环磷腺苷联合辛伐他汀治疗慢性心力衰竭的临床研究

目的 探讨环磷腺苷联合辛伐他汀治疗慢性心力衰竭的临床疗效。方法 将天津市北辰医院心血管内科2012年9月—2014年9月收治的慢性心力衰竭患者120例,随机分为治疗组和对照组,每组各60例。对照组在常规治疗的基础上口服辛伐他汀片,10 mg/次,3次/d。治疗组患者在对照组的基础上静脉滴注环磷腺苷葡胺注射液120 mg,1次/d。两组均治疗2周。比较两组的临床疗效,心功能指标左室射血分数(LVEF)、最大血流速度比(E/A)、左室短轴缩短率(FS),血清因子脑钠肽(BNP)、超敏C反应蛋白(hs-CRP)、血尿酸(UA)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α),以及血脂水平三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)。结果 治疗组总有效率(93.33%)明显高于对照组(80.00%),两组比较差异具有统计学意义(P< 0.05);治疗后,两组患者的LVEF、E/A、FS均较同组治疗前明显升高,且治疗后治疗组的相关指标均高于同期对照组,比较差异有统计学意义(P< 0.05);两组患者的BNP、hs-CRP、UA、IL-6、TNF-α均显著低于同组治疗前(P< 0.05);治疗后治疗组的BNP、hs-CRP、UA、IL-6、TNF-α均低于同期对照组,比较差异有统计学意义(P< 0.05);治疗后,两组患者的TC、TG、LDL-C均较同组治疗前显著降低,HDL-C较同组治疗前显著升高(P< 0.05)。治疗后,两组患者的TC、TG、HDL-C、LDL-C比较差异无统计学意义。结论 环磷腺苷联合辛伐他汀治疗慢性心力衰竭具有较好的临床疗效,改善患者的心功能,同时改善各种相关的血清因子指标。     

Experimental Investigation of Integrated Circular Triple-Wire Pulse GMAW of Q960E High-Strength Steel for Construction Machinery

Multi-wire welding has received much attention in the machinery industry due to its high efficiency. The aim of this study was to investigate a novel pulse gas metal arc welding (GMAW) that has circular triple-wire electrodes. The effect of the pulse phage angle on arc stability was particularly studied. Research showed that for typical phase angles the arc stability from low to high is 180°, 0°, and 120°, and the arcs are very stable at 120°. The triple-wire welding was used to weld a 9 mm thick Q960E steel, which is typically used for the arm of construction machinery. When the welding heat input was controlled at 1.26–1.56 kJ/mm, the weld zone was dominated by acicular ferrite, and the coarse-grained zone of the heat-affected zone was a mixed structure of lath martensite and lath bainite. The tensile strength of the welded joint reached 85% of the base metal and the impact toughness was above 62 J, which can meet the requirements of construction machinery. This indicates that the triple-wire welding has great potential to achieve efficient and high-quality welding for the construction machinery.     

Efficacy and Tolerability of Intravenous Immunoglobulin and Subcutaneous Immunoglobulin in Neurologic Diseases

PurposeIV immunoglobulin (Ig) therapy has been widely used for the treatment of neurologic disorders, autoimmune diseases, immunodeficiency-related diseases, blood system diseases, and cancers. In this review, we summarize the efficacy and tolerability of IVIg and SCIg therapy in neurologic diseases.MethodsWe summarized and analyzed the efficacy and tolerability of IVIg and SCIg in neurologic diseases, by analyzing the literature pertaining to the use of IVIg and SCIg to treat nervous system diseases.FindingsIn clinical neurology practice, IVIg has been shown to be useful for the treatment of new-onset or recurrent immune diseases and for long-term maintenance treatment of chronic diseases. Moreover, IVIg may have applications in the management of intractable autoimmune epilepsy, paraneoplastic syndrome, autoimmune encephalitis, and neuromyelitis optica. SCIg is emerging as an alternative to IVIg treatment. Although SCIg has a composition similar to that of IVIg, the applications of this therapy are different. Notably, the bioavailability of SCIg is lower than that of IVIg, but the homeostasis level is more stable. Current studies have shown that these 2 therapies have pharmacodynamic equivalence.ImplicationsIn this review, we explored the efficacy of IVIg in the treatment of various neurologic disorders. IVIg administration still faces many challenges. Thus, it will be necessary to standardize the use of IVIg in the clinical setting. SCIg administration is a novel and feasible treatment option for neurologic and immune-related diseases, such as chronic inflammatory demyelinating polyradiculoneuropathy and idiopathic inflammatory myopathies. As our understanding of the mechanisms of action of IVIg improve, potential next-generation biologics can being developed.     

Known epigenetic biomarkers for prostate cancer detection and management: exploring the potential of blood-based liquid biopsies

Introduction: Although prostate cancer (PCa) stands as an important cause of cancer-related deaths, a sizeable proportion of diagnosed cases are clinically insignificant. Hence, novel and more specific biomarkers to identify clinically significant PCa are needed. Liquid biopsies offer the potential to accurately identify cancer markers, including PCa. Epigenetic biomarkers such as cell-free DNA and circulating RNAs have emerged as minimally invasive cancer markers.

Areas covered: Herein, we provide an overview of epigenetic biomarkers current state based on a comprehensive review of the relevant literature in blood-based liquid biopsies and challenges/limitations of this new and growing field of cancer biomarkers.

Expert opinion: The epigenetic-based biomarkers characteristics make them attractive to the clinics and their minimally invasive assessment are a promising opportunity for PCa detection/management. The main limitations are the lack of robust validation studies and integrated approaches. Future studies would benefit from a change in focus to a ‘selected PCa detection’.     

Effects of calcium channel blocking agents on reperfusion arrhythmias

The effect of the calcium antagonists nifedipine (NF) and diltiazem (DT) on reperfusion after release of circumflex coronary artery (CX) occlusion was studied in open-chest dogs. Dogs were randomized to receive a bolus of 5 μg/kg NF (seven dogs), 1 μg/kg NF (nine dogs), or vehicle (nine dogs). After bolus, high and low dose NF dogs were infused with 1 μg/kg/min NF. All dogs then underwent 30 minutes CX occlusion followed by reperfusion. Dogs that did not develop ventricular fibrillation (VF) in the first 10 minutes of reperfusion were considered survivors. NF caused a dose-related increase in CX blood flow and decrease in mean arterial pressure (MAP), significant at the higher dose. Reperfusion VF occurred in five of nine low dose NF dogs, five of seven high dose NF dogs, and five of nine controls. Another 21 dogs were randomized to receive a bolus of 0.2 mg/kg DT (11 dogs) or vehicle (10 dogs). Infusion rates (and an additional bolus injection, if necessary) were chosen to produce a 10 to 20 mm Hg drop in MAP. CX occlusion and reperfusion were performed as above. Reperfusion VF occurred in 9 of 11 DT dogs vs 8 of 10 controls. Thus neither nifedipine nor diltiazem enhanced survival during reperfusion of myocardium previously subjected to 30 minutes of ischemia.     

Muscle protein catabolism in diabetes: 3-Methylhistidine excretion in the spontaneously diabetic “BB” rat

The muscle protein lost in uncontrolled diabetes may be due to decreased synthesis, increased catabolism, or to any combination of alteration in these rates that results in net loss. Differing methods of examining these rates in vivo and in vitro have given conflicting results. We assessed the rate of catabolism of proteins containing 3-methylhistidine (3-MH) by measurement of its urinary excretion in spontaneously diabetic “BB” Wistar rats. Prior to overt diabetes, rates of excretion were appropriate to the age of the rats (1.46 ± 0.15 μmole/day), with 34%–47% as the nonacetylated form. Accompanying diabetes there was an increase in urine urea nitrogen of two to threefold over 4–14 days, and an increase in ammonium nitrogen of sixfold. 3-MH excretion doubled by 4 days, and 81%–96% was excreted as the nonacetylated form. Subcutaneous insulin in doses sufficient to improve glycosuria and hyperglycemia was associated with normalized total 3-MH excretion (N-acetyl 3-MH plus 3-MH) but a greater proportion than normal appeared in the nonacetylated form. These results suggest that muscle protein catabolism increased with insulin deficiency and that this defect can be corrected by therapy. Both untreated and treated diabetic rats appear to have a limited capacity for acetylation of 3-MH prior to its excretion.     

Long-term safety of subcutaneous immunotherapy with TO-204 in Japanese patients with house dust mite-induced allergic rhinitis and allergic bronchial asthma: Multicenter,open label clinical trial

Background

To evaluate the long-term safety of subcutaneous immunotherapy with TO-204, a standardized house dust mite (HDM) allergen extracts, we conducted a multicenter, open label clinical trial.