[Recommendations of diagnosis and treatment of giant cell arteritis and polymyalgia rheumatic in China].

Polymyalgia rheumatica (PMR) is a syndrome characterized by pain and morning stiffness in the neck and shoulder and pelvic girdles, as well as raised acute-phase reactants, with or without systemic symptoms, such as fever. Giant cell arteritis (GCA) is a systemic vasculitis of unclear etiology that involves systemic arteries, principally affecting medium- and large-sized arteries with skipped, segmental alterations and granulomatous vasculitis seen on histopathology. In China, epidemiological data describing GCA are still limited; thus, the prevalence might be underestimated. The involvement of vessels in GCA can cause irreversible visual impairment or loss and stroke, which are serious complications. PMR is three times more prevalent than GCA, and other specific diseases should be excluded before the diagnosis is established. PMR symptoms can be present in 40%-60% of patients with GCA. Conversely, GCA can develop in 15% of patients with PMR. Chinese Rheumatology Association, based on the clinical diagnosis and treatment guidelines in 2005, utilizing the experience and guidelines of diagnosis and treatment at home and abroad, formulated this specification to standardize the diagnosis and treatment of GCA and PMR and improve the patient's prognosis.

[Association between occupational noise exposure and the risk of cardiovascular diseases].

Objective: To explore the association between occupational noise exposure and cardiovascular disease (CVD) risk in a large Chinese population. Methods: In December 2019, the study included 21412 retired participants from the Dongfeng-Tongji Cohort Study at baseline from September 2008 to June 2010, occupational noise exposure was evaluated through workplace noise level and/or the job titles. In a subsample of 8931 subjects, bilateral hearing loss was defined as a pure-tone mean of 25 dB or higher at 0.5, 1 , 2, and 4 kHz in both ears. Logistic regression models were used to explore the association of occupational noise exposure, bilateral hearing loss with 10-year CVD risk. Results: Compared with participants without occupational noise exposure, the 10-year CVD risk was significantly higher for noise exposure duration ≥20 years (OR=1.20, 95%CI:1.01-1.41 , P=0.001) after adjusting for potential confounders. In the sex-specific analysis, the association was only statistically significant in males (OR=2.34, 95%CI: 1.18-4.66, P<0.001) , but not in females (OR=1.15, 95%CI:0.97-1.37, P=0.153). In the subsample analyses, bilateral hearing loss, which was an indicator for exposure to loud noise, was also associated with a higher risk of 10-year CVD (OR= 1.17, 95% CI:1.05-1.44, P <0.001) , especially for participants who were males (OR =1.24, 95% CI:1.07-2.30, P<0.001) , aged equal and over 60 years old (OR=2.30, 95%CI: 1.84-2.88, P<0.001) , and exposed to occupational noise (OR=1.66, 95%CI: 1.02-2.70, P=0.001). Conclusion: Occupational noise exposure may be a risk factor for CVD.

The W alloying effect on thermal stability and hardening of nanostructured Cu-W alloyed thin films.

In order to achieve desired mechanical properties of alloys by manipulating grain boundaries (GBs) via solute decoration, it is of great significance to understand the underlying mechanisms of microstructural evolution and plastic deformation. In this work, nanocrystalline (NC) Cu-W alloyed films with W concentrations spanning from 0 to 40 at% were prepared by using magnetron sputtering. Thermal stability (within the temperature range of 200 °C-600 °C) and hardness of the films were investigated by using the x-ray diffraction, transmission electron microscope (TEM) and nanoindentation, respectively. The NC pure Cu film exhibited substantial grain growth upon all annealing temperatures. The Cu-W alloyed films, however, displayed distinct microstructural evolution that depended not only on the W concentration but also on the annealing temperature. At a low temperature of 200 °C, all the Cu-W alloyed films were highly stable, with unconspicuous change in grain sizes. At high temperatures of 400 °C and 600 °C, the microstructural evolution was greatly controlled by the W concentrations. The Cu-W films with low W concentration manifested abnormal grain growth (AGG), while the ones with high W concentrations showed phase separation. TEM observations unveiled that the AGG in the Cu-W alloyed thin films was rationalized by GB migration. Nanoindentation results showed that, although the hardness of both the as-deposited and annealed Cu-W alloyed thin films monotonically increased with W concentrations, a transition from annealing hardening to annealing softening was interestingly observed at the critical W addition of ∼25 at%. It was further revealed that an enhanced GB segregation associated with detwinning was responsible for the annealing hardening, while a reduced solid solution hardening for the annealing softening.

Biomechanical study on different lengths of PFNA fixation for unstable intertrochanteric femoral fractures.

OBJECTIVE: The aim of our study was to compare the biomechanical stability of the Proximal Femoral Nail Antirotation (PFNA) (with 200 mm, 240 mm and 280 mm-long main nails) for the management of unstable intertrochanteric femoral fractures. METHODS: Tronzo-Evans Type IV and V fractures were built by applying a three-dimensional finite element model. Further, PFNA-II with 200 mm, 240 mm and 280 mm-long main nails were applied for fixation. The above model is the creation of 3 researchers designed in order to obtain average values of numerical stress. Von Mises stress distribution and medial and lateral stress peak of the femur and PFNA were compared. RESULTS: 240 mm and 280 mm PFNA medial stress peak was reduced significantly in comparison to 200 mm PFNA (p⟨0.05). However, there was no difference between 240 mm and 280 mm PFN. Also, no statistical difference was observed with any of 3 lengths in both medial and lateral stress peak for Evans Type IV and V PFNA. CONCLUSION: 240 mm and 280 mm PFNA could reduce femur fixation medial stress peak. Further, they were more efficient in comparison to the 200 mm PFNA, and their biomechanical stability was similar to that of the 280 mm nail.

[The association between aflatoxin exposure and primary hepatocellular carcinoma risks: a case-control study in Chongqing].

Objective: To investigate the association between aflatoxin exposure and primary hepatocellular carcinoma (PHC) development. Methods: From December 2013 to May 2016, we selected 214 patients newly diagnosed with PHC as cases, and 214 patients as controls from three hospitals in Chongqing. Cases were confirmed with PHC diagnosis standard. And cases caused by clear reasons such as drug-induced liver injury, alcoholic liver damage, fatty liver and gallstones etiology, were excluded. Controls were included with no cancer and no digestive system disease, and recruited simultaneously with cases. Cases and controls were frequency-matched (1∶1) by same gender and age (±3 years). Peripheral blood and random urine samples were collected and analyzed for serum HBsAg status by biochemistry analyzer, and serum AFB(1)-ALB adduct and urinary AFB(1)-N(7)-GUA adduct by ELISA. Basic information, living habits and history of disease for patients were obtained by questionnaires. We used wilcoxon rank sum test to compare the median of serum AFB(1)-ALB adduct and urinary AFB(1)-N(7)-GUA adduct in cases and controls. Logistic regression analyses were performed to assess risk factors for PHC, and synergism index (S) of aflatoxin with other factors was estimated by the method of Andersson. Results: There was no significant difference in age between PHC cases (50.74±9.67) years and controls (51.15±9.90) years. Logistic regression showed that the odds ratio of HBV infection for PHC development was 46.3 (95% CI: 23.3-88.0). There was a significant difference in median concentrations of serum AFB(1)-ALB adduct (cases vs controls: 146.23 vs 74.42 ng/g albumin, P<0.001), but no difference in median concentrations of urinary AFB(1)-N(7)-GUA adduct was observed (cases vs controls: 0.17 vs 0.14 ng/mg creatinine, P<0.210). The odd ratios for PHC risk after adjustment were 1.9 (95%CI: 1.1-3.4) for AFB(1)-ALB adduct, and 2.1 (95%CI: 1.0-4.2) for AFB(1)-N(7)-GUA adduct. Moreover, we observed a positive interaction of aflatoxin exposure with HBV, alcohol drinking, and diabetes. The S was 4.7 (95%CI: 2.8-7.9), 3.5 (95%CI: 1.0-12.0), and 12.4 (95%CI: 1.8-84.2), respectively for serum AFB(1)-ALB adduct with each of the three factors mentioned, and was 1.9 (95%CI:1.1-3.1), 2.0 (95%CI: 1.1-3.6), and 2.0 (95%CI: 1.1-3.6), respectively for urinary AFB(1)-N(7)-GUA adduct with each of the three factors mentioned. Conclusion: HBV was still the main risk factor, and AFB(1) exposure was also an independent risk factor for PHC in Chongqing. There was a positive interaction of aflatoxin with HBV, alcohol drinking, and diabetes.

Efficacy and safety of total glucosides of paeony in treating primary Sjögren's syndrome: a propensity-matched study.

OBJECTIVE: This study aimed to evaluate the efficacy and safety of total glucosides of paeony (TGP) in patients with primary Sjögren's syndrome (pSS). PATIENTS AND METHODS: This study included 236 patients with pSS, including 118 TGP users and 118 non-users. Propensity score matching and Binary logistic regression analyses were used to minimize confounding factors and determine the association between TGP treatment and clinical variables. RESULTS: The baseline indexes of TGP users and non-users were basically the same. The median time of follow-up in the two groups was also similar (p < 0.05). Compared with non-users, TGP users showed higher rates of improvement in dry mouth and eyes and musculoskeletal involvement, as well as more significant reductions in serum alanine aminotransferase (ALT) and direct bilirubin (DBIL) levels after treatment. Logistic regression confirmed that the use of TGP was negatively correlated with the increase of ALT and DBIL in pSS patients, and the reduction in these variables was more pronounced after 2 years of treatment. The incidence of adverse reactions in the TGP users was 11.9%, which was compatible with those in non-users. CONCLUSIONS: TGP is often a safe option for treating pSS patients with musculoskeletal features and abnormal ALT levels. Besides, it can help improve dry mouth and dry eyes and decrease DBIL levels.

Influence of eutrophication on the distribution of total mercury and methylmercury in hydroelectric reservoirs.

The distribution of mercury (Hg) and the characteristics of its methylation were investigated in Wujiangdu (WJD) and Yinzidu (YZD) reservoirs in Guizhou province, China. The two reservoirs are characterized by high and low levels of primary productivity, respectively. Mercury species in water samples from depth profiles in both reservoirs and from interface water in the WJD were analyzed each season during 2007. The concentrations of total Hg (HgT(unf)) and methylmercury (MeHgT(unf)) in unfiltered water samples from the WJD varied from 3.0 to 18 pmol dm(-3) and from 0.17 to 15 pmol dm(-3), respectively; ranges were 2.0 to 9.5 pmol dm(-3) for HgT(unf) and 0.14 to 2.2 pmol dm(-3) for MeHgT(unf) in the YZD. Elevated methylmercury concentrations in water samples from the bottom water and water-sediment interface demonstrated an active net Hg methylation in the downstream reach of the WJD. There was no discernable Hg methylation occurring in the YZD, nor in the upstream and middle reaches of the WJD. The results suggest that high primary productivity resulting from cage aquaculture activities in the WJD is an important control on Hg methylation in the reservoir, increasing the concentrations of MeHg in water in the Wujiang River basin Southwestern China.

Two-Dimensional Numerical Study of Methane-Air Combustion Within Catalytic and Non-catalytic Porous Medium.

This study numerically investigates a two-dimensional physical model of methane/air mixture combustion in catalytic and non-catalytic porous media. The temperature distribution and flame stability of combustion in inert alumina (Al2O3) pellets and platinum (Pt) catalyst-supported alumina (Al2O3) pellets, were studied by changing the burner structure, operating parameters, and physical properties of alumina pellets. The simulation results indicated that the gas temperature in the inert porous medium is higher than that in a catalytic porous medium, while the solid temperature in an inert porous medium is lower than that in a catalytic porous medium. The flame moved toward the burner exit with the increasing diameter of the packed pellets at a lower equivalence ratio and moved toward upstream with the increased thermal conductivity of packed pellets. The flame location of the catalytic porous burner was more sensitive to the flame velocity and insensitive to thermal conductivity compared to the inert porous burner. The distance of the flame location to the burner inlet is almost constant with the increasing length of the porous media for both the catalytic and inert porous burner, while the relative position of the flame location moved toward the upstream.

Tailoring phase transformation strengthening and plasticity of nanostructured high entropy alloys.

Metastable high entropy alloys (HEAs) have attracted extensive attention due to their excellent combination of high strength and great plasticity. In this work, we utilize constraining effects to tailor phase transformation strengthening and plasticity of nanostructured HEA ([double bond, length as m-dash]FeCoCrNi) thin films prepared by the magnetron sputtering technique via HEA/Cu and HEA/Ni nanotwinned nanolaminates (NTNLs). It is uncovered that the HEA/Cu NTNLs without phase transformation exhibit the fashion of "smaller is stronger" and HEA layers become more favorable to detwin at a smaller layer thickness (h). By contrast, the HEA/Ni NTNLs manifest an ultra-high peak hardness plateau accompanied by the FCC-to-HCP phase transformation in HEA layers at large h≥ 25 nm, whereas they manifest size-dependent hardness when detwinning occurs at smaller h. This unusual plastic deformation behavior of HEA/X (X = Cu, Ni) NTNLs was rationalized by partial-based mechanisms. These findings open a new avenue to achieve superior mechanical properties of HEAs particularly at the nanoscale.

Influence of iron deficiency on serum IgG subclass and pneumococcal polysaccharides specific IgG subclass antibodies.

The serum IgG subclass concentrations in 47 cases and specific IgG subclass antibodies against pneumococcal polysaccharides (PnPs) were measured in 18 cases with iron deficiency. IgG subclass deficiencies were found in 28 (59.6%) cases with the frequency in order as IgG4 (27.7%, 13/47), IgG1 (21.3%, 10/47), IgG3 (14.9%, 7/47), and IgG2 (2.1%, 1/47). Compared with age-matched healthy children, the mean concentration of serum IgG4 and IgG1, and PnPs specific IgG1, IgG2 antibodies were decreased in children with iron deficiency. Decreased CD4+ cells and CD4+/CD8+ ratio in peripheral blood, low interleukin-6 (IL-6) activity, reduced lymphocyte proliferative responsiveness and increased recurrent respiratory tract infections (RRTI) were found in iron deficiency children. These results suggested that serum IgG subclass and PnPs specific IgG subclass antibody deficiencies caused by dysfunction of the regulation of T lymphocyte on B lymphocyte may be related to the susceptibility to RRTI in children with iron deficiency.

[Effect of chaihu guizhi decoction on the immunoglobulin and IgG subgroup in children with recurrent respiratory tract infection].

OBJECTIVE: To observe the effect of Chaihu Guizhi Decoction (CGD) on Immunoglobulin (Ig) and IgG subgroup in children with recurrent respiratory tract infection (RRTI). METHODS: Levels of Ig and IgG subgroup were measured in 23 cases of children with RRTI before and after treating with CGD, and compared with those in the control group. RESULTS: In RRTI group, the levels of IgG, IgA, IgM and IgG1 were lower than those of the control groups respectively (P < 0.01). The rate of IgG subgroup deficiency (ISD) was 60.9%. The effective rate of the CGD group was 95.6%. The IgG and IgG1 levels were increased after treatment as compared with before treatment (P < 0.05), and the ISD correcting rate being 71.4%. CONCLUSIONS: The hypoimmunofunction and IgG subgroup deficiency were important factors in RRTI pathogenesis. The CGD could improve the immunofunction and correct the IgG subgroup deficiency, and this effect might be one of the mechanism of CGD in treating RRTI.

Mercury pollution in Asia: a review of the contaminated sites.

This article describes the mercury contaminated sites in Asia. Among the various regions, Asia has become the largest contributor of anthropogenic atmospheric mercury (Hg), responsible for over half of the global emission. Based on different emission source categories, the mercury contaminated sites in Asia were divided into various types, such as Hg pollution from Hg mining, gold mining, chemical industry, metal smelting, coal combustion, metropolitan cities, natural resources and agricultural sources. By the review of a large number of studies, serious Hg pollutions to the local environment were found in the area influenced by chemical industry, mercury mining and gold mining. With the probable effects of a unique combination of climatic (e.g. subtropical climate), environmental (e.g. acid rain), economic (e.g. swift growth) and social factors (e.g. high population density), more effort is still needed to understand the biogeochemistry cycle of Hg and associated health effects in Asia. Safer alternatives and cleaner technologies must be developed and effectively implemented to reduce mercury emission; remedial techniques are also required to restore the historical mercury pollution in Asia.

A comparison of the effect of total intravenous anaesthesia with propofol and remifentanil and inhalational anaesthesia with isoflurane on the release of pro- and anti-inflammatory cytokines in patients undergoing open cholecystectomy.

The aim of the study was to investigate the effects of two anaesthetic techniques (total intravenous technique vs. inhalational technique) on changes in pro- and anti-inflammatory cytokine levels during open cholecystectomy. Forty ASA PS I-II patients undergoing open cholecystectomy were randomly assigned to two groups. Group R received total intravenous anaesthesia with propofol and remifentanil and group F received balanced inhalational anaesthesia with isoflurane. The plasma levels of tumour necrosis factor-alpha (TNF-alpha), interleukin IL-6 and interleukin IL-10 were measured during and after surgery. The pro-inflammatory cytokine levels (TNF-alpha and IL-6) and the anti-inflammatory cytokine (IL-10) showed a significant increase in their concentrations compared with pre-induction levels in both groups (P < 0.05). By the end of anaesthesia and surgery, TNF-alpha and IL-6 were significantly lower in group R than in group F (P < 0.05). At the end of anaesthesia and 12 hours postoperatively, IL-10 levels in group R were higher than in group F (P < 0.05). These findings suggest that total intravenous anaesthesia using propofol and remifentanil suppresses the inflammatory response caused by surgery to a greater extent than a balanced inhalation technique using isoflurane.

Abnormality of bone marrow-derived mesenchymal stem cells in patients with systemic lupus erythematosus.

Bone marrow-derived mesenchymal stem cells (MSCs) are key components of the hematopoietic microenvironment and provide support to hematopoiesis and modulate immune system. Several studies suggest that SLE may be seen as stem cell disorders. However, it is unclear that whether MSCs from SLE patients are defective. So in this research, we studied the biological character of bone marrow derived MSCs in patients with SLE, focused on their phenotype (morphology and immunophenotype), karyotype, cytokines expression and hematopoietic support of MSCs. Our results showed that MSCs from SLE patients and normal controls can be successfully culture-expanded, but the MSCs from SLE grew more slowly than those of normal controls (P < 0.05). Cells from both groups were positive for CD29, CD44 and CD105, and negative for CD14, CD34, CD45 and HLA-DR. MSCs from SLE have a normal karyotype. Both groups express IL-6, IL7, IL-11, macrophage colony stimulating factor (M-CSF) and stem cell factor (SCF) at mRNA level. While IL-6 and IL-7 were down-regulated in MSCs from SLE patient (P < 0.05) at mRNA level. The MSCs from SLE patients and normal controls were infused into ICR (Tac: Icr: Ha strain) mice after high-dose chemotherapy, with no adverse events in either group. Recovery of white blood cells, hemoglobin and platelet was more rapid (P < 0.05) compared with the group without MSCs infusion. We conclude that MSCs in patient with SLE have abnormalities compared with those in normal control. MSCs in patient with SLE may play an important role in the SLE pathogenesis.

[Effect of nicorandil on coronary circulation in ischemic region].

To clarify the role of nicorandil (Nic) in relieving myocardial ischemia, the effects of Nic in canine models of coronary arterial stenosis were studied. During stenosis of the anterior descending coronary artery by an external micrometer constrictor, intracoronary infusion of Nic 1, 5 micrograms/(kg.min) increased coronary blood flow and decreased distal coronary pressure, total coronary arterial resistance and small coronary arterial resistance; but did not affect mean aortic pressure, heart rate and large coronary arterial resistance. Whole blood viscosity, plasma viscosity and hematocrit in coronary vein after intracoronary infusion of Nic were reduced. The results intravenous infusion of Nic were similar to those of intracoronary infusion. These results indicate that Nic is capable of increasing coronary blood flow, alleviating myocardial ischemia due to direct dilatation of coronary artery and reduction of blood viscosity in ischemic region.