Effective heat redistribution in specific directions is vital for advanced thermal management, significantly enhancing device performance by optimizing spatial heat configurations. We have designed and fabricated a hierarchical fibrous membrane that enables precise heat directing. By integrating hierarchical structure design with the anisotropic thermal conductivity of two-dimensional (2D) materials, we developed a fibrous membrane for anisotropic heat transfer. Such a structure is fabricated by aligning a 1D structured fiber in the 2D plane to achieve anisotropy at each scale level. The fiber units, where 2D nanosheets circumferentially and axially aligned, achieved a high axial thermal conductivity of 16.8 W·m
Research on analgesic effect, stress response, and lung function of thoracic epidural blockade (TEB) and paravertebral blockade (PVB) are inconsistent. This study conducted a meta-analysis of related literature, aiming at comparing the clinical efficacy and safety of two analgesic methods, and providing scientific evidence-based basis for clinical choice of analgesic methods.PubMed, Embase, MEDLINE, Science Direct, Cochrane Library, CNKI, China Biomedical Resources Database, Wanfang Database, VIP, and Foreign Medical Journal Full-Text Service were searched. Keywords were as follows: thoracic epidural block (TEB), paravertebral blockade (PVB), paravertebral catheterization, thoracotomy, and analgesia. Two professionals independently screened documents and extracted data, and used Cochrane System Evaluator Manual (version 5.1.0) to repeatedly assess the bias risk of the documents included in the study.A total of 9 articles were included. Of the 9 RCTs in the present study, 5 described the allocation concealment in detail, 9 described the correct random allocation method, and 1 did not use the blind method. The visual simulation scores of the PVB group and TEB group at 24 and 48 h were not statistically significant [mean difference (MD): -0.17, 95% confidence interval (CI): -0.43 to 0.08, P=0.18; MD: 0.21, 95% CI: -0.06 to 0.48, P=0.13]. The fixed-effects model was used to analyze the incidence of hypotension, nausea, vomiting, and urinary retention. The results showed that there was significant difference between the PVB group and TEB group [hypotension: relative risk (RR): 0.16, 95% CI: 0.06-0.46, P=0.0006; nausea: RR: 0.40, 95% CI: 0.25-0.66, P=0.0002; vomiting: RR: 0.23, 95% CI: 0.06-0.87, P=0.03; urinary retention: RR: 0.36, 95% CI: 0.15-0.87, P=0.02].The meta-analysis confirmed that PVB has the same analgesic effect and postoperative pulmonary function as epidural blockade in open thoracotomy lung surgery. In addition, PVB can reduce the incidence of analgesia-related complications and postoperative chronic pain.
Abstract Background Resistin, a proinflammatory adipocytokine secreted predominately by macrophages in humans, plays an important role in the pathogenesis and development of atherosclerosis. The present research mainly investigated the association between serum resistin level and peak hypersensitive cardiac troponin I (hs-cTnI) in patients with ST-segment elevation myocardial infarction (STEMI).Methods We consecutively enrolled 92 patients with a first STEMI in this cross-sectional and observational study. Resistin concentrations upon admission and 24 h and 72 h after primary percutaneous coronary intervention (PCI) were all measured. The change in resistin (δ Resistin) was defined as (serum resistin concentration at admission)-(serum resistin concentration 24 h after intervention).Results Serum resistin concentration decreased rapidly after primary PCI. Resistin at admission correlated positively with tumour necrosis factor-α (r = 0.522, p<0.001) and macrophage migration inhibitory factor (r = 0.471, p<0.001). Additionally, resistin at admission correlated negatively with the reactive oxygen species scavengers superoxide dismutase (r = -0.261, p = 0.012) and glutathione peroxidase (r = -0.235, p = 0.024). Most importantly, serum resistin concentrations upon admission (r = 0.381, p<0.001) and 24 h (r = 0.372, p<0.001) and 72 h (r = 0.347, p = 0.001) after primary PCI all correlated with peak hs-cTnI, while δ Resistin was not associated with peak hs-cTnI. After multiple linear regression analysis, serum resistin (beta = 13.593, 95% CI 5.951 to 21.235, p < 0.001) at admission and 24 h (beta = 13.972, 95% CI 5.662 to 22.282, p = 0.001) and 72 h (beta = 14.455, 95% CI 5.178 to 23.733, p = 0.003) after intervention remained associated with peak hs-cTnI.Conclusions In our present research, serum resistin concentrations at different time points all correlated positively with peak hs-cTnI, which may suggest that serum resistin concentrations during the acute phase of STEMI are useful for forecasting myocardial infarction size and prognosis in patients after primary PCI. Additionally, our research also indicated that resistin may regulate myocardial IRI partly by promoting the inflammatory process and oxidative stress.
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Objective To explore the clinical manifestations and prognostic factors of cardiac injury in patients with tsutsugamushi disease.Methods The clinical data of 200 patients with tsutsugamushi disease who were admitted to our hospital between June 1985 and August 2012 were retrospectively analyzed,including the clinical manifestations,Weil-Felix test,myocardial enzyme profiles and electrocardiogram,etc.Patients were allocated based on the time from onset to confirmation of diagnosis (groups ＜7 d,7-13 d and ≥14 d) and the age (groups ＜60 years and ≥60 years) for determination of their effects on cardiac injury and the prognosis.Results Of 200 cases with tsutsugamushi disease mostly presented with typical clinical manifestations,33 (16.5％)complained of palpitation and chest distress,20 (10.0％) were accompanied by acute left heart failure,153(76.5％) had an elevation of one or more cardiac enzymes as predominated by increasing of lactate dehydrogenase,and 111 (55.5％) showed aberrant electrocardiogram with a minority developed into high-risk arrhythmia.Patients in the ＜7 d group had a significant lower mortality than those in the ≥14 d group (1.5％ vs 15.4％,P＜0.05).The ≥60 year group was characterized by a significantly higher probability of aberrant electrocardiogram and mortality than the ＜60 year group (64.7％ vs 48.7％ and 12.9％ vs 2.6％,both P＜0.05).Conclusion Patients with tsutsugamushi disease have a high incidence of cardiac injury,and the prognosis is related with the age and the time from onset to confirmation of diagnosis.
Key words:
Tsutsugamushi disease; Orientia tsutsugamushi; Heart injury; Prognosis
This study aimed to evaluate the feasibility and accuracy of non-electrocardiogram (ECG)-triggered chest low-dose computed tomography (LDCT) with a kV-independent reconstruction algorithm in assessing coronary artery calcification (CAC) degree and cardiovascular disease risk in patients receiving maintenance hemodialysis (MHD). In total, 181 patients receiving MHD who needed chest CT and coronary artery calcium score (CACS) scannings sequentially underwent non-ECG-triggered, automated tube voltage selection, high-pitch chest LDCT with a kV-independent reconstruction algorithm and ECG-triggered standard CACS scannings. Then, the image quality, radiation doses, Agatston scores (ASs), and cardiac risk classifications of the two scans were compared. Of the 181 patients, 89, 83, and 9 were scanned at 100, 110, and 120 kV, respectively. Excluding those scanned at 120 kV, 172 patients were enrolled. Although the ASs of non-ECG-triggered LDCT were lower than those of the standard CACS, the agreement and correlation of ASs of the two scans were excellent, and both intraclass correlation coefficients (ICCs) and Pearson's correlation coefficients were > 0.96. Cardiac risk classifications did not significantly differ between the non-ECG-triggered LDCT and standard CACS (χ2 = 3.933, P = 0.269), and the agreement was excellent (weighted kappa value = 0.936; 95% confidence interval (CI): 0.903–0.970). The effective radiation doses of standard CACS and non-ECG-triggered chest LDCT scannings were 1.34 ± 0.74 and 1.04 ± 0.35 mSv, respectively. The non-ECG-triggered, automated tube voltage selection, high-pitch chest LDCT protocol with a kV-independent reconstruction algorithm can obtain chest scans and ASs simultaneously and significantly reduce patients' radiation exposure.
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