Investigation of the predictive value of a novel algorithm based on coronary CT angiography regarding fractional flow reserve and revascularization in patients with stable coronary artery disease.

Fractional flow reserve (FFR) has been established as a gold standard for functional coronary ischemia. At present, the FFR can be calculated from coronary computed tomography angiography (CCTA) images (CT-FFR). Previous studies have suggested that CT-FFR outperforms CCTA and invasive coronary angiography (ICA) in determining hemodynamic significance of stenoses. Recently, a novel automatical algorithm of CT-FFR called RuiXin-FFR has been developed. The present study is designed to investigate the predictive value of this algorithm and its value in therapeutic decision making. The present study retrospectively included 166 patients with stable coronary artery disease (CAD) who underwent CCTA screening and diagnostic ICA examination at Peking University People's Hospital, in 73 of whom wire-derived FFR was also measured. CT-FFR analyses were performed with a dedicated software. All patients were followed up for at least 1 year. We validated the accuracy of RuiXin-FFR with invasive FFR as the standard of reference, and investigated the role of RuiXin-FFR in predicting treatment strategy and long-term prognosis. The mean age of the patients was 63.3 years with 63.9% male. The CT-FFR showed a moderate correlation with wire-derived FFR (r = 0.542, p < 0.0001) and diagnostic accuracy of 87.6% to predict myocardial ischemia (AUC: 0.839, 95% CI 0.728-0.950), which was significantly higher than CCTA and ICA. In the multivariate logistic regression analysis, CT-FFR ≤ 0.80 was an independent predictor of undergoing coronary revascularization (OR: 45.54, 95% CI 12.03-172.38, p < 0.0001), whereas CT-FFR > 0.80 was an independent predictor of non-obstructive CAD (OR: 14.67, 95% CI 5.42-39.72, p < 0.0001). Reserving ICA and revascularization for vessels with positive CT-FFR could have reduced the rate of ICA by 29.6%, lowered the rate of ICA in vessels without stenosis > 50% by 11.7%, and increased the rate of revascularization in patients receiving ICA by 21.2%. The average follow-up was 23.7 months, and major adverse cardiovascular events (MACE) occurred in 11 patients. The rate of MACE was significantly lower in patients with CT-FFR > 0.80. The new algorithm of CT-FFR can be used to predict the invasive FFR. The RuiXin-FFR can also provide useful information for the screening of patients in whom further ICA is indeed needed and prognosis evaluation.

Left ventricular function and coronary microcirculation in patients with mild reduced ejection fraction after STEMI.

BACKGROUND: The characteristics of heart failure (HF) with mildly reduced ejection fraction (EF) (HFmrEF) overlap with those of HF with reduced EF (HFrEF) and HF with preserved EF (HFpEF) and need to be further explored. This study aimed to evaluate left ventricular (LV) function and coronary microcirculation in patients with mildly reduced ejection fraction after acute ST-segment elevation myocardial infarction (STEMI). METHODS: We enrolled 119 patients with STEMI who had undergone speckle tracking imaging and myocardial contrast echocardiography during hospitalization from June 2016 to June 2021. They were classified into normal, HFmrEF, and HFrEF groups according to their left ventricular EF (LVEF): ≥ 50%, 40-50%, and ≤ 40%, respectively. The data of the HFmrEF group were analyzed and compared with those of the normal and HFrEF groups. RESULTS: HFmrEF was observed in 32 patients (26.9%), HFrEF in 17 (14.3%), and normal LVEF in 70 patients (58.8%). The mean global longitudinal strain (GLS) of all patients was - 11.9 ± 3.8%. The GLS of HFmrEF patients was not significantly different from that of the HFrEF group (- 9.9 ± 2.5% and - 8.0 ± 2.3%, respectively, P = 0.052), but they were both lower than that of the normal group (- 13.8% ± 3.5%, P < 0.001). The HFmrEF group exhibited significantly poorer myocardial perfusion index (1.24 ± 0.33) than the normal group (1.08 ± 0.14, P = 0.005) but displayed no significant difference from the HFrEF group (1.18 ± 0.19, P = 0.486). Moreover, a significant difference in the incidence of regional wall motion (WM) abnormalities in the three groups was observed (P = 0.009), and the WM score index of patients with HFmrEF was 1.76 ± 0.30, similar to that of patients with HFrEF (1.81 ± 0.43, P = 0.618), but poorer than that in the normal group (1.33 ± 0.25, P < 0.001). CONCLUSIONS: GLS is a more sensitive tool than LVEF for detecting LV systolic dysfunction. The LV systolic function, coronary microcirculation, and WM in patients with HFmrEF was poorer than that of patients with normal LVEF, but comparable to that in patients with HFrEF. Patients with HFmrEF after STEMI require more attention and appropriate management.

White thrombi on optical coherence tomography after rotational atherectomy of severely calcified coronary lesions.

PURPOSE: Rotational atherectomy (RA) has improved percutaneous treatment of severely calcified coronary lesions, but the "no-reflow" phenomenon remains a serious complication. Platelet activation by RA may contribute to no-reflow, and the use of optical coherence tomography (OCT) to test the effect of RA on white thrombus could confirm platelet activation indirectly. METHODS: We analyzed 53 consecutive patients with severely calcified lesions on coronary angiography. All patients were examined with OCT. In total, 20 patients who received RA and for whom OCT imaging was performed before and after RA and stent implantation comprised the RA group. The remaining 33 patients formed the control group, for whom OCT imaging was performed before balloon dilatation and after stent implantation. RESULTS: The patients in the RA group were older and had a higher incidence of diabetes mellitus. In the control group, there was no thrombogenesis during the procedure, whereas in the RA group, all the target vessels had white thrombi on OCT after RA. The average number of white thrombi per lesion after RA was 7.23 ± 4.4, and the average length of white thrombus was 0.51 ± 0.33 mm. Statistical analysis with Pearson's correlation coefficient showed that thrombus load was related to burr size (r = 0.575, p = 0.040) and number of rotations (r = 0.599, p = 0.031). CONCLUSION: White thrombi during RA can be verified by performing OCT. Treating calcified lesions with RA may enhance thrombogenesis. These data suggest using appropriate therapy to avoid no-reflow during RA.

Epirubicin-induced Kounis syndrome.

BACKGROUND: Kounis syndrome is an acute coronary syndrome that appears in the setting of anaphylactic reaction or hypersensitivity. Many drugs and environmental exposures have been identified as potential offenders, and diagnosis and treatment can be challenging. CASE PRESENTATION: A 62-year-old man with recurrent bladder cancer underwent an intra-iliac artery epirubicin injection. After the injection, he developed chest pain and a systemic allergic reaction, with electrocardiographic alterations and elevated troponin-I levels. Emergent coronary angiography showed right coronary artery spasm and no stenosis of the other coronary arteries. This reaction was considered compatible with an allergic coronary vasospasm. A diagnosis of Kounis syndrome was made. CONCLUSIONS: Kounis syndrome is common, but a prompt diagnosis is often not possible. This case is the first to suggest that an intraarterial epirubicin injection could potentially be one of its triggers. All physicians should be aware of the pathophysiology of this condition to better recognize it and start appropriate treatment; this will prevent aggravation of the vasospastic cardiac attacks and yield a better outcome.

Comparison of optical coherence tomography-guided and intravascular ultrasound-guided rotational atherectomy for calcified coronary lesions.

BACKGROUND: To compare the effect and outcomes of optical coherence tomography (OCT)-guided rotational atherectomy (RA) with intravascular ultrasound (IVUS)-guided RA in the treatment of calcified coronary lesions. METHODS: Data of calcified coronary lesions treated with RA that underwent OCT-guided or IVUS-guided from January 2016 to December 2019 at a single-center registry were retrospectively analyzed. The effect and outcomes between underwent OCT-guided RA and IVUS-guided RA were compared. RESULTS: A total of 33 lesions in 32 patients received OCT-guided RA and 51 lesions in 47 patients received IVUS-guided RA. There was no significant difference between OCT-guided RA group and IVUS-guided RA group in clinical baselines characteristics. Comparing the procedural and lesions characteristics of the two groups, the contrast volume was larger [(348.8 ± 110.6) ml vs. (275.2 ± 76.8) ml, P = 0.002] and the scoring balloon was more frequently performed (33.3% vs. 3.9%, P = 0.001) after RA and before stenting in the OCT-guided RA group. Comparing the intravascular imaging findings of the two groups, stent expansion was significantly larger in the OCT-guided RA group ([82 ± 8]% vs. [75 ± 9]%, P = 0.001). Both groups achieved procedural success immediately. There were no significantly differences in the incidence of complications. Although there was no statistical difference in the occurrence of MACE at 1 year between OCT-guided RA group and IVUS-guided RA group (3.1% vs. 6.4%, P = 0.517), no cardiovascular death, TVR and stent thrombosis occurred in OCT-guided RA group. CONCLUSIONS: OCT-guided RA compared to IVUS-guided RA for treating calcified coronary lesions resulted in better stent expansion and may have improved prognosis.

Comparison of bailout and planned rotational atherectomy for severe coronary calcified lesions.

BACKGROUND: To compare outcomes of bailout and planned rotational atherectomy (RA) in the treatment of severe calcified coronary lesions. METHODS: Data of patients treated with RA from 2017 to 2018 at a single-center registry were retrospectively analyzed. All patients were divided into planned RA and bailout RA groups, data between two groups were compared. RESULTS: A total of 190 patients were included in this study, 138 patients received planned RA and 52 patients received bailout RA. Baseline clinical characteristics had no significant differences between groups. The number of implanted stents and total stents length were similar. But the number of balloon (1.6 ± 0.8 vs. 2.7 ± 1.3, P < 0.001), procedure time (83.5 ± 26.2 vs. 100.8 ± 36.4 min, P = 0.007), fluoroscopy volume (941 ± 482 vs. 1227 ± 872 mGy, P = 0.012] and contrast amount (237 ± 62 vs. 275 ± 90 ml, P = 0.003) were all lower in planned RA group. Planned RA had a higher procedural success rate (99.3% vs. 92.3%, P = 0.007) and a lower complication incidence (4.3% vs. 17.3%, P = 0.009). But the primary outcomes at 3 years (9.2 and 16.6%, log rank p = 0.24) had no difference between groups. CONCLUSIONS: For severe coronary artery calcification, although planned RA did not improved the long term prognosis compared with bailout RA, but it can improve the immediate procedural success rate, reduce the incidence of complications, the procedure time and the volume of contrast.

Modified high-throughput quantification of plasma microRNAs in heparinized patients with coronary artery disease using heparinase.

Heparin, a widely used anticoagulant in cardiovascular diseases, is notorious for its inhibitory effect on qRT-PCR-based detection. Heparinase I could degrade heparin in RNA. qRT-PCR-based TaqMan Low Density Array (TLDA) technology is commonly used for circulating microRNAs (miRNAs) profiling analysis. However, the effect of heparin contamination on inhibition of miRNAs TLDA amplification, as well as the method for removing heparin during this process, are not yet well investigated. We obtained the plasma RNA samples from patients undergoing percutaneous coronary intervention (PCI) before and after heparinization (n = 26). We found that heparin suppressed the miRNAs amplification by ∼8 cycles in the TLDA assay, which was absolutely reversed after treating the RNA samples with heparinase I using the components from TLDA reverse transcription system. We further observed that heparin inhibited the miRNAs amplification by ∼4 cycles in the qRT-PCR assay, which was also reversed by heparinase I using the similar method. Furthermore, we demonstrated that plasma miR-92a and miR-155 were differentially expressed in the patients undergoing PCI tested by TLDA assay, which was validated by qRT-PCR. In conclusion, we present a simple method for the removal of heparin with heparinase I, and for the subsequent successful miRNAs TLDA or RT-qPCR amplification.

TRPV1 activation is involved in the cardioprotection of remote limb ischemic postconditioning in ischemia-reperfusion injury rats.

Limb remote ischemic postconditioning (RIPostC) has been proved to be a safe and effective measurement of cardioprotection against ischemia-reperfusion injury. But what bridges the remote organ insult and the cardioprotective effect in heart remains to be elucidated. This study aimed to found that whether TRPV1 may mediate the cardioprotective effect from remote organ to heart and the role of CGRP and SP in this process. We found that RIPostC effectively ameliorated cardiac ischemia/reperfusion injury in terms of limiting infarct size, lowering CK and cTnI release and improving cardiac function. In addition, these cardioprotective effects could be significantly abolished by inhibition of either CGRP or SP receptors with corresponding antagonists (CGRP8-37 for CGRP and RP-67580 for SP) injected before reperfusion. Besides, RIPostC resulted in significantly increase in the levels of CGRP and SP in plasma and hearts, as well as the levels and mRNA expression of CGRP and SP in DRG. The increase in CGRP and SP levels in plasma and hearts were markedly inhibited by TRPV1 receptor antagonist capsazepine. These findings indicate that limb remote ischemic postconditioning could attenuate cardiac ischemia/reperfusion injury in rats, and the cardioprotective mechanism is via TRPV1-mediated upregulation of CGRP and SP, which could subsequently act on their corresponding receptors in heart tissue.

Inactivation of glycogen synthase kinase-3ß up-regulates ß-catenin and promotes chondrogenesis.

This study aimed to investigate whether inhibition of glycogen synthase kinase-3ß (GSK-3ß) could promote chondrocytes proliferation. The expression pattern of GSK-3ß was firstly determined by immunohistochemistry (IHC) in normal mouse. Tibias were then isolated and cultured for 6 days. The tibias were treated with dimethylsulfoxide (control) or GSK-3 inhibitor SB415286 (SB86). Length of tibias was measured until 6 days after treatment. These bones were either stained with alcian blue/alizarin red or analyzed by IHC. In addition, GSK-3ß and ß-catenin were analyzed by Western blot. Finally, cartilage-specific GSK-3ß deletion mice (KO) were generated. Efficiency of GSK-3ß deletion was determined through Western blot and IHC. After treated by inhibitor SB86, the overall length of growth plate was not changed. However, growth of tibia in SB86 group was increased by 31 %, the length of resting and proliferating was increased 13 % (P < 0.01), whereas the length of hypertrophic was decreased by 57 % (P < 0.01). Besides, the mineralized length was found to be significant longer than the control group (P < 0.05). In KO mice, growth plate and calvaria tissue both exhibit significant reduction of GSK-3ß (P < 0.05) whereas the lengths of tibias in KO were almost same compared with control mice. Finally, an increase amount of ß-catenin protein was observed in SB86 (P < 0.05). In addition, significantly increased ß-catenin was also found in the growth plate of KO mice (P < 0.05). Inhibition of GSK-3 could promote longitudinal growth of bone through increasing bone formation. Besides, the inactivation of GSK-3ß could lead to enhancing ß-catenin, therefore promote chondrocytes proliferation.

MicroRNA-19b functions as potential anti-thrombotic protector in patients with unstable angina by targeting tissue factor.

The activation of a hemostatic system plays a critical role in the incidence of acute coronary events. Hemostatic proteins may be regulated by microRNAs (miRNAs). Microparticles (MPs) are the major carrier of circulating miRNAs. The aim of this study was to determine the potential role of miRNAs in regulating gene expression involved in the hemostatic system in patients with unstable angina (UA). MiRNA expression profiles in the plasma from patients with UA (UA group, n=9) compared with individuals with clinical suspicion of coronary artery disease (CAD) but negative angiography (control group, n=9) showed that among 36 differentially expressed miRNAs, miR-19b was the most obvious one. Using real-time PCR, 5 selected miRNA levels in plasma (UA group, n=20; control group, n=30) and plasma MPs (UA group n=6; control group n=6) were proved to be consistent with the miRNA array. Flow cytometry analysis indicated that the amounts of plasma endothelial microparticles (EMPs) were increased in UA patients (UA group, n=4) compared to controls (control group, n=4). In cultured endothelial cells (ECs), TNF-α increased miR-19b release and expression. Tissue factor (TF) was predicted to be the target of miR-19b by bioinformatics analysis. Luciferase reporter assays demonstrated that miR-19b binds to TF mRNA. Overexpression of miR-19b inhibited TF expression and procoagulant activity. This study indicates that in UA patients, the increase of miR-19b wrapped in EMPs due to endothelial dysfunction may partially contribute to the circulating miR-19b elevation and miR-19b may play an anti-thrombotic role by inhibiting the expression of TF in ECs.

Association analysis of two candidate polymorphisms in the tumour necrosis factor-α gene with osteoarthritis in a Chinese population.

PURPOSE: The purpose of this study was to investigate the possible association between single nucleotide polymorphisms (SNPs) rs1800629 (TNF-α -308) and rs361525 (TNF-α -238) of the tumour necrosis factor (TNF)-α gene and susceptibility to osteoarthritis (OA) in the Han Chinese population. METHODS: The TNF-α -308 and -238 genotypes were determined by TaqMan assay in 200 OA cases and 305 controls. Odds ratios (ORs) for OA and 95% confidence intervals (CIs) from unconditional logistic regression models were used to evaluate relative risks. RESULTS: The frequencies of the allele 'A' of rs1800629 were 16% and 8.85% in OA cases and in controls, respectively, and thus the -308A allele had a 1.9612-fold (95% CI = 1.3323-2.8869, P < 0.001) increased risk for OA as compared to the -308G allele. However, no significant differences were found in the genotype and allele frequencies for rs361525 between OA and HC groups. CONCLUSIONS: In the Han Chinese population, the allele 'A' of TNF-α -308 may increase the risk for OA, whereas TNF-α -238 polymorphisms do not play a role in OA patients.

Optimized N application improves N absorption, population dynamics, and ear fruiting traits of wheat.

Optimizing the N application amount and topdressing ratio can increase crop yield and decrease N loss, but its internal mechanisms have not been well studied, especially from the aspects of population dynamics and structure, ear fruiting traits. Here, field experiments, with three N rates 120 (N1), 180 (N2), and 240 (N3) kg N ha-1 and three N topdressing ratios T1 (7:3), T2 (6:4), and T3 (5:5) were conducted. At the same N level, results showed that the N accumulation amounts in the leaf, grain, and plant in T2 were higher than in T3 and T1, and increasing 60 kg N ha-1 (N3 compared to N2, N2 compared to N1) significantly enhanced N accumulation amounts. The effect of the N topdressing ratio on partial factor productivity of applied N was consistently T2 > T3 > T1, but T1 was more conducive to improving N utilization efficiency for grain and biomass production. After the jointing stage, compared to T1 and T3, T2 was more conducive to increasing the population growth rate of plant height, leaf area index, leaf area growth rate, dry matter weight, dry matter accumulation rate, light interception rate, and spikelets of population, and the above-mentioned indexes of population could be significantly enhanced by increasing 120 kg N ha-1. T2 increased the fruiting spikelets per ear, grains per ear, grain weight per ear, fruiting rate per ear, grain filling rate per ear, and yield but decreased the sterile spikelets at the top and bottom and imperfect grains per ear. Increasing N from 120 kg ha-1 to 180 kg ha-1 or from 180 kg ha-1 to 240 kg ha-1 significantly enhanced yield. The N accumulation amount in the grain, leaf, plant, leaf area growth rate, dry matter accumulation rate, light interception rate, population spikelets, fruiting spikelets per ear, grain filling rate, and yield were significantly positively correlated with each other. This study demonstrates a suitable N application rate with a N topdressing ratio 6:4 would more effectively improve N efficiency, population dynamics, structure, ear fruiting traits, and yield, but the effect of the N topdressing ratio is not as significant as that of increasing 60 kg N ha-1.

Response of Canopy Photosynthesis, Grain Quality, and Harvest Index of Wheat to Different Nitrogen Application Methods.

To fully explore the effects of N on enhancing photosynthesis, grain quality, and yield of wheat (Ningmai 13), experiments with four nitrogen levels 0 (N0), 120 (N1), 180 (N2), and 240 (N3) kg N ha−1 and four ratios of basal to topdressing R0 (0:0), R1 (7:3), R2 (6:4), and R3 (5:5) were conducted. The basal N was applied to soil before sowing and the topdressing N was applied at jointing stage. The effect of N topdressing ratio on improving leaf area of photosynthetic efficiency was insignificant under the same N level. The effect of N fertilization level on increasing chlorophyll content was more significant than that of N topdressing ratio. Within the same N level, the canopy photosynthetically active radiation in R2 was higher than that in R1 and R3, and increasing N by 60 kg ha−1 significantly enhanced canopy photosynthetically active radiation. The effect of N topdressing ratio on photosynthetic rate, stomatal conductance, and transpiration rate were consistently R2 > R3 > R1; compared to N1, N3 could significantly increase photosynthetic rate. Increasing 120 kg N ha−1 significantly enhanced grain protein content, wet gluten, and sedimentation value, while the effect of N topdressing ratio was insignificant. Increasing N dose from 120 kg ha−1 to 180 kg ha−1 significantly enhanced yield, and the yields and harvest indexes in 2019, 2020, and 2021 were consistently R2 > R3 > R1. The findings suggested that the effect of increasing N dose (60 kg ha−1) was more considerable than that of N topdressing ratio, N3R2 (within the range of N application in this experiment) was more conducive to improving canopy photosynthesis, yield, and harvest index, and R3 was more conducive to increasing grain protein content, wet gluten, and sedimentation value.

Incorporation of Laboratory Test Biomarkers Into Dual Antiplatelet Therapy Score Improves Prediction of Ischemic and Bleeding Events in Post-percutaneous Coronary Intervention Patients.

This study aimed to examine the performance of the dual antiplatelet therapy (DAPT) score in two retrospective cohorts of post-percutaneous coronary intervention (PCI) patients and to explore whether incorporating additional biomarkers could further improve the predictive power of the DAPT score. In a retrospective derivation cohort of 4,798 PCI patients, the validity of DAPT score for stratifying ischemic/bleeding risks was explored. Then, the association between the baseline status of 54 laboratory test biomarkers and ischemic/bleeding events was revealed while adjusting for the DAPT score. Combinations of individual laboratory test biomarkers that were significantly associated with ischemic/bleeding events were explored to identify the ones that improved discrimination of ischemic and bleeding events when incorporated into DAPT score. Finally, the impact of the combination of biomarkers with DAPT score was validated in an independent retrospective validation cohort of 1,916 PCI patients. Patients with a high DAPT score (DAPT score ≥ 2) had significantly higher risk of ischemic events and significantly lower risk of bleeding than patients with a low DAPT score (DAPT score < 2). Moreover, the addition of aspartate aminotransferase (AST) and red cell distribution width CV (RDW-CV) into the DAPT score further improved discrimination of ischemia and bleeding. Furthermore, the incremental predictive value of AST + RDW-CV maintained with measurements was updated at post-baseline time points. DAPT score successfully stratified the risks of ischemia/bleeding post PCI in the current cohorts. Incorporation of AST + RDW-CV into the DAPT score further improved prediction for both ischemic and bleeding events.

Bone morphogenetic protein-7 promotes chondrogenesis in human amniotic epithelial cells.

Bone morphogenetic proteins (BMPs) play important roles at multiple stages of chondrogenesis. This study was undertaken to investigate the potential role of bone morphogenetic protein-7 (BMP-7) in the differentiation of chondrocytes using tissue engineering techniques. The impact of BMP-7 on human amniotic epithelial cells (hAECs) was tested. The hAECs were treated either with recombinant human BMP-7 cDNA or with transforming growth factor beta 1 (TGF-ß1) as a positive control for three weeks in vitro. Cartilaginous differentiation and proliferation were assayed by quantitative RT-PCR, histology, and in situ hybridization. Our results were such that hAECs treated with either BMP-7 or TGF-ß1 expressed cartilage markers (aggrecan, Sox9, CEP-68, and type II and X collagens) within three weeks. Compared with a control vector, BMP-7 induced a decrease in type I collagen expression, while the transcription of the cartilage-specific type II collagen remained stable. In induction experiments, BMP-7 transgenic hAECs exhibited the largest amount of matrix synthesis. In conclusion, these data indicate that BMP-7 plays an important role in inducing the production of cartilage by hAECs in vitro. Cartilage differentiation and matrix maturation can be promoted by BMPs in a cartilage engineering paradigm. These properties make BMPs promising tools in the engineering of cartilaginous joint bio-prostheses and as candidate biological agents or genes for cartilage stabilisation.

Long-term organic and inorganic fertilization alters the diazotrophic abundance, community structure, and co-occurrence patterns in a vertisol.

Diazotrophs play a critical role in converting air-inactive nitrogen to bio-available nitrogen. Assessing the influences of different fertilization regimes on diazotrophs is essential for a better understanding of their maintenance of soil fertility and agricultural sustainability. In this study, we targeted the nifH gene to investigate the effects of different long-term fertilization on the diazotrophic community in a vertisol, using real-time quantitative polymerase chain reaction (PCR) and MiSeq sequencing. Five fertilization regimes were tested: no fertilizer (CK), chemical nitrogen, phosphorus, and potassium fertilizer (NPK), organic fertilizer (O), chemical NPK plus organic fertilizer with an equivalent application rate of nitrogen (NPKO), and chemical NPK plus organic fertilizer with a high application rate of nitrogen (HNPKO). Our results showed that fertilization significantly affected the diazotrophic activity, abundance and composition. NPK tended to reduce the activity, abundance, operational taxonomic units (OTU)-richness and alpha-diversity of the diazotrophs, while O had the opposite effect. The effects of inorganic and organic fertilization on the diazotrophs depended on the N application rate, showing that the diazotrophic activity, abundance, and alpha-diversity in NPKO were higher than that of HNPKO. For the diazotrophic community structure, CK, O, and NPKO were grouped and separated from NPK and HNPKO. The diazotrophic community structure strongly correlated with the soil pH, electrical conductivity (EC), total carbon content (TC), and total nitrogen content (TN), among which pH was the major factor shaping the diazotrophic community structure. Different network patterns were observed between the long-term organic and non-organic fertilizers, suggesting that the organic amendment resulted in a more complicated diazotrophic community than the non-organic amendments. Rhizobium was the most important hub connecting members in the community. These results indicated that organic amendments are beneficial to diazotrophic activity, abundance, OTU richness, alpha-diversity, and the diazotrophic communities' potential interactions, which may enhance biological nitrogen fixation in vertisols.

Objectifying the level of incomplete revascularization by residual SYNTAX score and evaluating the impact of incomplete revascularization on exercise tolerance in patients with coronary atherosclerotic heart disease treated by percutaneous coronary intervention.

The prognostic impact of incomplete revascularization (ICR) on patients underwent percutaneous coronary intervention (PCI) was vague. Our research aimed to objectify the level of ICR by residual SYNTAX score (rSS) and evaluate the impact of ICR on exercise tolerance.We enrolled 87 patients who completed cardiopulmonary exercise testing (CPET) within 12 months after PCI, retrospectively. According to rSS, patients were divided into rSS = 0 group, 0 < rSS ≤ 8 group, and rSS > 8 group. The CPET variables--including peak metabolic equivalent (METpeak), percentages of predicting value of METpeak (METpeak%pred), MET at anaerobic threshold (AT), peak oxygen uptake (VO2peak), percentages of predicting value of VO2peak (VO2peak%pred), VO2 at AT--were collected and compared.Among rSS = 0, 0 < rSS ≤ 8 and rSS > 8 groups, patients with higher rSS had progressively lower METpeak, METpeak%pred, VO2peak%pred, VO2 at AT, and MET at AT, which indicate reduced exercise tolerance. And further multiple comparisons showed that there were no statistically significant differences between rSS = 0 and 0 < rSS ≤ 8 groups, while the aforementioned CPET variables were significantly lower in rSS > 8 group compared with rSS = 0 group. Logistic regression analysis showed that rSS was an independent risk factor for reduced exercise tolerance.

Diagnostic performance of free-breathing coronary computed tomography angiography without heart rate control using 16-cm z-coverage CT with motion-correction algorithm.

OBJECTIVES: To evaluate the feasibility of coronary computed tomography angiography (CCTA) in patients with free-breathing using 16-cm z-coverage CT with motion correction algorithm. METHODS: 616 patients underwent CCTA without heart rate control. 325 examinations were performed during breath-holding (group A), and the remaining 291 were performed during free-breathing (group B). The image quality scores were defined as 1 (excellent), 2 (good), 3 (adequate), and 4 (poor). 22 patients in group A and 24 in group B underwent invasive coronary angiography (ICA) after CCTA within two weeks. The image quality score, diagnostic accuracy using ICA as reference, signal-to-noise ratio (SNR), and effective dose (ED) were compared between the two groups. RESULTS: Mean heart rate during scanning was 70.8 ±â€¯13.8 bpm in group A and 70.7 ±â€¯13.2 bpm in group B (P = .950). No significant differences were observed in SNR and image quality score (1.49 ±â€¯0.62 vs. 1.53 ±â€¯0.67; P = .647) between the breath-holding and free-breathing groups. ED (1.99 ±â€¯0.83  mSv vs. 2.01 ±â€¯0.88  mSv) was not significantly different between the two groups (P = .975). In a segment-based analysis, the sensitivity, specificity and diagnostic accuracy in the detection of coronary stenosis of more than 50% were 82.1%, 96.8% and 92.2%, respectively in the breath-holding group and 82.2%, 96.6% and 92.2%, respectively in the free-breathing group with no significant differences for these parameters between the two groups. CONCLUSIONS: CCTA for patients without heart rate control and during free-breathing using 16-cm z-coverage CT with motion correction algorithm showed no significant difference in image quality and diagnostic performance compared with CCTA during breath-holding.

The potential inhibitory effects of miR­19b on vulnerable plaque formation via the suppression of STAT3 transcriptional activity.

Atherosclerotic plaque growth requires angiogenesis, and acute coronary syndrome (ACS) is usually triggered by the rupture of unstable atherosclerotic plaques. Previous studies have identified typically circulating microRNA (miRNA/miR) profiles in patients with ACS. miRNAs serve important roles in the pathophysiology of atherosclerotic plaque progression. The present study aimed to investigate the potential role and mechanism of miR­19b in plaque stability. miRNA array data indicated that 28 miRNAs were differentially expressed in the plasma of patients with unstable angina (UA; n=12) compared with in control individuals (n=12), and miR­19b exhibited the most marked upregulation. Circulating miR­19b levels were further validated in another independent cohort, which consisted of 34 patients with UA and 24 controls, by quantitative polymerase chain reaction. Gene Ontology annotations of the predicted target genes of miR­19b suggested that miR­19b may be involved in endothelial cell (EC) proliferation, migration and angiogenesis, which was confirmed by Cell Counting kit­8, wound healing and tube formation assays in the present study. Finally, the present study indicated that miR­19b may suppress signal transducer and activator of transcription 3 (STAT3) tyrosine phosphorylation and transcriptional activity in ECs, as determined by western blot analysis and luciferase reporter assay. In conclusion, the present study revealed that increased miR­19b expression may delay unstable plaque progression in patients with UA by inhibiting EC proliferation, migration and angiogenesis via the suppression of STAT3 transcriptional activity.