Variations in Post-Operative Electrolyte in Coronary Artery Intervention.

Background: Low volume change and minimal trauma observed during angiography are the reason why physicians often overlook any changes affecting pre-operative electrolytes levels after coronary intervention. However, few studies have addressed the issue of electrolyte changes after the coronary intervention. Therefore, our study investigates coronary angiography's effect on electrolytes and provides the quick identification of groups more prone to electrolyte changes. Methods: From the department of cardiology of the second affiliated hospital of Shandong's first medical university, 374 patients undergoing coronary angiography were selected. Pre-intervention and post-intervention serums, sodium (Na+), potassium (K+), chloride (Cl-), magnesium (Mg2+) and renal function were analyzed. The correlation between influential factors was also assessed. The association of hypokalemia with short-major adverse cardiac events (MACE) and arrhythmia was evaluated. Results: Among the 374 subjects including 264 patients who had a simple angiography and 110 patients who received coronary artery interventional therapy. A decrease in potassium levels was found in 81.8% of the patients, and post-interventional hypokalemia was observed in 15.0%. After the intervention, the hypokalemia among males was 2.18 times than that of females, and the pre-operative serum potassium level was 3.5mmol/L≤K+<4.0mmol/L and was 2.09 times than that of K+≥4.0 mmol/L, but was not associated with age and either simple coronary angiography or PCI (percutaneous coronary intervention). Hypernatremia was also prevalent in males under 60 years and with pre-operative hypernatremia. Significant variations were found between hypokalemia and influential factors like hypertension, diabetes, and gastrointestinal disease. We also found that there was no obvious correlation between hypokalemia and recurrent angina, heart failure and death, but significantly increased the risk of some arrhythmias. Conclusion: Male patients are more likely to suffer from electrolyte disturbance after coronary intervention. There is a need to emphasize monitoring and managing electrolyte changes to prevent severe complications in the peri-operative period.

Impact of clogging on accumulation and stability of phosphorus in the subsurface flow constructed wetland.

Substrate clogging is one of the major operation challenges of subsurface flow constructed wetlands (SSF-CWs). And the phosphorus (P) removal performance and stability of P accumulation of SSF-CWs would be varied with the development of substrate clogging. In this study, three horizontal SSF-CWs microcosms with different clogging degrees were conducted to explore the mechanism of P accumulation behavior influenced by substrate clogging. Increase in clogging degree resulted in hydraulic retention time (HRT) diminution and adsorption sites increase, which jointly led to reduced P removal efficiency at low clogging degree (L-CW), however, higher P removal efficiency was obtained as adsorption sites increase offset HRT diminution at high clogging degree (H-CW). Substrate adsorption was the primary removal pathway in all SSF-CW systems. It accounted for 77.86 ± 2.63% of the P input in the H-CW, significantly higher than the control (60.08 ± 4.79%). This was attributed to a higher proportion of Fe/Al-P accumulated on the substrate of H-CW, since clogging aggravated the anaerobic condition and promoted the generation of Fe ions. The increase in clogging degree also elevated the release risk of the accrued P in SSF-CWs, since Fe/Al-P was considered bioavailable and readily released under environmental disturbance. The obtained results provide new insights into the P transport and transformation in SSF-CWs and would be helpful to optimize substrate clogging management.

Multi-Objective Optimisation in Multi-QoS Routing Strategy for Software-Defined Satellite Network.

The satellite network plays an increasingly important role in the global communication. With the development of communication technology, quality of service requirements have become more and more complex and diverse and the quality of service routing strategy of software-defined satellite network has become a more and more hot and difficult issue. In this paper, an interval-type-2 fuzzy set routing algorithm is proposed. Firstly, the multi- quality of service routing problem in software-defined satellite network is modeled. Then, the interval-type-2 fuzzy set routing algorithm is proposed to make fuzzy decisions. A series of experiments conducted in Network Simulator (Version 2.35) have proved that the proposed interval type-2 fuzzy set routing algorithm can reduce average delay, increase total throughput and reduce packet drop rate.

Identification of potentially relevant genes for myocardial infarction using RNA sequencing data analysis.

Myocardial infarction (MI) is a heart disease with high morbidity and mortality rates, thus it is critical to identify genes that serve roles during its pathogenesis. The objective of the present study was to identify potentially relevant genes during the progression of the disease. Blood samples from patients with MI and normal controls (n=3/group) were obtained, the RNA was extracted and cDNA libraries were established. RNA sequencing (RNA-seq) was performed on a HiSeq 2500 platform and fragments per kilobase of exon per million fragments mapped was utilized to calculate the gene expression value following preprocessing of the RNA-seq data. Electronic validation of several identified differentially expressed genes (DEGs) was performed on a Gene Expression Omnibus (GEO) dataset GSE59867 (390 cases and 46 healthy controls). Functional enrichment and protein-protein interaction network analysis was conducted for DEGs. A total of 977 DEGs, including 817 upregulated and 160 downregulated genes were identified in patients with MI. These DEGs were significantly enriched for 'positive regulation of the immune system process,' 'inflammatory response,' 'regulation of I-kappaB-kinase/NF-kappaB signaling' and 'TNF signaling pathway'. A protein-protein interaction network of the top 40 DEGs was used to identify high degree genes, including interferon induced protein with tetratricopeptide repeats 3 (IFIT3), MX dynamin like GTPase 1 (MX1), major histocompatibility complex, class II, DQ α1 (HLA-DQA1), RAR related orphan receptor A (RORA), prostaglandin D2 synthase (PTGDS), cysteine rich protein 2 (CRIP2), collagen type VI α 2 chain (COL6A2) and S100 calcium binding protein P (S100P). The results of validation in the GEO dataset were consistent with the sequencing analysis. A total of eight genes, including IFIT3, MX1, HLA-DQA1, RORA, PTGDS, CRIP2, COL6A2 and S100P may therefore be considered as potentially relevant genes in the pathology of MI.

Predictive value of left ventricular remodeling by area strain based on three-dimensional wall-motion tracking after PCI in patients with recent NSTEMI.

We aimed to explore whether a novel left ventricular performance index, area strain (AS), based on three-dimensional wall-motion tracking (3-D-WMT) done before and after percutaneous coronary intervention (PCI) could predict left ventricular (LV) remodeling in patients with recent non-ST elevation myocardial infarction (NSTEMI). Sixty-one patients (53.6 ± 8.8 years) with recent NSTEMI were enrolled. Coronary angiography and PCI were undertaken for reperfusion. Parameters of myocardial deformation (including LV end-diastolic volume, LV end-systolic volume, LV ejection fraction, LV global and regional peak area strain) were measured by 3-D-WMT before and 1 week after reperfusion therapy. Six months after reperfusion, LV negative remodeling was defined as lack of improvement in LV function, with increase in LV end-diastolic volume ≥15%. Patients were subdivided into remodeled group (n = 25) and non-remodeled group (n = 36) at follow-up. Patients with negative LV remodeling had significantly higher cardiac troponin I (cTnI) levels at baseline (21.21 ± 12.22 vs. 15.56 ± 8.91 ng/mL; p = 0.0357), higher B-type natriuretic peptide (BNP) level (247.56 ± 177.39 vs. 170.53 ± 97.89 pg/mL; p = 0.0336) and reduced global AS (-27.9 ± 4.6% vs. -31.9 ± 4.3%; p = 0.001) than those without remodeling. Global AS at baseline had a significantly close correlation with cTnI level 36 h after MI (r = 0.71, p < 0.001). Moreover, a weak relationship was found between LV global AS at baseline and BNP level 24 h after myocardial infarction (r = 0.423, p < 0.001). By multivariate logistic regression analysis, lack of improvement of global AS 1 week after PCI was found to be a powerful independent predictor of negative LV remodeling at follow-up (OR = 1.41, 95% CI 1.28-3.27, p = 0.003). In particular, a global AS ≤32% (absolute value) showed a sensitivity and a specificity of 86.1% and 68.0% in predicting negative LV remodeling. These data suggest that AS could be used to assess myocardial global and regional LV function with good feasibility and repeatability. Global AS 1 week after PCI is a good independent predictor of negative LV remodeling after 6-month follow-up.