Early vascular healing after neXt-generation drug-eluting stent implantation in Patients with non-ST Elevation acute Coronary syndrome based on optical coherence Tomography guidance and evaluation (EXPECT): study protocol for a randomized controlled trial.

Background: There is limited evidence about vessel wall healing response following implantation of next-generation drug-eluting stents (DES) in patients admitted with a non-ST elevation acute coronary syndrome (NSTE-ACS). Cumulative data indicate that optical coherence tomography (OCT) imaging can optimize percutaneous coronary intervention results and expedite stent endothelialization in the general population but there is lack of data in NSTE-ACS patients. Methods: The EXPECT study is an investigator-initiated, prospective, randomized trial to assess early vascular healing response following next-generation DES implantation in patients admitted with NSTE-ACS based on OCT guidance and evaluation. Sixty patients are randomized at 1:1:1 ratio to OCT-guided percutaneous coronary intervention (PCI) with 3-month follow-up OCT imaging (O3 group, n = 20), to angiography-guided PCI with 3-month follow-up OCT imaging (A3 group, n = 20) and to angiography-guided PCI with 6-month follow-up OCT imaging (A6 group, n = 20). The primary endpoint of the study is stent strut coverage rate at 3- or 6- month follow-up in the studied groups. The secondary endpoints of the study include OCT imaging endpoints, clinical endpoints, and molecular biology endpoints at the different time points. The clinical endpoints comprised of major cardiovascular adverse events and individual components. The molecular biology endpoints comprised of lipid levels and the levels of inflammatory indicators. Discussion: The findings of the EXPECT study are anticipated to provide novel insights into vessel wall healing in NSTE-ACS population following implantation of next-generation DES, underscore the value of OCT imaging in expediting strut coverage in this setting, and explore the potential of an early discontinuation of dual antiplatelet therapy (DAPT) in this population. Clinical Trial Registration: ClinicalTrials.gov, NCT04375319.

Portable Comestible-Liquid Quality Test Enabled by Stretchable and Reusable Ion-Detection Photonic Papers.

Currently, there have been widespread investigation conducted into responsive photonic crystal hydrogels (RPCHs) characterized by high selectivity and sensitivity for colorimetric indicators and physical/chemical sensors. In spite of this, it remains challenging to use RPCHs for sensing due to their limited mechanical property and molding capability. In the present study, a double-network structure is proposed to design highly stretchable, sensitive, and reusable ion-detection photonic papers (IDPPs) for assessing the quality of visual and portable comestible liquids (e.g., soy sauce). It is constructed by integrating polyacrylamide and poly-methacryloxyethyl trimethyl ammonium chloride with highly ordered polystyrene microspheres. The double-network structure improves the mechanical properties of IDPPs with their elongation at break increasing from 110 to 1600%. Meanwhile, the optical properties of photonic crystals are retained. The IDPPs achieve a fast ion response by applying control on the swelling behavior of the hydration radius of the counter ions through ion exchange. Given a certain concentration range (0.01-0.10 M), chloride ions can be detected fast (3-30 s) by exchanging ions with a small hydration radius through an IDPP, which is clearly observable. Due to the improvement of mechanical properties and the reversible exchange of ions derived from IDPPs, their reusability is significantly enhanced (>30 times). Characterized by a simple operation, high durability, and excellent sustainability, these IDPPs are promising for practical application in food security and human health assessment.

Clinical outcomes of percutaneous coronary intervention for de novo lesions in small coronary arteries: A systematic review and network meta-analysis.

Background: Percutaneous coronary intervention (PCI) has a well-established role in revascularization for coronary artery disease. We performed network meta-analysis to provide evidence on optimal intervention strategies for de novo lesions in small coronary arteries. Materials and methods: Enrolled studies were randomized clinical trials that compared different intervention strategies [balloon angioplasty (BA), biolimus-coated balloon (BCB), bare-metal stent (BMS), new-generation drug-eluting stent (New-DES), older generation sirolimus-eluting stent (Old-SES), paclitaxel-coated balloon (PCB), and paclitaxel-eluting stent (PES)] for de novo lesions in small coronary arteries. The primary outcome was major adverse cardiac events (MACE). Results: A total of 23 randomized clinical trials comparing seven intervention devices were analyzed. In terms of the primary outcome, New-DES was the intervention device with the best efficacy [surface under the cumulative ranking curve (SUCRA), 89.1%; mean rank, 1.7], and the Old-SES [risk ratio (RR), 1.09; 95% confidence interval (CI), 0.45-2.64] and PCB (RR, 1.40; 95% CI, 0.72-2.74) secondary to New-DES, but there was no statistically significant difference between these three intervention devices. All DES and PCB were superior to BMS and BA for MACE in both primary and sensitivity analysis. For secondary outcomes, there was no association between all-cause mortality and myocardial infarction (MI) with any intervention strategy, and additionally, the findings of target lesion revascularization (TLR) were similar to the primary outcomes. Conclusion: Paclitaxel-coated balloon yielded similar outcomes to New-DES for de novo lesions in small coronary arteries. Therefore, this network meta-analysis may provide potential support for PCB as a feasible, effective, and safe alternative intervention strategy for the revascularization of small coronary arteries. Systematic review registration: [https://www.crd.york.ac.uk/PROSPERO/#recordDetails], identifier [CRD42022338433].

Comparative analysis of instantaneous wave-free ratio and quantitative real-time myocardial contrast echocardiography for the assessment of myocardial perfusion.

Background and hypothesis: The field of coronary artery physiology is developing rapidly and changing the practice of interventional cardiology. A new functional evaluation technique using the instantaneous wave-free ratio (iFR) has become an alternative to fractional flow reserve. Future research studies need to determine whether physiological indicators play a role in evaluating myocardial perfusion in the catheter room. Materials and methods: Thirty-eight patients scheduled for coronary angiography and iFR evaluation underwent a real-time myocardial contrast echocardiography (RT-MCE) examination at rest. The myocardial perfusion parameters (A, ß, and A × ß) on the myocardial perfusion curve were quantitatively analyzed using Q-Lab software. Coronary angiography and iFR assessment were completed within 1 week after the RT-MCE examination in all patients. Correlation analysis was used to identify iFR- and MCE-related indicators. The sensitivity and specificity of iFR in the quantitative detection of coronary microcirculation were obtained. Results: The correlation coefficients between iFR and A, ß, and A × ß were 0.81, 0.66, and 0.82, respectively. The cut-off value for iFR was 0.85 for microvascular ischemia detection, while the sensitivity and specificity for the diagnosis of myocardial perfusion were 90.7 and 89.9%, respectively. The receiver operating characteristic (ROC) curve area for iFR was 0.946 in the segments related to myocardial blood flow. Conclusion: The iFR is an effective tool for detecting myocardial microcirculation perfusion, with satisfactory diagnostic performance and a demonstrated role in physiological indices used for the perfusion assessment.

Long-Term Clinical Outcomes After Percutaneous Coronary Intervention With Drug-Coated Balloon-Only Strategy in de novo Lesions of Large Coronary Arteries.

Background and Objectives: Use of drug-coated balloon (DCB)-only strategy for revascularization of native large coronary artery lesions is on the rise. The long-term efficacy of this approach for bifurcation and non-bifurcation lesions remains unknown. We aim to assess the long-term clinical outcomes of DCB-only strategy for the treatment of de novo bifurcation and non-bifurcation lesions in large coronary arteries. Methods: This multicenter, prospective, observational study enrolled 119 patients with de novo coronary lesions in vessels ≥2.75 mm. The primary end point was the rate of clinically driven target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization (TLR). Patients were followed up for a median of 2 years. Results: Of 119 patients with 138 lesions, 66 patients (75 lesions) had bifurcation and 53 patients (63 lesions) had non-bifurcation lesions. Average reference vessel diameter was 3.1 ± 0.3 mm, and there was no difference in bifurcation and non-bifurcation group (3.0 ± 0.3 vs. 3.1 ± 0.3mm; p = 0.27). At 2-year follow-up, the TLF occurred in five (4.2%), TLR in four (3.4%), and target vessel revascularization (TVR) in five (4.2%) cases. The frequency of TLR and TVR was higher in the non-bifurcation group (p = 0.04 and 0.02, respectively), but there were no differences in TLF between the two groups (p = 0.17). The cumulative incidence of TLF (Kaplan-Meier estimates) was also not different in the two groups (log-rank p = 0.11). Conclusion: DCB-only strategy for de novo lesions in large coronary arteries appears to be safe and effective for both bifurcation and non-bifurcation lesions. Further randomized clinical trials are warranted to confirm the value of DCB-only strategy in de novo bifurcation lesions of large vessels.

DCB combined with provisional DES implantation in the treatment of De Novo Medina 0,1,0 or 0,0,1 left main coronary bifurcation lesions: A proof-of-concept study.

OBJECTIVE: To investigate the safety and efficacy of a percutaneous revascularization strategy that is based on the use of drug-coated balloon for the treatment of patients with acute coronary syndrome and de novo Medina type 0,1,0 or 0,0,1 left main stem bifurcation lesions. METHODS: In this multicenter, prospective, proof-of-concept study, patients fulfilling the above criteria were enrolled and received treatment with drug-coated balloon combined with provisional drug-eluting stent implantation in the proximal major branches of the left main stem. Patients who declined this revascularization approach were treated with drug-eluting stent implantation 1-2 mm distally to the left anterior descending or left circumflex artery ostium followed by drug-coated balloon therapy for the ostial disease. The primary endpoint of the study was the calculation of percent diameter stenosis on quantitative coronary angiography post-procedure as well as event rate at 8 months follow-up. RESULTS: A total of 30 patients were enrolled in the study; their mean age was 60.3 ± 7.8 years, while 22 (73.3%) were male. Twenty-two patients were treated only with drugcoated balloon and provisional drug-eluting stent implantation and 8 had drug-eluting stent implantation followed by drug-coated balloon therapy of the ostium of the left main stem major branch. All the procedures were successful with no immediate complications. The percent diameter stenosis of lesion decreased significantly post-procedure from 87.5% (80.0-90.0) to 20% (17.5-30.0), P <.001. During the follow-up period, no major adverse cardiac events were reported. CONCLUSIONS: This proof-of-concept study indicates that ostial drug-coated balloon therapy of the left main stem major branches is safe and effective. Larger clinical data and longer follow-up are needed before advocating its regular use in clinical practice.

CT, MRI, and PET imaging features in cervical cancer staging and lymph node metastasis.

OBJECTIVE: To assess the computerized tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) fusion imaging technique features in cervical cancer staging and lymph node metastasis. METHODS: A total of 196 cervical cancer patients undergoing CT, MRI, PET/CT, and PET/MRI preoperatively were enrolled. The diagnostic accuracy and detection rates for paracervical invasion were evaluated on the basis of the International Federation of Gynecology and Obstetrics (FIGO) staging classification for cervical cancer. The diagnostic efficacy of each examination modality for determining lymph node metastasis was evaluated using surgical pathology as a reference. The CT and MRI imaging features of lymph node metastasis were compared. RESULTS: PET/MRI had a higher diagnostic accuracy for cervical cancer (94.90%) than PET/CT, MRI, and CT (83.67%, 75.51%, and 69.39%) (P < 0.05). PET/MRI showed a higher detection rate of vaginal invasion, uterine invasion, bladder invasion, and cervical invasion than PET/CT, MRI, and CT (P < 0.05). The metastasis group showed higher maximum long and short axis diameters and axial ratios than the non-metastasis group (P < 0.05). The metastasis group had higher wash-in rates (WIR), maximum relative enhancements (MRE), wash-out ratios (WOR), and apparent diffusion coefficients (ADC), and lower times to peak (TTP) than the non-metastasis group (P < 0.05). The sensitivity (94.74%), specificity (93.33%), and accuracy (93.88%) of PET/MRI in the diagnosis of cervical cancer lymph node metastasis were higher than the sensitivity, specificity, and accuracy of PET/CT, MRI and CT (P < 0.05). CONCLUSION: CT, MRI, PET/CT and PET/MRI can be used effectively in the diagnosis of cervical cancer staging and lymph node metastasis, among which PET/MRI has a higher diagnostic sensitivity, specificity, and accuracy and is helpful in clinical diagnosis and treatment.

Copper nanoparticles induce the formation of fatty liver in Takifugu fasciatus triggered by the PERK-EIF2α- SREBP-1c pathway.

Copper nanoparticles (CuNPs), a new pollutant in water environments, were widely used in various industrial and commercial applications. This study indicated that the presence of CuNPs exposure under environmental related concentration is an inducing factor that contributes to the fatty liver formation in Takifugu fasciatus. Furthermore, we explored the fatty liver formation mechanism. The results shown, (1) the cloned genes related to endoplasmic reticulum stress (ERS) (GRP78, IRE-1α, PERK, and ATF-6α) were highly expressed in the liver of T. fasciatus. (2) after 30-days exposure, CuNPs accumulated in the endoplasmic reticulum of liver and induced the appearance of ERS, then activated unfolded protein response (UPR) signaling pathway. Furthermore, the SREBP-1c pathway that plays a key role in lipid synthesis was activated. (3) by using 4-PBA and GSK inhibitors to respectively stimulate ERS and PKR-like ER kinase (PERK) through in vitro experiments, we confirmed that CuNPs induced the fatty liver formation in T. fasciatus triggered by the PERK-EIF2α pathway by activating the SREBP-1c pathway to promote fatty liver formation. This study provides a new perspective for identifying the pathogens of fatty liver formation, and adds to the knowledge of the ecological safety data service of CuNPs in water.

Transcriptomic analysis reveals different responses to ammonia stress and subsequent recovery between Coilia nasus larvae and juveniles.

Excessive ammonia triggered negative effects on aquatic animals' health, growth, and mass death, especially at different developmental periods. However, the underlying responses to ammonia stress in fish larvae and juveniles were much less explored. Transcriptomic analysis of Coilia nasus larvae and juveniles treated with ammonia stress and subsequent recovery in freshwater were performed. Total 958,213,132 clean reads were obtained. A total of 234,830 unigenes with an average length of 1397 bp and N50 value 2521 bp were assembled. 831 and 952 DEGs were identified in C. nasus larvae and juveniles, respectively. Transcriptomic analysis revealed that genes associated with purine metabolism, immune, inflammation, epigenetic modification, and nerve conduction presented different expression trends between C. nasus larvae and juveniles. Other genes related to purine metabolism (XDH) and epigenetic modifications (DNMT1, DNMT3A, and DNMT3B) detected by RT-qPCR also displayed different expression trends. These results indicated that ammonia detoxify strategies and gene regulation patterns were different in C. nasus larvae and juveniles. Higher TNF-α, ILF-2, and ILF-3 expression and reduced LZM, AKP, and ACP activities suggested that inflammation and declined immunity were triggered by ammonia stress. Additionally, nervous conduction was severely affected under ammonia stress in C. nasus juveniles. Furthermore, recovery in freshwater had positive effects on nervous conduction. However, it was worth noting that reduced immunity and inflammation were still existed after recovery in freshwater. In conclusion, our study would be beneficial to reveal the different responses to ammonia stress between larvae and juveniles.

The complete mitochondrial genome of the hybrid of Takifugu obscurus (♀) × Takifugu rubripes (♂).

The complete mitochondrial genome of the hybrid of Takifugu obscurus (♀) × Takifugu rubripes (♂) was sequenced and characterized in this study. The hybrid mitochondrial DNA, with a total length of 16,443 bp, contain 37 genes, including 13 protein-coding genes, 22 tRNAs genes, and 2 rRNA gene. There are two noncoding regions: the origin of light-strand replication (OL) and control region (D-loop). The complete mitochondrial genome of the hybrid of T. obscurus (♀) × T. rubripes (♂) provides data for studies on genetic diversity and species identification among Takifugu.

Comparison of new-generation drug-eluting stents versus drug-coated balloon for in-stent restenosis: a meta-analysis of randomised controlled trials.

OBJECTIVE: The study sought to compare angiographic and clinical outcomes of new-generation drug-eluting stents (DES) versus drug-coated balloon (DCB) in patients with coronary in-stent restenosis (ISR). DESIGN: Meta-analysis using data from randomised trial found by searches on PubMed, the Cochrane Library, ClinicalTrials.gov and websites of major cardiovascular congresses. SETTING: Only randomised trials comparing DES with DCB were included. PARTICIPANTS: Patients with ISR in the included trials. INTERVENTIONS: New-generation DES versus DCB. OUTCOMES: The angiographic and clinical outcomes including cardiac death, all-cause death, myocardial infarction, target lesion revascularisation (TLR), target vessel revascularisation (TVR), major adverse cardiac events (MACE) and stent thrombosis were investigated. RESULTS: Five trials including 913 patients were eligible and included. Pooled analysis in angiographic results identified that new-generation DES were associated with higher acute luminal gain (-0.31 mm, 95% CI -0.42 to -0.20, P<0.001) and lower per cent diameter stenosis (risk ratio (RR): 0.28, 95% CI 0.02 to 0.55, P=0.04). DES significantly reduced the risk of TLR (RR: 1.96, 95% CI 1.17 to 3.28, P=0.01) compared with DCB; however, there was no statistical differences for MACE (RR: 1.21, 95% CI 0.67 to 2.17, P=0.53), myocardial infarction (RR: 1.16, 95% CI 0.55 to 2.48, P=0.69) and cardiac death (RR: 1.80, 95% CI 0.60 to 5.39, P=0.29). CONCLUSIONS: Interventions with new-generation DES appear to be associated with significant reduction in per cent diameter stenosis and TLR at short-term follow-up, but had similar MACE, myocardial infarction and cardiac death for patients with coronary ISR compared with DCB. Appropriately powered studies with longer term follow-up are warranted to confirm these findings.

Fluorescence Enhancement on Large Area Self-Assembled Plasmonic-3D Photonic Crystals.

Discontinuous plasmonic-3D photonic crystal hybrid structures are fabricated in order to evaluate the coupling effect of surface plasmon resonance and the photonic stop band. The nanostructures are prepared by silver sputtering deposition on top of hydrophobic 3D photonic crystals. The localized surface plasmon resonance of the nanostructure has a symbiotic relationship with the 3D photonic stop band, leading to highly tunable characteristics. Fluorescence enhancements of conjugated polymer and quantum dot based on these hybrid structures are studied. The maximum fluorescence enhancement for the conjugated polymer of poly(5-methoxy-2-(3-sulfopropoxy)-1,4-phenylenevinylene) potassium salt by a factor of 87 is achieved as compared with that on a glass substrate due to the enhanced near-field from the discontinuous plasmonic structures, strong scattering effects from rough metal surface with photonic stop band, and accelerated decay rates from metal-coupled excited state of the fluorophore. It is demonstrated that the enhancement induced by the hybrid structures has a larger effective distance (optimum thickness ≈130 nm) than conventional plasmonic systems. It is expected that this approach has tremendous potential in the field of sensors, fluorescence-imaging, and optoelectronic applications.

Optical coherence tomography assessment of a complex bifurcation lesion treated with double kissing Crush technique: A case report.

The DEFINITION (Impact of the complexity of bifurcation lesions treated with drug-eluting stents) study has provided a novel classification to evaluate the complexity of coronary bifurcation lesion according to coronary angiography, but angiographic imaging due to its low resolution and inherited limitation may result in an inaccurate adjudication.We used optical coherence tomography (OCT) to further evaluate the coronary characteristics in a patient with "simple" bifurcation lesion which was classified by the DEFINITION criteria. However, a "complex" bifurcation lesion was defined and confirmed according to the OCT results.A double kissing Crush stenting approach was adopted to treat this "complex" case finally. The immediate and long-term angiographic and OCT results were excellent.OCT may be useful imaging modality to classify complexity of coronary bifurcation lesion and subsequently guide its treatment strategy.

Hydrophilic Conjugated Polymers with Large Bandgaps and Deep-Lying HOMO Levels as an Efficient Cathode Interlayer in Inverted Polymer Solar Cells.

Two hydrophilic conjugated polymers, PmP-NOH and PmP36F-NOH, with polar diethanol-amine on the side chains and main chain structures of poly(meta-phenylene) and poly(meta-phenylene-alt-3,6-fluorene), respectively, are successfully synthesized. The films of PmP-NOH and PmP36F-NOH show absorption edges at 340 and 343 nm, respectively. The calculated optical bandgaps of the two polymers are 3.65 and 3.62 eV, respectively, the largest ones so far reported for hydrophilic conjugated polymers. PmP-NOH and PmP36F-NOH also possess deep-lying highest occupied molecular orbital levels of -6.19 and -6.15 eV, respectively. Inserting PmP-NOH and PmP36F-NOH as a cathode interlayer in inverted polymer solar cells with a PTB7/PC71 BM blend as the active layer, high power conversion efficiencies of 8.58% and 8.33%, respectively, are achieved, demonstrating that the two hydrophilic polymers are excellent interlayers for efficient inverted polymer solar cells.

Maytansine-loaded star-shaped folate-core PLA-TPGS nanoparticles enhancing anticancer activity.

The efficient delivery of therapeutic molecule agents into target cells of interest is a critical challenge to broad application of non-viral vector systems. In this research, maytansine-loaded star-shaped folate-core polylactide-D-α-tocopheryl polyethylene glycol 1000 succinate (FA-PLA-TPGS) block copolymer was applied to be a vector of maytansine for folate receptor positive (FR(+)) breast cancer therapy. The uptake of maytansine nanoparticles by SKBR3 cells were observed by fluorescence microscopy and confocal laser scanning microscopy. The cell viability of maytansine-NPs in SKBR3 cells was assessed according to the changed level of intracellular microtubules and apoptosis-associated proteins. The cytotoxicity of the SKBR3 cells was significantly increased by maytansine-NPs when compared with control groups. In conclusion, the maytansine-NPs offer a considerable potential formulation for FR-expressing tumor targeting biotherapy.

Dithienobenzothiadiazole-based conjugated polymer: processing solvent-relied interchain aggregation and device performances in field-effect transistors and polymer solar cells.

DTfBT-Th(3), a new conjugated polymer based on dithienobenzothiadiazole and terthiophene, possesses a bandgap of ≈1.86 eV and a HOMO level of -5.27 eV. Due to strong interchain aggregation, DTfBT-Th(3) can not be well dissolved in chloro-benzene (CB) and o-dichlorobenzene (DCB) at room temperature (RT), but the polymer can be processed from hot CB and DCB solutions of ≈100 °C. In CB, with a lower solvation ability, a certain polymer chain aggregation can be preserved, even in hot solution. DTfBT-Th(3) displays a field-effect hole mobility of 0.55 cm(2) V(-1) s(-1) when fabricated from hot CB solution, which is higher than that of the device processed from hot DCB (0.16 cm(2) V(-1) s(-1) In DTfBT-Th(3) -based polymer solar cells, a good power conversion efficiency from 5.37% to 6.67% can be achieved with 150-300 nm thick active layers casted from hot CB solution, while the highest efficiency for hot DCB-processed solar cells is only 5.07%. The results demonstrate that using a solvent with a lower solvation ability, as a "wet control" process, is beneficial to preserve strong interchain aggregation of a conjugated polymer during solution processing, showing great potential to improve its performances in optoelectronic devices.

Bistable memory devices with lower threshold voltage by extending the molecular alkyl-chain length.

Three organic small molecules with alkyl chains of different lengths based on an azobenzene scaffold were designed and synthesized. The indium-tin oxide (ITO)-Azo-Al sandwich memory devices showed write-once-read-many-times (WORM) characteristics. The switch threshold voltage of Azo-based memory devices significantly decreased as the end-capping alkyl chain extends, which is totally consistent with the AFM and X-ray diffraction results that the thin films showed smoother morphologies and closer intermolecular packing with the molecular alkyl-chain length prolonging. These results demonstrated that variation in the alkyl-chain length at the end of the conjugated molecules is a powerful strategy for tuning film microstructure and intermolecular packing to enable high performance of the fabricated sandwiched devices.