Post-procedural and long-term functional outcomes of jailed side branches in stented coronary bifurcation lesions assessed with side branch Murray law–based quantitative flow ratio

IntroductionIn coronary bifurcation lesions treated with percutaneous coronary intervention (PCI) using a 1-stent strategy, the occurrence of side branch (SB) compromise may lead to long-term myocardial ischemia in the SB territory. Murray law–based quantitative flow ratio (μQFR) is a novel angiography-based approach estimating fractional flow reserve from a single angiographic view, and thus is more feasible to assess SB compromise in routine practice. However, its association with long-term SB coronary blood flow remains unknown.MethodsA total of 146 patients with 313 non-left main bifurcation lesions receiving 1-stent strategy with drug-eluting stents was included in this retrospective study. These lesions had post-procedural Thrombolysis in Myocardial Infarction (TIMI) flow grade 3 in SBs, and documented angiographic images of index procedure and 6- to 24-month angiographic follow-up. Post-procedural SB μQFR was calculated. Long-term SB coronary blood flow was quantified with the TIMI grading system using angiograms acquired at angiographic follow-up.ResultsAt follow-up, 8 (2.6%), 16 (5.1%), 61 (19.5%), and 228 (72.8%) SBs had a TIMI flow grade of 0, 1, 2, and 3, respectively. The incidences of long-term SB TIMI flow grade ≤1 and ≤2 both tended to decrease across the tertiles of post-procedural SB μQFR. The receiver operating characteristic curve analyses indicated the post-procedural SB μQFR ≤0.77 was the optimal cut-off value to identify long-term SB TIMI flow grade ≤1 (specificity, 37.50%; sensitivity, 87.20%; area under the curve, 0.6673; P = 0.0064), and it was independently associated with 2.57-fold increased risk (adjusted OR, 2.57; 95% CI, 1.02–7.25; P = 0.045) in long-term SB TIMI flow grade ≤1 after adjustment.DiscussionPost-procedural SB μQFR was independently associated with increased risk in impaired SB TIMI flow at long-term follow-up. Further investigations should focus on whether PCI optimization based on μQFR may contribute to improve SB flow in the long term

Optimizing the Junction-Tree-Based Reinforcement Learning Algorithm for Network-Wide Signal Coordination

This study develops three measures to optimize the junction-tree-based reinforcement learning (RL) algorithm, which will be used for network-wide signal coordination. The first measure is to optimize the frequency of running the junction-tree algorithm (JTA) and the intersection status division. The second one is to optimize the JTA information transmission mode. The third one is to optimize the operation of a single intersection. A test network and three test groups are built to analyze the optimization effect. Group 1 is the control group, group 2 adopts the optimizations for the basic parameters and the information transmission mode, and group 3 adopts optimizations for the operation of a single intersection. Environments with different congestion levels are also tested. Results show that optimizations of the basic parameters and the information transmission mode can improve the system efficiency and the flexibility of the green light, and optimizing the operation of a single intersection can improve the efficiency of both the system and the individual intersection. By applying the proposed optimizations to the existing JTA-based RL algorithm, network-wide signal coordination can perform better

Study on the Design of Variable Lane Demarcation in Urban Tunnels

In order to alleviate the influence of low-speed vehicles on tunnel safety, this paper discusses the setting method of variable lane boundaries in urban tunnels. VISSIM simulation software is used to analyze the influence of low-speed vehicles on tunnel traffic flow when lane changes are allowed and when lane changes are prohibited. The results show that the influence of low-speed vehicles on the average speed of traffic flow in urban tunnels is the greatest, and the influence of low-speed vehicles on the average speed of traffic flow can be significantly alleviated when lane changes are allowed in the lane dividing line. When the speed of low-speed vehicles is 40 km/h and the variable lane is set, the average delay time is reduced by 30–50%. The existence of low-speed vehicles significantly increased the average delay time of the local lane, and the lower the vehicle speed and the greater the road traffic volume, the longer the average delay time. When the speed of low-speed vehicles is 40 km/h and the traffic volume is 1200 pcu/h, the traffic density of the right-hand lane decreases by 43.5% after the variable lane is set. While lane changing is prohibited, the presence of low-speed vehicles causes a backlog of vehicles in the rear of the lane, which leads to a significant increase in traffic density. Setting lane-changing permits can alleviate the impact of low-speed vehicles on traffic flow. The research results can provide a scientific basis for the operation and management of urban tunnels

Study on the Design of Variable Lane Demarcation in Urban Tunnels

In order to alleviate the influence of low-speed vehicles on tunnel safety, this paper discusses the setting method of variable lane boundaries in urban tunnels. VISSIM simulation software is used to analyze the influence of low-speed vehicles on tunnel traffic flow when lane changes are allowed and when lane changes are prohibited. The results show that the influence of low-speed vehicles on the average speed of traffic flow in urban tunnels is the greatest, and the influence of low-speed vehicles on the average speed of traffic flow can be significantly alleviated when lane changes are allowed in the lane dividing line. When the speed of low-speed vehicles is 40 km/h and the variable lane is set, the average delay time is reduced by 30–50%. The existence of low-speed vehicles significantly increased the average delay time of the local lane, and the lower the vehicle speed and the greater the road traffic volume, the longer the average delay time. When the speed of low-speed vehicles is 40 km/h and the traffic volume is 1200 pcu/h, the traffic density of the right-hand lane decreases by 43.5% after the variable lane is set. While lane changing is prohibited, the presence of low-speed vehicles causes a backlog of vehicles in the rear of the lane, which leads to a significant increase in traffic density. Setting lane-changing permits can alleviate the impact of low-speed vehicles on traffic flow. The research results can provide a scientific basis for the operation and management of urban tunnels

SENP2 Promotes VSMC Phenotypic Switching via Myocardin De-SUMOylation

Myocardin is a master regulator of smooth muscle cell (SMC) differentiation, which induces the expression of smooth-muscle-specific genes through its direct association with serum response factor (SRF). During the past two decades, significant insights have been obtained regarding the regulatory control of myocardin expression and transcriptional activity at the transcriptional, post-transcriptional, and post-translational levels. However, whether and how SUMOylation plays important roles in modulating myocardin function remain elusive. In this study, we found that myocardin is modified by SUMO-1 at lysine 573, which can be reversibly de-conjugated by SENP2. SUMO-1 modification promotes myocardin protein stability, whereas SENP2 facilitates its proteasome-dependent degradation. Moreover, we found that PIAS4 is the SUMO E3 ligase that enhances the SUMOylation and protein stability of myocardin. Most importantly, we found that SENP2 promotes phenotypic switching of VSMC. We therefore concluded that SENP2 promotes VSMC phenotypic switching via de-SUMOylation of myocardin and regulation of its protein stability

Mulberry Leaf Polysaccharides Attenuate Oxidative Stress Injury in Peripheral Blood Leukocytes by Regulating Endoplasmic Reticulum Stress

The present study assessed the protective effects and underlying mechanisms of mulberry leaf polysaccharides (MLPs) against hydrogen peroxide (H2O2)-induced oxidative stress injury in the peripheral blood leukocytes (PBLs) of Megalobrama amblycephala. Five treatment groups were established in vitro: the NC group (PBLs incubated in an RPMI-1640 complete medium for 4 h), the HP group (PBLs incubated in an RPMI-1640 complete medium for 3 h, and then stimulated with 100 μM of H2O2 for 1 h), and the 50/100/200-MLP pre-treatment groups (PBLs were pre-treated with MLPs (50, 100, and 200 μg/mL) for 3 h, and then stimulated with 100 μM of H2O2 for 1 h). The results showed that MLP pre-treatment dose-dependently enhanced PBLs’ antioxidant capacities. The 200 μg/mL MLP pre-treatment effectively protected the antioxidant system of PBLs from H2O2-induced oxidative damage by reducing the malondialdehyde content and lactic dehydrogenase cytotoxicity, and increasing catalase and superoxide dismutase activities (p p foxO1α), binding immunoglobulin protein (bip), activating transcription factor 6 (atf6), and C/EBP-homologous protein (chop)), Ca2+ transport-related genes (voltage-dependent anion-selective channel 1 (vdac1), mitofusin 2 (mfn2), and mitochondrial Ca2+ uniporter (mcu)), and interleukin 6 (il-6) and bcl2-associated x (bax) were significantly lower in the 200-MLP pre-treatment group than in the HP group (p p > 0.05). These results indicated that MLP pre-treatment attenuated H2O2-induced PBL oxidative damage in the M. amblycephala by inhibiting endoplasmic reticulum stress and maintaining mitochondrial function. These findings also support the possibility that MLPs can be exploited as a natural dietary supplement for M. amblycephala, as they protect against oxidative damage