背景:将中药有效成分整合于水凝胶体系,作为生长因子的替代品或与生长因子相协同,有望显著增强生物材料在骨缺损修复中的治疗效能。目的:系统总结中药有效成分在改善水凝胶材料生物相容性、机械性能等方面的优势以及中药有效成分与水凝...背景:将中药有效成分整合于水凝胶体系,作为生长因子的替代品或与生长因子相协同,有望显著增强生物材料在骨缺损修复中的治疗效能。目的:系统总结中药有效成分在改善水凝胶材料生物相容性、机械性能等方面的优势以及中药有效成分与水凝胶协同运用促进骨修复方面的最新研究进展。方法:以“中药,中药单体,水凝胶,载体,骨组织工程,生物材料,骨,骨修复,骨缺损”为中文检索词,以“Chinese medicine,Chinese medicine monomer,Hydrogel,Carrier,Bone tissue engineering,Bio-material,Bone,Bone repair,Bone defect”为英文检索词,检索2005-2025年期间中国知网、万方、PubMed、Web of Science数据库内的相关文献,依据纳入及排除标准,最终纳入66篇文献进行归纳总结。结果与结论:中药有效成分可以改善水凝胶的生物相容性、机械性能及降解性能,二者联合应用突破了单一材料在力学、生物活性等方面的瓶颈。中药有效成分与水凝胶结合后,可通过调节骨代谢、促进软骨形成、抑制炎症及氧化应激、血管化与血管生成4个维度显著提升骨修复能力。然而,目前关于中药有效成分与水凝胶结合在骨组织工程中的研究仍有不足,距离实际的临床应用仍有挑战。展开更多
目的:观察益气温经穴位贴贴敷联合西药口服治疗绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)肾虚血瘀证的临床疗效。方法:将符合要求的120例PMOP肾虚血瘀证患者随机分为2组,每组60例,分别采用单纯西药(阿仑膦酸钠片、钙尔奇D片...目的:观察益气温经穴位贴贴敷联合西药口服治疗绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)肾虚血瘀证的临床疗效。方法:将符合要求的120例PMOP肾虚血瘀证患者随机分为2组,每组60例,分别采用单纯西药(阿仑膦酸钠片、钙尔奇D片、骨化三醇胶丸)口服治疗(西药治疗组)与益气温经穴位贴贴敷联合西药口服治疗(联合治疗组)。3个月为1个疗程,每个疗程之间隔1个月,共治疗3个疗程。分别于治疗前、治疗开始后6个月、治疗开始后12个月,比较2组患者的骨密度T值、血清雌二醇(estradiol,E2)水平、血清卵泡刺激素(follicle stimulating hormone,FSH)水平、血清Ⅰ型前胶原氨基端前肽(N-terminal propeptide of typeⅠprecollagen,PⅠNP)水平、血清Ⅰ型胶原羧基端肽β特殊序列(β-C-terminal telopeptide of typeⅠcollagen,β-CTX)水平、腰背部疼痛视觉模拟量表(visual analogue scale,VAS)评分、简明健康状况调查表(short form 36 health survey questionnaire,SF-36)评分。结果:①一般情况。共5例患者退出试验,其中西药治疗组3例、联合治疗组2例。最终西药治疗组纳入57例患者,联合治疗组纳入58例患者。②骨密度T值。治疗前后骨密度T值总体上随时间推移呈上升趋势(F=109.349,P=0.000),2组间差异无统计学意义(F=0.014,P=0.905)。③血清E2水平。治疗前后西药治疗组患者血清E2水平随时间推移无明显变化(F=0.790,P=0.456),联合治疗组患者血清E2水平随时间推移呈上升趋势(F=6.559,P=0.002)。治疗开始后6个月、12个月,联合治疗组患者血清E2水平均高于西药治疗组(t=-3.983,P=0.000;t=-4.177,P=0.000)。④血清FSH水平。治疗前后血清FSH水平总体上随时间推移呈下降趋势(F=17.933,P=0.000),2组间差异无统计学意义(F=1.123,P=0.291)。⑤血清PⅠNP水平。治疗前后西药治疗组患者血清PⅠNP水平随时间推移无明显变化(F=0.368,P=0.693),联合治疗组患者血清PⅠNP水平随时间推移呈上升趋势(F=11.724,P=0.000)。治疗开始后6个月、12个月,联合治疗组患者血清PⅠNP水平均高于西药治疗组(t=-5.844,P=0.000;t=-5.619,P=0.000)。⑥血清β-CTX水平。治疗前后血清β-CTX水平总体上随时间推移呈下降趋势(F=6.371,P=0.002),2组间差异无统计学意义(F=1.898,P=0.171)。⑦腰背部疼痛VAS评分。治疗前后2组患者腰背部疼痛VAS评分随时间推移均呈下降趋势(F=35.668,P=0.000;F=147.005,P=0.000)。治疗开始后6个月、12个月,联合治疗组患者腰背部疼痛VAS评分均低于西药治疗组(t=12.848,P=0.000;t=13.291,P=0.000)。⑧SF-36评分。治疗前后2组患者SF-36评分随时间推移均呈上升趋势(F=54.622,P=0.000;F=105.957,P=0.000)。治疗开始后6个月、12个月,联合治疗组患者SF-36评分均高于西药治疗组(t=-10.331,P=0.000;t=-10.323,P=0.000)。结论:益气温经穴位贴贴敷联合西药口服治疗PMOP肾虚血瘀证,在提高血清E2水平、促进骨形成、减轻腰背部疼痛、改善患者生活质量方面优于单纯西药口服治疗;但两者在降低血清FSH水平、抑制骨吸收、提高骨密度方面的效果相当。展开更多
2017年11月14日,美国心脏病学学会(American College of Cardiology,ACC)、美国心脏协会(American Heart Association,AHA)联合其他9大民间权威机构,发布了2017年版《美国成人高血压防治指南》(2017ACC/AHA).该版指南重新划分了高血压阈...2017年11月14日,美国心脏病学学会(American College of Cardiology,ACC)、美国心脏协会(American Heart Association,AHA)联合其他9大民间权威机构,发布了2017年版《美国成人高血压防治指南》(2017ACC/AHA).该版指南重新划分了高血压阈值,设置了新的降压目标值,而不再延续执行先前已颁布10余年的高血压诊断标准.该指南一经发布,就引起了全球范围的关注和争议,后续所带来的冲击更是不容小觑.结合中国高血压现状对该指南进行初步解读.展开更多
In recent years,the southwestern region of China has experienced a surge in significant mountain collapses,predominantly linked to underground mining operations.This investigation targets the Jiguanling area in Wulong...In recent years,the southwestern region of China has experienced a surge in significant mountain collapses,predominantly linked to underground mining operations.This investigation targets the Jiguanling area in Wulong,Chongqing,employing the UDEC numerical simulation technique to meticulously examine the deformation and failure characteristics,rock mass movement patterns,fracture evolution processes,and stress transmission mechanisms of anti-dip rock slopes composed of stratified rocks.These slopes are inherently susceptible to bending and tilting due to their own weight.Our findings elucidate that the predominant failure mode of anti-dip rock karst slopes is the inclined sliding(shear)type,which mirrors the fracture evolution mechanism as they extend in a quadrilateral pattern from the top and bottom plates of the mining area to the critical blocks at the rear and front edges of the slope.The disaster mechanism can be encapsulated as the"initial roof movement phase,direct roof collapse and crack propagation phase,critical block locking and sliding resistance phase,and deterioration phase".The four distinct stages of development and transformation encompass critical block slip(shear)and slope instability phases.An increase in coal seam thickness enlarges the deformation space in the lower part,while the dip angle of the coal seam influences the length and displacement range of rock fracture development.The mining sequence alters the stress failure mode of the underlying critical blocks,and the vertical height of the mining step distance modifies the potential sliding surface and failure mode of the underlying critical blocks.Ultimately,the distance between the goaf and the surface,along with the height of the mining impact,impacts the stability of the reverse slope.The results demonstrate that mining activities are the primary factor inducing the collapse of anti-dip rock slopes,with natural factors playing a secondary role.展开更多
To investigate the fracture propagation characteristics and failure mechanism of anti-dip rock slope induced by underground mining,the Jiguanling landslide in Wulong,Chongqing,China is taken as the prototype,and physi...To investigate the fracture propagation characteristics and failure mechanism of anti-dip rock slope induced by underground mining,the Jiguanling landslide in Wulong,Chongqing,China is taken as the prototype,and physical model test is utilized to study the fracture evolution process,deformation characteristics and failure mechanism of anti-dip rock slope.In this study,the digital image correlation(DIC)technique and pressure acquisition system are combined to analyze the displacement and stress field of rock slope during underground mining stages.The results show that the anti-dip rock slope experiences four stages during underground coal mining:tensile fracture propagation in upper toppling zone,shallow damage in the lower shear zone,coal seam roof caving,failure of the whole slope.There is a phenomenon of local tensile and compressive stress conversion in upper toppling zone after roof caving.The appearance of coal seam roof caving increases the compressive area and pressure of the shear zone,leading to the failure of the shear blocks at the front edge,and ultimately causing failure of the whole slope.Mining with retained coal pillar before shallow failure in the shear zone can effectively block the impact of lower mining on the upper toppling zone,achieve a 16%contraction in toppling zone,and improve the stability of the slope.The failure mode of slope can be summarized as shear–slip–toppling collapse failure.This paper improves the understanding on the failure mechanism of anti-dip rock slope caused by underground mining.展开更多
目的检测老年冠状动脉疾病(CAD)患者血清Wnt(wingless type protein)-1水平,探讨Wnt-1与炫速双源CT造影冠状动脉病变严重程度和形态的相关性。方法选取2016年10月至2018年5月就诊于郑州大学第一附属医院心血管内科且年龄大于60岁的疑似...目的检测老年冠状动脉疾病(CAD)患者血清Wnt(wingless type protein)-1水平,探讨Wnt-1与炫速双源CT造影冠状动脉病变严重程度和形态的相关性。方法选取2016年10月至2018年5月就诊于郑州大学第一附属医院心血管内科且年龄大于60岁的疑似冠心病患者371例,行炫速双源CT冠状动脉造影术,按管腔狭窄程度分组,≤50%为非严重冠状动脉病变,>50%为严重狭窄病变,根据冠状动脉斑块钙化情况分为非钙化斑块,钙化斑块和混合斑块。采用酶联免疫吸附试验(ELISA)法测定血清Wnt-1水平。结果严重冠状动脉病变组血清Wnt-1水平明显高于非严重冠状动脉病变组(132.52±40.48)vs.(98.39±28.23)ng/ml,P<0.001)。logistic回归分析发现血清Wnt-1水平是预测严重冠状动脉病变的独立预测因子(OR=1.56,95%CI:1.24~2.03,P=0.003)。并且冠状动脉钙化组血清Wnt-1水平(135.56±38.82)ng/ml显著高于非冠状动脉钙化组(96.75±29.13)ng/ml和混合斑块组(102.62±34.64)ng/ml(P<0.001)。logistic回归分析显示血清Wnt-1水平是预测冠状动脉钙化的独立预测因子(OR=2.07,95%CI:1.53~2.85,P<0.001)。结论血清Wnt-1水平显著与冠状动脉CT造影老年血管斑块严重程度和钙化密切相关。Wnt在老年冠状动脉疾病中的病理生理机制需要进一步的前瞻性临床研究。展开更多
文摘背景:将中药有效成分整合于水凝胶体系,作为生长因子的替代品或与生长因子相协同,有望显著增强生物材料在骨缺损修复中的治疗效能。目的:系统总结中药有效成分在改善水凝胶材料生物相容性、机械性能等方面的优势以及中药有效成分与水凝胶协同运用促进骨修复方面的最新研究进展。方法:以“中药,中药单体,水凝胶,载体,骨组织工程,生物材料,骨,骨修复,骨缺损”为中文检索词,以“Chinese medicine,Chinese medicine monomer,Hydrogel,Carrier,Bone tissue engineering,Bio-material,Bone,Bone repair,Bone defect”为英文检索词,检索2005-2025年期间中国知网、万方、PubMed、Web of Science数据库内的相关文献,依据纳入及排除标准,最终纳入66篇文献进行归纳总结。结果与结论:中药有效成分可以改善水凝胶的生物相容性、机械性能及降解性能,二者联合应用突破了单一材料在力学、生物活性等方面的瓶颈。中药有效成分与水凝胶结合后,可通过调节骨代谢、促进软骨形成、抑制炎症及氧化应激、血管化与血管生成4个维度显著提升骨修复能力。然而,目前关于中药有效成分与水凝胶结合在骨组织工程中的研究仍有不足,距离实际的临床应用仍有挑战。
文摘目的:观察益气温经穴位贴贴敷联合西药口服治疗绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)肾虚血瘀证的临床疗效。方法:将符合要求的120例PMOP肾虚血瘀证患者随机分为2组,每组60例,分别采用单纯西药(阿仑膦酸钠片、钙尔奇D片、骨化三醇胶丸)口服治疗(西药治疗组)与益气温经穴位贴贴敷联合西药口服治疗(联合治疗组)。3个月为1个疗程,每个疗程之间隔1个月,共治疗3个疗程。分别于治疗前、治疗开始后6个月、治疗开始后12个月,比较2组患者的骨密度T值、血清雌二醇(estradiol,E2)水平、血清卵泡刺激素(follicle stimulating hormone,FSH)水平、血清Ⅰ型前胶原氨基端前肽(N-terminal propeptide of typeⅠprecollagen,PⅠNP)水平、血清Ⅰ型胶原羧基端肽β特殊序列(β-C-terminal telopeptide of typeⅠcollagen,β-CTX)水平、腰背部疼痛视觉模拟量表(visual analogue scale,VAS)评分、简明健康状况调查表(short form 36 health survey questionnaire,SF-36)评分。结果:①一般情况。共5例患者退出试验,其中西药治疗组3例、联合治疗组2例。最终西药治疗组纳入57例患者,联合治疗组纳入58例患者。②骨密度T值。治疗前后骨密度T值总体上随时间推移呈上升趋势(F=109.349,P=0.000),2组间差异无统计学意义(F=0.014,P=0.905)。③血清E2水平。治疗前后西药治疗组患者血清E2水平随时间推移无明显变化(F=0.790,P=0.456),联合治疗组患者血清E2水平随时间推移呈上升趋势(F=6.559,P=0.002)。治疗开始后6个月、12个月,联合治疗组患者血清E2水平均高于西药治疗组(t=-3.983,P=0.000;t=-4.177,P=0.000)。④血清FSH水平。治疗前后血清FSH水平总体上随时间推移呈下降趋势(F=17.933,P=0.000),2组间差异无统计学意义(F=1.123,P=0.291)。⑤血清PⅠNP水平。治疗前后西药治疗组患者血清PⅠNP水平随时间推移无明显变化(F=0.368,P=0.693),联合治疗组患者血清PⅠNP水平随时间推移呈上升趋势(F=11.724,P=0.000)。治疗开始后6个月、12个月,联合治疗组患者血清PⅠNP水平均高于西药治疗组(t=-5.844,P=0.000;t=-5.619,P=0.000)。⑥血清β-CTX水平。治疗前后血清β-CTX水平总体上随时间推移呈下降趋势(F=6.371,P=0.002),2组间差异无统计学意义(F=1.898,P=0.171)。⑦腰背部疼痛VAS评分。治疗前后2组患者腰背部疼痛VAS评分随时间推移均呈下降趋势(F=35.668,P=0.000;F=147.005,P=0.000)。治疗开始后6个月、12个月,联合治疗组患者腰背部疼痛VAS评分均低于西药治疗组(t=12.848,P=0.000;t=13.291,P=0.000)。⑧SF-36评分。治疗前后2组患者SF-36评分随时间推移均呈上升趋势(F=54.622,P=0.000;F=105.957,P=0.000)。治疗开始后6个月、12个月,联合治疗组患者SF-36评分均高于西药治疗组(t=-10.331,P=0.000;t=-10.323,P=0.000)。结论:益气温经穴位贴贴敷联合西药口服治疗PMOP肾虚血瘀证,在提高血清E2水平、促进骨形成、减轻腰背部疼痛、改善患者生活质量方面优于单纯西药口服治疗;但两者在降低血清FSH水平、抑制骨吸收、提高骨密度方面的效果相当。
文摘2017年11月14日,美国心脏病学学会(American College of Cardiology,ACC)、美国心脏协会(American Heart Association,AHA)联合其他9大民间权威机构,发布了2017年版《美国成人高血压防治指南》(2017ACC/AHA).该版指南重新划分了高血压阈值,设置了新的降压目标值,而不再延续执行先前已颁布10余年的高血压诊断标准.该指南一经发布,就引起了全球范围的关注和争议,后续所带来的冲击更是不容小觑.结合中国高血压现状对该指南进行初步解读.
基金supported by the National Natural Science Foundation of China(No.52474092,52074042)National Key Research and Development Program of China(No.2018YFC1504802)。
文摘In recent years,the southwestern region of China has experienced a surge in significant mountain collapses,predominantly linked to underground mining operations.This investigation targets the Jiguanling area in Wulong,Chongqing,employing the UDEC numerical simulation technique to meticulously examine the deformation and failure characteristics,rock mass movement patterns,fracture evolution processes,and stress transmission mechanisms of anti-dip rock slopes composed of stratified rocks.These slopes are inherently susceptible to bending and tilting due to their own weight.Our findings elucidate that the predominant failure mode of anti-dip rock karst slopes is the inclined sliding(shear)type,which mirrors the fracture evolution mechanism as they extend in a quadrilateral pattern from the top and bottom plates of the mining area to the critical blocks at the rear and front edges of the slope.The disaster mechanism can be encapsulated as the"initial roof movement phase,direct roof collapse and crack propagation phase,critical block locking and sliding resistance phase,and deterioration phase".The four distinct stages of development and transformation encompass critical block slip(shear)and slope instability phases.An increase in coal seam thickness enlarges the deformation space in the lower part,while the dip angle of the coal seam influences the length and displacement range of rock fracture development.The mining sequence alters the stress failure mode of the underlying critical blocks,and the vertical height of the mining step distance modifies the potential sliding surface and failure mode of the underlying critical blocks.Ultimately,the distance between the goaf and the surface,along with the height of the mining impact,impacts the stability of the reverse slope.The results demonstrate that mining activities are the primary factor inducing the collapse of anti-dip rock slopes,with natural factors playing a secondary role.
基金supported by the National Natural Science Foundation of China(52474092 and 52074042).
文摘To investigate the fracture propagation characteristics and failure mechanism of anti-dip rock slope induced by underground mining,the Jiguanling landslide in Wulong,Chongqing,China is taken as the prototype,and physical model test is utilized to study the fracture evolution process,deformation characteristics and failure mechanism of anti-dip rock slope.In this study,the digital image correlation(DIC)technique and pressure acquisition system are combined to analyze the displacement and stress field of rock slope during underground mining stages.The results show that the anti-dip rock slope experiences four stages during underground coal mining:tensile fracture propagation in upper toppling zone,shallow damage in the lower shear zone,coal seam roof caving,failure of the whole slope.There is a phenomenon of local tensile and compressive stress conversion in upper toppling zone after roof caving.The appearance of coal seam roof caving increases the compressive area and pressure of the shear zone,leading to the failure of the shear blocks at the front edge,and ultimately causing failure of the whole slope.Mining with retained coal pillar before shallow failure in the shear zone can effectively block the impact of lower mining on the upper toppling zone,achieve a 16%contraction in toppling zone,and improve the stability of the slope.The failure mode of slope can be summarized as shear–slip–toppling collapse failure.This paper improves the understanding on the failure mechanism of anti-dip rock slope caused by underground mining.
文摘目的检测老年冠状动脉疾病(CAD)患者血清Wnt(wingless type protein)-1水平,探讨Wnt-1与炫速双源CT造影冠状动脉病变严重程度和形态的相关性。方法选取2016年10月至2018年5月就诊于郑州大学第一附属医院心血管内科且年龄大于60岁的疑似冠心病患者371例,行炫速双源CT冠状动脉造影术,按管腔狭窄程度分组,≤50%为非严重冠状动脉病变,>50%为严重狭窄病变,根据冠状动脉斑块钙化情况分为非钙化斑块,钙化斑块和混合斑块。采用酶联免疫吸附试验(ELISA)法测定血清Wnt-1水平。结果严重冠状动脉病变组血清Wnt-1水平明显高于非严重冠状动脉病变组(132.52±40.48)vs.(98.39±28.23)ng/ml,P<0.001)。logistic回归分析发现血清Wnt-1水平是预测严重冠状动脉病变的独立预测因子(OR=1.56,95%CI:1.24~2.03,P=0.003)。并且冠状动脉钙化组血清Wnt-1水平(135.56±38.82)ng/ml显著高于非冠状动脉钙化组(96.75±29.13)ng/ml和混合斑块组(102.62±34.64)ng/ml(P<0.001)。logistic回归分析显示血清Wnt-1水平是预测冠状动脉钙化的独立预测因子(OR=2.07,95%CI:1.53~2.85,P<0.001)。结论血清Wnt-1水平显著与冠状动脉CT造影老年血管斑块严重程度和钙化密切相关。Wnt在老年冠状动脉疾病中的病理生理机制需要进一步的前瞻性临床研究。
