Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by a unique combination of mechanical obstruction resulting from organized thrombi and a variable degree of secondary small-vessel remodeling, both of which contribute to increased pulmonary vascular resistance. In this process, pulmonary artery smooth muscle cell (SMC) phenotypic switching plays a critical role in the progression of microvascular disease. However, the underlying molecular mechanisms remain incompletely elucidated. Single-cell RNA sequencing (scRNA-seq) data from CTEPH patients and normal pulmonary artery tissues (GSE224143, GSE228644) were integrated. After data preprocessing, unsupervised clustering, and cell type annotation using Seurat, we focused on SMC subtype analysis and constructed functional landscapes via pseudobulk DESeq2, Gene Ontology (GO) enrichment analysis, Monocle3 pseudotime trajectory analysis, and high-dimensional weighted gene co-expression network analysis (hdWGCNA). Core findings were validated using bulk RNA-seq datasets (GSE84538) and experimental approaches, including Western blotting, immunofluorescence, EdU proliferation assay, and Transwell/scratch wound healing migration assay. scRNA-seq analysis identified 18 distinct cell clusters in pulmonary vascular tissues. Compared with controls, CTEPH tissues showed reduced fibroblasts and increased immune cells (T cells, monocytes/macrophages) and SMCs. Four SMC phenotypes were identified, with a marked expansion of fibroblast-like SMCs in CTEPH and a dynamic transition from contractile to fibroblast-like phenotype confirmed by pseudotime analysis. Upregulated genes in CTEPH SMCs were enriched in extracellular matrix organization and TGF-β signaling pathways (significantly activated). Cross-validation via hdWGCNA, pseudotime trajectory, and bulk RNA-seq data identified NDRG1 (a hypoxia-inducible gene) as a core gene. NDRG1 was significantly overexpressed in CTEPH SMCs and tissues, positively correlating with pulmonary vascular resistance (PVR). Functional experiments showed that NDRG1 knockdown inhibited hypoxia-induced migration/proliferation of human pulmonary artery smooth muscle cells (HPASMCs), suppressed TGF-β/SMAD pathway activation, and reduced fibroblast-like phenotype marker (Vimentin, COL1A1) expression. NDRG1 is associated with SMC phenotypic switching toward the fibroblast-like phenotype and promotes pulmonary vascular remodeling in CTEPH via the TGF-β/SMAD pathway. NDRG1 and related key gene axes may serve as potential therapeutic targets for CTEPH.

Background:Hybrid aortic arch repair combining debranching surgery with thoracic endovascular aortic repair (TEVAR) addresses complex aortic arch lesions. This study evaluated the long-term outcomes of hybrid aortic arch repair combining debranching surgery with TEVAR. Methods:We retrospectively analyzed 41 consecutive patients (mean age 56.9±14.6 years) undergoing hybrid arch repair between January 2010 and January 2021. Lesions included aneurysms (n=17), dissections (n=21), penetrating aortic ulcers (n=2), and intramural hematomas (n=1). Patients were stratified by proximal landing zones: zone 0 (n=8), zone 1 (n=12), and zone 2 (n=21). Primary endpoints were technical success, 30-day mortality, and long-term survival. Secondary endpoints included endoleak rates, bypass patency, and major complications. All patients underwent simultaneous hybrid surgery. Results:Technical success was achieved in all cases (100%). Early complications included type I endoleaks (4.8%, managed conservatively), severe pneumonia (14.6%), and incision hematomas (9.8%). The 30-day mortality was 2.4% (1/41, myocardial infarction). During a mean follow-up of 62.6 months, bypass graft occlusion occurred in 5 patients (4/5 axillary, 1/5 subclavian grafts, 12.8%). The 1-, 3-, and 5-year survival rates were 94.9%, 92.3%, and 84.6%, respectively, with no significant differences among landing zones (P=0.72). Axillary bypasses showed inferior patency compared to carotid-based reconstructions. Conclusions:Hybrid arch repair achieves favorable long-term outcomes with low mortality and stroke rates. Anatomical landing zone selection did not affect survival, but axillary bypasses demonstrated poorer durability. These findings support hybrid strategies for high-risk patients, with preferential use of carotid-based reconstructions to optimize bypass longevity.

BACKGROUND:Ischemic cardiomyopathy (ICM) with heart failure (HF) is characterized by myocardial hypoxia, microcirculation dysfunction, and neuroendocrine activation. While ivabradine and recombinant human brain natriuretic peptide (rhBNP) are individually used for HF, their combined efficacy remains underexplored. OBJECTIVE:To evaluate the effects of rhBNP combined with ivabradine on cardiac function, myocardial microcirculation, endocrine hormones, and biomarkers (CysC, Gal-3, miR-19a) in ICM-HF patients. METHODS:In this prospective study, 126 ICM-HF patients were randomized 1:1 to either ivabradine alone (control) or rhBNP + ivabradine (intervention). Both groups received conventional therapy. Cardiac function (LVEF, LVESD, LVEDD), microcirculation parameters (ischemic burden, ST-segment shift), serum hormones (ALD, NE, Ang II), and biomarkers were assessed at baseline and after 1 month. RESULTS:The intervention group showed higher total efficacy (93.65%¦vs. 76.19%, P<0.05), improved LVEF (51.76%¦vs. 46.68%), and reduced ventricular volumes (LVESD: 34.75 vs. 40.47 mm; P<0.05). Myocardial microcirculation parameters (ischemic burden, time, frequency) and neuroendocrine levels (ALD: 38.31 vs. 65.02 ng/L; NE: 102.39 vs. 180.23 ng/L; P<0.05) were significantly lower. Serum CysC, Gal-3, and miR-19a levels also decreased more prominently (P<0.05). Adverse reactions were comparable (11.11%¦vs. 7.94%, P>0.05). CONCLUSION:rhBNP combined with ivabradine synergistically improves cardiac function, myocardial microcirculation, and neuroendocrine regulation in ICM-HF patients, with superior efficacy and safety.

BackgroundAorto-caval fistula is a rare complication of abdominal aortic aneurysms that can occur spontaneously, iatrogenically, or traumatically, associated with high morbidity and mortality. Endovascular stent graft repair represents a practical approach to managing this fatal condition.Case presentationA 75-year-old male patient was admitted to the nephrology department of our hospital, complaining of acute back pain, hematuria, and repeated vomiting for one week. The laboratory assessments yielded high creatinine levels, indicating an acute renal impairment. Computed tomography angiography revealed an aorto-caval fistula complicating infrarenal abdominal aortic aneurysm. The patient was successfully treated with the endovascular approach by deploying covered stent grafts that completely excluded the fistula.ConclusionUtilizing covered stent grafts for endovascular management of aorto-caval fistula is a good alternative to conventional surgery, especially in elderly high-risk patients.

In this paper, we prove for $n\leq 7$ that if a differentiable $n$-manifold contains a relatively incompressible essential hypersurface in some class $\mathcal C_{deg}$, then it admits no complete metric with positive scalar curvature. Based on this result, we show for $n\leq 7$ that surgeries between orientable $n$-manifolds and $n$-torus along incompressible sub-torus with codimension no less than $2$ still preserve the obstruction for complete metrics with positive scalar curvature. As an application, we establish positive mass theorem with incompressible conditions for asymptotically flat/conical manifolds with flat fiber $F$ (including ALF and ALG manifolds), which can be viewed as a generalization of the classical positive mass theorem from \cite{SY79PMT} and \cite{SY2017}. Finally, we investigate Gromov's fill-in problem and bound the total mean curvature for nonnegative scalar curvature fill-ins of flat $2$-toruses (an optimal bound is obtained for product $2$-toruses). This confirms the validity of Mantoulidis-Miao's definition of generalized Brown-York mass in \cite{MM2017} for flat $2$-toruses.

OBJECTIVE:To investigate the role of glucagon-like peptide 1 (GLP-1) in myocardial perfusion, focusing on its effects on coronary microcirculation and cardiovascular outcomes. METHODS:Review of foundational research and large-scale clinical trials, including Cardiovascular Outcome Trials (CVOTs), examining the cardiovascular effects of GLP-1. Systematic analysis of trial data to assess the impact of GLP-1 therapy on myocardial infarction, composite cardiovascular events, and stroke incidence. RESULTS:GLP-1 therapy was found to significantly reduce myocardial infarction and composite cardiovascular events. Additionally, GLP-1 receptor agonists were observed to reduce stroke incidence, suggesting systemic effects on panvascular diseases. While direct protective effects on coronary microvasculature have been less studied, growing evidence supports GLP-1's role in comprehensive myocardial perfusion. CONCLUSION:GLP-1 is a promising therapeutic agent for improving myocardial perfusion and reducing cardiovascular events. Its protection is likely associated with comprehensive improvements in myocardial perfusion, including effects on coronary microcirculation. Further research is needed to fully elucidate its mechanisms of action and potential clinical applications.

Intestinal wound healing is a long-standing problem, with conventional suturing-based intestinal closure surgeries typically leading to postoperative problems. Alternative strategies or devices capable of effective wound healing have thus been sought. Here we report a self-powered electronic bandage made from soft and biodegradable materials that can accelerate wound healing in the intestine. The device uses dual electrostimulation to promote wound healing: a pulsed electrostimulation that induces electrotransfection of epithelial cells, promoting the expression of healing factors (such as epithelial growth factor); and a d.c. electrostimulation that enhances secretion of healing factors of the transfected cells. The electronic bandage exhibits high transfection efficiency and cell viability for intestinal epithelial cells in vitro, which boosts epithelial growth factor expression during the intraoperative period. Its self-powered galvanic cell from a magnesium and molybdenum microelectrode pair promotes healing factor exocytosis. In vitro and in vivo studies in mice show accelerated intestinal would healing compared to conventional suture-based treatments and an electronic bandage with single electrostimulation. A biodegradable electronic bandage that applies pulsed and d.c. electrostimulation can accelerate the healing of intestinal wounds in mice via transfection of cells and stimulation-induced secretion of healing factor from those cells.

Atherosclerosis (AS), a metabolic disorder, is usually caused by chronic inflammation. LETM1 Domain-Containing Protein 1 (LETMD1) is a mitochondrial outer membrane protein required for mitochondrial structure. This study aims to evaluate the functional role of LETMD1 in endothelial pathogenesis of AS. Oxidized low-density lipoprotein (ox-LDL)-induced human umbilical vein endothelial cells (HUVECs) and high-fat diet apolipoprotein E-deficient (ApoE−/−) mice were used to establish in vitro and in vivo models, respectively. Recombinant adenovirus vectors were constructed to investigate the role of LETMD1 in AS. mRNA sequencing was used to explore the effect of LETMD1 overexpression on gene expression in ox-LDL-induced HUVECs. A dual-luciferase reporting assay and chromatin immunoprecipitation (ChIP)-PCR were further conducted to verify the relationship between KLF4 and LETMD1. Results showed that LETMD1 was highly expressed in the aortas of atherosclerotic animals. LETMD1 overexpression reduced the expression of inflammatory factors, pyroptosis, ROS production, and NF-κB activation in ox-LDL-induced HUVECs, whereas LETMD1 knockdown had the opposite impact. LETMD1 overexpression was involved in regulating gene expression in ox-LDL-induced HUVECs. Overexpression of LETMD1 in mice reduced serum lipid levels as well as atherosclerotic lesions in the aortic roots. Furthermore, LETMD1 overexpression suppressed inflammatory reactions, cell pyroptosis, nuclear p65 protein level, cell apoptosis, and ROS generation in the aortas of AS mice. KLF4 (Krüppel-like factor 4) was found to be the transcriptional regulator of LETMD1. In conclusion, LETMD1, a target of KLF4, hinders endothelial inflammation and pyroptosis, which is a mechanism inhibiting the development of atherosclerosis.

Atherosclerosis (AS), characterized by a maladaptive inflammatory response, is one of the most common causes of death among the elderly. Karyopherin subunit alpha 2 (KPNA2), a member of the nuclear transport protein family, has been reported to play a pro-inflammatory role in various pathological processes by regulating the nuclear translocation of pro-inflammatory transcription factors. However, the function of KPNA2 in AS remains unknown. ApoE −/− mice were fed high-fat diets for 12 weeks to establish an AS mice model. Human umbilical vein endothelial cells (HUVECs) were treated with lipopolysaccharide (LPS) to establish an AS cell model. We found that KPNA2 was upregulated in the aortic roots of atherosclerotic mice and LPS-stimulated cells. KPNA2 knockdown inhibited LPS-induced secretion of pro-inflammatory factors and monocyte-endothelial adhesion in HUVECs, whereas KPNA2 overexpression exerted the opposite effects. p65 and interferon regulatory factor 3 (IRF3), the transcription factors known to regulate the transcription of pro-inflammatory genes, interacted with KPNA2, and their nuclear translocations were blocked following KPNA2 silencing. Furthermore, we found that KPNA2 protein level was decreased by E3 ubiquitin ligase F-box and WD repeat domain containing 7 (FBXW7), which was downregulated in the atherosclerotic mice. FBXW7 overexpression induced ubiquitination with subsequent proteasomal degradation of KPNA2. Meanwhile, the effects of KPNA2 deficiency on atherosclerotic lesions were further confirmed by in vivo experiments. Taken together, our study indicates that KPNA2 downregulation, regulated by FBXW7, may alleviate endothelial dysfunction and related inflammation in the progression of AS by suppressing the nuclear translocation of p65 and IRF3.

Objective Report our preliminary experience of carotid endarterectomy (CEA) for the treatment of carotid near-occlusion (CNO) with recurrent symptoms. Materials and Methods Retrospectively analyze the demographics, treatment detail, and outcomes data of 122 patients with CNO from 2014 to 2020. According to whether distal full collapse exists, patients were classified into the full collapse group and the non-full collapse group. The incidence of death, myocardial infarction, stroke, and other variables were compared between the two groups. Results A total of 122 patients with CNO and recurrent symptoms were enrolled. The demographics were comparable between the two groups. Thirty-day incidence of primary endpoints was 1.85% in the full collapse group and 4.41% in the non-full collapse group. Twelve-month incidence of primary endpoints was 7.41% in the full collapse group and 4.41% in the non-full collapse group. One re-stenosis occurred in the non-full collapse group 8 months after CEA. Conclusion For patients with CNO with recurrent symptoms, CEA is not worse than the results described in historical control groups, despite whether distal full collapse exists. The shunt is important to avoid intraoperative hypoperfusion and postoperative hyperperfusion. The long-term results should be further evaluated.

BACKGROUND:Acute carotid stent thrombosis (ACST) is a rare but devastating complication in the carotid artery stenting (CAS) procedure. The aim of this article is to report a case and review cases of ACST reported in the literature, and investigate risk factors and management strategies for ACST.CASE SUMMARY:We reviewed the treatment process of a patient with ACST after CAS. Then multiple databases were systematically searched to identify studies reporting ACST from 2005 to 2020. The demographic data, risk factors, treatment strategies, and prognosis were extracted and analyzed.CONCLUSION:The reason for ACST is multifactorial. Proper patient selection, normative anti-platelet treatment, and perfect technical detail may decrease the incidence of ACST. Several treatment strategies such as thrombolysis, mechanical thrombectomy, and open surgery may be options for the treatment of ACST. Limited data have shown that carotid endarterectomy is effective with favorable results.

BACKGROUND Portal vein thrombosis (PVT) was previously a contraindication for trans-jugular intrahepatic portosystemic shunt (TIPS). AIM To perform a systematic review and meta-analysis of the current available studies investigating outcomes of TIPS for cirrhotic patient with PVT. METHODS Multiple databases were systematically searched to identify studies investigating the outcomes of TIPS for cirrhotic patients with PVT. The quality of studies was assessed by Cochrane Collaboration method and Methodological Index for Non-Randomized Studies. The demographic data, outcomes, combined treatment, and anticoagulation strategy were extracted. RESULTS Twelve studies were identified with 460 patients enrolled in the analysis. The technical success rate was 98.9% in patients without portal vein cavernous transformation and 92.3% in patients with portal vein cavernous transformation. One-year portal vein recanalization rate was 77.7%, and TIPS patency rate was 84.2%. The cumulative encephalopathy rate was 16.4%. One-year overall survival was 87.4%. CONCLUSION TIPS is indicated for portal hypertension related complications and the restoration of pre-transplantation portal vein patency in cirrhotic patients with PVT. Cavernous transformation is an indicator for technical failure. Post-TIPS anticoagulation seems not mandatory. Simultaneous TIPS and percutaneous mechanical thrombectomy device could achieve accelerated portal vein recanalization and decreased thrombolysis-associated complications, but further investigation is still needed.

PURPOSE:The present meta-analysis evaluated the role of drug-coated balloon (DCB) angioplasty for in-stent restenosis (ISR) in femoropopliteal artery disease. MATERIALS AND METHODS:Cochrane Library, Embase, and PubMed were searched without language restrictions from inception to May 10, 2020. The endpoints included target lesion revascularization (TLR), recurrent ISR, clinical improvement, ankle-brachial index (ABI), and death. There were 5 randomized controlled trials with 425 patients (218 with DCB angioplasty and 207 with plain old balloon angioplasty [POBA]) were included in the meta-analysis. RESULTS:Compared with POBA, DCB angioplasty was associated with lower risk of TLR (odds ratio [OR], 0.21; 95% confidence interval [CI]: 0.09-0.49, P < .001 at 6 months and OR, 0.15; 95% CI, 0.08-0.30; P < .001 at 12 months) and recurrent ISR (OR, 0.22; 95% CI, 0.13-0.38; P < .001 at 6 months and OR, 0.31; 95% CI, 0.16-0.61; P < .001 at 12 months), and superior clinical improvement (OR, 1.98; 95% CI, 1.07-3.65; P = .03 at 6 months and OR, 2.84; 95% CI: 1.50-5.35; P = .001 at 12 months). There were no significant differences between groups in ABI and death. Subgroup analysis for patients with DCB angioplasty showed similar rates of TLR, recurrent ISR, clinical improvement, and death between the short lesion (<15 cm) and long lesion group (≥15 cm) (P > .05). CONCLUSIONS:The current meta-analysis suggests that DCB angioplasty is an improvement over POBA for femoropopliteal ISR. Future studies about the effect of lesion length on DCB performance are still needed.

Atherosclerosis and its complications diseases remain leading causes of cardiovascular morbidity and mortality, bringing a massive burden on public health worldwide. Atherosclerosis is recognized as chronic inflammation, and involves several highly correlated processes, including lipid metabolism dysfunction, endothelial cell dysfunction, inflammation, oxidative stress, vascular smooth muscle cell activation, platelet activation, thrombosis, altered matrix metabolism, and vascular remodeling. Within the past few decades, accumulating evidence has shown that the Yes-associated protein (YAP), the major effector of the Hippo pathway, can play a crucial role in pathogenesis and development of atherosclerosis. Activation of YAP-related pathways, which are induced by alerting flow pattern and matrix stiffness among others, can regulate processes including vascular endothelial cell dysfunction, monocyte infiltration, and smooth muscle cell migration, which contribute to atherosclerotic lesion formation. Further, YAP potentially modulates atherosclerotic complications such as vascular calcification and intraplaque hemorrhage, which require further investigation. Here, we summarized the relevant literature to outline current findings detailing the relationship between of YAP and atherosclerosis and highlight areas for future research.

笔者通过组织开展珠三角某市73家重点企业的VOCs"一企一策"综合整治方案评审与整治效果核实评估工作,总结了挥发性有机物综合整治过程中存在的数据失真、源头替代困难、台账管理不规范、环境保护与安全生产要求相冲突等问题,对问题产生的原因进行深入分析,为进一步推进工业企业挥发性有机物综合整治工作提出建议.

Object: The study sought to compare the safety and effectiveness of drug-coated balloon (DCB) with bare nitinol stent in patients with complex femoropopliteal(FP) lesions in real-world practice. Methods: Patients with symptomatic (Rutherford stage 2 to 5) femoropopliteal lesions who underwent DCB or bare nitinol stent implantation at the Department of Cardiovascular Surgery of China-Japan Friendship Hospital from June 2016 to September 2017 were included. Demographics, angiographic and procedural variables were included. Freedom from target lesion revascular ization (TLR), pr imar y patency and major adverse events were obtained from follow-up results at 3,6 and12 months. Descriptive analysis was performed on all variables. Results: A total of 90 eligible patients were enrolled, which included 51 DCB subjects (mean age, 63.1 +/- 13.2 years; 76.5% male) with 55 lesions and 39 nitinol stent subjects (mean age, 66.5 +/- 10.5 years; 61.5% male) with 42 lesions. Significant higher primary patency was observed in the DCB group compared with the stent group (74.5% vs. 52.4%; log-rank test P = 0.018; HR 0.335, 95%CI 0.124-0.903, P = 0.031). The rates of freedom from TLR (f-TLR) were 78.2% and 59.5% (log-rank test P = 0.032) for the DCB group and the stent group, respectively, at 12 months. CD-TLR rates were 18.2% vs. 38.1% with a P -value of 0.023. Female sex (HR 6.122, 95%CI 1.880-19.934, P = 0.003), lesion length over 20 cm (HR 5.514, 95%CI 2.312-13.148, P < 0.001) and renal insufficiency (HR 2.609, 95%CI 1.087-6.260, P = 0.032) were suggested as independent risk factors of reducing primary patency. There were no significant differences in major adverse events between the 2 groups. Conclusion: The result above demonstrates that DCB treatment has higher primary patency and lower TLR at 12 months than nitinol stent. These data confirm the safety and effectiveness of the DCB for patients with complex femoropopliteal lesions.

BACKGROUND:It was found that delayed activation wave often appeared in terminal QRS wave in non-ST-elevated myocardial infarction (NSTEMI) with culprit vessel in left circumflex artery (LCX), yet little is known about the similarities among non-"N"-wave non-ST-elevated myocardial infarction (N-NSTEMI) and ST-elevated myocardial infarction (STEMI).HYPOTHESIS:In AMI patients with the culprit vessel in LCX, "N" wave NSTEMI has a risk equivalent to STEMI.METHODS:All 874 patients admitted to Shenjing Hospital of China Medical University between January 1, 2013 and December 30, 2017 were included and whose coronary angiography (CAG) indicated the culprit vessel in LCX. Patients were divided into three groups: ST-elevated myocardial infarction group (STEMI group, n = 322), "N" wave non-ST-elevated myocardial infarction group (N-NSTEMI group, n = 232) and non-"N"-wave NSTEMI group (non N-NSTEMI group, n = 320). The basic data and the incidence of MACE during hospitalization and 12 months were analyzed.RESULTS:In STEMI and N-NSTEMI groups, AST, CK, CK-MB, TnI, and stenosis severity were significantly higher than non N-NSTEMI (P < .05). The lesions in the N-NSTEMI and STEMI groups were more often located proximal LCX before giving rise to OM1 of LCX (P < .05), however, the non N-NSTEMI group was often located distal LCX after giving rise to OM1 and the OM1 (P < .05). The incidence rates of all MACEs, all-cause death, ST, TVR, and rUAP were similar in N-NSTEMI and STEMI groups, which were greater than non N-NSTEMI (P < .05). Both N-NSTEMI and STEMI are independent risk factors for MACE (P < .05).CONCLUSION:The basic data and the incidence of major adverse cardiac event were similar in N-NSTEMI and STEMI patients, N-NSTEMI has a risk equivalent to acute STEMI.

To establish the vocational education personal learning account and achieve the traceability, query and conversion of learning results, the paper proposes a credit platform of vocational education chain. The technical characteristics of block chain decentralization, bookkeeping, asymmetric encryption, distributed, smart contract and consensus mechanism are used to construct the platform. In system design and system logic design, we focus on how to evaluate students more objectively, completely and accurately, how to make the platform more secure, public and shared, and how to make colleges, students and enterprises more trustworthy and prefer to use credit platforms. In view of the difficulties in the construction of credit platform nodes in polytechnic education chain, such as credit issuance and acquisition, credit query and so on, this paper puts forward some ideas and carries out prototype design. As a result, the credit platform is made more suitable for the development of educational alliance, collectivization, diversification and Internet +, open, shared and lifelong education.

Background: The optimal management for patients with concomitant severe coronary artery disease (CAD) and carotid artery stenosis (CAS) remains controversial. We reported our preliminary experience on a synchronous hybrid strategy. Methods: Seven patients with synchronous percutaneous coronary intervention (PCI)/carotid endarterectomy (CEA)/coronary artery bypass grafting (CABG) and 36 patients with synchronous CEA/CABG were enrolled. Then we analyzed the demographics, risk factors and 30-day results of the 2 groups, retrospectively. Results: The 2 groups were comparable in demographics. The operation time was 312.14 +/- 40.08 minutes for synchronous PCI/ CEA/CABG and 294.58 +/- 47.62 minutes for synchronous CEA/CABG (P = 0.367). The intraoperative blood loss was 814.29 +/- 195.18 mL for synchronous PCI/CEA/CABG and 769.44 +/- 330.21 mL for synchronous CEA/CABG (P = 0.731). There was no death in the 2 groups within 30 days. The incidence of primary endpoint [stroke, myocardial infarction (MI) and death] was 14.29% (1/7) in synchronous PCI/CEA/CABG group and 5.56% (2/36) in synchronous CEA/CABG group. The difference between the 2 groups was not statistically significant (P = 0.421). Conclusion: Synchronous PCI, CEA and CABG may be safe and effective in the management of patients with concomitant CAS and complicated multi-vessel CAD. The current data suggested that more studies and randomized controlled trials may be necessary to define whether this strategy is suitable for these patients.

建立了气相色谱/质谱同时测定水样中正十二烷、菲和苯酚的方法,研究了石油烃类污染物组分正十二烷、菲和苯酚共存体系在华南地区土壤土水系统中的分配机制及其影响因素.三种污染物在土壤中的吸附过程符合二级动力学方程,吸附速率大小为:正十二烷>菲>苯酚.试验浓度范围内,正十二烷和苯酚在土壤中的吸附符合Freundlish吸附模型;菲在土壤中的吸附符合Langmuir模型,且正十二烷和菲在土壤中的吸附是一个自发的放热过程;苯酚在土壤中的吸附是一个自发的吸热过程.土壤对三种污染物的吸附均以化学吸附为主.正十二烷和菲在土壤中的吸附率与土壤有机质含量呈正相关,相关系数分别为0.94和0.85.土壤不同粒径组分中正十二烷的吸附率大小顺序为:粉(砂)粒>黏粒>细砂粒>粗砂粒,菲的吸附率大小顺序为:粉(砂)粒>细砂粒>黏粒>粗砂粒,苯酚的吸附率大小顺序为:黏粒>粉(砂)粒>细砂粒>粗砂粒.结果表明,研究石油烃类污染物在土水系统中的平衡分配时,应基于各组分的含量、结构与性质的差异进行细分研究.