Clinical observation of 36 patients with chronic nephritis proteinuria treated with Zhuangshen Gujing decoction

Objective:Our goal was to examine the impact of Zhuangshen Gujing decoction on proteinuria associated with chronic nephritis.Methods:72 patients with chronic nephritis proteinuria were divided randomly into two groups;one group was treated with Zhuangshen Gujing(n=36;treatment group)and the other group was treated with irbesartan(n=36;control group).After 6 months’treatment,urine protein and renal function were evaluated.Results:Proteinuria resolved completely in four patients in the treatment group;complete disease resolution was observed only among three individuals in the control group.Of the 32 cases remaining in the treatment group,15 had substantial responses to Zhuangshen Gujing decoction,9 had partial responses,and 8 had no response to treatment;the overall the response rate was 73.33%.Among the 33 cases remaining in the control group,12 had a substantial response to irbesartan,5 had a partial response,and 16 had no response to treatment;the overall response rate among the controls was 57.67%(P=0.031).We also observed statistically significant differences with respect to quantitative comparisons of urinary protein at 24 days after a single course of treatment(P=0.001).Conclusion:Zhuangshen Gujing decoction is effective in treating chronic nephritis proteinuria.

生物制剂在炎症性肠病治疗中的矛盾性肠外表现研究进展

炎症性肠病(inflammatory bowel diseases,IBD)是一类由多基因及环境因素共同引起并加速免疫-肠道-微生态轴紊乱的遗传相关性疾病。病变常累及多个器官及系统.生物制剂是治疗IBD及其肠外表现的重要手段,目前研究多提示生物制剂能够为患者带来益处,但治疗过程中出现矛盾性皮肤病变、关节病变、眼部疾病、肺部病变等表现或病变在临床实践中容易被忽略,进而延误患者病情、影响患者生存质量。通过总结当前生物制剂应用出现的矛盾性肠外表现的临床特点及诊疗经验,旨在提高临床医师的认识,早期辨别这一临床表现,避免延误患者病情。

社区衰弱和肌少症老年人膳食营养干预的障碍和促进因素:质性 研究的meta整合

目的随着老龄化社会进程加速,老年人躯体衰弱和肌少症的患病率逐年上升,并带来诸多不良影响。膳食营养是防治躯体衰弱和肌少症的重要方式,但在社区环境中实施膳食营养干预受到诸多复杂因素影响。本综述旨在对相关研究中的促进和障碍因素进行系统综述,为制订相关健康管理方案提供参考。方法在Pub Med. .Web of Science 、Medline(Ovid). Embase(Ovid)和Cochrane Library 数据库进行检索,发表时间限定为建库至2023年1月。使用主题词和自由词组合完成检索。使用英国牛津大学循证医学中心质性研究质量评价工具(the Critical Appraisal Skills Program Qualiative Sudies Checklist)对 纳入研究进行质量评价。利用社会生态建模框架对提取的信息进行编码和分析。本综述方案已在PROSPERO注册(CRD42022381339)。结果共纳入10项研究。其中,4项研究仅进行营养相关干预,而膳食营养和运动干预相结合的有6项。根据社会生态模型,从个体特征、外部环境和干预措施3个层面对促进和障碍因素进行了总结,包含10个副主题。结论对社区中的躯体衰弱和肌少症老年人实施膳食营养干预措施时,应整合个人内部动机和外部支持,为参与者制订“量身定制”的干预方案,并最大程度地优化可利用的人力和物理资源。

“Glass-quake”in elastically loaded bulk metallic glasses

Amorphous solids exhibit scale-free avalanches,even under small external loading,and thus can work as suitable systems to study critical behavior and universality classes.The abundance of scale-free avalanches in the entire elastic tension regime of bulk metallic glass(BMG)samples has been experimentally observed using acoustic emission(AE)measurements.In this work,we compare the statistics of avalanches with those of earthquakes,and find that they both follow the Gutenberg–Richter law in the statistics of energies and Omori’s law of aftershock rates,and share the same characteristics in the distribution of recurrence times.These resemblances encourage us to propose the term“glass-quake”to describe avalanches in elastically loaded BMGs.Furthermore,our work echoes the potential universality of critical behavior in disordered physical systems from atomic to planetary scales,and motivates the use of elastic loaded BMGs as valuable laboratory simulators of seismic dynamics.

Doping PCBM with fullerene phosphinate derivatives enhances the interface energy alignment and synergistic passivation capability

Phenyl-C_(61)-butyric acid methyl ester(PCBM) serves as a common electron transport layer(ETL) in inverted p-i-n structure perovskite solar cells(IPSCs),yet energy barriers and insufficient passivation at the PCBM-perovskite interface hinder device effectiveness and durability.In this study,we present a series of novel Fullerene Phenylacid Ester Derivatives(FPEDs:FPP,FTPP,FDPP) incorporated into PCBM.Our investigations illustrate that FPEDs effectively act to passivate the perovskite surface by forming robust interactions with uncoordinated Pb^(2+) ions via the phosphine oxide groups present in their molecular structures,thereby enhancing the stability of the devices.Moreover,these additives elevate the energy level of the lowest unoccupied molecular orbital(LUMO) of ETL,diminish the electron injection barrier,and enhance the efficiency of interlayer electron transport.Incorporating FPEDs enhances ETL coverage on the perovskite layer,reducing leakage current significantly.Notably,Devices with PCBM/FTPP achieved a peak PCE of 23.62% and showed superior stability,maintaining 96,8% of the initial PCE after 500 h,while control devices retained merely 80.7% over the same period.

Hesperidin ameliorates H_(2)O_(2)-induced bovine mammary epithelial cell oxidative stress via the Nrf2 signaling pathway

Background Hesperidin is a citrus flavonoid with anti-inflammatory and antioxidant potential. However, its protective effects on bovine mammary epithelial cells(b MECs) exposed to oxidative stress have not been elucidated.Results In this study, we investigated the effects of hesperidin on H_(2)O_(2)-induced oxidative stress in b MECs and the underlying molecular mechanism. We found that hesperidin attenuated H_(2)O_(2)-induced cell damage by reducing reactive oxygen species(ROS) and malondialdehyde(MDA) levels, increasing catalase(CAT) activity, and improving cell proliferation and mitochondrial membrane potential. Moreover, hesperidin activated the Keap1/Nrf2/ARE signaling pathway by inducing the nuclear translocation of Nrf2 and the expression of its downstream genes NQO1 and HO-1, which are antioxidant enzymes involved in ROS scavenging and cellular redox balance. The protective effects of hesperidin were blocked by the Nrf2 inhibitor ML385, indicating that they were Nrf2 dependent.Conclusions Our results suggest that hesperidin could protect b MECs from oxidative stress injury by activating the Nrf2 signaling pathway, suggesting that hesperidin as a natural antioxidant has positive potential as a feed additive or plant drug to promote the health benefits of bovine mammary.

Hybrid HMX multi-level assembled under the constraint of 2D materials with efficiently reduced sensitivity and optimized thermal stability

The interfacial interaction between HMX molecules and coating materials is the key to the safety performance of explosives and has received extensive attention.However,screening suitable coating agents to enhance the interfacial effect to obtain high-energy and low-sensitivity explosives has long been a major challenge.In this work,HMX-PEI/rGO/g-C_(3)N_(4)(HPrGC)composites were innovatively prepared by a multi-level coating strategy of two-dimensional graphite rGO and g-C_(3)N_(4).The g-C_(3)N_(4) used for desensitization has a richπ-conjugated system and shows outstanding ability in reducing friction sensitivity.The hierarchical structure of HPrGC formed by electrostatic self-assembly andπ-πstacking can effectively dissipate energy accumulation under heat and mechanical stimulation through structural evolution,thus exhibiting a prominent synergistic desensitization effect on HMX.The results show that rGO/gC_(3)N_(4) coating has no effect on the crystal structure and chemical structure of HMX.More importantly,the perfect combination of g-C_(3)N_(4) and rGO endows HPrGC with enhanced thermal stability and ideal mechanical sensitivity(IS:21 J,FS:216 N).Obviously,the new fabrication of HPrGC enriches the variety of desensitizer materials and helps to deepen the understanding of the interaction between explosives and coatings.

Bioinformatics Analysis Revealed Potential Tumor Suppressors (KLF4/CGN), Oncogenes (SHH/LIF) and Biomarkers of Asian Stomach Adenocarcinoma

Stomach adenocarcinoma (STAD) is the fifth most prevalent cancer and the third leading cause of cancer-related death in the world and is more common in Asia than in most Western countries. There is an urgent need to identify potential novel oncogenes and tumor suppressor genes, and biomarkers for STAD. 6652 differentially expressed genes were identified between STAD and normal samples based on the transcriptome data analysis of the TCGA and GEO databases. 13 key modules were identified in STAD by WGCNA analysis. 293 potential STAD associated genes were identified from intersection by Venn Diagram. The 293 intersected genes were enriched in cell cortex and infection by GO and KEGG analysis. 10 hub genes were identified from PPI and Cytoscape analyses of the intersected genes. KLF4/CGN low and SHH/LIF high expression were associated with short overall survival of Asian STAD patients. Bioinformatics analysis revealed potential novel tumor suppressors (KLF4/CGN), oncogenes (SHH/LIF) and biomarkers for diagnosis, therapy and prognosis of STAD, specifically for Asian patients.

Oncolytic Engineering of ICP34.5 and LAT of Herpes Simplex Virus Type 1

Oncolytic virus (OV) is a kind of virus that can preferentially infect and kill tumor cells. The second oncolytic virus drug was oncolytic herpes simplex virus (oHSV) Talimogene Laherparepvec (T-VEC). HSV-1 infectious cell culture protein 34.5 (ICP34.5) and latency-associated transcript (LAT) genes are closely related to virus selective infection and latent infection. Their engineering is essential for constructing efficient and safe oHSV. We summarized the mechanisms of ICP34.5 and LAT in the course of HSV-1 infection and reviewed the engineered oHSVs. We are aimed to provide an insight in developing oHSV in the future.

炎症性肠病治疗中生物制剂的个体化选择

炎症性肠病(inflammatory bowel disease,IBD)是一种可累及全消化道的慢性非特异性疾病.越来越多针对不同靶点的生物制剂开始广泛用于IBD的治疗.IBD患者生物制剂的选择需结合不同生物制剂的特征,充分权衡风险和获益,医患共同参与决策,最终才能制定个体化的治疗方案.本文将从不同生物制剂的作用机制及临床应用、风险权衡、抗-TNF治疗失败的挽救治疗及血药浓度监测四个方面来探讨如何个体化选择生物制剂.

胸腔镜手术治疗肋骨骨纤维异常增殖症的可行性研究(附15例报告)

目的探讨胸腔镜微创手术治疗肋骨骨纤维异常增殖症的安全性、疗效及优势。方法回顾性分析2013年2月-2020年8月中南大学湘雅二医院胸外科收治的15例肋骨骨纤维异常增殖症患者的临床资料,患者均采用胸腔镜微创手术方法治疗。其中,男7例,女8例,年龄16~52岁,平均(36.7±12.6)岁。病变位于左侧6例,右侧9例;共17根肋骨发生病变,位于第4肋1例,第5肋5例,第6肋5例,第7肋3例,第8肋2例,第9肋1例。无合并奥尔布赖特综合征患者。手术均由同一组高年资医师完成。采用胸腔镜单操作孔进行手术(2孔,一孔为观察孔,一孔为操作孔),胸腔镜下定位病变肋骨,在胸腔内操作切除。结果15例患者均顺利完成手术。手术时间45~72 min,平均(61.0±10.5)min。术后病理均为肋骨骨纤维异常增殖症。术后住院时间3~5 d,平均(3.0±1.0)d。术后疼痛评分1~5分,平均(3.3±1.2)分。术中术后无严重并发症。术后随访12~36个月,平均(24.5±6.2)个月,所有患者未见复发。结论胸腔镜手术治疗肋骨骨纤维异常增殖症安全、可靠,创伤小,疗效满意,值得推广应用。

Effectiveness of Acupuncture for Alzheimer's Disease: An Updated Systematic Review and Meta-analysis

Acupuncture has reportedly improved memory and cognitive impairment in both animal and clinical studies. It may be an effective treatment for Alzheimer's disease (AD). The purpose of this meta-analysis was to review the effectiveness of acupuncture for the treatment of AD. Eight databases were searched for articles published up to and including July 2017, and 13 studies fulfilling the inclusion criteria were identified. The main outcomes assessed were clinical efficacy rate, Mini-Mental State Examination score, Ability of Daily Living Scale score, Alzheimer's Disease Assessment Scale-Cognition score, Hasegawa's Dementia Scale (HDS) score, and adverse events. The methodological quality of the articles was assessed using Cochrane's risk of bias. All the studies compared the efficacy of acupuncture with that of medication, and were published in Chinese journals. Meta-analysis revealed that acupuncture yielded positive results as determined via all the indexes scored except the HDS (95% CI -0.26 to 0.90, Z=0.35, P=0.73). Only one of the studies reported adverse events associated with acupuncture and medication. The rate of adverse events in the medication group was 13%. In most of the studies assessed in the current metaanalysis, acupuncture alone was better than conventional western medicines for the treatment of AD.

硬段类型和含量对嵌段聚氨酯脲性能的影响

以聚己二酸乙二醇-丙二醇酯二醇(PEPA)为软段,分别采用4种二胺扩链剂和3种二异氰酸酯为硬段,通过预聚体法合成了一系列不同硬段结构和含量的聚氨酯脲弹性体,并采用红外光谱、热失重分析、差示扫描量热和拉伸测试等手段,研究了硬段类型及含量对聚氨酯脲性能的影响。结果表明,在软段结构一致,硬段含量接近的情况下,兼具柔性和刚性的硬段有助于提升聚氨酯脲的力学性能、热学性能和微相分离程度。几种二胺扩链剂和二异氰酸酯中,由二苯基甲烷二异氰酸酯(MDI)和4,4'-二氨基二苯醚(ODA)构成的硬段性能最佳;在软、硬段结构一致的情况下,硬段含量对聚氨酯脲性能影响明显。随着硬段含量增加,聚氨酯脲的拉伸强度、微相分离程度先增大后减小,5%热失重温度和断裂伸长率逐渐下降。当PEPA/MDI/ODA摩尔比为1∶0.5∶0.5(硬段含量31.7%),聚氨酯脲拉伸强度达51.5 MPa,断裂伸长率为709%,5%热失重温度为282.7℃,性能最佳。

Blast response of continuous-density graded cellular material based on the 3D Voronoi model

One-dimensional blast response of continuous-density graded cellular rods was investigated theoretically and numerically. Analytical model based on the rigid-plastic hardening(R-PH) model was used to predict the blast response of density-graded cellular rods. Finite element(FE) analysis was performed using a new model based on the 3 D Voronoi technique. The FE results have a good agreement with the analytical predictions. The blast response and energy absorption of cellular rods with the same mass but different density distributions were examined under different blast loading. As a blast resistance structure, cellular materials with high energy absorption and low impulse transmit is attractive. However, high energy absorption and low impulse transmit cannot be achieved at the same time by changing the density distribution. The energy absorption capacity increases with the initial blast pressure and characteristic time of the exponentially decaying blast loading. By contract, when the blast loading exceeds the resistance capacity of cellular material, the transmitted stress will be enhanced which is detrimental to the structure being protected.

Microstructure and mechanical properties of Ti−Nb−Fe−Zr alloys with high strength and low elastic modulus

Zr was added to Ti−Nb−Fe alloys to develop low elastic modulus and high strengthβ-Ti alloys for biomedical applications.Ingots of Ti−12Nb−2Fe−(2,4,6,8,10)Zr(at.%)were prepared by arc melting and then subjected to homogenization,cold rolling,and solution treatments.The phases and microstructures of the alloys were analyzed by optical microscopy,X-ray diffraction,and transmission electron microscopy.The mechanical properties were measured by tensile tests.The results indicate that Zr and Fe cause a remarkable solid-solution strengthening effect on the alloys;thus,all the alloys show yield and ultimate tensile strengths higher than 510 MPa and 730 MPa,respectively.Zr plays a weak role in the deformation mechanism.Further,twinning occurs in all the deformed alloys and is beneficial to both strength and plasticity.Ti−12Nb−2Fe−(8,10)Zr alloys with metastableβphases show low elastic modulus,high tensile strength,and good plasticity and are suitable candidate materials for biomedical implants.

Advances in electrical impedance tomography-based brain imaging

Novel advances in the field of brain imaging have enabled the unprecedented clinical application of various imaging modalities to facilitate disease diagnosis and treatment. Electrical impedance tomography(EIT) is a functional imaging technique that measures the transfer impedances between electrodes on the body surface to estimate the spatial distribution of electrical properties of tissues. EIT offers many advantages over other neuroimaging technologies,which has led to its potential clinical use. This qualitative review provides an overview of the basic principles,algorithms, and system composition of EIT. Recent advances in the field of EIT are discussed in the context of epilepsy,stroke, brain injuries and edema, and other brain diseases. Further, we summarize factors limiting the development of brain EIT and highlight prospects for the field. In epilepsy imaging, there have been advances in EIT imaging depth,from cortical to subcortical regions. In stroke research, a bedside EIT stroke monitoring system has been developed for clinical practice, and data support the role of EIT in multi-modal imaging for diagnosing stroke. Additionally, EIT has been applied to monitor the changes in brain water content associated with cerebral edema, enabling the early identification of brain edema and the evaluation of mannitol dehydration. However, anatomically realistic geometry,inhomogeneity, cranium completeness, anisotropy and skull type, etc., must be considered to improve the accuracy of EIT modeling. Thus, the further establishment of EIT as a mature and routine diagnostic technique will necessitate the accumulation of more supporting evidence.

Fabrication of cobalt aluminum-layered double hydroxide nanosheets/carbon spheres composite as novel electrode material for supercapacitors

A new design route was presented to fabricate cobalt aluminum-layered double hydroxide(CoAl-LDH)thin layers whichgrow on carbon spheres(CSs)through a growth method.The CoAl-LDH thin layers consist of nanoflakes with a thickness of20nm.The galvanostatic charge-discharge test of the CoAl-LDH/CSs composite shows a great specific capacitance of1198F/g at1A/g(based on the mass of the CoAl-LDH/CSs composite)in6mol/L KOH solution,and the composite displays an impressive specificcapacitance of920F/g even at a high current density of10A/g.Moreover,the composite remains a specific capacitance of928F/gafter1000cycles at2A/g,and the specific capacitance retention is84%,indicating that the composite has high specific capacitance,excellent rate capability and good cycling stability in comparison to pristine CoAl-LDH.

Optimal design of a novel cylindrical sandwich panel with double arrow auxetic core under air blast loading

The increasing threat of explosions on the battle field and the terrorist action requires the development of more effective blast resistance materials and structures.Curved structure can support the external loads effectively by virtue of their spatial curvature.In review of the excellent energy absorption property of auxetic structure,employing auxetic structure as core material in curved sandwich shows the potential to improve the protection performance.In this study,a novel cylindrical sandwich panel with double arrow auxetic(DAA) core was designed and the numerical model was built by ABAQUS.Due to the complexity of the structure,systematic parameter study and optimal design are conducted.Two cases of optimal design were considered,case1 focuses on reducing the deflection and mass of the structure,while case2 focuses on reducing the deflection and increasing the energy absorption per unit mass.Parameter study and optimal design were conducted based on Latin Hypercube Sampling(LHD)method,artificial neural networks(ANN) metamodel and the nondominated sorting genetic algorithm(NSGA-Ⅱ).The Pareto front was obtained and the cylindrical DAA structure performed much better than its equal solid panel in both blast resistance and energy absorption capacity.Optimization results can be used as a reference for different applications.

High expression of anti-apoptotic protein Bcl-2 is a good prognostic factor in colorectal cancer: Result of a metaanalysis

AIM To systematically evaluate the prognostic-predictive capability of Bcl-2 in colorectal cancer(CRC).METHODS A systematic literature search was conducted using Pub Med,Web of Science and EMBASE databases. Any eligible study must meet the following criteria:(1) bcl-2 expression was evaluated in human CRC tissues by immunohistochemistry;(2) assessment of the relationships between bcl-2 expression and overall survival(OS),disease free survival(DFS),recurrent free survival(RFS) or clinic-pathological characteristics of CRC was included;(3) sufficient information was provided to estimate the hazard ratio(HR) or odds ratio and their 95% confidence intervals(CIs); and(4) the study was published in English. The impact of Bcl-2 expression on survival of CRC patients were evaluated through this meta-analysis.RESULTS A total of 40 eligible articles involving 7658 patients were enrolled in our final analysis. We drew the conclusion that Bcl-2 high expression was significantly correlated with favorable OS(pooled HR = 0.69,95%CI: 0.55-0.87,P = 0.002) and better DFS/RFS(pooled HR = 0.65,95%CI: 0.50-0.85,P = 0.001). Additionally,the subgroup analysis suggested that Bcl-2 overexpression was significantly associated withprognosis(OS) especially in patients came from Europe and America but not Asian and patients who did not receive any adjuvant therapy before surgery. Finally,our present results indicated that expression of bcl-2 protein was associated with high differentiation grade and A/B Ducks' stage. CONCLUSION Bcl-2 high expression was significantly correlated with favorable OS and better DFS/RFS. Hence,we propose that Bcl-2 may be a valuable prognostic-predictive marker in CRC.

A correlation of computed tomography perfusion and histopathology in tumor edges of hepatocellular carcinoma

BACKGROUND： The peripheral morphologic characteristics of hepatocellular carcinoma （HCC） reflect tumor growth patterns. Computed tomography （CT） perfusion is a new method to analyze hemodynamic changes in tissues. We assessed the relationship between CT perfusion and histopathologic findings in the periphery of HCC lesions. METHODS： Non-contrast CT, enhanced dual-phase CT, and CT perfusion were performed on 77 subjects （47 patients and 30 controls）. Based on the imaging findings of enhanced dual- phase CT, the tumor edges were classified into three types： type Ⅰ （sharp）; type Ⅱ （blurry）; and type Ⅲ （mixed）. The CT perfusion parameters included hepatic blood flow, hepatic arterial fraction, hepatic arterial perfusion, and hepatic portal perfusion. The tissue sections from resected specimens were subjected to routine hematoxylin and eosin staining and immunohistochemical staining for CD34. The correlations between microvessel density （MVD） and the CT perfusion parameters were analyzed using Pearson＇s product-moment correlation coefficient. Changes in the perfusion parameters in tumor edges of different tumor types were evaluated. RESULTS： Type Ⅰ （sharp）： the pathologic findings showed fibrous connective tissue capsules in the tumor edges, and an MVD 〈30/ram2. Type Ⅱ （blurry）： the histology showed that the edges were clear with no capsules and an MVD 〉30/ram2. Type Ⅲ （mixed）： the pathology was similar to that of types I and II, and an MVD 〉30/mm~. Hepatic blood flow, hepatic arterial fraction, hepatic arterial perfusion, and hepatic portal perfusion were significantly increased in the tumor edges of HCC patients compared to those of the controls （P〈0.05）. The correlation between CT perfusion parameters and MVD was higher in blurry tumor edges of type II than in those of types Ⅰ or Ⅲ. CONCLUSION： CT perfusion imaging of tumor edges may be helpful in revealing histopathological features, and indirectly reflect angiogenic changes of HCCs.