Calcium Channel Blocker Compared With Angiotensin Receptor Blocker for Patients With Hypertension: A Meta‐Analysis of Randomized Controlled Trials

To explore the clinical effects of a calcium channel blocker compared with an angiotensin II receptor blocker in hypertensive patients, the authors collected data from randomized controlled trials. The pooled outcomes were all‐cause mortality, stroke, myocardial infarction, and heart failure. Eight head‐to‐head trials enrolling 25,084 patients were included. There was no significant mortality difference in the two arms (relative risk, 0.99; 95% confidence interval, 0.91–1.07). However, calcium channel blockers were more effective in reducing stroke (relative risk, 0.87; 95% confidence interval, 0.76–0.99) and myocardial infarction incidence (relative risk, 0.86; 95% confidence interval, 0.76–0.98). There was no significant difference with heart failure incidence between the two arms but a lower trend in patients with angiotensin II receptor blockers was noted (relative risk, 1.4; 95% confidence interval, 0.99–1.98). The meta‐analysis suggested that initially use of a calcium channel blocker might be superior to an angiotensin II receptor blocker for prevention of stroke and myocardial infarction.     

Research on Microstructure and Mechanical Properties of Rheological Die Forging Parts of Al-6.54Zn-2.40Cu-2.35Mg-0.10Zr(-Sc) Alloy

High-strength aluminum alloy (mainly refers to the 7xxx series) is the optimum material for lightweight military equipment. However, this type of aluminum alloy is a wrought aluminum alloy. If it is directly formed by traditional casting methods, there will inevitably be problems such as coarseness, unevenness, looseness, and hot cracking in the structure, which will greatly affect the final performance of the part. Based on the internal cooling with annular electromagnetic stirring (IC-AEMS) method, a new technology of rheological die forging is developed in this paper, and the scale-reduced parts of a brake hub of Al-6.54Zn-2.40Cu-2.35Mg-0.10Zr aluminum alloy were prepared. The influence of IC-AEMS and the addition of rare element Sc on the structure and mechanical properties of the parts was studied. An optical microscope and scanning electron microscope (SEM) were used to observe the microstructure evolution, energy dispersive spectroscopy (EDS) was used to analyze the phase distribution and composition, and the mechanical properties of the parts were tested by uniaxial tensile tests. The results show that the addition of Sc element can effectively refine the grains and improve the strength and elongation of the material; the application of IC-AEMS improves the cooling rate of the melt, increases the effective nucleation rate, and the grains are further refined. Through process optimization, scale-reduced parts of a brake hub with good formability and mechanical properties can be obtained, the ultimate tensile strength is 597.2 ± 3.1 MPa, the yield strength is 517.8 ± 4.3 MPa, and the elongation is 13.7 ± 1.3%.     

The Effects of Grain Boundary Misorientation on the Mechanical Properties and Mechanism of Plastic Deformation of Ni/Ni3Al: A Molecular Dynamics Study

The effects of grain boundary misorientation angle (θ) on mechanical properties and the mechanism of plastic deformation of the Ni/Ni₃Al interface under tensile loading were investigated using molecular dynamics simulations. The results show that the space lattice arrangement at the interface is dependent on grain boundary misorientations, while the interfacial energy is dependent on the arrangement. The interfacial energy varies in a W pattern as the grain boundary misorientation increases from 0° to 90°. Specifically, the interfacial energy first decreases and then increases in both segments of 0–60° and 60–90°. The yield strength, elastic modulus, and mean flow stress decrease as the interfacial energy increases. The mechanism of plastic deformation varies as the grain boundary misorientation angle (θ) increases from 0° to 90°. When θ = 0°, the microscopic plastic deformation mechanisms of the Ni and Ni₃Al layers are both dominated by stacking faults induced by Shockley dislocations. When θ = 30°, 60°, and 80°, the mechanisms of plastic deformation of the Ni and Ni₃Al layers are the decomposition of stacking faults into twin grain boundaries caused by extended dislocations and the proliferation of stacking faults, respectively. When θ = 90°, the mechanisms of plastic deformation of both the Ni and Ni₃Al layers are dominated by twinning area growth resulting from extended dislocations.     

Periarticular Injection with Corticosteroid Has an Additional Pain Management Effect in Total Knee Arthroplasty

Purpose

Although the analgesic effects of corticosteroids have been well documented, little information is available on periarticular injection (PI) containing corticosteroids for early postoperative pain management after total knee arthroplasty (TKA). We performed a prospective double-blind randomized trial to evaluate the efficacy and safety of an intraoperative corticosteroid PI in patients undergoing TKA.

Materials and Methods

Seventy-six consecutive female patients undergoing bilateral staged TKA were randomized to receive steroid or non-steroid PI, with 3 months separating the procedures. The steroid group received PI with a mixture containing triamcinolone acetonide (40 mg). The non-steroid group received the same injection mixture without corticosteroid. During the postoperative period, nighttime pain, functional recovery [straight leg raising (SLR) ability and maximal flexion], patient satisfaction, and complications were recorded. Short-term postoperative clinical scores and patient satisfaction were evaluated at 6 months.

Results

The pain level was significantly lower in the PI steroid than the non-steroid group on the night of the operation (VAS, 1.2 vs. 2.3; p=0.021). Rebound pain was observed in both groups at POD1 (VAS, 3.2 vs. 3.8; p=0.248), but pain remained at a low level thereafter. No significant differences were seen in maximal flexion, frequency of acute rescuer, clinical scores, and patient satisfaction. The steroid group was able to perform SLR earlier than the non-steroid group (p=0.013). The incidence of complications was similar between the groups.

Conclusion

PI containing a corticosteroid provided an additional pain-relieving effect on the night of the operation. In addition, corticosteroid PI did not increase the perioperative complications of TKA.     

Single Nucleotide Polymorphisms of Toll-Like Receptor 7 and Toll-Like Receptor 9 in Hepatitis C Virus Infection Patients from Central China

Purpose

To analyze the correlation of polymorphisms of toll-like receptor 7 (TLR7) (rs179009) and toll-like receptor 9 (TLR9) (rs187084) in hepatitis C virus (HCV) infections in the Han population.

Materials and Methods

The genotypes of TLR7IVS2-151 in HCV infection were detected by Sanger sequencing using polymerase chain reaction-restriction fragment length polymorphism to determine the TLR9 T-1486C single nucleotide polymorphisms (SNP) for all enrolled patients.

Results

We found no significant difference between males with spontaneous clearance of HCV versus those chronically infected [χ²=2.71, p=0.10, odd ratios (OR)=0.58, 95% confidence interval (CI) 0.31-1.11]. However, significant differences were found for the distribution of TLR7 (rs179009) in females (χ²=9.46, p=0.01). In females, a significant difference was also found between chronic hepatitis C and those with spontaneous clearance of HCV in terms of TLR7 IVS2-151G/A allele frequencies (χ²=9.50, p=0.00, OR=0.46, 95% CI 0.28-0.75). In HCV-infected patients, no significant association was found between the frequency of TLR9 genotypes and alleles.

Conclusion

The site of TLR7 IVS2-151 (rs179009) G/A may be a factor for susceptibility of chronic HCV in the female Han population. TLR9T-1486C (rs18084) SNP may not play a major role in HCV infection. However, individual risk profiles for HCV infection did vary by sex and this relationship should be further investigated.     

Comparison of dynamic expressions of Tim-3 and PD-1 in the brains between toxoplasmic encephalitis-resistant BALB/c and -susceptible C57BL/6 mice

T cells and IFN-γ are essential for controlling the reactivation of toxoplasmic encephalitis (TE), regardless of whether mice are susceptible or resistant to TE. It has been demonstrated that CD8⁺ T cells exhausted in chronic Toxoplasma gondii infection result in TE reactivation in C57BL/6 mice. However, this phenomenon had not been reported in genetically TE-resistant BALB/c mice. To explore the immune mechanism of TE in different backgrounds of mice, the dynamic expressions of Tim-3, programmed cell death 1 (PD-1), and their ligands (galectin-9, PD-L1, PD-L2) in brain tissues were compared between TE-resistant BALB/c and -susceptible C57BL/6 mice infected with Prugniaud (Pru, a type II strain) of T. gondii in this study. Compared with infected BALB/c mice, there were remarkable pathological changes with significantly higher histological scores in the brains of C57BL/6 mice at 14, 35, 50, and 70 days postinfection (p.i., P?<?0.01); significantly increased mRNA expressions of Tim-3 at 35 (P?<?0.05) and 70 (P?<?0.01)?days p.i.; and significantly increased PD-1 at all the times p.i. (P?<?0.01) in the brains of infected C57BL/6 mice. Furthermore, there were significantly increased mRNA expressions of PD-L1 in the brain of C57BL/6 mice than that in BALB/c mice at all the times p.i. (P?<?0.01). Although the mRNA expressions of galectin-9 (ligand of Tim-3) were increased in the brains of both lineages of mice at all the times p.i., it showed no differences between the two lineages of mice. Our data suggest that the differences of Tim-3 and PD-1/PD-L1 expressions may contribute to the different immune responses between TE-resistant BALB/c and -susceptible C57BL/6 mice infected with Pru strain of T. gondii.     

Theoretical study on the excited state decay properties of iron(ii) polypyridine complexes substituted by bromine and chlorine

Transition metal iron(ii) polypyridyl complexes with quintet ground states were deeply investigated by density functional theory (DFT) and time-dependent density functional theory (TDDFT). Compared with the parent complex [Fe(tpy)₂]²⁺ (tpy = 2,2′:6′,2′′-terpyridine), the ground states of the complexes substituted by halogen atoms changed from singlet states to quintet states with rare high spin excited state lifetimes. The substituted complex [Fe(dbtpy)₂]²⁺ (1) results in a high spin metal–ligand charge transfer lifetime of 17.4 ps, which is 1.4 ps longer than that of [Fe(dctpy)₂]²⁺ (2) with the substitution of chlorine atoms. The reason for this is explored by a combination of electronic structures, absorption spectra, extended transition state coupled with natural orbitals for chemical valence (ETS-NOCV) studies and potential energy curves (PECs). The distortion of 1 in the angles and dihedrals of the ligands is slightly larger than that in 2, although the average metal–ligand bond lengths of the latter are larger. The twisted octahedron decreases the interactions between the d orbitals of iron(ii) and the n/π orbitals of the ligands. Compared with 2, the enlarged energy gaps among the different PECs of 1 and the increased energy crossing points caused by the larger distortion result in the increase of its excited state lifetime. The different pairwise orbital interaction contributions between the metal center and the ligands in their singlet states are qualitatively estimated by ETS-NOCV. The results show that the substitution of bromine atoms will decrease the electrostatic attraction between the metal and ligands but not significantly impact the orbital interactions.

Transition metal iron(ii) halogen substituted polypyridyl complexes with quintet ground states were deeply investigated by density functional theory (DFT) and time-dependent density functional theory (TDDFT).