Staged Revascularization for Chronic Total Occlusion in the Non-IRA in Patients with ST-segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention:An Updated Systematic Review and Meta-analysis

Objectives:Meta-analysis was performed to evaluate the effect of staged revascularization with concomitant chronic total occlusion(CTO)in the non-infarct-associated artery(non-IRA)in patients with ST-segment elevation myocardial infarction(STEMI)treated with primary percutaneous coronary intervention(p-PCI).Methods:Various electronic databases were searched for studies published from inception to June,2021.The primary endpoint was all-cause death,and the secondary endpoint was a composite of major adverse cardiac events(MACEs).Odds ratios(ORs)were pooled with 95%confidence intervals(CIs)for dichotomous data.Results:Seven studies involving 1540 participants were included in thefinal analysis.Pooled analyses revealed that patients with successful staged revascularization for CTO in non-IRA with STEMI treated with p-PCI had overall lower all-cause death compared with the occluded CTO group(OR,0.46;95%CI,0.23–0.95),cardiac death(OR,0.43;95%CI,0.20–0.91),MACEs(OR,0.47;95%CI,0.32–0.69)and heart failure(OR,0.57;95%CI,0.37–0.89)com-pared with the occluded CTO group.No significant differences were observed between groups regarding myocardial infarction and repeated revascularization.Conclusions:Successful revascularization of CTO in the non-IRA was associated with better outcomes in patients with STEMI treated with p-PCI.

A Novel Robotic Control System Mimics Doctor’s Operation to Assist Percutaneous Coronary Intervention

Objectives:The use of current robotic systems to assist in percutaneous coronary intervention(PCI)fundamentally differs from performing conventional PCI.To overcome this problem,we developed a novel master-slave robotic control system to assist in PCI,and evaluated its safety and feasibility in the delivery and manipulation of coronary guidewires in vitro and in vivo.Methods:The novel robotic assist PCI system is composed of three parts:1)a master actuator,which imitates the traditional torque used by surgeons in conventional PCI,2)a slave actuator,including a guidewire delivery system and force monitoring equipment,and 3)a local area network based communication system.Results:The experiment was performed in six pigs.Both robotic and manual control completed the operation with no device-or procedure-associated complications.An experienced interventional cardiologist who was afirst-time user of the novel robotic PCI system was able to advance the guidewire into a distal branch of a coronary artery within a similar time to that required with the manual procedure.Conclusion:This early in vivo experiment with the novel robotic assisted PCI control system demonstrated that its feasibility,safety,and procedural effectiveness are comparable to those of manual operation.The novel robotic-assisted PCI control system required significantly less time to learn than other currently available systems.

Online Magnetic Flux Leakage Detection System for Sucker Rod Defects Based on LabVIEW Programming

Aiming at the detection of the sucker rod defects,a real-time detection system is designed using the non-destructive testing technology of magnetic flux leakage(MFL).An MFL measurement system consists of many parts,and this study focuses on the signal acquisition and processing system.First of all,this paper introduces the hardware part of the acquisition system in detail,including the selection of the Hall-effect sensor,the design of the signal conditioning circuit,and the working process of the single chip computer(SCM)control serial port.Based on LabVIEW,a graphical programming software,the software part of the acquisition system is written,including serial port parameter configuration,detection signal recognition,original signal filtering,real-time display,data storage and playback.Finally,an experimental platform for the MFL detection is set up,and the MFL measurement is carried out on the transverse and longitudinal defects of the sucker rod surface.The experimental result shows that the designed acquisition and processing system has good detection performance,simple design and high flexibility.

Fasting Blood Glucose but not TMAO is Associated with in-Stent Restenosis in Patients with Acute Coronary Syndrome

Background:The purpose of our study was to assess whether the occurrence of ISR might be associated with plasma TMAO levels in patients with ACS after DES implantation.Methods:This was a single center retrospective case-control study,in which 64 symptomatic patients with repeated coronary angiography after PCI and 15 patients with ISR were included in the ISR group,and 49 patients without ISR were included in the non-ISR group.High-performance liquid chromatography with tandem mass spectrometry was used to measure plasma TMAO levels.Results:No significant differences were observed in plasma TMAO between the ISR and non-ISR groups.Plasma TMAO levels showed no significant correlation with ISR,but were significantly positively correlated with diabetes mellitus,serum HbA1c levels and serum creatinine levels;moreover,they were significantly negatively correlated with female sex.ISR was significantly positively correlated with diabetes mellitus,fasting blood glucose levels,the neutro-phil to lymphocyte ratio and syntax score;in addition,it was significantly negatively correlated with platelets.Logistic regression analysis indicated that fasting blood glucose was the only independent predictor of ISR.Conclusion:Plasma TMAO may not be associated with ISR and plaque burden in patients with ACS after DES im-plantation,whereas FBG may predict the development of ISR in these patients.

Heterometallic Ti-Zr oxo nanocluster photoresists for advanced lithography

Extreme ultraviolet lithography(EUVL)and electron beam lithography(EBL)are considered to be crucial lithography techniques utilized in the fabrication of nanoscale semiconductor devices.However,the industry currently faces a scarcity of EUV photoresists that meet the increasingly challenging standards in terms of resolution,sensitivity and roughness.Metal oxo nanoclusters have garnered significant interest in the field of EUV photoresist due to their relatively stronger absorption cross-section for extreme ultraviolet light and lower dimensions.In this study,we utilize a heterometallic nanocluster strategy by a combination of titanium and zirconium metals to investigate their solubility,assess the suitability of various developers,and evaluate their performance in electron-beam and EUVL,as well as study their etch resistance for pattern transfer.We demonstrate that R-4 is able to get a critical dimension(CD)of 25 nm at low doses under EBL,as well as 50 nm resolution at EUVL with a remarkable sensitivity of 19.7 mJ cm−2.This study offers an efficient heterometallic method for optimizing the lithographic performance of metal oxo nanocluster photoresists,which can benefit the development of commercially viable next-generation EUV photoresists.

以岗位综合胜任力为导向融合思政教育的多模式教学在卒中实习教学中的应用

目的探讨以岗位综合胜任力为导向融合思政教育的PBL+CBL多模式教学法在卒中实习教学中的应用效果。方法选取首都医科大学石景山教学医院实习的2017级、2018级临床医学专业本科生69人,分别将2017级、2018级学生作为传统教学组和多模式教学组。传统教学组采用传统教学法,多模式教学组采用以岗位综合胜任力为导向融合思政教育的多模式教学法,通过问卷调查、理论和临床技能考试评价教学效果,并采用t检验比较2组理论考核和技能操作考核成绩的差异,采用χ^(2)检验比较组间问卷调查结果的差异。结果与传统教学组相比,多模式教学组学生的理论成绩[(86.24±5.36)分vs(82.46±5.10)分]和技能操作成绩[(88.12±5.83)分vs(80.22±6.80)分]均显著提高,差异具有统计学意义(t=4.36,P=0.036;t=5.71,P=0.008)。教学后问卷调查显示,多模式教学组在主动学习兴趣、医患沟通能力、爱国教育重要性方面均明显优于传统教学组(91.3%vs 73.5%;82.8%vs 67.6%;82.8%vs 67.6%),且差异具有统计学意义(χ^(2)=6.33、4.05、4.05,P=0.005、0.044、0.044)。多模式教学组学生团队合作能力虽然有提升的趋势,但与传统教学组相比,差异并没有统计学意义(P>0.05)。结论以岗位综合胜任力为导向融合思政教育的多模式教学法可以增加学生主动学习的兴趣、提高学生解决临床问题的能力,并提升学生的医患沟通能力、爱国热情和敬业精神,在卒中临床实习教学工作中可推广应用。

POLY(THIOPHENE-3-ACETIC ACID)-PALLADIUM NANOPARTICLE COMPOSITE MODIFIED ELECTRODES FOR SUPERSENSITIVE DETERMINATION OF HYDRAZINE

A promising electrochemical sensor was fabricated by electrodeposition of Pd nanoparticles （PdNPs） on poly（thiophene-3-acetic acid） （PTAA）-modified glassy carbon electrode （GCE）, forming a PdNPs/PTAA composites-modified GCE （PdNPs/PTAA/GCE）. Scanning electron microscope （SEM） and electrochemical techniques were used for the characterization of these composites. It was found that the PdNPs/PTAA layer was very uniform. ]Electrochemical experiments showed that this proposed PdNPs/PTAA composites-modified electrode exhibited excellent electrocatalytic activity towards the oxidation of hydrazine. Under the optimum conditions, the proposed sensor can be applied to the quantification of hydrazine with a wide linear range from 8.0 × 10-9 mol/L to 1.0 × 10-5 mol/L with a low detection limit of 2.67 × 10-9 mol/L. The experiment results also showed that the sensor exhibited good reproducibility and long-term stability, as well as high selectivity with no interference from other potential competing species.