BACKGROUND Understanding the type and extent of coronary artery involvement in patients with acute type A aortic dissection(ATAAD)is vital for surgical planning.The Neri classification has been proposed as a guide for...BACKGROUND Understanding the type and extent of coronary artery involvement in patients with acute type A aortic dissection(ATAAD)is vital for surgical planning.The Neri classification has been proposed as a guide for surgical strategies,however,its prognostic impact on postoperative mortality rates remains understudied in large-scale cohorts.METHODS We reviewed 600 ATAAD patients who underwent surgery and coronary computed tomography angiography from 2016 to 2020 at Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China.Patients were classified based on the Neri classification system:no coronary artery involvement,type A(ostial involvement),type B(dissection in coronary body),and type C(circumferential detachment or complete avulsion).The primary endpoint was 30-day mortality.RESULTS Overall,28.3%of the patients had coronary artery involvement,with Neri type A,Neri type B,and Neri type C accounting for 13.3%,11.2%,and 3.8%,respectively.The right coronary artery was more frequently involved(25.3%)than the left coronary artery(8.0%).In the unadjusted analysis,patients with coronary artery involvement exhibited a numerically higher 30-day mortality compared to those without(5.3%vs.2.3%)(OR=2.35,95%CI:0.94–5.88,P=0.07),though this difference did not reach statistical significance.However,multivariable adjustment revealed significant association(adjusted OR=3.71,95%CI:1.05–13.13,P=0.04).Interestingly,after additional adjustment for coronary artery bypass grafting,the impact of coronary artery involvement on 30-day mortality no longer remained statistically significant(adjusted OR=3.13,95%CI:0.85–11.58,P=0.09).The 1-year mortality was higher in those with coronary artery involvement,but this significant association disappeared after adjusting for potential confounding variables.Furthermore,no significant difference in 30-day and 1-year mortality were observed among patients with different Neri classifications.CONCLUSIONS In patients with ATAAD who undergo surgery,the presence of coronary artery involvement is significantly associated with an increased risk of 30-day mortality.Proactive coronary artery bypass grafting may potentially mitigate the adverse impact of coronary artery involvement on 30-day mortality.展开更多
Objective To investigate the clinical predictors of malperfusion in patients with acute type A aortic dissection(ATAAD)and to construct a diagnostic model to identify high-risk individuals.Methods A retrospective anal...Objective To investigate the clinical predictors of malperfusion in patients with acute type A aortic dissection(ATAAD)and to construct a diagnostic model to identify high-risk individuals.Methods A retrospective analysis of 553 ATAAD patients from Tongji Hospital divided into malperfusion and non-malperfusion groups was conducted.Logistic regression was used to identify independent predictors of the outcome.Model performance via the Hosmer–Lemeshow test,decision curve analysis(DCA),the area under the receiver operating characteristic curve(AUC),sensitivity,specificity,and predictive values.Results Malperfusion was observed in 28.4%of ATAAD patients.Significant predictors included elevated lactate dehydrogenase(LDH)(OR:1.0019,95%CI:1.0002–1.0036,P=0.027),alanine aminotransferase(ALT)(OR:0.9936,95%CI:0.987–1.000,P=0.046)and estimated glomerular filtration rate(eGFR)(OR:0.9877,95%CI:0.977–0.998,P=0.021),suggesting roles for tissue ischemia and impaired renal or hepatic function.Other variables,such as D-dimer,uric acid,creatinine,and NT-proBNP,showed trends toward significance but did not reach the 0.05 threshold.The model demonstrated good calibration(Hosmer–Lemeshow P=0.318),moderate discriminatory power(AUC=0.725),high specificity(93.62%),and low sensitivity(26.75%).Conclusion The model based on routine biochemical markers provides a practical approach for the early identification of malperfusion in ATAAD patients.It shows strong specificity and clinical utility,although its limited sensitivity highlights the need for further refinement.Future improvements should focus on incorporating additional clinical or imaging data to increase diagnostic accuracy.展开更多
BACKGROUND Rhabdomyolysis(RML)as an etiological factor causing acute kidney injury(AKI)is sparsely reported in the literature.AIM To study the incidence of RML after surgical repair of an ascending aortic dissection(A...BACKGROUND Rhabdomyolysis(RML)as an etiological factor causing acute kidney injury(AKI)is sparsely reported in the literature.AIM To study the incidence of RML after surgical repair of an ascending aortic dissection(AAD)and to correlate with the outcome,especially regarding renal function.To pinpoint the perioperative risk factors associated with the development of RML and adverse renal outcomes after aortic dissection repair.METHODS Retrospective single-center cohort study conducted in a tertiary cardiac center.We included all patients who underwent AAD repair from 2011-2017.Post-operative RML workup is part of the institutional protocol;studied patients were divided into two groups:Group 1 with RML(creatine kinase above cut-off levels 2500 U/L)and Group 2 without RML.The potential determinants of RML and impact on patient outcome,especially postoperative renal function,were studied.Other outcome parameters studied were markers of cardiac injury,length of ventilation,length of stay in the intensive care unit),and length of hospitalization.RESULTS Out of 33 patients studied,21 patients(64%)developed RML(Group RML),and 12 did not(Group non-RML).Demographic and intraoperative factors,notably body mass index,duration of surgery,and cardiopulmonary bypass,had no significant impact on the incidence of RML.Preoperative visceral/peripheral malperfusion,though not statistically significant,was higher in the RML group.A significantly higher incidence of renal complications,including de novo postoperative dialysis,was noticed in the RML group.Other morbidity parameters were also higher in the RML group.There was a significantly higher incidence of AKI in the RML group(90%)than in the non-RML group(25%).All four patients who required de novo dialysis belonged to the RML group.The peak troponin levels were significantly higher in the RML group.CONCLUSION In this study,we noticed a high incidence of RML after aortic dissection surgery,coupled with an adverse renal outcome and the need for post-operative dialysis.Prompt recognition and management of RML might improve the renal outcome.Further large-scale prospective trials are warranted to investigate the predisposing factors and influence of RML on major morbidity and mortality outcomes.展开更多
Objective:To investigate the clinical efficacy of Shexiang Tongxin Dropping Pills combined with rosuvastatin calcium and clopidogrel bisulfate tablets in treating phlegm-heat and blood stasis type angina pectoris of c...Objective:To investigate the clinical efficacy of Shexiang Tongxin Dropping Pills combined with rosuvastatin calcium and clopidogrel bisulfate tablets in treating phlegm-heat and blood stasis type angina pectoris of coronary heart disease.Methods:Sixty-four patients with phlegm-heat and blood stasis type angina pectoris of coronary heart disease,hospitalized at Lin’an District Hospital of Traditional Chinese Medicine from January 2024 to April 2025,were selected and randomly divided into a control group(administered 10mg of rosuvastatin calcium and 75mg of clopidogrel bisulfate once daily)and an observation group(administered 2 Shexiang Tongxin Dropping Pills three times daily in addition to the control group’s treatment regimen),with 32 patients in each group.The therapeutic effects of the two groups were compared.Results:After 56 days of treatment,the angina pectoris score in the observation group was significantly lower than that in the control group(4.49±0.39 vs 4.88±0.47,p<0.05);the Seattle Angina Questionnaire(SAQ)score indicated improvement in the frequency of angina pectoris attacks.(SAQ-AF:71.35±5.29 vs.64.25±7.55,p<0.05)and treatment satisfaction(SAQ-TS:58.79±6.22 vs.54.16±5.02,p<0.05)were more significantly improved in the observation group.The total effective rate(96.87%vs.90.62%,p<0.05)and marked effective rate(62.50%vs.31.25%)were higher in the observation group than in the control group.The Traditional Chinese Medicine(TCM)syndrome score(4.49±0.39 vs.4.88±0.47,p<0.05)and lipid index(LDL-C:1.79±0.31 vs.1.99±0.33 mmol/L,p<0.05)decreased more significantly in the observation group.Conclusion:Shexiang Tongxin Dropping Pills combined with rosuvastatin calcium and clopidogrel bisulfate tablets demonstrated good efficacy and high safety in the treatment of phlegm-heat and blood stasis type angina pectoris associated with coronary heart disease.展开更多
The transmetallation reaction of 4 Schiff base type arylmercury compounds with metallic tin has been carried out in refluxing xylene.It was found that the reaction proceeds in the same manner as that of chloro[2-(phen...The transmetallation reaction of 4 Schiff base type arylmercury compounds with metallic tin has been carried out in refluxing xylene.It was found that the reaction proceeds in the same manner as that of chloro[2-(phenylazo)phenyl]mercury(Ⅱ) to give dichlorobisaryltin(Ⅳ).The ~1H NMR spectra of the products provide evidence for the presence of N→Sn intramolecular coordination.The formation of dichlorobisaryltin(Ⅳ)as a unique product probably arises from the N→Sn intramolecular coordination which results in the increasing of the stability of the molecule.展开更多
[Objective] The mating genotype was studied and compared with esterase isozyme of Ganoderma lucidum populations between groups in order to clarify their differences in genetic relationship analysis. [Method] OWE-SOJ t...[Objective] The mating genotype was studied and compared with esterase isozyme of Ganoderma lucidum populations between groups in order to clarify their differences in genetic relationship analysis. [Method] OWE-SOJ technique was applied to identify standard mating types and determinate mating genotype between groups of monokaryons isolates from 24 G. lucidum stains. Genetic relationships were analyzed by combined group mating genotype determination with esterase isozyme assay. [Result] All strains of G. lucidum could be divided into 7 large groups of the mating genotype. Four alleles of A factor, four alleles of B factor and one mixed alleles of A factor were found in this study. Distorted segregation ratio among monokaryon mycelia of G. lucidum had been observed in four kinds of mat- ing types to some extent. Twenty-eight different types of enzyme bands were determined in esterase isozyme test, Twenty-four strains of G. lucidum could be divided into 9 large groups through the cluster analysis when the genetic similarity coefficient was 0.73214. Comparing the results of mating genotype analysis and esterase isozyme analysis, it showed great similarity. [Conclusion] Mating genotype analysis could be used as an important supplementary method for strain identification and genetic diversity research.展开更多
Objective Type A acute aortic dissection(TAAAD)is a dangerous and complicated condition with a high death rate before hospital treatment.Patients who are fortunate to receive prompt surgical treatment still face high ...Objective Type A acute aortic dissection(TAAAD)is a dangerous and complicated condition with a high death rate before hospital treatment.Patients who are fortunate to receive prompt surgical treatment still face high in-hospital mortality.A series of post-operative complications further affects the prognosis.Post-operative pneumonia(POP)also leads to great morbidity and mortality.This study aimed to identify the prevalence as well as the risk factors for POP in TAAAD patients and offer references for clinical decisions to further improve the prognosis of patients who survived the surgical procedure.Methods The study enrolled 89 TAAAD patients who underwent surgical treatment in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei province,China from December 2020 to July 2021 and analyzed the perioperative data and outcomes of these patients.Logistic regression analyses were used to identify the risk factors for POP.Results In the study,31.5%of patients developed POP.Patients with POP had higher proportions of severe oxygenation damage,pneumothorax,reintubation,tracheotomy,renal replacement therapy,arrhythmia,gastrointestinal bleeding,and longer duration of mechanical ventilation,fever,ICU stay,and length of stay(all with P<0.05).The in-hospital mortality was 2.3%.Smoking,preoperative white blood cells,and intraoperative transfusion were the independent risk factors for POP in TAAAD.Conclusion Patients who underwent TAAAD surgery suffered poorer outcomes when they developed POP.Furthermore,patients with risk factors should be treated with caution.展开更多
BACKGROUND A 63-year-old female was diagnosed with acute Stanford type A aortic dissection.The patient had pain in the chest and back for 1 wk.The computed tomography angiography(CTA)showed Stanford type A aortic diss...BACKGROUND A 63-year-old female was diagnosed with acute Stanford type A aortic dissection.The patient had pain in the chest and back for 1 wk.The computed tomography angiography(CTA)showed Stanford type A aortic dissection(Myla type III aortic arch).The intimal tear was located at the top of the aortic arch and retrograded to the ascending aorta.CASE SUMMARY Preoperatively,a three-dimensional(3D)-printed model of the aortic arch was made according to CTA data.Then,under the guidance of the 3D-printed aortic model,a pre-fenestrated stent-graft was customized,and the diameter of the stent-graft was reduced intraoperatively by surgeons.3D printing,triple prefenestration,and reduced diameter techniques were used during the surgery.The CTA examinations were performed at the 3rd mo and 1st year after the surgery;the results showed that the aortic dissection was repaired without endoleak,and all three branches of the aortic arch remained unobstructed.CONCLUSION Applying the triple pre-fenestration technique for aortic arch lesions was feasible and minimally invasive in our case.The technique provides a new avenue for thoracic endovascular aortic repair of Stanford type A aortic dissection.展开更多
In this paper, we report new whole-rock geochemical and zircon U-Pb data for monzogranites in the NE Xing＇an block. These data constrained the petrogenesis of C type （high Sr/Y） adakitic rocks and showed the spatia...In this paper, we report new whole-rock geochemical and zircon U-Pb data for monzogranites in the NE Xing＇an block. These data constrained the petrogenesis of C type （high Sr/Y） adakitic rocks and showed the spatial extent of the influence of the Mongol-Okhostsk ocean tectonic regime and the collision between the Jiamusi Massif and Songliao Terrane. New zircon laser-ablation inductivity coupled plasma mass spectrometry （LA-ICP-MS） U-Pb data indicated that the monzogranites in the studied area were emplaced in the Early Jurassic （～ 180 Ma）. These rocks were characterized by unusally high SiO2 （≥67.49）, and Sr （461-759 ppm）, but strikingly low Y （4.63-8.06 ppm） and HREE （∑HREE = 3.83-6.49 ppm, Yb = 0.5-0.77 ppm） contents, with therefore high Sr/Y （67.2-119） and （La/Yb）N （29.7-41.5） ratios, showing the geochemical characteristics of C type adakitic granite. The data displayed negligible Eu anomalies （Eu/Eu^＊ =0.77-1.08）, LREE-enriched and pronounced negative Nb and Ta anomalies. The C-type adakites in the studied area were most likely derived from the partial melting of a thickened lower continental curst. The magma source is most likely dominated by amphibolites and garnet amphibolites. In combination with previously-reported data from igneous rocks from the Mesozoic in NE China, we conclude that the Xing＇ an block was influenced by the Mongol-Okhotsk subduction tectonic system, and experiences compressive settings from the amalgamation of the Jiamusi block in the east of the CAOB.展开更多
Objective.To introduce the properties of Chinese type A botulinum toxin(CBTXA,made by Lanzhou Institute of Biological Products),and its long?term effect for focal dystonia and hemifacial spasm.Method.The purity and re...Objective.To introduce the properties of Chinese type A botulinum toxin(CBTXA,made by Lanzhou Institute of Biological Products),and its long?term effect for focal dystonia and hemifacial spasm.Method.The purity and recovery of crude and crystalline toxin were tested.Long?term data from305patients with hemifacial spasm(HFS),blepharospasm(BS)and cervical dystonia(CD)were evalu-ated and subgroups of patients received CBTXA injections between1994and2000in at least six sepa-rate treatment sessions,with follow up for2～8years.The therapeutic results of the last session CBTXA injections were analyzed in comparison with the first session.Result.CBTXA purity was high[(2.55～2.60)×10 7 LD50/mgPr ,A260/A280≤0.55,high molecular substance accounted for99.2%of total proteins].Long term treatment with CBTXA in patients with focal dystonia and HFS was not associated with any decline in benefit,and efficacy may improve slightly with repeat treatments.CBTXA is an excellent long-term treatment of HFS,BS and CD.Conclusion.We conclude that Chinese type A botulinum toxin is of botulinum toxin therapy quality standard according to results obtained from the basic study and long?term clinical applications.The re?injection of CBTXA significantly improves the quality of life of most patients and is a safe,effective and comparatively economical treatment for patients with focal dystonia and HFS.展开更多
We report a case of multiple duodenal, pancreatic, and gastric carcinoids. A 67-year old woman was admitted to our hospital for treatment of a duodenal carcinoid. Laboratory tests revealed that the patient was associa...We report a case of multiple duodenal, pancreatic, and gastric carcinoids. A 67-year old woman was admitted to our hospital for treatment of a duodenal carcinoid. Laboratory tests revealed that the patient was associated with macrocytic anemia and hypergastrinemia, and type A gastritis was shown by gastrofiberscopy. During surgery, another tumor was incidentally found in the head of the pancreas. The tumors in the duodenum and pancreas were completely excised by pancreatoduodenectomy and immunohistologically diagnosed as gastrin-and serotonin-producing carcinoids, respectively. Pathological examination revealed that in addition to the grossly found carcinoids, there were subclinical carcinoids, one of which was an endocrine cell micronest, located in the stomach and duodenum. The tumors in the duodenum, pancreas, and stomach showed different characteristics from one another morphologically and immunochemically. Although no definitive evidence has been obtained, some sort of genetic anomaly may have been involved in this case, and hypergastrinemia due to duodenal gastrinoma may induce multiple gastric carcinoids.展开更多
No definite consensus has currently been reached regarding the safety and efficacy of low-or high-frequency repetitive transcranial magnetic stimulation in the treatment of post-stroke muscle spasticity.The latest res...No definite consensus has currently been reached regarding the safety and efficacy of low-or high-frequency repetitive transcranial magnetic stimulation in the treatment of post-stroke muscle spasticity.The latest research indicates that when combined with local injections of botulinum toxin type A,it is more effective on post-stroke muscle spasticity than local injections of botulinum toxin type A alone.We designed a prospective,single-center,non-randomized,controlled clinical trial to investigate the safety and effica cy of different frequencies of repetitive transcranial magnetic stimulation combined with local injections of botulinum toxin type A in treating post-stroke lower limb muscle spasticity to determine an optimal therapeutic regimen.This trial will enroll 150 patients with post-stroke muscle spasticity admitted to the Department of Rehabilitation Medicine at the First Affiliated Hos pital of China Medical Unive rsity.All enrolled patients will undergo ro utine rehabilitation training and will be divided into five groups in-30 per group) according to the particular area of cerebral infa rction and treatment methods.G roup A:Patients with massive cerebral infarction will be given local injections of botulinum toxin type A and low-frequency(1 Hz)repetitive transcranial magnetic stimulation on the contralate ral side;G roup B:Patients with non-massive cerebral infarction will be given local injections of botulinum toxin type A and high-frequency(10-20 Hz) re petitive transcranial magnetic stimulation on the affected side;G roup C:Patients with massive/non-massive cerebral infarction will be given local injections of botulinum toxin type A;G roup D:Patients with massive cerebral infarction will be given low-frequency(1 Hz) repetitive transcranial magnetic stimulation on the contralate ral side;and G roup E:Patients with non-massive cerebral infa rction will be given high-frequency(10-20 Hz) repetitive transcranial magnetic stimulation on the affected side.The primary outcome measure of this trial is a modified Ashwo rth scale score from 1 day before treatment to 12 months after treatment.Secondary outcome measures include Fugl-M eyer Assessment of Lower Extremity,Visual Analogue Scale,modified Barthel index,and Berg Balance Scale scores for the same time as specified for primary outcome measures.The safety indicator is the incidence of adverse events at 3-12 months after treatment.We hope to draw a definite conclusion on whether there are diffe rences in the safety and efficacy of low-or high-frequency repetitive transcranial magnetic stimulation combined with botulinum toxin type A injections in the treatment of patients with post-stroke lower limb spasticity under strict grouping and standardized operation,thereby screening out the optimal therapeutic regimen.The study protocol was approved by the Medical Ethics Committee of the First Affiliated Hospital of China Medical University(approval No.[2021] 2021-333-3) on August 19,2021.The trial was registe red with the Chinese Clinical Trial Registry(Registration No.ChiCTR2100052180) on October 21,2021.The protocol version is 1.1.展开更多
Clinically,it is widely recognized that surgical treatment is the preferred and reliable option for Stanford type A aortic dissection.Stanford type A aortic dissection is an emergent and serious cardiovascular disease...Clinically,it is widely recognized that surgical treatment is the preferred and reliable option for Stanford type A aortic dissection.Stanford type A aortic dissection is an emergent and serious cardiovascular disease characterized with an acute onset,poor prognosis,and high mortality.However,the incidences of postoperative complications are relatively higher due to the complexity of the disease and its intricate procedure.It has been considered that hypoxemia,one of the most common postoperative complications,plays an important role in having a worse clinical prognosis.Therefore,the effective intervention of postoperative hypoxemia is significant for the improved prognosis of patients with Stanford type A aortic dissection.展开更多
Background and objective:Botulinum toxin type A(BoNT/A)is a metalloprotease that blocks synaptic transmission via the cleavage of a synaptosomal-associated protein of 25 kDa(SNAP-25).It has gained widespread use as a ...Background and objective:Botulinum toxin type A(BoNT/A)is a metalloprotease that blocks synaptic transmission via the cleavage of a synaptosomal-associated protein of 25 kDa(SNAP-25).It has gained widespread use as a treatment for cerebral palsy and skeletal muscle hypertrophy.In China,Chinese botulinum toxin type A(CBTX-A),a type of BoNT/A,is in widespread clinical use.However,the changes in the morphological and biochemical properties of treated muscles and in remote muscles from the CBTX-A injection site are relatively unknown.Therefore,we investigated the changes in histomorphology and myosin heavy chain(MyHC)isoform composition and distribution in rat gastrocnemius muscles after intramuscular injection of CBTX-A.Methods:The weakness of the injected muscles was assessed periodically to identify their functional deficiency.Muscle slices were stained with hematoxylin-eosin(HE)and adenosine triphosphatase(ATPase).MyHC isoform composition was analyzed by sodium dodecyl sulfatepolyacrylamide gel electrophoresis(SDS-PAGE)to uncover changes in morphological and biochemical properties.Results:Our findings demonstrate that following injection of CBTX-A 5 U into rat gastrocnemius muscles,shifts in MyHC isoform composition emerged on the third day after injection and peaked in the fourth week.The composition remained distinctly different from that of the control group after the twelfth week.More specifically,there was a decrease in the proportion of the type IIb isoform and an increase in the proportions of type IIx,type IIa,and type I isoforms.Conclusions:Data revealed that CBTX-A led to a shift in MyHC composition towards slower isoforms and that the MyHC composition remained far from normal six months after a single injection.However,no noticeable remote muscle weakness was induced.展开更多
Type A aortic dissection(AD)is one of the most serious cardiovascular diseases,whose risk predictors are controversial.The purpose of this research was to investigate how elongation accompanied by dilation of the asce...Type A aortic dissection(AD)is one of the most serious cardiovascular diseases,whose risk predictors are controversial.The purpose of this research was to investigate how elongation accompanied by dilation of the ascending aorta(AAo)affects the relevant haemodynamic characteristics using image-based computational models.Five elongated AAos with different levels of dilation have been reconstructed based on the centerlines data of an elderly and an AD patient.Numerical simulations have been performed assuming an inflow waveform and a Windkessel model with three elements for all outflow boundaries.The numerical results have revealed that the elongation of AAo can disturb the systolic helical flow pattern between the root of AAo and the aortic arch.The helical flow inside the AAo starts to develop into a vortex flow when the elongated AAo becomes dilated.The vortex gives rise to a localized oscillatory shear index at the ostia of the brachiocephalic artery(BA)and the inner curve of the aortic arch.This study suggests that abnormal growth of AAo,especially accompanied by its moderate dilation,can be considered as morphological risk factors of AD.展开更多
BACKGROUND Type A insulin resistance syndrome is a rare disorder caused by mutations in the gene encoding the insulin receptor.Its coexistence with ovarian serous papillary cystadenofibroma is even rarer.CASE SUMMARY ...BACKGROUND Type A insulin resistance syndrome is a rare disorder caused by mutations in the gene encoding the insulin receptor.Its coexistence with ovarian serous papillary cystadenofibroma is even rarer.CASE SUMMARY A 14-year-old girl developed type A insulin resistance syndrome and showed high fasting insulin,glucose,and hemoglobin A1c(HbA1c)levels.The girl suffered from ovarian serous papillary cystadenofibroma.The laboratory results were as follows:fasting insulin was 2624.90 pmol/L and HbA1c was 8.5%.A heterozygous missense mutation on exon 20 of the insulin receptor gene(c.3601C>T,Arg1201Trp)was observed.The histopathological diagnosis was a cystic lesion that extended to the upper right uterus,indicating a right ovarian serous papillary cystadefibroma accompanied by focal interstitial hyperplasia.The patient was treated with metformin for over 6 mo.Additionally,laparoscopic resection(bilateral)of the ovarian lesion and laparoscopic intestinal adhesiolysis were performed under general anesthesia.Diet therapy combined with exercise was then initiated.The patient had an uneventful recovery.The patient also showed improved blood glucose control,with reduced levels of fasting insulin(857.84 pmol/L)and HbA1c(7.0%).CONCLUSION Insulin resistance may play a significant role in the induction of tumors.It is important to investigate further the association between insulin resistance and tumors and the underlying mechanism.展开更多
What is pursued by multi-product type and variant volume(MPTVV)production is rapid response and quick switching,so that structure of transferring line in manufacturing system is no longer unalterable.Cell formation(CF...What is pursued by multi-product type and variant volume(MPTVV)production is rapid response and quick switching,so that structure of transferring line in manufacturing system is no longer unalterable.Cell formation(CF)algorithm is the key technology of cellular manufacturing system(CMS).Currently,CF methods are mainly extended on the idea of group technology(GT)that covers a lot on analysis of resource capability matching and its algorithm.Various constraints are considered,but seldom utilized comprehensively.Aimed to the problem of manufacturing cell(MC)formation under MPTVV production mode,integrated formation technologies for typical MC as group type of cell(GC),flow type of cell(FC)and inherited cell(IC)are presented based on technical analysis of CF.Oriented to practical production constraints like delivery time,product batch,equipment ability,key machine,key part and machine sharing,etc,an integrated formation model is constructed and internal interrelations of these constraints are analyzed synthetically.Ulteriorly,formation goals of types of MCs and their formation procedures under joint effect of formation constraints and rules are spread.In case study,three highly balanced GC are formed first;then FC formation are implemented based on the same data which indicate good balancing effect of cell load and flow-style production for key tasks;When task is adjusted,a new scheme is constructed on the result of FC configuration by using IC formation method,and more optimal performance of flow-style production is manifested.The proposed comparative study of different type of cells strongly explains the validation of integrated MC formation in support of rapid manufacturing resource transformation under MPTVV production mode.展开更多
A new Diels-Alder type adduct mongolicin G （1） and a new flavone 5＇-（1＂, 1＂-dimethylallyl）-5,7,2＇,4＇-tetrahydroxyflavone （2） were isolated from the stem and root bark of Morus mongolica. Their structures we...A new Diels-Alder type adduct mongolicin G （1） and a new flavone 5＇-（1＂, 1＂-dimethylallyl）-5,7,2＇,4＇-tetrahydroxyflavone （2） were isolated from the stem and root bark of Morus mongolica. Their structures were determined by spectroscopic analysis and chiroptical methods.展开更多
BACKGROUND A 46-year-old male underwent ascending aortic replacement,total arch replacement,and descending aortic stent implantation for Stanford type A aortic dissection in 2016.However,an intraoperative stent-graft ...BACKGROUND A 46-year-old male underwent ascending aortic replacement,total arch replacement,and descending aortic stent implantation for Stanford type A aortic dissection in 2016.However,an intraoperative stent-graft was deployed in the false lumen inadvertently.This caused severe iatrogenic thoracic and abdominal aortic dissection,and the dissection involved many visceral arteries.CASE SUMMARY The patient had pain in the chest and back for 1 mo.A computed tomography scan showed that the patient had secondary thoracic and abdominal aortic dissection.The ascending aortic replacement,total arch replacement,and descending aortic stent implantation for Stanford type A aortic dissection were performed 2 years prior.An intraoperative stent-graft was deployed in the false lumen.Endovascular aneurysm repair was performed to address this intractable situation.An occluder was used to occlude the proximal end of the true lumen,and a covered stent was used to direct blood flow back to the true lumen.A three-dimensional printing technique was used in this operation to guide prefenestration.The computed tomography scan at the 1stmo after surgery showed that the thoracic and abdominal aortic dissection was repaired,with all visceral arteries remaining patent.The patient did not develop renal failure or neurological complications after surgery.CONCLUSION The total endovascular repair for false lumen stent-graft implantation was feasible and minimally invasive.Our procedures provided a new solution for stent-graft deployed in the false lumen,and other departments may be inspired by this case when they need to rescue a disastrous stent implantation.展开更多
基金supported by the National High Level Hospital Clinical Research Funding(No.2024-GSP-TJ-15&No.2023-GSP-QN-17)the Chinese Society of Cardiology’s Foundation(CSCF2023B03).
文摘BACKGROUND Understanding the type and extent of coronary artery involvement in patients with acute type A aortic dissection(ATAAD)is vital for surgical planning.The Neri classification has been proposed as a guide for surgical strategies,however,its prognostic impact on postoperative mortality rates remains understudied in large-scale cohorts.METHODS We reviewed 600 ATAAD patients who underwent surgery and coronary computed tomography angiography from 2016 to 2020 at Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China.Patients were classified based on the Neri classification system:no coronary artery involvement,type A(ostial involvement),type B(dissection in coronary body),and type C(circumferential detachment or complete avulsion).The primary endpoint was 30-day mortality.RESULTS Overall,28.3%of the patients had coronary artery involvement,with Neri type A,Neri type B,and Neri type C accounting for 13.3%,11.2%,and 3.8%,respectively.The right coronary artery was more frequently involved(25.3%)than the left coronary artery(8.0%).In the unadjusted analysis,patients with coronary artery involvement exhibited a numerically higher 30-day mortality compared to those without(5.3%vs.2.3%)(OR=2.35,95%CI:0.94–5.88,P=0.07),though this difference did not reach statistical significance.However,multivariable adjustment revealed significant association(adjusted OR=3.71,95%CI:1.05–13.13,P=0.04).Interestingly,after additional adjustment for coronary artery bypass grafting,the impact of coronary artery involvement on 30-day mortality no longer remained statistically significant(adjusted OR=3.13,95%CI:0.85–11.58,P=0.09).The 1-year mortality was higher in those with coronary artery involvement,but this significant association disappeared after adjusting for potential confounding variables.Furthermore,no significant difference in 30-day and 1-year mortality were observed among patients with different Neri classifications.CONCLUSIONS In patients with ATAAD who undergo surgery,the presence of coronary artery involvement is significantly associated with an increased risk of 30-day mortality.Proactive coronary artery bypass grafting may potentially mitigate the adverse impact of coronary artery involvement on 30-day mortality.
文摘Objective To investigate the clinical predictors of malperfusion in patients with acute type A aortic dissection(ATAAD)and to construct a diagnostic model to identify high-risk individuals.Methods A retrospective analysis of 553 ATAAD patients from Tongji Hospital divided into malperfusion and non-malperfusion groups was conducted.Logistic regression was used to identify independent predictors of the outcome.Model performance via the Hosmer–Lemeshow test,decision curve analysis(DCA),the area under the receiver operating characteristic curve(AUC),sensitivity,specificity,and predictive values.Results Malperfusion was observed in 28.4%of ATAAD patients.Significant predictors included elevated lactate dehydrogenase(LDH)(OR:1.0019,95%CI:1.0002–1.0036,P=0.027),alanine aminotransferase(ALT)(OR:0.9936,95%CI:0.987–1.000,P=0.046)and estimated glomerular filtration rate(eGFR)(OR:0.9877,95%CI:0.977–0.998,P=0.021),suggesting roles for tissue ischemia and impaired renal or hepatic function.Other variables,such as D-dimer,uric acid,creatinine,and NT-proBNP,showed trends toward significance but did not reach the 0.05 threshold.The model demonstrated good calibration(Hosmer–Lemeshow P=0.318),moderate discriminatory power(AUC=0.725),high specificity(93.62%),and low sensitivity(26.75%).Conclusion The model based on routine biochemical markers provides a practical approach for the early identification of malperfusion in ATAAD patients.It shows strong specificity and clinical utility,although its limited sensitivity highlights the need for further refinement.Future improvements should focus on incorporating additional clinical or imaging data to increase diagnostic accuracy.
基金Supported by Hamad Medical Corporation,No.MRC-01-18-073.
文摘BACKGROUND Rhabdomyolysis(RML)as an etiological factor causing acute kidney injury(AKI)is sparsely reported in the literature.AIM To study the incidence of RML after surgical repair of an ascending aortic dissection(AAD)and to correlate with the outcome,especially regarding renal function.To pinpoint the perioperative risk factors associated with the development of RML and adverse renal outcomes after aortic dissection repair.METHODS Retrospective single-center cohort study conducted in a tertiary cardiac center.We included all patients who underwent AAD repair from 2011-2017.Post-operative RML workup is part of the institutional protocol;studied patients were divided into two groups:Group 1 with RML(creatine kinase above cut-off levels 2500 U/L)and Group 2 without RML.The potential determinants of RML and impact on patient outcome,especially postoperative renal function,were studied.Other outcome parameters studied were markers of cardiac injury,length of ventilation,length of stay in the intensive care unit),and length of hospitalization.RESULTS Out of 33 patients studied,21 patients(64%)developed RML(Group RML),and 12 did not(Group non-RML).Demographic and intraoperative factors,notably body mass index,duration of surgery,and cardiopulmonary bypass,had no significant impact on the incidence of RML.Preoperative visceral/peripheral malperfusion,though not statistically significant,was higher in the RML group.A significantly higher incidence of renal complications,including de novo postoperative dialysis,was noticed in the RML group.Other morbidity parameters were also higher in the RML group.There was a significantly higher incidence of AKI in the RML group(90%)than in the non-RML group(25%).All four patients who required de novo dialysis belonged to the RML group.The peak troponin levels were significantly higher in the RML group.CONCLUSION In this study,we noticed a high incidence of RML after aortic dissection surgery,coupled with an adverse renal outcome and the need for post-operative dialysis.Prompt recognition and management of RML might improve the renal outcome.Further large-scale prospective trials are warranted to investigate the predisposing factors and influence of RML on major morbidity and mortality outcomes.
基金2023 Special Scientific Research Funding Project for Hospital Pharmacy by the Zhejiang Pharmaceutical Association(Project No.:2023ZYY33)。
文摘Objective:To investigate the clinical efficacy of Shexiang Tongxin Dropping Pills combined with rosuvastatin calcium and clopidogrel bisulfate tablets in treating phlegm-heat and blood stasis type angina pectoris of coronary heart disease.Methods:Sixty-four patients with phlegm-heat and blood stasis type angina pectoris of coronary heart disease,hospitalized at Lin’an District Hospital of Traditional Chinese Medicine from January 2024 to April 2025,were selected and randomly divided into a control group(administered 10mg of rosuvastatin calcium and 75mg of clopidogrel bisulfate once daily)and an observation group(administered 2 Shexiang Tongxin Dropping Pills three times daily in addition to the control group’s treatment regimen),with 32 patients in each group.The therapeutic effects of the two groups were compared.Results:After 56 days of treatment,the angina pectoris score in the observation group was significantly lower than that in the control group(4.49±0.39 vs 4.88±0.47,p<0.05);the Seattle Angina Questionnaire(SAQ)score indicated improvement in the frequency of angina pectoris attacks.(SAQ-AF:71.35±5.29 vs.64.25±7.55,p<0.05)and treatment satisfaction(SAQ-TS:58.79±6.22 vs.54.16±5.02,p<0.05)were more significantly improved in the observation group.The total effective rate(96.87%vs.90.62%,p<0.05)and marked effective rate(62.50%vs.31.25%)were higher in the observation group than in the control group.The Traditional Chinese Medicine(TCM)syndrome score(4.49±0.39 vs.4.88±0.47,p<0.05)and lipid index(LDL-C:1.79±0.31 vs.1.99±0.33 mmol/L,p<0.05)decreased more significantly in the observation group.Conclusion:Shexiang Tongxin Dropping Pills combined with rosuvastatin calcium and clopidogrel bisulfate tablets demonstrated good efficacy and high safety in the treatment of phlegm-heat and blood stasis type angina pectoris associated with coronary heart disease.
文摘The transmetallation reaction of 4 Schiff base type arylmercury compounds with metallic tin has been carried out in refluxing xylene.It was found that the reaction proceeds in the same manner as that of chloro[2-(phenylazo)phenyl]mercury(Ⅱ) to give dichlorobisaryltin(Ⅳ).The ~1H NMR spectra of the products provide evidence for the presence of N→Sn intramolecular coordination.The formation of dichlorobisaryltin(Ⅳ)as a unique product probably arises from the N→Sn intramolecular coordination which results in the increasing of the stability of the molecule.
基金Supported by National Science and Technology Support Program"Regional Development of Chinese Traditional Medicine Industry and Research of Characteristic Product"(2006BIA06A20)Personnel Services Business Action Plan of Ministry ofScience and Technology "Development of Series Products of Rare Edible Fungus"(2009GJD20012)~~
文摘[Objective] The mating genotype was studied and compared with esterase isozyme of Ganoderma lucidum populations between groups in order to clarify their differences in genetic relationship analysis. [Method] OWE-SOJ technique was applied to identify standard mating types and determinate mating genotype between groups of monokaryons isolates from 24 G. lucidum stains. Genetic relationships were analyzed by combined group mating genotype determination with esterase isozyme assay. [Result] All strains of G. lucidum could be divided into 7 large groups of the mating genotype. Four alleles of A factor, four alleles of B factor and one mixed alleles of A factor were found in this study. Distorted segregation ratio among monokaryon mycelia of G. lucidum had been observed in four kinds of mat- ing types to some extent. Twenty-eight different types of enzyme bands were determined in esterase isozyme test, Twenty-four strains of G. lucidum could be divided into 9 large groups through the cluster analysis when the genetic similarity coefficient was 0.73214. Comparing the results of mating genotype analysis and esterase isozyme analysis, it showed great similarity. [Conclusion] Mating genotype analysis could be used as an important supplementary method for strain identification and genetic diversity research.
基金supported by the National Natural Science Foundation of China(No.81370134).
文摘Objective Type A acute aortic dissection(TAAAD)is a dangerous and complicated condition with a high death rate before hospital treatment.Patients who are fortunate to receive prompt surgical treatment still face high in-hospital mortality.A series of post-operative complications further affects the prognosis.Post-operative pneumonia(POP)also leads to great morbidity and mortality.This study aimed to identify the prevalence as well as the risk factors for POP in TAAAD patients and offer references for clinical decisions to further improve the prognosis of patients who survived the surgical procedure.Methods The study enrolled 89 TAAAD patients who underwent surgical treatment in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei province,China from December 2020 to July 2021 and analyzed the perioperative data and outcomes of these patients.Logistic regression analyses were used to identify the risk factors for POP.Results In the study,31.5%of patients developed POP.Patients with POP had higher proportions of severe oxygenation damage,pneumothorax,reintubation,tracheotomy,renal replacement therapy,arrhythmia,gastrointestinal bleeding,and longer duration of mechanical ventilation,fever,ICU stay,and length of stay(all with P<0.05).The in-hospital mortality was 2.3%.Smoking,preoperative white blood cells,and intraoperative transfusion were the independent risk factors for POP in TAAAD.Conclusion Patients who underwent TAAAD surgery suffered poorer outcomes when they developed POP.Furthermore,patients with risk factors should be treated with caution.
基金Jiangsu Provincial Medical Youth Talent Foundation,No.QXRC201621Outstanding Youth Project supported by Nanjing Medical Science and Technology Development Foundation,No.JQX17003and Social Development Program of Jiangsu Province,No.BE2019604.
文摘BACKGROUND A 63-year-old female was diagnosed with acute Stanford type A aortic dissection.The patient had pain in the chest and back for 1 wk.The computed tomography angiography(CTA)showed Stanford type A aortic dissection(Myla type III aortic arch).The intimal tear was located at the top of the aortic arch and retrograded to the ascending aorta.CASE SUMMARY Preoperatively,a three-dimensional(3D)-printed model of the aortic arch was made according to CTA data.Then,under the guidance of the 3D-printed aortic model,a pre-fenestrated stent-graft was customized,and the diameter of the stent-graft was reduced intraoperatively by surgeons.3D printing,triple prefenestration,and reduced diameter techniques were used during the surgery.The CTA examinations were performed at the 3rd mo and 1st year after the surgery;the results showed that the aortic dissection was repaired without endoleak,and all three branches of the aortic arch remained unobstructed.CONCLUSION Applying the triple pre-fenestration technique for aortic arch lesions was feasible and minimally invasive in our case.The technique provides a new avenue for thoracic endovascular aortic repair of Stanford type A aortic dissection.
基金supported by the regional geology and mineralization research program of Heilongjiang province (HLJKD201417)
文摘In this paper, we report new whole-rock geochemical and zircon U-Pb data for monzogranites in the NE Xing＇an block. These data constrained the petrogenesis of C type （high Sr/Y） adakitic rocks and showed the spatial extent of the influence of the Mongol-Okhostsk ocean tectonic regime and the collision between the Jiamusi Massif and Songliao Terrane. New zircon laser-ablation inductivity coupled plasma mass spectrometry （LA-ICP-MS） U-Pb data indicated that the monzogranites in the studied area were emplaced in the Early Jurassic （～ 180 Ma）. These rocks were characterized by unusally high SiO2 （≥67.49）, and Sr （461-759 ppm）, but strikingly low Y （4.63-8.06 ppm） and HREE （∑HREE = 3.83-6.49 ppm, Yb = 0.5-0.77 ppm） contents, with therefore high Sr/Y （67.2-119） and （La/Yb）N （29.7-41.5） ratios, showing the geochemical characteristics of C type adakitic granite. The data displayed negligible Eu anomalies （Eu/Eu^＊ =0.77-1.08）, LREE-enriched and pronounced negative Nb and Ta anomalies. The C-type adakites in the studied area were most likely derived from the partial melting of a thickened lower continental curst. The magma source is most likely dominated by amphibolites and garnet amphibolites. In combination with previously-reported data from igneous rocks from the Mesozoic in NE China, we conclude that the Xing＇ an block was influenced by the Mongol-Okhotsk subduction tectonic system, and experiences compressive settings from the amalgamation of the Jiamusi block in the east of the CAOB.
文摘Objective.To introduce the properties of Chinese type A botulinum toxin(CBTXA,made by Lanzhou Institute of Biological Products),and its long?term effect for focal dystonia and hemifacial spasm.Method.The purity and recovery of crude and crystalline toxin were tested.Long?term data from305patients with hemifacial spasm(HFS),blepharospasm(BS)and cervical dystonia(CD)were evalu-ated and subgroups of patients received CBTXA injections between1994and2000in at least six sepa-rate treatment sessions,with follow up for2～8years.The therapeutic results of the last session CBTXA injections were analyzed in comparison with the first session.Result.CBTXA purity was high[(2.55～2.60)×10 7 LD50/mgPr ,A260/A280≤0.55,high molecular substance accounted for99.2%of total proteins].Long term treatment with CBTXA in patients with focal dystonia and HFS was not associated with any decline in benefit,and efficacy may improve slightly with repeat treatments.CBTXA is an excellent long-term treatment of HFS,BS and CD.Conclusion.We conclude that Chinese type A botulinum toxin is of botulinum toxin therapy quality standard according to results obtained from the basic study and long?term clinical applications.The re?injection of CBTXA significantly improves the quality of life of most patients and is a safe,effective and comparatively economical treatment for patients with focal dystonia and HFS.
文摘We report a case of multiple duodenal, pancreatic, and gastric carcinoids. A 67-year old woman was admitted to our hospital for treatment of a duodenal carcinoid. Laboratory tests revealed that the patient was associated with macrocytic anemia and hypergastrinemia, and type A gastritis was shown by gastrofiberscopy. During surgery, another tumor was incidentally found in the head of the pancreas. The tumors in the duodenum and pancreas were completely excised by pancreatoduodenectomy and immunohistologically diagnosed as gastrin-and serotonin-producing carcinoids, respectively. Pathological examination revealed that in addition to the grossly found carcinoids, there were subclinical carcinoids, one of which was an endocrine cell micronest, located in the stomach and duodenum. The tumors in the duodenum, pancreas, and stomach showed different characteristics from one another morphologically and immunochemically. Although no definitive evidence has been obtained, some sort of genetic anomaly may have been involved in this case, and hypergastrinemia due to duodenal gastrinoma may induce multiple gastric carcinoids.
文摘No definite consensus has currently been reached regarding the safety and efficacy of low-or high-frequency repetitive transcranial magnetic stimulation in the treatment of post-stroke muscle spasticity.The latest research indicates that when combined with local injections of botulinum toxin type A,it is more effective on post-stroke muscle spasticity than local injections of botulinum toxin type A alone.We designed a prospective,single-center,non-randomized,controlled clinical trial to investigate the safety and effica cy of different frequencies of repetitive transcranial magnetic stimulation combined with local injections of botulinum toxin type A in treating post-stroke lower limb muscle spasticity to determine an optimal therapeutic regimen.This trial will enroll 150 patients with post-stroke muscle spasticity admitted to the Department of Rehabilitation Medicine at the First Affiliated Hos pital of China Medical Unive rsity.All enrolled patients will undergo ro utine rehabilitation training and will be divided into five groups in-30 per group) according to the particular area of cerebral infa rction and treatment methods.G roup A:Patients with massive cerebral infarction will be given local injections of botulinum toxin type A and low-frequency(1 Hz)repetitive transcranial magnetic stimulation on the contralate ral side;G roup B:Patients with non-massive cerebral infarction will be given local injections of botulinum toxin type A and high-frequency(10-20 Hz) re petitive transcranial magnetic stimulation on the affected side;G roup C:Patients with massive/non-massive cerebral infarction will be given local injections of botulinum toxin type A;G roup D:Patients with massive cerebral infarction will be given low-frequency(1 Hz) repetitive transcranial magnetic stimulation on the contralate ral side;and G roup E:Patients with non-massive cerebral infa rction will be given high-frequency(10-20 Hz) repetitive transcranial magnetic stimulation on the affected side.The primary outcome measure of this trial is a modified Ashwo rth scale score from 1 day before treatment to 12 months after treatment.Secondary outcome measures include Fugl-M eyer Assessment of Lower Extremity,Visual Analogue Scale,modified Barthel index,and Berg Balance Scale scores for the same time as specified for primary outcome measures.The safety indicator is the incidence of adverse events at 3-12 months after treatment.We hope to draw a definite conclusion on whether there are diffe rences in the safety and efficacy of low-or high-frequency repetitive transcranial magnetic stimulation combined with botulinum toxin type A injections in the treatment of patients with post-stroke lower limb spasticity under strict grouping and standardized operation,thereby screening out the optimal therapeutic regimen.The study protocol was approved by the Medical Ethics Committee of the First Affiliated Hospital of China Medical University(approval No.[2021] 2021-333-3) on August 19,2021.The trial was registe red with the Chinese Clinical Trial Registry(Registration No.ChiCTR2100052180) on October 21,2021.The protocol version is 1.1.
文摘Clinically,it is widely recognized that surgical treatment is the preferred and reliable option for Stanford type A aortic dissection.Stanford type A aortic dissection is an emergent and serious cardiovascular disease characterized with an acute onset,poor prognosis,and high mortality.However,the incidences of postoperative complications are relatively higher due to the complexity of the disease and its intricate procedure.It has been considered that hypoxemia,one of the most common postoperative complications,plays an important role in having a worse clinical prognosis.Therefore,the effective intervention of postoperative hypoxemia is significant for the improved prognosis of patients with Stanford type A aortic dissection.
基金Project (No.491030-w10011) supported by the Zhejiang Provincial Natural Science Foundation of China
文摘Background and objective:Botulinum toxin type A(BoNT/A)is a metalloprotease that blocks synaptic transmission via the cleavage of a synaptosomal-associated protein of 25 kDa(SNAP-25).It has gained widespread use as a treatment for cerebral palsy and skeletal muscle hypertrophy.In China,Chinese botulinum toxin type A(CBTX-A),a type of BoNT/A,is in widespread clinical use.However,the changes in the morphological and biochemical properties of treated muscles and in remote muscles from the CBTX-A injection site are relatively unknown.Therefore,we investigated the changes in histomorphology and myosin heavy chain(MyHC)isoform composition and distribution in rat gastrocnemius muscles after intramuscular injection of CBTX-A.Methods:The weakness of the injected muscles was assessed periodically to identify their functional deficiency.Muscle slices were stained with hematoxylin-eosin(HE)and adenosine triphosphatase(ATPase).MyHC isoform composition was analyzed by sodium dodecyl sulfatepolyacrylamide gel electrophoresis(SDS-PAGE)to uncover changes in morphological and biochemical properties.Results:Our findings demonstrate that following injection of CBTX-A 5 U into rat gastrocnemius muscles,shifts in MyHC isoform composition emerged on the third day after injection and peaked in the fourth week.The composition remained distinctly different from that of the control group after the twelfth week.More specifically,there was a decrease in the proportion of the type IIb isoform and an increase in the proportions of type IIx,type IIa,and type I isoforms.Conclusions:Data revealed that CBTX-A led to a shift in MyHC composition towards slower isoforms and that the MyHC composition remained far from normal six months after a single injection.However,no noticeable remote muscle weakness was induced.
基金the National Natural Science Foundation of China[No.51976026]Dalian Innovative Funding of Science and Technology[No.2018J12SN076]the Fundamental Research Funds for the Central Universities[DUT20GJ203].
文摘Type A aortic dissection(AD)is one of the most serious cardiovascular diseases,whose risk predictors are controversial.The purpose of this research was to investigate how elongation accompanied by dilation of the ascending aorta(AAo)affects the relevant haemodynamic characteristics using image-based computational models.Five elongated AAos with different levels of dilation have been reconstructed based on the centerlines data of an elderly and an AD patient.Numerical simulations have been performed assuming an inflow waveform and a Windkessel model with three elements for all outflow boundaries.The numerical results have revealed that the elongation of AAo can disturb the systolic helical flow pattern between the root of AAo and the aortic arch.The helical flow inside the AAo starts to develop into a vortex flow when the elongated AAo becomes dilated.The vortex gives rise to a localized oscillatory shear index at the ostia of the brachiocephalic artery(BA)and the inner curve of the aortic arch.This study suggests that abnormal growth of AAo,especially accompanied by its moderate dilation,can be considered as morphological risk factors of AD.
文摘BACKGROUND Type A insulin resistance syndrome is a rare disorder caused by mutations in the gene encoding the insulin receptor.Its coexistence with ovarian serous papillary cystadenofibroma is even rarer.CASE SUMMARY A 14-year-old girl developed type A insulin resistance syndrome and showed high fasting insulin,glucose,and hemoglobin A1c(HbA1c)levels.The girl suffered from ovarian serous papillary cystadenofibroma.The laboratory results were as follows:fasting insulin was 2624.90 pmol/L and HbA1c was 8.5%.A heterozygous missense mutation on exon 20 of the insulin receptor gene(c.3601C>T,Arg1201Trp)was observed.The histopathological diagnosis was a cystic lesion that extended to the upper right uterus,indicating a right ovarian serous papillary cystadefibroma accompanied by focal interstitial hyperplasia.The patient was treated with metformin for over 6 mo.Additionally,laparoscopic resection(bilateral)of the ovarian lesion and laparoscopic intestinal adhesiolysis were performed under general anesthesia.Diet therapy combined with exercise was then initiated.The patient had an uneventful recovery.The patient also showed improved blood glucose control,with reduced levels of fasting insulin(857.84 pmol/L)and HbA1c(7.0%).CONCLUSION Insulin resistance may play a significant role in the induction of tumors.It is important to investigate further the association between insulin resistance and tumors and the underlying mechanism.
基金supported by National Defence Science&Technology Foundation of China(Grant No.K1301020706)
文摘What is pursued by multi-product type and variant volume(MPTVV)production is rapid response and quick switching,so that structure of transferring line in manufacturing system is no longer unalterable.Cell formation(CF)algorithm is the key technology of cellular manufacturing system(CMS).Currently,CF methods are mainly extended on the idea of group technology(GT)that covers a lot on analysis of resource capability matching and its algorithm.Various constraints are considered,but seldom utilized comprehensively.Aimed to the problem of manufacturing cell(MC)formation under MPTVV production mode,integrated formation technologies for typical MC as group type of cell(GC),flow type of cell(FC)and inherited cell(IC)are presented based on technical analysis of CF.Oriented to practical production constraints like delivery time,product batch,equipment ability,key machine,key part and machine sharing,etc,an integrated formation model is constructed and internal interrelations of these constraints are analyzed synthetically.Ulteriorly,formation goals of types of MCs and their formation procedures under joint effect of formation constraints and rules are spread.In case study,three highly balanced GC are formed first;then FC formation are implemented based on the same data which indicate good balancing effect of cell load and flow-style production for key tasks;When task is adjusted,a new scheme is constructed on the result of FC configuration by using IC formation method,and more optimal performance of flow-style production is manifested.The proposed comparative study of different type of cells strongly explains the validation of integrated MC formation in support of rapid manufacturing resource transformation under MPTVV production mode.
基金the National Natural Science Foundation of China(NO.20432030)for financial support.
文摘A new Diels-Alder type adduct mongolicin G （1） and a new flavone 5＇-（1＂, 1＂-dimethylallyl）-5,7,2＇,4＇-tetrahydroxyflavone （2） were isolated from the stem and root bark of Morus mongolica. Their structures were determined by spectroscopic analysis and chiroptical methods.
基金Supported by National Natural Science Foundation of China,No.81600375
文摘BACKGROUND A 46-year-old male underwent ascending aortic replacement,total arch replacement,and descending aortic stent implantation for Stanford type A aortic dissection in 2016.However,an intraoperative stent-graft was deployed in the false lumen inadvertently.This caused severe iatrogenic thoracic and abdominal aortic dissection,and the dissection involved many visceral arteries.CASE SUMMARY The patient had pain in the chest and back for 1 mo.A computed tomography scan showed that the patient had secondary thoracic and abdominal aortic dissection.The ascending aortic replacement,total arch replacement,and descending aortic stent implantation for Stanford type A aortic dissection were performed 2 years prior.An intraoperative stent-graft was deployed in the false lumen.Endovascular aneurysm repair was performed to address this intractable situation.An occluder was used to occlude the proximal end of the true lumen,and a covered stent was used to direct blood flow back to the true lumen.A three-dimensional printing technique was used in this operation to guide prefenestration.The computed tomography scan at the 1stmo after surgery showed that the thoracic and abdominal aortic dissection was repaired,with all visceral arteries remaining patent.The patient did not develop renal failure or neurological complications after surgery.CONCLUSION The total endovascular repair for false lumen stent-graft implantation was feasible and minimally invasive.Our procedures provided a new solution for stent-graft deployed in the false lumen,and other departments may be inspired by this case when they need to rescue a disastrous stent implantation.
