We aimed to investigate whether the prognostic nutritional index (PNI), a combined nutritional-inflammatory score based on serum albumin levels and lymphocyte count, was associated with mortality in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). From September 2011 to November 2014, 309 consecutive patients with STEMI undergoing pPCI were prospectively enrolled. Patients with a combined score of albumin (g/L) + 5 × total lymphocyte count × 10⁹/L ≥ 45 or <45 were assigned a PNI score of 0 or 1, respectively. Of the 309 STEMI patients, 24 (7.74%) died in the hospital, and 15 (4.83%) died during long-term follow-up (median follow-up time, 19.5 [3–36] months). Compared to patients with a PNI of 0, patients with a PNI of 1 had significantly higher in-hospital (14.2% vs. 3.7%; P < 0.001) and long-term follow-up (21.7% vs. 6.9%, P < 0.001) mortality rates. PNI (1/0, HR, 2.414; 95% CI, 1.016 to 5.736; P = 0.046) was a significant independent predictor of mortality in patients with STEMI undergoing pPCI. Moreover, cumulative survival was significantly lower for patients with a PNI of 1 compared to patients with a PNI of 0 (78.3% vs. 93.1%, log-rank P < 0.001). PNI appears useful for the risk stratification of STEMI patients undergoing pPCI.

Background: The long‐term association between the status of the false lumen and poor patient outcomes in acute aortic dissection ( AAD ) remains unclear. This systematic review and meta‐analysis investigated whether the status of the false lumen was a predictor of poor long‐term survival in AAD . Methods and Results: Eleven cohort studies (2924 participants) exploring the association between the false lumen status and long‐term outcomes (>1 year) in AAD were included. All studies reported multivariate‐adjusted hazard ratios ( HR s) with 95% CI s for long‐term outcomes, according to false lumen status. Pooled HR s for mortality and aortic events were computed and weighted using generic inverse‐variance and random‐effect modeling. Residual patent false lumen was an independent predictor of long‐term mortality in AAD type A ( HR , 1.71; 95% CI , 1.16–2.52; P =0.007) and type B ( HR , 2.79; 95% CI , 1.80–4.32; P <0.001). AAD patients with residual patent false lumen exhibited an increased risk of aortic events ( HR , 5.43; 95% CI , 2.95–9.99; P <0.001). Partial false lumen thrombosis was independently associated with long‐term mortality in type B AAD ( HR , 2.24; 95% CI , 1.37–3.65; P =0.001). This association was not observed in AAD type A patients ( HR , 1.75; 95% CI , 0.88–3.45; P =0.211). Conclusions: The false lumen status influences late outcomes in AAD . Residual patent false lumen is independently associated with poor long‐term survival in AAD . However, only type B AAD patients with partial false lumen thrombosis had an increased late mortality risk.

Background. Acupuncture is frequently advocated as an adjunct treatment for essential hypertension. The aim of this review was to assess its adjunct effectiveness in treating hypertension. Methods. We searched PubMed, the Cochrane Library, EMBASE, and the Chinese databases Sino‐Med, CNKI, WanFang, and VIP through November, 2012, for eligible randomized controlled trials that compared acupuncture with sham acupuncture. Outcome measures were changes in diastolic (DBP) and systolic blood pressure (SBP). Results. A total of 4 randomized controlled trials were included. We found no evidence of an improvement with the fact that acupuncture relative to sham acupuncture in SBP change (n = 386; mean difference = −3.80 mmHg, 95% CI = −10.03–2.44 mmHg; I² = 99%), and an insignificant improvement in DBP change (n = 386; mean difference = −2.82 mmHg, 95% CI = −5.22–(−0.43) mmHg; I² = 97%). In subgroup analyses, acupuncture significantly improved both SBP and DBP in patients taking antihypertensive medications. Only minor acupuncture‐related adverse events were reported. Conclusions. Our results are consistent with acupuncture significantly lowers blood pressure in patients taking antihypertensive medications. We did not find that acupuncture without antihypertensive medications significantly improves blood pressure in those hypertensive patients.

A series of novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since the end of 2019 is ongoing and triggering a global public health crisis. The estimated case fatality rate is approximately 3.4% in China. However, some patients experience dyspnea within 1 week and develop rapidly to organ injury and even death within 2 weeks after dyspnea. 1 In addition, early organ injury could lead to higher risks of mortality. Thus, early identification of patients at risk of organ injury and death is crucial, which saves the patients from classified and invasive treatment, improving clinical outcome and prognosis. The human immune system plays significant roles in the resistance of foreign pathogens and the progress of pneumonia. Recent studies have mentioned that T cells were decreased in COVID-19 patients, excessive activated immune response was caused by pathogenic Th1 cells, and inflammatory CD14 + CD16 + monocytes may connect to pulmonary immunopathology, leading to deleterious clinical manifestations and even acute mortality after SARS-CoV-2 infections. 2 SARS-CoV-2 might damage lymphocytes, especially T lymphocytes, and the immune system was impaired during the period of disease to cause tissue injury. 2,3 Therefore, immune dysfunction is very likely to be a risk factor for patients with COVID-19, and immunological profiling may assist in the prediction of organ injury and prognosis in COVID-19 patients. However, few studies have systematically reported immunological characteristics and their relationship with organ injury and mortality in patients with COVID-19. In this multicenter retrospective cohort study, we analyzed data from the Early Risk Stratification of Novel Coronavirus Pneumonia (ERS-COVID-19) study. The study was registered at www.chictr.org.cn (Identifier: ChiCTR2000030494). The study complied with the Declaration of Helsinki, and the Human Ethical Committee of West China Hospital of Sichuan University approved the study protocol. From January 31, 2020 to February 18, 2020, 509 patients retrospectively enrolled in the ERS-COVID-19 study. The COVID-19 was confirmed according to the National Health Commission of the People's Republic of China and the National Administration of Traditional Chinese Medicine. 4 The inclusion criteria were age >18 years old and first diagnosis of COVID-19. The exclusion criteria were examination without immune-related indicators before treatment, pregnancy, taking immunosuppressive drugs or corticosteroids, a history of chronic organ dysfunction or immunological disease, operation history within 3 months, and simultaneous infection with other diseases. Finally, a total of 163