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Surgical Treatment of Double Outlet Right Ventricle with Absent Pulmonary Valve and Bronchiarctia

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Chinese Medical Journal 2017年第7期130卷 881-882页

作者： Hong-chang Guo chang-wei ren Jiang Dai Yong-Qiang Lai Department of Cardiac Surgery Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

To the Editor：We report a successful treatment of a case diagnosed with double outlet right ventricle （DORV） with absent pulmonary valve （APV） and bronchiarctia.

关键词： Surgical Treatment Double Outlet Right Ventricle Absent Pulmonary Valve

Smoking history increases the risk of long-term mortality after thoracic endovascular aortic repair in patients with an uncomplicated type B dissection

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Chinese Medical Journal 2020年第4期133卷 402-407页

作者： Hui-Qiang Gao chang-wei ren Sheng Yang Lian-Jun Huang Li-Zhong Sun Shang-Dong Xu Department of Cardiac Surgery Beijing Anzhen HospitalBeijing Institute of HeartLung&Vascular DiseasesCapital Medical UniversityBeijing 100029China Department of Intervention Beijing Anzhen HospitalBeijing Institute of HeartLung&Vascular DiseasesCapital Medical UniversityBeijing 100029China

Background:The preferred treatment for uncomplicated type B dissection(thoracic endovascular aortic repair[TEVAR]or medical)is still under debate.Since 2001,our center has performed TEVAR for uncomplicated type B dissection.Based on our data,5-and 10-year survival rates among patients with uncomplicated type B dissection after TEVAR were 96.5%and 83.0%,respectively.We,therefore,believe that TEVAR is preferable for uncomplicated type B dissections.This study analyzed the impact of a pre-operative smoking history on long-term survival after TEVAR in patients with uncomplicated type B dissections.Methods:From May 2001 to December 2013,data from 751 patients with type B dissections were collected and analyzed.Patients were divided into two groups(337 smoking patients and 414 non-smoking patients).The Kaplan-Meier method and log-rank test were used to compare survival curves of the two groups.Multivariable analyses using the Cox proportional hazards model were used to estimate the effects of smoking on survival rates.Results:The 5-and 10-year survival rates of non-smokers were 97.6%(95%confidence interval[CI],96.0%-99.2%)and 87.0%(95%CI,81.6%-92.7%),respectively,and 94.9%(95%CI,92.2%-97.7%)and 73.8%(95%CI,62.3%-87.5%)for smokers,respectively(Log-rank test,P=0.006).Multivariable analyses showed that smoking increased the risk of death during follow-up,2.1-fold when compared to non-smokers(P=0.039).Conclusion:A pre-operative smoking history increases long-term mortality rates after TEVAR in patients with uncomplicated type B dissections.

关键词： Smoking TEVAR Uncomplicated type B dissection Survival rate

Comparison of Clinical Effects between Percutaneous Transluminal Septal Myocardial Ablation and Modified Morrow Septal Myectomy on Patients with Hypertrophic Cardiomyopathy

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Chinese Medical Journal 2018年第5期131卷 527-531页

作者： Hong-chang Guo Jin-Hua Li Teng-Yong Jiang chang-wei ren Jiang Dai Yu-Jie Zhou Yong-Qiang Lai Department of Cardiac Surgery Beijing Anzhen Hospital Capital Medical University Beijing 100029 China Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Background： Percutaneous transluminal septal myocardial ablation （PTSMA） and modified Morrow septal myectomy （MMSM） are two invasive strategies used to relieve obstruction in patients with hypertrophic cardiomyopathy （HCM）. This study aimed to determine the clinical outcome of these two strategies. Methods： From January 2011 to January 2015,226 patients with HCM were treated, 68 by PTSMA and 158 by MMSM. Both ultrasonic cardiograms and heart functional class were recorded before, alter operations and in the follow-up. Categorical variables were compared using Chi-square or Fisher＇s exact tests. Quantitative variables were compared using the paired samples t-test. Results： lnterventricular septal thickness was significantly reduced in both groups （21.27 ± 4.43 mm vs. 18.72 ±4.13 mm for PTSMA, t = 3.469, P 〈 0.001, and 21.83± 5.03 mm vs. 16.57 ± 3.95 mm for MMSM, t = 10.349, P 〈 0.001, respectively）. The left ventricular outflow tract （LVOT） pressure gradient （PG） significantly decreased after the operations in two groups （70.30 ± 44.79 mmHg vs. 39.78 ±22.07 mmHg for PTSMA, t = 5.041, P 〈 0.001, and 74.58 ± 45.52 mmHg vs. 13.95 ± 9.94 mmHg for MMSM, t = 16.357, P 〈 0.001, respectively）. Seven patients （10.29%） in the PTSMA group required a repeat operation in the follow-up. Eight （11.76%） patients were evaluated for New York I-lean Association （NYHA） Ill/IV in the PTSMA group, which was significantly more than the five （3.16%） in the same NYHA classes lbr the MMSM group at follow-up. Less than 15% of patients in the PTSMA group and none of the patients in the MMSM group complained of chest pain during follow-up. Conclusions： Both strategies can not only relieve LVOT PG but also improve heart function in patients with HCM. However, MMSM might provide a more reliable reduction in gradients compared to PTSMA.

关键词： Hypertrophic Cardiomyopathy Myectomy Percutaneous Translunainal Septal Myocardial Ablation

One-stage Hybrid Procedure for Patients with Valvular Pulmonary Stenosis and Coronary Artery Disease

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Chinese Medical Journal 2016年第5期129卷 624-625页

作者： Jia-Ji Liu chang-wei ren Wen-Hui Wu Yong-Qiang Lai Department of Cardiac Surgery Beijing Anzhen Hospital Capital Medical University Beijing 100029 China Intervention Department Beijing Anzhen Hospitai Capitai Medical University B-eijing 100029 China

To the Editor： We report two cases of hybrid approach by combining percutaneous balloon pulmonary valvuloplasty （PBPV） and off-pump coronary artery bypass grafting （OPCABG）.

关键词： OFF-PUMP BYPASS

Application of the "branch-first technique"in Sun's procedure

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Chinese Medical Journal 2019年第4期132卷 495-497页

作者： Jun Zheng Shang-Dong Xu chang-wei ren Sheng Yang Yong-Min Liu Jun-Ming Zhu Li-Zhong Sun Hui-Qiang Gao Department of Cardiac Surgery Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China

To the Editor:The branch-first technique has been reported in arch replacement for patients with arch lesions in order to provide total cerebral perfusion during the operation.A double "Y,"or modified three-branch graft, was used in this technique.Here we reported a branch-first technique combined with Sun's procedure using a "Y" shaped graft.

关键词： Application procedure graft

Event-triggered H_(∞) consensus control for input-constrained multi-agent systems via reinforcement learning

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Control Theory and Technology 2024年第1期22卷 25-38页

作者： Jinxuan Zhang chang-E ren College of Information Engineering Capital Normal UniversityBeijing100089China

This article presents an event-triggered H_(∞) consensus control scheme using reinforcement learning (RL) for nonlinear second-order multi-agent systems (MASs) with control constraints. First, considering control constraints, the constrained H_(∞) consensus problem is transformed into a multi-player zero-sum game with non-quadratic performance functions. Then, an event-triggered control method is presented to conserve communication resources and a new triggering condition is developed for each agent to make the triggering threshold independent of the disturbance attenuation level. To derive the optimal controller that can minimize the cost function in the case of worst disturbance, a constrained Hamilton–Jacobi–Bellman (HJB) equation is defined. Since it is difficult to solve analytically due to its strongly non-linearity, reinforcement learning (RL) is implemented to obtain the optimal controller. In specific, the optimal performance function and the worst-case disturbance are approximated by a time-triggered critic network;meanwhile, the optimal controller is approximated by event-triggered actor network. After that, Lyapunov analysis is utilized to prove the uniformly ultimately bounded (UUB) stability of the system and that the network weight errors are UUB. Finally, a simulation example is utilized to demonstrate the effectiveness of the control strategy provided.

关键词： H_(∞)optimal control Input constrains Multi-agent systems(MASs) Reinforcement learning(RL)

Sludge composition and characteristics shaped microbial community and further determined process performance: A study on full-scale thermal hydrolysis-anaerobic digestion processes

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Journal of Environmental Sciences 2024年第3期137卷 96-107页

作者： wei Liu Chenxiang Sun wei Li Tianle Li Zhan Chen Jiawei Wang Zhengran ren Xianghua Wen School of Environment Tsinghua UniversityBeijing 100084China Jinneng Holding Group DatongShanxi 037000China Research and Development Center Beijing Drainage Group Co.Ltd.Beijing 100124China Beijing Dabeinong Science and Technology Group Co. Ltd.Beijing 100080China

Anaerobic digestion (AD) with thermal hydrolysis (TH) pretreatment is a promising process for excess sludge treatment,while there lacks of the knowledge from full-scale process about the impact of sludge composition and characteristics on microbial community and performance.The sludge physiochemical indices,microbial community and performance data of four full-scale TH-AD plants were characterized,and their relationships was elucidated.The four plants were operated under almost similar total organic loading rate (OLR)but their methanogenesis performance differentiate into two groups,namely superior group(SupG) and the inferior group (Inf G).In both groups,TH effectively solubilized particulate organic compounds,meanwhile raised the ammonia nitrogen (NH_(4)^(+)-N) and volatile fatty acid (VFA) concentration.Compared with the Sup G,thermal hydrolyzed sludge of Inf G had higher level of VFAs,NH_(4)^(+)-N and total chemical oxygen demand (t COD),which showed higher inhibition effect on microbes,leading to a community with lower diversity,lower abundance of carbohydrate degrading functional guild,higher protein degrading one,and methanogens that adapted to limited substrates,and further declined the methane production rate.Thus,it was recommended that OLR alone was not sufficient for controlling the system in design and operation,the concentration of VFAs,NH_(4)^(+)-N and t COD should be equally considered.Their higher concentration,together with the higher abundance of Defluviitoga and Proteiniphilum were recommended as indicators for inferior running condition.Our results proposed that microbial communities played a role of bridge between environmental factors and performance,provided implications for engineering ecology and operational regulation for full-scale sludge TH-AD process.

关键词： Thermal hydrolysis Anaerobic digestion Microbial community Full-scale

Snap-through behaviors and nonlinear vibrations of a bistable composite laminated cantilever shell:an experimental and numerical study

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Applied Mathematics and Mechanics(English Edition) 2024年第5期45卷 779-794页

作者： Lele ren wei ZHANG Ting DONG Yufei ZHANG State Key Laboratory of Mechanical System and Vibration Shanghai Jiao Tong UniversityShanghai 200240China Department of Mechanics Guangxi UniversityNanning 530004China Beijing Key Laboratory of Nonlinear Vibrations and Strength of Mechanical Structures College of Mechanical EngineeringBeijing University of TechnologyBeijing 100124China School of Mechanical Engineering Beijing Institute of TechnologyBeijing 100081China

The snap-through behaviors and nonlinear vibrations are investigated for a bistable composite laminated cantilever shell subjected to transversal foundation excitation based on experimental and theoretical approaches.An improved experimental specimen is designed in order to satisfy the cantilever support boundary condition,which is composed of an asymmetric region and a symmetric region.The symmetric region of the experimental specimen is entirely clamped,which is rigidly connected to an electromagnetic shaker,while the asymmetric region remains free of constraint.Different motion paths are realized for the bistable cantilever shell by changing the input signal levels of the electromagnetic shaker,and the displacement responses of the shell are collected by the laser displacement sensors.The numerical simulation is conducted based on the established theoretical model of the bistable composite laminated cantilever shell,and an off-axis three-dimensional dynamic snap-through domain is obtained.The numerical solutions are in good agreement with the experimental results.The nonlinear stiffness characteristics,dynamic snap-through domain,and chaos and bifurcation behaviors of the shell are quantitatively analyzed.Due to the asymmetry of the boundary condition and the shell,the upper stable-state of the shell exhibits an obvious soft spring stiffness characteristic,and the lower stable-state shows a linear stiffness characteristic of the shell.

关键词： bistable composite laminated cantilever shell snap-through behavior nonlinear vibration nonlinear stiffness characteristic chaos and bifurcation

Effects of different concentrations of nicotinamide on hematopoietic stem cells cultured in vitro

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World Journal of Stem Cells 2024年第2期16卷 163-175页

作者： Yan ren Yan-Ni Cui Hong-wei Wang The Second Clinical Medical College Shanxi Medical UniversityTaiyuan 030001Shanxi ProvinceChina Department of Hematology The Second Hospital of Shanxi Medical UniversityTaiyuan 030001Shanxi ProvinceChina Department of Hematology Key Laboratory of Molecular Diagnosis and Treatment of Blood Diseases in Shanxi ProvinceTaiyuan 030001Shanxi ProvinceChina

BACKGROUND In vitro expansion to increase numbers of hematopoietic stem cells(HSCs)in cord blood could improve clinical efficacy of this vital resource.Nicotinamide(NAM)can promote HSC expansion ex vivo,but its effect on hematopoietic stem and progenitor cells(HSPCs,CD34^(+)CD38)and functional subtypes of HSCs-shortterm repopulating HSCs(ST-HSCs,CD34^(+)CD38CD45RACD49f^(+))and long-term repopulating HSCs(LT-HSCs,CD34^(+)CD38CD45RACD49f^(+)CD90^(+))is not yet known.As a sirtuin 1(SIRT1)inhibitor,NAM participates in regulating cell adhesion,polarity,migration,proliferation,and differentiation.However,SIRT1 exhibits dual effects by promoting or inhibiting differentiation in different tissues or cells.We propose that the concentration of NAM may influence proliferation,differentiation,and SIRT1 signaling of HSCs.AIM To evaluate the effects and underlying mechanisms of action of different concentrations of NAM on HSC proliferation and differentiation.METHODS CD34^(+)cells were purified from umbilical cord blood using MacsCD34 beads,and cultured for 10-12 d in a serum-free medium supplemented with cytokines,with different concentrations of NAM added according to experimental requirements.Flow cytometry was used to detect phenotype,cell cycle distribution,and apoptosis of the cultured cells.Real-time polymerase chain reaction was used to detect the transcription levels of target genes encoding stemness-related factors,che mokines,components of hypoxia pathways,and antioxidant enzymes.Dichloro-dihydro-fluorescein diacetate probes were used to evaluate intracellular production of reactive oxygen species(ROS).Determination of the effect of different culture conditions on the balance of cytokine by cytometric bead array.RESULTS Compared with the control group,the proportion and expansion folds of HSPCs(CD34^(+)CD38)incubated with 5 mmol/L or 10 mmol/L NAM were significantly increased(all P<0.05).The ST-HSCs ratio and fold expansion of the 5 mmol/L NAM group were significantly higher than those of the control and 10 mmol/L N

关键词： Hematopoietic stem cells Nicotinamide Concentration Proliferation Differentiation Sirtuin 1