Preprocessing and Efficacy Analysis of Comprehensive Anti-Inflammatory Treatment for Lymphedema in Patients with Irritating Contact Dermatitis

Objective: To explore the pre-treatment and efficacy analysis of comprehensive anti-inflammatory treatment for lymphedema in patients with irritating contact dermatitis. Method: Convenience sampling method was used to observe the skin of 160 patients with upper limb lymphedema admitted to the lymphedema outpatient department of our hospital. They were divided into an observation group (80 cases) and a control group (80 cases), and both groups received a course of comprehensive anti-inflammatory treatment (20 treatments). The control group received routine skin care;On the basis of the control group, the observation group received pre-treatment of the affected limb skin: Laofuzi herbal ointment was applied externally to the prone areas of irritating contact dermatitis (such as the upper arm, inner forearm, and cubital fossa). Result: The incidence of irritating contact dermatitis in the observation group was significantly lower than that in the control group (P 0.05). Patients in the observation group felt significantly better in terms of comfort, skin moisture, and itching relief after being wrapped with low elasticity bandages than those in the control group (P Conclusion: Preventive treatment can effectively reduce the incidence of irritating contact dermatitis, prolong the time of stress treatment, thereby increasing efficacy and improving patient compliance.

Tumor-infiltrating T-Lymphocyte immunity-related immune tolerance and anti–programmed cell death protein 1/ligand of programmed cell death protein 1 therapy for advanced hepatocellular carcinoma

Systemic therapy has become the standard treatment for patients with advanced hepatocellular carcinoma(HCC)whose treatment options are limited.However,the long-term patient response to drugs and the survival outcomes remain a concern.With increasing exploration of the HCC microenvironment,particularly in terms of T lymphocyte immunity,a new era of immunomolecular targeted therapy,based on molecular signaling,has arrived for advanced HCC.In the study of immune tolerance of the intrinsic HCC microenvironment,we found that multiple immunosuppressive mechanisms and immune checkpoint inhibitors,such as anti–programmed cell death protein 1/ligand of programmed cell death protein 1 therapy,have improved clinical outcomes in some patients with advanced HCC.Furthermore,various combination therapies have been investigated,and HCC types have been categorized into different types based on anti–programmed cell death protein 1(PD-1)/ligand of programmed cell death protein 1(PD-L1)treatment.In this paper,we first discuss the tumor-infiltrating T lymphocyte immunity and immune tolerance of HCC.We then clarify the basic mechanism of anti–PD-1/PD-L1 therapy and discuss the types of HCC based on anti–PD-1/PD-L1 therapy.Thereafter,we explain the relevant studies and mechanisms of combination therapy of anti–PD-1/PD-L1 with antiangiogenesis drugs or multikinase kinase inhibitors,anti–T lymphocyte–related signaling pathways in HCC,and other anti-CD8+T cell immune checkpoints.In this way,this review offers a deeper understanding of anti–PD-1/PD-L1 immunotherapy for advanced HCC,in order to provide better individualized treatments for patients with advanced HCC.

Tamanu Oil in Acne Management: Potential Anti-Inflammatory and Wound-Healing Properties for Scar Reduction

Tamanu oil, derived from the nuts of Calophyllum inophyllum, has gained increasing attention for its potential in acne management due to its purported anti-inflammatory and wound-healing properties. This analysis evaluates the efficacy of tamanu oil in acne treatment with a specific focus on its impact on inflammation and scar reduction. The novelty of this research lies in its comprehensive analysis of tamanu oil’s dual mechanism of action: reducing acne-related inflammation and promoting the healing of acne scars. Clinical trials and laboratory analyses were conducted to assess the oil’s effectiveness in diminishing erythema, swelling, and post-acne scarring compared to conventional treatments. Preliminary findings demonstrate that tamanu oil significantly reduces inflammation and accelerates wound healing, potentially offering a promising adjunct or alternative to standard acne therapies. Future research should aim to optimize formulation and application protocols, long-term effects, and comparative therapeutic efficacy with other anti-inflammatory agents. Tamanu oil offers a novel and effective approach to acne management, with potential advantages that go beyond inflammation reduction to include enhanced scar reduction, making it a subject that warrants further investigation.

Comparison of Histological, Microbiological, and Molecular Methods in Diagnosis of Patients with TBLN Having Different Anti-TB Treatment Background

Objective The influence of anti-tuberculosis （TB） treatment history on tuberculous lymphadenitis （TBLN） diagnosis is unclear. Therefore, this study aims to evaluate the diagnostic methods, including histology, microbiology, and molecular tests, used for TBLN. Methods In this study, suspected patients with TBLN and having different anti-T8 treatment background were enrolled. All the samples were tested simultaneously by histology, ZiehI-Neelsen （ZN） staining, mycobacterial culture （culture）, Xpert MTB/RIF （xpert）, real-time PCR, and high-resolution melting curve PCR （HRM）. Thereafter, the performance of these methods on samples with different anti-TB treatment background was assessed. Results In our study, 89 patients were prospectively included 82 patients with TBLN and 7 with other diseases. The overall sensitivities of Xpert, real-time PCR, histology, ZN staining, and culture were 86.6%, 69.5%, 58.5%, 43.9%, and 22.0%, respectively. The anti-TB treatment history revealed dramatic influences on the sensitivity of culture （P 〈 0.0001）. In fact, the treatment that lasted over 3 months also influenced the sensitivity of Xpert （P 〈 0.05）. However, the treatment history did not affect the performance of remaining tests （P 〉 0.05）. For rifampicin drug susceptibility test （DST）, the anti-T8 treatment showed only significant influence on the success rate of culture DST （P = 0.001）, but not on those of Xpert and HRM tests （P 〉 0.05）. Conclusion Other tests as welt as culture should be considered for patients with TBLN having retreatment history or over 1-month treatment to avoid false negative results.

Improvement in Socio-Economic Productivity of HIV Positive Individuals on Antiretroviral Treatment in a Private Setting in South India

PLHIV have decreased economic productivity both due to direct and indirect causes. Data from developed countries have shown that at the societal level, high costs ART are offset by increased productivity. We hypothesized that post-ART the SES would improve regardless of the baseline SES and will be sustained over time. Our objective was to perform a comprehensive SES evaluation pre/post ART initiation using an ambispective cohort study design. We used Indian household-specific SES validated tool, with score of 76 being affluent, along with clinical, ART adherence data at median of 6 and 18 months post ART, and compared using paired t-tests. Among 140 persons started on ART, with a median follow up of 22 months, 118 had Pre-ART SES data, of these: 57% were women;median age was 38 years;67% were married;89 (78%) had heterosexual sex as HIV risk;40 (34%) had major OI and/or TB at presentation. Reported self-occupation was: skilled labourers 41 (35%);12 (10%) unskilled labourers;27 (23%) housewives;26 (22%) pro-fessionals/blue collar job;1 student, 10 unemployed. The median pre-post ART CD4 cell counts were: 187 and 454 cells/cumm (P < 0.01);median body weight pre-post ART was 54 and 57 kg (P < 0.01);97% of the participants were 100% adherent. The mean Pre-ART total SES score was 37.06 (+/-10.2);and Post-ART SES score 40.62 (+10.1 P < 0.001) and these results were sustained over time and remained significant even when only monthly income was considered. Our data show a significant impact of ART on SES in a sustained manner in a developing world setting, which has policy level implications.

Adequate antiplatelet regimen in patients on chronic anti-vitamin K treatment undergoing percutaneous coronary intervention

AIM: To investigate the impact of dual antiplatelet therapy (DAT) in patients on antivitamin K (AVK) regimen requiring percutaneous coronary intervention (PCI).METHODS: Between February 2006 and February 2008, 138 consecutive patients under chronic AVK treatment were enrolled in this registry. Of them, 122 received bare metal stent implantation and 16 received drug elutingstent implantation. The duration of DAT, on top of AVK treatment, was decided at the discretion of the clinician. Adequate duration of DAT was def ined according to type of stent implanted and to its clinical indication. RESULTS: The baseline clinical characteristics of patients reflect their high risk, with high incidence of comorbid conditions (Charlson score ≥ 3 in 89% of the patients). At a mean follow-up of 17 ± 11 mo, 22.9% of patients developed a major adverse cardiac event (MACE): 12.6% died from cardiovascular disease and almost 6% had an acute myocardial infarction. Major hemorrhagic events were observed in 7.4%. Adequate DAT was obtained in only 44% of patients. In the multivariate analysis, no adequate DAT and Charlson score were the only independent predictors of MACE (both P = 0.02). CONCLUSION: Patients on chronic AVK therapy represent a high risk population and suffer from a high MACE rate after PCI. An adequate DAT regimen and absence of comorbid conditions are strongly associated with better clinical outcomes.

Process of Decision-Making of Anti-Cancer Treatment in Elderly Patients with Advanced Lung Cancer

The aim of this study was to identify the decision-making process of anti-cancer treatment in elderly patients with advanced lung cancer. Semi-structured interviews were conducted with 17 patients aged 70 and above to collect data on their feelings and thoughts from the time of diagnosis till they made treatment decisions. The data was analyzed using the Modified Grounded Theory Approach that was modified by Prof. Yasuhito Kinoshita. We found the process to be composed of six categories. The results showed that elderly patients with advanced lung cancer were panicked over unavoidable death when informed of stage IV lung cancer and offered suggestions about anti-cancer treatment. However, trying to accept the situation where death is imminent, patients reconsidered having cancer in older age and recognized a desire to survive even in older age. This process diverged into two paths: one group of patients changed their ideas from radical to life-prolonging treatment by recognizing a desire to survive even in older age and then made anti-cancer treatment decisions by carefully choosing treatment that would allow to carry on their usual way of life;the other group of patients made treatment decisions by carefully choosing physicians to whom they could entrust their life in older age. These findings suggest that it is important for nurses to: 1) encourage patients to talk in order to have them think about what they have valued and want to value in the rest of their life;2) assess if patients prefer to decide on their own by carefully choosing treatment or entrust treatment decisions to physicians;and 3) offer support according to patients’ preferences.

深厚覆盖层上土石坝防渗墙损伤开裂精细化分析及防渗功能评价

混凝土防渗墙是覆盖层上土石坝坝基的关键防渗结构,由于防渗墙与覆盖层的刚度和尺度差异巨大,通常的数值分析方法难以保证精度,且现有基于强度的安全评价方法,无法适应防渗墙作为防渗结构而非承载结构的功能评价要求。本文提出了比例边界元-有限元耦合跨尺度离散、塑性损伤模型和内聚力模型分离描述压损伤和受拉开裂、破损后防渗功能目标评价的精细化分析方法,实现了深厚覆盖层上土石坝防渗墙的性态演化评价。研究结果表明:超深覆盖层上悬挂式防渗墙在两岸底部因近似垂直于岸坡的高压应力发生压损伤,类“外伸梁”的面内弯曲变形使靠近防渗墙两岸的顶部和底部区域产生坝轴向高拉应力导致槽段间出现竖向裂缝;在防渗墙两岸的上游侧局部设置辅助防渗措施,可有效降低防渗墙破损后的渗流量。本文方法揭示了混凝土防渗墙的损伤开裂模式,定位了防渗墙薄弱区域,评价了防渗墙损伤开裂对防渗功能的影响,量化防渗措施效果,实现了防渗墙从传统承载能力评价到功能性态评价的跨越,可为深厚覆盖层上土石坝防渗墙的安全评价和设计优化提供理论和技术支持。

Antibodies to Tumor Necrosis Factors in the Treatment of Rheumatoid Arthritis and Spondyloarthritis: The Basic Science, Clinical Science and Unmet Needs;Results from a Single Center

Inflammatory rheumatological diseases like rheumatoid arthritis (RA) and ankylosing spondylitis/Spondyloarthritis (AS/SpA), have been treated with NSAIDs (non steroidal anti-inflammatory drugs), corticosteroids, and DMARDs (disease modifying anti-rheumatic drugs).These have been only partially effective for the management of symptoms, since they are rarely associated with the complete control of disease and rarely slow down radiological damage. Several cytokines have been implicated in the pathogenesis of the inflammation and tumor necrosis factor (TNF) is the most important. The last decade and a half has seen advances in the form of “anti-TNF” therapies for RA and AS/SpA patients which target and neutralize the TNF cytokines, and thus reduce the disease activity. Two anti-TNF therapies have been used in India for treating DMARD resistant RA and AS/SpA for the last 13 years;Infliximab and Etanercept respectively. This paper is a description of the clinical outcomes and unmet needs/toxicities associated with the treatment of RA and AS/SpA with anti-TNF therapies (Infliximab, Etanercept), at a single rheumatology center (tertiary care, super-specialty hospital, Indraprastha Apollo Hospitals, New Delhi) in north India.

内燃机活塞环材料及表面处理技术研究现状与发展趋势

活塞环是内燃机中重要的零部件之一,该部件的摩擦损耗占内燃机总摩擦损失的26%。因此,活塞环材料的选用及其表面处理研究对于优化提升内燃机性能、延长服役寿命具有重要意义。简单介绍并总结了内燃机活塞环常用材料及其发展趋势,详细综述了激光表面织构技术、表面涂层技术以及表面复合技术在内燃机活塞环减摩抗磨方面的研究和应用现状。其中,激光表面织构技术(LST)可起到接纳磨屑、保持油膜等作用,从而降低活塞环表面摩擦和磨损,但由于织构形貌和几何参数特征对摩擦学性能的影响较为复杂,仍需结合实际工况进一步研究并优化。以镀铬、热喷涂、气相沉积及激光熔覆为代表的涂层技术也常用于活塞环的表面强化处理,但涂层材料种类繁多,难以形成统一的行业标准进而规模应用。此外,通过合理复合多种表面处理技术,比如微弧氧化与电泳沉积复合、超声滚压与离子渗氮技术复合、磁控溅射和低温离子渗硫复合等,可实现优势互补、发挥协同作用,有效改善接触表面的摩擦性能,为活塞环的减摩增寿研究开拓了新的思路。最后对未来活塞环材料开发应用及其减摩抗磨方面的研究发展进行了展望。

托帕水库大坝沥青混凝土心墙设计及渗流特性分析

沥青混凝土具有防渗性能好和便于施工等特点,常作为水利工程的防渗材料。针对新疆托帕水库特有的坝址地形条件进行沥青混凝土心墙坝设计,详细阐述了沥青混凝土心墙的型式、布置型式、断面尺寸以及心墙与各部位衔接等方面的设计,并对已设计的沥青混凝土心墙坝进行渗流计算分析。结果表明:设计的沥青混凝土心墙坝结构合理,防渗设计满足规范要求。

“双电”法检测技术在新疆洼地水库超大面积土工膜渗漏检测的应用

土工膜防渗检测是防止库区渗漏的关键技术步骤,也是大型水库面临的重要工程问题。通过介绍电火花法和双电极法土工膜渗漏检测方法的工作原理、应用范围、操作步骤等,依托新疆阿克苏地区洼地水库工程,对超大面积水库库底及边坡进行实际应用检测,结果表明“双电”法检测精度准确、效率高,可精确发现水库土工膜铺设施工中的缺陷,减少水库运行期渗漏水量,消除了渗漏带给水库的安全隐患,为土工膜渗漏检测提供了技术支撑,为类似工程提供了借鉴。

关注新生血管性年龄相关性黄斑变性的创新药物治疗

湿性年龄相关性黄斑变性(nAMD)是老年人致盲的主要原因,抗VEGF是其主要治疗方法。目前,nAMD治疗仍面临诸多不足和挑战,开发新的治疗药物和给药方法是其主要研究的方向。近年来治疗nAMD的药物研发方向呈现多样化,包括开发新靶点/新机制药物及新型给药方式、优化给药剂量和基因疗法等,达到降低治疗频率、延长治疗间隔、提高患者治疗依从性和长期维持或改善视力的目的。眼科临床医师应对新的药物有较为全面的了解,进而发掘出适合不同nAMD亚型患者的优化方案,实现向精准化医疗迈进。

CCNE1表达水平与卵巢癌术后抗血管生成治疗反应性及预后的关系

目的探讨细胞周期蛋白E1(CCNE1)表达水平与卵巢癌术后抗血管生成治疗反应性及预后的关系。方法选取2019年6月至2021年6月该院收治的卵巢癌患者206例为研究对象,采用免疫组织化学染色分析术后(抗血管生成治疗前)CCNE1表达水平,根据组织学评分分为CCNE1高表达组和CCNE1低表达组,观察两组术后抗血管生成治疗反应,治疗2个疗程后比较两组客观缓解率(ORR)。同时随访2年,观察卵巢癌患者预后情况(以出现死亡为预后不佳),采用多因素Logistic回归分析筛选影响卵巢癌患者术后抗血管生成治疗反应性的相关因素,采用Cox回归分析影响卵巢癌患者预后的相关因素。结果治疗2个疗程后,CCNE1高表达组的ORR为65.63%,明显高于CCNE1低表达组的49.30%(P<0.05)。治疗反应患者肿瘤最大径、CA125水平低于无反应患者(P<0.05),CCNE1高表达比例高于无反应患者(P<0.05)。多因素Logistic回归分析结果显示,CCNE1高表达是卵巢癌患者抗血管生成治疗无反应的保护因素(P<0.05),CA125水平升高、肿瘤最大径增大均是卵巢癌患者抗血管生成治疗无反应的危险因素(P<0.05)。随访2年,6例失访(CCNE1高表达组2例,CCNE1低表达组4例),最终纳入200例,其中92例预后良好,108例预后不佳。Kaplan-Meier生存曲线分析显示,CCNE1高表达组的生存率低于CCNE1低表达组(Log-rankχ^(2)=7.554,P=0.006)。预后良好组肿瘤最大径、手术残余病灶最大径均小于预后不佳组(P<0.05),CCNE1高表达比例低于预后不佳组(P<0.05)。多因素Cox回归分析显示,术后残余病灶最大径增大、CCNE1高表达、肿瘤最大径增大均是卵巢癌患者术后抗血管生成治疗预后不佳的独立危险因素(P<0.05)。结论术后CCNE1表达水平是卵巢癌患者术后抗血管生成治疗反应性的影响因素,同时也是卵巢癌患者预后的影响因素。

《欧洲干眼专家组干眼炎症控制治疗推荐》解读

干眼是目前影响视觉与生活质量最常见的眼表疾病之一。国际干眼工作组报告中建议尽早使用局部糖皮质激素或/和环孢素A进行抗炎治疗。然而,目前在临床诊疗中应该何时使用、如何使用局部环孢素A和糖皮质激素治疗干眼,尚缺少的相关指导内容。欧洲干眼专家组通过问卷调查的方式就干眼疾病严重程度和进展、干眼患者的管理、环孢素的疗效、安全性和耐受性以及患者教育达成共识,并提出了糖皮质激素和环孢素A治疗干眼的具体治疗方案。目前我国开展大规模干眼抗炎治疗的时间较短,相关经验有限。为此,本文结合欧洲干眼专家组抗炎共识的内容及其相关文献,从炎症在干眼疾病发展中的作用、干眼患者的炎症表现方面阐述干眼抗炎治疗的必要性,并汇总分析干眼抗炎药物的使用方法,以期指导我国临床诊疗中干眼的抗炎治疗。

TRD工法在赣江尾闾围堰防渗工程中的应用

赣江下游尾闾综合整治工程4支枢纽采用TRD工法对防渗墙进行施工,并针对重难点区段调整了施工工艺,该做法克服了地质条件复杂、砂卵砾石地层厚度大、防渗墙深度大等不利因素的影响,施工效率高且安全环保,取得了良好的防渗效果。

载银纳米TiO_(2)改性对橡胶木防霉性能的影响研究

通过抑菌圈法探究不同浓度梯度载银纳米二氧化钛抑菌防霉剂对桔青霉、黑曲霉、白腐菌、密粘褶菌的抑菌效果,优化最佳抑菌浓度,然后选用该浓度改性剂对橡胶木进行常压浸渍处理,探究改性剂对橡胶木的防霉改性效果,并进行防霉改性机理分析。结果表明:载银纳米二氧化钛对黑曲霉、白腐菌、密粘褶菌有明显抑菌效果,对桔青霉的抑菌效果较差。随着载银纳米二氧化钛浓度的增加,白腐菌、密粘褶菌、桔青霉的抑菌圈直径呈增大趋势,黑曲霉的抑菌圈直径呈先增加后呈略微降低趋势,并优化得出最佳的抑菌浓度为10mg/mL,此时白腐菌、密粘褶菌、桔青霉、黑曲霉的抑菌圈平均直径分别为26.60mm、27.00mm、19.56mm、26.55mm;橡胶木经10mg/mL载银纳米二氧化钛改性剂浸渍处理后对黑曲霉、白腐菌、密粘褶菌的防治效力达到100%,对桔青霉的防治效力可达到85%以上,实现优异的防霉改性效果。

产妇及新生儿单核细胞增生李斯特菌感染情况分析

目的探讨该院单核细胞增生李斯特菌(简称单增李斯特菌)感染发病情况及预防治疗措施。方法回顾性选取2012-2021年该院检出的单增李斯特菌阳性病例为研究对象,统计分析其科室分布、发病及抗感染治疗情况。结果检出的阳性病例为产妇及其分娩新生儿。产科出院患者单增李斯特菌感染率为7.63/100000,分娩新生儿单增李斯特菌感染率为4.68/100000。全院产妇、新生儿单增李斯特菌感染率为5.32/100000。感染产妇分娩新生儿死亡率与正常分娩产妇的新生儿死亡率比较,差异有统计学意义(P<0.05)。经验性抗感染治疗,产妇用药选择针对单核李斯特菌敏感的青霉素类抗菌药物的病例数远少于新生儿,二者比较差异有统计学意义(P<0.05)。结论产妇单增李斯特菌感染率虽低,但危害大,经验性抗感染治疗应首选对单增李斯特菌敏感的抗菌药物。

纳米金材料在肿瘤诊治领域中的应用研究进展

在肿瘤的预防与控制方面,实施“三早”策略——即早期发现、早期诊断、早期治疗——被认为是实现一级预防效果的最有效途径。尽管如此,当前肿瘤早期诊断的技术和能力仍然遭遇着重大挑战。另一方面,传统的抗肿瘤药物由于其高毒性和缺乏针对特定组织的特异性,导致在实际治疗中的应用受到了显著限制。纳米金材料因其独特的优势而脱颖而出,包括表面易于改性、出色的生物相容性、小尺寸带来的特殊效应、光学性质以及量子效应等,使其在肿瘤细胞的诊断和治疗方面显示出巨大的应用潜力。近年来,纳米金在肿瘤的临床诊断和治疗领域受到了广泛的关注和研究,并已取得了令人鼓舞的进展。该文旨在对纳米金材料在肿瘤诊治领域中的最新研究进展进行全面的综述,以期为肿瘤患者提供更加有效和个性化的诊疗方案,推动其在临床实践中的广泛应用。

超深埋隧洞防渗排水措施与衬砌外水压力分布规律

高外水压力是制约超深埋水工隧洞建设的关键性难题之一,以排水孔为中心的综合堵排措施是降低外水压力的主要举措。为克服传统排水孔实体单元法整体网格划分难度大和计算效率较低的问题,首先,基于ABAQUS平台开发了两节点排水孔线单元模型,并验证其在隧洞工程数值模拟分析中的正确性和有效性;其次,建立了考虑防渗排水措施的围岩-衬砌三维有限元模型,研究多种防渗排水措施下的隧洞渗流场及衬砌外水压力分布规律;最后,探讨了防渗灌浆圈与排水孔设计参数对外水压力分布的影响,提出了防渗灌浆圈与排水孔间隔布置的原则。研究结果表明:所开发的两节点排水孔线单元具有较高的精度,在排水孔数目繁多的模型中具有极高效率;排水孔数目越多、深度越大、排距越小,衬砌外水压力越低;排水孔能够有效降低衬砌的外水压力,而防渗灌浆圈降外压能力有限;在排水孔末端间隔一定厚度围岩后再施作防渗灌浆圈,可更有效发挥两者的降压作用。