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Natural History of a Transitional Atrioventricular Septal Defect in an Adult Patient with Down Syndrome

2018年

作者： (澳)玛拉·穆斯塔芬(mara Moustafine)

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World Journal of Cardiovascular Diseases 2021年第7期11卷 342-346页

作者： mara Escudero-Salamanca Nilda Espinola-Zavaleta Nuclear Cardiology Department National Institute of Cardiology Ignacio Chavez Mexico City Mexico Mexican Faculty of Medicine La Salle University Mexico City Mexico Department of Echocardiography ABC Medical Center I.A.P Mexico City Mexico

Background: Atrioventricular septal defects (AVSD) are caused by a lack of development in atrioventricular endocardial cushions. Its spectrum varies from partial to transitional, or intermediate forms with a common AV valve and 2 orifices, or even the complete form. Aim: The aim of this study is to present a case of a woman in the fifth decade of life with Down syndrome and a transitional AVSD, diagnosed with echocardiography. Case presentation: This is a patient in the fifth decade of life with Down syndrome, transitional AVSD, and severe pulmonary hypertension. Her vital signs were normal, oxygen saturation of 89% on room air. Auscultation revealed pronounced pulmonary component of the second heart sound, diastolic murmur in second left intercostal space, and moderate holosystolic heart murmur that radiated to axilla. The diagnosis was made with a transthoracic echocardiogram. The patient is receiving only medical treatment and since her last consult she has New York Heart Association (NYHA) functional class II. Conclusion: This case demonstrates the natural history of a patient in her fifth decade of life with down syndrome and complex congenital heart disease, despite having received only medical treatment, she is in functional class II. Echocardiography is the noninvasive technique of choice in the diagnosis and follow-up of patients with congenital heart diseases, as seen in this case.

关键词： Transitional Atrioventricular Septal Defect Pulmonary Hypertension Echocardiography

Routine invasive strategy and frailty burden in non-ST-segment elevation acute myocardial infarction

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Journal of Geriatric Cardiology 2024年第10期21卷 954-961页

作者： Albert Ariza-Solé Juan Andrés Bermeo Francesc Formiga Héctor Bueno Gemma Miñana Oriol Alegre David martí Manuel martínez-Sellés Laura Domínguez-Pérez Pablo Díez-Villanueva JoséA Barrabés Francisco Marín Adolfo Villa Marcelo Sanmartín Cinta Llibre Alessandro Sionís Antoni Carol Sergio García-Blas María JoséMorales Gallardo Jaime Elízaga Iván Gómez-Blázquez Fernando Alfonso Bruno García Del Blanco Julio Núñez Juan Sanchis Cardiology Department Hospital Universitari de BellvitgeL’Hospitalet de LlobregatBarcelonaSpain Internal Medicine Department Hospital Universitari de BellvitgeL’Hospitalet de LlobregatBarcelonaSpain Centro Nacional de Investigaciones Cardiovasculares(CNIC) MadridSpain.Cardiology DepartmentHospital 12 de Octubreand Instituto de Investigación Sanitaria Hospital 12 de Octubre(imas12)MadridCIBERCVMadridSpain.Universidad ComplutenseMadridSpain Cardiology Department Hospital Clínico Universitario de ValenciaINCLIVAUniversidad de ValenciaCIBERCVValenciaSpain Cardiology Department Hospital Central de la DefensaMadridSpain Cardiology Department Hospital Universitario Gregorio MarañónCIBERCVUniversidad ComplutenseUniversidad EuropeaMadridSpain Cardiology Department Hospital Universitario La PrincesaIIS-IPCIBERCVMadridSpain Cardiology Department Hospital Universitari Vall d’HebronCIBERCVBarcelonaSpain Cardiology Department Hospital Virgen de la ArrixacaCIBERCVEl PalmarMurciaSpain Cardiology Department Hospital Universitario del SuresteArganda del ReyMadridSpain Cardiology Department Hospital Ramon y CajalCIBERCVMadridSpain Cardiology Department Hospital Germans Trias i PujolCIBERCVBadalonaBarcelonaSpain Cardiology Department Hospital Sant PauCIBERCVBarcelonaSpain Cardiology Department Hospital Moisés BroggiSant Joan DespíBarcelonaSpain

Objective To assess the prognostic impact of a routine invasive strategy according to the frailty burden in patients with non-ST-segment elevation myocardial infarction(NSTEMI)from the MOSCA-FRAIL clinical *** The MOSCA-FRAIL trial randomized 167 frail patients,defined by a Clinical Frailty Scale(CFS)≥4,with NSTEMI to an invasive or conservative *** primary endpoint was the number of days alive and out of hospital(DAOH)one year after *** this subanalysis,we compared the impact of an invasive strategy on the outcomes between vulnerable(CFS=4,n=43)and frail(CFS>4,n=124)*** Compared to vulnerable patients,frail patients presented lower values of DAOH(289.8 vs.320.6,P=0.146),more read-missions(1.03 vs.0.58,P=0.046)and higher number of days spent at the hospital during the first year(10.8 vs.3.8,P=0.014).The cau-ses of readmission were mostly non-cardiac(56%).Among vulnerable patients,DAOH were similar regardless of strategy(invasive ***:325.7 vs.314.7,P=0.684).Among frailest patients,the invasive group tended to have less DAOH(267.7 vs.311.1,P=0.117).Indeed,patients with CFS>4,invasively managed lived 29 days less than their conservative *** contrast,the-re were no differences in the subgroup with CFS=*** Adult patients with frailty and NSTEMI showed different prognosis according to the degree of frailty.A routine in-vasive strategy does not improve outcomes and might be harmful to the frailest patients.

关键词： routine invasive infarction

What will the future hold for artificial organs in the service of assisted reproduction: prospects and considerations

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Frontiers of Medicine 2019年第6期13卷 627-638页

作者： mara Simopoulou Konstantinos Sfakianoudis Petroula Tsioulou Anna Rapani Polina Giannelou Nikolaos Kiriakopoulos Agni Pantou Nikolaos Vlahos George Anifandis Stamatis Bolaris Konstantinos Pantos Michael Koutsilieri Department of Physiology Medical SchoolNational and Kapodistrian University of AthensMikras Asias11527AthensGreece Assisted Conception Unit 2nd Department of Obstetrics and GynecologyAretaieion HospitalMedical SchoolNational and Kapodistrian University of AthensVasilissis Sofias str.11528AthensGreece Centre for Human Reproduction Genesis Athens ClinicPapanikoli15232AthensGreece Department of Histology and Embryology Faculty of MedicineUniversity of Thessaly41500LarisaGreece Assisted Conception Unit General-Maternity District Hospital“Elena Venizelou”Plateia Elenas Venizelou11521AthensGreece

Assisted reproduction provides a wide spectrum of treatments and strategies addressing ***,distinct groups of infertile patients with unexplained infertility,congenital disorders,and other complex cases pose a challenge in in vitro fertilization(IVF)*** special cohort of patients is associated with futile attempts,IVF overuse,and dead ends in *** edge research on animal models introduced this concept,along with the development of artificial organs with the aim to mimic the respective physiological functions in *** on clinical application leads to the future use of infertility management in *** date,the successful clinical application of artificial reproductive organs in humans is not feasible because further animal model studies are required prior to clinical *** application of these artificial organs could provide a solution to infertility cases with no other *** manuscript presents an overview on the current status,future prospects,and considerations on the potential clinical application of artificial ovary,uterus,and gametes in *** paper presents how the IVF practice landscape may be shaped and challenged in the future,along with the subsequent concerns in assisted reproductive treatments.

关键词： artificial ovary artificial uterus artificial gametes assisted reproduction considerations in vitro fertilization

Edible Coatings Based on Apple Pectin,Cellulose Nanocrystals,and Essential Oil of Lemongrass:Improving the Quality and Shelf Life of Strawberries(Fragaria Ananassa)

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Journal of Renewable Materials 2019年第1期7卷 73-87页

作者： Ingrid Souza Vieira da Silva Natália Soares Prado Patrícia Gontijo de Melo Danilo Campion Arantes mara Zeni Andrade Harumi Otaguro Daniel Pasquini Instituto de Química Universidade Federal de UberlândiaCampus Santa MônicaAv.João Naves deÁvila2121Uberlândia-MG38400-902Brazil Instituto Federal do Triângulo Mineiro Campus Uberaba Rua João Batista Ribeiro4000Uberaba-MG38064-790Brazil Departamento de Ciências Naturais(DCNAT) Universidade Federal de São João Del-ReiPraça D.Helvécio74São João Del-Rei-MG36301-160Brazil Universidade de Caxias do Sul Rua Francisco Getúlio Vargas1130Caxias do Sul-RS95070-970Brazil

In this work,nine different types of edible coating based on pectin,cellulose nanocrystals,glycerol,and essential oil of lemongrass were prepared and used to coat strawberries with a film formed directly on the surface of the coated *** effects of the different edible coatings on refrigerated fruits in terms of weight loss,titratable acidity,total soluble solids,pH,and anthocyanin content was evaluated after 2 days,4 days,6 days,and 8 days of *** of the edible coatings reduced the weight loss of the coated strawberries and the anthocyanin *** total soluble solids content of or uncoated fruit increase more markedly than that of coated *** contrast,pH was maintained for both coated and uncoated *** edible coatings were effective in minimizing of the weight loss,without worsening the physical chemistry *** treatments T5 and T9 presented the best results.

关键词： Strawberry edible coating cellulose nanocrystals pectin shelf life

Cannabinoids drive Th17 cell differentiation in patients with rheumatic autoimmune diseases

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Cellular & Molecular Immunology 2021年第3期18卷 764-766页

作者： Konstantin Kotschenreuther Iris Waque Shuaifeng Yan Anja Meyer Thom Haak Julia von Tresckow Joanna Schiller Lydia Gloyer mara Dittrich-Salamon David M.Kofler Laboratory of Molecular Immunology and Division of Clinical Immunology and Rheumatology University of CologneCologneGermany DepartmentⅠof Internal Medicine University of CologneCologneGermany

The legalization of cannabinoids for medical use has reinforced their emerging role as a treatment of chronic pain in patients with cancer or rheumatic diseases.1,2 In addition to their role as pain relievers,evidence obtained from animal models suggests that cannabinoids have immunosuppressive properties.3 However,a definite immunosuppressive function of cannabinoids has not yet been confirmed in clinical trials.

关键词： rheumatic Th17 patients

The importance of functional diversity in the stability of Mediterranean shrubland communities after the impact of extreme climatic events

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Journal of Plant Ecology 2017年第2期10卷 281-293页

作者： Enrique Gde la Riva Francisco Lloret Ignacio MPérez-Ramos Teodoro marañón Sandra Saura-Mas Ricardo Díaz-Delgado Rafael Villar Area de Ecología Facultad de CienciasUniversidad de Cordoba.14071 CordobaSpain CREAF Cerdanyola del Vallés08193 BarcelonaSpain Unitat d’Ecologia Dept.Biologia AnimalBiologia Vegetal i EcologiaUniversitat Autònoma BarcelonaEdifici CCampus UAB08193Cerdanyola del VallèsBarcelonaSpain IRNAS CSICAv.Reina Mercedes 10PO Box 1052.41080 SevillaSpain Estación Biológica de Doñana CSIC.c/Americo Vespucios/nIsla de la Cartuja.41092 SevillaSpain

Aims Extreme climatic events may have important consequences for plant community structure and *** 2005,a severe drought together with a cold winter promoted extensive damage and mortal-ity in shrubland communities of southwest Spain(Doñana National Park).Here,we aim to identify the mechanisms underlying commu-nity stability(resistance and resilience)in response to this extreme climatic event,considering changes in the functional structure of these *** We used a trait-based approach,quantifying variations in 10 func-tional traits at the community level(community weighted means,CWM)and the functional diversity(functional richness,evenness and divergence)in 18 plots at three different times:predating the climatic event(estimated from the sum of the live and dead volume of each species in 2007),and 2 and 8 years after the 2005 *** also quantified the differences in functional traits and functional diversity between adult and recruit stages,which allowed us to bet-ter understand the contribution of the recruitment to the mainte-nance of the functional structure and diversity of the *** Findings Communities with higher functional divergence before the cli-matic event maintained nearly constant their levels of functional divergence 8 years after,but they were more prone to changes in species *** resistance in terms of vegeta-tion cover was positively correlated with root dry matter content,whereas community resilience was positively correlated with leaf chlorophyll(LChl).We also found that some values(weighted means)of functional community traits(such as root dry matter con-tent and LChl)had increased 2 years after the event,returning to the pre-event conditions after 8 *** addition,there was hardly any establishment of new species in the community and the recruits did not make substantial differences to the community functional *** seed mass differed significantly between the adult and se

关键词： climate change Doñana drought functional trait recruitment resilience resistance

烘焙处理对红松松籽植物化学成分和品质影响及变化规律研究

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烘焙处理对红松松籽植物化学成分和品质影响及变化规律研究

作者： Nadya mara Adelina 东北林业大学

学位级别：硕士

红松同砧嫁接（Grafted Pinus koraiensis on the same scions,PK）和樟子松异砧嫁接红松（Grafted tris on Pinus koraiensis rootstocks,PKS）是我国东北地区主要红松树种。烘焙处理是松籽产品最常采用的加工方式,有关烘焙处理对两种... 详细信息

红松同砧嫁接（Grafted Pinus koraiensis on the same scions,PK）和樟子松异砧嫁接红松（Grafted tris on Pinus koraiensis rootstocks,PKS）是我国东北地区主要红松树种。烘焙处理是松籽产品最常采用的加工方式,有关烘焙处理对两种红松松籽成分、品质特性和生物活性方面的影响尚未见报道。本研究以PK和PKS松籽为原料,进行不同烘焙处理（温度130、150、180℃,时间10、20、30 min）,对两种松籽壳、皮、仁的成分、品质和抗氧化性进行研究,比较营养成分、生物活性成分、感官品质及抗氧化活性受烘焙条件影响的变化模式,分析烘焙处理影响成分含量和产品品质变化的原因。为提高松籽加工利用水平,进一步开发利用嫁接红松松籽提供依据。主要研究结果如下:烘焙处理对PK和PKS加工副产物壳、皮中活性成分和抗氧化性影响。烘焙后松籽壳、皮中总多酚、总黄酮和原花青素含量及抗氧化活性（FRAP,ABTS和DPPH）均有所提高,PK松籽中活性成分和抗氧化指标高于PKS,皮中活性成分含量和抗氧化活性高于外壳（p＜0.05）。采用HPLC对关键酚类化合物（抗氧化活性较好）进行定量分析,结果表明,PK种籽衣在150℃30min条件下的抗氧化活性最高,香草酸和儿茶素是决定松籽壳和种籽衣抗氧化活性强弱的最主要化合物（在PK和PKS中分别为6.052 mg/g和3.418 mg/g）。相关性分析结果显示,活性物质含量与抗氧化活性指标之间具有高度相关性,而总酚类化合物与FRAP之间的相关性最高（r=0.941）。经中低温度、短时间烘焙处理（150℃ 20 min或者30min）的松籽壳、皮具有作为抗氧化性原料进一步利用的潜能。烘焙处理对PK和PKS松仁中化学成分和抗氧化性的影响。未经烘焙处理的PK和PKS化学成分中除灰分外,其他成分均存在显著差异。PK和PKS均富含脂肪和蛋白质,含量分别为61.89%、22.39%和59.65%、25.23%。烘焙使松仁中蛋白质和碳水化合物含量显著减少,这与发生美拉德反应有关。PK和PKS中的脂肪酸组成相似,其中亚油酸的比例最大,占40%以上。多不饱和脂肪酸和饱和脂肪酸含量经烘焙处理略有降低。丙二醛是脂质氧化的产物,在较高的烘焙温度下含量升高并在180℃ 30min烘焙条件下达到最高（PK和PKS的6倍）。在烘焙过程中,生物活性成分含量和抗氧化性逐渐提高。采用HPLC测定酚酸和黄酮含量变化结果表明,没食子酸是PK和PKS松仁中决定抗氧化活性高低的主要化合物,并在180℃ 20min条件下达到最高（在PK和PKS中分别为113.817和108.148 μg/g）。多元分析表明,适度烘焙（150℃ 20min）既不会造成松仁营养成分过多损失,又能促进其抗氧化能力的提高。烘焙处理对PK和PKS松仁品质的影响。采用仪器测定和感官分析方法评价烘焙处理对两种松仁品质的影响。烘焙处理显著影响了松仁的颜色（L*,a*和b*值）和质构特性,可以检测到棕褐色出现和质地逐渐变脆。松仁的香气特征采用顶空固相微萃取（HS-SPME）结合气相色谱-质谱法（GC-MS）和电子鼻（E-nose）检测其挥发性成分,在未处理和烘焙处理下PK和PKS仁中共鉴定出286种挥发性化合物,烘焙温度升高和烘烤时间延长显著降低了萜烯和芳烃的含量,在烘烤后期醛,呋喃,糠醛,吡嗪和吡咯成分逐渐形成,此时PKS松仁的相应成分含量高于PK。电子鼻检测到的香气特征表明,相比时间,温度带来的影响更大。基于感官分子网络,探讨了感官分析与仪器分析之间的相关性。研究表明,中度烘焙条件（150℃ 20min）具有更适宜的品质特征。烘烤处理对美拉德反应程度的影响。烘焙过程中发生美拉德反应,对其前体即蛋白质和糖,以及反应的变化程度进行了评估。单糖组成分析表明,葡萄糖和果糖是参与美拉德反应的主要还原糖。通过蛋白质组成和分子量分析,烘焙过程中从PK和PKS仁中提取的总蛋白逐渐减少,白蛋白和球蛋白作为松仁中的主要蛋白质组分在烘焙过程中含量逐渐降低,而松仁中谷蛋白含量较低,随烘焙处理而增加。SDS-PAGE电泳结果表明,在烘焙后期分子量为23、33和53 kDa的蛋白组分缺失,这可能是蛋白质受热变性结构发生改变以及发生美拉德反应的结果。FTIR光谱分析表明PK和PKS松仁蛋白的二级结构中β-折叠居多。荧光光谱显示样品荧光强度随着温度和烘焙时间的增加而下降,同时检测到美拉德反应的中间产物（5-羟甲基糠醛）和终产物（游离和结合的美拉德反应产物）的形成。以上结果可以用于评价美拉德反应程度及其对体系植物化学成分变化的影响。

关键词：松籽烘焙处理植物化学成分品质特性美拉德反应

The prevalence rates of major chronic diseases in retired and in-service Chinese military officers(2000-2016): a meta-analysis

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Military Medical Research 2018年第3期5卷 231-241页

作者： Thermite mara Long-Teng Ma Shuo Wang Ling Wang Fan Yang Jia-Hui Song Yi-Chun Cao Jian-Hua Yin Guang-Wen Cao Department of Epidemiology Second Military Medical University

Background:Chronic diseases cause a tremendous burden to the military medical ***,the prevalence rates of major chronic diseases among military officers remain unclear in ***:China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Database for Chinese Technical Periodicals(VIP),Pub Med and Web of Science were searched for studies(from 2000 to 2016)concerning 6 major chronic diseases:hypertension,hyperlipidemia,diabetes mellitus,heart diseases,cerebrovascular diseases,and chronic obstructive pulmonary diseases(COPD)in Chinese military officers following strict inclusion and exclusion *** researchers independently extracted data from the included studies,and a fourth researcher reviewed and solved every *** analysis was performed with STATA 14.0 and R *** was evaluated by the I^2 value.A random effect model was performed to combine the heterogeneous *** Egger test was performed to test the publication ***:A total of 90,758 military officers derived from 75 articles were pooled *** bias was only observed in 37 studies reporting heart disease(P_(Egger test)=0.01).The overall prevalence rates of hypertension,hyperlipidemia,diabetes mellitus,heart diseases,cerebrovascular diseases,and COPD were 46.6%(95%CI 41.8%–51.5%),30.9%(26.4%–35.7%),20.7%(16.5%–25.7%),48.2%(41.7%–54.9%),20.2%(14.8%–26.9%)and 16.6%(12.9%–21.0%),*** prevalence rates of hypertension,diabetes,heart disease,cerebrovascular disease,and COPD,rather than hyperlipidemia,increased with age in Chinese military *** diseases(P_(Q-test)<0.001)and hypertension(P_(Q-test)<0.001)increased sharply in retired officers compared with officers in *** disease was more frequent in Northern Theater Command than in any other theater command(P_(Q-test)<0.001).Conclusion:Major chronic diseases heavily affect Chinese military officers,especially *** intervention s

关键词： Chronic diseases Meta-analysis Hypertension,Hyperlipidemia Diabetes Cerebrovascular disease Chronic obstructive pulmonary disease

Very low calorie ketogenic diet and common rheumatic disorders:A case report

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World Journal of Clinical Cases 2023年第9期11卷 1985-1991页

作者： Mariangela Rondanelli Zaira Patelli Clara Gasparri Francesca Mansueto Cinzia Ferraris mara Nichetti Tariq A Alalwan Ignacio Sajoux Roberto Maugeri Simone Perna Department of Public Health Experimental and Forensic MedicineUnit of Human and Clinical NutritionIRCCS Mondino FoundationPavia 27100Italy Endocrinology and Nutrition Unit Azienda di Servizi alla Persona"Istituto Santa Margherita"University of PaviaPavia 27100Italy Food Education and Sport Nutrition Laboratory Department of Public HealthExperimental and Forensic MedicineUniversity of PaviaPavia 27100Italy Department of Biology College of ScienceUniversity of BahrainSakhir 32038Bahrain Chief Scientific Office Medical Department Pronokal GroupBarcelona 08001Spain Medical Direction PronoKal GroupSavigliano 12038Italy

BACKGROUND The scientific literature provides evidence that nutritional ketosis can be an important support in the treatment of pathologies in which inflammation is present,as recent studies have shown that ketone bodies have anti-inflammatory activity in numerous diseases,including rheumatic *** report the case of a 22-year-old woman with class I obesity and juvenile idiopathic arthritis who started treatment with a very low calorie ketogenic diet(VLCKD).CASE SUMMARY The patient was a 22-year-old woman diagnosed with juvenile idiopathic arthritis at age 4 years and with a body mass index(BMI)of 30.8 kg/m2,waist circumference(WC)80 cm,fat mass(FM)28.1 kg,free FM 45.7 kg,and visceral adipose tissue(VAT)3.5 kg,assessed on bioimpedance *** was treated using a commercial VLCKD weight-loss program(PNK®method);this program provides high-biological-value protein preparations and natural *** protein preparation contains 15 g protein,4 g carbohydrate,3 g fat,and 50 mg omega-3 docosahexaenoic acid,with an energy content of 90–120 *** four months on the program,the BMI was 28.6 kg/m2,WC 73 cm,FM 23.2 kg,free FM 41.9 kg,and VAT 2.9 *** VLCKD enabled the patient to reach her target weight and to reduce her joint pain and *** inflammatory indices also normalized.

关键词： Very low calorie ketogenic diet Inflammation PNK