk factors. The research landscape demonstrates signs of interdisciplinarity and integration as reflected in citation relationships. These findings suggest practical implications for optimising resource allocation in healthcare systems, guiding clinical guideline updates and informing policy-making to prioritise high-impact research areas aligned with evolving CVD challenges. Given the evolving global burden of CVD, continuous research and innovation are imperative, with interdisciplinary collaboration assuming a pivotal role in advancing scientific knowledge.

Background. To evaluate the feasibility of using a single device to close multiple atrial septal defects (ASDs) under the guidance of transthoracic echocardiography (TTE) and with the aid of three-dimensional (3D) printing models. Methods. Sixty-two patients with multiple ASDs were retrospectively analyzed. Thirty of these patients underwent TTE-guided closure (3D printing and TTE group) after a simulation of occlusion in 3D printing models. The remaining 32 patients underwent ASD closure under fluoroscopic guidance (conventional group). Closure status was assessed immediately and at 6 months after device closure. Results. Successful transcatheter closure with a single device was achieved in 26 patients in the 3D printing and TTE group and 27 patients in the conventional group. Gender, age [18.8 ± 15.9 (3–51) years in the 3D printing and TTE group; 14.0 ± 11.6 (3–50) years in the conventional group], mean maximum distance between defects, prevalence of 3 atrial defects and large defect distance (defined as distance ≥7 mm), and occluder size used were similarly distributed between groups. However, the 3D printing and TTE group had lower frequency of occluder replacement (3.8% vs 59.3%, p<0.0001), prevalence of mild residual shunts (defined as <5 mm) immediately (19.2% vs 44.4%, p<0.05) and at 6 months (7.7% vs 29.6%, p<0.05) after the procedure, and cost (32960.8 ± 2018.7 CNY vs 41019.9 ± 13758.2 CNY, p<0.01). Conclusion. The combination of the 3D printing technology and ultrasound-guided interventional procedure provides a reliable new therapeutic approach for multiple ASDs, especially for challenging cases with large defect distance.

Background Brain anatomical deficits associated with cognitive dysfunction have been reported in patients with schizophrenia. However, it remains unknown whether such anatomical deficits exist in individuals with prodromal psychosis. The present study is designed to investigate anatomical deficits in prodromal individuals and their associations with clinical/cognitive features. Methods Seventy‐four prodromal individuals and seventy‐six healthy controls were scanned using structural magnetic resonance imaging. Support vector machines were applied to test whether anatomical deficits might be used to discriminate prodromal individuals from healthy controls. Results Prodromal individuals showed significantly increased gray matter volume (GMV) in the right inferior frontal gyrus (IFG) and right rectus gyrus relative to healthy controls. No correlations were observed between increased GMV and clinical/cognitive characteristics. The combination of increased GMV in the right rectus gyrus and right IFG showed a sensitivity of 74.32%, a specificity of 67.11%, and an accuracy of 70.67% in differentiating prodromal individuals from healthy controls. Conclusion Our results provide evidence of increased frontal GMV in prodromal individuals. A combination of GMV values in the two frontal brain areas may serve as potential markers to discriminate prodromal individuals from healthy controls. The results thus highlight the importance of the frontal regions in the pathophysiology of psychosis.

Aim: To investigate the immunosuppressive effect of gossypol in mice both in vitro and in vivo . Methods: The in vitro effect of gossypol on the proliferation of lymphocytes isolated from lymph nodes of BALB/c mice was determined by CFSE staining and by an MTS assay. Lymphocyte activation and lymphoblastic transformation were evaluated with immunostaining. Cell apoptosis was detected by Annexin-V and Hoechst 33342 staining. The in vivo immunosuppressive effect of gossypol on the DTH reaction was evaluated using a mouse DTH model induced by 2,4-dinitro-1-fluorobenzene (DNFB). The thickness of the ears was measured, and the histological changes of the mouse auricles were observed after hematoxylin-eosin staining. The proliferation capacity of lymphocytes from DTH mice was also assayed. Results: In vitro , gossypol could significantly inhibit the proliferation of mouse lymphocytes stimulated with phorbol ester plus ionomycin in a dose-dependent manner. Although the expression of the early activation antigen CD69 was not affected, the lymphoblastic transformation of both T and B lymphocyte subsets was significantly suppressed by gossypol. Moreover, gossypol could induce apoptosis of lymphocytes, and the effect was time- and dose-dependent. In vivo , the DTH reaction in mice was markedly alleviated by gossypol injected intraperitoneally. Lymphocytes from drug-treated DTH mice had a reduced proliferation capacity as compared with lymphocytes from untreated DTH mice. Gossypol treatment also markedly reduced the number of infiltrated lymphocytes in the auricles of DTH mice. Conclusion Gossypol exhibited immunosuppressive effects in mice, probably by inhibition of lymphocyte proliferation and by induction of cell apoptosis.

Through methods, such as microscope analysis, metallographic examination, the crack located nearby the fusion line between tee joint and outlet steam pipe of subcritical power station boiler final superheater header is reheat crack (the main crack occurred in the heat affected zone and extended along the fusion line and grain boundary in HAZ. There are many small cracks paralleling with main crack). The base metal material (12Cr1MoV) and excessive welding residual stress are the primary inducement of crack. In repair crack, the measures of reducing residual stress, such as lower welding heat input, reducing thickness of welding layer, hammer blowing, assigning reasonably heat treatment power ,lengthening holding time and so on, were taken. The welding repair succeeded greatly.