Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, underscoring the importance of accessible health communication. Artificial intelligence (AI) tools such as ChatGPT and MediSearch have potential to bridge knowledge gaps, but their effectiveness depends on both accuracy and readability. This study evaluated how natural language processing (NLP) models respond to CVD-related questions across different education levels.

Thirty-five frequently asked questions from reputable sources were reformatted into prompts representing lower secondary, higher secondary, and college graduate levels, and entered into ChatGPT Free (GPT-4o mini), ChatGPT Premium (GPT-4o), and MediSearch (v1.1.4). Readability was assessed using Flesch-Kincaid Ease and Grade Level scores, and response similarity was evaluated with BERT-based cosine similarity. Statistical analyses included ANOVA, Kruskal-Wallis, and Pearson correlation.

Readability decreased significantly with increasing education level across all models (p < 0.001). ChatGPT Free responses were more readable than MediSearch (p < 0.001), while ChatGPT Free and Premium demonstrated higher similarity to each other than to MediSearch. ChatGPT Premium explained the greatest variance in readability (r = 0.350; p < 0.001), suggesting stronger adaptability to user education levels compared to ChatGPT Free (r = 0.530; p < 0.001) and MediSearch (r = 0.227; p < 0.001).

These findings indicate that while NLP models adjust readability by education level, output complexity often exceeds average literacy, highlighting the need for refinement to optimize AI-driven patient education.

Neurocysticercosis (NCC) is a leading cause of acquired epilepsy and other neurological disturbances worldwide. Developmental venous anomaly (DVA) is the most common cerebral vascular malformation, typically asymptomatic and discovered incidentally. This case report illustrates the rare instance of a DVA found adjacent to an NCC lesion on imaging. The patient is a 26-year-old male presenting with new-onset seizures. The diagnosis was made on MRI brain and serum cysticercosis antibody testing. Limited literature is available on the coexistence of these two entities, prompting contemplation about the implications for diagnosis, management, and prognosis.

Second-line options for biliary tract cancer (BTC) are limited. While nab-paclitaxel has demonstrated certain antitumor activity, evidence remains scarce. With gemcitabine-cisplatin plus anti-programmed death-ligand 1 (PD-(L)1) established as the first-line standard, the benefit of second-line immunotherapy-especially in patients without prior anti-PD-(L)1 exposure-remains unclear.

To evaluate the efficacy and safety of nab-paclitaxel-based second-line treatments for advanced BTC, and compare outcomes between regimens with and without anti-PD-(L)1.

This is a real-world retrospective study.

This study reviewed BTC patients who received second-line nab-paclitaxel-based therapy at West China Hospital between August 2018 and August 2023. The primary endpoint was overall survival (OS) in the entire population. Secondary endpoints were progression-free survival (PFS), response rate, adverse events (AEs) in the entire population, and comparison of survival outcomes and response rate between the chemo-anti-PD-(L)1 and chemotherapy groups.

Among 84 patients (41 in the chemo-anti-PD-(L)1 group and 43 in the chemotherapy group), the median OS was 15.17 months (95% confidence interval (CI), 12.63-21.43), median PFS was 5.40 months (95% CI, 3.23-8.03), objective response rate (ORR) was 21.43% (95% CI, 13.22-31.74), and disease control rate (DCR) was 60.71% (95% CI, 49.45-71.20). Common grade 3-4 AEs were leukopenia (21.4%), neutropenia (17.9%), and anemia (13.1%). Hepatitis (14.6%) was the most frequent immune-related AE. Although a numerical trend favored the chemo-anti-PD-(L)1 group, no statistically significant differences were observed in OS (16.9 vs 14.6 months), PFS (7.3 vs 4.6 months), ORR (29.3% vs 13.9%), or DCR (68.3% vs 53.5%). In the entire cohort, radical surgery improved OS. In addition, patients with a baseline neutrophil-to-lymphocyte ratio ⩾3 and a ⩽30% reduction in carbohydrate antigen 19-9 from an initially elevated level during treatment had worse OS and PFS.

Nab-paclitaxel-based regimens represent a promising second-line treatment option for BTC. Although the improvement was not statistically significant, adding anti-PD-(L)1 therapy showed a trend toward improved survival.

ChiCTR2500096599.

Microgravity-induced endothelial inflammation contributes to cardiovascular dysfunction in astronauts, but the metabolic mechanisms involved are not fully defined. Sirtuin-3 (SIRT3), a mitochondrial deacetylase, regulates cellular metabolism and redox balance. The results demonstrate that two-dimensional clinorotation-induced simulated microgravity suppresses SIRT3 in human umbilical vein endothelial cells (HUVECs), resulting in mitochondrial dysfunction, NLRP3 inflammasome activation, and pyroptosis. SIRT3 overexpression mitigated these effects, while SIRT3 knockdown exacerbated them. Mechanistically, SIRT3 deletion promoted acetylation of pyruvate dehydrogenase E1α (PDHA1) at lysine 83, inhibiting pyruvate dehydrogenase complex (PDHC) activity and shifting metabolism toward higher levels of glycolysis. PDHA1 transfection suppressed NLRP3 inflammasome activation, pyroptosis, and glycolysis in HUVECs under simulated microgravity, while restoring mitochondrial membrane potential (ΔΨm) and oxidative phosphorylation. The PDHA1-K83R mutant provided stronger protection than wild-type PDHA1. These findings reveal that the SIRT3-PDHA1 axis links mitochondrial metabolism to endothelial inflammation under simulated microgravity, suggesting that targeting this pathway could help maintain vascular health during spaceflight.

Mercury poisoning is an underdiagnosed condition in our setting. It affects multiple organs and systems, often presenting with variable and nonspecific symptoms that may mimic more common diseases. We report the case of a 42-year-old female patient who presented with multiple arterial and venous thrombotic events, cardiovascular complications, progressive cognitive impairment, and long-standing renal dysfunction. Imaging studies revealed embolic phenomena characterized by hyperdense material suggestive of metallic emboli in the thorax, abdomen, and pelvis, raising suspicion of heavy metal poisoning. Diagnosis was confirmed by a 24-hour urinary mercury concentration of 64.03 µg/L. Chelation therapy with the available agent in our setting was initiated, along with intravenous N-acetylcysteine. Selenium was not administered due to its unavailability. Mercury intoxication poses a diagnostic challenge due to its nonspecific clinical manifestations, which may be attributed to more prevalent pathologies in the region.

DEAD-box RNA helicase 17 (DDX17), a key member of the DEAD-box family, is vital in cellular physiological processes. This review summarizes its structural properties, distribution, functions, disease associations, and research trends. Structurally, DDX17 has a conserved DEAD-box domain with RNA-dependent ATPase and helicase activities, producing p72 and p82 isoforms. It distributes in the nucleus and cytoplasm, highly expressed in cardiomyocytes and neuronal tissues. Functionally, DDX17 regulates RNA metabolism, DNA repair, and protein interactions. It is linked to chronic non-infectious diseases: promoting tumor progression via pathways like Wnt/β-catenin; protecting myocardial function in cardiovascular diseases; and involving in neurological disorders.This review provides insights for exploring its biological functions and clinical applications.

Cerebrovascular neurological disorders, especially high-mortality and disabling stroke subtypes such as ischemic stroke and hemorrhagic stroke, have become a major global health issue. In addition to conventional treatments, the role of herbal medicines and their active ingredients in the prevention and treatment of cerebrovascular and nervous system diseases has received increasing attention in recent years. Among them, the primary active ingredient of Panax notoginseng is Panax Notoginseng Saponins (PNS), has become a research hotspot due to its diverse pharmacological activities. Existing evidence suggests that PNS exhibits various effects including anti-inflammatory, antioxidant, anti-apoptotic, immune regulation, neuroprotection, blood sugar and lipid lowering, and cardiovascular protection. This review systematically searches multiple databases for literature related to PNS and cerebrovascular neurological disorders, focusing on summarizing the role of PNS in specific diseases such as ischemic stroke, hemorrhagic stroke, and neurodegenerative disorders, exploring its pharmacokinetic characteristics, main mechanisms of action, and clinical application prospects, aiming to provide a theoretical basis for the in-depth research and development of PNS in cerebrovascular neurological disorders.

Glucagon-like peptide-1 (GLP-1) therapies are highly effective for weight loss and metabolic improvement in obesity and type 2 diabetes management. However, their use poses clinical challenges, including loss of lean muscle mass and gastrointestinal side effects, both of which may affect adherence and long-term outcomes.

This commentary synthesizes current evidence and expert perspectives, drawing on presentations from the 42nd International Symposium on Diabetes and Nutrition by the Diabetes and Nutrition Study Group, to develop practical recommendations for integrating nutrition and physical activity with GLP-1 therapies for obesity and diabetes management.

We summarize consensus recommendations from a global working group, organized into seven thematic modules, to guide alignment of GLP-1 therapies with dietary and lifestyle interventions across the key stages of the weight management journey. Evidence from several clinical trials demonstrate that the combination of GLP-1 therapies with structured dietary and exercise interventions results in additive weight loss effects compared with either strategy alone. Strategies to preserve lean mass with GLP-1 therapies include achieving protein intakes >1.2 g/kg/day, evenly distributed across meals, combined with aerobic activity and structured resistance training. Specific recommendations are provided to minimize nausea, vomiting, diarrhea, and constipation associated with GLP-1 therapies, as well as to prevent and manage complications such as, cholelithiasis and gastroesophageal reflux disease. Future research priorities include examining the impact of GLP-1 therapies on dietary habits and physical activity levels, improving muscle health assessment, and testing pharmacologic adjuncts to limit lean mass loss.

Maximizing the benefits of GLP-1 therapies require a multidisciplinary approach that integrates evidence-based nutrition, physical activity, and proactive management of gastrointestinal side effects. Such an approach can enhance adherence, preserve functional capacity, and sustain the long-term benefits of these therapies.

Advances in medical care have increased the number of adults with Down syndrome and congenital heart disease (CHD), including those with residual or unrepaired lesions. However, clinical outcomes following invasive cardiovascular procedures in this population remain poorly understood.

We extracted data on patients with Down syndrome aged ≥16 years and diagnosed with CHD from the Japanese Registry of All Cardiac and Vascular Diseases Diagnosis Procedure Combination (JROAD-DPC), covering the period from April 1, 2013, to March 31, 2023. Patients who underwent cardiovascular surgery or transcatheter procedures were included in the analysis.

The study included 115 patients (median age: 21 [17-33] years; 47.8 % female), of whom 72 underwent surgery and 43 underwent transcatheter intervention. Procedures were most common among those aged 16-29 years. The main CHD subtypes were tetralogy of Fallot, atrial septal defects, and atrioventricular septal defects. Catheter-based interventions were associated with shorter hospital stay and no in-hospital mortality. In contrast, all three deaths (4.2 %) occurred in the surgical group, with pulmonary hypertension medications used in two of these patients. Among surgical patients receiving pulmonary hypertension medications, the in-hospital mortality rate reached 25 %. In multivariate analysis, emergency admission and the use of pulmonary hypertension medications were independently associated with longer hospital stays after surgery.

In adults with Down syndrome and CHD, invasive cardiovascular procedures had relatively acceptable in-hospital outcomes. Careful patient selection and perioperative management are crucial when planning cardiac surgery, especially in patients taking medication for pulmonary hypertension.

This study aimed to investigate the effect of lipoprotein(a) (Lp(a)) on major adverse cardiovascular events (MACEs) among individuals with chronic coronary syndrome (CCS) according to ABO blood groups. Two independent cohorts of patients with CCS were included consecutively. Blood groups and Lp(a) levels were measured. Patients with the AB group were excluded due to the small sample size. In the exploratory cohort (n = 7611), 560 MACEs were recorded over a mean follow-up of 54.80 months. Stratification analysis revealed that the relationship of elevated Lp(a) levels with prognosis was more pronounced in patients with blood group A or B. Patients with blood group A or B plus medium Lp(a) (HR, 1.93, 95% CI: 1.24-3.01) or high Lp(a) (HR, 2.06, 95% CI: 1.32-3.24) concentrations had a significantly higher risk of MACEs compared to those with blood group O and low Lp(a) levels. Similar results were obtained in the confirmatory cohort (n = 7916). In conclusion, our data demonstrated for the first time a more prominent association between Lp(a) and adverse outcomes in CCS patients with non-O blood group compared to those with blood group O, suggesting that ABO blood group measurement may be clinically useful for decision-making in Lp(a) intervention.