Relationship of Microvascular Obstruction with Global and Regional Myocardial Function Determined by Cardiac Magnetic Resonance after ST-Segment Elevation Myocardial Infarction

Objective To investigate the impact of microvascular obstruction(MVO)on the global and regional myocardial function by cardiac magnetic resonance feature-tracking(CMR-FT)in ST-segment-elevation myocardial infarction(STEMI)patients after percutaneous coronary intervention.Methods Consecutive acute STEMI patients who underwent cardiac magnetic resonance imaging 1-7 days after successful reperfusion by percutaneous coronary intervention treatment were included in this retrospective study.Based on the presence or absence of MVO on late gadolinium enhancement images,patients were divided into groups with MVO and without MVO.The infarct zone,adjacent zone,and remote zone were determined based on a myocardial 16-segment model.The radial strain(RS),circumferential strain(CS),and longitudinal strain(LS)of the global left ventricle(LV)and the infarct,adjacent,and remote zones were measured by CMRFT from cine images and compared between patients with and without MVO using independent-samples t-test.Logistic regression analysis was used to assess the association of MVO with the impaired LV function.Results A total of 157 STEMI patients(mean age 56.66±11.38 years)were enrolled.MVO was detected in 37.58%(59/157)of STEMI patients,and the mean size of MVO was 3.00±3.76 mL.Compared with patients without MVO(n=98),the MVO group had significantly reduced LV global RS(t=-4.30,P<0.001),global CS(t=4.99,P<0.001),and global LS(t=3.51,P=0.001).The RS and CS of the infarct zone in patients with MVO were significantly reduced(t=-3.38,P=0.001;t=2.64,P=0.01;respectively)and the infarct size was significantly larger(t=8.37,P<0.001)than that of patients without MVO.The presence of LV MVO[OR=4.10,95%CI:2.05-8.19,P<0.001]and its size[OR=1.38,95%CI:1.10-1.72,P=0.01],along with the heart rate and LV infarct size were significantly associated with impaired LV global CS in univariable Logistic regression analysis,while only heart rate(OR=1.08,95%CI:1.03-1.13,P=0.001)and LV infarct size(OR=1.10,95%CI:1.03-1.16,P=0.003)were independent influencing factors for the impaired LV global CS in multivariable Logistic regression analysis.Conclusion The infarct size was larger in STEMI patients with MVO,and MVO deteriorates the global and regional LV myocardial function.

Colon Interposition for Corrosive Esophageal Stricture: Single Institution Experience with 119 Cases

The colon is an alternative graft organ for esophageal reconstruction.The present study reviewed our experience with the colon interposition for esophageal replacement following corrosive ingestion,to evaluate the outcomes of colon interposition based on our surgical experience. The clinical data of 119 patients who underwent colon interposition for esophageal replacement from January 2005 to March 2017 were retrospectively analyzed. The routes of the colon interposition were retrosternal in 119 (100%). The median operative time was 390 min (range: 290-610 min) and the median blood loss was 615 mL (range:270-2500 mL). Of these 119 patients, the cervical anastomosis was performed at the hypopharynx (n=20,16.8%), the larynx (n=3,2.5%), and the cervical esophagus (n=96, 80.7%). Five patients experienced cervical anastomotic leakage (4 cases for esophagus-colon, and one for hypopharynx-colon).One patient experienced wound infection of the abdominal wall. Three patients had injury of recurrent laryngeal nerve and hoarseness. Three patients had stress ulcer with bleeding and treated with octreotide. Two patients suffered from incomplete intestinal obstruction. The postoperative follow-up was made for 12 months in all patients and all of them were alive. In conclusion, The colon is well-suited for esophageal reconstruction. The selection of the colon graft should be flexible and be based on the inspection of blood supply and the length needed. We must therefore make every effort to reduce the number of postoperative complications, and improve the quality of life for patients.

Microphase Separation of Semiflexible Ring Diblock Copolymers

Aiming at the difficult problem of solving the conformation statistics of complex polymers, this study presents a novel and concise conformation statistics theoretical approach based on Monte Carlo and Neural Network method. This method offers a new research idea for investigating the conformation statistics of complex polymers, characterized by its simplicity and practicality. It can be applied to more complex topological structure, more higher degree of freedom polymer systems with higher dimensions, theory research on dynamic self-consistent field theory and polymer field theory, as well as the analysis of scattering experimental data. The conformation statistics of complex polymers determine the structure and response properties of the system. Using the new method proposed in this study, taking the semiflexible ring diblock copolymer as an example, Monte Carlo simulation is used to sample this ring conformation to construct the dataset of polymer. The structure factor describing conformation statistics are expressed as continuous functions of structure parameters by neural network supervised learning. This is the innovation of this work. As an application, the structure factors represented by neural networks were introduced into the random phase approximation theory to study the microphase separation of semiflexible ring diblock copolymers. The influence of the ring's topological properties on the phase transition behavior was pointed out.

Synthesis and antidiabetic activity of β-acetamido ketones

This paper reports the use of trifluoroacetic acid as a catalyst in the Dakin–Westreaction for the synthesis of b-acetamido ketones. The method has several advantages such asrequiring only mild conditions and a low concentration of catalyst. Screening of 19 b-acetamidoketones for antidiabetic activity in vitro showed that their activity as peroxisome proliferatoractivated receptor (PPAR) agonists and as dipeptidyl peptidase 4 (DPP-IV) inhibitors wasfairly weak.

Three-dimensional numerical simulation of flow and splash behavior in an oxygen coal combustion melting and separating furnace

The change of bubbles and the position of the tuyere in an oxygen coal combustion melting and separating furnace affect the flow and splash behavior of the molten pool.To analyze this problem further,a three-dimensional numerical simulation method was used to explore the behavior and change of the flow field inside the molten pool during double-row tuyere injection.In addition,the arrangement of the tuyere was changed for a more detailed understanding of the internal phase distribution and splashing in a molten pool.The results indicated that under three-dimensional numerical simulation conditions,bubbles rise after leaving the tuyere and break on the surface of the molten pool,which results in certain fluctuations in the nearby melt.During the injection process of the tuyere,the meteorological accumulation in the middle part of the molten pool formed part of the foam slag because of the influence of surface tension.When the layout of the upper and lower exhaust tuyeres was changed from staggered to symmetrical,or when the spacing of the upper and lower exhaust tuyeres changed,it had an effect on the phase distribution and splash behavior.