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BACKGROUND: Drug-eluting stent (DES) plus drug-coated balloon (DCB) is a safe and effective treatment strategy for coronary artery bifurcation lesions, but there is no report about this strategy being used for left main (LM) bifurcation lesions. We aim to explore the efficacy and safety of DES plus DCB in the treatment of LM bifurcation lesions. METHODS: A total of 100 patients diagnosed with LM bifurcation lesions by coronary angiography were retrospectively enrolled at our center from January 2018 to December 2019. They received either a two-stent strategy or a main branch (MB) stenting plus side branch (SB) DCB strategy and were accordingly divided into the 2-DES group and the DES + DCB group. Patients treated with DES + DCB were compared with a cohort of matched patients treated with a 2-DES strategy. Clinical data was collected and quantitative coronary analysis was performed. RESULTS: For immediate postoperative angiography, though the two groups had no differences in the minimal luminal diameter (MLD) and luminal stenosis of MB, the DES + DCB group had significantly lower SB ostial MLD and a higher degree of residual lumen stenosis than the 2-DES group (P < 0.05). At the time of follow-up, the SB ostial MLD of the DES + DCB group was higher than that of the 2-DES group, but lumen stenosis, late lumen loss (LLL), and LLL at the distal end of the left MB were all smaller than those of the 2-DES group (Ps < 0.05). Furthermore, the incidence of lumen restenosis and MACE between the two groups had no significance. CONCLUSION: The combination of DES and DCB is relatively safe and effective for the treatment of LM bifurcation lesions, and this strategy seems to have advantages in reducing LLL at the SB ostium.
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Angioplastia Coronaria con Balón , Stents Liberadores de Fármacos , Preparaciones Farmacéuticas , Stents Liberadores de Fármacos/efectos adversos , Humanos , Estudios Retrospectivos , StentsRESUMEN
The aerobic granular sludge simultaneous partial nitrification, denitrification and phosphorus removal (AGS-SPNDPR) process was carried out via tapered aeration in sequencing batch reactor (SBR) for treating low strength and low COD/TN ratio municipal wastewater. The results showed that aerobic granular sludge was successfully cultivated with good sedimentation performance when treating the municipal wastewater. Meanwhile, the median granule size increased to 270 (R1) and 257 (R2) µm on day 80. The excellent removal performance of COD (92%) and NH4+-N (95%) were achieved under different aeration modes, while the higher TN removal efficiency (76%) was achieved by tapered aeration. The accumulation of NO2--N in R2 indicated that the tapered aeration was beneficial to achieve simultaneously partial nitrification and denitrification. Meanwhile, the high-efficiency phosphorus (95%) removal was realized via additional carbon source, and SPNDPR process was formed under tapered aeration. The bacterial community analysis indicated denitrifying glycogen-accumulating organisms (DGAOs) Candidatus_Competibacter and ammonia-oxidizing bacteria (AOB) Nitrosomonas were more effectively enriched via tapered aeration, while phosphorus-accumulating organisms (PAOs) Candidatus_Accumulibacter were effectively enriched under additional organic carbon. AOB, denitrifying bacteria and PAOs were simultaneously enriched by tapered aeration and additional carbon source, which was beneficial to nutrients removal. This study might be conducive to the application of AGS-SPNDPR system for treating low strength and low COD/TN ratio municipal wastewater under tapered aeration.
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Nitrificación , Aguas del Alcantarillado , Reactores Biológicos/microbiología , Desnitrificación , Nitrógeno/análisis , Fósforo , Aguas del Alcantarillado/microbiología , Eliminación de Residuos Líquidos/métodos , Aguas ResidualesRESUMEN
BACKGROUND: Inflammation plays a key role in the initiation and progression of atrial fibrillation (AF). Lymphocyte-to-monocyte ratio (LMR) has been proved to be a reliable predictor of many inflammation-associated diseases, but little data are available on the relationship between LMR and AF. We aimed to evaluate the predictive value of LMR in predicting all-cause mortality among AF patients. METHODS: Data of patients diagnosed with AF were retrieved from the Medical Information Mart for Intensive Care-III (MIMIC-III) database. X-tile analysis was used to calculate the optimal cutoff value for LMR. The Cox regression model was used to assess the association of LMR and 28-day, 90-day, and 1-year mortality. Additionally, a propensity score matching (PSM) method was performed to minimize the impact of potential confounders. RESULTS: A total of 3567 patients hospitalized with AF were enrolled in this study. The X-tile software indicated that the optimal cutoff value of LMR was 2.67. A total of 1127 pairs were generated, and all the covariates were well balanced after PSM. The Cox proportional-hazards model showed that patients with the low LMR (≤2.67) had a higher 1-year all-cause mortality than those with the high LMR (>2.67) in the study cohort before PSM (HR = 1.640, 95% CI: 1.437-1.872, p < 0.001) and after PSM (HR = 1.279, 95% CI: 1.094-1.495, p = 0.002). The multivariable Cox regression analysis for 28-day and 90-day mortality yielded similar results. CONCLUSIONS: The lower LMR (≤2.67) was associated with a higher risk of 28-day, 90-day, and 1-year all-cause mortality, which might serve as an independent predictor in AF patients.
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Fibrilación Atrial/inmunología , Linfocitos , Monocitos , Puntaje de Propensión , Anciano , Anciano de 80 o más Años , Fibrilación Atrial/mortalidad , Femenino , Humanos , Recuento de Leucocitos , Masculino , Pronóstico , Modelos de Riesgos ProporcionalesRESUMEN
Seed germination is the process through which a quiescent organ reactivates its metabolism culminating with the resumption cell divisions. It is usually the growth of a plant contained within a seed and results in the formation of a seedling. Post-transcriptional regulation plays an important role in gene expression. In cells, post-transcriptional regulation is mediated by many factors, such as RNA-binding proteins, microRNAs, and the spliceosome. This review provides an overview of the relationship between seed germination and post-transcriptional regulation. It addresses the relationship between seed germination and RNA-binding proteins, microRNAs and alternative splicing. This presentation of the current state of the knowledge will promote new investigations into the relevance of the interactions between seed germination and post-transcriptional regulation in plants.
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Empalme Alternativo , Germinación/genética , MicroARNs/genética , Proteínas de Unión al ARN/genética , Semillas/crecimiento & desarrollo , MicroARNs/metabolismo , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , ARN de Planta/genética , ARN de Planta/metabolismo , Proteínas de Unión al ARN/metabolismoRESUMEN
ABSTRACT: Hydrogen sulfide (H2S), generally known as a new gas signal molecule after nitric oxide and carbon monoxide, has been found as an important endogenous gasotransmitter in the last few decades, and it plays a significant role in the cardiovascular system both pathologically and physiologically. In recent years, there is growing evidence that H2S provides myocardial protection against myocardial ischemia-reperfusion injury (MIRI), which resulted in an ongoing focus on the possible mechanisms of action accounting for the H2S cardioprotective effect. At present, lots of mechanisms of action have been verified through in vitro and in vivo models of I/R injury, such as S-sulfhydrated modification, antiapoptosis, effects on microRNA, bidirectional effect on autophagy, antioxidant stress, or interaction with NO and CO. With advances in understanding of the molecular pathogenesis of MIRI and pharmacology studies, the design, the development, and the pharmacological characterization of H2S donor drugs have made great important progress. This review summarizes the latest research progress on the role of H2S in MIRI, systematically explains the molecular mechanism of H2S affecting MIRI, and provides a new idea for the formulation of a myocardial protection strategy in the future.
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Sistema Cardiovascular/metabolismo , Gasotransmisores/metabolismo , Sulfuro de Hidrógeno/metabolismo , Daño por Reperfusión Miocárdica/metabolismo , Animales , Monóxido de Carbono/metabolismo , Sistema Cardiovascular/efectos de los fármacos , Sistema Cardiovascular/patología , Sistema Cardiovascular/fisiopatología , Muerte Celular , Gasotransmisores/uso terapéutico , Humanos , Sulfuro de Hidrógeno/uso terapéutico , Daño por Reperfusión Miocárdica/patología , Daño por Reperfusión Miocárdica/fisiopatología , Daño por Reperfusión Miocárdica/prevención & control , Miocardio/metabolismo , Miocardio/patología , Óxido Nítrico/metabolismo , Transducción de SeñalRESUMEN
Current studies indicate that long non-coding RNA (lncRNA) is often abnormally expressed in hepatocellular carcinoma (HCC). We intend to generate a multi-lncRNA signal to improve the prognosis of HCC. By analyzing 12 pairs of HCC and adjacent normal mucosal tissues, 3900 differentially expressed lncrnas were identified as candidate biomarkers for the prognosis of HCC. Then, the 12-lncrna signature was constructed using the LASSO Cox regression method and verified in the TCGA training dataset. Finally, we established a novel 12-lncrna signature that was significantly associated with overall survival (OS) in the training data set. With the use of 12-lncrna markers, patients in the training cohort were divided into high-risk and low-risk groups with significant OV differences (P < .0001). Similar results were consistent in the TCGA verification dataset (P = .046). Multivariate Cox model was used to analyze and construct the risk scores of selected key lncRNA and AJCC stages. The results showed that, compared with AJCC stages, lncRNA-based risk scores were another important factor affecting the OS of patients. We found that risk scores based on lncRNA have a stronger prediction ability than the AJCC stage alone on 4-year OS. For 4-year survival rates, prediction combined with the lncRNA risk score and AJCC stage, model effectiveness (sensitivity and specificity) has reached to 0.750. To further explore the biological processes involved in prognostic lncRNA, all HCC samples in TCGA are divided into two groups according to the median lncRNA risk score, and analyzed the gene enrichment of high expression genes and low expression genes in KEGG data using goana in limma. The results suggest that the genes associated with tumor pathways, such as PI3K-Akt and ECM-receptor interaction, are highly expressed in the high risk group.
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Rehmannia glutinosa Libosch, Achyranthes bidentata Bl. (A. bidentata), Dioscorea opposita Thunb, and Chrysanthemum morifolium Ramat (C. morifolium) are known as the 'Four Huaiqing Chinese Medicine' in China, which are used as materials for functional foods. In this paper, the constituents of Four Huaiqing Chinese Medicine were identified by UPLC-Q-TOF-MS/MS, and flavones and aromatic compounds are mainly responsible for these herbs. Moreover, C. morifolium exhibited the most significant effect in cobalt chloride-induced HUVECs injury, which could decrease cell apoptosis and the overproduction of ROS, lactic dehydrogenase (LD) and pyruvic acid, and increase the migration capacity of cells. Meanwhile, A. bidentata exhibited the most significant effect in isoproterenol-induced H9C2 cell injury, which could decrease the levels of ROS overproduction, BNP, NO, LD and pyruvic acid. Western blot revealed that C. morifolium and A. bidentata also could decrease the levels of bax/bcl-2 ratio, cleaved caspase-3, cytochrome c, HIF-1É, GLUT1, HKII and PFKFB3, respectively.
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The digital economy is playing a crucial effect in the field of environmental governance. Digital and intelligent management is an essential means to fully realize the "zero-waste city" construction. The present paper investigates the impact of digital economy on China's provincial "zero-waste city" construction. The results indicate that digital economy can contribute to "zero-waste city" construction. The digital economy has a positive nonlinear effect on the construction of "zero-waste city," but the marginal effect is diminishing. The digital economy can facilitate "zero-waste city" construction by improving industrial structure upgrading and green technology innovation. Heterogeneity analysis reveals that digital economy contributes to the construction of "zero-waste city" in the eastern and western regions and high-level environmental regulation regions, while this impact is insignificant in the central region and low-level environmental regulation regions. The digital economy exerts the most significant positive influence on waste resource recycling followed by waste final disposal and then waste reduction at the source. These findings underscore the effect of digital economy in fostering "zero-waste city" construction and promoting sustainable waste management. The present study provides new ideas for the "zero-waste city" construction in emerging developing countries such as China.
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Conservación de los Recursos Naturales , Política Ambiental , China , Industrias , Reciclaje , Desarrollo Económico , CiudadesRESUMEN
OBJECTIVE: Non-invasive computation of the index of microcirculatory resistance from coronary computed tomography angiography (CTA), referred to as IMR[Formula: see text], is a promising approach for quantitative assessment of coronary microvascular dysfunction (CMD). However, the computation of IMR[Formula: see text] remains an important unresolved problem due to its high requirement for the accuracy of coronary blood flow. Existing CTA-based methods for estimating coronary blood flow rely on physiological assumption models to indirectly identify, which leads to inadequate personalization of total and vessel-specific flow. METHODS: To overcome this challenge, we propose a vascular deformation-based flow estimation (VDFE) model to directly estimate coronary blood flow for reliable IMR[Formula: see text] computation. Specifically, we extract the vascular deformation of each vascular segment from multi-phase CTA. The concept of inverse problem solving is applied to implicitly derive coronary blood flow based on the physical constraint relationship between blood flow and vascular deformation. The vascular deformation constraints imposed on each segment within the vascular structure ensure sufficient individualization of coronary blood flow. RESULTS: Experimental studies on 106 vessels collected from 89 subjects demonstrate the validity of our VDFE, achieving an IMR[Formula: see text] accuracy of 82.08 %. The coronary blood flow estimated by VDFE has better reliability than the other four existing methods. CONCLUSION: Our proposed VDFE is an effective approach to non-invasively compute IMR[Formula: see text] with excellent diagnostic performance. SIGNIFICANCE: The VDFE has the potential to serve as a safe, effective, and cost-effective clinical tool for guiding CMD clinical treatment and assessing prognosis.
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Background: In cancer pathology, cell senescence not only alters cell function but also reshapes the immune microenvironments in tumours. However, the association between cell senescence, tumour microenvironment, and disease progression of hepatocellular carcinoma (HCC) is yet to be fully understood. Therefore, the role of cell senescence-related genes and long noncoding RNAs (lncRNAs) in evaluating the clinical prognosis and immune cell infiltration (ICI) of HCC patients requires further investigation. Methods: The limma R package was utilised to investigate differentially expressed genes according to the multiomics data. The CIBERSORT R package was utilised to assess ICI, and unsupervised cluster analysis was conducted using the R software's ConsensusClusterPlus package. A polygenic prognostic model of lncRNAs was constructed by conducting univariate and least absolute shrinkage and selection operator (Lasso) cox proportional-hazards regression analyses. The time-dependent receiver operating characteristic (ROC) curves were used for validation. We utilised the survminer R package to evaluate the tumour mutational burden (TMB). Moreover, the gene set enrichment analysis (GSEA) helped in pathway enrichment analysis, and the immune infiltration level of the model was evaluated using the IMvigor210 cohort. Results: The identification of 36 prognosis-related genes was achieved based on their differential expression between healthy and liver cancer tissues. Liver cancer individuals were categorised into 3 independent senescence subtypes using the gene list, revealing considerable survival differences (variations). We observed that the prognosis of patients in the ARG-ST2 subtype was substantially better as compared to that in the ARG-ST3 subtype. Differences were observed in gene expression profiles among the three subtypes, with the differentially expressed genes predominantly associated with cell cycle control. The enrichment of upregulated genes in the ARG-ST3 subtype was observed in pathways related to biological processes, for instance, organelle fission, nuclear division, and chromosome recombination. ICI in the ARG-ST1 and ARG-ST2 subtypes, with relatively better prognosis, was substantially higher as compared to the ARG-ST3 subtype. Furthermore, a risk-score model, which can be employed as a reliable prognostic factor in an independent manner for individuals suffering from liver cancer, was constructed based on 13 cell senescence-related lncRNAs (MIR99AHG, LINC01224, LINC01138, SLC25A30AS1, AC006369.2, SOCS2AS1, LINC01063, AC006037.2, USP2AS1, FGF14AS2, LINC01116, KIF25AS1, and AC002511.2). The individuals with higher risk scores had noticeably poor prognoses in contrast with those having low-risk scores. Moreover, increased levels of TMB and ICI were observed in individuals with low-risk scores and gaining more benefit from immune checkpoint therapy. Conclusion: Cell senescence is an essential factor in HCC onset and progression. We identified 13 senescence-related lncRNAs as HCC prognostic markers, which can help understand their function in the onset and progression of HCC and guide clinical diagnosis and treatment.
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A core-shell covalent organic framework encapsulated Co1.2Fe1.8O4 magnetic particles (CFO@COF) was designed and prepared successfully to activate peroxymonosulfate (PMS) for sulfamethoxazole (SMX) degradation. It displays amazing catalytic reactivity since the unique interior structure and synergistic effect between COF shell and CFO core, reaching 99.8% removal of SMX (10 mg/L) within 30 min and 90.8% TOC removal. The synergy between bimetals vests high reactivity to CFO core. And the outer COF shell can stabilize the CFO core under intricate reaction conditions to restrain the leaching of Co ions (decreased from 0.75 to 0.25 mg/L). Further investigation compared the activation mechanism in two different system, CFO/PMS system and CFO@COF/PMS system. The result showed that the radical mechanism controlled by SO4â - guided the SMX degradation in CFO/PMS system whereas the 1O2 played a pivotal role in CFO@COF/PMS system called non-radical leading. The influences of various factors on degradation experiments and SMX degradation pathway were also studied. Most importantly, risk assessment in CFO@COF/PMS/SMX system was estimated via "ecological structure activity relationships". In most case, the toxicities of intermediates were lower than the initial samples, which confirmed the effectiveness of CFO@COF/PMS/SMX system in the reduction of toxicity of SMX.
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AIMS: Molecular hydrogen has been exhibited a protective function in heart diseases. Our previous study demonstrated that hydrogen-rich saline (HRS) could scavenge free radicals selectively and alleviate the inflammatory response in the myocardial ischaemia/reperfusion (I/R) injury, but the underlying mechanism has not been fully clarified. METHODS AND RESULTS: Adult (10 weeks) C57BL/6 male mice and neonatal rat cardiomyocytes were used to establish I/R and hypoxia/reoxygenation (H/R) injury models. I/R and H/R models were treated with HRS to classify the mechanisms of cardioproctective function. In this study, we found that miR-124-3p was significantly decreased in both I/R and H/R models, while it was partially ameliorated by HRS pretreatment. HRS treatment also alleviated ischaemia-induced apoptotic cell death and increased cell viability during I/R process, whereas silencing expression of miR-124-3p abolished this protective effect. In addition, we identified calpain1 as a direct target of miR-124-3p, and up-regulation of miR-124-3 produced both activity and expression of calpain1. It was also found that compared with the HRS group, overexpression of calpain1 increased caspase-3 activities, promoted cleaved-caspase3 and Bax protein expressions, and correspondingly decreased Bcl-2, further reducing cell viability. These results illustrated that calpain1 overexpression attenuated protective effect of HRS on cardiomyocytes in H/R model. CONCLUSIONS: The present study showed a protective effect of HRS on I/R injury, which may be associated with miR-124-3p-calpain1 signalling pathway.
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Calpaína , MicroARNs , Daño por Reperfusión Miocárdica , Animales , Masculino , Ratones , Ratas , Apoptosis , Ratones Endogámicos C57BL , MicroARNs/genética , MicroARNs/metabolismo , Daño por Reperfusión Miocárdica/genética , Daño por Reperfusión Miocárdica/metabolismo , Miocitos Cardíacos/metabolismo , Calpaína/genética , Calpaína/metabolismoRESUMEN
The stable nitrite (NO2--N) generation and rapid startup of anammox-based process are the main bottlenecks hindering its application in mainstream municipal wastewater treatment. In this study, a Partial-Denitrification (PD) system reducing nitrate (NO3--N) to NO2--N was rapidly developed within 40 days, using the nitrification/denitrification sludge from wastewater treatment plant. The NO3--N to NO2--N transformation ratios achieved 80.6 %. Significantly, a fast self-enrichment of anammox bacteria in this system was subsequently obtained, resulting in the successful transformation to an efficient PD/Anammox (PD/A) process after 79-day operation. The total nitrogen removal efficiency increased from 12.4 % to 90.0 % with influent ammonia and nitrate of 45.9 mg N/L and 62.2 mg N/L, corresponding to the anammox activity significantly increasing to 6.0 mgNH4+-N/g VSS/h without seeding anammox sludge. Abundance of anammox increased from 6.7 × 108 to 2.0 × 1011 copies/g dry sludge. High-throughput sequencing results showed that Candidatus Brocadia was the only known anammox genus and accounted for 1.08 % during the PD/A stage. Functional bacteria for PD, assumed to be the Thauera, was enriched from 1.99 % to 60.06 % but decreased to 32.49 % during the improvement of anammox activity. It demonstrated that the PD system with stable NO2--N accumulation enabled a rapid self-enrichment of anammox bacteria and sufficient nitrogen removal with ordinary nitrification/denitrification sludge. This provides new insights into the scaling application of anammox by integrating PD with shortened startup periods and improved TN removal efficiency.
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Nitrificación , Aguas del Alcantarillado , Aguas del Alcantarillado/microbiología , Desnitrificación , Nitratos , Reactores Biológicos/microbiología , Oxidación Anaeróbica del Amoníaco , Dióxido de Nitrógeno , Aguas Residuales/microbiología , Oxidación-Reducción , Nitrógeno , BacteriasRESUMEN
BACKGROUND: Gastrodin is an effective polyphenol extracted from Chinese natural herbal Gastrodiae elata Blume, which exhibits antioxidant and anti-inflammatory effects. It has been reported to benefit neurodegenerative diseases, but the effect of Gastrodin on atherosclerosis and the underlying mechanisms remain elusive. The aim of this study is to investigate the function and mechanism of Gastrodin in atherosclerosis. METHODS: Atherosclerosis mouse model was established by fed low density lipoprotein receptor-deficient (Ldlr-/-) mice with a high fat diet (HFD, 20% fat and 0.5 cholesterol) for 8 weeks and Gastrodin was administered daily via oral gavage. Plasma lipid levels were measured using commercial kits. En face and aortic sinus lipid accumulation were analyzed with Oil Red O staining. In vitro cell models using foam cell formation model and classical atherosclerosis inflammation model, macrophages were incubated with oxygenized low-density lipoproteins (ox-LDL) or lipopolysaccharide (LPS) in the presence of different concentration of Gastrodin or vehicle solution. Foam cell formation and cellular lipid content were evaluated by Oil Red O staining and intracellular lipids extraction analysis. Gene expression and proteins related to cholesterol influx and efflux were examined by quantitative reverse transcription PCR (RT-qPCR) and western blotting analysis. Furthermore, the effect of Gastrodin on LPS induced macrophage inflammatory responses and NF-κB pathway were evaluated by RT-qPCR and western blotting analysis. RESULTS: Gastrodin administration reduced the body weight, plasma lipid levels in Ldlr-/- mice after fed a high fat diet. Oil Red O staining showed Gastrodin-treated mice displayed less atherosclerosis lesion area. Furthermore, Gastrodin treatment significantly ameliorated ox-LDL-induced macrophage-derived foam cells formation through suppressing genes expression related to cholesterol efflux including scavenger receptor class B and ATP-binding cassette transporter A1. Moreover, Gastrodin markedly suppressed pro-inflammatory cytokines secretion and LPS induced inflammatory response in macrophage through downregulating NF-κB pathway. CONCLUSIONS: Our study demonstrated that Gastrodin attenuates atherosclerosis by suppressing foam cells formation and LPS-induced inflammatory response and represents a novel therapeutic target for the treatment of atherosclerosis.
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In suspended sludge system, efficient enrichment and retention of anammox bacteria are crucial obstacles in mainstream wastewater treatment by anammox process. In this study, anammox bacteria was self-enriched in a pilot-scale suspended sludge system of two-stage nitrification-denitrification process serving municipal wastewater treatment. With the low ammonia (NH4+-N) of 9.3 mg/L, nitrate (NO3--N) of 15.6 mg/L and COD/NO3--N of 2.2 under extremely low nitrogen loading rate of 0.012 kg N/m3/d, anammox activity bloomed after its abundance increasing from 5.9 × 107 to 4.6 × 109 copies/g dry sludge. Significant NH4+-N removal was occurred and maintained stably in the denitrification reactor with anammox bacteria accounting for 1.13%, even under temperature decreasing to 20.0â. The adequately anoxic environment, efficient retention with the static settlement, and NO2- production via NO3- reduction provided favorable environment for anammox bacteria. This study demonstrated the feasibility and great potential in mainstream anammox application without seeding specific sludge.
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Aguas del Alcantarillado , Aguas Residuales , Oxidación Anaeróbica del Amoníaco , Desnitrificación , Nitrificación , Bacterias , NitrógenoRESUMEN
BACKGROUND: The diagnostic accuracy of fractional flow reserve (FFR) derived from coronary computed tomography angiography (CCTA) (FFR-CT) needs to be further improved despite promising results available in the literature. While an innovative myocardial computed tomographic perfusion (CTP)-derived fractional flow reserve (CTP-FFR) model has been initially established, the feasibility of CTP-FFR to detect coronary artery ischemia in patients with suspected coronary artery disease (CAD) has not been proven. METHODS: This retrospective study included 93 patients (a total of 103 vessels) who received CCTA and CTP for suspected CAD. Invasive coronary angiography (ICA) was performed within 2 weeks after CCTA and CTP. CTP-FFR, CCTA (stenosis ≥ 50% and ≥70%), ICA, FFR-CT and CTP were assessed by independent laboratory experts. The diagnostic ability of the CTP-FFR grouped by quantitative coronary angiography (QCA) in mild (30-49%), moderate (50-69%) and severe stenosis (≥70%) was calculated. The effect of calcification of lesions, grouped by FFR on CTP-FFR measurements, was also assessed. RESULTS: On the basis of per-vessel level, the AUCs for CTP-FFR, CTP, FFR-CT and CCTA were 0.953, 0.876, 0.873 and 0.830, respectively (all p < 0.001). The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of CTP-FFR for per-vessel level were 0.87, 0.88, 0.87, 0.85 and 0.89 respectively, compared with 0.87, 0.54, 0.69, 0.61, 0.83 and 0.75, 0.73, 0.74, 0.70, 0.77 for CCTA ≥ 50% and ≥70% stenosis, respectively. On the basis of per-vessel analysis, CTP-FFR had higher specificity, accuracy and AUC compared with CCTA and also higher AUC compared with FFR-CT or CTP (all p < 0.05). The sensitivity and accuracy of CTP-FFR + CTP + FFR-CT were also improved over FFR-CT alone (both p < 0.05). It also had improved specificity compared with FFR-CT or CTP alone (p < 0.01). A strong correlation between CTP-FFR and invasive FFR values was found on per-vessel analysis (Pearson's correlation coefficient 0.89). The specificity of CTP-FFR was higher in the severe calcification group than in the low calcification group (p < 0.001). CONCLUSIONS: A novel CTP-FFR model has promising value to detect myocardial ischemia in CAD, particularly in mild-to-moderate stenotic lesions.
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Nutrient removal in carbon limited wastewater with high efficiency and energy saving remains a bottleneck for wastewater treatment plants (WWTPs). This study established a pilot-scale anaerobic/aerobic/anoxic (AOA) system with processing capacity of 100 m3/d for the first time. During almost 300 days of stable operation, enhanced nitrogen and phosphorus removal at a C/N of 5 was achieved, and the concentrations of total nitrogen (TN) and total phosphorus (TP) in effluent were 3.60 ± 1.55 and 0.24 ± 0.13 mg/L. Tetrasphaera and Candidatus Competibacter were the dominant phosphorus accumulating organisms (PAOs) and glycogen accumulating organisms (GAOs) in the AOA system. Moreover, the low phosphorus release ensured sufficient intracellular carbon storage by endogenous denitrification, which was the critical factor for nitrogen and phosphorus removal in carbon limited wastewater. The denitrification phosphorus removal (DPR) ability further removed phosphorus and prevented secondary phosphorus release to maintain a low phosphorus concentration in effluent. Finally, rapid start-up, high nutrient removal efficiency and low energy consumption make the proposed AOA process suitable for application in newly constructed and renovated WWTPs.
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Nitrógeno , Fósforo , Anaerobiosis , Reactores Biológicos , Carbono , Desnitrificación , Glucógeno , Nitrificación , Aguas del Alcantarillado , Eliminación de Residuos Líquidos , Aguas ResidualesRESUMEN
BACKGROUND AND OBJECTIVE: Coil embolization has become a new treatment method for pulsatile tinnitus (PT) caused by sigmoid sinus diverticulum (SSD). Although this therapy has achieved good results in clinical reports, the hemodynamic mechanism of coils in the treatment of PT in SSD remained unclear. METHODS: Finite element method (FEM) and computational fluid dynamics (CFD) were combined to explore the hemodynamic mechanism of coil embolization in SSD treatment. Three personalized geometric models of sigmoid sinus were established according to the CTA data of patients. Coil model were established by FEM, and the hemodynamic differences of SSD before and after coiling were compared by transient CFD method. RESULTS: Velocity streamlines disappeared in the SSD after coiling. At the peak time (t1 = 0.22 s), the SSD-average velocity decreased in every patient. The average value of the decreased in three patients was 0.154 ± 0.028 m/s (mean ± SD). Wall average pressure (Pavg) also showed a decline in every patient. Average of decrements of three patients was 17.69 ± 4.91 Pa (mean ± SD). Average WSS (WSSavg) was also reduced in every patient. The average value of WSS drop was 9.74 ± 3.02 Pa (mean ± SD). After coiling, the proportion of low-velocity region in the sigmoid sinus cortical plate dehiscence (SSCPD) area increased. Average of increments was 22.1 ± 5.36% (mean ± SD). CONCLUSIONS: A reduction in SSD-average velocity, wall pressure, and WSS were the short-term hemodynamic mechanism of coil embolization for PT. Coil embolization increased the proportion of low-velocity region in the SSCPD area, thereby creating a hemodynamic environment that easily produced thrombus and protects blood vessels from the impact of blood flow. This phenomenon was the long-term effect of coil embolization.
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Divertículo , Acúfeno , Senos Craneales , Divertículo/complicaciones , Hemodinámica , Humanos , Hidrodinámica , Acúfeno/etiología , Acúfeno/terapiaRESUMEN
The study aimed to evaluate the efficacy and safety of drug coated balloon-only strategy (DCB-only) in the treatment of de novo left main coronary artery (LM) bifurcation lesions. 85 patients were enrolled in this study and classified them into two groups: DCB-only group (n = 36) and DES group (n = 49). The MLD of target vessels was measured before and immediately after percutaneous coronary intervention (PCI) and late luminal loss (LLL) were also calculated. And the occurrence of major adverse cardiovascular events (MACE) was also evaluated. Compared with that before PCI, the MLD of target lesions significantly increased immediately after PCI (P < .05) and no MACE was recorded during the perioperative period both in two groups. The MLD at follow-up was significantly higher than that before both DCB and DES treatment. Compared with the DES group, the MLD of the DCB group was smaller than immediately after PCI in the LM and LAD (P < .05). The LLL of LAD in DCB group was smaller than that in DES group (P < .05). There was no significant difference in the incidence of luminal restenosis at the target lesion between the two groups, and no significant difference in the incidence of MACE (P > .05). The use of DCB-only to treat de novo LM bifurcation lesions is effective and relatively safe, which provides new ideas for the treatment of LM coronary artery bifurcation lesions in the future.
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Enfermedad de la Arteria Coronaria , Reestenosis Coronaria , Stents Liberadores de Fármacos , Intervención Coronaria Percutánea , Angiografía Coronaria/efectos adversos , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/cirugía , Reestenosis Coronaria/etiología , Stents Liberadores de Fármacos/efectos adversos , Humanos , Intervención Coronaria Percutánea/efectos adversos , Resultado del TratamientoRESUMEN
BACKGROUND: High-density lipoprotein cholesterol (HDL-C) and monocytes are associated with coronary artery disease, and the ratio of monocytes to high-density lipoprotein (MHR) is associated with long-term adverse outcomes and the recurrence of atrial fibrillation. Currently, the trend of coronary heart disease proned to young people is becoming prominent. However, the relationship between MHR and in-stent restenosis (ISR) in patients with premature coronary heart disease (PCHD) has not been investigated. Therefore, we aimed to assess the relationship between MHR and ISR in patients with PCHD. METHODS: We retrospectively included 257 patients (men ≤ 55 years old, women ≤ 65 years old) with PCHD who underwent drug-eluting stent implantation and follow-up coronary angiography at the First Affiliated Hospital of Zhengzhou University from September 2016 to September 2019. Patients were divided into ISR and non-ISR groups depending on their follow-up coronary angiography results. Relative clinical information was recorded and analyzed. A receiver operating characteristic curve analysis was used to determine the optimum pre-procedural MHR cutoff value to predict ISR. RESULTS: Logistic regression analysis showed that MHR, smoking history, and fibrinogen were independent risk factors for ISR in patients with PCHD. The area under the receiver operating characteristic curve (AUC) of MHR was 0.750 (95% confidence interval, 0.695-0.820; Pâ <â .001), the cutoff value was 546.88, and the specificity and sensitivity were 65.2% and 78%, while the AUC of monocytes was 0.631 (95% confidence interval, 0.638-0.794; Pâ <â .001), the cutoff value was 590, and the specificity and sensitivity were 77.1% and 60.0%. CONCLUSION: MHR is an independent risk factor for ISR in patients with PCHD and showed a certain predictive value.