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Objective:To investigate the risk factors for retrograde type A dissection (RTAD) associated with thoracic endovascular aortic repair (TEVAR) which provided the basis for clinical risk stratification and treatment decision.Methods:The clinical data of 1 688 patients with thoracic aortic disease who underwent TEVAR in our center from January 2004 to December 2019 were retrospectively analyzed. The pathological classification included aortic dissection (1 592 cases) and other thoracic aortic diseases (96 cases). Univariate analysis and categorical multiple logistic regression analysis were used to explore the risk factors for the development of RTAD during or after TEVAR.Results:A total of 18 cases of RTAD were found, with an overall incidence of 1.1% (18/1 688), all of which occurred in aortic dissection group. After adjusting for confounding factors, multivariate logistic regression analysis showed that the incidence of RTAD was significantly decreased(OR=0.27,95%CI 0.07-0.96, P=0.043) when the oversize of stentgraft was 11%-20%, the oversize of stentgraft was ≤10% as the control group, and the difference was statistically significant( P<0.05). The ascending aorta diameter was <40 mm as the control group, and there was no significant difference in the incidence of RTAD between the ≥40 mm group and the control group(OR=2.71,95%CI 0.94-7.84, P=0.065). Conclusions:Aortic dissection is more likely to develop RTAD than other thoracic aortic diseases. A proper stentgraft oversizing ratio could reduce the probability of RTAD. That is to say that a too low stentgraft oversizing ratio is not recommended.
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@#Due to the abnormal structure and function of the cardiac valves, cardiac valve disease gradually appears the expansion of left ventricular inner diameter and volume. When the left ventricular end-diastolic dimension and volume expand severely, it becomes a giant left ventricle. Surgical valve replacement is still one of the main treatment methods for this disease. The degree of postoperative ventricular recovery is closely related to perioperative mortality and long-term prognosis. However, the existing clinical preoperative assessment methods still cannot accurately predict the degree of postoperative left ventricular recovery and long-term prognosis of such patients, so it is difficult to determine the optimal operation timing and surgical methods for patients. Therefore, we reviewed the existing literature and discussed different evaluation methods of the giant left ventricle associated with valvular disease before surgery, so as to optimize the perioperative treatment of such patients, clarify the timing of surgery and improve the prognosis.
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@#The conventional total arch replacement (cTAR) with frozen elephant trunk implantation is commonly regarded as the gold standard for aortic pathologies involving ascending aorta and proximal aortic arch. By combining open supra-aortic vessels debranching and emerging endovascular technologies, hybrid arch repair (HAR) has been increasingly performed as a promising alternative in risky patients with comorbidities and frailties. Nevertheless, the advantages or disadvantages of hybrid arch procedures and cTAR in terms of survival and related outcomes remain controversial. This study is aimed to briefly review the role and results of HAR in the management of aortic arch pathology in comparison of contemporary cTAR.
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Objective@#To explore the subunit strategy for perineal defect reconstruction and flap selection.@*Methods@#This is a respective study of 21 patients, with perineal defect, during January 2008 to December 2018. All patients were admitted to the fifth section of Burn and Plastic Surgery in the Fourth Medical Center of the People′s Liberation Army General Hospital. There were 10 males and 11 females, aged from 4 to 68 years old, with the mean age of 26.4 years. The causes of injury included burn (n=11), trauma (n=2), Paget′s disease (n=2), Brown′s disease (n=2), perineal squamous cell carcinoma (n=3)and hemangioma (n=1). The perineum is divided into 4 subunits, according to the anatomical structure: a front area monsveneris or pubic symphysis, 2 middle areas (labia or scrotum) and a posterior area (anal). The defects ranged 23 cm×11 cm-5 cm×3 cm after perineal lesions were removed. Appropriate flaps were selected based on tissue defect.@*Results@#Nine patients were repaired with superficial inferior epigastric artery flap, 3 patients were repaired with superficial circumflex iliac artery flap, and 2 patients were repaired with combined superficial inferior epigastric artery flap and superficial circumflex iliac artery island flap. Internal pudendal arterial perforator flap was performed in 5 patients, and anterolateral thigh perforator flap in 2 patients. The size of flap was 25 cm×12 cm-6 cm×3 cm. All flaps survived, and incisions were primary healing. Patients were followed up for 6 months to 9 years, with an average of 13 months. The patients were satisfied with the appearances and functions of the recipient and doner sites. Scars were concealed well.@*Conclusions@#Appropriate flap can be chosen to repair perineal defects, based on the subunit principle in perineum, in order to restore function and appearance, and achieve satisfactory clinical outcomes.
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Objective@#To investigate the effects of simulated-thermobaric explosive gas on the respiration and nervous system in rats.@*Methods@#70 of SPF SD rats were randomly divided into four thermobaric explosive gas groups, two restoration observation groups and control group from April to August in 2018. The exposure time of in four thermobaric explosive gas groups were 3.75, 7.5, 15.0 and 30 min, respectively. The restoration observation groups were designed to observe for 30 and 120 min after exposure thermobaric explosive gas 30 min. The bloods were collected and analyzed at the end of exposure and recovery observation. The endogenous carbon monoxide (CO) , nitric oxide (NO) , glutamic acid (GLU) , acetylcholinesterase (AchE) and dopamine (DA) were detected in brain tissues, respectively.@*Results@#The blood gas index (pH, PCO2, PO2, COHb, O2Hb, MeHbt) and blood electrolytes (Na+, K+, Ca2+ and Cl-) in exposure groups have significant differences with these in control (P<0.05) . The pH value decreased with the exposure time longer. However, it basically returned to normal level when terminating exposure for 120 min. The concentration of PCO2, MeHb and CoHb increased first and then decreased with the exposure time extension. Conversely, The PO2 and O2Hb decreased first and then increased with the exposure time longer. The concentration of endogenous CO, GLU, and AchE decreased and NO increased in exposure group 4 and the restoration observation group 1 compared with those in control (P<0.01) . In addition, there were pathological changes in lung and brain tissue of exposure group, such as inflammatory cell infiltration and edema.@*Conclusion@#The blood gas index, electrolytes, neurotransmitter, histopathology of lung and brain were changed to various degrees by thermobaric bomb gas exposure. These findings would provide some beneficial support for evaluating the damage effect of thermobaric bomb gas on organisms.
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Objective To investigate the influences of IL-17 on regulatory T ( Treg) cells during Chlamydia trachomatis infection. Methods Wild-type ( WT) C57BL/6 mice and IL-17-/- mice were in-tranasally injected with 1×103inclusion forming units (IFU) of Chlamydia muridarum (Cm) to establish the mouse model of Chlamydia trachomatis respiratory tract infection. Mouse spleen and lung single cells were prepared. The percentages of CD4+CD25+T and CD4+CD25+Foxp3+T cells were detected by flow cytome-try. Expression of Foxp3 and TGF-β at mRNA level in lung was detected by RT-PCR. The levels of IL-10 in bronchoalveolar lavage fluid samples were detected by ELISA. Results Compared with the WT mice, the IL-17-/- mice had higher percentages of CD4+CD25+T and CD4+CD25+Foxp3+T cells in spleen and lung on the third day of Cm infection. Both of the expression of Foxp3 at mRNA level in lung and the secretion of IL-10 in bronchoalveolar lavage fluid were increased in IL-17-/- mice as compared with those in WT mice. No significant difference in the expression of TGF-β at mRNA level in lung tissues was found between the two groups. Conclusion IL-17 might inhibit the proliferation of Treg cells and the secretion of IL-10 in the very early stage of Cm respiratory tract infection.
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Objectives: To explore the effect of percutaneous transluminal angioplasty (PTA) combining thrombolysis on ankle brachial index (ABI) in patients with aortoiliac stenosis or occlusive disease (ASOD). Methods: A total of 100 ASOD patients treated in our hospital from 2012-06 to 2015-06 were enrolled. According to treatment method, the patients were divided into 2 groups: Traditional surgery group and PTA combining thrombolysis group. 50 in each group. Results: Compared with Traditional surgery group, PTA combining thrombolysis group had the less intra-operative bleeding, shorter bed time, hospital stay time and the lower complication rate. ABI, walking distance were improved after the operation in both groups and they were better in PTA combining thrombolysis group than Traditional surgery group, P<0.001. The 1, 2, 3 years total patency rates and limb salvage rates were similar between 2 groups, P>0.05. Conclusions: PTA combining thrombolysis method had good short- and long-term efficacy for treating ASOD; it may reduce surgical trauma and complications, should be beneficial to future recovery in relevant patients.
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This study has revealed the change of the soil micro-ecology of farmlands, which used for ginseng cultivation, brought by comprehensive soil improvement. The process of soil improvement was described as follows： soil was sterilized using trichloronitromethane, and then perilla seeds were planted. After growing up, the perillas were turned over into the field and fermented, then organic fertilizer was added. Rotary tillages were carried out during the intervals. Physical and chemical properties of treated soil were measured, as well as microbial diversity, which was illustrated using 16s high through-put sequencing. The survival rate and growth data of ginseng seedlings were recorded. The analysis showed that after improvement, the soil organic matter content was increased and soil bulk density was decreased, compare to the controls, and the fertility in 0-20 cm of soil layer was increased in the treatment. Additionally, the soil microbial diversity was changed greatly. In detail, alpha diversity of the soil decreased after soil improvement while the beta diversity increased. In order to verify the achievement of soil improvement, ginseng seedlings were planted. Compared to the untreated land blocks, the survival rate of ginseng on improved blocks was increased up to 21.4%, and the ginseng physiological index were all better than the controls. Results showed that comprehensive soil improvements including soil sterilization, green manure planting and organic fertilization application effectively improved the soil micro-ecology in farmlands. This study will pave the way for the future standardization of ginseng cultivation on farmlands.
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Continuous cropping obstacles resulted in the yield losses of Panax ginseng, and affected the development of ginseng industry. Soil fungal communities participated in the key ecological process, and their changes of diversity and composition were related to the continuous cropping obstacles. We analyzed the changes of fungal diversity and composition in the rhizosphere of ginseng using the high-throughput sequencing method, stated the effects of ginseng cultivation on the micro-ecology, and provided effective strategies for overcoming continuous cropping obstacles. Compared to those of the forest soils, the fungal diversity of ginseng rhizosphere soils was increased, and the increasing trends were declined with an increasing years of ginseng cultivation; the relative abundance of Sordariomycetes, Alatospora, Eurotiomycetes, Leotiomycetes, Saccharomycetes, Mucorales and Pezizomycetes were increased in the rhizosphere of ginseng. Pearson's correlation index indicated that soil chemical perporties affected the relative abundance of fungal communities. pH was significantly related to the relative abundance of Dothideomycetes and Alatospora; the content of available potassium was markedly associated with the relative abundance of Dothideomycetes, Alatospora and Mucorales; the content of total nitrogen was significant correlation with the relative abundance of Sordariomycetes and Mucorales. These results indicated that fertilization was one of pivotal factors affecting the rhizosphere micro-ecology of ginseng, and optimization of fertilization system was an effective method to overcome continuous cropping obstacles.
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Microbial fuel cells (MFCs) is a highly promising bioelectrochemical technology and uses microorganisms as catalyst to convert chemical energy directly to electrical energy. Microorganisms in the anodic chamber of MFC oxidize the substrate and generate electrons. The electrons are absorbed by the anode and transported through an external circuit to the cathode for corresponding reduction. The flow of electrons is measured as current. This current is a linear measure of the activity of microorganisms. If a toxic event occurs, microbial activity will change, most likely decrease. Hence, fewer electrons are transported and current decreases as well. In this way, a microbial fuel cell-based biosensor provides a direct measure to detect toxicity for samples. This paper introduces the detection of antibiotics, heavy metals, organic pollutants and acid in MFCs. The existing problems and future application of MFCs are also analyzed.
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Objective To evaluate CT findings and the common causes of calcification of the eyeball wall.Methods CT manifestations of 26 cases of calcification of the eyeball wall were reviewed.3 cases were confirmed by surgery and pathology.Etiological diagnosis was made in 23 cases on the basis of detailed history,ophthalmic examination,clinical laboratory and follow-up results.Results Of the 26 patients with calcification of the eyeball wall,19 occurred in unilateral eye,7 occurred in bilateral eyes.The common causes of calcification of the eyeball wall included choroidal osteoma(n= 7),sclerochoroidal calcification(n= 5),subconjunctival lipoma with calcification(n= 4),optic diskdrusen(n=3),long-standing retinal detachment(n=3),recurrent traumatic endophthalmitis(n=2),chronic uveitis(n=1)and postkeratoplasty (n=1).The calcified lesions located in the back of equator of eyeball were showed in 17 patients(66%),in the front of equator in 5 patients(19%),both in the front and back of equator were seen in 4 patients(15%)with multiple lesions.On CT,calcified lesions of the eyeball wall mainly demonstrated some punctiformed,stippled,flat,peltate and irregular high density lesions,and 4 cases with ocular atrophy.Conclusion Most diseases that result in calcification of the eyeball wall have typical location and lesion shape.CT scan is valuable for finding the etiological factors and guiding the clinical treatment.
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The study was aimed to establish a liquid chromatography-tandem mass spectrometric method for the determination of the duloxetine concentration in rat plasma, and compare the pharmacokinetics in normal and diabetes mellitus rat models. Diazepam was used as an internal standard. The separation was achieved on a Waters Xterra® RP18 column (100 mm × 4.6 mm, 3.5 μm) with a mobile phase consisting of methanol -0.3% formic acid containing 5 mmol·L-1 ammonium acetate (75:25) at the flow rate of 0.6 mL·min-1. Electrospray ionization source was applied and operated in the positive multiple reaction monitoring mode. A good linearity of duloxetine was obtained in the concentration range of 10-5 000 ng·mL-1. The rat models of diabetes mellitus were established by intraperitoneal injection of streptozotocin. The same dose of duloxetine (40 mg·kg-1) was given by intragastric administration to the normal and diabetic rats. Blood samples were collected from the orbital venous plexus to determinate duloxetine concentration in the plasma. The pharmacokinetic parameters were calculated by DAS software. Statistical analysis was performed by SPSS software. The major pharma-cokinetic parameters of diabetes group were as follows: Cmax was 1 185 ± 190.0 ng·mL-1; AUC0-∞ was 8 398 ± 1 835 ng·mL-1·h; tmax was 1.6 ± 0.4 h; t1/2z was 3.6 ± 0.9 h. The major pharmacokinetic parameters of normal group were as follows: Cmax was 368.1 ± 40.7 ng·mL-1; AUC0-∞ was 4145 ± 640.1 ng·mL-1·h; tmax was 1.6 ± 0.3 h; t1/2z was 4.1 ± 0.8 h. The results of pharmacokinetic experiments suggest that the exposure amount of duloxetine in diabetic rats is twice higher than that in normal rats.
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Anode is an important part of microbial fuel cell, its performance significantly affects the electricity generation of microbial fuel cells (MFCs). Nanomaterials have excellent properties, such as good conductivity and large surface area. Therefore, nanomaterials modified anode can effectively reduce the electrode resistance, increase the amount of microbial adhesion and improve the electricity generation of MFCs. In this paper, we introduced various nanomaterials modified anodes and summarized their effects on the output performance of MFCs. Finally, the prospect of modifying nanomaterials and technologies were discussed.
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Fuentes de Energía Bioeléctrica , Electricidad , Electrodos , NanoestructurasRESUMEN
This study analysed the changes of the soil micro-ecology in the process of soil sterilization, green manure returning farmlands and fertilization. The methods of soil improvement was initially built which ensured the successful proceed of ginseng cultivation in farmlands. The soil chemical properties were analysed, the diversity and composition of bacterial community after soil sterilization, sterilization+green manure returning farmlands and sterilization+green manure returning farmlands+fertilization. The results exhibited that measures of soil improvement decreased the pH, increased soil fertility, declined the diversity of bacterial community and changed the composition of soil bacterial community. The comprehensive measures of sterilization+green manure returning farmlands+fertilization decreased the ginseng death rate compared to the control. Our data indicated that soil micro-ecological environment was changed by the treatments of soil sterilization, sterilization+green manure returning farmlands and sterilization+green manure returning farmlands+fertilization, and comprehensive measures improved the survival rate and guaranteed the development of ginseng cultivation in farmlands.
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Objective To investigate CT features of subconjunctival fat prolapse and choristoma. Methods Thirty-eight patients, including 18 with subconjunctival fat prolapse and 20 with choristoma, were retrospectively analyzed. Transverse plain CT scan was performed in all the patients, and then coronal plane images was reconstructed at CT workstation. Results CT features of subconjunctival fat prolapse revealed a crescent-shaped or horn-shaped fat density mass continuous with the orbital fat in the superior temporal quadrant of the orbit. CT features of choristoma revealed a crescent-shaped or triangle fat density mass incontinuous with the orbital fat in the temporal side. Conclusion Subconjunctival fat prolapse typically occurs in bilateral superior temporal quadrant of the orbit in elderly males. Subconjunctival choristoma occurs in the unilateral temporal side in adolescent. CT is helpful to distinguish subconjunctival fat prolapse and choristoma.