Clinical Value of the Quantitative Flow Ratio to Predict Long-term Target Vessel Failure in Patients with In-stent Restenosis after Drug-coated Balloon Angioplasty

Objective The study sought to investigate the clinical predictive value of quantitative flow ratio(QFR)for the long-term target vessel failure(TVF)outcome in patients with in-stent restenosis(ISR)by using drug-coated balloon(DCB)treatment after a long-term follow-up.Methods This was a retrospective study.A total of 186 patients who underwent DCB angioplasty for ISR in two hospitals from March 2014 to September 2019 were enrolled.The QFR of the entire target vessel was measured offline.The primary endpoint was TVF,including target vessel-cardiac death(TV-CD),target vessel-myocardial infarction(TV-MI),and clinically driven-target vessel revascularization(CD-TVR).Results The follow-up time was 3.09±1.53 years,and 50 patients had TVF.The QFR immediately after percutaneous coronary intervention(PCI)was significantly lower in the TVF group than in the no-TVF group.Multivariable Cox regression analysis indicated that the QFR immediately after PCI was an excellent predictor for TVF after the long-term follow-up[hazard ratio(HR):5.15×10−5(6.13×10−8−0.043);P<0.01].Receiver-operating characteristic(ROC)curve analysis demonstrated that the optimal cut-off value of the QFR immediately after PCI for predicting the long-term TVF was 0.925(area under the curve:0.886,95%confidence interval:0.834–0.938;sensitivity:83.40%,specificity:88.00;P<0.01).In addition,QFR≤0.925 post-PCI was strongly correlated with the TVF,including TV-MI and CD-TVR(P<0.01).Conclusion The QFR immediately after PCI showed a high predictive value of TVF after a long-term follow-up in ISR patients who underwent DCB angioplasty.A lower QFR immediately after PCI was associated with a worse TVF outcome.

Determination of optimal blowing-to-suction flow ratio in mechanized excavation face with wall-mounted swirling ventilation using numerical simulations

Wall-mounted swirling ventilation is a new type of system in mechanized excavation faces with a dust sup-pression performance that is closely related to the blowing-to-suction flow ratio.Physical and simulation models were developed according to the No.C103 mechanized excavation face in the Nahe Coal Mine of the Baise Mining Bureau,Guangxi Province to optimize the blowing-to-suction flow ratio for wall-mounted swirling ventilation.Both the k-εturbulence model and the discrete phase model were utilized to simulate airflow field structures and dust concentration distribution patterns at various blowing-to-suction flow ratios.The results suggest that higher blowing-to-suction flow ratios increase the airflow field disturbance around the working face and weaken the intensity of the axial air curtain.On the other hand,both the intensity of the radial air curtain and the dust suppression effect are enhanced.At a blowing-to-suction flow ratio of 0.8,the wall-mounted swirling ventilation system achieved the most favorable dust suppression performance.Both the total dust and respirable dust had their lowest concentrations with maximum efficiencies of reducing both types at 90.33%and 87.16%,respectively.

Quantitative flow ratio and intravascular ultrasound guided percutaneous coronary intervention of left anterior descending lesion concomitant with severe coronary myocardial bridge

Severe coronary stenosis concomitant with congenital coronary myocardial bridge(MB)is a tough scenario for cardiologist to perform revascularization,for which the complication rates including in-stent restenosis,stent fracture,stent thrombosis and even coronary perforation are still high.[1,2]Meanwhile,the necessity of revascularization in such patients is worth prudent evaluation.Cardiac imaging modalities are crucial and helpful in making revascularized decisions and strategies.Herein,we report a case using quantitative flow ratio(QFR)and intravascular ultrasound(IVUS)to facilitate accurate revascularization in a patient with both severe coronary stenosis and deep coronary MB.

Cut-off values of lesion and vessel quantitative flow ratio in de novo coronary lesion post-drug-coated balloon therapy predicting vessel restenosis at mid-term follow-up

Background:Drug-coated balloons(DCBs)have emerged as potential alternatives to drug-eluting stents in specific lesion subsets for de novo coronary lesions.Quantitative flow ratio(QFR)is a method based on the three-dimensional quantitative coronary angiography and contrast flow velocity during coronary angiography(CAG),obviating the need for an invasive fractional flow reserve procedural.This study aimed to assess the serial angiographic changes of de novo lesions post-DCB therapy and further explore the cut-off values of lesion and vessel QFR,which predict vessel restenosis(diameter stenosis[DS]≥50%)at mid-term follow-up.Methods:The data of patients who underwent DCB therapy between January 2014 and December 2019 from the multicenter hospital were retrospectively collected for QFR analysis.From their QFR performances,which were analyzed by CAG images at follow-up,we divided them into two groups:group A,showing target vessel DS≥50%,and group B,showing target vessel DS<50%.The median follow-up time was 287 days in group A and 227 days in group B.We compared the clinical characteristics,parameters during DCB therapy,and QFR performances,which were analyzed by CAG images between the two groups,in need to explore the cut-off value of lesion/vessel QFR which can predict vessel restenosis.Student's t test was used for the comparison of normally distributed continuous data,Mann-Whitney U test for the comparison of non-normally distributed continuous data,and receiver operating characteristic(ROC)curves for the evaluation of QFR performance which can predict vessel restenosis(DS≥50%)at mid-term follow-up using the area under the curve(AUC).Results:A total of 112 patients with 112 target vessels were enrolled in this study.Group A had 41 patients,while group B had 71.Vessel QFR and lesion QFR were lower in group A than in group B post-DCB therapy,and the cut-off values of lesion QFR and vessel QFR in the ROC analysis to predict target vessel DS≥50%post-DCB therapy were 0.905(AUC,0.741[95%confidence interval,CI:0.645,0.837];sensitivity,0.817;specificity,0.561;P<0.001)and 0.890(AUC,0.796[95%CI:0.709,0.882];sensitivity,0.746;specificity,0.780;P<0.001).Conclusions:The cut-off values of lesion QFR and vessel QFR can assist in predicting the angiographic changes post-DCB therapy.When lesion/vessel QFR values are<0.905/0.890 post-DCB therapy,a higher risk of vessel restenosis is potentially predicted at follow-up.

Non-invasive Angiographic-based Fractional Flow Reserve:Technical Development,Clinical Implications,and Future Perspectives

New non-and less-invasive techniques have been developed to overcome the procedural and operator related burden of the fractional flow reserve(FFR)for the assessment of potentially significant stenosis in the coronary arteries.Virtual FFR-techniques can obviate the need for the additional flow or pressure wires as used for FFR measurements.This review provides an overview of the developments and validation of the virtual FFR-algorithms,states the challenges,discusses the upcoming clinical trials,and postulates the future role of virtual FFR in the clinical practice.

An online method to determine chlorine stable isotope composition by continuous flow isotope ratio mass spectrometry (CF-IRMS) coupled with a Gasbench Ⅱ

An online method using continuous flow isotope ratio mass spectrometry （CF-IRMS） interfaced with a Gasbench Ⅱ was presented to determine chlorine stable isotope composition. Silver chloride （AgCl） was quantitatively derived from chloride by using silver nitrate （AgNO3）, and then was reacted with iodomethane （CH3Ⅰ） to produce methyl chloride （CH3Cl）. A GasBench Ⅱ equipped with a PoraPlot Q column was used to separate CH3Cl from any other gas species. Finally, chlorine stable isotope analysis was carried out on CH3Cl introduced to the IRMS in a helium stream via an active open split. The minimum amount of Cl used in this method is of the order of 1.4 μmol. Inter-laboratory and inter-technique comparisons show that the total uncertainty incorporating both the precision and accuracy of this method is better than 0.007%. Furthermore, ten seawaters sampled from different locations have a narrow δ37Cl value range from -0.008% to 0.010%, with a mean value of （0.000±0.006）%. This supports the assumption that any seawater can be representative of standard mean ocean chloride （SMOC） and used as an international reference material.

Gravel Accumulation in Deposits of Viscous Debris Flows with Hyper-concentration

According to the observational data of viscous debris flows with hyper-concentration, debris flows can be classified into three types:high-viscous, viscous, and sub-viscous debris flows.Distinct formation mechanism of different graded bedding structures in deposits of viscous debris flows was analyzed in this paper by using their yield-stress ratio and flow plug ratio.This paper specially analyzed the effect of Weissenberg which the gravels in squirm condition of hyper-concentration viscous flows would tend to move vertically, and the formation mechanism of the gravels accumulated at surface was also studied.The analysis in this paper can establish a foundation for the studies on differentiation of bedding structures of debris flow deposits and studies on dynamic parameters of debris flows.

Crustal Composition of China Continent Constrained from Heat Flow Data and Helium Isotope Ratio of Underground Fluid

Based on conservation of energy principle and heat flow data in China continent, the upper limit of 1.3 μW/m3 heat production is obtained for continental crust in China. Furthermore, using the data of heat flow and helium isotope ratio of underground fluid, the heat productions of different tectonic units in China continent are estimated in range of 0.58-1.12 μW/m3 with a median of 0.85 μW/m3. Accordingly, the contents of U, Th and K20 in China crust are in ranges of 0.83-1.76 μg/g, 3.16-6.69 μg/g, and 1.0%-2.12%, respectively. These results indicate that the abundance of radioactive elements in the crust of China continent is much higher than that of Archean crust; and this fact implies China＇s continental crust is much evolved in chemical composition. Meanwhile, significant lateral variation of crustal composition is also exhibited among different tectonic units in China continent. The crust of eastern China is much enriched in incompatible elements such as U, Th and K than that of western China; and the crust of orogenic belts is more enriched than that of platform regions. It can also be inferred that the crusts of eastern China and orogenic belts are much felsic than those of western China and platform regions, respectively, derived from the positive correlation between the heat production and SiO2 content of bulk crust. This deduction is consistent with the results derived from the crustal seismic velocity data in China. According to the facts of the lower seismic velocity of China than the average value of global crust, and the higher heat production of China continent compared with global crust composition models published by previous studies, it is deduced that the average composition models of global continent crust by Rudnick and Fountain （1995）, Rudnick and Gao （2003）, Weaver and Tarney （1984）, Shaw et al. （1986）, and Wedepohl （1995） overestimate the abundance of incompatible elements such as U, Th and K of continental crust.

Yield ratios and directed flows of light particles from proton-rich nuclei-induced collisions

The neutron-to-proton and3 H-to-3 He yield ratios, and the directed flows of particles dependent on a reduced rapidity, the transverse momentum per nucleon,and a reduced impact parameter are investigated for ^(28)S+^(28)Si and ^(32)S+^(28)Si systems at 50 and 400 MeV/u using an isospin-dependent quantum molecular dynamics model.The results show that these yield ratios of projectile-like fragments are approximately equal to the constituent neutron-to-proton ratio of the projectile. There are clear differences of the directed flows for isospin-related fragments neutron and proton,~3H and ~3He from ^(28)S+^(28)Si collisions.The differences in directed flows for neutrons and protons and ~3H–~3He from a proton-rich nucleus ^(28)S- induced collisions are noticeably larger than those from a stable nucleus ^(32)S- induced reactions under medium impact parameters. Thus, the yield ratios and differences in directed flows for the neutrons and protons and ~3H–~3He under medium impact parameters are proposed as possible observable items for studying isospin physics.

Debris flow impact on flexible barrier: effects of debrisbarrier stiffness and flow aspect ratio

Conventionally,flexible barriers are rated based on their ability to resist a free-falling boulder with a particular input energy.However,there is still no well-accepted approach for evaluating performance of flexible barrier under debris flow impact.In this study,a large-nonlinear finite-element model was used to back-analyze centrifuge tests to discern the effects of impact material type,barrier stiffness,and flow aspect ratio(flow height to flow length)on the reaction force between the impacting medium and flexible barrier.Results show that,in contrast to flexible barriers for resisting rockfall,the normal impact force induced by the highly frictional and viscous debris is insensitive to barrier stiffness.This is because the elongated distributions of kinetic energy are mainly dissipated by the internal and boundary shearing,and only a small portion is forwarded to the barrier.Furthermore,a new stiffness number is proposed to characterize the equivalent stiffness between a debris flow or a boulder,and a flexible barrier.Under the circumstance of an extremely elongated debris flow event,i.e.,low aspect ratio,the load on a barrier is dominated by the static component and thus not sensitive to the barrier stiffness.

Air flow control based on optimal oxygen excess ratio in fuel cells for vehicles

Air flow control is one of the most important control methods for maintaining the stability and reliability of a fuel cell system, which can avoid oxygen starvation or oxygen saturation. The oxygen excess ratio （OER） is often used to indicate the air flow condition. Based on a fuel cell system model for vehicles, OER performance was analyzed for different stack currents and temperatures in this paper, and the results show that the optimal OER was affected weakly by the stack temperature. In order to ensure the system working in optimal OER, a control scheme that includes an optimal OER regulator and a fuzzy control was proposed. According to the stack current, a reference value of air flow rate was obtained with the optimal OER regulator and then the air compressor motor voltage was controlled with the fuzzy controller to adjust the air flow rate provided by the air compressor. Simulation results show that the control method has good dynamic and static characteristics.

Influence of Rotating Speed Ratio on the Annular Turbulent Flow between Two Rotating Cylinders

Rotating flows represent a very interesting area for researchers and industry for their extensive use in industrial and domestic machinery and especially for their great energy potential, annular flows are an example that draws the attention of researchers in recent years. The best design and optimization of these devices require knowledge of thermal, mechanical and hydrodynamic characteristics of flows circulating in these devices. An example of hydrodynamic parameters is the speed of rotation of the moving walls. This work is to study numerically the influence of the rotating speed ratio Γ of the two moving cylinders on the mean and especially on the turbulent quantities of the turbulent flow in the annular space. The numerical simulation is based on one-point statistical modeling using a low Reynolds number second-order full stress transport closure (RSM model), simulation code is not a black box but a completely transparent code where we can intervene at any step of the calculation. We have varied Γ from -1.0 to 1.0 while maintaining always the external cylinder with same speed Ω. The results show that the turbulence structure, profiles of mean velocities and the nature of the boundary layers of the mobile walls depend enormously on the ratio of speeds. The level of turbulence measured by the kinetic energy of turbulence and the Reynolds stresses shows well that the ratio Γ is an interesting parameter to exploit turbulence in this kind of annular flows.

INFLUENCES OF THE FISH-MOUTH PROJECT AND THE GROINS ON THE FLOW AND SEDIMENT RATIO OF THE YANGTZE RIVER WATERWAY

A depth_integrated two_dimensional numerical model of current, salinity and sediment transport was proposed and calibrated by the observation data in the Yangtze River Estuary. It was then applied to investigate the flow and sediment ratio of the navigation channel, i.e. the North Channel of the Yangtze River Estuary,before and after the first phase waterway project is implemented. Particularly, the influences of groin length and the orientation of the submerged dam on the flow ratio and sediment load discharging into the North Channel were discussed. The numerical results demonstrate that less sediment load discharges into the navigation channel, which unburdens the waterway dredging, but in the meantime the flow ratio is also decreased. The flow and sediment ratio can be adjusted by changing layout and dimensions of the hydro_structures, such as the groin length, the top height, etc. The effect of the orientation of the submerged dam is more obvious than the groin lengh.

Effects of aspect ratio on unsteady solutions through curved duct flow

The effects of the aspect ratio on unsteady solutions through the curved duct flow are studied numerically by a spectral based computational procedure with a temperature gradient between the vertical sidewalls for the Grashof number 100 ≤ Gr ≤ 2 000. The outer wall of the duct is heated while the inner wall is cooled and the top and bottom walls are adiabatic. In this paper, unsteady solutions are calculated by the time history analysis of the Nusselt number for the Dean numbers Dn = 100 and Dn = 500 and the aspect ratios 1≤γ≤ 3. Water is taken as a working fluid （Pr =7.0）. It is found that at Dn = 100, there appears a steady-state solution for small or large Gr. For moderate Gr, however, the steady-state solution turns into the periodic solution if γ is increased. For Dn = 500, on the other hand, it is analyzed that the steady-state solution turns into the chaotic solution for small and large Gr for any γ lying in the range. For moderate Gr at Dn = 500, however, the steady-state flow turns into the chaotic flow through the periodic oscillating flow if the aspect ratio is increased.

Effects of ratio of hydrogen flow on microstructure of hydrogenated microcrystalline silicon films deposited by magnetron sputtering at 100 ℃

Hydrogenated microcrystalline silicon(μc-Si:H)films were prepared on glass and silicon substrates by radio frequency magnetron sputtering at 100°C using a mixture of argon(Ar)and hydrogen(H2)gasses as precursor gas.The effects of the ratio of hydrogen flow(H2/(Ar+H2)%)on the microstructure were evaluated.Results show that the microstructure,bonding structure,and surface morphology of theμc-Si:H films can be tailored based on the ratio of hydrogen flow.An amorphous to crystalline phase transition occurred when the ratio of hydrogen flow increased up to 50%.The crystallinity increased and tended to stabilize with the increase in ratio of hydrogen flow from 40%to 70%.The surface roughness of thin films increased,and total hydrogen content decreased as the ratio of hydrogen flow increased.Allμc-Si:H films have a preferred(111)orientation,independent of the ratio of hydrogen flow.And theμc-Si:H films had a dense structure,which shows their excellent resistance to post-oxidation.

Numerical Study on the Effects of Contraction Ratio in a Two-Phase Flow Injection Nozzle

The Euler-Euler numerical method was used to investigate the effects of contraction ratio on twophase flow mixing with mass transfer in the flow injection nozzle. The geometric shape of the nozzle was modified to improve carbonation efficiency. A gas inlet hole was created to increase the flow mixing of CO2 with water. A nozzle throat was also introduced to increase the gas dissolution by increasing flow rates. Various contraction ratios of nozzle throat, inlet gas and liquid velocities, and gas bubble sizes were employed to determine their effects on gas hold-up, gas concentration, and mass transfer coefficient. Results revealed that the flow injection nozzle with high contraction ratios improved carbonation because of high gas hold-up. Gas concentration was directly related to contraction ratio and gas flow velocities. Carbonation reduced when high liquid velocities and large gas bubbles were employed because of inefficient flow mixing. This study indicated that flow injection nozzle with large contraction ratios were suitable for carbonation because of their ability to increase gas hold-up, gas concentration, and mass transfer coefficient.

应用瑞加诺生负荷D-SPECT评价定量血流分数在经皮冠状动脉介入治疗中的作用

目的应用瑞加诺生负荷动态单光子发射计算机断层扫描(dynamic single-photon emission computed tomography,D-SPECT)评价定量血流分数(quantitative flow ratio,QFR)在经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)中的作用。方法选择2021年6月31日至2023年6月31日在河北医科大学第一医院心内科住院行择期PCI术的200例不稳定型心绞痛患者,年龄(57.56±8.23)岁,按照随机数字表法分为常规组(n=100)和QFR组(n=100),试验采用双盲法进行。常规组根据医师经验行PCI术治疗,QFR组根据QFR测定结果行PCI治疗。所有入选患者术前及PCI术后7 d,应用瑞加诺生负荷D-SPECT,分别采集短轴、垂直长轴、水平长轴的图像,计算心肌17节段分布下心肌灌注总积分、心肌缺血总节段数情况。结果PCI术前两组患者心肌缺血节段数(7.59±3.14 vs.7.48±3.36,P=0.811)、心肌灌注总积分(15.87±7.61 vs.15.63±5.97,P=0.860)差异无统计学意义,QFR组PCI术后7 d的心肌缺血节段数(5.58±3.36 vs.6.51±2.14,P=0.020)和心肌灌注总积分(10.55±4.41 vs.12.96±6.50,P=0.002)显著优于常规组(P<0.05)。结论应用QFR指导PCI可以更好改善患者心肌缺血程度。

Zonal flow energy ratio evolution during L-H and H-L transitions in EAST plasmas

The essential role of zonal flow in the L-H transition and the suppression of turbulence have been studied with a long range correlation technique using Langmuir probe arrays in EAST tokamak.Two toroidally localized probe arrays are used to measure the zonal flow during L-H transition and H-L back transition.The energy ratio of the low frequency zonal flow to the total drift wave turbulence is calculated.During ELM-free H mode,the energy ratio is higher than that in L mode,which reveals the important role of zonal flows in regulating turbulence amplitude in L-H transition.

Augmentation of Heat Transfer in Pipe Flow Using Plain Twisted Tape Inserts for Different Twist Ratios

The heat transfer augmentation of plain twisted tape inserts for different twist ratios has been studied in this study. The data are conducted using the plain twisted tape insert with five different twist ratios respectively. The range of Reynolds number is considered under a uniform heat flux condition. In the case of simulation, the tapes are made from a stainless steel strip with a thickness of 2 mm. A tubular pipe with 850mm U-loop length and twist length of 800 mm each is considered in our study for simulation. Water is used as working fluids inside the tube for our simulation. The simulation results demonstrate that the important heat transfer parameters including Nusselt number (Nu), friction factor (f) and thermal performance index (η) are gradually increased with the increment of the twist ratio and reached at the saturated level while twist ratio is 3.5,?afterward the thermal properties are decreased.

血管内超声测定定量血流分数对临界病变冠状动脉介入手术策略的价值

目的结合血管内超声结果分析定量血流分数在评估冠状动脉中重度狭窄及介入手术策略的指导价值。方法回顾性收集2022年2—10月在北京安贞医院住院行冠状动脉造影(CA)和/或经皮冠状动脉介入治疗(PCI)并接受靶血管血管内超声检查(IVUS)的患者110例,基于IVUS结果定量测定靶血管最小管腔面积(MLA)和斑块负荷(PB)等参数。利用患者的冠状动脉造影图像数据,对接受治疗的靶病变血管计算定量血流分数(QFR)。以IVUS结果为依据,评价QFR对血管病变程度的诊断及对行介入手术策略的价值。结果筛选临界病变并行IVUS检查110例,其中IVUS图像伪影严重13例,血管严重迂曲18例,造影显示全程病变或图像质量不佳24例,最终共计入组患者55例、靶血管55支。以IVUS管腔面积≤3 mm^(2)或IVUS管腔面积≤4 mm^(2)并且IVUS斑块负荷≥70%,作为血管显著狭窄引起心肌缺血的诊断标准。患者QFR值为0.75±0.12,MLA为(3.32±0.74)mm^(2),PB为(70±9)%。QFR值≤0.800时与IVUS评价冠状动脉狭窄缺血的一致性良好(Kappa=0.656,P<0.01,95%CI 0.452~0.860)。QFR的敏感度为0.853,特异度为0.810,阳性预测值为87.9%,阴性预测值为77.3%;MLA和QFR值之间存在中度正相关关系(r=0.566,P<0.01)。PB和QFR值之间存在轻度负相关关系(r=-0.371,P<0.01)。结论QFR对冠脉临界病变狭窄治疗决策的指导具有良好的诊断意义。