RESUMO
The estimation of terrestrial carbon sinks in the Qinghai-Tibet Plateau (QTP) still faces significant uncertainties, and the spatiotemporal dynamics of terrestrial carbon sinks along altitudinal gradients remain unexplored. Moreover, the driving mechanisms of terrestrial carbon sinks at the watershed scale in the QTP continue to be lacking. To address these research gaps, based on multi-source remote sensing data and meteorological data, this study calculated the Net Ecosystem Productivity (NEP) in the QTP from 2000 to 2020 using the Modis NPP-soil respiration model. Through the coefficient of variation (CV), the Mann-Kendall test (MK), and the spatial autocorrelation methods, the spatial distribution pattern and spatiotemporal trends of NEP were investigated. Employing a pixel accumulation method, the variation of NEP along altitudinal gradients was explored. Grey relation analysis, Pearson correlation analysis, and Geographical detector (GD) were used to investigate the driving mechanisms of NEP at the watershed scale. Results showed that: (1) the terrestrial ecosystem in the QTP served as a carbon sink, which produced a total of 2.04 Pg C from 2000 to 2020, and the multi-year average of total carbon sinks was 96.92 Tg C; (2) the spatial distribution of NEP shows a decreasing change from southeast to northwest, and the clustering characteristic of NEP is significant at the watershed scale; (3) the elevation of 4507 m we proposed is likely to be a key threshold for biophysical processes of the terrestrial ecosystems in the QTP; (4) the fluctuation and change trend of carbon sources and carbon sinks show significant differences between the East and West; (5) at the watershed scale, precipitation and temperature play a dominant role in the variation of NEP, while the impact of human activities on NEP variation is weak. Our study aims to address the existing knowledge gaps and provide valuable insights into the management of terrestrial carbon sinks in QTP.
Assuntos
Sequestro de Carbono , Ecossistema , Tibet , Solo/química , Carbono/análiseRESUMO
The requirement of carbon emission reduction promotes the continuous implementation and development of low carbon emission mode in typical high-carbon industry aquaculture, especially in the resourceful treatment of terminal waste. However, the previous studies usually focus on a single process or chain, the difference between the long-chain (LC) and automated integration (AI) in the overall environmental impact needs to be quantified and standardised. This paper intends to make a comparative study on two waste treatment biogas projects of aquaculture, a typical industry with high resource consumption and pollution emission in industry and agriculture, and a typical production mode case of aquaculture. The life cycle assessment method is adopted to analyse the environmental impact intensity, identify key link materials, and put forward targeted improvement and optimization schemes. The study found the LC system's comprehensive environmental impact (CEI) is smaller, which is 59.73% less than the AI system. Biogas slurry returning to the field can effectively avoid inorganic fertilizer input. The pretreatment and storage of feces are the key stages. The key substances are NH3 and nitrogen oxides. Suggestions were put forward to optimize the manure management process. In practical pig farms, the process of dry-cleaning manure pre-treatment, automatic fermentation gas production and final biogas slurry filtration drip irrigation should be promoted.
Assuntos
Biocombustíveis , Carbono , Animais , Fezes , Estágios do Ciclo de Vida , Esterco , SuínosRESUMO
Accurate understanding of the relationship between urban land morphology and the concentration of PM2.5 is essential for achieving high-quality development of urban agglomerations. Based on a mechanism framework of "Internal-External driving force", 19 Chinese urban agglomerations at different development levels were analysed using the geographically weighted regression model to evaluate the impacts of urban land morphology on PM2.5 concentrations in years 2000-2017. The results show: (1) The PM2.5 average concentrations of all 19 urban agglomerations continue to increase from 30 µg/m3 in 2000 to 52 µg/m3 in 2007 but decreased to 34 µg/m3 in 2017. The changes in PM2.5 concentrations vary for urban agglomerations at different development levels. Spatial differences in PM2.5 concentrations are significant, forming a pattern that decreases from the centre to the periphery regions; (2) The urban land morphology of the entire urban agglomeration areas has undergone significant changes. The fractal dimension index (from 4.150 to 2.731) and the compactness (from 0.647 to 0.635) showed a downward trend, while the shape indices (from 1.421 to 1.606) demonstrated an increasing trend. National-level urban agglomerations are more compact and more complex in shape, while more fragmented are regional and local urban agglomerations; (3) Different parameters of urban land morphology have varying effects on PM2.5 concentration varies and at different development levels of urban agglomerations. The combination of urban land morphology, socio-economic factors, and natural elements has a complex effect on PM2.5 concentrations. It can contribute to understanding the linkage between urban land morphology and PM2.5, providing references for future studies.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/análise , China , Cidades , Monitoramento Ambiental , Previsões , Material Particulado/análiseRESUMO
Sustainable development emphasizes the sustainability of natural resources and the environment as well as the development of social welfare. Under the background of resource scarcity and environmental constraints, maximizing social welfare is an inevitable choice to achieve sustainable development. Ecological Wellbeing Performance (EWP) can comprehensively reflect the efficiency of natural capital conversion into social welfare, and improving EWP is a feasible measure to achieve sustainable development. Moreover, island areas are the extremely complicated ecological-social-economic systems due to the traits that are geographical isolation, scarce resources, and frequent natural disasters, so that emphasizing the sustainability of island systems is a key step for achieving sustainable development goals. This study developed the EWP model based on the improved Three-dimensional Ecological Footprint (EF) and urban-scale Human Development Index (HDI), to synthetically evaluate and analyze the sustainable development of four major island regions in China with the data in 2017. Results found that: (1) The four regions are all in ecological deficits, being in exchange for overdraft natural capital for economic development. The EFdepth is greater than the original length 1 indicating the excessive consumption of the natural capital stock. The EFsize reflects the abundance and liquidity of regional natural capital, all the four regions are with the generally low level of flow capital utilization. Hainan with highest EFsize 0.428 is due to its comparatively sparse population density, abundant resources, and strong ecological capacity, while the relatively large population density and more restricted natural capital flows make Taiwan in the lowest value. (2) Judging from the evaluation results of the HDI, Chongming (0.796) and Hainan (0.773) high development level are relatively behind Taiwan (0.912) and Zhoushan (0.827) very high development level, for the impact of income is greater, that is, economic development in Hainan and Chongming is slightly weak. (3) Taiwan, with the highest EWP 3.646, shows the excellent natural resource utilization efficiency and sustainability, followed by Zhoushan, Chongming, and Hainan. In general, increasing HDI while reducing EF can be an ideal way to improve the efficiency of ecological resources and achieve sustainable urban development.
Assuntos
Conservação dos Recursos Naturais , Ecossistema , China , Humanos , Ilhas , TaiwanRESUMO
Enhanced biological phosphorus removal (EBPR) process is susceptible to the changed operation condition, which results in an unstable treatment performance. In this work, long-term effect of coagulants addition, aluminum salt for the reactor R1 and iron salt for the reactor R2, on EBPR systems was comprehensively evaluated. Results showed that during the initial 30 days' coagulant addition, effluent chemical oxygen demand and phosphorus can be reduced below 25 and 0.5 mg·L-1, respectively. Further supply of metal salts would stimulate microbial extracellular polymeric substance excretion and induce reactive oxygen species accumulation, which destroyed the cell membrane integrity and deteriorated the phosphorus removal performance. Moreover, coagulants would decrease the relative abundance of Candidatus Accumulibacter while increase the relative abundance of Candidatus Competibacter, leading phosphors accumulating organisms in a disadvantage position. The results of this work might be valuable for the operation of chemical assisted biological phosphorus removal bioreactor.
Assuntos
Betaproteobacteria , Fósforo , Reatores Biológicos , Matriz Extracelular de Substâncias Poliméricas , Glicogênio , PolifosfatosRESUMO
The COVID-19 pandemic developed the severest public health event in recent history. The first stage for defence has already been documented. This paper moves forward to contribute to the second stage for offensive by assessing the energy and environmental impacts related to vaccination. The vaccination campaign is a multidisciplinary topic incorporating policies, population behaviour, planning, manufacturing, materials supporting, cold-chain logistics and waste treatment. The vaccination for pandemic control in the current phase is prioritised over other decisions, including energy and environmental issues. This study documents that vaccination should be implemented in maximum sustainable ways. The energy and related emissions of a single vaccination are not massive; however, the vast numbers related to the worldwide production, logistics, disinfection, implementation and waste treatment are reaching significant figures. The preliminary assessment indicates that the energy is at the scale of ~1.08 × 1010 kWh and related emissions of ~5.13 × 1012 gCO2eq when embedding for the envisaged 1.56 × 1010 vaccine doses. The cold supply chain is estimated to constitute 69.8% of energy consumption of the vaccination life cycle, with an interval of 26-99% depending on haul distance. A sustainable supply chain model that responds to an emergency arrangement, considering equality as well, should be emphasised to mitigate vaccination's environmental footprint. This effort plays a critical role in preparing for future pandemics, both environmentally and socially. Research in exploring sustainable single-use or reusable materials is also suggested to be a part of the plans. Diversified options could offer higher flexibility in mitigating environmental footprint even during the emergency and minimise the potential impact of material disruption or dependency.
RESUMO
OBJECTIVE: The present study aims to investigate micro ribonucleic acid-365 (miR-365) serum expression and its correlation with left ventricular hypertrophy (LVH) in patients with hypertension (HT). METHODS: Eighty-four patients were selected as study subjects and divided into three groups: the experimental group (n = 28), the observation group (n = 29), and the control group (n = 27). The experimental group included patients with LVH-accompanied HT who were treated in the People's Hospital of Hebei Province between November 2019 and November 2020, the observation group included patients with HT unaccompanied by LVH, and the control group included healthy age and gender-matched subjects who underwent health examinations in our physical examination center. The cardiac echocardiography, 24-h Holter electrocardiogram, and circulating miR-365 levels in all subjects were measured. The differences in circulating miR-365 expression levels among the three groups were compared, and the correlations between the miR-365 expression levels and the blood pressure parameters (24-h mean systolic blood pressure [SBP] and 24-h mean diastolic blood pressure [DBP]), inter-ventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular internal diameter (LVID), left ventricular mass (LVM), LVM index (LVMI), and LVH-related indicators were analyzed. RESULTS: The relative miR-365 expressions in the experimental, observation, and control groups were 2.08 (1.60, 2.34), 0.62 (0.44, 0.83), and 0.66 (0.35, 0.86), respectively. Patient miR-365 expression was significantly higher in the experimental group than in the observation group and the control group; the differences were statistically significant (p < 0.000). Furthermore, miR-365 expression was significantly correlated with SBP, DBP, IVST, LVPWT, LVID, LVM, and LVMI; the greatest correlation was with LVMI. Further univariate linear regression analysis revealed that miR-365 expression was linearly and positively correlated with LVMI and that miRNA-365 expression increased with the LVMI value. CONCLUSION: The miR-365 serum expression in patients with LVH-accompanied HT was increased compared with the observation group and the control group and positively correlated with the LVH degree.
RESUMO
BACKGROUND: At present, the treatment for acute myocardial infarction has achieved great progress. Reperfusion therapy in the short term can effectively reduce recurrence rates and mortality in patients with acute myocardial infarction. According to a report of a large national registry, the mortality of patients with acute coronary syndrome combined with acute heart failure is 10 times of that of patients without heart failure, and the mortality in nearly 10 years has no significant change. Therefore, people are constantly exploring indicators for acute heart failure prognosis to improve a patient's prognosis. With the constant understanding and exploration of acute myocardial infarction, more and more researches have focused in determining how to predict the occurrence of acute heart failure. The present study focuses on presenting the latest progress of Carbohydrate Antigen-125 (CA125) and Brain Derived Neurotrophic Factor (BDNF) in serum of patients with acute myocardial infarction in predicting acute heart failure.
Assuntos
Fator Neurotrófico Derivado do Encéfalo/sangue , Antígeno Ca-125/sangue , Insuficiência Cardíaca/sangue , Infarto do Miocárdio/sangue , Doença Aguda , Progressão da Doença , Humanos , PrognósticoRESUMO
OBJECTIVE: To investigate the distributive path and proliferative rule of marrow mesenchymal stem cells (MSCs) in the rat transplanted via caudal vein from male rat to female rats model of chronic aristolochic acid nephropathy (CAAN). METHODS: Cells taken from femoral bone marrow of male Wistar rats were made into single cell suspension, cultured, purified and identified as MSCs. MSCs were transplanted via caudal vein into 50 female Wistar CAAN model rats allocated in the test group, they were killed, 10 rats in a batch, at various time points (6 h, 48 h, 10 d, 30 d and 60 d after transplantation). Besides, 10 rats allocated in the control group were killed on the 30th day after received sham-transplantation. Kidney tissue of all rats was taken for detecting cells originated from the donors by fluorescence in situ hybridization test with FAM-labeled sex determining region of Y chromosome (SRY FISH) probe, and their number in SRY was counted using SRY PCR. RESULTS: MSCs were mainly distributed in the glomerular capillaries at the time points of 6 h and 48 h, but the number of MSCs in glomerular capillaries decreased and those in renal mesenchyma increased at the time points from 10 d to 60 d gradually, then tended to a steady state, meanwhile it showed a stable increasing trend in renal tubule. Cell colony of MSCs could be found in mesenchyma with a slowed down increasing between 30 d to 60 d, but the increasing in tubule was still steady. CONCLUSION: MSCs originated from the donor can enter the kidney of acceptor and distribute from blood capillary to renal mesenchyma and tubule, and they can long time inhabit there and make propagation.
Assuntos
Ácidos Aristolóquicos/toxicidade , Células da Medula Óssea/citologia , Nefropatias/induzido quimicamente , Nefropatias/patologia , Células-Tronco Mesenquimais/citologia , Animais , Proliferação de Células , Feminino , Rim/patologia , Masculino , Ratos , Ratos WistarRESUMO
OBJECTIVE: This study aims to investigate the clinical efficacy of ticagrelor in patients who underwent emergency percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI), and its impact on platelet aggregation rate. METHODS: A total of 257 AMI patients who underwent emergency PCI in our hospital were included in the present study. These patients were randomly divided into two groups: ticagrelor group (n = 129), patients took 180 mg of ticagrelor (qd) before the intervention, and subsequently took 90 mg of ticagrelor (bid) for maintenance; clopidogrel group (n = 128), patients took 300 mg of clopidogrel (qd) before PCI, and subsequently took 75 mg of clopidogrel (qd) for maintenance. Patients in both groups took 100 mg of aspirin. The major adverse cardiovascular events (MACE) within one year, changes in LVEF and LVEDD, platelet aggregation rate and drug safety before PCI and at one week and 30 days after PCI were observed in these two groups. RESULTS: The differences in baseline data between these two groups were not statistically significant. Within one year after the intervention, in the ticagrelor group, the total incidence of MACE was lower (P < 0.05), LVEF and LVEDD was improved (P < 0.05), and the decrease in platelet aggregation rate after the intervention was more significant (P < 0.05). Furthermore, the incidence of bleeding events was higher in the ticagrelor group than in the clopidogrel group (P < 0.05). CONCLUSIONS: Compared with clopidogrel, ticagrelor decreases the incidence of adverse cardiovascular events in AMI patients who underwent emergency PCI, does better in improving the fluctuation level of LVEF and LVEDD, and strongly inhibits platelet aggregation. Some patients encountered adverse drug events, but drug withdrawal or medication change did not occur.
RESUMO
OBJECTIVE: To determine whether insulin resistance (IR) was associated with essential hypertension (EH) in YI nationality living in Liangshan, Sichuang Province. METHODS: A case-control study consisting of 113 YI hypertensives as cases and 156 YI normotensives as controls were conducted to investigate the level of fasting glucose (FG) and fasting insulin (FINS), and insulin resistance index was used as the indicator of IR. RESULTS: It was found that impaired fasting glucose (IFG) and IR were associated with EH significantly among YI migrants, and OR (95% CI) were 3.98 (2.14 approximately 7.42, P < 0.001) and 2.55 (1.35 approximately 4.83, P = 0.004) respectively. Being stratified by sex, both IFG and IR were associated with EH significantly among YI male migrant, and OR were 4.31 (2.01 approximately 9.24, P < 0.001) and 3.14 (1.45 approximately 6.82, P = 0.003) respectively; but only IFG was associated with EH significantly among YI female migrant and OR was 3.46 (1.17 approximately 10.22, P = 0.022). Among YI farmers, both IFG and IR were not associated with EH significantly. The non-conditional logistic regression analysis showed that IR was associated significantly with EH among YI migrants. This was not as same as observed in YI farmers. CONCLUSION: It is likely that IR is the risk factor of EH among YI migrants in our study. However, the association between IR and EH among YI farmers needs some further studies.
Assuntos
Hipertensão/fisiopatologia , Resistência à Insulina , Determinação da Pressão Arterial/estatística & dados numéricos , Estudos de Casos e Controles , China/epidemiologia , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Humanos , Hipertensão/sangue , Hipertensão/epidemiologia , Insulina/sangue , Modelos Logísticos , Masculino , Prevalência , Fatores de Risco , População Rural/estatística & dados numéricosRESUMO
AIM: To find new peroxisome proliferator-activated y agonists with high activity and low toxicity. METHODS: Based on JTT-501 and JTT-20993, new isoxazolidine-3,5-dione and noncyclic 1,3-dicarbonyl compounds were designed and synthesized. Their insulin-sensitizing activities were evaluated. RESULTS: Eight new compounds were obtained. The structures of synthesized compounds were characterized by NMR, MS and IR. Four compounds (1A-4A) showed insulin-sensitizing activities. CONCLUSION: Compounds (1A and 3A) showed excellent insulin-sensitizing activities and should be worth further investigation.
Assuntos
Hipoglicemiantes , Insulina , Isoxazóis , PPAR gama , Células 3T3-L1 , Animais , Glucose/metabolismo , Hipoglicemiantes/agonistas , Hipoglicemiantes/síntese química , Hipoglicemiantes/farmacologia , Insulina/farmacologia , Isoxazóis/síntese química , Isoxazóis/farmacologia , Camundongos , PPAR gama/agonistas , PPAR gama/síntese química , PPAR gama/farmacologiaRESUMO
On the basis of the national survey of the urban sewage treatment, the survey of 2007 national urban sewage reuse was conducted under the charge of the Ministry of Water Resources. The survey results indicated that the amount of urban sewage reuse was 17.9 x 10(8) m3 x a(-1), mainly used for industry, landscape, agriculture forestry, animal husbandry, urban non-potable water, and groundwater recharge. The urban sewage reuse rate was 5.23%. There were 127 sewage reclaiming plants in China, of which the production capacity of reclaimed water reached 347.75 x 10(4) m3 x d(-1), which produced 5.74 x 10(8) m3 reclaimed water in 2007. The total investment of sewage reclaiming plants was 56.44 x 10(8) Yuan, in which the central government investment, local fiscal investment and other investments accounted for 16%, 26% and 58%, respectively. The reclaimed water price varied greatly with the purposes or areas.
Assuntos
Conservação dos Recursos Naturais/métodos , Conservação dos Recursos Naturais/estatística & dados numéricos , Eliminação de Resíduos Líquidos/métodos , Abastecimento de Água/estatística & dados numéricos , China , Cidades , Conservação dos Recursos Naturais/economia , Esgotos , Purificação da Água/estatística & dados numéricos , Abastecimento de Água/economiaRESUMO
BACKGROUND: Anisodamine is widely used in therapy for treating acute glomerulonephritis and diabetic nephropathy because it can improve renal microcirculation. We performed a study to evaluate the preventive effects of anisodamine against contrast-induced nephropathy (CIN) in type 2 diabetics with renal insufficiency undergoing coronary angiography or angioplasty. METHODS: A total of 260 patients with type 2 diabetes and an estimated glomerular filtration rate (eGFR) of 60 ml(-1)×min(-1)×1.73 m(-2) or less, who were undergoing coronary angiography or angioplasty, were randomly assigned to receive an infusion of either sodium chloride (control group, n = 128) or anisodamine (treatment group, n = 132). Patients in the treatment group received an infusion of anisodamine at a rate of 0.2 µg×kg(-1)×min(-1) from 12 hours before to 12 hours after coronary angiography or angioplasty, while patients in the control group received an infusion of sodium chloride with the same volume as the treatment group. All patients received intravenous sodium chloride hydration. CIN was defined as a 25% increase in serum creatinine from baseline or an absolute increase of > 0.5 mg/dl within three days after contrast exposure. The primary end point was the incidence of CIN. The secondary end point was a 25% or greater reduction in eGFR. RESULTS: There were no significant differences between the two groups with regard to age, gender, risk factors, laboratory results, medications and interventions. The incidence of CIN was 9.8% (13/132) in the treatment group and 20.3% (26/128) in the control group (P < 0.05). The secondary end point was 6.0% (8/132) in the treatment group and 16.4% (21/128) in the control group (P < 0.05). CONCLUSION: These results indicate the preventive effects of anisodamine against CIN in type 2 diabetics with renal insufficiency who are undergoing coronary angiography or angioplasty.
Assuntos
Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/prevenção & controle , Meios de Contraste/efeitos adversos , Angiografia Coronária/efeitos adversos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Insuficiência Renal/tratamento farmacológico , Alcaloides de Solanáceas/uso terapêutico , Idoso , Angioplastia Coronária com Balão/efeitos adversos , Creatinina/sangue , Diabetes Mellitus Tipo 2/sangue , Feminino , Taxa de Filtração Glomerular , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência Renal/sangue , Cloreto de Sódio/administração & dosagemRESUMO
BACKGROUND: Previous studies have proved the renal protective effects of anisodamine in patients with septic shock. The aim of this study was to investigate anisodamine for the prevention of contrast induced nephropathy (CIN) in patients with acute coronary syndrome (ACS). METHODS: Consecutive ACS patients undergoing elective percutaneous coronary intervention (PCI) were randomly assigned to one of two groups: patients in the anisodamine group (ANI group) were assigned to receive intravenous infusions of anisodamine by an adjusted-dose (0.1 - 0.2 µg × kg(-1)× min(-1)) from the PCI procedure to 24 hours after PCI, and the control group (CON group) received 0.9% isotonic saline of the same volume. All patients were hydrated for 6 to 12 hours before and 12 hours after PCI. Blood samples were taken on the day of PCI and at 24, 48 and 72 hours after PCI to measure the serum creatinine (SCr). RESULTS: A total of 177 patients were involved in the study, 88 in the ANI group and 89 in the CON group. In both groups, the SCr concentrations significantly increased after PCI, with the peak value occurring at 48 hours. At 72 hours, the SCr concentration in the ANI group retuned to the baseline level (P > 0.05), but the SCr concentration in CON group was still higher than baseline level (P < 0.01). The SCr concentrations at 48 and 72 hours after PCI were much lower in the ANI group than those in the CON group (both P < 0.01). The estimated glomerular filtration rate (eGFR) significantly decreased after PCI, the lowest value occurred at 48 hours. In the ANI group, the eGFR at 72 hours was similar to the baseline level. In the CON group, the eGFR failed to return to baseline at 72 hours (P < 0.01). The eGFR at 24, 48 and 72 hours after PCI were higher in the ANI group (all P < 0.05). The incidence of CIN in the ANI group was lower than that in the CON group within 72 hours after PCI (P < 0.05). The results of multiple Logistic regression proved that both diabetes and left ventricular ejection fraction (LVEF) were independent predictors of CIN, and treatment with anisodamine was an independent preventive factor of CIN (OR 0.369 and 95%CI 0.171 to 0.794, P = 0.011). No serious side effects were found in the ANI group. CONCLUSION: Intravenous infusion of anisodamine during and after elective PCI may safely prevent the occurrence of CIN in ACS patients.
Assuntos
Síndrome Coronariana Aguda/terapia , Angioplastia Coronária com Balão , Meios de Contraste/efeitos adversos , Nefropatias/prevenção & controle , Alcaloides de Solanáceas/uso terapêutico , Adulto , Idoso , Creatinina/sangue , Feminino , Taxa de Filtração Glomerular , Humanos , Nefropatias/induzido quimicamente , Nefropatias/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Alcaloides de Solanáceas/efeitos adversosRESUMO
BACKGROUND: Early percutaneous coronary intervention (PCI) following thrombolysis may be beneficial in patients with ST-segment elevation myocardial infarction (STEMI) who were admitted at a non-PCI hospital. The aim of this study was to evaluate the safety and efficacy of the radial artery as a vascular route for early PCI following thrombolysis in patients with STEMI. METHODS: All consecutive STEMI patients within 12 hours after thrombolysis were enrolled, and eligible patients were randomly assigned to either transfemoral (TFI group) or transradial catheterization (TRI group). Several time intervals were measured. The puncture success rate and ambulation time were assessed. The vascular access-site complications were also assessed after the PCI procedure, and the incidence of major adverse cardiac events (MACE) in hospital was observed. RESULTS: A total of 119 cases were enrolled, with 60 in the TRI group and 59 in the TFI group. There were no significant differences in transfer time and total procedure time. The puncture time in the TRI group was not significantly different compared to the TFI group. The time between PCI and ambulation in the TRI group was shorter than in the TFI group. There was a trend toward lower in the incidence of bleeding complications and vascular complications in the TRI group. CONCLUSION: TRI for STEMI patients following intravenous thrombolysis was as safe and feasible as TFI, with a trend toward lower incidence of bleeding complications and vascular complications.
Assuntos
Perda Sanguínea Cirúrgica/estatística & dados numéricos , Cateterismo Periférico , Artéria Femoral/cirurgia , Infarto do Miocárdio , Artéria Radial/cirurgia , Terapia Trombolítica/métodos , Idoso , Cateterismo Periférico/efeitos adversos , Cateterismo Periférico/métodos , Intervenção Médica Precoce/métodos , Eletrocardiografia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/terapia , Planejamento de Assistência ao Paciente , Intervenção Coronária Percutânea/métodos , Tempo para o Tratamento , Resultado do TratamentoRESUMO
BACKGROUND: Diabetic patients undergoing percutaneous coronary intervention (PCI) have a higher incidence of contrast-induced nephropathy (CIN) than nondiabetic patients, and no pharmacological approach has been demonstrated to offer consistent protection. Therefore, identifying individuals who are at increased risk becomes essential. This study was designed to assess the predictive role of the ratio of contrast medium volume to estimated glomerular filtration rate (CMV/eGFR) in diabetic patients undergoing elective PCI who developed CIN. METHODS: We retrospectively investigated clinical factors associated with the development of CIN in 114 diabetic patients who had undergone elective PCI. The risk factors for CIN included age, gender, body mass index (BMI), left ventricular ejection fraction (LVEF), hemoglobin (Hb), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), volume of contrast medium, basic levels of serum creatinine (Scr), the number of treated vessels and the number of stents used. We conducted a stepwise regression analysis to evaluate the predictive role of these risk factors in the incidence of CIN. RESULTS: The incidence of CIN was 18.4% (21/114). There were no significant differences in age, gender, BMI, LVEF, Hb, FPG, HbA1c, and incidence of hypertension and number of acute myocardial infarction (AMI) in patients between the CIN (n = 21) and the non-CIN (n = 93) groups. However, the eGFR was significantly lower ((72.0 ± 12.5) ml·min(-1)·1.73 m(-2) vs. (82.0 ± 16.5) ml·min(-1)·1.7 m(-2), P = 0.010), and the basic serum creatinine level ((1.07 ± 0.12) mg/dl vs. (0.97 ± 0.19) mg/dl P = 0.014) was significantly higher in the CIN group. In addition, the volume of contrast medium was significantly larger ((253 ± 75) ml vs. (211 ± 71) ml, P = 0.017) and the CMV/eGFR ratio was significantly greater (3.64 ± 1.26 vs. 2.70 ± 1.11, P = 0.001) in the CIN group. Stepwise regression analysis showed that the CMV/eGFR ratio was a significant independent predictor for the development of CIN (P = 0.001). At a cut-off point of > 3.1, the CMV/eGFR ratio exhibited 71% sensitivity and 70% specificity for detecting CIN. CONCLUSION: The CMV/eGFR ratio could be a valuable predictor of CIN for diabetic patients after elective PCI. At a cut-off point of > 3.1, the CMV/eGFR ratio was an optimal predictor for the incidence of CIN.
Assuntos
Meios de Contraste/efeitos adversos , Diabetes Mellitus/terapia , Nefropatias Diabéticas/induzido quimicamente , Idoso , Angioplastia Coronária com Balão , Feminino , Taxa de Filtração Glomerular , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de RiscoRESUMO
We found that dioxiranes generated in situ from ketones 1-6 and Oxone underwent intramolecular oxidation of unactivated C-H bonds at delta sites of ketones to yield tetrahydropyrans. From the trans/cis ratio of oxidation products 1a and 2a as well as the retention of the configuration at the delta site of ketone 5, we proposed that the oxidation reaction proceeds through a concerted pathway under a spiro transition state. The intramolecular oxidation of ketone 6 showed the preference for a tertiary delta C-H bond over a secondary one. This intramolecular oxidation method can be extended to the oxidation of the tertiary gamma' C-H bond of ketones 9 and 10. For ketone 11 with two delta C-H bonds and one gamma' C-H bond linked respectively by a sp(3) hydrocarbon tether and a sp(2) ester tether, the oxidation took place exclusively at the delta C-H bonds. Finally, by introducing proper tethers, regioselective hydroxylation of steroid ketones 12-14 have been achieved at the C-17, C-16, C-3, and C-5 positions.