Dear editor,Transcatheter aortic valve replacement (TAVR) is a safe and effective treatment for severe aortic valve stenosis and aortic regurgitation. Multiple randomized trials have proved its therapeutic advantages ...Dear editor,Transcatheter aortic valve replacement (TAVR) is a safe and effective treatment for severe aortic valve stenosis and aortic regurgitation. Multiple randomized trials have proved its therapeutic advantages in patients at any level of surgical risks.展开更多
BACKGROUND Immunoglobulin light chain(AL)amyloidosis is a rare disease characterized by deposition of ALs essentially in any organ or tissue,with cardiac involvement being very frequent(61%).Early diagnosis is of high...BACKGROUND Immunoglobulin light chain(AL)amyloidosis is a rare disease characterized by deposition of ALs essentially in any organ or tissue,with cardiac involvement being very frequent(61%).Early diagnosis is of high importance because early initiation of treatment in AL amyloidosis may improve outcomes.Despite the administration of immunotherapeutic agents,in particular bortezomib and daratumumab,which have improved the outcomes of AL amyloidosis,antiplasma cell therapy remains suboptimal for some patients.CASE SUMMARY We report the case of a 55-year-old man presenting with heart failure who was diagnosed with cardiac AL amyloidosis by an endomyocardial biopsy.He experienced a short-term hematological remission with no organ response after being administered a bortezomib-daratumumab containing regimen.The treatment was switched to pomolidomide due to pulmonary involvement and progressive pleural effusion,in which flow cytometry analysis showed abnormal plasma cells.After two cycles of this regimen,the pleural effusion was controlled effectively with no recurrence.CONCLUSION This case emphasizes the crucial role of endomyocardial biopsy in early diagnosis of cardiac amyloidosis and suggests that pomolidomide may be an effective treatment for patients with AL amyloidosis that is relapsed/refractory to both bortezomib and daratumumab.展开更多
Objective: To investigate the effect of laparoscopic radical resection of colorectal cancer on the immune status and CRP. Methods: A total of 90 patients with colorectal cancer treated in our hospital from January 201...Objective: To investigate the effect of laparoscopic radical resection of colorectal cancer on the immune status and CRP. Methods: A total of 90 patients with colorectal cancer treated in our hospital from January 2017 to June 2017 were randomly divided into the observation group and the control group, each with 45 cases. The observation group received laparoscopic surgery, while the control group was given open surgery. The changes of immune indexes and CRP in two groups before and after 3 d and after 7 d were compared. Results: (1) In the control group, the postoperative 3 d and postoperative 7 d, CRP index were (7.87±2.01) mg/dL, (2.81±1.03) mg/dL, the observation group postoperative 3 d and postoperative 7 d, CRP index were (7.01±1.33) mg/dL, (1.59±0.81) mg/dL, compared with before treatment, the difference was statistically significant. The CRP in the observation group postoperative 7 d were significantly lower than those in the control group at the same time period, the difference was significant. The IgM and IgG index level of control group postoperative 3 d respectively (137.04±23.46) IU/mL and (114.36±27.18) IU/mL, compared with preoperative and observation group postoperative 3 d index level (163.07±30.19) IU/mL, (130.24±31.16) IU/mL decreased significantly, the difference was significant. (2) The control group postoperative 3 d CD4+and CD8+index level were respectively (0.49±0.05)×109/L, (0.29±0.08)×109/L. CD8+index level of 7 d after operation was (0.31±0.10)×109/L, which were significantly decreased than 1 d before operation and significantly lower than the same period of observation group indicator level (0.59±0.09)×109/L, (0.35±0.11)×109/L, (0.37±0.12)×109/L, the differences were statistically significant. Conclusion: Compared with open surgery, laparoscopic surgery has less influence on the immune function of patients, and has less inflammatory and stress damage, so it is worthy of clinical application.展开更多
The effects of journal misalignment on the transient flow of a finite grooved journal bearing are presented in this study. A new 3D computational fluid dynamics (CFD) analysis method is applied. Also, the quasi-coupli...The effects of journal misalignment on the transient flow of a finite grooved journal bearing are presented in this study. A new 3D computational fluid dynamics (CFD) analysis method is applied. Also, the quasi-coupling calculation of transient fluid dynamics of oil film in journal bearing and rotor dynamics is considered in the analysis. Based on the structured mesh, a new approach for mesh movement is proposed to update the mesh volume when the journal moves during the fluid dynamics simula- tion of an oil film. Existing dynamic mesh models provided by FLUENT are not suitable for the transient oil flow in journal bearings. The movement of the journal is obtained by solving the moving equations of the rotor-bearing system with the calculated film pressure as the boundary condition of the load. The data exchange between fluid dynamics and rotor dynamics is realized by data files. Results obtained from the CFD model were consistent with previous experimental results on misaligned journal bearings. Film pressure, oil film force, friction torque, misalignment moment and attitude angle were calculated and compared for mis- aligned and aligned journal bearings. The results indicate that bearing performances are greatly affected by misalignment which is caused by unbalanced excitation, and the CFD method based on the fluid-structure interaction (FSI) technique can effectively predict the transient flow field of a misaligned journal bearing in a rotor-bearing system.展开更多
文摘Dear editor,Transcatheter aortic valve replacement (TAVR) is a safe and effective treatment for severe aortic valve stenosis and aortic regurgitation. Multiple randomized trials have proved its therapeutic advantages in patients at any level of surgical risks.
文摘BACKGROUND Immunoglobulin light chain(AL)amyloidosis is a rare disease characterized by deposition of ALs essentially in any organ or tissue,with cardiac involvement being very frequent(61%).Early diagnosis is of high importance because early initiation of treatment in AL amyloidosis may improve outcomes.Despite the administration of immunotherapeutic agents,in particular bortezomib and daratumumab,which have improved the outcomes of AL amyloidosis,antiplasma cell therapy remains suboptimal for some patients.CASE SUMMARY We report the case of a 55-year-old man presenting with heart failure who was diagnosed with cardiac AL amyloidosis by an endomyocardial biopsy.He experienced a short-term hematological remission with no organ response after being administered a bortezomib-daratumumab containing regimen.The treatment was switched to pomolidomide due to pulmonary involvement and progressive pleural effusion,in which flow cytometry analysis showed abnormal plasma cells.After two cycles of this regimen,the pleural effusion was controlled effectively with no recurrence.CONCLUSION This case emphasizes the crucial role of endomyocardial biopsy in early diagnosis of cardiac amyloidosis and suggests that pomolidomide may be an effective treatment for patients with AL amyloidosis that is relapsed/refractory to both bortezomib and daratumumab.
文摘Objective: To investigate the effect of laparoscopic radical resection of colorectal cancer on the immune status and CRP. Methods: A total of 90 patients with colorectal cancer treated in our hospital from January 2017 to June 2017 were randomly divided into the observation group and the control group, each with 45 cases. The observation group received laparoscopic surgery, while the control group was given open surgery. The changes of immune indexes and CRP in two groups before and after 3 d and after 7 d were compared. Results: (1) In the control group, the postoperative 3 d and postoperative 7 d, CRP index were (7.87±2.01) mg/dL, (2.81±1.03) mg/dL, the observation group postoperative 3 d and postoperative 7 d, CRP index were (7.01±1.33) mg/dL, (1.59±0.81) mg/dL, compared with before treatment, the difference was statistically significant. The CRP in the observation group postoperative 7 d were significantly lower than those in the control group at the same time period, the difference was significant. The IgM and IgG index level of control group postoperative 3 d respectively (137.04±23.46) IU/mL and (114.36±27.18) IU/mL, compared with preoperative and observation group postoperative 3 d index level (163.07±30.19) IU/mL, (130.24±31.16) IU/mL decreased significantly, the difference was significant. (2) The control group postoperative 3 d CD4+and CD8+index level were respectively (0.49±0.05)×109/L, (0.29±0.08)×109/L. CD8+index level of 7 d after operation was (0.31±0.10)×109/L, which were significantly decreased than 1 d before operation and significantly lower than the same period of observation group indicator level (0.59±0.09)×109/L, (0.35±0.11)×109/L, (0.37±0.12)×109/L, the differences were statistically significant. Conclusion: Compared with open surgery, laparoscopic surgery has less influence on the immune function of patients, and has less inflammatory and stress damage, so it is worthy of clinical application.
基金supported by the National High-Tech R&D (863) Program of China (No. 2009AA04Z413)the Natural Science Foundation of Zhejiang Province (No. Y1110109),China
文摘The effects of journal misalignment on the transient flow of a finite grooved journal bearing are presented in this study. A new 3D computational fluid dynamics (CFD) analysis method is applied. Also, the quasi-coupling calculation of transient fluid dynamics of oil film in journal bearing and rotor dynamics is considered in the analysis. Based on the structured mesh, a new approach for mesh movement is proposed to update the mesh volume when the journal moves during the fluid dynamics simula- tion of an oil film. Existing dynamic mesh models provided by FLUENT are not suitable for the transient oil flow in journal bearings. The movement of the journal is obtained by solving the moving equations of the rotor-bearing system with the calculated film pressure as the boundary condition of the load. The data exchange between fluid dynamics and rotor dynamics is realized by data files. Results obtained from the CFD model were consistent with previous experimental results on misaligned journal bearings. Film pressure, oil film force, friction torque, misalignment moment and attitude angle were calculated and compared for mis- aligned and aligned journal bearings. The results indicate that bearing performances are greatly affected by misalignment which is caused by unbalanced excitation, and the CFD method based on the fluid-structure interaction (FSI) technique can effectively predict the transient flow field of a misaligned journal bearing in a rotor-bearing system.
基金Project supported by the National Natural Science Foundation of China(Nos.61271084 and 51275454)the Fundamental Research Funds for the Central Universities,China