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Thorombolytic therapy with rescue percutaneous coronary intervention versus primary percutaneous coronary intervention in patients with acute myocardial infarction： a multicenter randomized clinical trial

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Chinese Medical Journal 2010年第11期123卷 1365-1372页

作者： GAO Run-lin HAN Ya-ling YANG Xin-chun MAO Jie-ming FANG Wei-yi WANG Lei SHEN Wei-feng LI Zhan-quan JIA Guo-liang LU Shu-zheng WEI Meng ZENG Ding-yin CHEN Ji-lin QIN Xue-wen XU Bo du chang-hui Department of Cardiology Cardiovascular Institute & Fu WaiHospital Chinese Academy of Medical Sciences Beijing 100037China Department of Cardiology Shenyang Northern HospitalShenyang Liaoning 110840 China Depal-tment of Cardiology Beijing Chaoyang Hospital Beijing100020 China Department of Cardiology Peking University Third HospitalBeijing 100083 China Department of Cardiology First Affiliated Hospital of DalianMedical University Dalian Liaoning 116011 China Department of Cardiology Beijing Friendship Hospital Beijing100050 China Department of Cardiology Ruijin Hospital Shanghai Jiao TongUniversity School of Medicine Shanghai 200025 China Department of Cardiology Liaoning Provincial People's HospitalShenyang Liaoning 110016 China Department of Cardiology Xijing Hospital Forth Military MedicalUniversity Xi'an Shaanxi 710032 China Department of Cardiology Beijing Anzhen Hospital CapitalMedical University Beijing 100029.C.hina Department of Cardiology Shanghai sixth People's HospitalShanghai 200233 China Western China Public Health Institute Sichuan UniversityChengdu Sichuan 610041 China

Background Although thrombolytic therapy with rescue percutaneous coronary intervention （PCI） is a common treatment strategy for ST-segment elevation acute myocardial infarction （STEMI）, scant data are available on its efficacy relative to primary PCI, and comparison was therefore the aim of this study. Methods This multicenter, open-label, randomized, parallel trial was conducted in 12 hospitals on patients （age 〈70 years） with STEMI who presented within 12 hours of symptom onset （mean interval 〉3 hours）. Patients were randomized to three groups： primary PCI group （n=101）; recombinant staphylokinase （r-Sak） group （n=-104）; and recombinant tissue-type plasminogen activator （rt-PA） group （n=-106）. For all patients allocated to the thrombolytic therapy arm, coronary angiography was performed at 90 minutes after drug therapy to confirm infarct-related artery （IRA） patency; rescue PCI was performed in cases with TIMI flow grade 〈2. Bare-metal stent implantation was planned for all patients. Results After randomization it required an average of 113.4 minutes to start thrombolytic therapy （door-to-needle time）and 141.2 minutes to perform first balloon inflation in the IRA （door to balloon time）. Rates of IRA patency （TIMI flow grade 2 or 3） and TIMI flow grade 3 were significantly lower in the thrombolysis group at 90 minutes after drug therapy than in the primary PCI group at the end of the procedure （70.5% vs. 98.0%, P 〈0.0001, and 53.0% vs. 85.9%, P 〈0.0001, respectively）. Rescue PCI with stenting was performed in 117 patients （55.7%） in the thrombolytic therapy arm. Rates of patency and TIMI flow grade 3 were still significantly lower in the rescue PCI than in the primary PCI group （88.9% vs. 97.9%, P=-0.0222, and 68.4% vs. 85.0%, P=0.0190, respectively）. At 30 days post-therapy, mortality rate was significantly higher in the thrombolysis combined with rescue PCI group than in primary PCI group （7.1% vs. 0, P=0.0034）. Rates of death/MI and bleeding complications were significantly higher in the thrombolysis with re

关键词： acute myocardial infarction thorombolytic therapy rescue percutaneous coronary intervention primary percutaneous coronary intervention

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Development of CONTHAC-3D and hydrogen distribution analysis of HPR1000

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Nuclear Science and Techniques 2024年第2期35卷 210-221页

作者： hui Wang Jing-Jing Li Yuan chang Gong-Lin Li Ming Ding China Nuclear Power Engineering Co.LTD. Beijing 100084China Fundamental Science on Nuclear Safety and Simulation Technology Laboratory Harbin 100049China

An in-house code,CONTHAC-3D,was developed to calculate and analyze thermal-hydraulic phenomena in containments during severe accidents.CONTHAC-3D is a three-dimensional computational fluid dynamics code that can be applied to predict gas flow,diffusion,and steam condensation in a containment during a severe hypothetical accident,as well as to obtain an estimate of the local hydrogen concentration in various zones of the containment.CONTHAC-3D was developed using multiple models to simulate the features of the proprietary systems and equipment of HPR1000 and ACP100,such as the passive cooling system,passive autocatalytic recombiners and the passive air cooling system.To validate CONTHAC-3D,a GX6 test was performed at the Battelle Model Containment facility.The hydrogen concentration and temperature monitored by the GX6 test are accurately predicted by CONTHAC-3D.Subsequently,the hydrogen distribution in the HPR1000 containment during a severe accident was studied.The results show that the hydrogen removal rates calculated using CONTHAC-3D for different types of PARs agree well with the theoretical values,with an error of less than 1%.As the accident progresses,the hydrogen concentration in the lower compartment becomes higher than that in the large space,which implies that the lower compartment has a higher hydrogen risk than the dome and large space at a later stage of the accident.The amount of hydrogen removed by the PARs placed on the floor of the compartment is small;therefore,raising the installation height of these recombiners appropriately is recommended.However,we do not recommend installing all autocatalytic recombiners at high positions.The study findings in regard to the hydrogen distribution in the HPR1000 containment indicate that CONTHAC-3D can be applied to the study of hydrogen risk containment.

关键词： Hydrogen risk mitigation Pressurized water reactor HPR1000 Thermal hydraulic CONTHAC-3D

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Study on cumulative effects of biological craniocerebral trauma underrepeated blast

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Theoretical & Applied Mechanics Letters 2024年第3期14卷 174-183页

作者： Xingyuan Huang Bingchen Xia Lijun chang Zhikang Liao hui Zhao Zhihua Cai Hunan Provincial Key Laboratory of Health Maintenance for Mechanical Equipment Hunan University of Science and TechnologyXiangtan 411201China School of Mechanical and Electrical Engineering Foshan UniversityFoshan 528231China Institute for Traffic Medicine PLA Army Characteristic Medical CenterChongqing 400042China

Repeated blast impacts on personnel in explosive environments can exacerbate craniocerebral trauma.Most ex-isting studies focus on the injury effects of a single blast,lacking in-depth analysis on the injury effects andcumulative effects of repeated blasts.Therefore,rats were used as the experimental samples to suffer from ex-plosion blasts with different peak air overpressures(167 kPa∼482 kPa)and varying number of repeated blasts.The cumulative effect of craniocerebral trauma was most pronounced for moderate repeated blast,showing ap-proximately 95%increase of trauma severity with penta blast,and an approximately 85%increase of traumaseverity with penta minor blast.The cumulative effect of craniocerebral trauma from severe,repeated blast has asmaller rate of change compared to the other two conditions.The severity of trauma from penta blast increasedby approximately 69%compared to a single blast.Comprehensive physiological,pathological and biochemicalanalysis show that the degree of neurological trauma caused by repeated blasts is higher than that of single blasts,and the pathological trauma to brain tissue is more extensive and severe.The trauma degree remains unchangedafter double blast,increases by one grade after triple or quadruple blast,and increases by two grades after pentablast.

关键词： Repeated blast Craniocerebral trauma Trauma severity grade Cumulative effects

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Differences and Correlations of Morphological and Hemodynamic Parameters between Anterior Circulation Bifurcation and Side-wall Aneurysms

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Current Medical Science 2024年第2期44卷 391-398页

作者： Kai-kai GUO chang-ya LIU Gao-hui LI Jian-ping XIANG Xiao-chang LENG Yi-ke CAI Xue-bin HU Department of Neurosurgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Department of Emergency Longhua HospitalShanghai University of Traditional Chinese MedicineShanghai 200032China Artery Flow Technology Co. Ltd.Hangzhou 310051China

Objective:The objective of this research was to explore the difference and correlation of the morphological and hemodynamic features between sidewall and bifurcation aneurysms in anterior circulation arteries,utilizing computational fluid dynamics as a tool for analysis.Methods:In line with the designated inclusion criteria,this study covered 160 aneurysms identified in 131 patients who received treatment at Union Hospital of Tongji Medical College,Huazhong University of Science and Technology,China,from January 2021 to September 2022.Utilizing follow-up digital subtraction angiography(DSA)data,these cases were classified into two distinct groups:the sidewall aneurysm group and the bifurcation aneurysm group.Morphological and hemodynamic parameters in the immediate preoperative period were meticulously calculated and examined in both groups using a three-dimensional DSA reconstruction model.Results:No significant differences were found in the morphological or hemodynamic parameters of bifurcation aneurysms at varied locations within the anterior circulation.However,pronounced differences were identified between sidewall and bifurcation aneurysms in terms of morphological parameters such as the diameter of the parent vessel(Dvessel),inflow angle(θF),and size ratio(SR),as well as the hemodynamic parameter of inflow concentration index(ICI)(P0.5,P<0.001).Conclusions:The significant differences in certain morphological and hemodynamic parameters between sidewall and bifurcation aneurysms emphasize the importance to contemplate variances in threshold values for these parameters when evaluating the risk of rupture in anterior circulation aneurysms.Whether it is a bifurcation or sidewall aneurysm,these disparities should be considered.The morphological parameter SR has the potential to be a valuable clinical tool for promptly distinguishing

关键词： sidewall bifurcation unruptured aneurysms computational fluid dynamics

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Effects of Aromatherapy on Physical and Mental Health of Cancer Patients Undergoing Radiotherapy and/or Chemotherapy: A Meta-Analysis

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Chinese Journal of Integrative Medicine 2024年第5期30卷 449-457页

作者： XIE Shuang-ran MA Liang XU Xin-yu ZHOU Shu XIE hui-miao XIE chang-sheng The First Clinical Medical College Zhejiang Chinese Medical UniversityHangzhou 310053China Department of Medical Oncology Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical UniversityHangzhou 310007China Department of Dermatology the Third Xiangya HospitalCentral South UniversityChangsha 410013China Department of Famous Chinese Medicine Clinic the Second Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310005China Department of Medical Oncology the First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310006China

Backgroup:Currently,aromatherapy is being increasingly utilized in clinical practice,particularly in managing the side effects associated with radiotherapy and chemoradiotherapy.However,it remains to be established whether aromatherapy can effectively alleviate these symptoms.Objective:To investigate the effects of aromatherapy on the physical and mental health of patients with cancer undergoing radiotherapy and chemotherapy.Methods:Seven databases were researched from inception until September 29,2023,including PubMed,Scopus,and Web of Science,Chinese National Knowledge Infrastructure,Wanfang database,China Biology Medicine disc and VIP Chinese Medical Journal Database.Review Manager version 5.3 was utilized for data analysis.The Cochrane Risk of Bias tool RoB2 was employed to evaluate the quality of the literature included in the study.Evidence quality rating was assessed using the Grading of Recommendations Assessment,Development,and Evaluation(GRADE) approach through the GRADEpro GDT online tool.Results:Nineteen studies involving 1,541 patients were included.Aromatherapy can alleviate nausea [relative risk(RR)=0.64,95% confidence interval(CI):0.53 to 0.78,P<0.05,I^(2)=46%;standardized mean difference(SMD)=-0.86,95% CI:-1.21 to-0.51,P<0.05,I^(2)=64%] and vomiting(RR=0.54,95% CI:0.42 to 0.69,P<0.05,I^(2)=35%;SMD=-1.28,95% CI:-1.52 to-1.03,P<0.05,I^(2)=92%),improve sleep disorders [mean difference(MD)=-3.39,95% CI:-3.95 to-2.84,P<0.05,I^(2)=0%],relieve pain(SMD=-1.58,95% CI:-1.96 to-1.21,P<0.05,I^(2)=0%),mitigate fatigue(SMD=-1.28,95% CI:-2.44 to-0.11,P<0.05,I^(2)=93%) and enhance quality of life(SMD=0.50,95% CI:0.22 to 0.79,P<0.05,I^(2)=0%) in cancer patients after radiotherapy and chemotherapy,but it may not have a significant effect on anxiety.The risk of bias was high in the included studies using the Cochrane Risk of Bias tool RoB2,and no studies were considered to be of high grade according to the GRADE system.Conclusions:Aromatherapy is an efficacious,safe and economic adjunctive therapy for cancer patien

关键词： aromatherapy cancer chemoradiotherapy physical psychological

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Therapeutic utility of human umbilical cord-derived mesenchymal stem cells-based approaches in pulmonary diseases:Recent advancements and prospects

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World Journal of Stem Cells 2024年第2期16卷 70-88页

作者： Min Meng Wei-Wei Zhang Shuang-Feng Chen Da-Rui Wang chang-hui Zhou Department of Central Laboratory Liaocheng People’s HospitalLiaocheng 252000Shandong ProvinceChina Department of Clinical Laboratory Liaocheng People’s HospitalLiaocheng 252000Shandong ProvinceChina

Pulmonary diseases across all ages threaten millions of people and have emerged as one of the major public health issues worldwide.For diverse disease con-ditions,the currently available approaches are focused on alleviating clinical symptoms and delaying disease progression but have not shown significant therapeutic effects in patients with lung diseases.Human umbilical cord-derived mesenchymal stem cells(UC-MSCs)isolated from the human UC have the capacity for self-renewal and multilineage differentiation.Moreover,in recent years,these cells have been demonstrated to have unique advantages in the treatment of lung diseases.We searched the Public Clinical Trial Database and found 55 clinical trials involving UC-MSC therapy for pulmonary diseases,including coronavirus disease 2019,acute respiratory distress syndrome,bron-chopulmonary dysplasia,chronic obstructive pulmonary disease,and pulmonary fibrosis.In this review,we summarize the characteristics of these registered clinical trials and relevant published results and explore in depth the challenges and opportunitiesfaced in clinical application.Moreover,the underlying mole-cular mechanisms involved in UC-MSC-based therapy for pulmonary diseases are also analyzed in depth.In brief,this comprehensive review and detailed analysis of these clinical trials can be expected to provide a scientific reference for future large-scale clinical application.

关键词： Pulmonary diseases Mesenchymal stem cells Human umbilical cord Cell therapy Clinical trials

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Crossed renal ectopia with rectal cancer:A case report

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World Journal of Clinical Cases 2024年第12期12卷 2122-2127页

作者： Zhen-Wei Tang hui-Feng Yang Zhao-Yu Wu chang-You Wang Department of General Surgery North China University of Science and Technology Affiliated HospitalTangshan 063000Hebei ProvinceChina

BACKGROUND Crossed renal ectopia(CRE)occurs when one kidney crosses the midline from the primary side to the contralateral side while the ureter remains on the primary side.Rectal cancer,one of the most common malignant tumors of the digestive tract,refers to cancer from the dentate line to the rectosigmoid junction.The concurrent presentation of CRE alongside rectal cancer is an uncommon clinical observation.CASE SUMMARY Herein,we report a 69-year-old male patient with rectal cancer who was diagnosed with CRE via computed tomography during hospitalization.Following thorough preoperative evaluations,the patient underwent Dixon surgery.CONCLUSION We performed laparoscopic radical resection of rectal cancer and adequate lymph node removal in a patient with CRE with no postoperative discomfort.

关键词： Rectal cancer Crossed renal ectopia Anatomy Laparoscopic surgery Case report

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dual-filler reinforced PVDF-HFP based polymer electrolyte enabling high-safety design of lithium metal batteries

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Nano Research 2024年第6期17卷 5251-5260页

作者： chang Fang Kangsheng Huang Jing Zhao Shiqi Tian hui Dou Xiaogang Zhang Jiangsu Key Laboratory of Electrochemical Energy Storage Technologies College of Materials Science and TechnologyNanjing University of Aeronautics and AstronauticsNanjing 210016China

Despite the high energy density of lithium metal batteries(LMBs),their application in rechargeable batteries is still hampered due to insufficient safety.Here,we present a novel flame-retardant solid-state electrolyte based on polyvinylidene fluoride-hexafluoropropylene(PVDF-HFP)with nano SiO_(2)aerogel as an inert filler but Li_(6.4)La_(3)Zr_(1.4)Ta_(0.6)O_(12)(LLZTO)as an auxiliary component to enhance the ion conductivity.The introduction of SiO_(2)aerogels imparts the polymer electrolyte with exceptional thermal stability and flame retardancy.Simultaneously,the interaction between hydroxyl groups of SiO_(2)particles and PVDF-HFP creates a strong cross-linking structure,enhancing the mechanical strength and stability of the electrolyte.Furthermore,the presence of SiO_(2)aerogel and LLZTO facilitates the dissociation of lithium salts through Lewis acid-base interactions,resulting in a high ionic conductivity of 1.01×10^(−3)S·cm^(−1)and a wide electrochemical window of~5.0 V at room temperature for the prepared electrolytes.Remarkably,the assembled Li|Li cell demonstrates the excellent resistance to lithium dendrite and runs stablly for over 1500 h at a current density of 0.25 mA·cm^(−2).Thus,we prepare a pouch cell with high safety,which can work normally after short-circuiting under the external folding and cutting.

关键词： polymer electrolyte SiO_(2)/Li_(6.4)La_(3)Zr_(1.4)Ta_(0.6)O_(12)(LLZTO)dual-filler non-flammable long cycle life lithium metal battery

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A robust & weak-nucleophilicity electrocatalyst with an inert response for chlorine ion oxidation in large-current seawater electrolysis

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Journal of Energy Chemistry 2024年第3期90卷 486-495,I0011页

作者： Junting Dong chang Yu hui Wang Lin Chen Hongling Huang Yingnan Han Qianbing Wei Jieshan Qiu State Key Laboratory of Fine Chemicals Frontier Science Center for Smart MaterialsSchool of Chemical EngineeringDalian University of TechnologyDalian 116024LiaoningChina College of Chemical Engineering State Key Laboratory of Chemical Resource EngineeringBeijing University of Chemical TechnologyBeijing 100029China

Seawater splitting into hydrogen,a promising technology,is seriously limited by the durability and tolerance of electrocatalysts for chlorine ions in seawater at large current densities due to chloride oxidation and corrosion.Here,we present a robust and weak-nucleophilicity nickel-iron hydroxide electrocatalyst with excellent selectivity for oxygen evolution and an inert response for chlorine ion oxidation which are key and highly desired for efficient seawater electrolysis.Such a weak-nucleophilicity electrocatalyst can well match with strong-nucleophilicity OH-compared with the weak-nucleophilicity Cl^(-),resultantly,the oxidation of OH-in electrolyte can be more easily achieved relative to chlorine ion oxidation,confirmed by ethylenediaminetetraacetic acid disodium probing test.Further,no strongly corrosive hypochlorite is produced when the operating voltage reaches about 2.1 V vs.RHE,a potential that is far beyond the thermodynamic potential of chlorine ion oxidatio n.This concept and approach to reasonably designing weaknucleophilicity electrocatalysts that can greatly avoid chlorine ion oxidation under alkaline seawater environments can push forward the seawater electrolysis technology and also accelerate the development of green hydrogen technique.

关键词： Nickel-iron hydroxide electrocatalysts Highly selective seawater electrolysis Weak nucleophilicity Oxygen evolution reaction Hydrogen

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Association between Serum Ferritin Levels and Metabolic-associated Fatty Liver Disease in Adults:a Cross-sectional Study Based on the NHANES

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Current Medical Science 2024年第3期44卷 494-502页

作者： Jiang-hui LI Xue-yao MA Yun YI Lu-rao LI Zhi-yong XU Ying chang Department of Gastroenterology Zhongnan Hospital of Wuhan UniversityWuhan430071China Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases Wuhan430071China Endoscopy Center The People’s Hospital of YingshanHuanggang438799China

Objective Ferritin,initially acting as an iron-storage protein,was found to be associated with metabolic diseases.Our study was designed to investigate the association between serum ferritin and metabolic-associated fatty liver disease(MAFLD)using data from the National Health and Nutrition Examination Survey(NHANES)of the United State of America.Methods A cross-sectional study was conducted,enrolling a total of 2145 participants from the NHANES in the 2017–2018 cycles.Hepatic steatosis and liver fibrosis were assessed by ultrasound images and several non-invasive indexes.Multiple regression analysis was conducted to determine the associations between serum ferritin concentration and MAFLD and liver fibrosis.Results The analysis revealed that participants with higher serum ferritin levels(Q3 and Q4 groups)had a higher prevalence of MAFLD than those with the lowest serum ferritin levels[Q3 vs.Q1:OR=2.17(1.33,3.53),P<0.05 in fatty liver index(FLI);Q4 vs.Q1:OR=3.13(1.91,5.13),P<0.05 in FLI].Additionally,participants with the highest serum ferritin levels(Q4 group)displayed a higher prevalence of liver fibrosis[Q4 vs.Q1:OR=2.59(1.19,5.62),P<0.05 in liver stiffness measurement;OR=5.06(1.12,22.94),P<0.05 in fibrosis-4 index],with significantly increased risk observed in participants with concomitant diabetes[OR=7.45(1.55,35.72),P=0.012].Conclusion Our study revealed that elevated serum ferritin levels are associated with a higher prevalence of MAFLD and advanced liver fibrosis in patients.Elevated serum ferritin levels combined with diabetes are important risk factors for liver fibrosis.

关键词： serum ferritin liver fibrosis metabolic-associated fatty liver disease National Health and Nutrition Examination Survey

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