噻托溴铵对稳定期COPD患者血清HIF-1α及其睡眠质量的影响

目的探讨噻托溴铵对稳定期COPD患者血清缺氧诱导因子-1 (HIF-1α)及其睡眠质量的影响。 方法选取2016年12月至2017年12月期间本院呼吸内科住院部收治的60例稳定期COPD患者作为研究对象,按照随机原则将患者分为对照组和研究组,每组各30例。对照组采用常规治疗,研究组在对照组基础上采用噻托溴铵治疗。采用双抗体夹心-酶联免疫吸附试验(DAS-ELISA)测定HIF-1α水平。参照匹茨堡睡眠质量指数量表(PSQI)评定睡眠质量。 结果治疗前,两组血清HIF-1α水平比较差异无统计学意义(P>0.05),治疗后,两组血清HIF-1α明显低于治疗前,P<0.05,研究组血清HIF-1α明显低于对照组,P<0.05。治疗前,两组PSQI评分比较差异无统计学意义(P>0.05),治疗后,两组上述评分明显低于治疗前,P<0.05,研究组上述评分明显低于对照组,P<0.05。治疗前,两组第1 s用力呼气容积(FEV₁)、呼气峰流速值(PEF)、用力肺活量(FVC)和深吸气量(IC)比较差异无统计学意义(P>0.05),治疗后,两组上述指标明显高于治疗前,P<0.05,研究组上述指标明显高于对照组,P<0.05。 结论噻托溴铵有助于降低稳定期COPD患者血清HIF-1α水平,改善患者睡眠质量和肺功能。     

补阳还五汤联合子午流注纳甲法治疗脑中风后遗症及对炎症因子的影响

目的探讨补阳还五汤联合子午流注纳甲法治疗脑中风后遗症病人的临床疗效以及对白细胞介素-10(interleukin-10,IL-10)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的影响。方法以2014年3月—2017年3月收入我院的96例脑中风后遗症病人为研究对象。随机分为对照组和研究组,每组48例。所有病人给予相同的基础治疗,对照组病人进行子午流注纳甲法针灸,研究组病人在对照组基础上服用补阳还五汤。治疗3个疗程。比较两组的临床疗效及治疗前后Fugl-Meyel评分、Bathel评分和美国国立卫生研究院卒中量表(NIHSS)评分,比较两组病人治疗前后IL-10、IL-6及TNF-α水平。结果研究组总有效率为95.83%,显著高于对照组的81.25%(P<0.05)。治疗前两组各指标差异无统计学意义(P>0.05)。治疗后,两组病人的Fugl-Meyel评分和Bathel评分均显著升高(P<0.01),NIHSS评分均显著降低(P<0.01),且研究组Fugl-Meyel评分和Bathel评分均显著高于对照组(P<0.01),NIHSS评分显著低于对照组(P<0.01)。治疗后,两组病人血清IL-10显著升高(P<0.01),IL-6及TNF-α水平均显著下降(P<0.05),且研究组IL-10高于对照组(P<0.05),IL-6及TNF-α显著低于对照组(P<0.05)。结论补阳还五汤联合子午流注纳甲法可以有效改善脑中风后遗症病人的临床症状,提高其运动功能和生活质量,改善神经功能缺损,同时降低血清IL-6和TNF-α水平,升高IL-10水平,减轻炎症反应,改善机体免疫平衡。     

法舒地尔联合丁苯酞对老年急性脑梗死的疗效及对血清ApoE、Toll样受体和氧化应激的影响

目的探讨法舒地尔联合丁苯酞对老年急性脑梗死患者的疗效及对血清载脂蛋白(Apo)E、Toll样受体(TLR)4和氧化应激的影响。方法选择老年急性脑梗死患者86例,根据随机表法随机分为对照组43例与观察组43例。对照组给予丁苯酞治疗,观察组在对照组基础上结合法舒地尔治疗。两组疗程均为14 d。比较两组治疗疗效,治疗前后Barthel指数和美国国立卫生研究院脑卒中量表(NIHSS)评分、血清ApoE水平变化、TLR4 mRNA表达及氧化应激指标变化。结果观察组总有效率(91.70%)显著高于对照组(69.77%,P<0.05)。两组治疗后Barthel指数评分较治疗前显著增加而NIHSS评分较治疗前显著降低(观察组:t=14.555、26.791,对照组:t=6.435、14.910,均P<0.05);观察组治疗后Barthel指数评分显著高于对照组而NIHSS评分显著低于对照组(t=7.343、10.362,均P<0.05)。两组治疗后血清ApoE水平较治疗前显著降低(观察组:t=11.794,对照组:t=4.922,均P<0.05);观察组治疗后血清ApoE水平显著低于对照组(t=7.451,P<0.05)。两组治疗后TLR4 mRNA表达较治疗前显著降低(观察组:t=21.825,对照组:t=8.588,P<0.05);观察组治疗后TLR4 mRNA表达显著低于对照组(t=8.162,P<0.05)。两组治疗后血浆超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)水平较治疗前显著升高,而丙二醛(MDA)水平较治疗前显著降低(观察组:t=22.703、15.753、13.862,对照组:t=12.112、6.398、5.492,均P<0.05);观察组治疗后血浆SOD和GSH-Px水平显著高于对照组,而MDA水平显著低于对照组(t=11.050、10.282、8.576,均P<0.05)。结论法舒地尔联合丁苯酞对老年急性脑梗死患者疗效明显,可降低血清ApoE水平,下调TLR4表达,改善氧化应激。     

灯盏花素对老年脑卒中病人血清hs-CRP、TNF-α水平及预后的影响

目的探讨灯盏花素对老年脑卒中病人血清超敏-C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平及预后的影响。方法将76例老年脑卒中病人随机分为对照组和研究组,各38例。对照组采用常规西药治疗,研究组在对照组基础上采用灯盏花素治疗。采用乳胶免疫增强透射比浊法(LETIA)测定血清hs-CRP水平,采用酶联免疫吸附试验(ELISA)测定血清TNF-α水平。观察并比较两组临床疗效、血清hs-CRP及TNF-α水平美国国立卫生研究院脑卒中量表(NIHSS)、急性生理和慢性健康状况评价系统Ⅱ(APACHEⅡ)评分、格拉斯哥昏迷评分量表(GCS)变化及不良反应发生情况。结果研究组总有效率(94.74%)高于对照组(65.79%),差异有统计学意义(P0.05)。治疗后两组血清hs-CRP、TNF-α较治疗前降低(P0.05),且研究组低于对照组(P0.05);治疗后两组NIHSS、APACHEⅡ评分低于治疗前,GCS评分高于治疗前(P0.05),且研究组NIHSS、APPACHEⅡ评分低于对照组,GCS评分高于对照组(P0.05)。研究组药物不良反应发生率为5.26%,低于对照组的21.05%,差异有统计学意义(P0.05)。结论灯盏花素治疗老年脑卒中,可降低病人血清hs-CRP、TNF-α水平,进而改善预后。     

维拉帕米联合干扰素α-2b对流行性出血热患者疗效及对CRP、TNF-α、IL-6、NGAL、KIM-1表达的影响

目的 探讨维拉帕米联合干扰素α-2b对流行性出血热患者的治疗效果，为临床诊治EHF提供更多参考依据。方法 选取本院2018年8月至2022年8月收治的68例EHF患者作为研究对象，使用随机数字表通过简单随机法分为研究组与对照组，每组34例，对照组接受干扰素α-2b治疗，研究组接受维拉帕米联合干扰素α-2b治疗。比较两组疗效、肾损伤指标[中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肾损伤分子1(KIM-1)]、血清炎症因子[C反应蛋白(CRP)、肿瘤坏死因子-α(THF-α)、白细胞介素-6(IL-6)],并对两组不良反应情况进行比较。结果 研究组与对照组治疗总有效率分别为97.06%和82.35%,差异具有统计学意义(P<0.05);治疗后两组尿上清液中NGAL、KIM-1、血清IL-6、CRP及TNF-α水平均较本组治疗前明显降低(P<0.05),其中研究组明显低于对照组(P<0.05);研究组与对照组不良反应发生率分别为11.76%和8.82%,差异无统计学意义(P>0.05),两组均无低血压性休克、死亡病例。结论 维拉帕米联合干扰素α-2b治疗流行性出血...     

新生儿缺氧缺血性脑病血清HIF-1α、miR-210水平与NBNA评分的相关性

目的检测缺氧缺血性脑病(HIE)新生儿血清中低氧诱导因子-1α(HIF-1α)、微小RNA-210(miR-210)水平,同时对新生儿进行行为神经测定(NBNA)评分,探讨HIE新生儿血清HIF-1α、miR-210水平与NBNA评分的相关性。方法选取2016年3月—2019年2月本院收治的80例HIE新生儿为研究对象(HIE组);同期选取75名正常新生儿作为对照组。采用酶联免疫吸附法(ELISA)检测血清HIF-1α水平,实时荧光定量聚合酶链式反应(qRT-PCR)法检测miR-210水平,对新生儿NBNA评分进行评定。比较两组一般资料、血清相关指标,分析HIE新生儿血清HIF-1α、miR-210水平与NBNA评分的相关性以及HIF-1α、miR-210、NBNA评分与血清相关指标的相关性;并分析影响新生儿HIE的因素。结果两组胎龄、性别、出生体重、钙比较,差异均无统计学意义(P>0.05);HIE组血清HIF-1α、miR-210、天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)水平高于对照组(P<0.05);HIE组Apgar评分、NBNA评分低于对照组(P<0.05);HIE新生儿血清HIF-1α、miR-210水平与NBNA评分均呈负相关(P<0.05);HIE新生儿血清AST、LDH、CK、CK-MB与HIF-1α、miR-210呈正相关(P<0.05),与NBNA评分呈负相关(P<0.05);HIF-1α、CK-MB是影响新生儿HIE的危险因素,NBNA评分是影响新生儿HIE的保护因素。结论HIE新生儿血清HIF-1α、miR-210水平与NBNA评分均呈负相关,三者与新生儿HIE病情发展密切相关。     

老年急性脑梗死溶栓后24 h内使用注射用丹参多酚酸的疗效及对血清炎性因子水平的影响

目的探讨老年急性脑梗死溶栓后24 h内使用注射用丹参多酚酸的疗效及对血清炎性因子水平的影响。方法选择老年急性脑梗死溶栓治疗患者200例,根据随机数字发分为对照组和丹参多酚酸组,每组100例。对照组给予急性脑梗死常规溶栓治疗,丹参多酚酸组给予常规溶栓治疗24 h内给予丹参多酚酸治疗。测定血清超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α水平。结果丹参多酚酸组疗效明显优于对照组(P<0.05),总有效率明显高于对照组(P<0.05)。治疗前,两组Barthel指数和美国国立卫一研究院脑卒中量表(NIHSS)评分差异无统计学意义(P>0.05);治疗后,两组Barthel指数明显高于治疗前(P<0.05),NIHSS评分明显低于治疗前(P<0.05),丹参多酚酸组Barthel指数明显高于对照组(P<0.05),NIHSS评分明显低于治疗前(P<0.05)。治疗前,两组炎性因子水平差异无统计学意义(P>0.05);治疗后,两组炎性因子水平明显低于治疗前(P<0.05),且丹参多酚酸组明显低于对照组(P<0.05)。两组均无明显不良反应发生。结论老年急性脑梗死溶栓后24 h内使用注射用丹参多酚酸安全有效,可通过降低血清炎性因子水平提高效果。     

破格救心汤对急诊心脏骤停病人心肺复苏、氧化应激及血清S100b、TNF-α、IL-8的影响

目的观察破格救心汤对急诊心脏骤停病人心肺复苏、氧化应激及血清S100b、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)的影响。方法选取2016年3月—2017年3月吉林省长春市农安县中医院急诊抢救室救治的心脏骤停病人80例为研究对象,按照随机数字表法分为研究组和对照组,各40例。对照组给予西医基础治疗,研究组在对照组基础上配合破格救心汤治疗,持续用药24h。统计两组自主循环恢复(ROSC)时间、ROSC率,记录两组复苏后格拉斯哥昏迷量表(GCS)评分,检测两组复苏后氧化应激水平、血清S100b、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平。结果急救后研究组ROSC率显著高于对照组(P 0.05),研究组ROSC时间显著短于对照组(P 0.05);复苏后24h,对照组存活18例,研究组存活25例,研究组GCS评分较复苏后12h显著升高(P 0.05),且显著高于对照组(P 0.05);复苏后24h,两组血清超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平较ROSC后显著降低,丙二醛(MDA)水平较ROSC后显著升高(P 0.05),且研究组显著优于对照组(P 0.05);复苏后24h,两组血清S100b、TNF-α、IL-8水平较ROSC后显著升高(P 0.05),且研究组显著低于对照组(P 0.05)。结论破格救心汤治疗急诊心脏骤停病人可促进心肺复苏,改善氧化应激水平和血清S100b、TNF-α、IL-8水平。     

雷贝拉唑联合微生态制剂治疗老年功能性消化不良的临床疗效及对患者血清GHR、AchE水平的影响

目的 探讨雷贝拉唑联合微生态制剂治疗老年功能性消化不良(FD)的临床疗效及对患者血清促生长素(GHR)及乙酰胆碱酯酶(AchE)水平的影响。方法 120例老年FD患者随机分为研究组与对照组各60例。常规干预基础上对照组采取雷贝拉唑,研究组于对照组基础上加用双歧杆菌四联活菌,两组均治疗2个月。统计两组临床疗效及治疗前后症状评分、血清胃泌素(GAS)及胃动素(MTL)水平、GHR及AchE水平、胃动过缓及胃电节律异常发生率、不良反应。结果 研究组总有效率明显高于对照组(P<0.05);治疗后研究组餐后饱胀、上腹痛、上腹部烧灼感、早饱分值明显低于对照组(P<0.05);治疗后研究组血清MTL、GAS水平明显高于对照组(P<0.05);治疗后两组血清GHR及AchE水平较治疗前明显增高,且研究组明显高于对照组(P<0.05);治疗后两组餐前及餐后胃动过缓及胃电节律异常发生率较治疗前明显降低,且研究组低于对照组(P<0.05);两组不良反应发生率比较,无显著差异(P>0.05)。结论 联合采取双歧杆菌四联活菌及雷贝拉唑治疗老年FD,疗效确切,可更有效改善患者临...     

银杏叶联合丁苯酞注射液对老年急性脑梗死患者炎性因子、血流动力学和氧化应激反应的影响

目的 探讨银杏叶联合丁苯酞注射液对老年急性脑梗死患者炎性因子、血流动力学和氧化应激反应的影响。方法 选择老年急性脑梗死患者100例，运用随机表法分为治疗组与对照组各50例。对照组给予丁苯酞注射液治疗，治疗组在丁苯酞注射液基础上口服银杏叶片治疗。两组治疗疗程2 w。比较两组临床疗效，治疗前后美国国立卫生研究院脑卒中量表(NIHSS)神经功能缺损程度、Barthel指数(BI)量表和脑卒中患者生活质量专用量表(SS-QOL)评分，炎性因子，血流动力学和氧化应激反应变化。结果 治疗组总有效率显著高于对照组(P<0.05)。两组治疗后NIHSS评分显著低于治疗前，而BI评分和SS-QOL评分显著高于治疗前(P<0.05);且治疗组NIHSS评分显著低于对照组，而BI评分和SS-QOL评分显著高于对照组(P<0.05)。两组治疗后血清肿瘤坏死因子(TNF)-α、超敏C反应蛋白(hs-CRP)和白细胞介素(IL)-6水平显著低于治疗前，且治疗组显著低于对照组(P<0.001)。两组治疗后大脑中动脉收缩期峰值流速(Vs)和平均血流速度(Vm)显著高于治疗前，而波动指数(PI)...     

Cardiovascular,diabetes, and cancer strips: evidences,mechanisms, and classifications

Objectives

To report and name firstly that there are cardiovascular disease (CVD), diabetes mellitus (DM) and cancers (CDC) strips; and disclose their mechanisms, classifications, and clinical significances.

Study design

Narrative and systematic review study and interpretive analysis.

Methods

Data sources and study selection: to collect and present related evidences on CDC strips from evidence-based, open-access, both Chinese- and English-language literatures in recent 10 years on clinical trials from PubMed according to keywords “CVD, DM and cancers” as well as authors’ extensive clinical experience with the treatment of more than fifty thousands of patients with CVD, diabetes and cancers over the past decades, and analyze their related mechanisms and categories which based on authors’ previous works. Data extraction: data were mainly extracted from 48 articles which are listed in the reference section of this review. Qualitative, quantitative and mixed data were included, narratively and systematically reviewed.

Results

With several conceptual and technical breakthrough, authors present related evidences on CDC strips, these are, CVD and DM, DM and cancers, cancers and CVD linked, respectively; And “Bad SEED” +/– “bad soil” theory or doctrine may explain this phenomenon due to “internal environmental injure, abnormal or unbalance” in human body resulting from the role of risk factors (RFs) related multi-pathways and multi-targets, which including organ & tissue (e.g., vascular-specific), cell and gene-based mechanisms. Their classifications include main strips/type B, and Branches/type A as showed by tables and figures in this article.

Conclusions

There are CDC strips and related mechanisms and classifications. CDC strips may help us to understand, prevent, and control related common non-communicable diseases (NCDs) as well as these high risk strips.     

Lipoxins,Resolvins, Protectins,Maresins, and Nitrolipids: Connecting Lipids,Inflammation, and Cardiovascular Disease Risk

Essential fatty acids and their metabolites (γ-linolenic acid [GLA], dihomo-GLA, arachidonic acid, eicosapentaenoic acid, and docosahexaenoic acid; prostaglandin E₁; prostacyclin [PGI₂]; PGI₃; lipoxins; resolvins; protectins; maresins; and nitrolipids) prevent platelet aggregation, produce vascular relaxation, inhibit neutrophil degranulation and superoxide formation, inhibit platelet activation, possess peroxisome proliferator-activated receptor-γ ligand activity, and release nitric oxide. Thus, they lower blood pressure, are anti-arrhythmic and anti-inflammatory in nature, reduce low-density lipoprotein cholesterol, ameliorate the adverse actions of homocysteine, activate telomerase, and have cytoprotective properties—actions that prevent atherosclerosis and cardiovascular disease. Because coronary heart disease (CHD) and atherosclerosis are low-grade systemic inflammatory conditions, it is likely that reduced formation of lipoxins, resolvins, protectins, maresins, and nitrolipids plays a significant role in the pathogenesis of CHD. Hence, development of stable synthetic analogues of lipoxins, resolvins, protectins, and maresins may form a new therapeutic approach to CHD and other low-grade systemic inflammatory conditions.     

Lumbar spine radiographic features and demographic,clinical, and radiographic knee,hip, and hand osteoarthritis

Objective

To determine the prevalence of lumbar spine individual radiographic features (IRFs) of disc space narrowing (DSN), osteophytes (OST), and facet joint osteoarthritis (FOA); to describe the frequencies of demographic, clinical, and radiographic knee, hip, and hand osteoarthritis (OA) across lumbar spine IRFs; and to determine factors associated with lumbar spine IRFs.

Methods

We conducted a cross‐sectional study of 840 participants enrolled in the Johnston County Osteoarthritis Project (2003–2004). Sample‐based prevalence estimates were generated for each lumbar spine IRF. The associations between lumbar spine IRFs and demographic, clinical, and peripheral joint OA were determined with logistic regression models.

Results

Sample‐based prevalence estimates were similar for DSN (57.6%) and FOA (57.9%) but higher for OST (88.1%), with significant differences across race and sex. Hand and knee OA frequencies increased across IRFs, whereas the effect was absent for hip OA. African Americans had lower odds of FOA (adjusted odds ratio [OR_adj] 0.45 [95% confidence interval (95% CI) 0.32–0.62]), while there was no racial association with DSN and OST. Low back symptoms were associated with DSN (OR_adj 1.37 [95% CI 1.04–1.80]) but not OST or FOA. Knee OA was associated with OST (OR_adj 1.62 [95% CI 1.16–2.27]) and FOA (OR_adj 1.69 [95% CI 1.15–2.49]) but not DSN. Hand OA was associated with FOA (OR_adj 1.67 [95% CI 1.20–2.28]) but not with DSN or OST. No associations were found with hip OA.

Conclusion

These findings underscore the importance of analyzing lumbar spine IRFs separately as the associations with demographic, clinical, and radiographic knee, hip, and hand OA differ widely.     

Meta-analysis,meta-regression,and meta-physics

Παντɛςανθρωποιτοv ɛιδɛναιορɛγονταιφvσɛι. σημɛιονδɛητωναισθησɛωναγαπησις. Kαιγαρχωριςτηςχρɛιαςαγαπωνταιδι' αvτας, καιμαλλιστατωναλλωνηδιατωνομματων.
By nature humans thirst for knowledge. A sign of this is our love of the senses. Because irrespective of our needs we love our senses in themselves and most of all vision (eyesight). ¹     

Drunkenness,Hangover, and the Heart

Cardiac effects of ethanol ingestion (1.75 g/kg within 3 hours) were examined in 8 healthy males by echocardiography and systolic time intervals in a controlled study. Heart rate (HR) was increased by 15% (p<0.05) during intoxication when blood ethanol (mean±SD) was 33.7 ±4.1 mmol/l. Left ventricular (LV) end-diastolic dimension was simultaneously shortened by 4% (p<0.01) and LV end-systolic dimension by 3% (p<0.05). Stroke volume was reduced by 12% (p<0.05). Most subjects experienced hangover symptoms 12 hours after the beginning of ethanol intake; blood ethanol was 8.8 ± 4.0 mmol/l. At this time, HR was raised by 17% (p<0.05), ejection fraction by 7% (p<0.05), and circumferential fiber shortening velocity by 19% (p<0.01); total peripheral resistance was decreased by 17% (p<0.001). The resultant increase in cardiac output amounted to 22% (p<0.01). In short, the main effect of ethanol at modest blood concentrations was to reduce LV preload without detectably impairing myocardial performance. Hangover was characterized by vasodilation as well as intensified LV myocardial and pump performances.     

Hyperinsulinaemia,obesity, and syndrome X

Abstract. Objective . The major aim of this study was to compare various aspects of carbohydrate, insulin, and lipoprotein metabolism, serum uric acid concentration, and blood pressure in normal subjects stratified on the basis of both plasma insulin concentration and degree of obesity. The hypothesis to be tested was that hyperinsulinaemia, per se, was associated with relative glucose intolerance, higher triglyceride and uric acid concentrations, lower high-density lipoprotein cholesterol concentration and higher blood pressure, irrespective of degree of obesity. Design . This represents a case-control study, in which normal volunteers were subdivided into four equal groups based upon degree of obesity and plasma insulin response to a 74 g oral glucose challenge. Setting . The study was performed in the out-patient clinic of a university hospital. Subjects . Sixty-four individuals were recruited for this study, subdivided into four groups based upon their plasma insulin concentration and body mass index. Subjects were classified as hyperinsulinaemic if their plasma insulin concentrations in response to an oral glucose challenge were more than two standard deviations above the mean of 732 volunteers previously studied [1]. Obesity was defined as a body mass index of > 30 kg m^-2, and individuals were classified as non-obese if their body mass index was < 27.0 kg m^-2. Based upon these criteria, four experimental groups were created: (i) non-obese hyperinsulinaemic (NOB hyper); (ii) obese hyperinsulinaemic (OB hyper); (iii) non-obese normo-insulinaemic (NOB normo); and (iv) obese normo-insulinaemic (OB normo). Main outcome measures . Subject groups were compared on the basis of the integrated plasma glucose response to a 75 g oral glucose challenge, fasting plasma triglyceride, cholesterol, high-density lipoprotein cholesterol, and uric acid concentrations, and blood pressure. Results . Mean (± standard error of the mean) integrated plasma glucose response area for 2 h following a 75 g oral glucose load was significantly higher (13.4 ± 0.4 vs. 11.0 ± 0.4 mmol 1^-1, P < 0.001) in the hyperinsulinaemic group, as were the fasting triglyceride levels (2.4 ± 0.2 vs. 1.4 ± 0.1 mmol 1^-1, P < 0.001) and uric acid (5.3 ± 0.2 vs. 4.4 ± 0.2 mmol 1^-1, P < 0.05) concentrations. In contrast, high-density lipoprotein concentrations were lower in the hyperinsulinaemic group (1.06.0.05 vs. 1.32 ± 0.05 mmol 1^-1, P < 0.001). In addition, blood pressure was higher in the hyperinsulinaemic group (136 ± 5/87 ± 2 vs. 123 ± 2/82 ± 1 mmHg, P < 0.05). Furthermore, when each of the two groups were divided into obese (n = 16) and non-obese (n = 16) groups, all of the differences outlined above persisted. These changes were independent of age, gender distribution, generalized and abdominal obesity, cigarette smoking, and estimated physical activity. Conclusions . The cluster of changes subsumed under the heading of syndrome X are closely associated with hyperinsulinaemia (and presumably insulin resistance), and can be discerned irrespective of degree of obesity.     

Cholesterol, Inflammasomes, and Atherogenesis

Plasma cholesterol levels have been strongly associated with atherogenesis, underscoring the role of lipid metabolism in defining cardiovascular disease risk. However, the atherosclerotic plaque is highly dynamic and contains elements of both the innate and adaptive immune system that respond to the aberrant accumulation of lipids in the subendothelial space. Previous research has focused on defining how proinflammatory cytokines synthesized by macrophages, such as interleukin-1β (IL-1β), modulate the progression of atherosclerosis, supporting the notion that chronic inflammation accelerates atherogenesis. More recently, emphasis has been placed on the elucidation of the mechanisms that contribute to pro–IL-1β production and finally its processing via multiprotein complexes termed the inflammasomes, a family of cytosolic multiprotein complexes that serve as sensors of either pathogen invasion or cellular stress (ie, cholesterol crystals) and work via triggering caspase-1–mediated processing of pro–IL-1β to IL-1β. Based on this link between cholesterol metabolism, NLRP3 inflammasome activation, and IL-1β release, it is important to re-evaluate how the atherogenic environment stimulates immune cells to produce IL-1β.     

Fatigue-free,superstretchable, transparent,and biocompatible metal electrodes

Next-generation flexible electronics require highly stretchable and transparent electrodes. Few electronic conductors are both transparent and stretchable, and even fewer can be cyclically stretched to a large strain without causing fatigue. Fatigue, which is often an issue of strained materials causing failure at low strain levels of cyclic loading, is detrimental to materials under repeated loads in practical applications. Here we show that optimizing topology and/or tuning adhesion of metal nanomeshes can significantly improve stretchability and eliminate strain fatigue. The ligaments in an Au nanomesh on a slippery substrate can locally shift to relax stress upon stretching and return to the original configuration when stress is removed. The Au nanomesh keeps a low sheet resistance and high transparency, comparable to those of strain-free indium tin oxide films, when the nanomesh is stretched to a strain of 300%, or shows no fatigue after 50,000 stretches to a strain up to 150%. Moreover, the Au nanomesh is biocompatible and penetrable to biomacromolecules in fluid. The superstretchable transparent conductors are highly desirable for stretchable photoelectronics, electronic skins, and implantable electronics.Flexible transparent electrodes are crucial to the emerging fields of flexible solar cells (1, 2), flexible electronics (3–5), electronic skins (e-skins) (6), and implantable electronics (7, 8). Among the several modes of flexibility, including bending, folding, twisting, and stretching, stretching generates the largest strain and therefore is the most demanding (9). What is even more challenging is to make transparent electrodes fatigue-free under cyclic stretches. Fatigue often happens during strain cycling, even if the strain level is relatively low. It determines the real loading that can be applied to a material in practical applications. However, metallic materials often exhibit high cycle fatigue (10), and fatigue has been a deadly disease for metals.Several types of transparent conductors, including graphene sheets, carbon nanotube (CNT) films, metal nanowire (NW) networks, composites based on Ag NWs, metal meshes, and ultrathin metal films have been found to be stretchable (1, 3, 6, 11–18). However, sheet resistance (R_sh) of existing stretchable transparent electrodes often sharply increases when highly stretched, or repeatedly stretched to relatively small strains for thousands of cycles. Graphene can be stretched one time to 30%, or cyclically stretched to 6% for a few times (11). Metal meshes made of straight lines and ultrathin metal films are also stretchable, but typically they cannot be stretched to more than 100% (16, 17). The Bao group has shown that CNT network film with a serpentine morphology can be stretched one time to 170% before failure, or repeatedly stretched to 25% for 12,500 cycles with a modest increase of resistance (6). Here we show that optimizing topology of a Au nanomesh can significantly improve the stretchability, revealing an R_sh of ∼28 Ω/□ and a transmittance (T) ∼90% when stretched to 300%. Moreover, by tuning the adhesion between the Au nanomesh and the underlying substrate, the conductor exhibits high fatigue resistance: The resistance does not increase and the morphology has little change after 50,000 cycles of stretching to a large strain of 150%. We ascribe the fatigue-free nature to two reasons. First, the ligaments in the Au nanomesh on a slippery substrate can locally shift and reorient to relax stress. Second, the Au nanoserpentines are well interconnected, and the nodes play an important role for the metal nanomesh to return to the original shape after stress is removed. The Au nanomesh is also biocompatible, and penetrable to body fluid, allowing biomacromolecules to pass through freely. The large stretchability, high fatigue resistance, and good biocompatibility of the transparent electrode are highly desired for stretchable photoelectronics, e-skins, and implantable electrodes in medical devices.     

Dietary Fiber,Kidney Function,Inflammation, and Mortality Risk

Background and objectives

In the United States population, high dietary fiber intake has been associated with a lower risk of inflammation and mortality in individuals with kidney dysfunction. This study aimed to expand such findings to a Northern European population.

Design, setting, participants, & measurements

Dietary fiber intake was calculated from 7-day dietary records in 1110 participants aged 70–71 years from the Uppsala Longitudinal Study of Adult Men (examinations performed during 1991–1995). Dietary fiber was adjusted for total energy intake by the residual method. Renal function was estimated from the concentration of serum cystatin C, and deaths were registered prospectively during a median follow-up of 10.0 years.

Results

Dietary fiber independently and directly associated with eGFR (adjusted difference, 2.6 ml/min per 1.73 m² per 10 g/d higher; 95% confidence interval [95% CI], 0.3 to 4.9). The odds of C-reactive protein >3 mg/L were lower (linear trend, P=0.002) with higher fiber quartiles. During follow-up, 300 participants died (incidence rate of 2.87 per 100 person-years at risk). Multiplicative interactions were observed between dietary fiber intake and kidney dysfunction in the prediction of mortality. Higher dietary fiber was associated with lower mortality in unadjusted analysis. These associations were stronger in participants with kidney dysfunction (eGFR<60 ml/min per 1.73 m²) (hazard ratio [HR], 0.58; 95% CI, 0.35 to 0.98) than in those without (HR, 1.30; 95% CI, 0.76 to 2.22; P value for interaction, P=0.04), and were mainly explained by a lower incidence of cancer-related deaths (0.25; 95% CI, 0.10 to 0.65) in individuals with kidney dysfunction versus individuals with an eGFR≥60 ml/min per 1.73 m² (1.61; 95% CI, 0.69 to 3.74; P value for interaction, P=0.01).

Conclusions

High dietary fiber was associated with better kidney function and lower inflammation in community-dwelling elderly men from Sweden. High dietary fiber was also associated with lower (cancer) mortality risk, especially in individuals with kidney dysfunction.     

Endothelin, vascular hypertrophy, and hypertension

Summary The endothelins (ET-1,2, and 3) constitute a family of 21 amino-acid peptides with potent biological activities. They are synthesized in several tissues, including the vascular endothelium (ET-1 exclusively) and smooth muscle cells. The production and release of endothelin is stimulated by many factors, hormonal and metabolic, and by growth factors, hypoxia, and shear stress. Released endothelin binds to the endothelin receptors ET_A and ET_B, the ET_A receptors on vascular smooth muscle cells mediating vasoconstriction, and the ET_B receptors on the endothelium linked to nitric oxide (NO) and prostacyclin release. The ET_A receptors activate the PLC-IP₃-DAG transduction pathway, which through an increase in cytosolic Ca²⁺ and protein kinase C (PKC) causes vasoconstriction and stimulation of vascular smooth muscle cell growth and proliferation. In the pathogenesis of vascular hypertrophy in hypertension, there is a complex interaction between endothelin, angiotensin II, 795-1 agonists, Ca²⁺, and other growth factors. In animal models of hypertension, endothelin causes vascular hypertrophy, more pronounced in deoxycorticosterone acetate (DOCA)-salt hypertension in the rat than in the spontaneously hypertensive rat. In humans there is an increase in the plasma concentration of endothelin in severe atherosclerotic disease, but not consistently in hypertension. Evidence for the role of endothelin in the vascular hypertrophy of human hypertension is scanty, but the development of nonpeptide and receptor subtype-selective antagonists will permit meaningful studies, including clinical trials of a new class of antihypertensive agents.