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Background: Chronic total occlusion (CTO) is the most challenging subset in percutaneous coronary intervention (PCI), but the optimal selection of patients and indication for such procedures remain a subject of debate. We sought to investigate the role of physiological function in treatment decisions of CTO PCI by measuring fractional flow reserve (FFR) and Dynamic SPECT imaging in this study. Methods: All the FFR of CTO vessel were measured before and immediately after CTO revascularization, and Dynamic SPECT imaging were detected before PCI in patients with an identified CTO. Results: A total of 53 patients with single-vessel CTO lesions were included in this cohort study. The mean FFR value was 0.34 ± 0.09 at baseline. Immediately after successful CTO PCI, the FFR value significantly increased to 0.79 ± 0.11. The regional coronary flow reserve (CFR) of CTO vessels was 1.62 ± 0.64, which was significantly and positively correlated with the baseline FFR value (r = 0.607, p = 0.005). The area under the ROC curve of the baseline FFR for the detection of ischemia was 0.923 (p

Abstract Background Indobufen is widely used in patients with aspirin intolerance in East Asia. The OPTION trial launched by our cardiac center examined the performance of indobufen based dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). However, the vast majority of patients with acute coronary syndrome (ACS) and aspirin intolerance were excluded. We aimed to explore this question in a real-world population. Methods Patients enrolled in the ASPIRATION registry were grouped according to the DAPT strategy that they received after PCI. The primary endpoints were major adverse cardiovascular and cerebrovascular events (MACCE) and Bleeding Academic Research Consortium (BARC) type 2, 3, or 5 bleeding. Propensity score matching (PSM) was adopted for confounder adjustment. Results A total of 7135 patients were reviewed. After one-year follow-up, the indobufen group was associated with the same risk of MACCE versus the aspirin group after PSM (6.5% vs. 6.5%, hazard ratio [HR] = 0.99, 95% confidence interval [CI] = 0.65 to 1.52, P = 0.978). However, BARC type 2, 3, or 5 bleeding was significantly reduced (3.0% vs. 11.9%, HR = 0.24, 95% CI = 0.15 to 0.40, P

Abstract Background Antiphospholipid antibody syndrome (APS) is a multisystemic autoimmune disorder which affects many organs or systems; however, coronary artery is relatively less frequently involved. Case presentation A 65-year-old female with effort chest pain was hospitalized for unstable angina in Janurary, 2015. Coronary angiography revealed sub-total occlusion of proximal left anterior descending (LAD) coronary artery, where a drug-eluting stent was successfully deployed. The patient experienced multiple in-stent stenosis at LAD coronary artery and coronary artery bypass graft (CABG) surgery was advised. Subsequently, severe stenosis of left circumflex (LCX) coronary artery emerged, and the patient suffered persistent in-stent restenosis. Eventually, the patient was diagnosed with seronegative antiphospholipid antibody syndrome and salvaged by immunosuppressants. Conclusions Repeated in-stent restenosis could be a primary manifestation of seronegative antiphospholipid antibody syndrome, and suppression of autoimmune activity and inflammation other than purely coronary revascularization might be a better option.

As the main factors affecting stable and high production and the production regularity of lacustrine shale oil are unclear, the theoretical understandings, key exploration and development technologies, development effect and production regularity of lacustrine shale oil have been analyzed and summarized based on 700 m cores taken systematically from Paleogene Kong 2 Member of 4 wells in Cangdong sag, over 100 000 analysis data and formation testing data. Three theoretical understandings on shale oil enrichment and high production have been reached: (1) High-quality shale with “three highs and one low” is the material base for shale oil enrichment. (2) Medium—slightly high thermal evolution degree is the favorable condition for shale oil enrichment. (3) Laminar felsic shale is the optimal shale layer for oil enrichment in semi-deep lake facies. Key exploration and development technologies such as shale oil enrichment layer and area evaluation and prediction, horizontal well pattern layout, shale oil reservoir fracturing, optimization of shale oil production regime have been established to support high and stable shale oil production. Under the guidance of these theoretical understandings and technologies, shale oil in Cangdong sag has achieved high and stable production, and 4 of them had the highest production of over 100 tons a day during formation testing. In particular, Well GY5-1-1L had a daily oil production of 208 m3. By April, 2022, the 28 wells combined have a stable oil production of 300–350 tons a day, and have produced 17.8×104 t of oil cumulatively. It is found that the shale oil production of horizontal well declines exponentially in natural flow stage, and declines in step pattern and then tends stable in the artificial lift stage. Proportion of light hydrocarbons in produced shale oil is in positive correlation with daily oil production and decreases regularly during production test.

IntroductionThe production of root exudates with biological nitrification inhibition (BNI) effects is a strategy adopted by ammonium-N (NH4+‐N) tolerant plant species that occur in N-limited environments. Most knowledge on BNI comes from plant species that occur in acidic soils.MethodsHere, combining field sampling and laboratory culture, we assessed the BNI-capacity of Leymus chinensis, a dominant grass species in alkaline grasslands in eastern Asia, and explored why L. chinensis has BNI ability.Results and discussionThe results showed that L. chinensis has strong BNI-capacity. At a concentration of 1 mg mL-1, L. chinensis’ root exudates inhibited nitrification in soils influenced by Puccinellia tenuiflora by 72.44%, while DCD only inhibited it by 68.29%. The nitrification potential of the soil of L. chinensis community was only 53% of the P. tenuiflora or 41% of the Suaeda salsa community. We also showed that the supply of NH4+‐N driven by L. chinensis’ BNI can meet its requirements . In addition, NH4+‐N can enhance plant adaptation to alkaline stress by regulating pH, and in turn, the uptake of nitrate-N (NO3‐‐N). We further demonstrated that the regulatory function of NH4+‐N is greater than its nutritional function in alkaline environment. The results offer novel insights into how L. chinensis adapts to high pH and nutrient deficiency stress by secreting BNIs, and reveal, for the first time, differences in the functional roles of NH4+‐N and NO3‐‐N in growth and adaptation under alkaline conditions in a grass species.

Abstract Necroptosis is a mode of programmed cell death that overcomes apoptotic resistance. The accurate prognosis of cutaneous melanoma is complicated to predict due to tumor heterogeneity. Necroptosis contributes to the regulation of oncogenesis and cancer immunity. We comprehensively investigated different necroptosis patterns by the non-negative matrix factorization (NMF) clustering analysis and explored the relationships among necroptosis patterns, infiltered immune cells, and tumor microenvironment (TME) scores. Two different necroptosis patterns were identified, and the two clusters could predict prognosis and immune landscape. A four-gene signature was successfully constructed and validated its predictive capability of overall survival (OS) in cutaneous melanoma patients. The prognostic value of the signature was further enhanced by incorporating other independent prognostic factors such as age and clinicopathological stages in a nomogram-based prediction model. Patients with lower risk scores tended to have better OS, higher TME score, immune checkpoints, immunophenoscore (IPS), and lower Tumor Immune Dysfunction and Exclusion (TIDE), which indicated better responses to immunotherapy. In addition, the pigmentation score of the high-risk group was visibly higher than those of the low-risk group. In conclusion, the necroptosis-related signature indicated favorable predictive performance in cutaneous melanoma patients, which provides guidance for immunotherapy and provide novel insights into precision medicine.

In the context of global change, the frequency of precipitation pulses is expected to decrease while nitrogen (N) addition is expected to increase, which will have a crucial effect on soil C cycling processes as well as methane (CH4) fluxes. The interactive effects of precipitation pulses and N addition on ecosystem CH4 fluxes, however, remain largely unknown in grassland. In this study, a series of precipitation pulses (0, 5, 10, 20, and 50 mm) and long-term N addition (0 and 10 g N m-2 yr-1, 10 years) was simulated to investigate their effects on CH4 fluxes in a semi-arid grassland. The results showed that large precipitation pulses (10 mm, 20 mm, and 50 mm) had a negative pulsing effect on CH4 fluxes and relatively decreased the peak CH4 fluxes by 203-362% compared with 0 mm precipitation pulse. The large precipitation pulses significantly inhibited CH4 absorption and decreased the cumulative CH4 fluxes by 68-88%, but small precipitation pulses (5 mm) did not significantly alter it. For the first time, we found that precipitation pulse size increased cumulative CH4 fluxes quadratically in both control and N addition treatments. The increased soil moisture caused by precipitation pulses inhibited CH4 absorption by suppressing CH4 uptake and promoting CH4 release. Nitrogen addition significantly decreased the absorption of CH4 by increasing NH4+-N content and NO3–-N content and increased the production of CH4 by increasing aboveground biomass, ultimately suppressing CH4 uptake. Surprisingly, precipitation pulses and N addition did not interact to affect CH4 uptake because precipitation pulses and N addition had an offset effect on pH and affected CH4 fluxes through different pathways. In summary, precipitation pulses and N addition were able to suppress the absorption of CH4 from the atmosphere by soil, reducing the CH4 sink capacity of grassland ecosystems.

Compared with marine facies shale strata, lacustrine shale strata are more complicated in geological conditions, and thus more difficult to explore and develop. To realize economic exploration and development of lacustrine shale oil, the geological regularities of accumulation and high yield of retained movable petroleum in shale should be understood first. In this work, taking the shale strata of Kong 2 Member and Sha 3 Member in the Paleogene of Huanghua depression in the Bohai Bay Basin as examples, based on the previous joint analysis results of over ten thousand core samples and the latest oil testing, production test and geochemical data of more than 30 horizontal wells, accumulation conditions and models of retained movable petroleum in lacustrine shale were studied comprehensively. The study shows that at moderate organic matter abundance (with TOC from 2% to 4%), shale strata have the best match between oil content and brittleness, and thus are rich in oil and good in fracability. Moderate ancient lake basin size and moderate sediment supply intensity are the internal factors leading to best coupling of organic matter abundance and brittle mineral content in the shale formation. Moderate thermal evolution maturity of Ro of 0.7%–1.0% (at burial depth of 3200 to 4300 m) is the interval where oil generation from thermal evolution and oil adsorption by kerogen in shale layers match best, and retained movable petroleum is high in proportion. Moderate diagenetic evolution stage (3200 to 4300 m in the middle diagenetic stage A) is conducive to the formation of a large number of dissolved pores and organic matter pores, which provide storage space for shale oil enrichment. Moderate development degree of natural fractures (without damaging the shale oil roof and floor sealing conditions) is conducive to the storage, seepage and preservation of shale oil. The research results have overthrown the general understanding that high organic matter abundance, high maturity, and high development degree of natural fractures are conducive to shale oil enrichment, and have guided the comprehensive evaluation of shale oil and gas sweet spots and well deployment in the second member of the Kongdian Formation in the Cangdong sag and the Shahejie Formation in the Qikou sag. Industrial development of the shale oil in Kong 2 Member of the Cangdong sag has made major breakthrough, and important signs of shale oil have been found in Sha 3 Member of the Qikou sag, demonstrating huge exploration potential of lacustrine shale oil.

Abstract Background Myocardial infarction (MI) is a major cause of death worldwide. Although percutaneous coronary intervention and coronary artery bypass grafting can prolong life, cardiac damage persists. In particular, cardiomyocytes have no regenerative capacity. Mesenchymal stem cells (MSCs) are attractive candidates for the treatment of MI. The manner by which MSCs exert a beneficial effect upon injured cells is a source of continued study. Methods After the isolation and identification of exosomes from MSCs, the expression of miR-210 was determined by microarray chip. Subsequently, gain- and loss-function approaches were conducted to detect the role of exosomes and exosomal-miR-210 in cell proliferation and apoptosis of cardiomyocytes, as well as the MI in vivo. Dual-Luciferase Report Gene System was used to demonstrate the target gene of miR-210. Results We tested the hypothesis that MSC-derived exosomes transfer specific miRNA to protect cardiomyocytes from apoptotic cell death. Interestingly, direct cardiac injection of MSC exosomes reduced infarct size and improved heart function after coronary ligation. In vitro, the MSC exosomes enhanced cardiomyocyte survival to hypoxia. Confirmation of exosome uptake in myocytes was confirmed. Dual-luciferase reporter assay implicated miR-210 as a mediator of the therapeutic effect and AIFM3 as a downstream target. Treatment with miR-210 overexpressing MSC exosomes improved myocyte protection to both in vitro and in vivo stress. Furthermore, the endogenous and exogenous miR-210 had the same therapeutic effects. Conclusion These results demonstrated that the beneficial effects offered by MSC-exosomes transplantation after MI are at least partially because of excreted exosome containing mainly miR-210. Graphical abstract

This work was to explore the changes of T lymphocyte subsets in peripheral blood of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) (AECOPD) and the role of cellular immunity mediated in the disease process. Eighty-six patients with AECOPD who visited Qingdao Hiser Medical Center from June 2020 to December 2021 and 30 healthy people (controls) who underwent health examination in the same period were selected. The differences of pulmonary function (PF), arterial blood gas (ABG), blood routine inflammatory indexes, T lymphocyte and T lymphocyte subsets were compared between the two groups, and the correlation between T lymphocyte subsets and each index was analyzed. There were clear differences in PF, ABG, and PB inflammation indexes between AECOPD patients and the controls (P

Grasslands store 20–30% of global soil organic carbon (SOC) but a majority of grasslands are suffering degradation accompanied by SOC loss. SOC stock is determined by the balance between C input from plants and C output from microbial decomposition, but the relative importance of these factors in controlling SOC and the stabilization mechanisms of SOC are poorly understood. Here, we investigated the main factors influencing SOC loss along a grassland degradation gradient in the Horqin grassland, including non-degraded (ND), lightly degraded (LD), moderately degraded (MD), and severely degraded (SD) grasslands. The contents of SOC, TN and TP at the ND and LD sites were significantly higher than those at the MD and SD sites. Plant aboveground, belowground and litter biomass significantly decreased with the intensification of degradation. Compared to the ND site, the mean weight diameter of soil aggregates decreased by 8.70%, 17.39% and 26.1% at the LD, MD and SD sites, respectively. Exchangeable Ca2+ and Mg2+ contents also decreased along the degradation gradient. Moreover, the results of structural equation modeling indicated that grassland degradation reduced plant biomass, resulting in an increase in soil available phosphorus content, thus causing less energy losses for microbes through their deployment of extracellular enzymes, eventually leading to an increase in microbial carbon use efficiency. Correlation analysis also confirmed that microbial carbon use efficiency was positively correlated with the ratio of G+/G-. The results of boosted regression tree model suggested that exchangeable Ca2+ and mean weight diameter were the two most influential factors on SOC among the 13 studied variables. Stabilization mechanisms linked to chemical stabilization by polyvalent cations and soil aggregation were the most important controlling factors on SOC content during grassland degradation. In summary, although microorganisms mitigated soil carbon loss to some extent by decreasing their total biomass and increasing their carbon use efficiency, the weakened physical protection of SOC resulted in SOC loss during grassland degradation.

Abstract The China‐France Oceanography Satellite (CFOSAT) was successfully launched on October 29, 2018, which carries two innovative payloads, that is, the surface waves investigation and monitoring (SWIM) instrument and the rotating fan‐beam scatterometer (RFSCAT). CFOSAT scatterometer (CSCAT) is dedicated to the monitoring of sea surface wind vectors and climate studies, but also for the applications over land and polar regions. CSCAT employs a “rotating fan‐beam” design rather than “pencil‐beam” approach and “fixed fan‐beam” approach adopted by the scatterometers in orbit before. In this paper, the data processing approach of CSCAT is described. The geolocation reference mapping model is employed in CSCAT slice geolocation. In noise processing, CSCAT adopts the method of weighted least squares polynomial surface fitting to conduct noise correction factor estimation adaptively. The attitude cube algorithm used for X integral factor computation is developed to obtain precise backscatter coefficients based on the radar equation. Because of the interdependency of the CSCAT data processing and the hardware configuration and onboard signal processing of the instrument, the instrument module configuration and signal processing design are also analyzed and presented comprehensively. Especially, the influence and compensation of Doppler frequency are introduced. The backscatter coefficient accuracy is estimated on the Amazon forest, and the results show that the backscatter coefficient accuracy of CSCAT on 25 × 25 km grids is less than 0.5 dB except that the near end and far end of the beam are slightly higher. The statistical results show the wind retrieval results meet the CFOSAT mission requirements.

Based on seismic and logging data, taking the downthrow fault nose of Binhai fault in Qikou Sag as the object of study, we analyzed fault characteristics, sand body distribution, fault-sand combinations and hydrocarbon accumulation to reveal the hydrocarbon enrichment law in the fault-rich area of fault depression lake basin. The results show that the Binhai Cenozoic fault nose is characterized by east-west zoning, the main part of the western fault segment is simple in structure, whereas the broom-shaped faults in the eastern segment are complex in structure, including several groups of faults. The difference of fault evolution controls the spatial distribution of sand bodies. The sand bodies are in continuous large pieces in the downthrow fault trough belt along the Gangdong Fault in the middle segment of the fault nose, forming consequent fault-sand combination; whereas the fault activity period of the eastern part of the fault nose was later, and the sand bodies controlled by paleogeomorphology are distributed in multi-phase north-south finger-shaped pattern, forming vertical fault-sand combination pattern matching with the fault. The configuration between faults and sand bodies, and oil sources and caprocks determine the vertical conductivity, plane distribution and vertical distribution of oil and gas. Two oil and gas accumulation modes, i.e. single main fault hydrocarbon supply–fault sand consequent matching–oil accumulation in multi-layers stereoscopically and fault system transportation–fault sand vertical matching–oil accumulation in banded overlapping layers occur in the middle and eastern segments of the fault nose respectively, and they control the difference of oil and gas distribution and enrichment degree in the Binhai fault nose. Key words: Bohai Bay Basin, Qikou Sag, Binhai fault nose, sandstone development mechanism, fault-sand combination, oil and gas accumulation, reservoir control mechanism

Objective: The aim of the study is to assess the predictors of failure of percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) lesions using a retrograde approach. Methods: The present study retrospectively enrolled all 211 patients who underwent retrograde CTO PCI from January 2009 to December 2015 at Shanghai Institute of Cardiovascular Disease. Multivariate Cox regression analysis was used to assess potential predictors of retrograde CTO PCI failure including sex, vascular access site, sheath size, prior PCI, prior coronary artery bypass grafting, history of myocardial infarction, target vessel of CTO, J-CTO score, retrograde wire crossing collaterals, and reverse controlled antegrade and retrograde subintimal tracking (CART) use. Results: Of the 211 patients studied, retrograde CTO PCI was successful in 115 (54.5%) patients, and in an additional 46 (21.8%) with an antegrade approach after retrograde failure. For the 50 (23.7%) patients who failed both retrograde and antegrade approaches, the most common (50% [25/50]) reason was inability to cross collaterals with the retrograde wire. This group of patients had fewer instances of a prior PCI (P < 0.05). Retrograde CTO PCI failure rate was lower with increasing sheath size and with either radial-only or one radial and one femoral access versus femoral-only access (P < 0.05). A multivariate Cox regression analysis showed that the inability to cross collaterals with the retrograde wire (hazard ratio, 5.52 [95% confidence interval, 2.08–12.81];P < 0.001), no prior PCI (3.27 [1.24–8.58];P = 0.01), and no reverse CART use (4.19 [1.33–13.19];P = 0.03) were an independent predictors of retrograde CTO PCI failure. Conclusion: Independent predictors of retrograde CTO PCI failure were the inability to cross collaterals with the retrograde wire, no prior PCI, and no reverse CART use. Vascular access site and sheath size do not have effect on the success of the retrograde approach.

Objectives. The present study aimed to investigate the short- and long-term clinical outcomes of self-made polyurethane-covered stents (PU-CS) in patients for the management of coronary artery perforation (CAP) during percutaneous coronary intervention (PCI). Background. Coronary artery perforation is reckoned as a serious complication in PCI and associated with considerable morbidity and mortality. Covered stents have been used for treating the life-threatening CAP during PCI. But in some catheterization laboratories, no commercial CS is immediately available when there is an urgent need for CS to rescue the coronary rupture site. Methods. We retrospectively identified 24 patients who underwent 31 self-made PU-CS implantations due to CAP in Zhongshan Hospital, Fudan University, from June 2015 to January 2020. Results. The total procedural success rate of CS to seal the perforation was 79.2%. Nine patients (37.5%) developed cardiac tamponade, of which 8 patients (33.3%) underwent pericardiocentesis and 4 patients (16.7%) underwent cardiac surgeries. Except for 4 cardiac death cases (16.7%), none of myocardial infarction (MI), target lesion revascularization (TLR), and stent thrombosis (ST) was reported during hospital stay. Data from 22 patients (91.7%) were available at 610.4 ± 420.9 days of follow-up. Major adverse cardiac events (MACE) occurred in 6 patients (27.3%), including 5 cases of cardiac death and one TLR case. Conclusions. Self-made PU-CS demonstrates high rates of successful delivery and sealing of severe CAP during PCI. Although the in-hospital mortality remains high after PU-CS implantation, the long-term follow-up shows favorable clinical outcomes, indicating the feasibility of PU-CS in treating CAP.

Objective. The initial recanalization rate of coronary chronic total occlusions (CTOs) is >85% when performed by experienced operators, but only 10% of prior failed CTO patients receive reattempted recanalization. This retrospective study analyzed the success rate and strategies used in reattempt percutaneous coronary intervention (PCI) of CTOs after prior failures. Methods. Overall, 206 patients with 212 CTOs were enrolled. All patients with prior recanalization failures received reattempt PCIs from January 2015 to March 2019 at Zhongshan Hospital, Fudan University. Data on clinical factors (age, sex, comorbidities, left ventricular ejection fraction, history of cigarette usage, and revascularization), angiographic characteristics of CTOs (target lesion, Japanese Chronic Total Occlusion (J-CTO) score, the morphology of CTO lesions, and collateral channel scale), strategies (procedural approach and use of devices), and major adverse events were obtained and analyzed. Results. The mean age of enrolled patients was 60.96 ± 12.36 years, with a male predominance of 90.3%. Of the patients, 47.1% had a prior myocardial infarction and 70.4% underwent stent implantation previously, while the in-stent occlusion rate was 6.6%. CTOs were primarily localized in the left anterior descending artery (43.9%) and the right coronary artery (43.9%). 80.7% of lesions were classified as very difficult (J-CTO score ≥3), and the overall success rate was 81.1%. In multivariable regression analysis, J-CTO score, collateral channel scale, application of coronary multispiral computed tomography angiography, dual injection, intravascular ultrasound, active greeting technique, parallel wiring, and CTO morphology were predictors of recanalization success. There were no significant differences in rates of procedural complications between the final recanalization success and failure groups. Conclusions. Recanalization of complex CTOs is associated with high success rate and low complication rates when performed by high-volume CTO operators and after multiple reattempts.

Acute myocardial infarction (AMI), one of the most severe and fatal cardiovascular diseases, remains the main cause of mortality and morbidity worldwide. The objective of this study is to investigate the potential biomarkers for AMI based on bioinformatics analysis. A total of 2102 differentially expressed genes (DEGs) were screened out from the data obtained from the gene expression omnibus (GEO) database. Weighted gene co-expression network analysis (WGCNA) explored the co-expression network of DEGs and determined the key module. The brown module was selected as the key one correlated with AMI. Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses demonstrated that genes in the brown module were mainly enriched in ‘ribosomal subunit’ and ‘Ribosome’. Gene Set Enrichment Analysis revealed that ‘TNFA_SIGNALING_VIA_NFKB’ was remarkably enriched in AMI. Based on the protein–protein interaction network, ribosomal protein L9 (RPL9) and ribosomal protein L26 (RPL26) were identified as the hub genes. Additionally, the polymerase chain reaction (PCR) results indicated that the expression levels of RPL9 and RPL26 were both downregulated in AMI patients compared with controls, in accordance with the bioinformatics analysis. In summary, the identified DEGs, modules, pathways, and hub genes provide clues and shed light on the potential molecular mechanisms of AMI.

Factor XI deficiency is a rare coagulopathy which has a higher risk of bleeding following trauma or an operation. Stable coronary artery disease patients complicated by factor XI deficiency draw extraordinary caution when coronary artery stents are needed, for interventional cardiologists must balance the need for antithrombosis and bleeding complications. Currently, there is no guideline for the management of such patients. Here, we describe a patient with coronary artery disease with factor XI deficiency who underwent an uneventful percutaneous coronary intervention.

Objective: The main objective is to investigate the value of the treadmill exercise test (TET) for guiding the clinical therapy of myocardial bridging (MB) patients. Subjects and Methods: We retrospectively analyzed the TET results of 70 patients with MB and their electrocardiography (ECG) characteristics then evaluated the relationship between the TET results and the patients' clinical characteristics, including sex, age, bridge length, and the degree of bridge compression. Results: There were 27 patients (38.6%) with a positive TET, 31 (44.3%) negative, and 12 (17.1%) probably positive. For positive and probably positive patients, 31 patients had ECGs that shared similar ST segments depression in II, III, and avF leads with or without V4–V6 segments depression. Male patients had a higher TET positive rate than female patients. No relationships were found between the bridge length, bridge compression, and TET results. In addition, no relationships were identified between hypertension, diabetes, hyperlipemia, smoking, age, and TET results. Conclusions: The main ECG characteristics of patients with MB whose TET results were positive were II, III, and avF ST-T segment depression with or without V4–V6 segment depression. Male patients had higher TET positive rates than female patients. No relationships were identified between the bridge length, bridge compression, and the TET results.

Introduction. Although coronary artery disease (CAD) presentations and clinical outcomes differ by sex, little is known about premature CAD (PCAD). The present analysis aimed to evaluate the gender-related differences of PCAD in an Asian population from the FOCUS registry. Methods. A total of 1397 Asian young patients with angiographically confirmed CAD undergoing drug-eluting stent implantation were included in this analysis and divided into two groups according to the genders. Patients were followed up for three years and clinical outcomes were compared between groups. Results. Young women were older and more likely to have hypertension and diabetes than men (all p0.05). Conclusion. Despite remarkable differences in clinical characteristics between Asian males and females with PCAD, the two groups did not differ significantly in clinical outcomes.

To understand the morphological and physiological responses of leaves to changes in altitudinal gradients, we examined ten morphological and physiological characteristics in one-year-old needles of Picea schrenkiana var. tianschanica at ten points along an altitudinal gradient from 1420 to 2300 m a.s.l. on the northern slopes of the Tianshan Mountains in northwest China. Our results indicated that LA, SD, LPC, and LKC increased linearly with increasing elevation, whereas leaf δ13C, LNC, Chla + b, LDMC, LMA, and Narea varied nonlinearly with changes in altitude. With elevation below 2100 m, LNC, Narea, and Chla + b increased, while LDMC and LMA decreased with increasing altitude. When altitude was above 2100 m, these properties showed the opposite patterns. Leaf δ13C was positively correlated with Narea and LNC and negatively correlated with SD and LA, suggesting that leaf δ13C was indirectly controlled by physiological and morphological adjustments along altitudinal gradients. Based on the observed maximum values in LNC, Narea, Chla + b, and LA and the minimum values in LMA and LDMC at the elevation of 2100 m, suggesting higher photosynthetic capacity and greater potential for fast growth under superior optimum zone, we concluded that the best growing elevation for P. schrenkiana var. tianschanica in the Tianshan Mountains was approximately 2100 m.