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Background For acute type A aortic dissection involving the aortic root with root diameter no more than 45 mm, there are various aortic root repair techniques. In this study, a novel surgical technique using a pericardial autograft for aortic root repair was introduced. We described its surgical steps in detail and compare its clinical outcomes with direct suture technique. Methods Between July 2017 and August 2022, 95 patients with acute type A aortic dissection who underwent aortic root repair were enrolled, including aortic root repair using pericardial autograft (group A, n  = 49) or direct suture (group B, n  = 46). The patient’s clinical data were retrospectively analyzed, and a 5-year follow-up was conducted. Results The 30-day mortality, re-exploration for bleeding, postoperative new-onset renal failure requiring continuous renal replacement therapy, stroke, and paraplegia occurred in 3%, 4%, 11%, 5%, and 2% of the overall patients, respectively. There was no significant difference in the 30-day mortality and complication rate between the two groups. The 30-day mortality and re-exploration for bleeding marked the primary endpoint events. Logistic regression analysis indicated that there was a significant correlation between the primary endpoint events and surgical technique (odds ratio, 0.002; 95% confidence interval, 0-0.159; P  = 0.026). The aortic valve insufficiency of the two groups were significantly improved after operation (group A, P  < 0.001; group B, P  < 0.001). During follow-up, there was no significant difference in short-term survival between the two groups after surgery (log-rank P  = 0.75), and all patients were free from reoperation for aortic disease. Conclusions Patients who underwent aortic root repair using pericardial autograft tended to have reduced 30-day mortality and a lower risk of re-exploration for bleeding. Using pericardial autograft for aortic root repair is a safe and useful approach for patients with acute type A aortic dissection involving the aortic root.

Background The triglyceride‐glucose index (TyG), a novel marker of insulin resistance, is recognised as a risk factor for multiple cardiovascular diseases. The link between its risk and aortic dissection and aortic aneurysm (AD/AA) is not well‐defined. This research seeks to explore the relationship. Methods This study analysed 386 063 participants from the UK Biobank, a large prospective cohort, all initially free of AD/AA. The main focus was on the occurrence rate of AD/AA. Multivariate Cox regression models were used to analyse the association between the TyG index, its related parameters, and the risk of AD/AA. Association was further validated using a real‐world clinical cohort from Central China Fuwai Hospital. A two‐sample Mendelian randomisation (MR) analysis utilising the inverse variance weighting method was conducted to investigate the causal link between TyG and AD/AA. Result Among the 386 063 participants in the UK Biobank cohort, 3805 cases of AD/AA were reported. After controlling for covariates, a higher TyG index and its related parameters were associated with an increased incidence of AD/AA. The hazard ratios (HRs) were as follows: TyG (HR = 1.14, 95% CI: 1.07–1.22, p <.001), TyG‐WHR (HR = 1.17, 95% CI: 1.12–1.22, p <.001), and TyG‐WHtR (HR = 1.11, 95% CI: 1.06–1.16, p <.001). Association between TyG and the risk of aortic diseases was also replicated in the single‐centre cohort. Two‐sample MR analysis indicated strong evidence of a causal relationship between genetically predicted TyG levels and AA (OR = 1.97, 95% CI: 1.37–2.84, p <.001), while no significant association was observed with AD (OR = 0.79, 95% CI: 0.31–1.99, p = .61). Conclusion Through complementary epidemiological, clinical, and genetic approaches, our findings indicate that elevated TyG index represents a robust and potentially causal risk factor for aortic diseases (especially AA). These results highlight the importance of metabolic risk assessment in aortic disease prevention and emphasise the need for further mechanistic studies to understand the differential links between TyG and specific aortic phenotypes. Highlights Higher TyG index and related ratios are linked to increased AD/AA risk. Prospective cohort analysis confirms robust linear associations. Mendelian randomisation supports a causal role of TyG in AA. Findings highlight TyG as a potential target for early prevention. Elevated TyG index and its related parameters were associated with an increased risk of aortic diseases in a prospective cohort of 386 063 participants. Mendelian randomisation suggested a potential causal link with AA but not with aortic dissection (AD).

Using the three-dimensional model of executive function and the I3 theory of aggressive behavior, we examined the mediating roles of inhibition, working memory, and cognitive flexibility in the relationship between impulsivity and both proactive and reactive aggression in adolescents. We recruited 1,462 middle school and high school students in Sichuan Province, who completed the Reactive-Proactive Aggression Questionnaire, the Barratt Impulsivity Scale, the Teenage Executive Function Inventory, and the Cognitive Flexibility Questionnaire. Results showed that impulsivity was positively correlated with both proactive and reactive aggression, and was negatively correlated with the three subcomponents of executive function. The three-dimensional components of executive function in adolescents were negatively correlated with both proactive and reactive aggression. Further, impulsivity directly predicted both proactive and reactive aggression. In addition, all three subcomponents of executive function in parallel mediated the relationship between impulsivity and proactive aggression. However, only inhibition mediated the relationship between impulsivity and reactive aggression. In conclusion, improving executive function may reduce the impact of impulsivity on aggression.

Using the three-dimensional model of executive function and the [I.sup.3] theory of aggressive behavior, we examined the mediating roles of inhibition, working memory, and cognitive flexibility in the relationship between impulsivity and both proactive and reactive aggression in adolescents. We recruited 1,462 middle school and high school students in Sichuan Province, who completed the Reactive-Proactive Aggression Questionnaire, the Barratt Impulsivity Scale, the Teenage Executive Function Inventory, and the Cognitive Flexibility Questionnaire. Results showed that impulsivity was positively correlated with both proactive and reactive aggression, and was negatively correlated with the three subcomponents of executive function. The three-dimensional components of executive function in adolescents were negatively correlated with both proactive and reactive aggression. Further, impulsivity directly predicted both proactive and reactive aggression. In addition, all three subcomponents of executive function in parallel mediated the relationship between impulsivity and proactive aggression. However, only inhibition mediated the relationship between impulsivity and reactive aggression. In conclusion, improving executive function may reduce the impact of impulsivity on aggression.

AbstractMCC950 has been proposed as a specific small molecule inhibitor that can selectively block NLRP3 inflammasome activation. However, the exact mechanism of its action is still ambiguous. Accumulating investigations imply that chloride efflux–dependent ASC speck oligomerization and potassium efflux–dependent activation of caspase-1 are the two relatively independent, but indispensable events for NLRP3 inflammasome activation. Previous studies suggested that influence of MCC950 on potassium efflux and its consequent events such as interaction between NEK7 and NLRP3 are limited. However, inhibiting chloride intracellular channel–dependent chloride efflux leads to a modification of inflammatory response, which is similar to the function of MCC950. Based on these findings, we shed new insights on the understanding of MCC950 that its function might correlate with chloride efflux, chloride intracellular channels, or other targets that act upstream of chloride efflux.

Angiogenesis is crucial for tissue engineering, wound healing, and regenerative medicine. Nanomaterials constructed based on specific goals can be employed to activate endogenous growth factor‐related signaling. In this study, based on the conventional single‐stranded DNA self‐assembly into tetrahedral framework nucleic acids (tFNAs), the Apt02 nucleic acid aptamer and dimethyloxallyl glycine (DMOG) small molecule are integrated into a complex via a template‐based click chemistry reaction and toehold‐mediated strand displacement reaction. Thus, being able to simulate the VEGF (vascular endothelial growth factor) function and stabilize HIF (hypoxia‐inducible factor), a functional whole is constructed and applied to angiogenesis. Cellular studies demonstrate that the tFNAs‐Apt02 complex (TAC) has a conspicuous affinity to human umbilical vein endothelial cells (HUVECs). Further incubation with DMOG yields the tFNAs‐Apt02‐DMOG complex (TACD), which promotes VEGF secretion, in vitro blood vessel formation, sprouting, and migration of HUVECs. Additionally, TACD enhances angiogenesis by upregulating the VEGF/VEGFR and HIF signaling pathways. Moreover, in a diabetic mouse skin defect repair process, TACD increases blood vessel formation and collagen deposition, therefore accelerating wound healing. The novel strategy simulating VEGF and stabilizing HIF promotes blood‐vessel formation in vivo and in vitro and has the potential for broad applications in the vascularization field. Angiogenesis is crucial for tissue engineering, wound healing, and regenerative medicine. Here, a framework nucleic acid‐based nanomaterial is synthesized by combining tFNAs, DNA aptamer Apt02, and DMOG to enhance angiogenesis through upregulating the VEGF/VEGFR and HIF signaling in vitro and in vivo.

Mycoplasma synoviae (MS) is a prominent poultry pathogen that has caused considerable economic pressure on the poultry industry. Although we have a good understanding of MS infection, research is still lacking on the pathogenicity of MS and host-MS interactions, especially the metabolic basis of MS infection. In this study, a lethal MS strain ZX313 was identified. Then, untargeted metabolomic analysis was performed on the plasma of 18 SPF chickens infected with the ZX313 strain and the low-virulence strain SD2. A total of 699 and 720 significantly differentially abundant metabolites (SDMs) were detected after ZX313 and SD2 infection, respectively, among which 95 and 116 SDMs were group-specific. Metabolic pathway enrichment analysis revealed that MS infection significantly disturbed host amino acid, nucleotide and lipid metabolism. Moreover, the differential expression of amino acid metabolism in different virulence groups may be related to the severity of the disease and the pathogenicity of MS. A total of 20 plasma metabolites were identified to exhibit a significant correlation with disease severity, with an area under the curve of 0.986. These findings demonstrate that the host’s systemic metabolism undergoes significant changes following MS infection, providing valuable references for elucidating infection-related metabolic alterations and their association with disease severity.

Gastrointestinal tumors represent a significant component of the cancer burden in Asia. This study aims to evaluate the burden of gastrointestinal tumors in Asia from 1990 to 2021 using data from the Global Burden of Disease Study 2021 (GBD 2021). The absolute incidence, mortality, and disability adjusted life years (DALYs) number and rate of six gastrointestinal tumors(colon and rectum cancer (CRC), stomach cancer (SC), pancreatic cancer (PC), esophageal cancer (EC), liver cancer (LC) and gallbladder and biliary tract cancer (GBTC)) in 48 Asian countries were extracted from GBD 2021. Differences were analyzed based on gender, age, year, location and socio-demographic index (SDI). In 2021, SC accounted for the highest disease burden in Asia (DALYs=16.41million [95% : 13.70, 19.62]). From 1990 to 2021, the age-standardized incidence rates of EC, LC, and SC in Asia declined, while the incidence rates of CRC and PC increased significantly, with CRC showing the largest rise (AAPC=1.08 [95% : 1.02 to 1.12]). Gastrointestinal tumors DALY rates peaked at age 70 and above, with males generally exhibiting higher rates than females. Furthermore, East Asia bears a higher burden compared to other Asian subregions. A higher SDI correlates with increased DALY rates for PC, but no linear relationship was observed for other gastrointestinal tumors. The burden of gastrointestinal tumors in Asia remains high and may continue to increase. Therefore, effective prevention and treatment measures are essential to address the challenge posed by gastrointestinal tumors.

Heart failure is a serious threat to human health, with morbidity and mortality rates increasing despite the existence of multiple treatment options. Therefore, it is necessary to identify new therapeutic targets for this disease. Sacubitril/valsartan is a supramolecular sodium salt complex of the enkephalinase inhibitor prodrug sacubitril and the angiotensin receptor blocker valsartan. Its combined action increases endogenous natriuretic peptides while inhibiting the renin-angiotensin-aldosterone system and exerting cardioprotective effects. Clinical evidence suggests that sacubitril/valsartan is superior to conventional renin-angiotensin-aldosterone inhibitor therapy for patients with reduced ejection fraction heart failure who can tolerate angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. The therapy reduces the risk of heart failure hospitalization, cardiovascular mortality, and all-cause mortality and has a better safety and tolerability record. This review describes the potential pathophysiological mechanisms of cardiomyocyte injury amelioration by sacubitril/valsartan. We explore the protective effects of sacubitril/valsartan and outline the therapeutic value in patients with heart failure by summarizing the results of recent large clinical trials. Furthermore, a preliminary outlook shows that sacubitril/valsartan may be effective at treating other diseases, and provides some exploratory observations that lay the foundation for future studies on this drug.

Background This study aimed to assess the independent prognostic value of tumor size compared with other clinical and pathologic features of primary invasive cutaneous melanoma (CM). Methods This study included 28,593 patients with primary invasive CM in Surveillance, Epidemiology, and End Results Program database diagnosed from 2004 through 2016. Tumor size was divided into five subgroups (≤6, 7‐12, 13‐30, 31‐42, and >42 mm). The primary endpoint was melanoma‐specific survival (MSS). Results The relationship between tumor size and survival was piecewise. After adjusting for age, sex, primary site, histopathologic cell type, Breslow thickness, ulceration, mitotic rate, regional metastasis, and distant metastasis, the hazard ratio (HR) of MSS increased with increasing tumor size until a peak at 31‐42 mm (HRs, 1.33, 1.59, 2.41, respectively; all P < .0001), and then decreased when tumor size was larger than 42 mm using tumor size ≤ 6 mm as the reference (HR, 2.11; 95% confidence interval [CI], 1.84 −2.42; P < .0001). This pattern mostly remained after stratification by T subcategories from T1 to T4 in localized primary CM except that tumor size >42 mm subgroup had the shortest MSS in T4. In addition, tumor size with a cutoff value of 12 mm showed stronger prognostic value for MSS (HR, 2.32; 95% CI, 1.80‐2.98; P < .0001) than Breslow thickness and mitotic rate in primary CM with T1N0M0. Conclusions Tumor size was an important independent prognostic factor for MSS in patients with primary invasive CM. Tumor size larger than 30 mm would provide additional and important prognostic information in each T subcategory of localized CM. Furthermore, tumor size with a cutoff value of 12 mm has great potential in improving the accuracy of melanoma T1 substaging. Tumor size was an important independent prognostic factor for MSS in patients with primary invasive CM. Tumor size larger than 30 mm would provide additional important prognostic information in each T subcategory of localized CM.Tumor size with a cutoff value of 12 mm has great potential in improving the accuracy of melanoma T1 substaging.