Repair of Type Ia Endoleaks Involving the Distal Arch Using Left Subclavian Artery-Left Common Carotid Artery Transposition with a Stented Elephant Trunk.

BACKGROUND: Type Ia endoleaks are common after thoracic endovascular aortic repair (TEVAR). However, the repair of type Ia endoleaks involving the distal arch is challenging because of the presence of the interventional endografts, potential damage to the aortic arch vessels, and the location and size of the aneurysmal body. We retrospectively reviewed our experience of the surgical treatment of type Ia endoleaks with distal arch involvement using left subclavian artery (LSCA)-left common carotid artery (LCCA) transposition with a stented elephant trunk. METHODS: Sixteen patients (male = 16; mean age, 47 ± 9 years, range 31-63 years) with type Ia endoleaks involving the distal arch underwent LSCA-LCCA transposition with a stented elephant trunk from July 2010 to July 2018. TEVAR failure occurred in 12 patients, re-TEVAR was performed in two patients, hybrid aortic arch repair in one patient, and the chimney technique in one patient. RESULTS: There were no in-hospital deaths. Fourteen patients required mechanical ventilation for <24 h and one for <48 h. One patient required reintubation after mechanical ventilation for 19 h and continuous renal replacement therapy because of renal failure. One patient received pericardial drainage, and recurrent laryngeal nerve injury occurred in one patient. Three patients died during follow-up. CONCLUSIONS: The LSCA-LCCA transposition with a stented elephant trunk can produce satisfactory results in patients with a type Ia endoleak involving the distal arch. Using this technique, it is possible to exclude the aneurysm sac distal to the LCCA origin and seclude the failed interventional endograft. These encouraging outcomes suggested that this technique could be a suitable surgical treatment for this type of lesion.

Distal Arch Aneurysm Repair Using Left Subclavian Artery Transposition With Stented Elephant Trunk in the Hybrid Repair Era.

BACKGROUND: Hybrid aortic arch repair is an invasive approach to the surgical management of distal aortic arch aneurysm. The complications associated with hybrid aortic arch repair, such as stroke and endoleaks, are not uncommon and late reintervention is frequent. We retrospectively reviewed our experience of distal aortic arch aneurysm repair using the stented elephant trunk procedure with left subclavian artery (LSCA)-left common carotid artery (LCCA) transposition in the hybrid repair era. METHODS: Between May 2009 and September 2016, 19 patients with distal aortic arch aneurysm underwent LSCA-LCCA transposition with stented elephant trunk implantation under hypothermic cardiopulmonary bypass with selective antegrade cerebral perfusion. All patients were males with a median age of 51±14 (range 20-69) years. RESULTS: There were no in-hospital deaths. Continuous renal replacement therapy was not required in patients with preoperative renal dysfunction after surgery. No neurologic deficits were observed in any patients prior to hospital discharge. One patient underwent concomitant thoracic endovascular aortic repair after this technique. One case required reoperation due to bleeding. One patient required debridement due to poor wound healing. During a mean follow-up of 33±21months, one patient died. CONCLUSIONS: Satisfactory results were obtained in suitable patients undergoing surgery for distal aortic arch aneurysm using LSCA-LCCA transposition with stented elephant trunk implantation in the hybrid repair era. The straightforward nature of the surgical approach, with avoidance of the complications related to hybrid aortic arch repair and reduction of late re-intervention favours this technique for treating distal aortic arch aneurysm.

Repair of Distal Aortic Arch Aneurysms by Left Subclavian Artery Transposition with Stented Elephant Trunk Implantation.

BACKGROUND: Repair of distal aortic arch aneurysms remains technically challenging using conventional open surgery due to its location. Several techniques, including a conventional prosthetic graft replacement and a hybrid technique, were introduced to manipulate this lesion. We retrospectively reviewed our experience with left subclavian artery (LSCA) transposition with stented elephant trunk implantation for repair of distal aortic arch aneurysms. METHODS: From May 2009 to December 2014, 9 men (mean age 55 ± 16 years) with distal aortic arch aneurysms underwent LSCA transposition with stented elephant trunk implantation under hypothermic cardiopulmonary bypass with antegrade selective cerebral perfusion via a median sternotomy. One case had a history of endovascular abdominal aortic repair. RESULTS: There was no in-hospital death. The mean time of mechanical ventilation and intensive care unit stay was 22 ± 9 and 53 ± 17 hr, respectively. No severe complications occurred in this group. All patients survived and were discharged. No patient died during the follow-up period. Postoperative computed tomography revealed good patency of the anastomotic site between the LSCA and the left common carotid artery. CONCLUSIONS: Satisfactory surgical results and follow-up outcomes were achieved by simultaneous repair of proximal aortic lesions and complete seal of the lesion involving the distal aortic arch and proximal descending aorta using LSCA transposition with implantation of a stented elephant trunk. Encouraging outcomes favor this technique for distal aortic arch aneurysm.

[Research progress in epigenetic regulation of myocardial ischemia/ reperfusion injury by traditional Chinese medicine].

Epigenetic is a hotspot of post-genomic era research, and epigenetic modification is a mechanism in the study of cardiovascular disease. Myocardial ischemia-reperfusion injury (MIRI) is one of the problems in the cardiovascular disease, and many experimental interventions are reported in the protection of the ischemic myocardium in experimental animals. However, with the exception of early reperfusion, none has been translated into clinical practice. There is an advantage of traditional Chinese medicine (TCM) in the regulation of epigenetic modification, and pathogenesis of myocardial ischemia-reperfusion injury. This review article is prepared to cover the research progress in the treatment of myocardial ischemia-reperfusion injury by TCM with a focus on epigenetic regulation. The epigenetic regulation is documented in TCM theory through a systematic review of the protecting drugs in the MIRI development guidelines.

[Research progress of Guanxin Danshen formula and its effective components in treating coronary artery heart disease].

Coronary artery heart disease (CHD) is one of the common cardiovascular diseases in clinical. The morbidity and mortality of CHD recently continue increasing in our country, which has aroused wide attention. Many studies confirm that traditional Chinese medicine has better therapeutic effect on CHD. Guanxin Danshen formula, widely used in the treatment of CHD, consists of Salviae Miltiorrhizae Radix et Rhizoma, Notoginseng Radix et Rhizoma and volatile oil from Dalbergiae Odoriferae Lignum, and has the efficacy in promoting blood circulation to resolve stasis, regulating the circulation of Qi and alleviating pain. This review summarized the pharmacologic effects and mechanism of Guanxin Danshen formula and its effective components in the treatment of CHD to provide reference for its fundamental research and clinical application.

Repair of type A dissection with mitral regurgitation using total arch replacement with mitral valve surgery.

BACKGROUND: Mitral regurgitation (MR) is very rare in patients with type A dissection. We retrospectively reviewed our experience of total arch replacement (TAR) with mitral valve surgery for type A dissection with MR. METHODS: From November 2009 to October 2012, 14 patients with type A dissection (chronic = 11; acute = 3) with MR underwent TAR combined with mitral valve surgery under hypothermic cardiopulmonary bypass with selective cerebral perfusion. The Bentall procedure was performed in 11 patients, aortic valve replacement (AVR) in one patient, coronary artery bypass grafting (CABG) in three patients, and tricuspid valvuloplasty (TVP) in one patient. RESULTS: Thirty-day mortality was 7.1% (1/14). One patient died after transfer to another hospital secondary to renal failure. Low cardiac output syndrome was observed in three patients (21.4%, 3/14), one of whom underwent left ventricular assist device implantation. Continuous renal replacement therapy was performed in four cases (28.6%, 4/14). Two patients underwent reoperation during follow-up period: One patient had mitral paravalvular leakage and the other dilatation of the thoracoabdominal aorta. CONCLUSIONS: Repair of type A dissection with MR can be performed in a single operation. Combined TAR and mitral valve surgery is a much bigger and more complex operation associated with high morbidity.

[Phytoestrogens in application prospect of treatment of myocardial ischemia/reperfusion injury].

Reperfusion is the most effective treatment for acute myocardial infarction, markedly reducing mortality and morbidity. Reperfusion however induces necrotic and apoptotic damages to cardiomyocytes, that were viable prior to reperfusion, a process called myocardial ischemia/reperfusion injury(MI/RI). Over the past 30 years, hundreds of experimental interventions (both pharmacologic and nonpharmacologic) have been reported to protect the ischemic myocardium in experimental animals; however, with the exception of early reperfusion, none has been translated into clinical practice. The population-based survey assessed men have about twice the total incidence of morbidity and mortality of women, and the sex gap in morbidity tends to diminish after age 45 years. So hormone replacement therapy (HRT) is given to treat the MI/RI, and lots of studies shows that the side effect is greater for estrogen, compared with phyestrogen. In this article, we review the important pathogenesis of myocardial ischemia reperfusion injury, the prevention and limitations of HRT. And we highlight the mechanism of phyestrogens treatment the MI/RI in experiment. The aim is to provide the theoretically new way of develop the safe and effective products for the researchers.

[The prospect of using bioinformatics technology in the field of biological medicine in the era of big data].

With the advanced development of information technology, there is a huge impact on various industries for the arrival of big data. In the biomedical field, innovative genome sequencing technology enables low-cost, high-throughput, and high-speed to become a reality, which leads to an explosive growth in data and also appeared in an urgent need to process those massive biological information. High performance computing (HPC) along with effective methods is one of the best ways to deal with the problem of big data in biomedical field which could serve the biomedical development best. We discussed the issues faced in biomedical big data processing and concluded that the bioinformatics is an indispensable component of biomedical technologies.

Multi-component analysis of bile acids in natural Calculus bovis and its substitutes by ultrasound-assisted solid-liquid extraction and UPLC-ELSD.

An ultrasound-assisted solid-liquid extraction (USLE) coupled to ultra-performance liquid chromatography-evaporative light scattering detection (UPLC-ELSD) method has been developed for the simultaneous extraction and determination of six bile acids (BAs) in natural Calculus bovis and its substitutes, collected from different origins. The USLE conditions, UPLC chromatographic and ELSD conditions for BAs were optimized. Under optimum conditions, the six target analytes were efficiently extracted and baseline separated within 10 min. The limits of detection (LODs) and quantification (LOQs) for six BAs were less than 7 ng and 22 ng, respectively. Average recoveries were within the range of 98.8-100.7% with relative standard deviations (RSDs) <2% for the six analytes. This method, due to its convenience, high selectivity, fast analysis efficiency and good reproducibility can be employed for analyzing the content differences of six BAs in 40 batches of natural C. bovis and its existing substitutes. The differences of the content of each BA in natural C. bovis and its substitutes were significant, and the total contents of six BAs in 13 batches of natural C. bovis were in the range of 7.96-160.17 mg g(-1), in 20 natural C. bovis of 0-245.89 mg g(-1), in 2 artificial cultivated C. bovis of 178.48-194.22 mg g(-1), in 3 cultured C. bovis of 41.01-107.3 mg g(-1), and in 2 counterfeit C. bovis of 144.9-340.25 mg g(-1). The significant differences of multi-component contents reflected the various inherent qualities of these samples, so, the use of these substitutes as the replacers of natural source in clinic should be paid more attention. Some substitutes could not be used as the replacers.

Effect of berberine on Escherichia coli, Bacillus subtilis, and their mixtures as determined by isothermal microcalorimetry.

The strong toxicity of pathogenic bacteria has resulted in high levels of morbidity and mortality in the general population. Developing effective antibacterial agents with high efficacy and long activity is in great demand. In this study, the microcalorimetric technique based on heat output of bacterial metabolism was applied to evaluate the effect of berberine on Escherichia coli, Bacillus subtilis, individually and in a mixture of both using a multi-channel microcalorimeter. The differences in shape of the power-time fingerprints and thermokinetic parameters of microorganism growth were compared. The results revealed that low concentration (20 µg/mL) of berberine began to inhibit the growth of E. coli and mixed microorganisms, while promoting the growth of B. subtilis; high concentration of berberine (over 100 µg/mL) inhibited B. subtilis. The endurance of E. coli to berberine was obviously lower than B. subtilis, and E. coli could decrease the endurance of B. subtilis to berberine. The sequence of half-inhibitory concentration (IC(50)) of berberine was: B. subtilis (952.37 µg/mL) > mixed microorganisms (682.47 µg/mL) > E. coli (581.69 µg/mL). Berberine might be a good selection of antibacterial agent used in the future. The microcalorimetric method should be strongly suggested in screening novel antibacterial agents for fighting against pathogenic bacteria.

Evaluation of the liver protection and toxicity of Da-Huang-Zhe-Chong pill in rats.

CONTEXT: Da-Huang-Zhe-Chong pill (DHZCP), a classical traditional Chinese formula, consists of 12 crude drugs which have been widely used with significant therapeutic effects. Some drugs in this formula have toxicities that might result in some adverse effects of DHZCP. OBJECTIVE: The liver protection and toxicity of DHZCP were first evaluated against chronic carbon tetrachloride (CCl(4))-induced liver injury in rats. MATERIALS AND METHODS: The rats were treated by intraperitoneal injection of 10% CCl(4) for 12 weeks. At the end of week 4, DHZCP at doses of 44 g/kg (high-dose group) and 22 g/kg (low-dose group) was intragastrically administered to CCl(4)-treated rats, once a day for four weeks. At the end of weeks 8 and 12, the general status of the rats, histopathology of liver, serum alanine aminotransaminase (ALT), aspartate aminotransaminase (AST), alkaline phosphatase (ALP) and total bilirubin (TBIL) levels were observed or determined and recorded. By correspondence analysis (CA) on biochemical markers and liver histopathological score (HS), the "dose-time-response" relationship of DHZCP on the hepatic injury rats was evaluated. RESULTS: The results showed that DHZCP exhibited a significant protective effect on liver injury by reversing the biochemical parameters and histopathological changes. However, this hepatoprotective effect may be weakened, or even be transferred to toxicity with the increase of the administration dose (44 g·kg(-1)·d(-1)) and time (more than 2 months) of this formula. These results were consistent with the histopathological observation and the serum levels. DISCUSSION AND CONCLUSION: Administration of proper dose and time of DHZCP could well play its hepatoprotective effect and even treat hepatitis, but the safety on liver should be considered when large-dose (44 g·kg(-1)·d(-1)) DHZCP is used for long time (more than 2 months). We suggest that the administration dose and time of DHZCP in clinical use should not be increased and prolonged, and simultaneously liver function should be regularly monitored.

[Analyzing variations and clinical significance of perioperative serum inflammatory indicators in patients undergoing acute aortic dissection repair].

OBJECTIVES: To study perioperative inflammatory response status in patients with acute aortic dissection. To analyze the reason and outcome of the inflammatory activation. METHODS: Between August 2011 and December 2011, 30 patients (22 male and 8 female, mean aged (43 ± 9) years) had undergone open repairs of aortic dissection or aneurysm with deep hypothermic circulatory arrest. Indications for surgical intervention were type A aortic dissection in 26 patients and aortic aneurysm in 4 patients. In detail, ascending aorta and arch replacement combined with stent elephant trunk were done in 29 patients, arch replacement combined with stent elephant trunk in 1 patient. According to the time from clinical onset of the dissection to operation, acute group (less than 7 days, group A) 20 patients, chronic group (more than 30 days and aortic aneurysm, group C) 10 patients. White blood cell, C-reactive protein and procalcitonin were assayed before and after operation. These valuables were recorded and compared statistically between two groups. RESULTS: There were no significant differences in age, operation time, and blood transfusion volume (P > 0.05). Preoperative serum level of inflammatory indicators in group A were significant higher than in group C (t > 3, P < 0.05). Postoperative serum peak level of these indicators were significant higher than preoperative level in both groups (t > 4, P < 0.05). There were much more complications occurred on patients in group A (21 cases) than in group C (0 cases). The occurrence of early postoperative complications in group A was much higher than group C (χ(2) = 12.209, P = 0.000). Mechanic ventilation time in group A and group C were (35 ± 58) hours and (18 ± 9) hours respectively. ICU length of stay in two group were (49 ± 61) hours and (33 ± 12) hours, respectively. The patients with mechanic ventilation time more than 24 h, ICU length of stay more than 5 days in group A was more than in group C significantly (χ(2) = 5.161, P = 0.010; χ(2) = 3.657, P = 0.024). CONCLUSIONS: Acute aortic dissection and surgical procedure induce an acute phase inflammatory reaction. The patients with acute aortic dissection involved more serious organic injury and worse outcome following surgery compared with chronic aortic dissection.

Preparation and Properties of Thin-Film Composite Forward Osmosis Membranes Supported by Cellulose Triacetate Porous Substrate via a Nonsolvent-Thermally Induced Phase Separation Process.

A porous substrate plays an important role in constructing a thin-film composite forward osmosis (TFC-FO) membrane. To date, the morphology and performance of TFC-FO membranes are greatly limited by porous substrates, which are commonly fabricated by non-solvent induced phase separation (NIPS) or thermally induced phase separation (TIPS) processes. Herein, a novel TFC-FO membrane has been successfully fabricated by using cellulose triacetate (CTA) porous substrates, which are prepared using a nonsolvent-thermally induced phase separation (N-TIPS) process. The pore structure, permeability, and mechanical properties of CTA porous substrate are carefully investigated via N-TIPS process (CTAN-TIPS). As compared with those via NIPS and TIPS processes, the CTAN-TIPS substrate shows a smooth surface and a cross section combining interconnected pores and finger-like macropores, resulting in the largest water flux and best mechanical property. After interfacial polymerization, the obtained TFC-FO membranes are characterized in terms of their morphology and intrinsic transport properties. It is found that the TFC-FO membrane supported by CTAN-TIPS substrate presents a thin polyamide film full of nodular and worm-like structure, which endows the FO membrane with high water permeability and selectivity. Moreover, the TFC-FO membrane supported by CTAN-TIPS substrate displays a low internal concentration polarization effect. This work proposes a new insight into preparing TFC-FO membrane with good overall performance.

Virologic and clinical characteristics of HBV genotypes/subgenotypes in 487 Chinese pediatric patients with CHB.

BACKGROUND: The association of hepatitis B virus (HBV) genotypes/subgenotypes with clinical characteristics is increasingly recognized. However, the virologic and clinical features of HBV genotypes/subgenotypes in pediatric patients remain largely unknown. METHODS: Four hundred and eighty-seven pediatric inpatients with CHB were investigated, including 217 nucleos(t)ide analog-experienced patients. HBV genotypes/subgenotypes and reverse transcriptase (RT) mutations were determined by direct sequencing. The stage of fibrosis and degree of inflammatory activity were evaluated by the Metavir score system. RESULTS: Among 487 enrolled pediatric patients, HBV genotype C2 and B2 were the most two prevalent (73.7% and 21.1%). Comparing with HBV/B2 infected patients, no significant difference was observed in the incidence rate and mutant patterns of lamivudine- or adefovir-resistant mutations in HBV/C2 infected patients (P > 0.05). Importantly, we found that the degree of hepatic inflammation degree, fibrosis stage and ALT level were significantly higher in HBV/C2-infected HBeAg positive patients than it was in HBV/B2-infected ones. CONCLUSIONS: The pediatric patients with HBV/C2 infection might be more susceptible to develop severe liver pathogenesis.

[Antihypertensive effect of metformin in essential hypertensive patients with hyperinsulinemia.].

OBJECTIVE: To investigate the possibility and utility of metformin alone or in combination with fosinopril to reduce blood pressure in patients with essential hypertension. METHODS: A total of 140 cases of non-diabetic essential hypertension with hyperinsulinemia were recruited and randomly assigned to two groups: a group of 68 treated with metformin 500 mg tid and a group of 72 treated with fosinopril 10 mg qd. The duration of the treatment was 8 weeks. Combination therapy with the two drugs was used after 4 weeks of treatment if needed. If the target goals of systolic blood pressure (SBP) < 140 mm Hg (1 mm Hg = 0.133 kPa) and/or diastolic blood pressure (DBP) < 90 mm Hg were not attained 4 weeks, combination therapy with two drugs was used in either group in the next 4 weeks. The changes of blood pressure and insulin sensitivity of the two groups were observed before and after treatment. RESULTS: (1) After 4 weeks of treatment, SBP in metformin group and fosinopril group decreased by (13.0 +/- 1.2) mm Hg and (15.4 +/- 1.4) mm Hg, and DBP decreased by (9.0 +/- 1.0) mm Hg and (10.4 +/- 1.1) mm Hg respectively. After 8 weeks of treatment, SBP in metformin group and fosinopril group decreased by (17.8 +/- 1.5) mm Hg and (20.9 +/- 1.5) mm Hg, and DBP decreased by (13.2 +/- 0.9) mm Hg and (15.3 +/- 1.1) mm Hg respectively. There was no significant difference in the decline of blood pressure between the two groups (P > 0.05). The rates of combination therapy were both 54% in the two groups. (2) Fasting insulin as well as 30 min and 120 min insulin levels after oral glucose tolerance test and insulin area under the curve in the metformin group were significantly reduced after 4 and 8 weeks of treatment as compared with those of baseline (P < 0.05 and P < 0.01). In the fosinopril group, however, they decreased only after 8 weeks treatment (P < 0.05). The insulin action index in the metformin group was higher than that in the fosinopril group after 4 weeks of treatment (P < 0.05), but there was no significant difference between the two groups after 8 weeks of treatment (P > 0.05). CONCLUSION: Metformin and fosinopril have similar antihypertensive effect and a good synergy in essential hypertension with hyperinsulinemia.

Jinbei Oral Liquid ameliorates bleomycin-induced idiopathic pulmonary fibrosis in rats via reversion of Th1/Th2 shift.

Objective: Idiopathic pulmonary fibrosis (IPF) is a progressive and lethal interstitial lung disease with high mortality. The pivotal role of Th1/Th2 immunological balance in the development and progression of IPF has been demonstrated previously. This study aimed to evaluate the effect of Jinbei Oral Liquid (JBOL) on IPF and its relationship with Th1/Th2 shift. Methods: Rats were divided into six groups: control group, model group (bleomycin), pirfenidone group (positive group, 54 mg/kg, i.g.) and JBOL (5.4, 10.8 and 21.6 mL/kg, i.g.) groups. The rat model was established by an intratracheal instillation of bleomycin (BLM, 5 mg/kg). One day after injection of BLM, pirfenidone or JBOL was given to rats once daily within 28 consecutive days, respectively. Positron emission tomography/computed tomography (PET/CT) was performed on the treated rats. The extent of alveolitis and fibrosis was observed by H&E and Masson trichrome staining. The contents of TGF-ß1, TNF-α, IL-4 and IFN-γ were further quantified by ELISA assay. Results: PET/CT and histopathological evidence showed the ability of JBOL to attenuate bleomycin-induced alveolitis and fibrosis extent, and the alveolitis lesion score was markedly decreased compared with the model group. The increased expression of inflammatory cytokines TGF-ß1 and TNF-α induced by bleomycin was also suppressed by JBOL. The Th1 response was limited by the reduced IFN-γ after BLM administration, and the Th2 response predominated significantly marked by the increased IL-4. JBOL could increase the level of IFN-γ and markedly increased the ratio of IFN-γ/IL-4. Conclusion: These findings suggested that JBOL may attenuate BLM-induced idiopathic pulmonary fibrosis via reducing inflammatory cell infiltration, pro-inflammatory cytokine release and excessive collagen deposition in rats. One of the mechanisms is the reversion of Th1/Th2 shift caused by BLM.

[Effect of moxibustion on clinical symptoms, peripheral inflammatory indexes and T lymphocyte subsets in COVID-19 patients].

OBJECTIVE: To explore the therapeutic effect and the mechanism of the adjuvant treatment with moxibustion on coronavirus disease 2019 (COVID-19). METHODS: A total of 95 patients with COVID-19 were randomly divided into a moxibustion group (45 cases) and a basic treatment group (50 cases). The routine treatment of western medicine was applied in the patients of both groups. In the moxibustion group, on the base of the treatment of western medicine, moxibustion was applied to Dazhui (GV 14), Feishu (BL 13), Qihai (CV 6) and Zusanli (ST 36), once daily and consecutively for 14 days. At the end of treatment courses, clinical symptom scores for cough, asthmatic breathing, chest oppression and short breath, as well as their remission rates were compared between the two groups before and after treatment. Before and after treatment, the white blood cell (WBC) count, the levels of c-reactive protein (CRP) and interleukin-6 (IL-6) and the absolute number of T lymphocyte subsets, i.e. , and of the peripheral blood were compared in the patients between the two groups. The principal component analysis was adopted to analyze the common data extracted from the above 10 clinical indexes variables and comprehensively evaluate the differences in the therapeutic effect of two regimens. RESULTS: The clinical symptom scores were all decreased after treatment in both of the moxibustion group and the basic treatment group as compared with those before treatment (P<0.05). After treatment, the clinical symptom scores of cough, chest oppression and asthmatic breathing in the moxibustion group were lower significantly than those in the basic treatment group (P<0.05) and the remission rates of cough, chest oppression and asthmatic breathing were higher than the basic treatment group (P<0.05). After treatment, WBC count was increased as compared with that before treatment in either group (P<0.05) and the levels of CRP and IL-6 in the moxibustion group were reduced as compared with those before treatment (P<0.05). The reducing range of IL-6 level in the moxibustion group was larger than the basic treatment group (P<0.05). After treatment, the absolute number of , and T lymphocytes was increased as compared with that before treatment in the moxibustion group (P<0.05), and its increase range was larger than the basic treatment group (P<0.05). The difference value was 33.38 for the score of comprehensive evaluation before and after treatment in the moxbustion group, higher obviously than 8.91 in the basic treatment group. CONCLUSION: On the base of the routine treatment with western medicine, moxibustion therapy supplemented relieves the clinical symptoms, reduces the levels of inflammatory indexes, i.e. IL-6 and CRP as well as improves the absolute number of peripheral T lymphocyte subsets. The clinical therapeutic effect of such regimen with moxibustion supplemented is significantly better than the simple routine treatment of western medicine.

[The association of stroke with high plasma low-density lipoprotein cholesterol level and metabolic syndrome in Chinese adults].

OBJECTIVE: To investigate the impact of high plasma LDL-C level with or without metabolic syndrome (MS) on the incidence of stroke in Chinese adults. METHODS: Totally 42 626 subjects (25-75 years old) from Chinese National Health and Nutrition Survey in 2002 were stratified four groups based on plasma LDL-C level:<2.00 mmol/L group, 2.00-2.50 mmol/L group, 2.51-3.31 mmol/L group, and >or=3.32 mmol/L group. The prevalence of MS (with 2005 International Diabetes Federation criteria) and stroke and the risk factors of stroke were compared among the four groups. RESULTS: (1) The prevalence of MS and stroke increased with rising of LDL-C level. The prevalence of MS in LDL-C>or=3.32 mmol/L group increased 2.5 times (7.9% vs 20.1%) as compared with that in LDL-C<2.00 mmol/L group and the prevalence of stroke increased 4.2 times (0.5% vs 2.1%), all P<0.01. (2) In subjects with similar LDL-C level, the prevalence of stroke was significantly higher in a subgroup with MS than that without (P<0.01). (3) After adjustment for age, sex and smoking, logistic regression analysis showed that both LDL-C level and MS were positively associated with the development of stroke; the odds ratio (OR) was 2.35 and 3.15 (P<0.0001), respectively. (4) Compared with the subgroup of LDL-C<2.00 mmol/L without MS, OR for stroke in the subgroups of LDL-C 2.00-2.50 mmol/L, 2.51-3.31 mmol/L, and >or=3.32 mmol/L without MS was 1.03, 1.89, and 2.08, whereas the OR for stroke in the subgroups with MS and similar level of LDL-C was 4.38, 5.23 and 6.15; this indicated that the risk of stroke in subjects with MS increased by 3-4 times compared with subjects without (P<0.0001). CONCLUSION: Both high LDL-C level and MS are independent risk factors of stroke, but the risk of stroke will be further increased in the presence of high LDL-C level plus MS. It is suggested that combined intervention therapy of LDL-C and MS will play an important role in the prevention of stroke.

MARCH: factors associated with weight loss in patients with newly diagnosed type 2 diabetes treated with acarbose or metformin.

INTRODUCTION: In this secondary analysis of the Metformin and AcaRbose in Chinese as the initial Hypoglycaemic treatment (MARCH) trial, we evaluated what demographic and clinical factors were associated with reduction in weight. We also assessed the effects of acarbose and metformin treatment on weight reduction. MATERIAL AND METHODS: We analyzed the demographic and clinical laboratory values from the 784 patients with type 2 diabetes of the MARCH study who were treated for 48 weeks with acarbose or metformin. We determined the association of the different parameters with a weight reduction of ≥ 2 kg in patients using univariate and multivariate analysis. RESULTS: In patients treated with acarbose, males were less likely than females to lose ≥ 2 kg of weight (p = 0.025). Higher baseline HbA1c levels and lower decreases from baseline in fasting plasma glucose (FPG) levels after 48 weeks of treatment were negatively associated with losing ≥ 2 kg of weight (both, p < 0.05). Higher baseline glucagon AUC was also positively associated with reducing weight by ≥ 2 kg (p = 0.010). In patients treated with metformin, change from baseline in whole body insulin sensitivity increased the odds of having a weight reduction of ≥ 2 kg (p = 0.014). CONCLUSIONS: This study found that for both acarbose and metformin, control of FPG significantly impacted weight loss. Baseline AUC for glucagon in patients treated with acarbose and an increase of whole body insulin sensitivity after 48 weeks of treatment with metformin were important factors for weight reduction.

Construction of Antifouling Membrane Surfaces through Layer-by-Layer Self-Assembly of Lignosulfonate and Polyethyleneimine.

Lignin is the second most abundant and low-cost natural polymer, but its high value-added utilization is still lack of effective and economic ways. In this paper, waste lignosulfonate (LS) was introduced to fabricate antifouling membrane surfaces via layer-by-layer self-assembly with polyethyleneimine (PEI). The LS/PEI multilayers were successfully deposited on the polysulfone (PSf) membrane, as demonstrated by ATR-FTIR, XPS, Zeta potential measurements, AFM, and SEM. Meanwhile, the effect of the number of bilayers was investigated in detail on the composition, morphologies, hydrophilicity, and antifouling performance of the membrane surface. As a result, with the bilayer numbers increase to 5, the PSf membrane shows smooth surface with small roughness, and its water contact angle reduces to 44.1°, indicating the improved hydrophilicity. Accordingly, the modified PSf membrane with 5 LS/PEI bilayers repels the adsorption of protein, resulting in good antifouling performance. This work provides a green, facile, and low-cost strategy to construct antifouling membrane surfaces.