Rituximab for the treatment of refractory anti-glomerular basement membrane disease

BackgroundAnti-glomerular basement membrane (anti-GBM) disease is a rare but severe autoantibody-mediated immune disorder. The typical clinical presentation includes rapidly progressive glomerulonephritis and often concurrent pulmonary hemorrhage. The present study is aimed to investigate the therapeutic effects of rituximab either used alone or with other immunosuppressants.MethodsEight patients diagnosed with anti-GBM disease and treated with rituximab from 2014 to 2020 were retrospectively reviewed.ResultsEight patients included 5 males and 3 females with a median age of 58.5 years. They all presented severe kidney injuries and 1 patient had lung hemorrhage. At diagnosis, the median of serum creatinine was 246 µmol/L (ranging from 91 to 850 µmol/L), with 3 patients requiring dialysis. All of them received corticosteroids and plasmapheresis. Rituximab was given as either standard four weekly doses or one pulse ranging from 100 to 600 mg. After a median follow-up of 34.5 months, kidney function was partially recovered or stabilized in 5/8 (62.5%) patients, free of dialysis. Anti-GBM antibodies remained undetected in all patients during follow-up. No severe adverse effect associated with rituximab was observed.ConclusionRituximab may be an alternative therapy in the treatment of patient with severe or refractory anti-GBM disease.     

肌激动器在安氏Ⅱ类错(牙合)治疗中的应用

目的 肌激动器矫正器在安氏Ⅱ类错[牙合]患者治疗中的应用特点。方法 20名10～11岁的以下凳后缩为主的安氏Ⅱ类错[牙合]患者应用肌激动器进行矫治。男9名,女11名。每位患者治疗前拍摄头颅侧位、曲面断层及手腕骨X线片。对肌激动器治疗前后及固定矫活器治疗后的头颅侧位X光片进行18个项目的测量,并对治疗前后测量结果进行配对t检验。结果SNA、ANB、OJ、U1／SN、UL-ELine、LL-ELine等在治疗后减小,差异有显著性;SNB、Li／MP、U1／PP、U6／PP、L1／MP、L6／MP、鼻唇角及额唇角增大,差异有显著性。下颌升支、下颌体以及下颌综合长度均有增长,差异有显著性。下领平面角在正畸治疗后无显著变化。结论 肌激动器在生长发育期的Ⅱ类患者的治疗中可以减小覆盖、覆皓、改善[牙合]关系并有效的改善患者下颌后缩的面型。对于存在拥挤的Ⅱ类患者,肌激动器度二期治疗时的拔牙治疗也可以达到良好的治疗效果。     

热环境对机体功能影响的机制及防护研究进展

热环境增加高温作业人员发生热损伤的风险,充分认识热环境对高温作业人员机体的影响和危害,对提高高温作业人员防暑意识、减少作业时的职业性热损伤具有重要意义.笔者主要从热环境的定义、热环境对人体主要功能系统影响的机制、热应激的影响因素及防护研究进展进行综述,为高温作业人员对热致疾病的认识及防护提供参考.     

音乐疗法联合右美托咪定对LC患者炎症的影响

目的：探讨音乐疗法联合右美托咪定对腹腔镜胆囊切除术(LC)患者炎症的影响。方法：选择2020年10月～2021年4月本院因胆囊良性疾病全身麻醉下择期行LC手术患者60例,随机分为两组,每组30例：对照组给予右美托咪定治疗;试验组给予音乐疗法+右美托咪定治疗。记录两组术中情况和生命体征;采用视觉模拟评分法(VAS)评估患者术后疼痛程度;用ELISA法测定血浆中TNF-α、IL-8、IL-10的浓度。结果：两组患者的ASA分级、性别、年龄、体重指数、麻醉时长、手术时长、输液量、出血量比较差异均无统计学意义。试验组在出手术室时以及术后8h、24h、48h的VSA评分与对照组同时间点相比较均明显降低。接受音乐疗法后,试验组的MAP、HR与对照组同时间点相比较均明显降低;试验组TNF-α、IL-8的浓度与对照组同时间点相比较均明显降低;试验组IL-10的浓度与对照组同时间点相比较明显升高。结论：音乐疗法联合右美托咪定可以更好的缓解LC患者术后疼痛,降低炎症反应。     

多节段布鲁菌性脊柱炎与脊柱结核MRI特征分析

目的 探讨多节段布鲁菌性脊柱炎(BS)及脊柱结核(ST)在MRI中的不同影像特点,从而提高早期诊断及鉴别诊断水平.方法 回顾性分析33例由临床或病理确诊为多节段BS患者、30例多节段ST患者,根据两者MRI表现,分析其发生部位、椎体形态、周围组织情况及伴随征象.结果 多节段BS患者的椎体形态、椎间盘受累、后凸畸形、死骨...     

胰岛素抵抗对不同性别实验大鼠脂肪肝形成的作用

目的观察胰岛素抵抗对不同性别实验大鼠脂肪肝形成的作用.方法32只Wistar大鼠雌雄各半,按性别不同随机分为4组,雌性对照组、雄性对照组,每组8只.雌性脂肪肝组、雄性脂肪肝组.以复合因子的造模方法饲喂3 w后,形成脂肪肝,测定血清及肝组织脂质、血浆内皮素(ET)、ALT、血浆肿瘤坏死因子(TNF)、空腹血糖(FBS)、胰岛素(FINS)的含量变化,计算肝指数及胰岛素抵抗指数并做石蜡切片,HE染色.结果雌性脂肪肝组、雄性脂肪肝组大鼠肝脏均有重度脂肪变,肝指数、肝组织匀浆甘油三酯(TG)与总胆固醇(TC)、血清TG与TC、 ET、TNF、FBC、FINS、胰岛素抵抗指数(HOMA-IR)和ALT均较两对照组升高(P＜0.05或P＜0.01),雌性大鼠肝组织匀浆TG、ALT、FINS与HOMA-IR均显著高于雄性组(P＜0.05或P＜0.01),各组大鼠FBG比较,没有统计学意义(P＞0.05).结论雌性脂肪肝组、雄性脂肪肝组大鼠发生了脂肪性肝炎和胰岛素抵抗,其中以雌性大鼠更加显著.在脂肪肝发生发展过程中胰岛素抵抗的作用可能存在性别差异.     

Microstructure and Electrochemical Behavior of a 3D-Printed Ti-6Al-4V Alloy

3D printing (or more formally called additive manufacturing) has the potential to revolutionize the way objects are manufactured, ranging from critical applications such as aerospace components to medical devices, making the materials stronger, lighter and more durable than those manufactured via conventional methods. While the mechanical properties of Ti-6Al-4V parts manufactured with two major 3D printing techniques: selective laser melting (SLM) and electron beam melting (EBM), have been reported, it is unknown if the corrosion resistance of the 3D-printed parts is comparable to that of the alloy made with isothermal forging (ISF). The aim of this study was to identify the corrosion resistance and mechanisms of Ti-6Al-4V alloy manufactured by SLM, EBM and ISF via electrochemical corrosion tests in 3.5% NaCl solution, focusing on the effect of microstructures. It was observed that the equiaxed α + β microstructure in the ISF-manufactured Ti-6Al-4V alloy had a superior corrosion resistance to the acicular martensitic α′ + β and lamellar α + β microstructures of the 3D-printed samples via SLM and EBM, respectively. This was mainly due to the fact that (1) a higher amount of β phase was present in the ISF-manufactured sample, and (2) the fraction of phase interfaces was lower in the equiaxed α + β microstructure than in the acicular α′ + β and lamellar α + β microstructures, leading to fewer microgalvanic cells. The lower corrosion resistance of SLM-manufactured sample was also related to the higher strain energy and lower electrochemical potential induced by the presence of martensitic twins, resulting in faster anodic dissolution and higher corrosion rate.     

Network Structure and Properties of Lithium Aluminosilicate Glass

Based on lithium aluminosilicate glass, the composition of glass was optimized by replacing SiO₂ with B₂O₃, and the influence of glass composition on structure and performance was studied. With the increase in B₂O₃ concentrations from 0 to 6.5 mol%, Al₂O₃ always existed in the form of four-coordinated [AlO₄] in the network structure, and B₂O₃ mainly entered the network in the form of four-coordinated [BO₄]. The content of Si-O-Si linkages (Q₄^(0Al)) was always dominant. The incorporation of boron oxide improved the overall degree of polymerization and connectivity of the lithium aluminosilicate glass network structure. An increase in the degree of network polymerization led to a decrease in the thermal expansion coefficient of the glass and an increase in Vickers hardness and density. The durability of the glass in hydrofluoric acid and NaOH and KOH solutions was enhanced overall.     

Effects of Reserve Capacity on Seismic Response of Concentrically Braced Frames by Considering Brace Failure

In order to study the influence of brace failure on the seismic response of concentrically braced frames and the improvement of the residual structure’s resistance to collapse due to reserve capacity, a series of concentrically braced frame prototypes with different story numbers is designed. A matrix of six finite-element concentrically braced-frame (CBF) models is established, which is varied by the number of stories and the level of reserve capacities. Accuracy of the numerical model is verified by comparing the responses of the shaking-table test of the concentrically braced frames, under 10 different working conditions. Then, a nonlinear time-history analysis, considering brace failure in one specified story, is carried out. The results show that the story-drift angle of the failure story as well as its adjacent stories increases greatly in the ideal pinned model. The above phenomenon is particularly serious, when the failure occurs at the top or bottom of the structure. With the reserve capacity brought by column continuity, and the semi-rigid rotation capacity of the beam-to-column and column-to-base connections are taken into consideration, the increase in story-drift angle caused by the brace failure is effectively reduced. However, the inherent reserve capacity has little influence on the dynamic characteristics of concentrically braced frames in the elastic stage.     

Research on Dynamic Compressive Performance and Failure Mechanism Analysis of Concrete after High Temperature and Rapid Cooling

To investigate the dynamic compressive properties of concrete after high temperature and rapid cooling, an experimental study was carried out by considering five temperatures and four strain rates. The coupling effect of high temperature and strain rate on concrete damage morphology and mechanical parameters was comparatively analyzed. The main conclusions are as follows: the compressive damage morphology of concrete is affected by strain rate development trends of significant variability under different temperature conditions. As the strain rate increases, the compressive stress and elastic modulus of concrete are gradually increased. As the temperature increases, the increase in compressive stress is gradually reduced by the strain rate. For the temperatures of 20 °C and 800 °C, the increase in compressive stress by the strain rate is 38.69% and 7.78%, respectively. Meanwhile, SEM and CT scanning technology were applied to examine the mechanism of the effect of high temperature and strain rate on the mechanical properties of concrete from the microscopic perspective, and the corresponding constitutive model was proposed.