Résumé
Transthyretin cardiac amyloidosis myocardiopathy （ATTR-CM） is an infiltrative cardiomyopathy characterized by the deposition of amyloidogenic material in the myocardial interstitium due to the misfolding of monomers following the dissociation of unstable transthyretin （TTR） tetramers. Previous treatments for ATTR-CM lacked specificity，primarily targeting symptomatic management of heart failure and arrhythmias. In recent years，researchers have developed two major classes of drugs addressing the pathogenesis of ATTR-CM. The first class stabilizes TTR tetramer structure （such as tafamidis and acoramidis）， while the second class interferes with TTR synthesis （such as patisiran）. Among these，tafamidis has been confirmed as the only currently effective treatment for ATTR-CM，while other drugs are still in clinical trial stages with limited clinical evidence. Concerning the management of comorbidities in ATTR-CM，treatment mainly focuses on common cardiac comorbidities （such as heart failure and arrhythmias）. Traditional drugs used to improve heart failure prognosis （such as β-blockers and renin-angiotensin- receptor blocker），have not demonstrated prognosis improvement in ATTR-CM patients and may even lead to adverse reactions. For ATTR-CM patients with concurrent atrial fibrillation，anticoagulation therapy is recommended to prevent thrombus formation，and amiodarone can be used for rhythm control. Despite significant advancements in pharmaceutical treatments for ATTR-CM，the overall prognosis remains poor，necessitating further research into the pathogenesis and target development to enhance the prognosis of ATTR-CM patients.
Résumé
Objective To investigate cognitive status of medical students of a medical university on laboratory biosafety,and provide basic data for laboratory biosafety management in Chinese universities.Methods 900 full-time undergraduate medical students were chosen by cluster random sampling,questionnaires were filled out in by them.Results 900 questionnaires were distributed,877 (98.21％) valid questionnaires were obtained,49.03％ (n =430) were from sophomores,50.97 ％ (n =447) from juniors,148 (16.88 ％) students have ever participated in students'scientific research.The overall awareness rate of laboratory biosafety was 58.72％,only 32.16％ of students understood the detailed contents of laboratory biosafety regulations,only 8.21％ of students have received training in laboratory biosafety;the awareness rate of laboratory biosafety cabinet was only 14.14％,only 7.75％ of students knew which operation should be performed in biosafety cabinet;28.28％ of students could deal with waste according to the rules,68.19％ of students were able to identify warning signs of biological hazard;92.82％ of the students thought that laboratory biosafety-related courses should be set up.The overall awareness rate of laboratory biosafety knowledge and safety behavior was low,which were 42.65％ and 41.96％ respectively,juniors was higher than that of sophomores(P＜0.05);in the aspect of chemical hazards and biological hazards,students with scientific research experience scored higher than those who did not participate in scientific research(all P＜0.05).Conclusion Medical students' cognition on knowledge of laboratory biosafety is not optimistic,it is imperative to strengthen the management of education and publicity of laboratory biosafety.
Résumé
Objective To investigate the role of chitosan in combination with far infrared treatment on vascular access flow of arteriovenous fistula .Methods A total of 172 hemodialysis patients were recruited in this study .The patients were admitted to the blood purification center in Department of Nephrology in Daping Hospital from 2012 to 2013 .The 172 hemodialysis patients ,were randomized into 4 groups ,43 patients in each group ,including control group ,chitosan group ,far infrared group and combined treat‐ment group .The combined treatment group were treated with chitosan and far infrared in vessel puncture for 40 min at the begin‐ning of each dialysis ;chitosan group accepted the chitosan treatment only ;far infrared group just used far infrared therapy device ;control group were treated with conventional nurses .Arteriovenous fistula blood flow was detected by doppler ultrasound equip‐ment ,the maximum blood flow Qa0 (at the beginning of the study) ,Qa1 (1 month later in the study) ,Qa2(3 months later in the study) ,Qa3(6 months later in the study) ,were analyzed and compared .Results There were no significant difference at different times between the blood flow of arteriovenous fistula in the chitosan group (P>0 .05) .Qa2 and Qa3 of the far infrared group were significantly higher than Qa0 (P<0 .05) .Qa1 ,Qa2 ,Qa3 were significantly higher than Qa0 in the combined treatment group (P<0 .05) .Qa2/Qa0 and Qa3/Qa0 in the far infrared group were significantly higher than control group and chitosan group (P<0 .05) . Compared with the other three group ,Qa1/Qa0 ,Qa2/Qa0 and Qa3/Qa0 were significantly increased in the combined treatment group (P<0 .05) .Conclusion The chitosan and far infrared combined treatment can effectively protect the blood flow of arteriove‐nous fistula in the hemodialysis patients .The combined treatment is one effective method for nursing arteriovenous fistula .