EPIDEMIOLOGIE DE L’HYPERTENSION ARTERIELLE EN TUNISIE.Etude Hammam Sousse/Sahloul Heart Study (HSHS)

Introduction: Tunisia is experiencing a double burden of morbidity, characterized by the explosion of cardiovascular diseases and their risk factors including arterial Hypertension. The objective of this study, based on the HSHS cohort (Hammam Sousse Sahloul Heart Study), was to determine the prevalence of hypertension in the general population and to identify its predisposing factors. Methods: HSHS is a cardiovascular health promotion initiative in the city of Hammam Sousse (Tunisia). The study was conducted via a random sample of households, using the WHO PEV technique, made up of 33 clusters, of 33 households each. All people aged 20 and over, included, benefited from a questionnaire, a physical examination and a biological assessment. The Systolic Blood Pressure (SBP) and the Diastolic Blood Pressure (DBP) were measured from the average of the last two measurements, by an OMRON type tensiometer, of suitable width. These prevalences were adjusted according to sex and age group, by their weighting coefficients in the general population, and they were accompanied by their 95% CIs. Binary logistic regression was conducted to identify independent factors associated with hypertension. Results: The study population was composed of 481 men (33.4%) and 960 women (66.6%), with an average age of 49.6±16.35 years in males (M) and 46.6±16.18 in females (F). In addition to the family history of hypertension, the sufficient weekly consumption of vegetables and fruits was low (M: 32.4%, F: 24.9%). The adjusted rate of hypertension in the adult study population was 32.5%, 95%CI[31.9-33.1] (M: 36.4%, 95%CI[35, 5-37.3]; F: 28.4%; 95% CI[27.6-29.2]), reaching in the age group of 60 years and above: M: 74.6% (95%CI[66.9-82.3], F: 82.7% (95%CI[73.8-83.6]) Multivariate analysis identified five independent factors significantly associated with hypertension: male sex (ORa=1.55 [1.18-2.03]), age over 40 years (ORa=6.54[4.70-9.11]), low level of schooling (ORa=1.80 [1.36-2.38]), low physical activity (ORa=1.42[1.07-1.88]) and high socio-economic level (ORa=1 .84 [1.30-2.63]). Conclusion: The HSHS study confirmed the high prevalence of hypertension, and the extent of its low detection and control. Hence the need for a universal approach to health promotion, oriented towards the general population, piloted by its local organizations, based on the adoption of a healthy lifestyle, and centered on physical activity.     

Frequency of serological markers of rheumatoid arthritis in patients with IgA anti‐β2 glycoprotein I antibodies

AimTo determine the frequency of serological markers of RA in patients with anti‐β2 glycoprotein I antibodies (aβ2GPI) of IgA isotype.Material and MethodsA retrospective study was conducted on 67 patients with aβ2GPI‐IgA. Ninety healthy blood donors (HBD) were used as a control group. IgG anti‐cyclic citrullinated peptides antibodies (CCP‐Ab) and rheumatoid factors (RF) IgG, IgA, and IgM were detected by enzyme‐linked immunosorbent assay (ELISA).ResultsSeventeen patients and eight HBD had CCP‐Ab and/or RF (25.4% vs. 8.9%, p = 0.005, CI 95% [14.95; 35.79], odds ratio = 3.5). The frequency of CCP‐Ab was significantly higher in patients than in healthy subjects (14.9% vs. 3.3%, p = 0.009). IgA isotype of RF was significantly higher in patients than in controls (7.5% vs. 0%, p = 0.02). In male patients, CCP‐Ab and/or RF were more frequent than in healthy male subjects (37.5% vs. 11.8%, p = 0.02). In patients, no correlation was found between the levels of aβ2GPI‐IgA and CCP‐Ab (r = 0.082, p = 0.51). There was no correlation between the level aβ2GPI‐IgA and the level of the isotypes of RF (IgG, IgA, and IgM) in patients (r = 0.1, p = 0.37; r = 0.17, p = 0.17 and r = 0.07, p = 0.59 respectively).ConclusionFrequencies of CCP‐Ab and RF are high in patients with aβ2GPI‐IgA suggesting that these patients are susceptible to developing RA.     

19例经导管主动脉瓣植入术患者的护理及治疗效果评价

目的：总结经导管主动脉瓣植入术(TAVI)治疗重度主动脉瓣狭窄的术前术后护理经验,并对治疗效果进行评价。方法：选取2016年3月—2020年4月19例行TAVI术患者为研究对象,术前充分了解病情,完善相关检查,给予饮食、活动及心理护理,术后观察病情变化并对症处理。分别在术前和术后1,3,6个月评估心功能分级(NYHA),并监测主动脉瓣口面积、左心射血分数(LVEF)及血清N端脑钠肽前体(NT-ProBNP)等指标,评价治疗效果。结果：19例患者均康复出院,随访半年治疗效果良好,生活质量改善。术前NYHA分级Ⅲ级10例、Ⅳ级9例,术后6个月NYHA分级Ⅰ级15例、Ⅱ级4例;术后主动脉瓣口面积、LVEF、血清NT-ProBNP与术前比较,差异均有统计学意义(P<0.05)。结论：TAVI操作难度大、并发症多,术前应全面评估,预见性发现问题,根据患者出现的情况行针对性处理,并于术后对患者实施全面持续的护理,可提高治疗效果。     

A facile imine-linked covalent organic framework doped with a carbon dot composite for the detection and removal of Hg2+ in surface water

Hg²⁺ is one of the most toxic chemical species in the water environment, and thus developing a new fluorescent covalent organic framework for both the detection and removal of Hg²⁺ is highly desirable. Herein, a fluorescent composite, termed TpPa-1 COF@CDs, was synthesized by inverse emulsion polymerization method using an imine covalent organic framework as the supporting material and carbon dots as the fluorescent sensor element. The crystallinity, porosity, rich functional receptors (hydroxyl and amino groups), thermal stability and fluorescent properties of TpPa-1 COF@CDs were characterized. The results showed that TpPa-1 COF@CDs exhibited a good detection and removal performance for Hg²⁺, which was evidenced by its high sensitivity (LOD = 0.75 μg L⁻¹), superior selectivity, large adsorption capacity (235 mg g⁻¹), fast adsorption rate (30 min equilibrium time) and good regeneration (at least five cycles). More importantly, the simple functional monomer, short reaction time and metal-free raw material made TpPa-1 COF@CDs reliable, cost effective and eco-friendly. This research demonstrated the facile construction of a functional covalent organic framework composite for water environmental remediation technologies of metal pollution.

TpPa-1 COF@CDs as a fluorescent composite exhibited good detection and removal performance for Hg²⁺. The simple functional monomer, short reaction time and metal-free raw material made TpPa-1 COF@CDs reliable, cost effective and eco-friendly.     

Long-term durable repaired cartilage induced by SOX9 in situ with bone marrow-derived mesenchymal stem cells

Background: Microfracture is a common procedure for cartilage repair, but it often produces inferior fibrocartilage. We previously reported that a super positively charged SOX9 (scSOX9) promoted hyaline-like cartilage regeneration by inducing bone marrow derived mesenchymal stem cell differentiation into chondrocytes in vivo. Here we examined the long-term efficacy of cartilage repair induced by microfracture with scSOX9 by assessing the biomechanical property of the repaired cartilage.Methods: A cartilage defect was created at the right femoral trochlear groove in New Zealand female rabbits and microfracture was performed. The scSOX9 protein was administered at the site of microfracture incorporated in a collagen membrane.Results: At 12 and 24 weeks, scSOX9 treatment induced hyaline-like cartilage while collagen-membrane alone induced fibrocartilage and mutant scSOX9-A76E poorly induced cartilage repair. The cartilage matrix in scSOX9-treated group showed highly enriched proteoglycan content. Consistent with the histological feature and the thickness of the repaired cartilage, the mechanical property of scSOX9-induced cartilage was also similar to that of normal cartilage.Conclusion: This long-term in vivo study demonstrated that in combination with microfracture, scSOX9 was able to induce reparative tissue with features of hyaline cartilage which was durable in long-term. This technology has the potential to translate into clinical use for cartilage repair to prevent progression to osteoarthritis.     

黄芪汤治疗肝硬化及其相关并发症研究进展

黄芪汤（黄芪、甘草）始载于《太平惠民和剂局方》,具有补中、益气、生津之效,治疗诸虚不足。黄芪汤为中医经典名方,临床广泛应用于多种辨证属虚损不足的疾病与证候。前期临床观察和实验研究证实,黄芪汤可显著提高肝脏的合成能力,有效延缓肝纤维化和肝硬化进展,并改善肝硬化门脉高压等相关并发症。故就黄芪汤全方、组分及其有效成分在抗肝纤维化,防治肝硬化及其并发症的基础和临床研究进展作一综述。     

静脉用更昔洛韦在治疗婴儿巨细胞病毒感染中的不良反应

巨细胞病毒（Cytomegalovirus,CMV）是新生儿感染的重要病原之一,曾有学者对1996-2006年MEDLINE数据库中有关婴幼儿巨细胞病毒感染的流行病学资料进行Meta分析发现,活产婴儿中先天性巨细胞病毒感染的患病率约为0.64%,其中约11%的患儿出现临床症状[1]。     

Synthesis and Microphase Separation of PS‐b‐P(MA‐alt‐St) Block Copolymers and Their Ionomers for the Design of Polymer Crystallization Nucleation Agents

Several well‐controlled polystyrene‐block‐poly(styrene‐alt‐maleic anhydride) (PS‐b‐P(St‐alt‐MA)) functionalized block copolymers (BCs) and their sodium salt ionomers with different block ratios and molecular weights are synthesized through two‐step reversible addition–­fragmentation chain transfer (RAFT) polymerization. The atomic force microscopy (AFM) images and differential scanning calorimetry (DSC) results reveal that the prepared BCs and their ionomers microphase separate into various nanostructures depending on the block ratios. By taking advantage of the formation of amphiphilic nanostructures via the microphase, the block ionomers serve as nucleation agents to improve the crystallization rate of poly(ethylene terephthalate) (PET). The crystallization behavior of PET upon the addition of block ionomers is investigated isothermally and non‐isothermally by DSC. The results show that the block ionomers can effectively accelerate the crystallization rate of PET, which strongly depends on the molecular weights and block ratios