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Background: High D-dimer (DD) is associated with short-term adverse outcomes in patients with acute coronary syndrome (ACS). In ACS patients who underwent percutaneous coronary intervention (PCI), however, the value of DD (or combined with neutrophil to lymphocyte ratio [NLR]) to predict long-term major adverse cardiovascular events (MACEs) has not been fully evaluated. Methods: Patients diagnosed with ACS and receiving PCI were included. The primary outcome was MACEs. Cox proportional hazards regression and logistic regression was used to illustrate the relationship between clinical risk factors, biomarkers and MACEs. Survival models were developed based on significant factors and evaluated by the Concordance-index (C-index). Results: The final study cohort was comprised of 650 patients (median age, 64 years; 474 males), including 98 (15%) with MACEs during a median follow-up period of 40 months. According to the cut-off value of DD and NLR, the patients were separated into four groups: high DD or nonhigh DD with high or nonhigh NLR. After adjusting for confounding variables, DD (adjusted hazard ratio [aHR]: 2.39, 95% confidence interval [CI]: 1.52–3.76) and NLR (aHR: 2.71, 95% CI: 1.78–4.11) were independently associated with long-term MACEs. Moreover, patients with both high DD and NLR had a significantly higher risk in MACEs when considering patients with nonhigh DD and NLR as reference (aHR: 6.19, 95% CI: 3.30–11.61). The area under curve (AUC) increased and reached 0.70 in differentiating long-term MACEs when DD and NLR were combined, and survival models incorporating the two exhibited a stronger predictive power (C-index: 0.75). Conclusions: D-dimer (or combined with NLR) can be used to predict long-term MACEs in ACS patients undergoing PCI.

Background Growing evidence indicates that poor sleep harms health. Early to bed and early to rise is considered as a healthy lifestyle in Chinese population. The current study aimed to examine the effects of sleep habits on acute myocardial infarction (AMI) risk and severity of coronary artery disease (CAD) in Chinese population from two centers. Methods A total of 873 patients including 314 AMI cases and 559 controls were recruited from the inpatient cardiology department of the Affiliated Jiangning Hospital and the First Affiliated Hospital of Nanjing Medical University. 559 controls included 395 CAD cases and 164 non-CAD cases. We used a 17-item sleep factors questionnaire (SFQ) to evaluate sleep habits comprehensively by face-to-face interview. The severity of CAD was assessed by Gensini score in AMI and CAD groups. The effects of sleep factors on AMI risk and Gensini score were examined by unconditional logistic regression. Results After mutually adjustment for other sleep factors and demographic characteristics, the timing of sleep (24:00 and after) and morning waking (after 7:00) and sleep duration (P P = 0.011 and OR = 2.968, P P = 0.009). In subgroup analysis by age, both late sleep timing and short sleep duration were associated with increased risk of AMI regardless of age. In subjects with age ≤ 65 years, daytime napping was related to reduced risk of AMI (OR = 0.645, P = 0.046). In subjects with age > 65 years, the frequency of night-time waking (3 times) was associated with increased risk of AMI (OR = 3.467, P = 0.035). Short sleep duration was correlated with increased risk of high Gensini score (OR = 2.374, P Conclusion Sleep insufficiency is an important risk factor both for AMI risk and CAD severity. Late sleeping is also associated with increased risk of AMI. In young and middle-aged people, regular naps may have a protective effect. Graphic abstract

Purpose:Exercise leads to a lower risk of coronary artery disease (CAD). However, whether time of day physical exercise has effects on CAD is still unclear. The present study is to investigate the relationship between time of day physical exercise and angiography determined CAD in a Chinese population.Subjects:A total of 1,129 consecutive participants who underwent coronary angiography for the first time were enrolled in our study. Participants were divided into non-CAD group and CAD group according to the result of coronary angiography. We used a predesigned questionnaire—the work-related activity, leisure-time activity, and physical exercise information were recorded in the form of self-reporting.Results:Doing physical exercise was associated with a reduced risk of CAD, after adjusting the established and potential confounders, with an adjusted odds ratio (OR) of 0.48 (95% CI, 0.35–0.67) compared with those who did not any physical exercise. Moreover, the risk of CAD could linearly decrease with increase of intensity, duration and frequency of exercise. Further stratification analysis revealed that the protective effects of exercise were more significant in the afternoon and evening group than in the morning and forenoon group. The adjusted ORs of doing physical exercise in morning, forenoon, afternoon, and evening groups were 0.53 (0.36–0.78), 0.51(0.27–0.96), 0.46(0.25–0.85), 0.43(0.28–0.66), respectively, compared with nonexerciser (p < .05).Conclusions:Doing physical exercise can decrease the risk of CAD, and exercising in the afternoon or evening may have more significant effects on the prevention of CAD than in other time of day.

Tabular alumina, α-Al2O3powder, TiO2powder and metal aluminum powder in purity of 99%(by mass) were uesd to prepare the Al2O3-TiN composite ceramics by mechanical mixing and thermal reduction of aluminum in situ reaction sintering in the flow of nitrogen gas under atmospheric pressure;the influences of phase composition and microstructure changes at 1200°C-1500°C nitridation reaction in situ,different amount of TiN formations and sintering temperature on the properties of the samples were analyzed by thermal analysis, XRDand SEM. The results show that: TiO2was reduced by Al and then nitrided as TiN in the test temperature, the porosity has been increasesd while the bulk density has been decreased with the increased content of TiN formation because of the process of nucleation growth and the strong exothermic of the reaction.The mechanical properties of the composites are relatively better of TiN generated 10%content,because the structure of the skeleton formed by corundum was filled of part matrix evenly and was integrated closely by the matrix.

Erosion tests on high strengh refractory castables were carried out using SiC grains at impact angles of 30°,45°,60°,and 90° with the velocity of 5m/s.In order to study the variation in stress and system energy with impact angles during solid particle erosion process,a single particle erosion model was designed by means of three-dimensional explicit dynamic software ANSYS/LS-DYNA according to experiment parameters. The Johnson-Holmquist brittle ceramic model was employed to model the failure of target material. The impact angles varied from 15° to 90° in increments of 15°.The simulation results were compared with erosion rate values from experiments. The results show that the variation trends of both the maximum stress of targets and system total energy loss are in a good agreement with experiment data,which increaes with increasing impact angle. The variation of erosion rate as a function of impact angle can be explained by the variation of the maximum stress of target material. The rule “the maximum erosion of typical brittle material occurs at 90°” is confirmed by the view of energy analysis.

Al2O3-Ti(C,N)composite ceramics were prepared by in situ aluminothermic reduction and pressureless sintering. The effects of different Ti(C,N) contents and sintering temperatures on microstructure and mechanical properties (bulk density ,apparent porosity and blending strength)of samples were investigated through experiments.The results show that Al2O3-Ti(C,N) composite ceramics with 10 wt.% Ti(C,N) prepared using titanium dioxide and metal aluminum powder as raw materials and sintered at 1300 °C for 3h under a flowing nitrigen stream have good properties ,with bulk density 2.94g/cm3,apparent porosity 26.4%, and blending strength reaches to 28.04 MPa. According to the microstructure analysis,the fine in situ synthesis Ti(C,N) particles are uniformly dispersed in tabular alundum matrix. Ti(C,N) and tabular alundum phases are closely combined and can inhibit grain growth each other,which is benefical in improving the comprehensive properties of composite ceramics.

Despite significant advances in the treatment of coronary artery disease, the prevalence of ischemic heart failure is still increasing rapidly. Long noncoding RNAs are a novel class of gene regulators and may contribute to disease cause. The aim of the present study was to investigate the expression profiles of long noncoding RNAs and their potential functional roles in ischemic heart failure.We applied a well-established ischemic heart failure rat model and performed long noncoding RNA microarray experiments on the left ventricular tissue of rats with ischemic heart failure and under sham control. Differentially expressed long noncoding RNAs and mRNAs were identified through fold-change filtering. Bioinformatic analyses were performed to predict the potential biological roles of key long noncoding RNAs.We found that 1197 long noncoding RNAs and 2066 mRNAs were upregulated, whereas 1403 long noncoding RNAs and 2871 mRNAs were downregulated in failing hearts (fold-change 2.0). We also identified 331 pairs of differentially expressed long noncoding RNAs and nearby coding genes, which contained 291 long noncoding RNAs and 296 mRNAs. Expression levels of four long noncoding RNA-mRNA pairs, which might be involved in the pathogenesis of ischemic heart failure were confirmed by quantitative real-time PCR.Our study identified a set of long noncoding RNAs that were aberrantly expressed in rats with ischemic heart failure and might be involved in the pathogenesis of ischemic heart failure. The results of our study may provide a novel perspective for better understanding the molecular basis of ischemic heart failure.

To examine the influence of walking at different times of day on lipids and inflammatory markers in sedentary patients with coronary artery disease (CAD).A total of 330 patients recruited from Nanjing between September 2011 and November 2012 were randomly assigned to a control group (n=110), morning (n=110) or evening walking group (n=110). Both the walking groups were asked to walk 30 min/day or more on at least 5 days/week either in the morning or evening for 12 weeks. Lipids and inflammatory markers were measured before and after exercise intervention.Compared with baseline, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were improved in all groups. Significances were shown in the changes of fibrinogen, high sensitivity C-reactive protein (hsCRP), white blood cell (WBC) count, TC, triglycerides, LDL-C, lipoprotein(a) between groups. The evening walking group had a larger decrease in fibrinogen (0.16 ± 0.19 g/L, P0.001), hsCRP (1.16 ± 1.07 mg/L, P0.001), WBC count (0.76 ± 1.53·10(9)/L, P=0.004) and LDL-C (0.34 ± 0.31 mmol/L, P0.001) than the other two groups.Our walking program successfully resulted in a favorable change in lipids and inflammatory markers. Patients in the evening walking group gained more benefits than those walking in the morning walking group. NCT01887093.

OBJECTIVE:To investigate the association between the time of day of sports-related physical activity and the onset of acute myocardial infarction (AMI) in a coronary artery disease (CAD) population in China. METHODS:Between February 2014 and March 2015, a total of 696 patients from Nanjing, China, who had CAD were studied and divided into two groups (Non-AMI and AMI groups). The work-related activity and sports-related physical activity information were obtained from a self-reporting predesigned patient questionnaire. RESULTS:Sports-related physical activity was associated with a lower risk of the onset of AMI, after adjusting the established and potential confounders, with an adjusted odds ratio (OR) of 0.67 (95% CI, 0.47-0.94) compared with those who did not have any sports-related physical activity. A dose-response relationship was observed for intensity, duration, and frequency of sports-related physical activity. Further stratification analysis revealed that the protective effects of sports-related physical activity were significant in the morning and evening groups, and patients who exercised in the evening were at a lower risk of AMI than those doing sports-related physical activity in the morning. The adjusted ORs for doing sports-related physical activity in the morning and evening groups were 0.60(0.36-0.98) and 0.56(0.37-0.87), respectively, compared with inactivity (all P

Background Hyperlipidemia plays a crucial role in the development and progression of coronary artery disease (CAD). Recent studies have identified that microRNAs (miRNAs) are important regulators of lipid metabolism, but little is known about the circulating levels of lipometabolism-related miRNAs and their relationship with the presence of CAD in patients with hyperlipidemia. Methods In the present study, we enrolled a total of 255 hyperlipidemia patients with or without CAD and 100 controls with normal blood lipids. The plasma levels of four known lipometabolism-related miRNAs, miR-122, miR-370, miR-33a, and miR-33b were quantified by real-time quantitative PCR. Blood levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol were determined. Furthermore, the severity of CAD was assessed with the Gensini score system based on the degree of luminal narrowing and its geographic importance. Results Our results revealed for the first time that plasma levels of miR-122 and miR-370 were significantly increased in hyperlipidemia patients compared with controls, and the levels of miR-122 and miR-370 were positively correlated with TC, TG, and LDL-C levels in both hyperlipidemia patients and controls. Multiple logistic regression analysis demonstrated that the increased levels of miR-122 and miR-370 were associated with CAD presence, even after adjustment for other cardiovascular risk factors. Furthermore, miR-122 and miR-370 levels were positively correlated with the severity of CAD quantified by the Gensini score. However, both miR-33a and miR-33b were undetectable in plasma. Conclusions Our results suggest that increased plasma levels of miR-122 and miR-370 might be associated with the presence as well as the severity of CAD in hyperlipidemia patients.