Background:Non-valvular atrial fibrillation(NVAF),the most prevalent cardiac arrhythmia globally,poses a dual challenge of thromboembolic and bleeding risks,with stroke being the most devastating complication.Despite ...Background:Non-valvular atrial fibrillation(NVAF),the most prevalent cardiac arrhythmia globally,poses a dual challenge of thromboembolic and bleeding risks,with stroke being the most devastating complication.Despite advancements in anticoagulation and rhythm control,patient outcomes remain suboptimal.Aim:This review synthesizes current evidence on the pathophysiological mechanisms,multidimensional management strategies,and emerging innovations in NVAF to inform clinical practice and future research directions.Methods:A systematic literature search was conducted across nine databases(CNKI,Wanfang,SinoMed,VIP,PubMed,Web of Science,Cochrane Library,Embase,and MEDLINE)using combined Medical Subject Headings(MeSH)and free-text terms,including“atrial fibrillation,”“non-valvular atrial fibrillation,”“risk factors,”and“mechanism”(and their Chinese equivalents).Studies on NVAF pathogenesis,therapeutic interventions,and risk stratification tools were analyzed.Results:(1)Risk Factors and Pathophysiology:NVAF progression is driven by hemodynamic stress(e.g.,hypertension),metabolic disorders(e.g.,obesity,diabetes),chronic inflammation,and fibrosis.Biomarkers such as CRP and Galectin-3,along with TGF-β/Smad signaling,are central to atrial remodeling.(2)Anticoagulation Controversies:While NOACs reduce stroke risk compared to warfarin(HR=0.79),challenges persist in extreme body weight populations and drug-drug interactions(e.g.,with P-glycoprotein inhibitors).(3)Left Atrial Appendage Closure(LAAC):LAAC demonstrates non-inferiority to anticoagulation in stroke prevention(HR=0.79)with reduced major bleeding(HR=0.49),though device-related thrombosis(1.8–7%)remains a concern.(4)Precision Medicine:AI-driven models enhance stroke prediction(AUC=0.71;sensitivity 92%),while genotype-guided warfarin dosing shortens INR stabilization by 40%.(5)Lifestyle Interventions:Combined Mediterranean diet and moderate exercise reduce AF burden(HR=0.69)and reverse left atrial enlargement(LAVI reduced by 12%).(6)Multidisciplinary Care:Integrated“heart-brain team”approaches combining LAAC and PFO closure lower annual stroke recurrence from 8.2%to 2.1%,while comprehensive rehabilitation improves functional capacity(6MWD+45 m)and quality of life(SF-36+12 points).Conclusion:NVAF management has evolved from isolated anticoagulation to a multidimensional paradigm integrating genomics,AI,and lifestyle modification.Future priorities include validating long-term outcomes of novel therapies,addressing evidence gaps in special populations,and implementing digitally enabled,cross-disciplinary care models to mitigate the global burden of NVAF-related complications.展开更多
Background:Diabetes retinopathy(DR)is a complication of diabetes that affects patients’vision.Previous studies have found blueberry anthocyanins extract(BAE)can inhibit the progression of DR,but its mechanism is not ...Background:Diabetes retinopathy(DR)is a complication of diabetes that affects patients’vision.Previous studies have found blueberry anthocyanins extract(BAE)can inhibit the progression of DR,but its mechanism is not completely clear.Methods:To study the role of BAE in diabetes retinopathy,we treated human retinal endothelial cells(HRCECs)with 30 mM high glucose to simulate the microenvironment of diabetes retinopathy and used BAE to intervene the in vitro high glucose-induced retinopathy model.HRCEC cell viability and apoptosis rates were examined by Cell Counting Kit 8(CCK-8)assay and flow cytometry assay.The binding sites between miR-33 and glucocorticoid-induced transcript 1(GLCCI1)were assessed by luciferase reporter assay.Retinal neovascularization and oxidative stress contribute to diabetic retinopathy.The tubule formation assay was applied to detect the retinal neovascularization.The oxidative stress in the HRCECs was manifested by the reactive oxygen species(ROS)level,the malondialdehyde(MDA)level,and the superoxide dismutase(SOD)activity.Results:Compared with HRCECs cells cultured under normal conditions,high glucose(HG)can induce oxidative stress in HRCRCs,specifically manifested in the increase of ROS and MDA levels,and the decrease of SOD activity.BAE relieved the tubule formation in n the HRCEC.BAE also relieved the ROS and MDA levels and increased the SOD activity.Luciferase reporter assay revealed that GLCCI1 is a target molecule downstream of miR-33.In HRCEC,BAE significantly inhibited the expression of miR-33 induced by HG.miR-33 mimic inhibited the BAE’s effects on oxidative stress and angiogenesis in an in vitro high glucose-induced retinopathy model.Conclusion:BAE alleviated the oxidative stress and microangiogenesis of HRCEC by regulating the miR-33/GLCCI1 axis.展开更多
COVID-19 vaccine-induced protection declines over time.This waning of immunity has been described in modelling as a lower level of protection.This study incorporated finescale vaccine waning into modelling to predict ...COVID-19 vaccine-induced protection declines over time.This waning of immunity has been described in modelling as a lower level of protection.This study incorporated finescale vaccine waning into modelling to predict the next surge of the Omicron variant of the SARS-CoV-2 virus.In Hong Kong,the Omicron subvariant BA.2 caused a significant epidemic wave between February and April 2022,which triggered high vaccination rates.About half a year later,a second outbreak,dominated by a combination of BA.2,BA.4 and BA.5 subvariants,began to spread.We developed mathematical equations to formulate continuous changes in vaccine boosting and waning based on empirical serological data.These equations were incorporated into a multi-strain discrete-time Susceptible-Exposed-Infectious-Removed model.The daily number of reported cases during the first Omicron outbreak,with daily vaccination rates,the population mobility index and daily average temperature,were used to train the model.The model successfully predicted the size and timing of the second surge and the variant replacement by BA.4/5.It estimated 655,893 cumulative reported cases from June 1,2022 to 31 October 2022,which was only 2.69%fewer than the observed cumulative number of 674,008.The model projected that increased vaccine protection(by larger vaccine coverage or no vaccine waning)would reduce the size of the second surge of BA.2 infections substantially but would allow more subsequent BA.4/5 infections.Increased vaccine coverage or greater vaccine protection can reduce the infection rate during certain periods when the immune-escape variants cocirculate;however,new immune-escape variants spread more by out-competing the previous strain.展开更多
A Parasitic Model is proposed in this study for Digital Earth running on mobile phones through a mobile network.Because of mobile phones’limited capabilities in high-performance computing,rendering,storing,and networ...A Parasitic Model is proposed in this study for Digital Earth running on mobile phones through a mobile network.Because of mobile phones’limited capabilities in high-performance computing,rendering,storing,and networking(CRSN),these functions are accomplished by a superior host computer in this model.Rendered virtual scenes are compressed in a time-series as a data stream and are sent to the mobile phone through a mobile network,thus allowing Digital Earth to be operated on a mobile phone.This study examines a prototype and shows that a Mobile Digital Earth based on a Parasitic Model can achieve functionality beyond the mobile phone’s actual hardware capabilities and can reduce network traffic.These results demonstrate quasi-real-time interactions,but with bandwidth increases in next-generation mobile networks such as 4G and 5G,there is potential for real-time interactions in the near future.展开更多
文摘Background:Non-valvular atrial fibrillation(NVAF),the most prevalent cardiac arrhythmia globally,poses a dual challenge of thromboembolic and bleeding risks,with stroke being the most devastating complication.Despite advancements in anticoagulation and rhythm control,patient outcomes remain suboptimal.Aim:This review synthesizes current evidence on the pathophysiological mechanisms,multidimensional management strategies,and emerging innovations in NVAF to inform clinical practice and future research directions.Methods:A systematic literature search was conducted across nine databases(CNKI,Wanfang,SinoMed,VIP,PubMed,Web of Science,Cochrane Library,Embase,and MEDLINE)using combined Medical Subject Headings(MeSH)and free-text terms,including“atrial fibrillation,”“non-valvular atrial fibrillation,”“risk factors,”and“mechanism”(and their Chinese equivalents).Studies on NVAF pathogenesis,therapeutic interventions,and risk stratification tools were analyzed.Results:(1)Risk Factors and Pathophysiology:NVAF progression is driven by hemodynamic stress(e.g.,hypertension),metabolic disorders(e.g.,obesity,diabetes),chronic inflammation,and fibrosis.Biomarkers such as CRP and Galectin-3,along with TGF-β/Smad signaling,are central to atrial remodeling.(2)Anticoagulation Controversies:While NOACs reduce stroke risk compared to warfarin(HR=0.79),challenges persist in extreme body weight populations and drug-drug interactions(e.g.,with P-glycoprotein inhibitors).(3)Left Atrial Appendage Closure(LAAC):LAAC demonstrates non-inferiority to anticoagulation in stroke prevention(HR=0.79)with reduced major bleeding(HR=0.49),though device-related thrombosis(1.8–7%)remains a concern.(4)Precision Medicine:AI-driven models enhance stroke prediction(AUC=0.71;sensitivity 92%),while genotype-guided warfarin dosing shortens INR stabilization by 40%.(5)Lifestyle Interventions:Combined Mediterranean diet and moderate exercise reduce AF burden(HR=0.69)and reverse left atrial enlargement(LAVI reduced by 12%).(6)Multidisciplinary Care:Integrated“heart-brain team”approaches combining LAAC and PFO closure lower annual stroke recurrence from 8.2%to 2.1%,while comprehensive rehabilitation improves functional capacity(6MWD+45 m)and quality of life(SF-36+12 points).Conclusion:NVAF management has evolved from isolated anticoagulation to a multidimensional paradigm integrating genomics,AI,and lifestyle modification.Future priorities include validating long-term outcomes of novel therapies,addressing evidence gaps in special populations,and implementing digitally enabled,cross-disciplinary care models to mitigate the global burden of NVAF-related complications.
基金supported by the Science and Technology Project of Jiangxi Provincial Administration of Traditional Chinese Medicine(Grant Number:2022A359).
文摘Background:Diabetes retinopathy(DR)is a complication of diabetes that affects patients’vision.Previous studies have found blueberry anthocyanins extract(BAE)can inhibit the progression of DR,but its mechanism is not completely clear.Methods:To study the role of BAE in diabetes retinopathy,we treated human retinal endothelial cells(HRCECs)with 30 mM high glucose to simulate the microenvironment of diabetes retinopathy and used BAE to intervene the in vitro high glucose-induced retinopathy model.HRCEC cell viability and apoptosis rates were examined by Cell Counting Kit 8(CCK-8)assay and flow cytometry assay.The binding sites between miR-33 and glucocorticoid-induced transcript 1(GLCCI1)were assessed by luciferase reporter assay.Retinal neovascularization and oxidative stress contribute to diabetic retinopathy.The tubule formation assay was applied to detect the retinal neovascularization.The oxidative stress in the HRCECs was manifested by the reactive oxygen species(ROS)level,the malondialdehyde(MDA)level,and the superoxide dismutase(SOD)activity.Results:Compared with HRCECs cells cultured under normal conditions,high glucose(HG)can induce oxidative stress in HRCRCs,specifically manifested in the increase of ROS and MDA levels,and the decrease of SOD activity.BAE relieved the tubule formation in n the HRCEC.BAE also relieved the ROS and MDA levels and increased the SOD activity.Luciferase reporter assay revealed that GLCCI1 is a target molecule downstream of miR-33.In HRCEC,BAE significantly inhibited the expression of miR-33 induced by HG.miR-33 mimic inhibited the BAE’s effects on oxidative stress and angiogenesis in an in vitro high glucose-induced retinopathy model.Conclusion:BAE alleviated the oxidative stress and microangiogenesis of HRCEC by regulating the miR-33/GLCCI1 axis.
基金support from grants funded by the City University of Hong Kong[#7005523,#7005748 and#7005876]the General Research Fund[#11203823]from the Research Grants Council of Hong Kong。
文摘COVID-19 vaccine-induced protection declines over time.This waning of immunity has been described in modelling as a lower level of protection.This study incorporated finescale vaccine waning into modelling to predict the next surge of the Omicron variant of the SARS-CoV-2 virus.In Hong Kong,the Omicron subvariant BA.2 caused a significant epidemic wave between February and April 2022,which triggered high vaccination rates.About half a year later,a second outbreak,dominated by a combination of BA.2,BA.4 and BA.5 subvariants,began to spread.We developed mathematical equations to formulate continuous changes in vaccine boosting and waning based on empirical serological data.These equations were incorporated into a multi-strain discrete-time Susceptible-Exposed-Infectious-Removed model.The daily number of reported cases during the first Omicron outbreak,with daily vaccination rates,the population mobility index and daily average temperature,were used to train the model.The model successfully predicted the size and timing of the second surge and the variant replacement by BA.4/5.It estimated 655,893 cumulative reported cases from June 1,2022 to 31 October 2022,which was only 2.69%fewer than the observed cumulative number of 674,008.The model projected that increased vaccine protection(by larger vaccine coverage or no vaccine waning)would reduce the size of the second surge of BA.2 infections substantially but would allow more subsequent BA.4/5 infections.Increased vaccine coverage or greater vaccine protection can reduce the infection rate during certain periods when the immune-escape variants cocirculate;however,new immune-escape variants spread more by out-competing the previous strain.
基金supported by the National Natural Science Foundation of China(40871181)the Key Knowledge Innovative Project of the Chinese Academy of Sciences(KZCX2-EW318)+1 种基金the Plans of the National Sci-Tech Major Special Item 2012ZX10003-005key technology and applications of the integration of remote sensing geo-information and model computing based on cloud computing。
文摘A Parasitic Model is proposed in this study for Digital Earth running on mobile phones through a mobile network.Because of mobile phones’limited capabilities in high-performance computing,rendering,storing,and networking(CRSN),these functions are accomplished by a superior host computer in this model.Rendered virtual scenes are compressed in a time-series as a data stream and are sent to the mobile phone through a mobile network,thus allowing Digital Earth to be operated on a mobile phone.This study examines a prototype and shows that a Mobile Digital Earth based on a Parasitic Model can achieve functionality beyond the mobile phone’s actual hardware capabilities and can reduce network traffic.These results demonstrate quasi-real-time interactions,but with bandwidth increases in next-generation mobile networks such as 4G and 5G,there is potential for real-time interactions in the near future.
