Preoperative Quantitative Flow Ratio, Intraoperative Transit Time Flow Measurement Parameters, and Their Predictive Value for Short-Term Graft Failure After Coronary Artery Bypass Grafting.

BACKGROUND: Studies on the relationship between the preoperative quantitative flow ratio (QFR) and parameters of intraoperative transit time flow measurement (TTFM) are extremely rare. In addition, the predictive value of QFR and TTFM parameters for early internal mammary artery (IMA) failure after coronary artery bypass grafting still needs to be validated.Methods and Results: We retrospectively collected data from 510 patients who underwent in situ IMA grafting to the left anterior descending (LAD) artery at Fuwai Hospital. Spearman correlation coefficients between preoperative QFR of the LAD artery and intraoperative TTFM parameters of the IMA were -0.13 (P=0.004) for mean graft flow (Qm) and 0.14 (P=0.002) for the pulsatility index (PI). QFR and TTFM exhibited similar and good predictive value for early IMA failure (5.7% at 1 year), and they were better than percentage diameter stenosis (area under the curve 0.749 for QFR, 0.733 for Qm, 0.688 for PI, and 0.524 for percentage diameter stenosis). The optimal cut-off value of QFR was 0.765. Both univariate and multivariable regression analyses revealed that QFR >0.765, Qm ≤15 mL/min, and PI >3.0 independently contributed to early IMA failure. CONCLUSIONS: There were statistically significant correlations between preoperative QFR of the LAD artery and intraoperative TTFM parameters (Qm, PI) of the IMA. Preoperative QFR and intraoperative Qm and PI exhibited excellent predictive value for early IMA failure.

Seasonal nitrate variations, risks, and sources in groundwater under different land use types in a thousand-year-cultivated region, northwestern China.

The global public health concern of nitrate (NO3-) contamination in groundwater is particularly pronounced in irrigated agricultural regions. This paper aims to analyze the spatial distribution of groundwater NO3-, assess potential health risks for local residents, and quantitatively identify nitrate sources during different seasons and land use types in the Jinghuiqu Irrigation District, a region in northwestern China with a longstanding agricultural history. The investigation utilizes hydrochemical parameters, dual isotopic data, and the Bayesian stable isotope mixing model (MixSIAR). The findings underscore significant seasonal variations in the average concentrations of NO3-, with values of 87.72 mg/L and 101.87 mg/L during the wet and dry seasons, respectively. Furthermore, distinct fluctuations in nitrate concentration were observed across different land use types, whereby vegetable lands manifested the maximum concentration. Prolonged exposure to elevated nitrate concentrations may pose potential health risks to residents, especially in the dry season when the non-carcinogenic groundwater nitrate risk surges past its wet season counterpart. The MixSIAR analysis revealed that chemical fertilizers accounted for the majority of nitrate pollution in vegetable lands, both during the dry season (49.6%) and wet season (41.2%). In contrast, manure and sewage contributed significantly to NO3-concentrations in residential land during the wet (74.9%) and dry seasons (67.6%). For croplands, soil nitrogen emerged as a dominant source during the wet season (42.2%), while chemical fertilizers prevailed in the dry season (38.7%). In addition to source variations, the nitrate concentration of groundwater is further affected by hydrogeological conditions, with more permeable aquifers tending to display higher nitrate concentrations. Thus, targeted measures were proposed to modify or impede the nitrogen migration pathway, taking into consideration hydrogeological conditions and incorporating domestic sewage, organic fertilizer, and agricultural management practices.

Modeling the effects of land use/land cover changes on river runoff using SWAT models: A case study of the Danjiang River source area, China.

Land use/land cover (LULC) is a crucial factor that directly influences the hydrology and water resources of a watershed. In order to assess the impacts of LULC changes on river runoff in the Danjiang River source area, we analyzed the characteristics of LULC data for three time periods (2000, 2010, and 2020). The LULC changes during these periods were quantified, and three Soil and Water Assessment Tool (SWAT) models were established and combined with eight LULC scenarios to quantitatively analyze the effects of LULC changes on river runoff. The results revealed a decrease in the cropland area and an increase in the forest, grassland, and urban land areas from 2000 to 2020. Grassland, forest, and cropland collectively accounted for over 94% of the total area, and conversions among these land types were frequent. The SWAT models constructed based on the LULC data demonstrated good calibration and validation results. Based on the LULC data in three periods, the area of each LULC type changed slightly, so the simulation results were not significantly different. In the subsequent LULC scenarios, we found that the expansion of cropland, grassland, and urban areas was associated with increased river runoff, while an increase in forest area led to a decrease in river runoff. Among the various LULC types, urban land exerted the greatest influence on changes in river runoff. This study establishes three SWAT models and combines multiple LULC scenarios, which is novel and innovative. It can provide scientific basis for the rational allocation of water resources and the optimization of LULC structure in the Danjiang River source area.

RNF43 Suppressed Triple-Negative Breast Cancer Progression by Inhibiting Wnt/beta-Catenin Pathway.

OBJECTIVE: Triple-negative breast cancer (TNBC) is a subtype with high invasiveness. Due to lacking specific and effective therapies, it is necessary to explore the mechanism of TNBC progression and search for new therapeutic targets. METHODS: Data from the GEPIA2 database was analyzed to explore RNF43 expression in each subtype of breast cancer. RNF43 expression in TNBC tissue and cell lines was determined by RT-qPCR. In vitro biological function analyses including MTT assay, colony formation assay, wound-healing assay and Transwell assay were conducted to explore the role of RNF43 in TNBC. In addition, the markers of epithelial-mesenchymal transition (EMT) were detected by western blot. The expression of ß-Catenin and its downstream effectors were also detected. RESULTS: Data from the GEPIA2 database indicated that RNF43 expression was lower in tumor tissue compared to paired adjacent tissue in TNBC. In addition, RNF43 expression in TNBC was lower than in other subtypes of breast cancer. Consistently, down-regulation of RNF43 expression in TNBC tissue and cell lines was observed. Overexpressing RNF43 attenuated the proliferation and migration of TNBC cells. Depletion of RNF43 showed the opposite effect, confirming that RNF43 played an anti-oncogenic role in TNBC. In addition, RNF43 suppressed several markers of EMT. Furthermore, RNF43 restrained the expression of ß-Catenin and its downstream effectors, implying RNF43 exerted the suppressive role in TNBC by inhibiting the ß-Catenin pathway. CONCLUSIONS: This study demonstrated that the RNF43-ß-Catenin axis attenuated TNBC progression, which might provide novel therapeutic targets for TNBC.

Venovenous extracorporeal membrane oxygenation for coronavirus disease 2019 patients: A systematic review and meta-analysis.

OBJECTIVE: Although the application of venovenous extracorporeal membrane oxygenation (VV-ECMO) in coronavirus disease 2019 (COVID-19) patients with acute respiratory distress syndrome (ARDS) is accumulating, the feasibility and safety of this therapy remain controversial. We aimed to evaluate the effect of VV-ECMO in the treatment of these patients. METHODS: A comprehensive literature search was performed using PubMed, Embase, the Cochrane Library, and International Clinical Trials Registry Platform databases through November 2021. According to the inclusion and exclusion criteria, the included studies were screened, and meta-analysis was performed by R software (version 4.0.2). RESULTS: Forty-two studies including 2037 COVID-19 patients supported with VV-ECMO due to ARDS were identified. The pooled analysis revealed that 30-, 60-, and 90-day mortality among patients were respectively 46% (95% CI 37%-57%, I2 = 66%), 46% (95% CI 30%-70%, I2 = 93%), and 49% (95% CI 43%-58%, I2 = 52%), and the pooled incidence rate of in-hospital mortality, major bleeding, hemorrhagic stroke, thrombosis, pulmonary embolism, deep venous thrombosis, and renal replacement therapy were respectively 35%, 39%, 11%, 40%, 15%, 21%, and 44%. CONCLUSION: Although COVID-19 patients may have a higher risk of bleeding, hemorrhagic stroke, and acute kidney injury during ECMO therapy, the survival rate was more than half of the cases. Our data may support the application of VV-ECMO in COVID-19 patients.

Del Nido cardioplegia for myocardial protection in adult cardiac surgery: a systematic review and update meta-analysis.

OBJECTIVE: Although the application of del Nido cardioplegia solution (DNC) in adult cardiac surgery is accumulating, the feasibility and safety of this myocardial protection strategy in adults remains controversial. We aimed to update our previous meta-analysis to determine the myocardial protective effect of DNC versus conventional cardioplegia (CC) in adult cardiac surgery. METHODS: A comprehensive literature search was performed using PubMed, EMBASE, the Cochrane Library, and International Clinical Trials Registry Platform databases through November 2020. RESULTS: Thirty-seven observational studies and four randomized controlled trials (RCTs) including 21,779 patients were identified. The DNC group was associated with decreased postoperative cardiac enzymes [troponin T (cTnT) and creatine kinase-MB (CK-MB)] [standardized mean differences (SMD): -0.59, 95% confidence interval (CI): -0.99 to -0.19, p = 0.004], cardiopulmonary bypass (CPB) time (MD: -9.31, 95% CI: -13.10 to -5.51, p < 0.00001), aortic cross-clamp (ACC) time (MD: -7.20, 95% CI: -10.31 to -4.09, p < 0.00001), and cardioplegia volume (SMD: -1.95, 95% CI: -2.46 to -1.44, p < 0.00001). Intraoperative defibrillation requirement was less in the DNC group [relative risk (RR): 0.50, 95% CI: 0.33 to 0.75, p = 0.0007]. The pooled analysis revealed no significant difference in operative mortality among the patients assigned to DNC and those undergoing CC. CONCLUSION: In adult cardiac surgery, compared to CC, myocardial protection used with DNC yield similar or better short-term clinical outcomes. More high-quality trials and RCTs reflecting long-term follow-up morbidity and mortality are required in the future to confirm these findings.

Establishment of a venovenous extracorporeal membrane oxygenation in a rat model of acute respiratory distress syndrome.

INTRODUCTION: Venovenous extracorporeal membrane oxygenation (VV ECMO) is now considered a reasonable option to salvage acute respiratory distress syndrome (ARDS). However, we lack a rodent model for experimental studies. This study was undertaken to establish an animal model of VV ECMO in ARDS rats. METHODS: A total of 18 Sprague-Dawley (SD) rats (350 ± 50 g) were used in this study. Using a rat model of oleic acid (OA)-induced ARDS, VV ECMO was established through cavoatrial cannulation of the right jugular vein for venous drainage and venous reinfusion with a specially designed three-cavity catheter. Continuous arterial pressure monitoring was implemented by using a catheter through cannulation of the right femoral artery. The central temperature was monitored with a rectal probe. Arterial blood gas monitoring was implemented by a blood gas analyzer at three-time points: at baseline, 1-hour (after OA modeling), and 3.5-hour (after VV ECMO support). Lung tissue and bronchoalveolar lavage fluid were harvested respectively for protein concentration and pulmonary histologic evaluation to confirm the alleviation of lung injury during VV ECMO. RESULTS: Following ARDS induced by OA, ten rats were successfully established on VV ECMO without failure and survived the ECMO procedure. VV ECMO alleviated lung injury and restored adequate circulation for the return of lung function and oxygenation. VV ECMO was associated with decreased lung injury score, wet/dry weight ratio, and fluid leakage into airspaces. CONCLUSION: We have established a reliable, economical, and functioning ARDS rat model of VV ECMO.

N7-Methylguanosine Regulatory Genes Profoundly Affect the Prognosis, Progression, and Antitumor Immune Response of Hepatocellular Carcinoma.

Background: Hepatocellular carcinoma (HCC) is a common abdominal cancer with poor survival outcomes. Although there is growing evidence that N7-methylguanosine (m7G) is closely associated with tumor prognosis, development, and immune response, few studies focus on this topic. Methods: The novel m7G risk signature was constructed through the Lasso regression analysis. Its prognostic value was evaluated through a series of survival analyses and was tested in ICGC-LIRI, GSE14520, and GSE116174 cohorts. CIBERSORT, ssGSEA, and ESTIMATE methods were applied to explore the effects of the m7G risk score on tumor immune microenvironment (TIM). The GSEA method was used to evaluate the impacts of the m7G risk score on glycolysis, ferroptosis, and pyroptosis. The human protein atlas (HPA) database was used to clarify the histological expression levels of five m7G signature genes. The biofunctions of NCBP2 in hepatocellular cancer (HC) cells were confirmed through qPCR, CCK8, and transwell assays. Results: Five m7G regulatory genes comprised the novel risk signature. The m7G risk score was identified as an independent prognostic factor of HCC and could increase the decision-making benefit of traditional prognostic models. Besides, we established a nomogram containing the clinical stage and m7G risk score to predict the survival rates of HCC patients. The prognostic value of the m7G model was successfully validated in ICGC and GSE116174 cohorts. Moreover, high m7G risk led to a decreased infiltration level of CD8+ T cells, whereas it increased the infiltration levels of Tregs and macrophages. The glycolysis and pyroptosis processes were found to be enriched in the HCC patients with high m7G risk. Finally, overexpression of NCBP2 could promote the proliferation, migration, and invasion of HC cells. Conclusions: The m7G risk score was closely related to the prognosis, antitumor immune process, glycolysis, and malignant progression of HCC. NCBP2 has pro-oncogenic abilities, showing promise as a novel treatment target.

Decomposition-Coordination of Double-Layer MPC for Constrained Systems.

Large-scale industrial processes usually adopt centralized control and optimization methods. However, with the growth of the scale of industrial processes leading to increasing computational complexity, the online optimization capability of the double-layer model predictive control algorithm is challenged, exacerbating the difficulty of the widespread implementation of this algorithm in the industry. This paper proposes a distributed double-layer model predictive control algorithm based on dual decomposition for multivariate constrained systems to reduce the computational complexity of process control. Firstly, to solve the problem that the original dual decomposition method does not apply to constrained systems, two improved dual decomposition model prediction control methods are proposed: the dual decomposition method based on the quadratic programming in the subsystem and the dual decomposition method based on constraint zones, respectively. It is proved that the latter will certainly converge to the constraint boundaries with appropriate convergence factors for the controlled variables. The online optimization ability of the proposed two methods is compared in discussion and simulation, concluding that the dual decomposition method based on the constraint zones exhibits superior online optimization ability. Further, a distributed double-layer model predictive control algorithm with dual decomposition based on constraint zones is proposed. Different from the objective function of the original dual decomposition model predictive control, the proposed algorithm's dynamic control-layer objective function simultaneously tracks the steady-state optimization values of the controlled and manipulated variables, giving the optimal solution formulation of the optimization problem consisting of this objective function and the constraints. The algorithm proposed in this paper achieves the control goals while significantly reducing the computational complexity and has research significance for promoting the industrial implementation of double-layer model predictive control.