Objective:To analyze the relationship between corrected Tp-e interval(Tp-ec), Tp-e/QT ratio and the degree of vein bridge vessel stenosis after coronary artery bypass grafting(CABG) in patients with left main coronary artery stenosis, and its predictive value for malignant electrophysiological events.Methods:Patients admitted to Beijing Anzhen Hospital affiliated to Capital Medical University from January 2018 to August 2019 were selected, coronary angiography was performed 5-7 years after coronary artery bypass grafting(CABG) due to recurrence of symptoms. 169 patients with >50% restenosis in SVG were selected. According to the degree of bridge angiography stenosis, the patients were divided into group A(50%-70% SVG restenosis, 105 cases) and group B(SVG restenosis >70%, 64 cases), routine electrocardiogram examination, measurement and correction of QT interval(QTc), Tp-ec and Tp-e/QT ratio were made. Patients were followed up 6 months, the occurrence of malignant ECG events is observed, and the area under the receiver operating characteristic( ROC) curve( AUC) was used to quantitatively evaluate the predictive power of Tp-ec and Tp-e/QT ratios for malignant ECG events. Results:The QTc, Tp-ec and Tp-e/QT ratios in group B were significantly greater than those in group A, and the differences were statistically significant( P<0.05). After multivariate logistic regression analysis, both the Tp-ec and Tp-e/QT ratios were independent influencing factors for the degree of vein bridge vessel stenosis>70%( P<0.05). After Pearson correlation analysis, both the Tp-ec and Tp-e/QT ratios were positively correlated with the degree of vein bridge vessel stenosis( r= 0.384 and 0.457, both P=0.000). A total of 162 cases(95.86%) were followed up, 25 cases of malignant electrophysiological events occurred. After ROC curve analysis, Tp-ec combined with Tp-e/QT ratio predicted coronary malignant electrophysiological events in patients with left main artery stenosis after GABG with AUC=0.924, which was significantly greater than 0.698 of the single index Tp-ec and 0.712 of the Tp-e/QT ratio, the differences were both statistically significant( P<0.05). Conclusion:Tp-ec and Tp-e/QT ratios are both positively correlated with the degree of vein bridge vessel stenosis after CABG in patients with left main coronary artery stenosis, the combined effect of them in predicting the occurrence of malignant electrocardiological events is good, and it is worth further research and application.

Piwi-interacting RNA (piRNA) is a new class of small non-coding RNAs that function by specifically binding to the Piwi subfamily members of the Argonaute protein family. piRNA regulates the expression of target genes at epigenetic and post-transcriptional levels, and participates in the development and progression of cerebral ischemia by mediating pathophysiological processes such as inflammation, angiogenesis, and neuronal synaptic plasticity.

Objective:To observe the changes of cognitive function, subcortical nuclei volumes, and diffusion kurtosis imaging (DKI) parameters (values of fractional anisotropy [FA], mean diffusivity [MD] and mean kurtosis [MK]) after surgery in patients with aneurysmal subarachnoid hemorrhage (aSAH), and analyze the correlations of cognitive dysfunction with subcortical nuclei volumes and DKI parameters.Methods:A prospective sutdy was conducted;17 patients with aSAH confirmed by surgery in our hospital from September 2019 to June 2020 were selected as patient group, and 16 healthy volunteers whose age, gender, and education level were matched with the patient group were recruited as control group. Neuropsychological tests and MR imaging were performed in the patients 3 months after surgery and the controls right after enrollment. The structural image data of all subjects were post-processed. Bilateral subcortical nuclei volumes and DKI parameters were analyzed. The differences of general clinical data, subcortical nuclei volumes and DKI parameters were compared between the two groups. The correlations of mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) scores with subcortical nuclei volumes and DKI parameters were analyzed.Results:As compared with the control group, the patient group had significantly lower MMSE and MoCA scores, and statistically decreased volumes of ipsilateral hippocampus, ipsilateral thalamus and ipsilateral lentiform nucleus ( P<0.05). The FA values of the contralateral caudate nucleus, bilateral thalamus and bilateral lentiform nucleus and MK values of the ipsilateral hippocampus in the patient group were significantly decreased as compared with those in the control group ( P<0.05); while the MD values of the ipsilateral caudate nucleus in the patient group were significantly increased as compared with those in the control group ( P<0.05). The volume of ipsilateral hippocampus was positively with MoCA scores ( r=0.604, P=0.038); the FA values of contralateral caudate nucleus were negatively correlated with MMSE scores ( r=-0.579, P=0.049). Conclusions:Cognitive dysfunction, atrophy of ipsilateral hippocampus, thalamus and lenticular nucleus, and changes of DKI parameters exist in patients with aSAH after surgery. The changes in ipsilateral hippocampus volume and FA values of caudate nucleus may be related to the postoperative cognitive dysfunction in these patients.