Objective Single-pill amlodipine besylate (AML) plus losartan (LOS) has been used to treat inadequately controlled hypertension after antihypertensive monotherapy; however, relevant data in China are limited. This study aimed to compare the efficacy and safety of single-pill AML/LOS and LOS alone in Chinese patients with inadequately controlled hypertension after LOS treatment. Methods In this multicenter, double-blind, randomized, controlled phase III clinical trial, patients with inadequately controlled hypertension after 4 weeks of LOS treatment were randomized to receive daily single-pill AML/LOS (5/100 mg, AML/LOS group, N = 154) or LOS (100 mg, LOS group, N = 153) tablets for 8 weeks. At weeks 4 and 8 of treatment, sitting diastolic and systolic blood pressure (sitDBP and sitSBP, respectively) and the BP target achievement rate were assessed. Results At week 8, the sitDBP change from baseline was greater in the AML/LOS group than in the LOS group (−8.84 ± 6.86 vs. −2.65 ± 7.62 mmHg, P < 0.001). In addition, the AML/LOS group also showed greater sitDBP change from baseline to week 4 (−8.77 ± 6.60 vs. −2.99 ± 7.05 mmHg) and sitSBP change from baseline to week 4 (−12.54 ± 11.65 vs. −2.36 ± 10.33 mmHg) and 8 (−13.93 ± 10.90 vs. −2.38 ± 12.71 mmHg) (all P < 0.001). Moreover, the BP target achievement rates at weeks 4 (57.1% vs. 25.3%, P < 0.001) and 8 (58.4% vs. 28.1%, P < 0.001) were higher in the AML/LOS group than those in the LOS group. Both treatments were safe and tolerable. Conclusion Single-pill AML/LOS is superior to LOS monotherapy for controlling BP and is safe and well tolerated in Chinese patients with inadequately controlled hypertension after LOS treatment.
Objective To investigate the effect of lipoicacid on renal function in patients with cardiac valve replacement.Methods Thirty patients scheduled to receive cardiac valve replacement were randomly divided into lipoicacid group(group L,n =15) and control group(group C,n =15).After tracheal intubation,lipoicacid 50 mg/kg was administered intravenously in group L and lipoicacid was infused at 50 mg/kg on the first 5 days after operation,while in group C only equivalent normal saline was administed.Blood samples were taken before operation (T0),on the 1st(T1),3rd (T3),5th (T5),and 7th(T7) day after operation for measurement of serum urea nitrogen(BUN),creatinine(Cr),β2-microglobulin(β2-MG).Results BUN,Cr and serum β2-MG levels increased significantly after operation at T1 and T3,as compared with the baseline values (T0) in both groups,but the levels in group L were significantly lower than those in group C at the same stage (P ＜ 0.01).Conclusions Applying lipoicacid at the perioperative stage has protective effects on renal function in patients with cardiac valve replacement.
Key words:
Cardiopulmonary bypass; Renal function test; Lipoicacid
Abstract Background Remote ischemic preconditioning (RIPC) initiates endogenous protective pathways in the brain from a distance and represents a new, promising paradigm in neuroprotection against cerebral ischemia-reperfusion (I/R) injury. However, the underlying mechanism of RIPC-mediated cerebral ischemia tolerance is complicated and not well understood. We reported previously that preactivation of Notch1 mediated the neuroprotective effects of cerebral ischemic preconditioning in rats subjected to cerebral I/R injury. The present study seeks to further explore the role of crosstalk between the Notch1 and NF-κB signaling pathways in the process of RIPC-induced neuroprotection. Methods Middle cerebral artery occlusion and reperfusion (MCAO/R) in adult male rats and oxygen-glucose deprivation and reoxygenation (OGD/R) in primary hippocampal neurons were used as models of I/R injury in vivo and in vitro, respectively. RIPC was induced by a 3-day procedure with 4 cycles of 5 min of left hind limb ischemia followed by 5 min of reperfusion each day before MCAO/R. Intracerebroventricular DAPT injection and sh-Notch1 lentivirus interference were used to inhibit the Notch1 signaling pathway in vivo and in vitro, respectively. After 24 h of reperfusion, neurological deficit scores, infarct volume, neuronal apoptosis, and cell viability were assessed. The protein expression levels of NICD, Hes1, Phospho-IKKα/β (p-IKK α/β), Phospho-NF-κB p65 (p-NF-κB p65), Bcl-2, and Bax were assessed by Western blotting. Results RIPC significantly improved neurological scores and reduced infarct volume and neuronal apoptosis in rats subjected to I/R injury. OGD preconditioning significantly reduced neuronal apoptosis and improved cell viability after I/R injury on days 3 and 7 after OGD/R. However, the neuroprotective effect was reversed by DAPT in vivo and attenuated by Notch1-RNAi in vitro. RIPC significantly upregulated the expression of proteins related to the Notch1 and NF-κB pathways. NF-κB signaling pathway activity was suppressed by a Notch1 signaling pathway inhibitor and Notch1-RNAi. Conclusions The neuroprotective effect of RIPC against cerebral I/R injury was associated with preactivation of the Notch1 and NF-κB pathways in neurons. The NF-κB pathway is a downstream target of the Notch1 pathway in RIPC and helps protect focal cerebral I/R injury.
Introduction Glioblastoma(GBM) is a highly malignant primary brain tumor. Even after undergoing surgery and chemotherapy, patients with this affliction still have little to no chance of survival. Current research on immunotherapy treatment for GBM shows that immune-checkpoint inhibitors (ICIs) may be a promising new treatment method. However, at present, the relationship between the fatty acid metabolic process and the prognosis of GBM patients who are receiving immunotherapy is not clear. Methods First, we downloaded a GBM cohort that had been treated with immunotherapy, which included the mutation and prognosis data, and the TCGA-GBM and Jonsson-GBM queues. CIBERSORT and single sample gene set enrichment analysis(ssGSEA) were used to evaluate immune cell scores. Gene set enrichment analysis (GSEA) was used to evaluate the patient’s accessment score. The pRRophetic algorithm was used to evaluate the drug sensitivity of each patient. Univariable and multivariate cox regression analyses, as well as the Kaplan-Meier (KM) method, were used to evaluate the relationship between the fatty acid metabolic process and the prognosis of GBM patients. Results The univariate and multivariate cox regression models showed that the fatty acid metabolic process mutant-type (MT) can be used as an independent predictor of the efficacy of immunotherapy for GBM patients. In addition, fatty acid metabolic process MT is related with significantly longer overall survival (OS) time than the wild-type(WT) variant. However, the mutation status of the fatty acid metabolic process has nothing to do with the prognosis of GBM patients who are receiving conventional treatment. Our analysis showed that fatty acid metabolic process MT correlated with significantly increased natural killer T (NKT) cells and significantly decreased CD8+T cells. At the same time, GSEA analysis revealed that fatty acid metabolic process MT was associated with significantly increased immune activation pathways and an enriched fraction of cytokine secretion compared with WT. Conclusions We found that fatty acid metabolic process MT may be used as an independent predictor of the efficacy of ICI treatment in GBM patients. Use of the fatty acid metabolic process MT will result in higher immunogenicity rates, a significant increase in the proportion of activated immune cells, and improvement of the immune microenvironment.
A robotic vision sensing system for taking and processing the image of MIG welding pool of aluminum alloy is established. A series of clear welding pool images are obtained during welding process.The welding pool's image processing and edge detection method is designed,which effects good conditions for MIG welding.
Objective
To evaluate the efficacy of unilateral open-door laminoplasty with reserved bilateral semispinalis for the treatment of multi-level cervical diseases.
Methods
A retrospective study of prospectively collected data from hospital was conducted. From January 2013 to December 2015, thirty-three patients with multi-level cervical disease underwent C3-C6 unilateral open-door laminoplasty with reserved bilateral semispinalis. There were 19 males and 14 females with average age 57.22±10.75 years (range 35-75 years). Moreover, 32 patients with multi-level cervical disease underwent unilateral open-door laminoplasty with only reserved supraspinal ligamentum, and 35 underwent C3-C7 traditional open-door laminoplasty at the same time. The demographics, operation duration, blood loss volume, cervical curvature, range of motion, axial symptoms, visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) score, the neck disability index (NDI) and complications were recorded and analyzed at preoperation, postoperation and at final follow-up.
Results
The demographics, cervical curvature and range of motion at preoperation, operation duration and blood loss were not significantly difference among three groups (P>0.05). Cervical curvature and range of motion of traditional open-door laminoplasty were 34.38°±7.96° and 11.89°±7.70° at final follow-up (P 0.05), while VAS score, NDI score were significantly different (P<0.05). In particular, VAS and NDI of unilateral open-door laminoplasty with reserved bilateral semispinalis were better than other groups. Early pain was reported in each patients. Two patients (6%) with axial symptom was present in unilateral open-door laminoplasty with reserved bilateral semispinalis, 5 patients (16%) in unilateral open-door laminoplasty with only reserved supraspinal ligamentum and 12 patients (34%) in traditional open-door laminoplasty. There were significantly difference among these groups (P<0.05). One patient with C5 nerve root palsy was reported in unilateral open-door laminoplasty with reserved bilateral semispinalis and unilateral open-door laminoplasty with only reserved supraspinal ligamentum, and two patients in traditional open-door laminoplasty. No cerebrospinal fluid leakage, spinal cord injury, door-hinge fracture, infection, implant loosening or breakage and other complications were observed in each groups.
Conclusion
Unilateral open-door laminoplasty with reserved bilateral semispinalis is an effective technique in treating multi-level cervical disease. The technique not only guaranteed to have good recovery of neurological functional and to maintain cervical curvature and range of motion, but also contributed to decrease the occurrence of postoperative axial symptom.
Key words:
Cervical spondylosis; Ossification of posterior longitudinal ligament; Spinal stenosis; Treatment outcome
Adding aid leaching agent leached the soluble salts in iron dust. The K+ and Na+ leaching rates reached 81.95% and 72.45% separately and the content of Cl- in the slurry decreased to 0.4 g/L. In the reclamation of the slurry remade by the filter cake, the separation indexes recovering iron and carbon were improved, resolving the problems of equipment corrosion and interference separation caused by soluble salts and improving the utilization rate of secondary resource.
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