本经取穴调控无先兆偏头痛患者基因表达谱的研究

【目的】研究针刺少阳经穴与针刺非经非穴治疗无先兆偏头痛患者前后的基因表达谱。【方法】采用基因芯片技术,分析比较采用经穴（经穴组）和非经非穴（非经非穴组）治疗无先兆偏头痛患者（各10例）后基因表达谱的差异;选取部分基因进行Real-time聚合酶链反应（RT－PCR）,验证基因芯片结果的准确性。【结果】经穴组治疗前后筛选出72个差异基因;非经非穴组治疗前后筛选出110个差异基因。经穴组差异基因涉及的功能包括脑内啡肽酶、 ATP合酶等,与治疗该病的关联性大。但非经非穴组涉及的基因功能广泛且分散,与治疗该病关联性较小,如细胞凋亡、 DNA修复等。 RT－PCR检测了经穴组的ATPAF2、 PTGS2、 TOR3A基因,非经非穴组的ACP2、 AURKA、 ARHGEF11、 CASP8基因,验证了基因芯片数据的可靠性。【结论】本经取穴治疗无先兆偏头痛的经穴效应在分子水平是多基因作用的综合结果,而非经非穴产生的安慰效应并未找到与之对应的与治疗无先兆偏头痛相关的靶基因,进一步证明了经穴效应的存在。     

Design of melt-recyclable poly(ε-caprolactone)-based supramolecular shape-memory nanocomposites

A novel poly(epsilon-caprolactone) (PCL) supramolecular network exhibiting shape-memory behavior was successfully constructed with pendant UPy units that are highly able to dimerize. The dynamic network was obtained by a simple and versatile strategy consisting of chain-extension reaction between α,ω-dihydroxyoligoPCL and hydroxylated UPy units in the presence of hexamethylene diisocyanate as a coupling agent and further intermolecular dimerization of the UPy along the polyurethane backbone. ¹H NMR analyses confirmed the dynamic features of the system, and DMTA in tensile mode was investigated to assess the SMP properties. Recyclability was also assessed by taking advantage of these supramolecular networks. Further addition of cellulose nanocrystals into the polymer network enabled adjustment of the extent of the net-points and therefore the SMP features. As confirmed by dispersion tests in solution and SEM observations, these bio-based nanofillers were homogeneously distributed in the network via supramolecular interaction between the hydroxyl groups present on their surface and UPy moieties along the polyurethane backbone. Thus, the here developed nanomaterials might reveal applicability in areas where a combination of SMP and biocompatibility is needed.

Novel melt-recyclable poly(ε-caprolactone)/cellulose nanocrystals supramolecular nanocomposite networks with shape-memory behavior have been successfully constructed by playing with UPy chemistry.     

Prognostic value of blood pressure in ambulatory heart failure: a meta-analysis and systematic review. Ambulatory blood pressure predicts heart failure prognosis

Heart Failure Reviews - Previous primary studies have explored the association between blood pressure (BP) and mortality in ambulatory heart failure (HF) patients reporting varying and contrasting...     

Fludarabine-based cytoreductive regimen and T-cell-depleted grafts from alternative donors for the treatment of high-risk patients with Fanconi anaemia

Eighteen consecutive patients aged 5·5–24 years with Fanconi anaemia and diagnoses of aplastic anaemia ( n  = 8), myelodysplastic syndrome ( n  = 4), acute myeloid leukaemia ( n  = 6), received allogeneic haematopoietic stem cell transplants from alternative donors. All patients had been transfused, 13 had previously been treated with androgens and 14 had a history of infection. Donors were related human leucocyte antigen (HLA) mismatched for eight patients, unrelated HLA mismatched for seven patients and unrelated HLA matched for three patients. Cytoreduction included single dose total body irradiation (450 cGy), fludarabine (150 mg/m²) and cyclophosphamide (40 mg/kg). Immunosuppression included antithymocyte globulin and tacrolimus. Grafts were granulocyte colony-stimulating factor-mobilized, CD34⁺ T-cell-depleted peripheral blood stem cells in 15 patients and T-cell-depleted marrows in three. All 18 patients engrafted with 100% donor chimaerism; only one patient developed graft-versus-host disease (GVHD). With a median follow-up of 4·2 years, 13/18 patients were alive, 12 of these were disease-free. Five-year overall survival and disease-free survival were 72·2% and 66·6% respectively. Immune reconstitution was achieved at approximately 6 months post-transplant for most patients. These are encouraging results of T-cell-depleted transplants from alternative donors using fludarabine-based cytoreduction in 18 high-risk patients with Fanconi anaemia, with no evidence of rejection and minimal GVHD.     

Short-term Effects of Alfacalcidol on Hospital Length of Stay in Patients Undergoing Valve Replacement Surgery: A Randomized Clinical Trial

PurposeVitamin D deficiency is highly prevalent in critically ill patients, and has been associated with more prolonged length of hospital stay and poor prognosis. Patients undergoing open-heart surgery are at higher risk due to the associated life-threatening postoperative complications. This study investigated the effect of alfacalcidol treatment on the length of hospital stay in patients undergoing valve-replacement surgery.MethodsThis single-center, randomized, open-label, controlled trial was conducted at El-Demerdash Cardiac Academy Hospital (Cairo, Egypt), from April 2017 to January 2018. This study included adult patients undergoing valve-replacement surgery who were randomized to the intervention group (n = 47; alfacalcidol 2 μg/d started 48 h before surgery and continued throughout the hospital stay) or to the control group (n = 42). The primary end points were lengths of stay (LOS) in the intensive care unit (ICU) and in the hospital. Secondary end points were the prevalence of postoperative hospital-acquired infections, cardiac complications, and in-hospital mortality.FindingsA total of 86 patients were included in the final analysis, with 51 (59.3%) being vitamin D deficient on hospital admission. Treatment with alfacalcidol was associated with a statistically significant decrease in ICU LOS (hazard ratio = 1.61; 95% CI, 1.77–2.81; P = 0.041) and hospital LOS (hazard ratio = 1.63; 95% CI, 1.04–2.55; P = 0.034). Treated patients had a significantly lower postoperative infection rate than did the control group (35.5% vs 56.1%; P = 0.017). The median epinephrine dose was lower in the intervention group compared to that in the control group (5.9 vs 8.2 mg; P = 0.019). The rate of in-hospital mortality was not significantly different between the 2 groups.ImplicationsEarly treatment with 2 μg of alfacalcidol in patients undergoing valve-replacement surgery is promising and well tolerated. This effect may be attributed to its immunomodulatory and cardioprotective mechanisms. ClinicalTrials.gov identifier: NCT04085770.     

经胸与经食管超声心动图在先天性心脏病介入治疗中的应用

导管室介入封堵及外科小切口介入封堵都已经被广泛地应用于临床,封堵成功的关键在于经胸与经食管超声心动图在术前对病例精确的筛选、术中监测及术后即刻评价。文章结合目前国内外文献及临床病例,对经胸与经食管超声心动图在房间隔缺损、室间隔缺损和动脉导管未闭3种常见先天性心脏病介入治疗中的应用进行综述,为临床提供更加准确的超声影像学诊断依据。     

Investigation of the structural,optical and gas sensing properties of PANI coated Cu–ZnS microsphere composite

Polyaniline (PANI)/Cu–ZnS composites with porous microspheres are prepared by a hydrothermal and in situ polymerization method. The structural, optical, and morphological properties are characterized by X-ray powder diffraction, FTIR, UV-vis, scanning electron microscope, transmission electron microscope. The XRD results confirmed that the PANI/Cu–ZnS composite is formed. The morphological analyses exhibited that the PANI/Cu–ZnS composite comprises the porous microspherical structures. The emission peaks obtained in photoluminescence spectra confirm the presence of surface defects in the prepared composite. The UV-DRS study shows that the bandgap of the samples is found to decrease for the PANI/Cu–ZnS composite compared to the pure Cu–ZnS sample. The calculated band gap (E_g) value of PANI/Cu–ZnS composite is 2.47 eV. Furthermore, the fabricated gas sensor based on PANI/Cu–ZnS can perform at room temperature and exhibits good gas sensing performance toward CO₂ gas. In particular, PANI/Cu–ZnS sensor shows good response (31 s) and recovery time (23 s) upon exposure to CO₂ gas. The p/n heterojunction, surface defects, and porous nature of the PANI/Cu–ZnS composite microsphere enhanced sensor performance.

Polyaniline (PANI)/Cu–ZnS composites with porous microspheres are prepared by a hydrothermal and in situ polymerization method.