TEDA International Cardiovascular Hospital

This study aimed to evaluate the prognostic significance of dynamic cadmium-zinc-telluride (CZT) cardiac-dedicated single photon emission computed tomography (SPECT)-derived myocardial flow reserve (MFR) in patients with suspected or confirmed coronary artery disease (CAD) and normal myocardial perfusion. A consecutive cohort of patients who completed dynamic myocardial perfusion imaging and routine myocardial perfusion imaging (MPI) using CZT cardiac-dedicated SPECT were selected and followed up for at least 24 months to determine the occurrence of major adverse cardiac events (MACEs). Patients were divided into groups with no MACEs and MACEs. Differences between the two groups in baseline characteristics, semiquantitative, and quantitative parameters were compared. Cox regression analysis was performed to identify predictive factors associated with MACEs. Kaplan-Meier survival curves were plotted, and log-rank tests were performed to compare the incidence of MACEs between the normal MFR group and the reduced MFR group. A total of 369 patients with negative routine MPI results were included in this study, with an average age of 61.82±8.68 years (113 males and 256 females). The median follow-up duration was 30 months [IQR (25, 34)], during which 73 patients experienced MACEs. The incidence of MACEs was significantly higher in patients with reduced MFR than in those with normal MFR (P<0.05). Cox regression analysis identified reduced MFR as an independent predictor of MACEs (HR: 2.076, 95%CI: 1.174-3.669, P=0.012). The proportion of patients diagnosed with obstructive coronary artery disease (OCAD) was significantly higher in the MACE group compared to the no MACE group (P<0.05). These findings provide critical clinical insights, particularly for patients in whom myocardial ischemia is not detected via traditional semiquantitative MPI analysis. CZT cardiac-dedicated SPECT, which enables quantitative assessment of myocardial blood flow, serves as a more precise tool for early CAD diagnosis and prognostic evaluation. This underscores the role of CZT cardiac-dedicated SPECT in assessing myocardial ischemia and prognosis among patients with negative conventional MPI, helping to identify high-risk individuals that conventional MPI may overlook. By leveraging CZT cardiac-dedicated SPECT to obtain absolute quantitative myocardial blood flow (MBF) and MFR, myocardial perfusion is quantified more accurately, thereby overcoming the limitations of traditional MPI and providing a more reliable basis for early clinical diagnosis and treatment. MFR measured with CZT cardiac-dedicated SPECT can effectively predict the prognosis of patients with suspected or confirmed CAD and normal MPI. Reduced MFR is significantly associated with a higher incidence of MACEs, and MFR reduction is an independent predictor of MACEs.

ObjectiveTo assess the knowledge, attitudes, and practices (KAP) of patients with coronary artery disease (CAD) and their families regarding coronary artery bypass grafting (CABG), multimodal imaging examinations, and postoperative daily management.MethodsA cross-sectional study was conducted on patients with CAD and their families between January and April 2025, at TEDA International Cardiovascular Hospital, using a self-designed, validated questionnaire.ResultsA total of 512 (96.24%) valid responses were obtained. Among the participants, 338 (66.0%) were CAD patients and 174 (34.0%) were family members. A total of 322 (62.9%) participants were male, and 205 (40.0%) had undergone coronary stenting prior to the current hospitalization. The mean scores for knowledge, attitudes, and practices were 6.26 ± 5.34 (range: 0–26), 28.89 ± 4.10 (range: 8–40), and 32.49 ± 6.23 (range: 10–50), respectively. Multivariable analysis revealed that among patients, higher education, retirement/self-employment, higher income, prior MI hospitalization, and longer CAD duration (>3 years) were associated with better knowledge, which correlated with attitude. Among family members, higher income predicted better knowledge. Better practice was associated with attitude in patients and with attitude, knowledge, female sex, absence of hypertension, and prior MI in family members.ConclusionSignificant knowledge deficits and suboptimal practices were identified among CAD patients and their families regarding CABG and postoperative management, despite generally positive attitudes. Clinicians and radiologists should prioritize educational programs that address gaps in knowledge and emphasize the interplay between attitudes and practices to enhance postoperative management and long-term outcomes for CAD patients and their families.

Purpose This study aimed to systematically identify drug‐associated signals for hepatic veno‐occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) using large‐scale real‐world data and to decode the underlying molecular mechanisms of high‐risk agents. Methods We analyzed FDA Adverse Event Reporting System (FAERS) data (2004–2024) using four distinct disproportionality algorithms to strictly detect VOD/SOS safety signals. To validate these signals and elucidate pathogenic mechanisms, we performed an in silico integrative analysis by intersecting the transcriptomic profiles of representative high‐risk drugs (Busulfan and Oxaliplatin) with known VOD/SOS disease targets. Results Among 3726 VOD/SOS reports identified from over 21 million records, 39 drugs met the stringent criteria for a positive safety signal. Alkylating agents (e.g., Busulfan), antimetabolites (e.g., Thioguanine), and antibody–drug conjugates exhibited the strongest statistical associations. Age‐stratified analysis revealed distinct risk profiles, identifying Busulfan and Oxaliplatin as the most frequent suspects in adults and pediatric populations, respectively. Integrative transcriptomic validation uncovered divergent molecular drivers: Busulfan induces toxicity primarily through DNA damage response and apoptotic signaling (involving CDKN1A and GADD45A ), whereas Oxaliplatin is linked to inflammatory responses and tissue development pathways (involving PHLDA3 and MYF5 ). Conclusion This study integrates big data pharmacovigilance mining with transcriptomic validation to provide a comprehensive landscape of drug‐induced VOD/SOS. We identified distinct age‐specific risk profiles and revealed that different high‐risk agents drive hepatic toxicity through divergent molecular mechanisms, offering novel potential biomarkers for precision monitoring. However, safety signals identified for anti‐infective agents should be interpreted with caution, as they likely reflect confounding by indication in high‐risk populations rather than direct hepatotoxicity.

BackgroundDrug-coated balloons (DCBs) are commonly used in small coronary arteries. A recent trial reported similar outcomes between paclitaxel-coated balloons (PCBs) and sirolimus-coated balloons (SCBs) in side branch (SB) stenosis after stenting main branch (MB). This trial investigated whether SCBs and PCBs produce similar effects in de novo bifurcation lesions.MethodsIn this prospective, multicenter, randomized, non-inferiority clinical trial, patients with de novo non-left main coronary bifurcation lesions undergoing provisional stent of SB were randomly assigned in a 1:1 ratio to receive either SCBs or PCBs in SB. The primary efficacy endpoint was the percentage of target lesion stenosis (TLS) in the SB observed on angiogram 9 months after treatment. Secondary endpoints included efficacy and safety endpoints. The former included restenosis of target lesions and the latter included adverse events (AEs) and serious adverse events (SAEs).ResultsDuring June 2021 and October 2023, a total of 241 patients (SCB 121 vs. PCB 120) were included at 10 centers in China (mean age 63.92±9.48 years; 32% female). At the 9-month follow-up, the difference in the primary efficacy endpoint between the SCB (26.8%±14.4%) and PCB (30.6%±17.1%) groups was −3.8% (95% confidence interval: −7.9% to 0.2%, P<0.05 for non-inferiority margin of 7%). The secondary efficacy endpoints were similar between the two groups, including restenosis of target lesions (7.2% vs. 7.8%, P=0.88), late lumen loss (LLL) (0.21 vs. 0.26 mm, P=0.69), target lesion revascularization (TLR) (0.84% vs. 0.85%, P>0.99), target vessel revascularization (TVR) (0.84% vs. 0.85%, P>0.99), target lesion failure (TLF) (0.84% vs. 0.85%, P>0.99), major adverse cardiac event (MACE) (4.2% vs. 2.0%, P=0.43), and major adverse cardiac and cerebral event (MACCE) (0.84% vs. 1.71%, P=0.62) at 9 months. The secondary safety endpoints were also similar between the groups.ConclusionsIn patients with de novo non-left main coronary bifurcation lesions treated with provisional stenting in the SB, SB dilation with SCB was non-inferior to PCB in terms of percentage of TLS at 9-month follow-up.Trial RegistrationThis study was registered at the National Research Registration and Filing Information System (https://www.medicalresearch.org.cn/, MR-12-24-007528).

ABSTRACT Adolescence is an important period for cognitive development. During this period, the development of an individual's belief in a just world (BJW) is a dynamic process predominantly influenced by cognitive development. Moreover, a substantial body of prior research has demonstrated that BJW impacts adolescents’ mental health and facilitates the establishment of long‐term goals. However, the factors influencing adolescents’ BJW, particularly the role of parental attachment, remain unclear. This study aimed to explore the following: (1) how general and personal BJW develop over time; and (2) how paternal and maternal attachment predict these two types of BJW? A total of 239 sixth‐grade adolescents ( M age = 11.35, SD age = 0.54) participated in a two‐wave longitudinal study, 1 year apart. The results showed that there were no significant changes in the levels of general or personal BJW across the two time points. There was no significant difference between general and personal BJW at Time 1 (T1), whereas general BJW was significantly lower than personal BJW at Time 2 (T2). Hierarchical multiple regression analysis showed that, after controlling for autoregressive effects and demographic variables, only paternal attachment at T1 uniquely and positively predicted general BJW at T2. While maternal and paternal attachment each separately predicted personal BJW, neither retained its unique predictive power when the other was included in the model. This study highlights the influence of parent–child attachment on the general and personal BJW of adolescents, with particular emphasis on the role of paternal attachment.

Despite advancements in primary percutaneous coronary intervention (PCI), cardiac dysfunction remains a challenge in patients with ST-segment elevation myocardial infarction (STEMI). Although thymosin beta 4 has shown cardioprotective effects in preclinical MI models, its impact on chronic cardiac functional recovery post ischemia/reperfusion (I/R), especially in STEMI, warrants further investigation. This study aims to explore the therapeutic potential of recombinant human thymosin beta 4 (rhTB4) in both murine models subjected to I/R and in subjects with STEMI post-PCI. In C57BL/6J mice, 7-day rhTB4 treatment prevented cardiac dysfunction and fibrosis 28 days post-I/R surgery and significantly reduced plasma NT-proBNP levels at both 1 day and 28 days post-I/R. Similarly, in a permanent ligation model, rhTB4 improved cardiac function and reduced infarct size at 8 weeks post-MI. RNA-seq analysis of I/R heart tissues revealed that rhTB4 modulated the ErbB signaling pathway. In vitro hypoxia/reoxygenation (H/R) models (HL-1, neonatal mouse cardiomyocytes, H9C2) demonstrated that rhTB4 activated the ErbB2/Raf1 signaling pathway, attenuated cardiomyocyte apoptosis and suppressed pro-apoptotic protein Bad expression. The cardioprotective effects of rhTB4 on cardiac function and adverse cardiac remodeling in I/R mice were abolished by ErbB2 inhibition. In a randomized, placebo-controlled, double-blind trial involving 96 STEMI patients, the infarcted areas were significantly reduced in the rhTB4 group, which received the first dose of rhTB4 within 8 h after PCI (n = 43), as compared to the placebo group at the 90-day follow-up. However, the overall differences in infarcted areas were not significantly between the rhTB4 group and the placebo group (n = 96). These findings underscore the crucial role of rhTB4 in mitigating cardiac dysfunction in an ErbB2-dependent manner. The clinical relevance of rhTB4 is demonstrated through a randomized controlled trial, emphasizing its translational potential. Further rigorous randomized studies are needed to assess the significance of early rhTB4 use post-myocardial infarction reperfusion.

This article delves deeply into the differences and complementarities between the two major medical systems of traditional Chinese medicine and Western medicine, aiming to comprehensively interpret their core characteristics. By comparing and analyzing the fundamental differences in their theoretical systems and medical processes, it is found that both have their own advantages and disadvantages in different fields. For instance, traditional Chinese medicine emphasizes the mutual complementarity between humans and nature, while Western medicine relies more on precise data obtained through advanced instruments. After classifying these advantages and disadvantages and identifying the areas where both can fill the gaps (such as the different roles they play in the early, middle, and late stages of treatment), it is evident that the integration of traditional Chinese and Western medicine has become an inevitable trend in today's world. The new medical system resulting from their combination can not only provide patients with more comfortable and reliable services but also contribute to the development of global medicine. Subsequent analysis of the methods and results in handling specific cases (such as cancer) can clearly identify most of the problems that need to be solved in the future, which are mostly incurable terminal diseases. This research supports this view through the use of literature review and theoretical analysis methods, as well as drawing on a large number of domestic and international research results.

ObjectiveTo explore the current status and characteristics of upper gastrointestinal bleeding (UGIB) in patients with acute myocardial infarction complicated by cardiogenic shock (AMICS) following emergency percutaneous coronary intervention (PCI), and to develop and validate a predictive model based on baseline risk factors at the time of admission.MethodsWe selected patients diagnosed with AMICS who underwent emergency PCI. Patients were categorized into the non-bleeding group and the bleeding group based on the occurrence of UGIB during hospitalization. Logistic regression analysis was employed to construct a predictive model for UGIB based on baseline risk factors at admission.ResultsA total of 253 patients were included in the study, of whom 58 experienced UGIB, resulting in an incidence rate of 22.9%. Univariate analysis indicated that the levels of uric acid, lactate, and alanine aminotransferase (ALT) were higher in the bleeding group compared to the non-bleeding group. Conversely, the estimated glomerular filtration rate (eGFR), left ventricular ejection fraction (LVEF), and albumin were lower in the bleeding group. Additionally, the bleeding group had a higher stage of American Society for Cardiovascular Angiography and Interventions-Cardiogenic Shock(SCAI-CS). The least absolute shrinkage and selection operator (LASSO) regression identified 5 non-zero coefficient variables, and the variance inflation factor (VIF) test excluded the collinearity relationships among these 5 variables. Continuous variables were converted into categorical variables and assigned as follows: albumin was categorized based on whether below 35 g/L, indicating hypoproteinemia; eGFR was categorized based on whether below 45 ml/(min·1.73 m2), indicating moderate to severe renal function decline;The receiver operating characteristic curve (ROC) curve was employed to identify the node with the highest Youden index, which determines the cut-off value: For lactate, the corresponding value is 6.95 mmol/L, rounded to 7 mmol/L. For LVEF, the corresponding value is 35.5%, rounded to 36%.Multivariate logistic regression analysis identified 3 risk factors for UGIB following AMICS emergency PCI: baseline SCAI-CS stage D + E, baseline eGFR < 45 ml/(min·1.73 m2), and baseline LVEF < 36% (P < 0.05). The predictive model based on multivariate logistic regression results, demonstrated good fit according to the Hosmer-Lemeshow test (χ² = 6.968, P = 0.324). The model achieved an AUC of 0.768 [95% CI (0.700, 0.837)] in predicting UGIB in patients undergoing emergency PCI for AMICS, with a sensitivity of 87.9% [95% CI (0.700, 0.837)] and a specificity of 52.3% [95% CI (27.8%, 61.2%)]. The DeLong test indicated that the AUC of the predictive model was superior to that of any individual indicator (P < 0.05), and the DCA curve confirmed the model's clinical utility. Recent Prognosis: The mortality rate during hospitalization in the bleeding group was significantly higher than that in the non-bleeding group (63.8% vs. 29.7%, P < 0.05). Additionally, the duration of hospital stays for surviving patients in the bleeding group was significantly longer than that in the non-bleeding group [19 (14,37) vs. 12 (9,16), (P < 0.001)].ConclusionHigh baseline SCAI-CS stage, poor kidney function, and low LVEF are independent risk factors for UGIB during hospitalization. The constructed predictive model demonstrates high predictive efficacy.