药物涂层球囊治疗对冠状动脉再狭窄老年患者靶血管内膜反应、靶病变血运重建的影响

目的探讨药物涂层球囊治疗冠状动脉再狭窄老年患者对靶血管内膜反应、靶病变血运重建的影响及安全性。方法选取2017年11月—2019年1月锦州医科大学附属第一医院收治的冠状动脉再狭窄老年患者198例,根据随机数字表法分为研究组与对照组,每组99例。对照组采取切割球囊治疗,研究组采取药物涂层球囊治疗。对两组治疗前和治疗3个月、6个月后靶血管内膜反应、心功能、中国心血管病人生活质量评定问卷(CCQQ)评分、不良心血管事件发生率、管腔再狭窄率及靶病变血运重建发生率进行比较。结果两组最小腔径、最小管腔面积比较,差异有统计学意义(P<0.05),两组左室射血分数、NT-proBNP及每搏输出量比较,差异有统计学意义(P<0.05),两组不良心血管事件总发生率比较,差异无统计学意义(P>0.05),对照组靶病变血运重建发生率高于研究组(P<0.05)。两组CCQQ评分比较,差异有统计学意义(P<0.05)。结论药物涂层球囊治疗冠状动脉再狭窄老年患者可明显改善靶血管内膜反应,降低靶病变血运重建发生率,促进心功能恢复,可以改善生活质量。

The subsurface structure and stratigraphy of the Chang’E-4 landing site:orbital evidence from small craters on the Von Kármán crater floor

Chang’E-4(CE-4)successfully landed on the floor of the Von Kármán crater within the South Pole-Aitken basin(SPA).One of its scientific objectives is to determine the subsurface structure and the thickness of lunar regolith at the landing site and along the traverse route of the Yutu-2 rover.Using orbital data,we employed small craters(diameters<1 km)on the floor of the Von Kármán crater as probes to investigate the subsurface structure and stratigraphy of the CE-4 landing site.In this study,40 dark-haloed craters that penetrate through the surface Finsen ejecta and excavate underlying mare deposits were identified,and 77 bright ray craters that expose only the underlying fresh materials but do not penetrate through the surface Finsen ejecta were found.The excavation depths of these craters and their distances from the Finsen crater center were calculated,and the thickness distribution of Finsen ejecta on the Von Kármán floor was systematically investigated.The boundary between Finsen ejecta and underlying mare basalt at the CE-4 landing site is constrained to a depth of 18 m.We have proposed the stratigraphy for the CE-4 site and interpreted the origins of different layers and the geological history of the Von Kármán crater.These results provide valuable geological background for interpreting data from the Lunar Penetrating Radar(LPR)and Visible and Near-infrared Imaging Spectrometer(VNIS)on the Yutu-2 rover.The CE-4 landing site could provide a reference point for crater ejecta distribution and mixing with local materials,to test and improve ejecta thickness models according to the in situ measurements of the CE-4 LPR.

Liver transplantation for late-onset ornithine transcarbamylase deficiency:A case report

BACKGROUND Ornithine transcarbamylase deficiency(OTCD)is an X-linked inherited disorder and characterized by marked elevation of blood ammonia.The goal of treatment is to minimize the neurological damage caused by hyperammonemia.OTCD can be cured by liver transplantation(LT).Post-transplant patients can discontinue anti-hyperammonemia agents and consume a regular diet without the risk of developing hyperammonemia.The neurological damage caused by hyperammonemia is almost irreversible.CASE SUMMARY An 11.7-year-old boy presented with headache,vomiting,and altered consciousness.The patient was diagnosed with late-onset OTCD.After nitrogen scavenging treatment and a protein-free diet,ammonia levels were reduced to normal on the third day of admission.Nevertheless,the patient remained in a moderate coma.After discussion,LT was performed.Following LT,the patient’s blood ammonia and biochemical indicators stabilized in the normal range,he regained consciousness,and his nervous system function significantly recovered.Two months after LT,blood amino acids and urine organic acids were normal,and brain magnetic resonance imaging showed a decrease in subcortical lesions.CONCLUSION LT can significantly improve partial neurological impairment caused by late-onset OTCD hyperammonemic encephalopathy,and LT can be actively considered when early drug therapy is ineffective.

Data processing for the Active Particle-induced X-ray Spectrometer and initial scientific results from Chang'e-3 mission

The Active Particle-induced X-ray Spectrometer （APXS） is an important payload mounted on the Yutu rover, which is part of the Chang＇e-3 mission. The sci- entific objective of APXS is to perform in-situ analysis of the chemical composition of lunar soil and rock samples. The radioactive sources, 55Fe and 109Cd, decay and produce a-particles and X-rays. When X-rays and a-particles interact with atoms in the surface material, they knock electrons out of their orbits, which release energy by emitting X-rays that can be measured by a silicon drift detector （SDD）. The elements and their concentrations can be determined by analyzing their peak energies and in- tensities. APXS has analyzed both the calibration target and lunar soil once during the first lunar day and again during the second lunar day. The total detection time lasted about 266 min and more than 2000 frames of data records have been acquired. APXS has three operating modes： calibration mode, distance sensing mode and detection mode. In detection mode, work distance can be calculated from the X-ray counting rate collected by SDD. Correction for the effect of temperature has been performed to convert the channel number for each spectrum to X-ray energy. Dead time correction is used to eliminate the systematic error in quantifying the activity of an X-ray pulse in a sample and derive the real count rate. We report APXS data and initial results during the first and second lunar days for the Yutu rover. In this study, we analyze the data from the calibration target and lunar soil on the first lunar day. Seven major elements, including Mg, A1, Si, K, Ca, Ti and Fe, have been identified. Comparing the peak areas and ratios of calibration basalt and lunar soil the landing site was found to be depleted in K, and have lower Mg and A1 but higher Ca, Ti, and Fe. In the future, we will obtain the elemental concentrations of lunar soil at the Chang＇e-3 landing site using APXS data.

细胆管癌的临床病理特征

细胆管癌(cholangiolocellular carcinoma,CLC)由于其特殊的细胞起源,具有肝细胞癌和胆管细胞癌的双重临床病理和影像学特点,由于惰性生长的特点、预后相对较好,其生长特点和临床特征明显有别于传统的肝内胆管癌(intrahepatic cholangiocarcinoma,ICC),是一种特殊类型的原发性肝脏恶性肿瘤.在细胞起源、临床病理特征、生长特点和预后等方面与传统意义的ICC是两种截然不同的疾病,但国内外有关ICC的研究中往往将两者混为一谈,没有明确的区分.本文就CLC临床病理特征进行综述,以期引发大家对这一问题的重视,并加强相关的研究.

Laboratory verification of the Active Particle-induced X-ray Spectrometer(APXS) on the Chang'e-3 mission

In the Chang＇e-3 mission, the Active Particle-induced X-ray Spectrometer（APXS） on the Yutu rover is used to analyze the chemical composition of lunar soil and rock samples. APXS data are only valid are only if the sensor head gets close to the target and integration time lasts long enough. Therefore, working distance and integration time are the dominant factors that affect APXS results. This study confirms the ability of APXS to detect elements and investigates the effects of distance and time on the measurements. We make use of a backup APXS instrument to determine the chemical composition of both powder and bulk samples under the conditions of different working distances and integration times. The results indicate that APXS can detect seven major elements, including Mg, Al, Si, K, Ca, Ti and Fe under the condition that the working distance is less than 30 mm and having an integration time of 30 min. The statistical deviation is smaller than 15%. This demonstrates the instrument＇s ability to detect major elements in the sample. Our measurements also indicate the increase of integration time could reduce the measurement error of peak area, which is useful for detecting the elements Mg, Al and Si. However, an increase in working distance can result in larger errors in measurement, which significantly affects the detection of the element Mg.

Mapping and compositional analysis of mare basalts in the Aristarchus region of the Moon using Clementine data

The process of accurately defining and outlining mare basalt units is nec- essary for constraining the stratigraphy and ages of basalt units, which are used to determine the duration and the flux of lunar volcanism. We use a combination of Clementine＇s five-band ultraviolet/visible data and Ti02 and FeO abundance distri- bution maps to define homogenous mare basalt units and characterize their composi- tional variations （with maturity） in the Aristarchus region. With 20 groups of distinct mare basaltic soils identified using the method in this paper, six additional spectrally defined areas and five basaltic units are constructed, and their mineralogic quanfiza- tion values provide new constraints on their temporal and spatial evolution. Our results indicate that the Aristarchus region has diverse basalt units and a complex history of volcanic evolution. We also demonstrate that the techniques, from which spectrally distinct mare basalts can be mapped, performed well in this study and can be confi- dently expanded to other mare regions of the Moon.

Possible aerosol transmission of COVID-19 and special precautions in dentistry

Since its emergence in December 2019,corona virus disease 2019(COVID-19)has impacted several countries,affecting more than 90 thousand patients and making it a global public threat.The routes of transmission are direct contact,and droplet and possible aerosol transmissions.Due to the unique nature of dentistry,most dental procedures generate significant amounts of droplets and aerosols,posing potential risks of infection transmission.Understanding the significance of aerosol transmission and its implications in dentistry can facilitate the identification and correction of negligence in daily dental practice.In addition to the standard precautions,some special precautions that should be implemented during an outbreak have been raised in this review.

Injectable Supramolecular Hydrogels via Inclusion Complexation of m PEG-grafted Copolyglutamate with α-Cyclodextrin

A series of monomethoxy poly（ethylene glycol） （mPEG） grafted copolyglutamates （PmPEGs） were synthesized through ring-opening polymerization （ROP） followed by click chemistry. Supramolecular hydrogels based on polymer inclusion complexes （ICs） between PmPEG and α-cyclodextriri （α-CD） were prepared in aqueous solution. The rheological measurements indicated their gelation properties were affected by several factors including the mPEG length, graft density and the sample concentration. These hydrogels displayed thermo-sensitive gel-sol transition under appropriate conditions due to the reversible mPEG and α-CD inclusion complexation. These hydrogels also showed pH-sensitive behavior due to the deprotonate of carboxylic acid side groups. The ICs formation of a channel-type crystalline structure induced gelation mechanism was verified by various techniques. In vitro cytotoxicity assays demonstrated that the supramolecular hydrogels are nontoxic and cytocompatible.

Dual Thermal-and p H-responsive Polypeptide-based Hydrogels

Smart hydrogels have received increasing attention for their great potential for the applications in many fields. Herein, we report a facile approach to prepare a class of dual-responsive hydrogels assembled from synthetic statistical/block thermal-responsive copoly（L-glutamate）s copolymerized with poly（ethylene glycol）, which were prepared by ring-opening polymerization（ROP） and post-modification strategy. The incorporation of oligo（ethylene glycol）（OEG） and glutamic acid residues offers the gels with thermal-and p H-responsive properties simultaneously. We have systematically studied the influence of both temperature and p H on the gelation behaviors of these copolymers. It is found that the increase of glutamic acid content and solution p H values can significantly suppress the gelation ability of the samples. Circular dichroism（CD） results show that the α-helix conformation appears to be the dominant secondary conformation. More interestingly, the gelation property of the block copolymer with statistical thermal-responsive copoly（L-glutamate）s shows greater dependence on p H as compared to that with block segments due to the distinct morphology of the self-assemblies. The obtained hydrogels exhibit p H-dependent and thermal-responsive gelation behaviors, which enable them as an ideal smart hydrogel system for biomedical applications.

Thermal and Redox Dual Responsive Poly(L-glutamate)with Oligo(ethylene glycol)Side-chains

A series of poly（L-glutamate）s grafted with oligo（ethylene glycol） （OEG） side-chains through the thioether linkages （PALGn-g-EGx, x = 2, 3 and 4） were prepared by ring-opening polymerization （ROP） of γ-allyl-L-glutamate N-carboxyanhydride （ALG-NCA） and thiol-ene photoaddition. The chemical structures and physical properties were characterized by 1H-NMR, Fourier transform infrared （FTIR）, circular dichroism （CD）, etc. The PALGn-g-EGx samples with x = 3 and 4 displayed lower critical solution temperature （LCST） in water due to the presence of OEG units. The clouding point （CP） of polypeptides can be finely tuned by changing the side chain structures, molecular weights and sample concentrations. In addition, the thioether linkages in the side chains offer additional redox-responsive properties. The influence of both OEG units and thioether linkages on the LCST behavior was systematically investigated. This work provides an efficient way to prepare multi-stimuli responsive materials with highly tunable properties.