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Insulin resistance is associated with subclinical vascular disease in humans 预览
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作者 María M Adeva-Andany Eva Ameneiros-Rodríguez +2 位作者 Carlos Fernández-Fernández Alberto Domínguez-Montero Raquel Funcasta-Calderón 《世界糖尿病杂志:英文版(电子版)》 2019年第2期63-77,共15页
Insulin resistance is associated with subclinical vascular disease that is not justified by conventional cardiovascular risk factors,such as smoking or hypercholesterolemia.Vascular injury associated to insulin resist... Insulin resistance is associated with subclinical vascular disease that is not justified by conventional cardiovascular risk factors,such as smoking or hypercholesterolemia.Vascular injury associated to insulin resistance involves functional and structural damage to the arterial wall that includes impaired vasodilation in response to chemical mediators,reduced distensibility of the arterial wall(arterial stiffness),vascular calcification,and increased thickness of the arterial wall.Vascular dysfunction associated to insulin resistance is present in asymptomatic subjects and predisposes to cardiovascular diseases,such as heart failure,ischemic heart disease,stroke,and peripheral vascular disease.Structural and functional vascular disease associated to insulin resistance is highly predictive of cardiovascular morbidity and mortality.Its pathogenic mechanisms remain undefined.Prospective studies have demonstrated that animal protein consumption increases the risk of developing cardiovascular disease and predisposes to type 2 diabetes(T2D)whereas vegetable protein intake has the opposite effect.Vascular disease linked to insulin resistance begins to occur early in life.Children and adolescents with insulin resistance show an injured arterial system compared with youth free of insulin resistance,suggesting that insulin resistance plays a crucial role in the development of initial vascular damage.Prevention of the vascular dysfunction related to insulin resistance should begin early in life.Before the clinical onset of T2D,asymptomatic subjects endure a long period of time characterized by insulin resistance.Latent vascular dysfunction begins to develop during this phase,so that patients with T2D are at increased cardiovascular risk long before the diagnosis of the disease. 展开更多
关键词 Diabetes Cardiovascular risk ARTERIAL stiffness ARTERIAL ELASTICITY Intimamedia thickness Vascular CALCIFICATION Insulin resistance Animal PROTEIN Vegetable PROTEIN WJD
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中心静脉血气分析在心源性休克中的研究 预览
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作者 梁日明 蔡炜标 +2 位作者 岑锦明 杨希立 吴国新 《吉林医学》 CAS 2019年第2期213-214,共2页
目的:探讨心源性休克患者中心静脉血气分析对组织血流灌注和缺氧程度评估的意义。方法:选取诊断为急性心肌梗死的患者患者,其中合并心源性休克为A组,无心源性休克为B组,对两组患者行桡动脉和中心静脉抽取血样标本后行血气分析。结果:心... 目的:探讨心源性休克患者中心静脉血气分析对组织血流灌注和缺氧程度评估的意义。方法:选取诊断为急性心肌梗死的患者患者,其中合并心源性休克为A组,无心源性休克为B组,对两组患者行桡动脉和中心静脉抽取血样标本后行血气分析。结果:心源性休克患者中心静脉血较动脉血更早表现出酸中毒,A组的中心静脉血pH值和中心静脉血氧分压相对B组有显著性下降;而A组的动静脉血间pH差值、中心静脉血二氧化碳分压和动静脉血二氧化碳分压差值比较,相对B组有显著性升高。结论:心源性休克患者单纯检测动脉血血气并不能反映组织内确切的酸碱状态;同时检测动静脉血气分析能更准确更迅速地反映病情严重程度、变化及细胞内酸碱状态。 展开更多
关键词 中心静脉 动脉 血气分析 心源性休克
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Impurity profile of macitentan in tablet dosage form using a stability-indicating high performance liquid chromatography method and forced degradation study 预览
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作者 Narasimha S LAKKA Chandrasekar KUPPAN Parthasarathy RANGASAMY 《色谱》 CAS CSCD 北大核心 2019年第1期100-110,共11页
Macitentan(MAC)is a pulmonary arterial hypertension(PAH)drug marketed as a tablet and often has stability issues in the final dosage form.Quantitative determination of MAC and its associated impurities in tablet dosag... Macitentan(MAC)is a pulmonary arterial hypertension(PAH)drug marketed as a tablet and often has stability issues in the final dosage form.Quantitative determination of MAC and its associated impurities in tablet dosage form has not been previously reported.This study quantified impurities present in Macitentan tablets using a binary solvent-based gradient elution method using reversed phase-high performance liquid chromatography.The developed method was validated per International Conference on Harmonization(ICH)guidelines and the drug product was subjected to forced degradation studies to evaluate stability.The developed method efficiently separated the drug and impurities(48 min)without interference from solvents,excipients,or other impurities.The developed method met all guidelines in all characteristics with recoveries ranging from 85%-115%,linearity with r^2≥0.996 6,and substantial robustness.The stability-indicating nature of the method was evaluated using stressed conditions(hydrolysis:1 N HCl at 80℃/15min;1 N NaOH at 25℃/45min;humidity stress(90%relative humidity)at 25℃for 24h,oxidation:at 6%(v/v)H2O2,80℃/15min,thermolysis:at 105℃/16h and photolysis:UV light at 200Wh/m^2;Fluorescent light at 1.2 million luxh).Forced degradation experiments showed that the developed method was effective for impurity profiling.All stressed samples were assayed and mass balance was>96%.Forced degradation results indicated that MAC tablets were sensitive to hydrolysis(acid and alkali)and thermal conditions.The developed method is suitable for both assay and impurity determination,which is applicable to the pharmaceutical industry. 展开更多
关键词 reverse phase-high performance liquid chromatography(RP-HPLC) STABILITY-INDICATING METHOD forced degradation STUDY binary solvent gradient ENDOTHELIN receptor antagonist(ERA) pulmonary arterial hypertension(PAH) macitentan(MAC) IMPURITY profiling
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基于公交优先的多路口车速引导控制方法 预览
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作者 蔡雅苹 王伟智 《福州大学学报:自然科学版》 北大核心 2019年第5期700-706,共7页
对于复杂的交通流,传统公交信号优先有可能会破坏干线协调控制效果,为此,提出公交优先可变车速引导和多交叉口信号配时优化的集成方案.以背景公交线路需求的历史数据为前提,通过定时检测公交车流状况,优化公共周期、绿信比和相位差,实... 对于复杂的交通流,传统公交信号优先有可能会破坏干线协调控制效果,为此,提出公交优先可变车速引导和多交叉口信号配时优化的集成方案.以背景公交线路需求的历史数据为前提,通过定时检测公交车流状况,优化公共周期、绿信比和相位差,实时调整多路口交通信号配时,以此改善公交车的通行效率.同时,以福州市金山大道三个交叉口为例,进行Vissim仿真模拟验证,仿真结果表明:所提方法可有效提升多交叉口公交车流的通行效益,减少公交车辆的延误,最大化减少停车次数. 展开更多
关键词 车速引导 干线 公交优先 协调控制
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Probable sirolimus-induced rupture of arterial anastomosis after liver transplantation in a patient intolerant of tacrolimus 预览
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作者 Meng-Yi Lao Tao Ma +3 位作者 Xue-Li Bai Xiao-Zhen Zhang Tian-Yu Tang Ting-Bo Liang 《国际肝胆胰疾病杂志:英文版》 SCIE CAS CSCD 2019年第4期398-400,共3页
To the Editor:Liver transplantation remains the only cure for end-stage liver disease.Tacrolimus is widely used as a first-line immunosuppressive drug to prevent organ rejection after liver transplantation[1–3].Howev... To the Editor:Liver transplantation remains the only cure for end-stage liver disease.Tacrolimus is widely used as a first-line immunosuppressive drug to prevent organ rejection after liver transplantation[1–3].However,tacrolimus has a narrow therapeutic index and wide inter-individual variability in pharmacokinetics,which can result in underimmunosuppression or toxicity.Orally administered tacrolimus is rapidly absorbed from the distal gastrointestinal tract and extensively metabolized in the liver and intestinal walls by cytochrome P450(CYP)3A4 and 3A5[2,4,5]. 展开更多
关键词 RUPTURE liver ARTERIAL
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Population-based volume kinetics of Ringer’s lactate solution in patients undergoing open gastrectomy
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作者 Joo-Hyun Lee Yeong-Jin Choo +6 位作者 Yong-Hun Lee Jin-Ho Rhim Soo-Han Lee Byung-Moon Choi Sung-Tae Oh Kyu-Taek Choi Gyu-Jeong Noh 《中国药理学报:英文版》 SCIE CAS CSCD 2019年第5期710-716,共7页
In order to maintain stable blood pressure and heart rate during surgery, anesthesiologists need to administer the appropriate amount of fluid with appropriate fluid type to the patient, then quantifying how fluid is ... In order to maintain stable blood pressure and heart rate during surgery, anesthesiologists need to administer the appropriate amount of fluid with appropriate fluid type to the patient, then quantifying how fluid is distributed and eliminated from the body is useful for establishing a fluid administration strategy. In this study we characterized the volume kinetics of Ringer’s lactate solution in patients undergoing open gastrectomy. When propofol and remifentanil reached a pseudosteady state at the target concentration and blood pressure was stabilized following surgical stimulation, enrolled patients were administered 1000mL of Ringer’s lactate solution for 20?min, followed by continuous infusion at a rate of 6?mL/kg/h until the time of the last blood collection for volume kinetic analysis. Arterial blood samples were collected to measure the hemoglobin concentration at different time points. The change in hemoglobin-derived plasma dilution induced by the administration of Ringer’s lactate solution was evaluated by nonlinear mixed effects modeling. Three hundred and twenty-three plasma dilution data points from 27 patients were used to determine the pharmacokinetic characteristics of Ringer’s lactate solution. A two-volume model best described the pharmacokinetics of Ringer’s lactate solution. The mean arterial pressure (MAP) and body weight (WT) were significant covariates for the elimination clearance (kr) and central volume of distribution at baseline (Vc0), respectively. The parameter estimates were as follows: kr (mL/min)=124+(MAP/70)^14.2, Vc0 (mL)=0.95+3440×(WT/63), Vt0 (mL)=2730, and kt (mL/min)=181. A higher MAP was associated with a greater elimination clearance and, consequently, less water accumulation in the interstitium. As body weight increases, volume expansion in the blood vessels increases. 展开更多
关键词 ANESTHESIOLOGIST CRYSTALLOID SOLUTION fluid SHIFTS pharmacokinetics mean arterial pressure body weight
Extravascular findings during upper limb computed tomographic angiography focusing on undiagnosed malignancy 预览
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作者 Romman Nourzaie Jeeban Das +7 位作者 Hiba Abbas Narayanan Thulasidasan Panos Gkoutzios Shahzad Ilyas Leo Monzon Tarun Sabharwal Steven Moser Athanasios Diamantopoulos 《世界放射学杂志:英文版(电子版)》 2019年第1期10-18,共9页
BACKGROUND Computer tomography angiography(CTA)has been an established method for diagnostic vascular disease of lower limbs.Recently,the method is widely used for diagnosis of vascular pathologies in the upper limbs ... BACKGROUND Computer tomography angiography(CTA)has been an established method for diagnostic vascular disease of lower limbs.Recently,the method is widely used for diagnosis of vascular pathologies in the upper limbs too.It also has increased the possibilities of this scans being reviewed by no specially trained radiologists.This increases the risk of incidental non vascular findings to be missed or misinterpreted.The study is focusing in the frequency of extravascular incidental finding(EVIF)and highlights the importance for both the reporting radiologist and the referring physician recognizing the frequency of EVIFs.AIM To analyse the frequency of EVIF identified on computed angiography(CT)of the upper limb.METHODS A total of 1383 CT angiographic studies of the peripheral arterial system were performed between August 2015 and August 2017.All upper limb CTAs(n=79)were retrospectively reviewed for the presence of non-vascular incidental findings within the chest,abdomen/pelvis,musculoskeletal system or head and neck.These EVIFs were subsequently grouped into 3 categories based on clinical significance.EVIFs of immediate clinical relevance were included in category A,findings considered indeterminate but most likely benign were placed in category B,while incidental findings of no clinical significance were included in category C.RESULTS Complete imaging datasets were available in 74/79(93.7%).Patient demographics included 39(52.7%)females and 35(47.2%)males with a mean age of 59±19.5 years(range 19-93 years).A total of 153 EVIFs were reported in 52 patients(70.3%).Of these,44 EVIFs(28.7%)were found in the chest,83(54.2%)in the abdomen,14(9.2%)in the musculoskeletal system and 9(5.8%)in the head and neck.Thirteen EVIFs(8.4%)identified in 11 patients were noted to be of immediate clinical significance(Category A),50 EVIFs(32.3%)were identified in 20 patients and were considered indeterminate but most likely benign,while the remaining 91 EVIFs(59.5%)identified in 21 patients were determined to be of no clinical sign 展开更多
关键词 Extravascular INCIDENTAL FINDINGS Computed ANGIOGRAPHY Upper LIMBS Arterial Extravascular FINDINGS
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Stress doppler echocardiography in connective tissue disease patients without overt pulmonary arterial hypertension
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作者 李贺智 雷云霞 +3 位作者 侯乐正 罗冬玲 张曹进 费洪文 《岭南心血管病杂志:英文版》 CAS 2019年第1期31-36,共6页
Background Pulmonary arterial hypertension(PAH) is a common complication of connective tissue disease(CTD) and confers a worse prognosis. Stress doppler echocardiography(SDE) can detect early pulmonary vasculopathy an... Background Pulmonary arterial hypertension(PAH) is a common complication of connective tissue disease(CTD) and confers a worse prognosis. Stress doppler echocardiography(SDE) can detect early pulmonary vasculopathy and assess right heart function in patients with pulmonary arterial hypertension. In this study, the SDE was applied to analyze the degree of pulmonary vascular lesion and the function of right heart in CTD patients without overt PAH. Methods CTD patients without overt PAH were divided into exercised-induced pulmonary hypertension(EIPH) group and non-EIPH group depending on whether tricuspid regurgitation(TR) exceeded 3.1 m/s during exercise and assessed by echocardiography at rest and during exercise. The data of right ventricular function and the slope of the incremental of the mean pulmonary artery pressure and cardiac output(ΔmPAP/ΔCO) were analyzed. Results Forty-seven CTD patients without overt PAH(35 female, mean age 40.3±12.0 years) were enrolled and divided into EIPH group(n=21) and non-EIPH group(n=26). Patients with systemic sclerosis(SSc) were more likely to have EIPH(47.6% vs. 28.6%, P<0.05) than those with systemic lupus erythematosus(SLE). Patients in EIPH group had a higher value of ΔmPAP/ΔCO than that of the non-EIPH group(4.5±3.1 vs. 2.2±1.3, P<0.05). SSc was more prevalent in CTD patients and the symptoms of dyspnea occurred more often in EIPH group(52.4%), indicating a pressure-flow mismatch induced by exercise. However, the cardiac function demonstrated by left ventricular ejection fraction(LVEF), tricuspid annular plane systolic excursion(TAPSE),DTI-Derived S’-wave velocity(S’) and right ventricular fractional area change(RVFAC), as well as functional reserve reflected by the changes of TAPSE, S’, RVFAC before and after exercise, did not differ significantly between the two groups. Conclusions Although right ventricular(RV) reserve function does not change much before and after exercise, patients in EIPH group have a higher value of ΔmPAP/ΔCO than that of the non-EI 展开更多
关键词 STRESS DOPPLER ECHOCARDIOGRAPHY CONNECTIVE tissue disease pulmonary ARTERIAL HYPERTENSION
Y90-radioembolization via variant hepatic arteries:Is there a relevant risk for non-target embolization? 预览
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作者 Markus Zimmermann Maximilian Schulze-Hagen +4 位作者 Federico Pedersoli Peter Isfort Alexander Heinzel Christiane Kuhl Philipp Bruners 《世界放射学杂志:英文版(电子版)》 2019年第7期102-109,共8页
BACKGROUND The hepatic arterial anatomy is highly variable, with the two most common variants being a replaced right hepatic artery(RHA) originating from the superior mesenteric artery(SMA) and a left hepatic artery(L... BACKGROUND The hepatic arterial anatomy is highly variable, with the two most common variants being a replaced right hepatic artery(RHA) originating from the superior mesenteric artery(SMA) and a left hepatic artery(LHA) originating from the left gastric artery(LGA). These anatomical variants could potentially increase the risk for non-target embolization during Y90-Radioembolization due to the close proximity between hepatic and enteric vessel branches.AIM To evaluate the safety of Yttrium-90radioembolization(90Y-RE) with resin microspheres in patients with a variant hepatic arterial anatomy.METHODS In this retrospective single-center observational study, 11 patients who underwent RE with 90Y-resin microspheres via a LHA originating from the LGA,and 13 patients via a RHA originating from the SMA were included. Patient and treatment data were reviewed regarding clinical and imaging evidence of nontarget embolization of 90Y-resin microspheres to the GI tract. Positioning of the tip of the microcatheter in relationship to the last hepatoenteric side branch was retrospectively analyzed using angiographic images, cone-beam CT and preinterventional CT-angiograms.RESULTS None of the 24 patients developed clinical symptoms indicating a potential nontarget embolization to the GI tract within the first month after 90Y-RE. On thepostinterventional 90Y-bremsstrahlung images and/or 90Y-positron emission tomographies, no evidence of extrahepatic 90Y-activity in the GI tract was noted in any of the patients. The mean distance between the tip of the microcatheter and the last enteric side branch during delivery of the 90Y microspheres was 3.2 cm(range: 1.9-5 cm) in patients with an aberrant LHA originating from a LGA. This was substantially shorter than the mean distance of 5.2 cm(range: 2.9-7.7 cm) in patients with an aberrant right hepatic originating from the SMA.CONCLUSION90Y-RE via aberrant hepatic arteries appears to be safe;at least with positioning of the microcatheter tip no less than 1.9 cm distal to the last hepatoen 展开更多
关键词 RADIOEMBOLIZATION Yttrium 90 ABERRANT HEPATIC ARTERIES HEPATIC arterial VARIANTS Safety
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Association of hemoglobin with arterial stiffness evaluated by carotid-femoral pulse wave velocity among Chinese adults
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作者 Zhen-Zhen Zhang Ping Wang +2 位作者 Xiang-Lei Kong Wen-Li Mao Mei-Yu Cui 《慢性疾病与转化医学:英文版》 CSCD 2019年第2期122-128,共7页
Objective: Increased hemoglobin (Hb) levels are known to be associated with increased cardiovascular events and mortalities. Therefore, we assumed that high Hb levels were associated with arterial stiffness. Pulse wav... Objective: Increased hemoglobin (Hb) levels are known to be associated with increased cardiovascular events and mortalities. Therefore, we assumed that high Hb levels were associated with arterial stiffness. Pulse wave velocity (PWV) is a simple and noninvasive method for measuring arterial stiffness to assess cardiovascular disease in general populations. Accordingly, we conducted a cross-sectional study to explore the association of Hb with PWV. Methods: A total of 6642 adults aged 54.5 ± 11.2 years undergoing physical examinations were enrolled, 71.7% of whom were males. Arterial stiffness was evaluated by carotid-femoral PWV (cfPWV). Multivariable regression analyses were performed to determine the relationship between Hb and increased cfPWV. Results: In this study, the mean Hb (per 10 g/L increase) was 144.7 ± 13.9 g/L, and the mean cfPWV was 15.1 ± 3.1 m/s. cfPWV was significantly higher in high hemoglobin groups >15.4 g/L (Quartile 4) than in the lowest hemoglobin group (Quartile 1 < 13.6 g/L;P < 0.001). Multiple linear regression analysis revealed that Hb positively correlated with cfPWV (β= 0.16, P < 0.01). Univariate Logistic regression analysis revealed that Hb was associated with increased cfPWV, with an odd ratio (OR) of 1.46 (95% confidence interval [CI], 1.39-1.54). After adjusting for potential confounders, Hb and the highest Hb quartile group were also independently associated with increased cfPWV, with a fully adjusted OR of 1.11 (95% CI, 1.02-1.20) and 1.45 (95% CI, 1.01-2.08), respectively. Conclusion: This study demonstrated that Hb levels significantly correlate with increased cfPWV. 展开更多
关键词 HEMOGLOBIN Pulse wave velocity ARTERIAL STIFFNESS CARDIOVASCULAR diseases
Pulmonary arterial stent for pulmonary trunk stenosis after size-mismatched lung transplantation
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作者 Fei Xiao Chao-Yang Liang +4 位作者 Wen-Hui Chen Min Li Xin-Cao Tao He Chen Jing-Yu Chen 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第10期1247-1249,共3页
To the Editor: Appropriate donor-to-recipient size matching is of crucial importance in lung transplantation. Although tailoring of the lung has been described as a successful means of overcoming size disparities, its... To the Editor: Appropriate donor-to-recipient size matching is of crucial importance in lung transplantation. Although tailoring of the lung has been described as a successful means of overcoming size disparities, its merits and demerits remain unclear. Here, we present a case of recurrent hypoxemia after unmatched single lung transplantation. 展开更多
关键词 PULMONARY TRUNK STENOSIS PULMONARY ARTERIAL LUNG transplantation
A case report about a new frequency-code therapy of type 2 diabetes for 12 days 预览
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作者 Yurii Pozniak 《TMR生命研究》 2019年第4期137-144,共8页
The mainstay of type 2 diabetes treatment used to be blood glucose control in order to prevent or delay the development of various diabetic complications. On September 1, 2018, one of our patients was diagnosed with s... The mainstay of type 2 diabetes treatment used to be blood glucose control in order to prevent or delay the development of various diabetic complications. On September 1, 2018, one of our patients was diagnosed with several serious illnesses: type 2 diabetes, 3 degrees of obesity, arterial hypertension, peripheral vascular atherosclerosis of the lower extremities with swelling of the shins and feet, fatty hepatosis and metabolic syndrome since June 2019. The patient was restricted in movement due to excessive body weight, shortness of breath and joint pain. Conventional medical methods did not work well for him, so the prognosis is very poor. In this case, we used a new frequency-code therapy which could transmit the signal into the patient's brain by the method of frequency code influence to cure diabetes and associated diseases, restore the patient's body and improve his living quality. According to our forecasts in September 2018 the treatment of acquired diseases and the restoration of the patient's body to a viable level, with the help of our technology, may take more a year. Carrying out step-by-step noninvasive treatment by the method of frequency-code influence on the patient's brain we received positive results at each stage of treatment which together gave a complex positive result in ridding the patient of acquired diseases and restoring his body to the level of active life-activity without restrictions. Now the patient does not follow a diet and enjoys physical activity. No side effects were observed. The human body is unique, even in adulthood, the protective functions of the body are able to defeat the most complex diseases without damage to the body. To do this need to activate the "sleeping protective mechanism" of the body or translate the "healthy memory of the brain" in the period of active resistance to premature age-related diseases. 展开更多
关键词 Treatment of diabetes MELLITUS ARTERIAL hypertension ATHEROSCLEROSIS WEIGHT loss REJUVENATION
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Role of Wnt/β-Catenin Pathway in the Arterial Medial Calcification and Its Effect on the OPG/RANKL System 预览
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作者 Bin NIE Shao-ying ZHANG +2 位作者 Si-ming Guan Shao-qiong ZHOU Xin FANG 《当代医学科学(英文)》 SCIE CAS 2019年第1期28-36,共9页
In this study,the hypothesis that Wnt/β-catenin pathway is involved in the arterial calcification by regulating the osteoprotegerin(OPG)/receptor activator of NF-κB ligand(RANKL)system was tested.Theβ-catenin expre... In this study,the hypothesis that Wnt/β-catenin pathway is involved in the arterial calcification by regulating the osteoprotegerin(OPG)/receptor activator of NF-κB ligand(RANKL)system was tested.Theβ-catenin expression was measured in the warfarin-induced calcified arteries and the osteoblast-like cells differentiating from smooth muscle cells(SMCs)by immunohistochemistry and Western blotting.The Wnt/β-catenin pathway was activated or inhibited by lithium chloride(LiCl)or dickkopf 1(DKK1)in vitro and in vivo.Then the calcification level was determined by von Kossa staining,Ca^2+content assay,and alkaline phosphatase(ALP)activity assay.The expression levels of osteocalcin,OPG and RANKL were detected by Western blotting or real-time PCR.The results showed that in calcified arteries and OBL cells,the activation of Wnt/β-catenin pathway significantly enhanced the calcification as evidenced by increased von Kossa stains,Ca^2+contcnts,ALP activities,and osteocalcin expression levels(P<0.05),and it promoted the RANKL expression(P<0.05),but slightly affected the OPG expression.These results indicated that the activation of Wnt/β-catenin pathway worsens the arterial calcification,probably by promoting the RANKL expression. 展开更多
关键词 ARTERIAL CALCIFICATION Wnt/β-catenin pathway OSTEOPROTEGERIN receptor ACTIVATOR of NF-κB ligand
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Approach to a patient with pulmonary hypertension 预览
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作者 Chakradhari Inampudi Anna R Hemnes Alexandros Briasoulis 《老年心脏病学杂志:英文版》 SCIE CAS CSCD 2019年第6期478-481,共4页
Pulmonary hypertension is a common clinical condition that can complicate various cardiac and respiratory abnormalities. Interest in pulmonary hypertension has grown remarkably among the scientific community in the la... Pulmonary hypertension is a common clinical condition that can complicate various cardiac and respiratory abnormalities. Interest in pulmonary hypertension has grown remarkably among the scientific community in the last decade. It is now clear based on the scientific advances have paved the way in understanding the effects of abnormal pulmonary hemodynamics development and its antecedent consequences on the right heart in reducing the quality of life and survival of the patient. 展开更多
关键词 PULMONARY ARTERIAL HYPERTENSION
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Post-operative computed tomography scan – reliable tool for quality assessment of complete mesocolic excision 预览
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作者 Cristian Livadaru Stefan Morarasu +7 位作者 Tudor Cristian Frunza Florina A Ghitun Elena Florina Paiu-Spiridon Florina Sava Cristina Terinte Dan Ferariu Sorinel Lunca Gabriel Mihail Dimofte 《世界胃肠肿瘤学杂志:英文版(电子版)》 CAS 2019年第3期208-226,共19页
BACKGROUND Quality control in colon cancer surgery is an ongoing debate ever since standardization proved to be highly efficient in improving survival in rectal cancer. Complete mesocolic excision(CME) is widely accla... BACKGROUND Quality control in colon cancer surgery is an ongoing debate ever since standardization proved to be highly efficient in improving survival in rectal cancer. Complete mesocolic excision(CME) is widely acclaimed as the new goldstandard in colon cancer resections, thus it is imperative to establish quality criteria of CME in order to make it easily understood and verified by surgeons worldwide. One simple and reproducible tool could be the measurement of arterial stumps postoperatively and a straightforward way to test its reliability is to test it in a comparative study between CME and non-CME surgery.AIM To validate arterial stump measurement as a surgical quality tool by comparing CME with conventional radical colectomies.METHODS This was a retrospective study, carried out on a prospective database. We collected data from two groups of patients, divided according to standard CME with D2 central vascular ligation(group A) and non-standardized surgery(group B). The two groups were compared with regard to the arterial stump length after right-and left-sided colectomies for colon cancer. The actual stump lengths of the ileocolic artery(ICA) and inferior mesenteric artery(IMA) were compared with their theoretical best D2 position of predicted ligation levels(D2 PLLs) for calculating the potential for improvement. Measurements on follow-up computed tomography scans were carried out by three observers. Pathological data were recorded(specimen length, lymph node yield) and correlated with stump length.RESULTS We analysed 58 colectomies. The stump lengths(mean ± SD) in group A were16.97 ± 4.77 mm for ICA and 31.70 ± 15.71 mm for IMA, whereas group B had 49.93 ± 20.29 mm for ICA and 67.24 ± 28.71 mm for IMA. Shorter lengths were obtained in group A, by a mean difference of 35.66 mm(χ~2 = 27.38, P < 0.001),which was significant for all types of colectomies. Except for a 5.85 ± 4.71 mm difference for right colectomies, all the ligations from group A significantly reached their potential height(0.26 ± 12.1 展开更多
关键词 Complete mesocolic EXCISION Central vascular LIGATION COLON surgery Arterial stump measurement COMPUTED tomography
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Dysregulation of miR-135a-5p promotes the development of rat pulmonary arterial hypertension in vivo and in vitro
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作者 Hong-mei Liu Yi Jia +4 位作者 Ying-xian Zhang Jun Yan Ning Liao Xiao-hui Li Yuan Tang 《中国药理学报:英文版》 SCIE CAS CSCD 2019年第4期477-485,共9页
Pulm onary arterial hyperte nsion (PAH) is the most comm on form of pulmonary hypertension. Pulm onary arterial remodeli ng is closely related to the abnormal proliferation of pulmonary artery smooth muscle cells (PAS... Pulm onary arterial hyperte nsion (PAH) is the most comm on form of pulmonary hypertension. Pulm onary arterial remodeli ng is closely related to the abnormal proliferation of pulmonary artery smooth muscle cells (PASMCs), which leads to the thickening of the medial layer of muscular arteries and then results in the narrowing or occlusion of the precapillary arterioles and PAH. However, the mechanisms underlying the abnormal proliferation of PASMCs remain unclear. In this study, we established rat primary PAH models using monocrotaline (MCT) injection or hypoxic exposure, then investigated the expression patterns of seven miRNAs associated with multiple pathogenic pathways central to pulmonary hypertension, and further explored the roles and the possible mechanisms of miR-135a during the development of PAH. In the rat primary PAH models, we observed that the expression of miR-135a-5p in lungs was drastically decreased at the initial stage of PAH development after MCT administration or hypoxic exposure, but it increased by 12-fold or 10-fold at the later stage. In vitro study in PASMCs showed a similar pattern of miR-135a-5p expression, with downregulation at 6 h but upregulation at 18, 24, and 48 h after hypoxic exposure. Early, but not late, administration of a miR-135a-5p mimic inhibited hypoxia-induced proliferation of PASMCs. The protective role of early miR-135a-5p agomir in the PAH rat model further supported the hypothesis that the early decrease in the expressi on of miR-135a-5p con tributes to the proliferation of PASMCs and development of PAH, as early administration of miR-135a-5p agomir (1 OnM, i.v.) reversed the elevated mean pulmonary arterial pressure and pulmonary vascular remodeling in MCT-treated rats. We revealed that miR-135a-5p directly bound to the y-UTR sequence of rat transient receptor potential channel 1 (TRPC1) mRNA and decreased TRPC1 protein expression, thus inhibiting PASMC proliferation. Collectively, our data suggest that dysregulation of miR-135a-5p in PASMCs con tributes to the a 展开更多
关键词 PULMONARY ARTERIAL hypertension miR-135a-5p PULMONARY artery SMOOTH MUSCLE cells transient receptor potential cha nnel 1
Super-selective arterial embolization in the control of acute lower gastrointestinal hemorrhage 预览
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作者 Liang-Shan Lv Jing-Tao Gu 《世界临床病例杂志》 2019年第22期3728-3733,共6页
BACKGROUND Acute gastrointestinal bleeding is an emergency condition that can lead to significant morbidity and mortality.Embolization is considered the preferred therapy in the treatment of lower gastrointestinal ble... BACKGROUND Acute gastrointestinal bleeding is an emergency condition that can lead to significant morbidity and mortality.Embolization is considered the preferred therapy in the treatment of lower gastrointestinal bleeding when it is unrealistic to perform the surgery or vasopressin infusion in this population.Treatment of acute lower gastrointestinal(GI)bleeding(any site below the ligament of Treitz)using this technique has not reached a consensus,because of the belief that the risk of intestinal infarction in this condition is extremely high.The purpose of the study is to evaluate the effectiveness and safety of this technique in a retrospective group of patients who underwent embolization for acute lower GI bleeding.AIM To evaluate the efficacy and safety of super-selective arterial embolization in the management of acute lower GI bleeding.METHODS A series of 31 consecutive patients with angiographically demonstrated small intestinal or colonic bleeding was retrospectively reviewed.The success rate and complication rate of super-selective embolization were recorded.RESULTS Five out of thirty-one patients(16.1%)could not achieve sufficiently selective catheterization to permit embolization.Initial control of bleeding was achieved in 26 patients(100%),and relapsed GI bleeding occurred in 1 of them at 1 wk after the operation.No clinically apparent bowel infarctions were observed in patients undergoing embolization.CONCLUSION Super-selective embolization is a safe therapeutic method for acute lower GI bleeding,and it is suitable and effective for many patients suffering this disease.Importantly,careful technique and suitable embolic agent are essential to the successful operation. 展开更多
关键词 Lower gastrointestinal bleeding EMBOLIZATION INFARCTION BOWEL HEMORRHAGE Selective arterial embolization
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Arterial faults and their role in mineralizing systems 预览
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作者 Richard H.Sibson 《地学前缘:英文版》 CAS CSCD 2019年第6期2093-2100,共8页
In quartzo-feldspathic continental crust with moderate-to-high heat flow,seismic activity extends to depths of 10-20 km,bounded by isotherms in the 350-450 C range.Fluid overpressuring above hydrostatic in seismogenic... In quartzo-feldspathic continental crust with moderate-to-high heat flow,seismic activity extends to depths of 10-20 km,bounded by isotherms in the 350-450 C range.Fluid overpressuring above hydrostatic in seismogenic crust,is heterogeneous but tends to develop in the lower seismogenic zone(basal seismogenic zone reservoir=b.s.z.reservoir) where the transition between hydrostatically pressured and overpressured crust is likely an irregular,time-dependent.3-D interface with overpressuring concentrated around active faults and their ductile shear zone roots.The term Arterial Fault is applied to fault structures that root in portions of the crust where pore fluids are overpressured(i.e.at> hydrostatic pressure) and serve as feeders for such fluids and their contained solutes into overlying parts of the crust.While arterial flow may occur on any type of fault,it is most likely to be associated with reverse faults in areas of horizontal compression where fluid overpressuring is most easily sustained.Frictional stability and flow permeability of faults are both affected by the state of stress on the fault(shear stress,τ;normal stress,σn),the level of pore-fluid pressure,Pf,and episodes of fault slip,allowing for a complex interplay between fault movement and fluid flow.For seismically active faults the time dependence of permeability is critical,leading to fault-valve behaviour whereby overpressures accumulate at depth during interseismic intervals with fluid discharged along enhanced fault-fracture permeability following each rupture event.Patterns of mineralization also suggest that flow along faults is non-uniform,concentrating along tortuous pathways within the fault surface.Equivalent hydrostatic head above ground level for near-lithostatic overpressures at depth(<1.65×depth of zone) provides a measure of arterial potential.Settings for arterial faults include fault systems developed in compacting sedimentary basins,faults penetrating zones of active plutonic intrusion that encounter overpressured fluids exsolv 展开更多
关键词 Fault conduits Fluid overpressures Arterial potential Valve action MINERALIZATION
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Clinical efficacy of gemcitabine and cisplatin-based transcatheter arterial chemoembolization combined with radiotherapy in hilar cholangiocarcinoma 预览
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作者 Wen-Heng Zheng Tao Yu +7 位作者 Ya-Hong Luo Ying Wang Ye-Fu Liu Xiang-Dong Hua Jie Lin Zuo-Hong Ma Fu-Lu Ai Tian-Lu Wang 《世界胃肠肿瘤学杂志:英文版(电子版)》 CAS 2019年第6期489-498,共10页
BACKGROUND Radical surgical resection is regarded as the best treatment for hepatic hilar cholangiocarcinoma. However, 60%-70% of patients have lost the chance of surgery at the time of diagnosis. Simple biliary stent... BACKGROUND Radical surgical resection is regarded as the best treatment for hepatic hilar cholangiocarcinoma. However, 60%-70% of patients have lost the chance of surgery at the time of diagnosis. Simple biliary stent or drainage tube placement may fail in a short time due to tumor invasion or overgrowth, bile accumulation, or biofilm formation. Effective palliative treatments to extend the effective drainage time are of great significance for improving the quality of life of patients and changing the prognosis of patients. AIM To investigate the clinical efficacy of gemcitabine and cisplatin-based transcatheter arterial chemoembolization (TACE) combined with radiotherapy in hilar cholangiocarcinoma.METHODS A retrospective analysis was conducted on patients clinically diagnosed with hilar cholangiocarcinoma from June 2014 to January 2017 at the Liaoning Provincial Cancer Hospital. Patients were evaluated by specialists, and those who were not suitable for surgery or unwilling to undergo surgery and met the inclusion criteria were included in the study. There were a total of 72 patients (34 males and 38 females) with an average age of 59.9 years (range, 40-72 years). According to percutaneous transhepatic biliary angiography and the patients’ wishes, stent implantation or biliary drainage tube implantation was used to relieve biliary obstruction. The patients were divided into either a control group or a combined treatment group according to their follow-up treatment. The control group consisted of a total of 35 patients who received simple biliary drainage tube placement and biliary stent implantation (7 patients with bilateral stents and 6 with a unilateral stent) and 22 patients receiving biliary drainage tube placement alone. The combined treatment group received TACE and extracorporeal radiotherapy after biliary drainage or biliary stent implantation and consisted of a total of 37 patients, including 21 patients receiving combined treatment after biliary stent placement (14 patients with bilateral stents an 展开更多
关键词 HILAR cholangiocarcinoma BILIARY stent Percutaneous BILIARY drainage GEMCITABINE CISPLATIN RADIOTHERAPY Transcatheter arterial CHEMOEMBOLIZATION
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Blood oxygen level–dependent functional magnetic resonance imaging can evaluate the efficiency of transcatheter arterial chemoembolization in hepatocellular carcinoma
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作者 Lizhi Xiao Enhua Xiao 《介入医学杂志》 2019年第1期5-7,共3页
Hepatocellular carcinoma(HCC) is among the most common malignant tumors worldwide, and transcatheter arterial chemoembolization(TACE) technology has become the first-line treatment for advanced HCC. Another important,... Hepatocellular carcinoma(HCC) is among the most common malignant tumors worldwide, and transcatheter arterial chemoembolization(TACE) technology has become the first-line treatment for advanced HCC. Another important, recently developed technique is blood oxygen level–dependent functional magnetic resonance imaging(BOLD-fMRI), which utilizes hemoglobin as an endogenous contrast agent and measures deoxygenated hemoglobin content by sampling the oxygen content of tissues, thus reflecting the hemodynamics and pathophysiologic changes in body organs. Currently this technology is being used in patients with liver tumors;that is, it serves as an important tool in follow-up after TACE. The present paper summarizes these developments. 展开更多
关键词 Blood oxygen level–dependent Magnetic resonance imaging EFFICIENCY Hepatocellular carcinoma TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION
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