Timely recognition of cardiac arrhythmias is essential in Intensive Care Units (ICUs). Electrocardiogram (ECG) interpretation is a core component of nursing practice, yet international studies show persistent gaps. In Greece, limited evidence exists regarding ICU nurses' interpretation, educational preparedness and role perception in ECG interpretation.

The aim of this study was to evaluate ICU nurses' knowledge, attitudes and self-perceived preparedness regarding ECG interpretation and to investigate whether these outcomes were associated with demographic and professional characteristics.

A descriptive, cross-sectional web-based survey was conducted among ICU nurses in Greece between October 2024 and February 2025. The instrument included demographic variables, 10 true/false knowledge items and 10 Likert-scale attitude items. Internal consistency was acceptable (α = 0.81-0.87). Data analysis included descriptive statistics, chi-squared tests and multivariable logistic regression (p < 0.05).

A total of 100 ICU nurses participated in the study. The mean knowledge score was 6.1 ± 1.8/10, with high accuracy on basic items (88%) but low performance on complex patterns (24%). Prior ECG training was the only independent predictor of adequate knowledge (OR = 2.85, 95% CI: 1.12-7.26, p = 0.028). The mean attitude score was 38.4 ± 6.2/50; although 96% recognised ECG interpretation as essential, 49% reported limited knowledge. Positive attitudes were linked to prior training, ICU experience and frequency of ECG evaluation, whereas 25% expressed ambiguity about whether ECG interpretation falls within nursing responsibilities.

ICU nurses demonstrated moderate theoretical ECG knowledge but variable preparedness and role clarity. Prior training, ICU type and clinical experience were key determinants. Standardised, simulation-based training and clearer responsibility delineation could strengthen cardiac monitoring safety.

Targeted ECG education and explicit clarification of nurses' responsibilities in cardiac monitoring are essential to strengthen arrhythmia recognition and timely intervention in ICUs. Implementing structured training pathways and ongoing assessment of ECG interpretation skills may support safer cardiac monitoring practices and more autonomous, confident intensive care nursing.

Acute aortic dissection (AAD) is a life-threatening condition with difficulty in early differential diagnosis, and ideal biomarkers are still lacking. This study aims to investigate the diagnostic value of serum semaphorin 7A (Sema7A), calponin 1 (CNN1), and plasma D-dimer, alone and in combination, in patients with AAD.

A retrospective study was conducted. 90 patients with AAD who visited the Second Xiangya Hospital of Central South University from December 2022 to December 2023 were enrolled, along with 53 patients with acute myocardial infarction (AMI) and 18 patients with acute pulmonary embolism (APE). Additionally, 25 patients without chest pain symptoms or cardiogenic diseases admitted during the same period were included as the control group. General clinical data and laboratory indicators were collected. Serum Sema7A and CNN1 levels were detected using enzyme-linked immunosorbent assay or chemiluminescence immunoassay. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for AAD. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value of D-dimer, Sema7A, and CNN1.

Serum Sema7A and CNN1 levels in the AAD group were significantly higher than those in the control, AMI, and APE groups (all P<0.05). D-dimer levels in the AAD group were significantly higher than those in the AMI and control groups (all P<0.05), but showed no significant difference compared with the APE group (P>0.05). Binary logistic regression analysis showed that elevated levels of Sema7A (OR=2.138, P<0.001), D-dimer (OR=1.211, P=0.002), and CNN1 (OR=1.042, P=0.016) were independent risk factors for AAD. ROC curve analysis demonstrated that the areas under the curve (AUC) for Sema7A, CNN1, and D-dimer for distinguishing AAD from non-AAD patients were 0.870, 0.726, and 0.836, respectively (all P<0.001). The combined AUC of the three markers was 0.910 (P<0.001), which was higher than that of each single marker (P<0.05), with sensitivity and specificity of 80.0% and 91.7%, respectively. The combined AUC for distinguishing type A and type B AAD patients was 0.631 (P<0.05).

The combined application of Sema7A, CNN1, and D-dimer significantly improves the diagnostic performance for AAD and may also serve as an indicative marker for clinical classification, providing new insights for the early differential diagnosis of AAD.

The Colchicine for prevention of vascular inflammation in Non-CardioEmbolic stroke (CONVINCE) trial showed that recurrent events were significantly reduced among colchicine-adherent non-cardioembolic stroke patients in the on-treatment analysis. This study aimed to validate the SMART-REACH risk score in stroke patients, and to determine whether colchicine's efficacy varies by baseline atherosclerotic cardiovascular disease (ASCVD) risk.

Patients with non-severe non-cardioembolic ischaemic stroke/transient ischaemic attack (TIA) were randomised to colchicine 0.5 mg plus usual care or usual care alone. Participants were stratified into moderate (10%-19%), high (20%-30%) and very high (≥30%) 10-year ASCVD risk categories using the SMART-REACH model. Model performance was assessed using the C-statistic and calibration plots. The primary endpoint (major adverse cardiovascular events [MACE]) was a composite of fatal or non-fatal recurrent ischaemic stroke, myocardial infarction, cardiac arrest or hospitalisation for unstable angina.

Among 3144 patients, MACE incidence significantly increased with ASCVD risk levels: 7.2% (moderate), 8.8% (high) and 13.8% (very high) (P < .01). The C-statistic for 3-year risk of MACE was 0.59 (95% CI, 0.56-0.63). While no statistically significant treatment interaction was found (P = .88), absolute risk reductions (ARRs) were more pronounced in higher-risk groups: moderate risk 7.2% (colchicine) vs 7.2% (usual care) (hazard ratio [HR] 1.01; 95% CI, 0.55-1.83); high risk 7.7% vs 9.8% (ARR 2.1%; HR 0.79; 95% CI, 0.53-1.18); very high risk 12.5% vs 15.2% (ARR 2.7%; HR 0.85; 95% CI, 0.64-1.12).

We identified an association between very high baseline ASCVD risk (≥30%) assigned by the SMART-REACH score and increased recurrent MACE. Although no significant treatment interaction was observed, patients in higher risk categories may represent a more promising target population for secondary prevention with colchicine.

ClinicalTrials.gov Identifier: NCT02898610.

The mechanism of abnormal eye movements in patients with cerebral small vessel disease (CSVD) remains unclear. This study aims to explore the potential link between eye movement in CSVD patients and the severity and distribution of white matter hyperintensities (WMH), and to evaluate the possibility of using eye movement assessment as a tool for specific diagnosis.

This retrospective cross-sectional study was conducted at Xiangya Hospital, Central South University between September 7th, 2022 and October 27th, 2023, enrolling a total of 161 patients with CSVD. Demographic characteristics, past medical history, medication history, and imaging data were collected. The Montreal Cognitive Assessment (MoCA) was used to evaluate patients' cognitive function, and the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to assess patients' anxiety and depressive symptoms. All participants completed the EyeKnow Intelligent Eye Movement Analysis System within one week of enrollment, with data recorded on the following eye movement paradigms: saccade, smooth pursuit, fixation, and antisaccade. WMH were scored using both the Age-Related White Matter Change (ARWMC) scale and the Fazekas grading system. Based on the scores, patients were categorized into three severity groups (mild, moderate, severe). The Kruskal-Wallis rank sum test was used to analyze intergroup differences, while Spearman correlation analysis and multiple linear regression were used to explore the relationship between eye movement characteristics and WMH. Receiver Operating Characteristic (ROC) curve analysis was performed to evaluate the ability of eye movement characteristics to discriminate between patients with and without WMH in the five brain regions: frontal lobe, temporal lobe, parietal-occipital lobe, infratentorial region, and basal ganglia region. A weighted random forest model was developed to assess the performance of eye movement characteristics in predicting WMH severity at different locations.

This study enrolled a total of 161 patients with CSVD. Baseline data were collected for all participants. According to the total ARWMC scores, patients were divided into a mild (0 to 10 points), a moderate (11 to 20 points), and a severe (21 to 30 points) WMH groups. The mild WMH group included 100 patients [66 males and 34 females, age (61.40±9.45) years]. The moderate WMH group included 46 patients [32 males and 14 females, age (63.72±8.77) years]. And the severe WMH group included 15 patients [12 males and 3 females, age (63.47±10.40) years]. Significant differences were observed among the 3 groups in MoCA scores (P=0.008), severity of cerebral microbleeds (CMB) (P<0.001), severity of basal ganglia perivascular spaces (BG-PVS) (P<0.001), and global cortical atrophy (GCA) grading system scores (P=0.003). Analysis of intergroup differences in eye movement characteristics revealed that with increasing WMH severity, the fastest saccade reaction time increased (P=0.008), the smooth pursuit deviation (P=0.013) and the number of fixation shifts (>2°) (P=0.025) decreased. In post-hoc pairwise comparisons, there were no significant differences in any eye movement characteristics between the moderate and severe WMH group (all P>0.05). Spearman correlation analysis demonstrated a strong positive correlation between the total Fazekas and total ARWMC scores (r=0.867, P<0.01), confirming their concordance for rating WMH severity. Additionally, MoCA scores were significantly negatively correlated with both the total Fazekas scores (r=-0.302, P<0.01) and the total ARWMC scores (r=-0.245, P<0.01). Multiple linear regression analysis based on the total ARWMC scores revealed that after adjusting for multicollinearity, oculomotor features including smooth pursuit initiation time (β=-0.001, P=0.009), smooth pursuit deviation (β=-1.212, P=0.001), number of fixation shifts (>2°) (β=-0.102, P=0.011), and mean reaction time of antisaccade (β=0.016, P=0.018) remained statistically significant predictors of cognitive function. After adjusting for gender, age, years of education, MoCA, HAMA, HAMD scores, and the presence of other imaging markers, the associations of smooth pursuit initiation time (β<0.001, P=0.010), smooth pursuit deviation (β=-1.066, P=0.002), and mean reaction time of antisaccade (β=0.013, P=0.034) with the outcome variable remained statistically significant. In the distribution of WMH locations, ROC curve analysis was conducted based on all eye movement characteristics to discriminate the presence of WMH in the whole brain, frontal lobe, temporal lobe, parietal-occipital lobe, and infratentorial region, with AUC values of 0.933, 0.928, 0.758, 0.784, and 0.881, respectively. For the basal ganglia region, binary logistic regression analysis showed no significant association, and therefore ROC curve analysis was not applicable. Using a weighted random forest method, the severity of WMH at different locations was further classified. After adjusting for gender, age, years of education, MoCA, HAMA, HAMD scores, and the presence of other imaging markers, the model's classification accuracy improved to 85.71% for the frontal lobe, 81.63% for the infratentorial region, and 75.51% for the parietal-occipital lobe.

The eye movement performance of CSVD patients worsens with the increasing severity of WMH, especially in the frontal lobe and infratentorial region. Cognitive function exerts an influence on eye movement that appears largely independent of imaging changes.

Pulsed radiofrequency (PRF) treatment of the trigeminal ganglion via foramen ovale puncture for zoster-associated trigeminal neuralgia typically requires patient feedback during sensory and motor stimulation, and is usually performed under regional anesthesia (RA). However, under RA, patients often experience poor comfort due to pain and anxiety during puncture and PRF, and severe pain occurs when adjusting needle position or increasing output voltage. This often leads to lower-than-optimal treatment voltages, poor patient cooperation, and sometimes interruption or refusal of treatment. The Department of Anesthesiology at Xiangya Hospital, Central South University, has performed CT-guided trigeminal ganglion PRF under general anesthesia (GA) for zoster-associated trigeminal neuralgia. Currently, no studies directly compare the efficacy and safety of GA versus RA for this procedure. This study aims to compare GA and RA in terms of safety and efficacy for trigeminal ganglion PRF treatment of zoster-associated trigeminal neuralgia, providing clinical guidance for optimal anesthesia choice.

Data were retrospectively collected for hospitalized and treated with trigeminal ganglion PRF for zoster-associated trigeminal neuralgia at Xiangya Hospital, Central South University, from July 2022 to January 2025. Patients were grouped according to the anesthesia method used during PRF: GA group and RA group. Baseline characteristics (demographics, comorbidities, disease features) were compared between groups. Pain was assessed using the Visual Analogue Scale (VAS) at 1 day, 1 month, 3 months, and 6 months postoperatively, and changes from baseline were analyzed. Patient satisfaction, total hospitalization duration, direct medical costs, and perioperative complications (hypertension, hypotension, bradycardia, tachycardia, etc.) were also compared.

A total of 61 patients were included (GA group, n=29; RA group, n=32). Baseline characteristics were comparable between groups (all P>0.05). Two-way repeated measures analysis of variance showed a significant main effect of time [F(4, 295)=2 181, P<0.001], no significant main effect of group [F(1, 295)=1.377, P=0.241 5], and a significant interaction effect [F(4, 295)=4.821, P<0.001]. VAS scores at 1 day, 1 month, 3 months, and 6 months postoperatively were significantly lower than preoperative values in both groups (all P<0.05); differences between groups at all time points were not statistically significant (all P>0.05). Median hospitalization costs were 16 602 (14 904, 17 988) CNY for the GA group and 12 719 (8 709, 13 876) CNY for the RA group, with a significant difference (P<0.001). Median hospital stay was 6 (5, 7) days for both groups (P=0.606). Incidences of hypertension and tachycardia were significantly higher in the RA group than the GA group (both P<0.05). Other complications (facial swelling, dizziness, nausea, vomiting) did not differ significantly (all P>0.05). Patient satisfaction was higher in the GA group than the RA group (82.76% vs 56.25%, P=0.031).

GA and RA provide comparable efficacy for trigeminal ganglion PRF in zoster-associated trigeminal neuralgia. However, GA significantly improves patient satisfaction and reduces cardiovascular stress without increasing other postoperative complications. PRF under GA is safe and feasible.

Despite being a common reason for Emergency Department (ED) admission, information about the management of acute pericarditis is limited in this setting.

In this retrospective study conducted at the ED of Ospedale di Circolo in Varese (Italy) from 2019 to 2023, patients with acute pericarditis were included. The primary endpoint was the occurrence of the 12-month composite outcome (treatment failure, recurrent pericarditis, cardiac tamponade, constrictive pericarditis or death).

One-hundred and sixty-nine patients were included (median age 54 years, 65.1% males). Chest pain was the main symptom (96.4%). On admission, aspirin was more frequently given over non-steroidal anti-inflammatory drugs (NSAIDs), and colchicine was prescribed in 40% of patients. At discharge, more patients were prescribed ibuprofen, and colchicine prescription significantly increased to 71%. Drug doses were compliant with guidelines in a limited number of patients at admission and increased at discharge. The composite outcome occurred in 20.1% of patients (n = 34), mainly driven by recurrences (n = 18) and treatment failure. Patients with a complicated course were older, of female sex, with a larger proportion of comorbidities and higher CRP levels. Diabetes (HR 3.9, 95% CI 1.7-9.1), COPD (HR 6.2, 95% CI 2.3-17.1), recent percutaneous cardiac procedures (HR 6.5, 95% CI 2.1-19.6), and recent SARS-CoV-2 vaccination (HR 3.0, 95% CI 1.1-8.2) were independent risk factors for the composite outcome.

A significant proportion of patients with acute pericarditis experience long-term complications. Sub-optimal adherence to guideline-recommended doses of anti-inflammatory drugs was commonly observed, suggesting an area for improvement in the management of these patients.

Chronic heart failure (HF) remains a global health challenge due to the lack of therapies that effectively disrupt the pathological fibro-inflammatory networks driving disease progression. While current nanomedicine strategies often target intracellular pathways in isolated cell types, they overlook the multicellular crosstalk central to HF. Here, we develop scalably synthesized Prussian blue (PB) nanoparticles that selectively intercept the CCL2-CCR2 chemokine axis, a key pathway in fibroblast-macrophage communication. Single-nucleus RNA sequencing of murine and human failing hearts identifies a conserved pro-fibroinflammatory cardiac fibroblast subpopulation (POSTN^hi CCL2^hi) that recruits CCR2⁺ macrophages via CCL2 secretion. PB nanoparticles exhibit ultrahigh affinity (K_D = 1.11 × 10^-10 m) for free CCL2, inducing conformational distortion in its N-terminal domain via specific C≡N interface interactions with CRS1 residues, thereby blocking CCR2 engagement, a mechanism distinct from conventional nanomaterials. Although ineffective in monocultures, PB nanoparticles robustly improve cardiac function and remodeling in murine and translational porcine pressure-overload HF models, reducing left ventricular end-diastolic volume by 56.2% and fibrosis by 40.5%, while selectively depleting CCR2⁺ macrophages without systemic immunosuppression. Supported by scalable production (> 100 g/batch), long-term stability, and biosafety, this work establishes a cell communication-targeting nanomedicine strategy for network-driven diseases like HF.

Succinylation is a post-translational modification that occurs on lysine residues and is mediated by succinyl-CoA, an intermediate of the tricarboxylic acid (TCA) cycle. It can significantly affect protein conformation, activity, stability, and interactions with other molecules, thereby participating in the regulation of important biological processes such as cellular metabolism, energy homeostasis, and signaling pathways. In recent years, increasing evidence has shown that succinylation plays a key role in central nervous system (CNS) diseases, particularly in Alzheimer's disease, stroke, subarachnoid hemorrhage (SAH), and microglial glioma. Succinylation modification participates in neuronal injury and repair processes by influencing mitochondrial function, oxidative stress, autophagic flux, immune responses, and inflammation. A systematic description of the enzymatic and non-enzymatic regulatory mechanisms of succinylation, along with a summary of its functional roles and potential therapeutic value in different CNS diseases, especially the role of desuccinylases such as sirtuin 5 (SIRT5) as potential therapeutic targets, can provide a new theoretical basis and conceptual support for understanding the pathogenesis of CNS diseases and developing targeted intervention strategies. Future research should further clarify the core characteristics of disease-specific succinylation profiles and the integration patterns of multi-omics data, elucidate the molecular mechanisms of crosstalk among post-translational modifications, and promote the clinical translation of biomarkers and precision therapeutic drugs based on succinylation pathways.

Cardiac fibrosis is a common pathological feature during the progression of various cardiovascular diseases and is characterized by excessive deposition of extracellular matrix (ECM) in the myocardial interstitium, accompanied by alterations in cardiac structure and function. MicroRNAs (miRNAs) play important roles in the regulation of cardiac fibrosis. Previous studies have suggested that miR-34a is involved in fibrotic processes; however, its in vivo effects on cardiac fibrosis and cardiac function, as well as its relationship with mitochondrial tumor suppressor 1 (MTUS1), remain unclear. This study aimed to investigate the effects of miR-34a targeting MTUS1 on cardiac fibrosis and cardiac function in rats through in vivo intervention.

Healthy adult male Sprague-Dawley (SD) rats were used to establish a myocardial fibrosis model by subcutaneous injection of isoproterenol (ISO) at a dose of 10 mg/(kg·d) for 14 consecutive days (model group), while the control group received equal volumes of normal saline. Transthoracic echocardiography (TTE) was performed to evaluate cardiac structural and functional changes. Left ventricular tissues were collected and paraffin sections were prepared. Hematoxylin-eosin (HE) staining was used to observe histological changes in myocardial tissue, and Masson staining was used to assess collagen deposition. Real-time polymerase chain reaction (real-time PCR) and Western blotting were performed to detect the expression levels of miR-34a, MTUS1, and fibrosis-related proteins including α-smooth muscle actin (α-SMA) and collagen I. Bioinformatics analysis was used to predict potential binding sites between miR-34a and MTUS1. A dual-luciferase reporter assay was performed to verify the targeting relationship between miR-34a and MTUS1. Furthermore, adeno-associated virus (AAV) was used in vivo to downregulate the expression of miR-34a and MTUS1, and the effects on cardiac function and myocardial fibrosis were evaluated.

ISO-treated rats exhibited pronounced myocardial fibrotic changes. HE staining revealed disorganized myocardial fibers and widened interstitial spaces, and Masson staining demonstrated increased collagen deposition. TTE analysis showed that left ventricular ejection fraction was reduced in the model group compared with the control group (P<0.05). Compared with control rats, ISO-treated rats showed increased miR-34a expression and decreased MTUS1 expression in myocardial tissues, accompanied by elevated protein levels of α-SMA and collagen I (all P<0.05). Dual-luciferase reporter assays demonstrated that miR-34a directly bound to the 3' untranslated region of MTUS1 and suppressed its expression. AAV-mediated downregulation of miR-34a attenuated myocardial fibrosis, reduced collagen deposition, and improved cardiac functional parameters compared with the model group; these effects were correspondingly altered when MTUS1 expression was concurrently modulated.

In an ISO-induced rat model of cardiac fibrosis, miR-34a participates in the regulation of myocardial fibrosis and cardiac functional alterations by targeting MTUS1. The in vivo AAV intervention results suggest that the miR-34a-MTUS1 regulatory axis is associated with the progression of cardiac fibrosis.

Postmenopausal women with rheumatoid arthritis (RA) experience worsening functional decline, independent of disease activity. Estrogen replacement therapy (ERT) has been proposed to mitigate musculoskeletal deterioration, but its role in RA remains unclear. This study investigated the association between ERT use and physical function in postmenopausal women with RA.

This longitudinal study analyzed data from Forward, the National Databank for Rheumatic Diseases (2000-2022). Postmenopausal women with RA who initiated ERT were matched 1:1 to non-users based on menopause year or ERT initiation. The primary outcome was physical function, assessed using the Health Assessment Questionnaire (HAQ). Generalized estimating equations (GEE) were used to evaluate the association between ERT and HAQ scores, adjusting for demographics, reproductive history, RA duration, comorbidities, and medication use. Sensitivity analyses with propensity score matching were conducted.

A total of 8,246 women were included, with 4,123 ERT users matched to non-users. ERT use was associated with modestly improved HAQ scores (β = -0.02, 95% CI -0.03, -0.01; p< 0.001). Later menopause correlated with better function (β = -0.008 per year after menopause, 95% CI -0.03, -0.01; p< 0.001). Women initiating ERT within five years of menopause demonstrated greater benefits. Sensitivity analyses using propensity score adjustment confirmed these findings and revealed additional improvements in patient-reported outcomes (PROs).

ERT use was modestly associated with improved physical function and other PROs in postmenopausal women with RA, with the greatest benefits seen in early postmenopausal initiation. No excess crude rates of cardiovascular or cancer events were observed. Further research is needed to determine the clinical implications of ERT in RA management.