Background: Cardiac lymphangiogenesis has been proposed as a potential therapeutic target to prevent the development of heart failure. However, the efficiency of systemically delivered VEGFC ( vascular endothelial growth factor C) protein in inducing cardiac lymphangiogenesis has shown inconsistency across different studies. Moreover, the mechanisms underlying lymphatic remodeling during heart failure remain poorly understood. Methods: To determine the role of lymphatic remodeling in heart failure, we used adeno‐associated virus–mediated gene therapy to either inhibit VEGFR3 ( vascular endothelial growth factor receptor 3) expression or enhance VEGFC expression in mice subjected to transverse aortic constriction. In vitro studies were further conducted to investigate the role of Yes‐associated protein in VEGFC/VEGFR3 signaling in lymphatic endothelial cells. Results: Our study shows that transverse aortic constriction induces dynamic lymphatic remodeling, characterized by an early adaptive cardiac lymphangiogenic response and enhanced peripheral lymphatic transport function. Adeno‐associated virus‐sh‐VEGFR3 treatment inhibited this early adaptive lymphangiogenesis, exacerbating cardiac inflammation and adverse remodeling. Conversely, adeno‐associated virus–VEGFC therapy appeared to be cardioprotective by promoting adaptive lymphangiogenesis and facilitating the resolution of cardiac inflammation. Moreover, adeno‐associated virus–VEGFC treatment improved peripheral lymphatic drainage function, potentially alleviating peripheral congestion in heart failure. Further in vivo and in vitro analyses revealed that Yes‐associated protein dephosphorylation is essential for VEGFC/VEGFR3 signaling‐dependent lymphangiogenesis and for upregulation of lymphatic chemokines and scavenger receptors. Conclusions: These findings highlight that targeting cardiac lymphangiogenesis via VEGFC/VEGFR3 signaling through genetic approaches represents a promising therapeutic strategy for heart failure. Moreover, VEGFC administration may offer a novel, noninvasive decongestive approach by modulating the lymphatic system in heart failure management.

Voltage-gated sodium (Nav) channels play a crucial role in initiating and propagating action potentials throughout the heart, muscles and nervous systems, making them targets for a number of drugs and toxins. While patch-clamp electrophysiology is considered the gold standard for measuring ion channel activity, its labor-intensive and time-consuming nature highlights the need for fast screening strategies to facilitate a preliminary selection of potential drugs or hazards. In this study, a high-throughput and cost-effective biosensing method was developed to rapidly identify specific agonists and inhibitors targeting the human Nav1.1 (hNav1.1) channel. It combines a red fluorescent dye sensitive to transmembrane potentials with CHO cells stably expressing the hNav1.1 α-subunit (hNav1.1-CHO). In the initial screening mode, the tested compounds were mixed with pre-equilibrated hNav1.1-CHO cells and dye to detect potential agonist effects via fluorescence enhancement. In cases where no fluorescence enhancement was observed, the addition of a known agonist veratridine allowed the indication of inhibitor candidates by fluorescence reduction, relative to the veratridine control without test compounds. Potential agonists or inhibitors identified in the initial screening were further evaluated by measuring concentration–response curves to determine EC₅₀/IC₅₀ values, providing semi-quantitative estimates of their binding strength to hNav1.1. This robust, high-throughput biosensing assay was validated through comparisons with the patch-clamp results and tested with 12 marine toxins, yielding consistent results. It holds promise as a low-cost, rapid, and long-term stable approach for drug discovery and non-target screening of neurotoxins.

Background: Hypertriglyceridemia is a risk factor for cardiovascular diseases. Internet usage in China is increasing, giving rise to large-scale data sources, especially to access, disseminate, and discuss medical information. Social media listening (SML) is a new approach to analyze and monitor online discussions related to various health-related topics in diverse diseases, which can generate insights into users’ experiences and expectations. However, to date, no studies have evaluated the utility of SML to understand patients’ cognizance and expectations pertaining to the management of hypertriglyceridemia. Objective: The aim of this study was to utilize SML to explore the disease cognition level of patients with hypertriglyceridemia, choice of intervention measures, and the status quo of online consultations and question-and-answer (Q&A) search platforms. Methods: An infosurveillance study was conducted wherein a disease-specific comprehensive search was performed between 2004 and 2020 in Q&A search and online consultation platforms. Predefined single and combined keywords related to hypertriglyceridemia were used in the search, including disease, symptoms, diagnosis, and treatment indicators; lifestyle interventions; and therapeutic agents. The search output was aggregated using an aggregator tool and evaluated. Results: Disease-specific consultation data (n=69,845) and corresponding response data (n=111,763) were analyzed from 20 data sources (6 Q&A search platforms and 14 online consultation platforms). Doctors from inland areas had relatively high voice volumes and appear to exert a substantial influence on these platforms. Patients with hypertriglyceridemia engaging on the internet have an average level of cognition about the disease and its intervention measures. However, a strong demand for the concept of the disease and “how to treat it” was observed. More emphasis on the persistence of the disease and the safety of medications was observed. Young patients have a lower willingness for drug interventions, whereas patients with severe hypertriglyceridemia have a clearer intention to use drug intervention and few patients have a strong willingness for the use of traditional Chinese medicine. Conclusions: Findings from this disease-specific SML study revealed that patients with hypertriglyceridemia in China actively seek information from both online Q&A search and consultation platforms. However, the integrity of internet doctors’ suggestions on lifestyle interventions and the accuracy of drug intervention recommendations still need to be improved. Further, a combined prospective qualitative study with SML is required for added rigor and confirmation of the relevance of the findings.

Objective This study aimed to describe the epidemiological and clinical features and potential factors related to the time to return negative reverse transcriptase (RT)-PCR in discharged paediatric patients with COVID-19. Design Retrospective cohort study. Setting Unscheduled admissions to 12 tertiary hospitals in China. Participants Two hundred and thirty-three clinical charts of paediatric patients with confirmed diagnosis of COVID-19 admitted from 1 January 2020 to 17 April 2020. Primary and secondary outcome measures Primary outcome measures: factors associated with the time to return negative RT-PCR from COVID-19 in paediatric patients. Secondary outcome measures: epidemiological and clinical features and laboratory results in paediatric patients. Results The median age of patients in our cohort was 7.50 (IQR: 2.92–12.17) years, and 133 (57.1%) patients were male. 42 (18.0%) patients were evaluated as asymptomatic, while 162 (69.5%) and 25 (10.7%) patients were classified as mild or moderate, respectively. In Cox regression analysis, longer time to negative RT-PCR was associated with the presence of confirmed infection in family members (HR (95% CI): 0.56 (0.41 to 0.79)). Paediatric patients with emesis symptom had a longer time to return negative (HR (95% CI): 0.33 (0.14 to 0.78)). During hospitalisation, the use of traditional Chinese medicine (TCM) and antiviral drugs at the same time is less conducive to return negative than antiviral drugs alone (HR (95% CI): 0.85 (0.64 to 1.13)). Conclusions The mode of transmission might be a critical factor determining the disease severity of COVID-19. Patients with emesis symptom, complications or confirmed infection in family members may have longer healing time than others. However, there were no significant favourable effects from TCM when the patients have received antiviral treatment.

BACKGROUND Hypertriglyceridemia is a risk factor for cardiovascular diseases. Internet usage in China is increasing, giving rise to large-scale data sources, especially to access, disseminate, and discuss medical information. Social media listening (SML) is a new approach to analyze and monitor online discussions related to various health-related topics in diverse diseases, which can generate insights into users’ experiences and expectations. However, to date, no studies have evaluated the utility of SML to understand patients’ cognizance and expectations pertaining to the management of hypertriglyceridemia. OBJECTIVE The aim of this study was to utilize SML to explore the disease cognition level of patients with hypertriglyceridemia, choice of intervention measures, and the status quo of online consultations and question-and-answer (Q&A) search platforms. METHODS An infosurveillance study was conducted wherein a disease-specific comprehensive search was performed between 2004 and 2020 in Q&A search and online consultation platforms. Predefined single and combined keywords related to hypertriglyceridemia were used in the search, including disease, symptoms, diagnosis, and treatment indicators; lifestyle interventions; and therapeutic agents. The search output was aggregated using an aggregator tool and evaluated. RESULTS Disease-specific consultation data (n=69,845) and corresponding response data (n=111,763) were analyzed from 20 data sources (6 Q&A search platforms and 14 online consultation platforms). Doctors from inland areas had relatively high voice volumes and appear to exert a substantial influence on these platforms. Patients with hypertriglyceridemia engaging on the internet have an average level of cognition about the disease and its intervention measures. However, a strong demand for the concept of the disease and “how to treat it” was observed. More emphasis on the persistence of the disease and the safety of medications was observed. Young patients have a lower willingness for drug interventions, whereas patients with severe hypertriglyceridemia have a clearer intention to use drug intervention and few patients have a strong willingness for the use of traditional Chinese medicine. CONCLUSIONS Findings from this disease-specific SML study revealed that patients with hypertriglyceridemia in China actively seek information from both online Q&A search and consultation platforms. However, the integrity of internet doctors’ suggestions on lifestyle interventions and the accuracy of drug intervention recommendations still need to be improved. Further, a combined prospective qualitative study with SML is required for added rigor and confirmation of the relevance of the findings.