Improvement of the conjugation transfer of N. gerenzanensis based on the synergistic effect of quorum sensing and antibiotic interference.

Nonomuraea gerenzanensis (N. gerenzanensis) is known for its ability to biosynthesize A40926, the precursor of the glycopeptide antibiotic (GPA) Dalbavancin. However, challenges and uncertainties related to the genetic manipulation of the rare actinomycetes remain. In order to improve the conjugation transfer of N. gerenzanensis, the crucial factors affecting conjugal transfer were evaluated, including agar medium, mycelial state, donor-recipient ratio, magnesium ion concentration, and antibiotic coverage time firstly. Additionally, γ-butyrolactone (GBL) for quorum sensing (QS) and antibiotics targeting bacterial walls were applied to evaluate their effects on conjugation transfer. As a result, the optimal conditions of 5%TSB of liquid medium, 24 h of the period time, V0.1 of agar medium, 30 mM of magnesium ion, the ratio 10:1 of donor-to-recipient, and 27 h of the overlaying time of antibiotic were determined. Furthermore, the results showed that autoinducer GBL and GPA teicoplanin had a synergetic effect on the conjugation transfer of N. gerenzanensis at a working concentration of 60 µM and 0.5 µg mL-1, respectively. The highest conjugation efficiency could reach about 1.3 depending on the optimal process conditions and the interference of QS and antibiotics.

Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow.

OBJECTIVE: The impact of uric acid on worsening of diastolic function and clinical outcomes in patients with coronary slow flow remains unclear. This study aims to investigate possible associations between serum uric acid, worsening of diastolic function, and major adverse cardiovascular events in coronary slow flow patients. METHODS: Blood samples were obtained prospectively from 537 patients who had been angiographically diagnosed with coronary slow flow. Of those, 425 patients underwent comprehensive cardiac function assessment both before and after maximal treadmill exertion by stress echocardiography. The association between serum uric acid and major adverse cardiovascular events was examined using Cox proportional hazards regression model. RESULTS: Among the 425 patients (mean age: 58 ± 11 years; 52.2% men), worsening of diastolic function occurred in 176 (41.4%) after exercise stress. Patients with worsening of diastolic function had elevated levels of serum uric acid compared to those without (5.7 [4.1, 6.7] vs 4.3 [3.6, 5.3] mg/dL, respectively; P <.001). Higher serum uric acid levels were also significantly associated with neutrophil counts and high-sensitive C-reactive protein in patients with worsening of diastolic function but not in those without. Multivariate regression analysis found serum uric acid to be an independent predictor of worsening of diastolic function (odds ratio = 1.87 [1.17-3.82], P =.023). Moreover, serum uric acid remained associated with major adverse cardiovascular events even after adjusting for echocardiographic and clinical variables (hazard ratio = 1.56 [1.03-2.89], P =.016). CONCLUSION: Serum uric acid is associated with worsening of diastolic function and may be mediated by inflammation. These findings indicate that uric acid is a risk factor for major adverse cardiovascular events in patients with coronary slow flow.

Correlations of High-frequency Ultrasound Evaluation of Brachial Artery Endothelial Dilatation and Carotid Atherosclerosis with Glucose and Lipid Metabolism, Inflammatory Cytokines, Severity of Coronary Artery Disease and Vascular Endothelial Function in Elderly Patients.

The study aimed to explore the correlations of the results of the high-frequency ultrasound evaluation of the brachial artery endothelial dilatation and carotid atherosclerosis with glucose and lipid metabolism, inflammatory cytokines, the severity of coronary artery disease (CAD) and vascular endothelial function in elderly patients. 78 elderly patients with CAD in Beijing Anzhen Hospital were selected. The high-frequency ultrasonography was carried out to observe the flow-mediated dilatation (FMD) and intima-media thickness (IMT) and to analyze their correlations with inflammatory cytokines [C-reactive protein (CRP) and plasminogen activator inhibitor (PAI-1)], endothelial function [nitric oxide (NO) and endothelin-1 (ET-1)], glycolipid metabolism [high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), triglyceride (TG) and fasting blood glucose (FBG)] and the severity of CAD. FMD, NO and HDL-C: patients with single-vesselCAD> those with double-vessel CAD>those with multi-vessel CAD. IMT, CRP, PAI-1, FBG, ET-1, TC and TG: patients with single-vesselCAD< those with double-vessel CAD

Diagnostic performance of coronary computed tomography (CT) angiography derived fractional flow reserve (CTFFR) in patients with coronary artery calcification: insights from multi-center experiments in China.

Background: Coronary computed tomography angiography (CCTA) is affected by calcification artifacts, which reduces its diagnostic efficacy. CT-derived fractional flow reserve (CTFFR) based on CCTA has been proven to be accurate in the diagnosis of non-calcified patients, but its clinical use in patients with calcified coronary artery disease remains to be investigated. The purpose of this study was to determine the effect of coronary artery calcification on CTFFR. Methods: CCTA, coronary angiography, and FFR were performed on 128 patients in three clinical medical centers. Local investigators performed an assessment of stenosis for CCTA and the core laboratory performed the CTFFR calculations. CTFFR ≤0.8 and diameter stenosis ≥50% for CCTA was identified as lesion-specific ischemia. The diagnostic performance of CTFFR in identifying the diagnostic sensitivity, specificity, and accuracy was analyzed using an invasive FFR ≤0.8 as the gold standard. We compared the diagnostic performances between CTFFR and CCTA according to the level of calcification. We divided patients into four groups based on the coronary artery calcification score [coronary artery calcification score (CACS) =0, >0 to <100, ≥100 to <400, and ≥400]. Results: The Youden index indicated an optimal threshold of 0.80 for CTFFR to identify functionally ischemic lesions. The sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), and area under receiver operating characteristic curve (AUC) for CTFFR on a per-patient basis were 90% (80-96%), 98% (92-99%), 94% (89-97%), 98% (91-99%), 92% (83-97%), and 96.9% (94.2-99.6%), respectively. Compared to CCTA, CTFFR had a higher specificity, accuracy, PPV, NPV, and AUC in both the low to intermediate calcification group and the high calcification group. The diagnostic efficacy of CTFFR was higher than that of CCTA without the influence of calcification. Conclusions: This Chinese multi-center study showed that CTFFR based on novel computational fluid dynamics (CFD) modeling demonstrated very high diagnostic efficacy compared to the invasive measurement of FFR in all lesions suspected coronary artery disease (CAD). Of particular note are the high specificity, sensitivity, and accuracy of CTFFR, even in patients with calcification, which were significantly better than previous CCTA assessments.

Impact of metabolic syndrome and systemic inflammation on endothelial function in postmenopausal women.

OBJECTIVE: Data on the impact of metabolic syndrome (MetS) and systemic inflammation on endothelial function remains scarce. In this study, we aimed to investigate the combined effects of MetS and systemic inflammation on endothelial function in postmenopausal women. METHODS: We identified 423 postmenopausal women from February 2019 through July 2020. MetS was diagnosed according to the International Diabetes Federation (IDF) criteria, and high sensitivity C-reaction protein (hs-CRP) was measured to assess the degree of underlying inflammation. The measurement of endothelial function was using digital arterial tonometry by assessing reactive hyperemia-induced vasodilation in one arm and adjusting for changes in the contralateral arm (reactive hyperemia index, RHI). RESULTS: There were 156 patients with MetS and 267 without MetS. Compared to the group without MetS, patients with MetS had significantly lower natural logarithmic RHI (0.66±0.29 versus 0.91±0.31; p<0.001), but higher levels of hs-CRP (0.98 [0.31, 3.54] versus 0.53 [0.20, 2.14]; p<0.001). In sequential multivariable analysis, the presence of hs-CRP (ΔR2=0.047, p=0.004) had a significant and independent influence on natural logarithmic RHI. Furthermore, the interaction of hs-CRP*MetS was synergistically associated with endothelial dysfunction even in the fully adjusted model (ß=-0.107, 95% CI [-0.161~-0.053], p=0.009). CONCLUSION: MetS and systemic inflammation are synergistically associated with endothelial dysfunction in postmenopausal women. Postmenopausal women with both these conditions appear to be at a significantly higher risk for adverse cardiovascular events.

Blood lead level in Chinese adults with and without coronary artery disease.

BACKGROUND: The Trial to Assess Chelation Therapy study found that edetate disodium (disodium ethylenediaminetetraacetic acid) chelation therapy significantly reduced the incidence of cardiac events in stable post-myocardial infarction patients, and a body of epidemiological data has shown that accumulation of biologically active metals, such as lead and cadmium, is an important risk factor for cardiovascular disease. However, limited studies have focused on the relationship between angiographically diagnosed coronary artery disease (CAD) and lead exposure. This study compared blood lead level (BLL) in Chinese patients with and without CAD. METHODS: In this prospective, observational study, 450 consecutive patients admitted to Beijing Anzhen Hospital with suspected CAD from November 1, 2018, to January 30, 2019, were enrolled. All patients underwent coronary angiography, and an experienced heart team calculated the SYNTAX scores (SXscore) for all available coronary angiograms. BLLs were determined with atomic absorption spectrophotometry and compared between patients with angiographically diagnosed CAD and those without CAD. RESULTS: In total, 343 (76%) patients had CAD, of whom 42% had low (0-22), 22% had intermediate (23-32), and 36% had high (≥ 33) SXscore. BLLs were 36.8 ± 16.95 µg/L in patients with CAD and 31.2 ± 15.75 µg/L in those without CAD (P = 0.003). When BLLs were categorized into three groups (low, middle, high), CAD prevalence increased with increasing BLLs (P < 0.05). In the multivariate regression model, BLLs were associated with CAD (odds ratio (OR): 1.023, 95% confidence interval (CI): 1.008-1.039; P = 0.0017). OR in the high versus low BLL group was 2.36 (95% CI: 1.29-4.42,P = 0.003). Furthermore, BLLs were independently associated with intermediate and high SXscore (adjusted OR: 1.050, 95% CI: 1.036-1.066; P < 0.0001). CONCLUSION: BLLs were significantly associated with angiographically diagnosed CAD. Furthermore, BLLs showed excellent predictive value for SXscore, especially for complex coronary artery lesions.

Balloon internal fixation: A novel approach to manipulate catheter knotting.

A successful alternative technique to resolve the catheter knotting during radial access using balloon internal fixation of 5F angiographic catheter in the cath laboratory.

PHD Finger Protein 19 Promotes Cardiac Hypertrophy via Epigenetically Regulating SIRT2.

Epigenetic regulations essentially participate in the development of cardiomyocyte hypertrophy. PHD finger protein 19 (PHF19) is a polycomb protein that controls H3K36me3 and H3K27me3. However, the roles of PHF19 in cardiac hypertrophy remain unknown. Here in this work, we observed that PHF19 promoted cardiac hypertrophy via epigenetically targeting SIRT2. In angiotensin II (Ang II)-induced cardiomyocyte hypertrophy, adenovirus-mediated knockdown of Phf19 reduced the increase in cardiomyocyte size, repressed the expression of hypertrophic marker genes Anp and Bnp, as well as inhibited protein synthesis. By contrast, Phf19 overexpression promoted Ang II-induced cardiomyocyte hypertrophy in vitro. We also knocked down Phf19 expression in mouse hearts in vivo. The results demonstrated that Phf19 knockdown reduced Ang II-induced decline in cardiac fraction shortening and ejection fraction. Phf19 knockdown also inhibited Ang II-mediated increase in heart weight, reduced cardiomyocyte size, and repressed the expression of hypertrophic marker genes in mouse hearts. Further mechanism studies showed that PHF19 suppressed the expression of SIRT2, which contributed to the function of PHF19 during cardiomyocyte hypertrophy. PHF19 bound the promoter of SIRT2 and regulated the balance between H3K27me3 and H3K36me3 to repress the expression of SIRT2 in vitro and in vivo. In human hypertrophic hearts, the overexpression of PHF19 and downregulation of SIRT2 were observed. Of importance, PHF19 expression was positively correlated with hypertrophic marker genes ANP and BNP but negatively correlated with SIRT2 in human hypertrophic hearts. Therefore, our findings demonstrated that PHF19 promoted the development of cardiac hypertrophy via epigenetically regulating SIRT2.

Novel Pathway for Vanadium(V) Bio-Detoxification by Gram-Positive Lactococcus raffinolactis.

Whereas prospects of bioremediation for a vanadium(V) [V(V)]-contaminated environment are widely recognized, reported functional species are extremely limited, with the vast majority of Gram-negative bacteria in Proteobacteria. Herein, the effectiveness of V(V) reduction is proved for the first time by Lactococcus raffinolactis, a Gram-positive bacterium in Firmicutes. The V(V) removal efficiency was 86.5 ± 2.17% during 10-d operation, with an average removal rate of 4.32 ± 0.28 mg/L·d in a citrate-fed system correspondingly. V(V) was bio-reduced to insoluble vanadium(IV) and distributed both inside and outside the cells. Nitrite reductase encoded by gene nirS mainly catalyzed intracellular V(V) reduction, revealing a previously unrecognized pathway. Oxidative stress induced by reactive oxygen species from dissimilatory V(V) reduction was alleviated through strengthened superoxide dismutase and catalase activities. Extracellular polymeric substances with chemically reactive hydroxyl (-OH) and carboxyl (-COO-) groups also contributed to V(V) binding and reduction as well as ROS scavenging. This study can improve the understanding of Gram-positive bacteria for V(V) bio-detoxification and offer microbial resources for bioremediation of a V(V)-polluted environment.

Microbial vanadate reduction coupled to co-metabolic phenanthrene biodegradation in groundwater.

Vanadate [V(V)] and phenanthrene (PHE) commonly coexist in groundwater aquifer, posing potential threats to ecological environment and public health. However, little is known about the complicated biogeochemical processes involving microbial V(V) reduction coupled with co-metabolic PHE biodegradation. Herein we demonstrated that synchronous removal of V(V) and PHE could be realized under anaerobic condition. Complete V(V) removal and PHE degradation efficiency of 82.0 ± 0.8% were achieved in 7-d operation in batch experiment. 250-d continuous column experiment implied that hydrochemical condition affected V(V) and PHE removals. V(V) was reduced to insoluble vanadium (IV) and PHE was degraded into small molecule organics (e.g. salicylic acid). Geobacter and Acetobacterium used methanol and intermediates from PHE degradation as electron donors for V(V) reduction. PHE was decomposed by Mycobacterium and Clostridium with methanol as co-metabolic substrate and V(V) as electron acceptor. Genes encoding proteins for V(V) reduction (omcA, omcB and mtrC) and PHE degradation (phnAc) were upregulated. Cytochrome c and nicotinamide adenine dinucleotide promoted electron transfer for V(V) and PHE detoxification. Extracellular polymeric substances could bind V(V) and improve the bioavailability of PHE. Our findings provide a robust strategy for remediation of V(V) and PHE co-contaminated groundwater.

Revascularization versus drug therapy for coronary artery disease in patients aged over 80 years: a real-world study.

BACKGROUND: Revascularization for the treatment of coronary artery disease (CAD) is advancing rapidly and is used increasingly in old patients. This study aimed to compare the efficacy and safety of revascularization with drug therapy in CAD patients aged over 80 years at a real-world clinical setting. METHODS: A total of 501 CAD patients aged over 80 years were consecutively enrolled from January 2011 to January 2016 in Anzhen Hospital (Beijing, China), Capital Medical University. The patients were treated with percutaneous coronary intervention (PCI) (n=283), coronary artery bypass grafting (CABG) (n=106), or drug therapy (n=112). All-cause mortality, cardiovascular-related mortality, readmission rate, and Seattle Angina Questionnaire (SAQ) score were compared between the three treatment methods. RESULTS: A total of 411 patients (82.04%) were followed with a median duration of 25 months. All-cause mortality and cardiovascular-related mortality in the drug therapy group were significantly higher than the PCI and CABG groups (both P<0.05). Readmission rate for cardiovascular events in the CABG group was significantly lower than the PCI and drug therapy groups (both P<0.05). Scores of physical limitation, angina frequency, treatment satisfaction, and disease perception of the SAQ in the PCI and CABG groups were significantly higher than the drug therapy group (both P<0.05). Scores of angina stability did not differ significant between the three groups (P=0.127). CONCLUSIONS: Revascularization is superior to drug therapy in efficacy and safety in the treatment of oldest-old patients with CAD.

Clinical efficacy of different treatments and their impacts on the quality of life of octogenarians with coronary artery disease.

BACKGROUND: Coronary artery disease (CAD) in octogenarians (age of ≥80 years) has a high risk of mortality and high medical expenses. Research shows that the prevalence of CAD is higher among octogenarians than that among younger people, but few such patients undergo percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). This study aimed to evaluate different treatments with respect to their clinical effects and impacts on quality of life of octogenarians with CAD. METHODS: Data of 519 octogenarians with CAD consecutively treated at Beijing Anzhen Hospital, Capital Medical University (Beijing, China) from January 2010 to January 2016 were collected in this study. The patients were categorized into three groups based on the treatments they received: the PCI group (n = 292), CABG group (n = 110), and medical treatment group (n = 117). The followings were recorded during follow-up: clinical data, death (all-cause and cardiovascular-related), re-hospitalization time, Seattle Angina Questionnaire (SAQ) score, and occurrence of hemorrhagic events (cerebral bleeding, gastrointestinal bleeding, and dermal ecchymosis). RESULTS: The median follow-up duration was 25.0 (25th, 75th percentile: 17.0, 55.5) months among 417 patients. The all-cause death rates (28.2% vs. 12.0% and 14.6%, respectively) and cardiovascular-related death rates (15.4% vs. 3.8% and 6.4%, respectively) were significantly higher in the medical treatment group than those in the PCI group and CABG group (all P < 0.05). The re-hospitalization rate for cardiovascular events was significantly lower in the CABG group than those in the PCI group and medical treatment group (3.8% vs. 12.8% and 14.9%, respectively) (χ = 8.238, P = 0.018). The SAQ scores of physical limitation, angina frequency, treatment satisfaction, and disease perception were significantly higher in the PCI group and CABG group than those in the medical treatment group (all P < 0.05). No significant difference in the angina stability score was observed among the three groups (F = 3.179, P = 0.204). CONCLUSION: PCI and CABG result in reduced mortality and better quality of life in octogenarians with CAD.

2,3,5,4'-Tetrahydroxystilbene-2-O-ß-d-glucoside eliminates ischemia/reperfusion injury-induced H9c2 cardiomyocytes apoptosis involving in Bcl-2, Bax, caspase-3, and Akt activation.

OBJECTIVE: This study was designed to explore the protective effect of 2,3,5,4'-tetrahydroxystilbene-2-O-ß-d-glucoside (TSG) against ischemia/reperfusion (I/R) injury-induced cardiomyocytes apoptosis. METHODS: The H9c2 cell I/R injury model was induced by simultaneous shortage of nutrients and oxygen. TSG administration (0.10, 0.25, and 0.50 mM) was performed before and during I/R stimulation. Cell apoptosis was evaluated using terminal deoxynucleotidyl transferase dUTP nick end labeling assay. Expression of cell-related proteins was detected to assess the effect of TSG on cell apoptosis. RESULTS: I/R injury induced significant cell apoptosis. Significantly decreased Bcl-2 and increased Bax, caspase-3, and p-Akt expression ( P < 0.01) was detected in the cell model of I/R injury. In contrast, TSG administration eliminated all the changes induced by I/R injury in a dose-dependent manner. Compared with the H9c2 cell model of I/R injury, the H9c2 cells treated with 0.50 mM TSG showed the lowest cell apoptosis percentage, the highest expression of Bcl-2, and the lowest expression of Bax, caspase-3, and p-Akt ( P < 0.01). CONCLUSION: We confirmed that the protective effect of TSG against I/R injury-induced cell apoptosis in H9c2 in vitro was associated with the Bcl-2/Bax ratio, caspase-3, and Akt activation.

Downregulation of PTEN by sodium orthovanadate protects the myocardium against ischemia/reperfusion injury after chronic atorvastatin treatment.

Acute statin treatment has been reported to be critical in protecting the cardiac cells against ischemia/reperfusion injury by activating PI3K/Akt signal pathway. In vitro rat myocardial ischemia/reperfusion model, chronic statin treatment led to upregulation of phosphatase and tensin homolog (PTEN). This has been potentially indicated the correlation in PTEN and protective effect of statin on myocardium. In this current study, we evaluated the role of sodium orthovanadate a nonspecific inhibitor to PTEN and its correlation with atorvastatin on protecting myocardium against ischemia/reperfusion injury. We found a long-term statin treatment could increase the PTEN level, and this process was counteracted in the presence of sodium orthovanadate. However, the phosphotyrosine level was not affected by this statin. Besides, this process was mediated by Akt signaling since phosphorylated Akt level was altered by statin and sodium orthovanadate treatment. In a conclusion, this study showed a potential mechanism underlying PTEN-induced attenuation in long-term statin's therapeutic effect, which provided the new insight into the synergic role of PTEN and atorvastatin in protecting cardiac cells against ischemia/reperfusion injury.

Unfractionated Heparin with Sequential Enoxaparin in Patients with Complex Coronary Artery Lesions during Percutaneous Coronary Intervention.

BACKGROUND: Unfractionated heparin (UFH), despite its limitations, has been used as the primary anticoagulant alternative during the percutaneous coronary intervention (PCI). Some studies indicated that intravenous enoxaparin could be an effective and safe option. Our team used enoxaparin alone at one time according to the guidelines (Class IIA) and found a little catheter thrombosis during PCI. We recommend a new anticoagulation strategy using enoxaparin in combination with UFH. Enoxaparin has a more predictable anticoagulant response with no need of repeatedly monitoring anticoagulation during PCI. This retrospective study aimed to evaluate the efficacy and safety of using enoxaparin in combination with UFH in PCI patients with complex coronary artery disease. METHODS: Between January 2015 and April 2017, 600 PCI patients who received intravenous UFH at an initial dose of 3000 U plus intravenous enoxaparin at a dose of 0.75 mg/kg (observation group) and 600 PCI patients who received UFH at a dose of 100 U/kg (control group) were consecutively included in this retrospective study. The endpoints were postoperative 48-h thrombolysis in myocardial infarction (TIMI) bleeding and transfusion and 30-day and 1-year major adverse cardio-cerebrovascular events (MACCE). RESULTS: Baseline clinical, angiographic, and procedural characteristics were similar between groups, except there was less stent implantation per patient in the observation group (2.13 vs. 2.25 in the control group, P = 0.002). TIMI bleeding (3.3% vs. 4.7%) showed no significant difference between the observation group and control group. During the 30-day follow-up, the rate of MACCE was 0.9% in the observation group and 1.5% in the control group. There was no significant difference in the rates of MACCE, death, myocardial infarction, target vessel revascularization, cerebrovascular event, and angina within 30 days and 1 year after PCI between groups as well as in the subgroup analysis of transfemoral approach. CONCLUSIONS: UFH with sequential enoxaparin has similar anticoagulant effect and safety as UFH in PCI of complex coronary artery disease.

Performances and structures of functional microbial communities in the mono azo dye decolorization and mineralization stages.

Removal of azo dye from wastewater with biological method is a complicated process, including decolorization and mineralization. However, there is little understanding of the functional microbial community involved in the whole dye degradation process. In this study, a simplified model using anaerobic3-oxic2-sedimentaion reactor was proposed. Acid Orange and Methyl Orange were treated as model azo dyes. In each compartment, the degradation intermediates of azo dyes were identified with UV-Vis, FTIR, HPLC-MS and GC-MS, and the corresponding microorganisms were determined with 16S rDNA high throughput Miseq sequencing. Decolorization happened in anaerobic compartments, while mineralization of the resulted aromatic amines mainly occurred under aerobic circumstance. LEfSe analysis demonstrated that the microbial community compositions were significantly influenced by the chemical structures of substrates. With t-value biplot, the relationship between azo dye degradation and microbial community structure was proposed statistically. It was found that the functional microbial communities varied with the change of azo dye degradation intermediates. Besides, cleavage of benzene ring also happened under anaerobic circumstance. This may be due to the genera of Parabacteroides and Bacteroides, which exhibited significantly positive relationships with 1,4-Benzenediol. With the new model, the performances and structures of functional microbial communities for NN- reduction and aromatic amines mineralization were characterized and the reaction mechanism was explored.

Enhancement of synchronous bio-reductions of vanadium (V) and chromium (VI) by mixed anaerobic culture.

The co-occurrence of toxic vanadium (V) and chromium (VI) in groundwater receives incremental attention while knowledge on their interactions in biogeochemical processes is limited, with lack of efficient removal means. This study is the first to realize synchronous bio-reductions of V(V) and Cr(VI) with high efficiency by mixed anaerobic culture. After 72-h operation, 97.0 ±â€¯1.0% of V(V) and 99.1 ±â€¯0.7% of Cr(VI) were removed, respectively, with initial concentration of 1 mM for both V(V) and Cr(VI). Cr(VI) bio-reduction took priority while V(V) detoxification was inhibited. V(IV) and Cr(III) were the identified reduction products, both of which could precipitate naturally. Initial Cr(VI) and acetate concentrations as well as pH affected this process significantly. High-throughput 16S rRNA gene sequencing analysis indicated the accumulation of Anaerolineaceae, Spirochaeta and Spirochaetaceae, which could contribute to V(V) and Cr(VI) bio-reductions. The new knowledge obtained in this study will facilitate understanding the biogeochemical fate of co-existing V(V) and Cr(VI) in groundwater and development of bioremediation strategy for their induced combined pollution.

Identify Unsuitable Patients with Left Main Coronary Artery Disease in Intermediate SYNTAX Scores Treated by Percutaneous Coronary Intervention.

BACKGROUND: With the follow-up extending to 5 years, the outcomes of SYNTAX (Synergy Between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery) trial were comparable between coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) in left-main (LM) patients with intermediate SYNTAX scores of 23-32. A subdivision depending on SYNTAX score will help to identify unsuitable LM patients with intermediate SYNTAX scores to receive PCI treatment. METHODS: Between January 2011 and June 2013, 104 patients with LM Coronary Artery Disease (CAD) undergoing PCI were selected retrospectively. We compared clinical outcomes in patients with SYNTAX score <27 and ≥27. The follow-up time was 25.23 ± 7.92 months. Kaplan-Meier survival analyses and Cox proportional hazards models were used to compare various outcomes between two groups. RESULTS: Higher rates of repeated revascularization (18.2% versus 4.2%, P = .027) and major adverse cerebro-cardiovascular events (MACCE) (24.2% versus 7.0%, P = .014) were shown in patients with SYNTAX score ≥ 27. After multivariate adjustment, a significant higher risk of repeated revascularization (hazard ratio: 6.25, 95% confidence interval: 1.48 to 26.37, P = .013) and MACCE (hazard ratio: 4.49, 95% confidence interval: 1.41 to 14.35, P = .011) were also found in patients with SYNTAX score ≥ 27. CONCLUSIONS: Based on the higher rate of repeated revascularization and MACCE, patients with LM CAD and intermediate SYNTAX scores will need a subdivision to identity the one not benefit from PCI. CABG is still the standard treatment method for patients of LM CAD with a SYNTAX score of ≥ 27.

Microbial reduction of vanadium (V) in groundwater: Interactions with coexisting common electron acceptors and analysis of microbial community.

Vanadium (V) pollution in groundwater has posed serious risks to the environment and public health. Anaerobic microbial reduction can achieve efficient and cost-effective remediation of V(V) pollution, but its interactions with coexisting common electron acceptors such as NO3-, Fe3+, SO42- and CO2 in groundwater remain unknown. In this study, the interactions between V(V) reduction and reduction of common electron acceptors were examined with revealing relevant microbial community and identifying dominant species. The results showed that the presence of NO3- slowed down the removal of V(V) in the early stage of the reaction but eventually led to a similar reduction efficiency (90.0% ± 0.4% in 72-h operation) to that in the reactor without NO3-. The addition of Fe3+, SO42-, or CO2 decreased the efficiency of V(V) reduction. Furthermore, the microbial reduction of these coexisting electron acceptors was also adversely affected by the presence of V(V). The addition of V(V) as well as the extra dose of Fe3+, SO42- and CO2 decreased microbial diversity and evenness, whereas the reactor supplied with NO3- showed the increased diversity. High-throughput 16S rRNA gene pyrosequencing analysis indicated the accumulation of Geobacter, Longilinea, Syntrophobacter, Spirochaeta and Anaerolinea, which might be responsible for the reduction of multiple electron acceptors. The findings of this study have demonstrated the feasibility of anaerobic bioremediation of V(V) and the possible influence of coexisting electron acceptors commonly found in groundwater.