Chronic hyperglycemia is one of the main characteristics of diabetes. Persistent exposure to elevated glucose levels has been recognized as one of the major causal factors of diabetic complications. In pathologies, li...Chronic hyperglycemia is one of the main characteristics of diabetes. Persistent exposure to elevated glucose levels has been recognized as one of the major causal factors of diabetic complications. In pathologies, like type 2 diabetes mellitus(T2DM), mechanical and biochemical stimuli activate profibrotic signaling cascades resulting in myocardial fibrosis and subsequent impaired cardiac performance due to ventricular stiffness. High levels of glucose nonenzymatically react with long-lived proteins, such as collagen, to form advanced glycation end products(AGEs). AGE-modified collagen increase matrix stiffness making it resistant to hydrolytic turnover, resulting in an accumulation of extracellular matrix(ECM) proteins. AGEs account for many of the diabetic cardiovascular complications through their engagement of the receptor for AGE(RAGE). AGE/RAGE activation stimulates the secretion of numerous profibrotic growth factors, promotes increased collagen deposition leading to tissue fibrosis, as well as increased RAGE expression. To date, the AGE/RAGE cascade is not fully understood. In this review, we willdiscuss one of the major fibrotic signaling pathways, the AGE/RAGE signaling cascade, as well as propose an alternate pathway via Rap1 a that may offer insight into cardiovascular ECM remodeling in T2 DM. In a series of studies, we demonstrate a role for Rap1 a in the regulation of fibrosis and myofibroblast differentiation in isolated diabetic and non-diabetic fibroblasts. While these studies are still in a preliminary stage, inhibiting Rap1 a protein expression appears to down-regulate the molecular switch used to activate the ζ isotype of protein kinase C thereby promote AGE/RAGE-mediated fibrosis.展开更多
Diabetic retinopathy(DR) is the leading cause of blindness in industrialized countries. Remarkable advances in the diagnosis and treatment of DR have been made during the past 30 years, but several important managemen...Diabetic retinopathy(DR) is the leading cause of blindness in industrialized countries. Remarkable advances in the diagnosis and treatment of DR have been made during the past 30 years, but several important management questions and treatment deficiencies remain unanswered. The global diabetes epidemic threatens to overwhelm resources and increase the incidence of blindness, necessitating the development of innovative programs to diagnose and treat patients. The introduction and rapid adoption of intravitreal pharmacologic agents, particularly drugs that block the actions of vascular endothelial growth factor(VEGF) and corticosteroids, have changed the goal of DR treatment from stabilization of vision to improvement. Anti-VEGF injections improve visual acuity in patients with diabetic macular edema(DME) from 8-12 letters and improvements with corticosteroids are only slightly less. Unfortunately, a third of patients have an incomplete response to anti-VEGF therapy, but the best second-line therapy remains unknown. Current first-line therapy requires monthly visits and injections; longer acting therapies are needed to free up healthcare resources and improve patient compliance. VEGF suppression may be as effective as panretinal photocoagulation(PRP) for proliferative diabetic retinopathy, but more studies are needed before PRP is abandoned. For over 30 years laser was the mainstay for the treatment of DME, but recent studies question its role in the pharmacologic era. Aggressive treatment improves vision in most patients, but many still do not achieve reading and driving vision. New drugs are needed to add to gains achieved with available therapies.展开更多
2001年,美国阴道镜与宫颈病理学会(American Society for Colposcopyand Cervical Pathology,ASCCP)联合其他专业学会以及联邦与国际组织.制订了2001版的宫颈癌细胞学筛查结果异常妇女处理的共识指南。这是全面的、以循证医学为依...2001年,美国阴道镜与宫颈病理学会(American Society for Colposcopyand Cervical Pathology,ASCCP)联合其他专业学会以及联邦与国际组织.制订了2001版的宫颈癌细胞学筛查结果异常妇女处理的共识指南。这是全面的、以循证医学为依据的指南,其目的是帮助所有亚专业的临床医生,处理每年约480万诊断为细胞学异常的美国妇女。展开更多
To review studies on hypertension in Nigeria over the past five decades in terms of prevalence,awareness and treatment and complications.Following our search on Pubmed,African Journals Online and the World Health Orga...To review studies on hypertension in Nigeria over the past five decades in terms of prevalence,awareness and treatment and complications.Following our search on Pubmed,African Journals Online and the World Health Organization Global cardiovascular infobase,1060 related references were identified out of which 43 were found to be relevant for this review.The overall prevalence of hypertension in Nigeria ranges from 8%-46.4% depending on the study target population,type of measurement and cut-off value used for defining hypertension.The prevalence is similar in men and women(7.9%-50.2% vs 3.5%-68.8%,respectively) and in the urban(8.1%-42.0%) and rural setting(13.5%-46.4%).The pooled prevalence increased from 8.6% from the only study during the period from 1970-1979 to 22.5%(2000-2011).Awareness,treatment and control of hypertension were generally low with attendant high burden of hypertension related complications.In order to improve outcomes of cardiovascular disease in Africans,public health education to improve awareness of hypertension is required.Further epidemiological studies on hypertension are required to adequately understand and characterize the impact of hypertension in society.展开更多
Diamond-like carbon(DLC)coatings are known to provide beneficial mechanical and tribological properties in harsh environments.Their combination of high wear resistance and low friction has led to their extensive use i...Diamond-like carbon(DLC)coatings are known to provide beneficial mechanical and tribological properties in harsh environments.Their combination of high wear resistance and low friction has led to their extensive use in any number of industries.The tribological performance of a DLC coating is varied however,and the frictional response is known to be strongly dependent on the surrounding environment,as well as the material composition and bonding structure of the DLC coating.This paper presents an up-to-date review on the friction of DLC coatings in a water environment,with a special focus on transfer layer formation and tribochemistry.展开更多
Water pollution in the Taihu Lake Basin has been the focus of attention in China and abroad for a long time, due to its position in the forefront of urban development in China. Based on data gathering and processing f...Water pollution in the Taihu Lake Basin has been the focus of attention in China and abroad for a long time, due to its position in the forefront of urban development in China. Based on data gathering and processing from 84 monitoring sections in this heavily polluted area, this study first analyzes spatial patterns of urbanization and the distribution of river water pollution, and then uses the GeoDa bivariate spatial autocorrelation model to investigate the spatial correlation between urbanization and river water pollution at the scale of township units. The results show that urbanization has adverse impacts on water pollution, and the influence varies in different levels of development areas. The urban township units have the highest level of urbanization and highest pollution, but the best water quality; the suburban units have lower level of urbanization, but higher pollution and worse water quality; however the rural units have the lowest level of urbanization and lowest pollution, mainly affected by upstream pollution, but worst water quality. Lastly, urban and rural planning committees, while actively promoting the process of development in the region, should gradually resolve the issue of pollution control lagging behind urban life and urban develop- ment, giving priority to construction of centralized sewage treatment facilities and associated pipeline network coverage in the rural areas and suburban areas.展开更多
A new guideline for diagnosis and treatment of syncope in children and adolescents was published by Chinese Pediatric Cardiology Society (CPCS)[1].This guideline admirably outlines a differential diagnosis of syncope ...A new guideline for diagnosis and treatment of syncope in children and adolescents was published by Chinese Pediatric Cardiology Society (CPCS)[1].This guideline admirably outlines a differential diagnosis of syncope in the Chinese population,placing appropriate emphasis on vasovagal syncope (VVS,simple faint), the most common cause.The authors appropriately discuss other more ominous causes of syncope such as cardiogenic syncope and neurogenic orthostatic hypotension.In particular,cardiogemc syncope can have lethal consequences if not promptly treated.展开更多
Despite advancements in medical therapy of Crohn's disease(CD), majority of patients with CD will eventually require surgical intervention, with at least a third of patients requiring multiple surgeries. It is imp...Despite advancements in medical therapy of Crohn's disease(CD), majority of patients with CD will eventually require surgical intervention, with at least a third of patients requiring multiple surgeries. It is important to understand the role and timing of surgery, with the goals of therapy to reduce the need for surgery without increasing the odds of emergency surgery and its associated morbidity, as well as to limit surgical recurrence and avoid intestinal failure. The profile of CD patients requiring surgical intervention has changed over the decades with improvements in medical therapy with immunomodulators and biological agents. The most common indication for surgery is obstruction from stricturing disease, followed by abscesses and fistulae. The risk of gastrointestinal bleeding in CD is high but the likelihood of needing surgery for bleeding is low. Most major gastrointestinal bleeding episodes resolve spontaneously, albeit the risk of re-bleeding is high. The risk of colorectal cancer associated with CD is low. While current surgical guidelines recommend a total proctocolectomy for colorectal cancer associated with CD, subtotal colectomy or segmental colectomy with endoscopic surveillance may be a reasonable option. Approximately 20%-40% of CD patients will need perianal surgery during their lifetime. This review assesses the practice parameters and guidelines in the surgical management of CD, with a focus on the indications for surgery in CD(and when not to operate), and a critical evaluation of the timing and surgical options available to improve outcomes and reduce recurrence rates.展开更多
As a soil amendment, biochar can reduce soil bulk density, increase soil porosity, and alter soil aggregates and thus affect the infiltration. Researchers have proposed and revised several theoretical models to descri...As a soil amendment, biochar can reduce soil bulk density, increase soil porosity, and alter soil aggregates and thus affect the infiltration. Researchers have proposed and revised several theoretical models to describe the process of soil infiltration. Although these models have been successfully used to evaluate the soil infiltration in different scenarios in agricultural fields, little effort has been devoted to assess their performances in arid and semi-arid soils after the addition of biochar. A laboratory experiment was performed to study the infiltration characteristics of two typical Loess Plateau soils at three particle sizes(2–1, 1–0.25, and 〈0.25 mm) and five biochar application amounts(0, 10, 50, 100, and 150 g/kg). The performance of five models(i.e., the Philip model, Kostiakov model, Mezencev model, USDA-NRCS model, and Horton model) in simulating the infiltration process was then evaluated based on the adjusted coefficient of determination and a reduced Chi-Square test. Results indicated that the Horton model best simulated the water-infiltration process in an aeolian sandy soil with added biochar. However, the Mezencev model best simulated the infiltration process in a loamy clay soil(Eum-Orthic Anthrosol). The three-parameter model, i.e., Mezencev and Horton models can better describe the relationship between cumulative infiltration and infiltration time. In conclusion, biochar reduced the soil infiltration capacity of the aeolian sandy soil and increased that of the Eum-Orthic Anthrosol.展开更多
基金Supported by Grants from the American Heart Association,No.SDG5310006(JAS)and No.BGIA4150122(JAS)
文摘Chronic hyperglycemia is one of the main characteristics of diabetes. Persistent exposure to elevated glucose levels has been recognized as one of the major causal factors of diabetic complications. In pathologies, like type 2 diabetes mellitus(T2DM), mechanical and biochemical stimuli activate profibrotic signaling cascades resulting in myocardial fibrosis and subsequent impaired cardiac performance due to ventricular stiffness. High levels of glucose nonenzymatically react with long-lived proteins, such as collagen, to form advanced glycation end products(AGEs). AGE-modified collagen increase matrix stiffness making it resistant to hydrolytic turnover, resulting in an accumulation of extracellular matrix(ECM) proteins. AGEs account for many of the diabetic cardiovascular complications through their engagement of the receptor for AGE(RAGE). AGE/RAGE activation stimulates the secretion of numerous profibrotic growth factors, promotes increased collagen deposition leading to tissue fibrosis, as well as increased RAGE expression. To date, the AGE/RAGE cascade is not fully understood. In this review, we willdiscuss one of the major fibrotic signaling pathways, the AGE/RAGE signaling cascade, as well as propose an alternate pathway via Rap1 a that may offer insight into cardiovascular ECM remodeling in T2 DM. In a series of studies, we demonstrate a role for Rap1 a in the regulation of fibrosis and myofibroblast differentiation in isolated diabetic and non-diabetic fibroblasts. While these studies are still in a preliminary stage, inhibiting Rap1 a protein expression appears to down-regulate the molecular switch used to activate the ζ isotype of protein kinase C thereby promote AGE/RAGE-mediated fibrosis.
文摘Diabetic retinopathy(DR) is the leading cause of blindness in industrialized countries. Remarkable advances in the diagnosis and treatment of DR have been made during the past 30 years, but several important management questions and treatment deficiencies remain unanswered. The global diabetes epidemic threatens to overwhelm resources and increase the incidence of blindness, necessitating the development of innovative programs to diagnose and treat patients. The introduction and rapid adoption of intravitreal pharmacologic agents, particularly drugs that block the actions of vascular endothelial growth factor(VEGF) and corticosteroids, have changed the goal of DR treatment from stabilization of vision to improvement. Anti-VEGF injections improve visual acuity in patients with diabetic macular edema(DME) from 8-12 letters and improvements with corticosteroids are only slightly less. Unfortunately, a third of patients have an incomplete response to anti-VEGF therapy, but the best second-line therapy remains unknown. Current first-line therapy requires monthly visits and injections; longer acting therapies are needed to free up healthcare resources and improve patient compliance. VEGF suppression may be as effective as panretinal photocoagulation(PRP) for proliferative diabetic retinopathy, but more studies are needed before PRP is abandoned. For over 30 years laser was the mainstay for the treatment of DME, but recent studies question its role in the pharmacologic era. Aggressive treatment improves vision in most patients, but many still do not achieve reading and driving vision. New drugs are needed to add to gains achieved with available therapies.
文摘2001年,美国阴道镜与宫颈病理学会(American Society for Colposcopyand Cervical Pathology,ASCCP)联合其他专业学会以及联邦与国际组织.制订了2001版的宫颈癌细胞学筛查结果异常妇女处理的共识指南。这是全面的、以循证医学为依据的指南,其目的是帮助所有亚专业的临床医生,处理每年约480万诊断为细胞学异常的美国妇女。
文摘To review studies on hypertension in Nigeria over the past five decades in terms of prevalence,awareness and treatment and complications.Following our search on Pubmed,African Journals Online and the World Health Organization Global cardiovascular infobase,1060 related references were identified out of which 43 were found to be relevant for this review.The overall prevalence of hypertension in Nigeria ranges from 8%-46.4% depending on the study target population,type of measurement and cut-off value used for defining hypertension.The prevalence is similar in men and women(7.9%-50.2% vs 3.5%-68.8%,respectively) and in the urban(8.1%-42.0%) and rural setting(13.5%-46.4%).The pooled prevalence increased from 8.6% from the only study during the period from 1970-1979 to 22.5%(2000-2011).Awareness,treatment and control of hypertension were generally low with attendant high burden of hypertension related complications.In order to improve outcomes of cardiovascular disease in Africans,public health education to improve awareness of hypertension is required.Further epidemiological studies on hypertension are required to adequately understand and characterize the impact of hypertension in society.
文摘Diamond-like carbon(DLC)coatings are known to provide beneficial mechanical and tribological properties in harsh environments.Their combination of high wear resistance and low friction has led to their extensive use in any number of industries.The tribological performance of a DLC coating is varied however,and the frictional response is known to be strongly dependent on the surrounding environment,as well as the material composition and bonding structure of the DLC coating.This paper presents an up-to-date review on the friction of DLC coatings in a water environment,with a special focus on transfer layer formation and tribochemistry.
基金Knowledge Innovation Program of the Chinese Academy of Sciences,No.KZCX2-EW-315 National Water Pollution Control and Management Technology Major Projects,No.20082X07101-002+2 种基金 National Natural Science Foundation of China,No.41130750 135 Strategic Development Planning Project of Nanjing Institute of Geography and Limnology,CAS,No.2012135006 Fund from the State Key Laboratory of Lake Science and Environment,Nanjing Institute of Geography and Limnology,CAS
文摘Water pollution in the Taihu Lake Basin has been the focus of attention in China and abroad for a long time, due to its position in the forefront of urban development in China. Based on data gathering and processing from 84 monitoring sections in this heavily polluted area, this study first analyzes spatial patterns of urbanization and the distribution of river water pollution, and then uses the GeoDa bivariate spatial autocorrelation model to investigate the spatial correlation between urbanization and river water pollution at the scale of township units. The results show that urbanization has adverse impacts on water pollution, and the influence varies in different levels of development areas. The urban township units have the highest level of urbanization and highest pollution, but the best water quality; the suburban units have lower level of urbanization, but higher pollution and worse water quality; however the rural units have the lowest level of urbanization and lowest pollution, mainly affected by upstream pollution, but worst water quality. Lastly, urban and rural planning committees, while actively promoting the process of development in the region, should gradually resolve the issue of pollution control lagging behind urban life and urban develop- ment, giving priority to construction of centralized sewage treatment facilities and associated pipeline network coverage in the rural areas and suburban areas.
基金supported by RO1 HL 134674RO1 HL 112736 from the National Heart Lung and Blood Institute.
文摘A new guideline for diagnosis and treatment of syncope in children and adolescents was published by Chinese Pediatric Cardiology Society (CPCS)[1].This guideline admirably outlines a differential diagnosis of syncope in the Chinese population,placing appropriate emphasis on vasovagal syncope (VVS,simple faint), the most common cause.The authors appropriately discuss other more ominous causes of syncope such as cardiogenic syncope and neurogenic orthostatic hypotension.In particular,cardiogemc syncope can have lethal consequences if not promptly treated.
文摘Despite advancements in medical therapy of Crohn's disease(CD), majority of patients with CD will eventually require surgical intervention, with at least a third of patients requiring multiple surgeries. It is important to understand the role and timing of surgery, with the goals of therapy to reduce the need for surgery without increasing the odds of emergency surgery and its associated morbidity, as well as to limit surgical recurrence and avoid intestinal failure. The profile of CD patients requiring surgical intervention has changed over the decades with improvements in medical therapy with immunomodulators and biological agents. The most common indication for surgery is obstruction from stricturing disease, followed by abscesses and fistulae. The risk of gastrointestinal bleeding in CD is high but the likelihood of needing surgery for bleeding is low. Most major gastrointestinal bleeding episodes resolve spontaneously, albeit the risk of re-bleeding is high. The risk of colorectal cancer associated with CD is low. While current surgical guidelines recommend a total proctocolectomy for colorectal cancer associated with CD, subtotal colectomy or segmental colectomy with endoscopic surveillance may be a reasonable option. Approximately 20%-40% of CD patients will need perianal surgery during their lifetime. This review assesses the practice parameters and guidelines in the surgical management of CD, with a focus on the indications for surgery in CD(and when not to operate), and a critical evaluation of the timing and surgical options available to improve outcomes and reduce recurrence rates.
基金supported by the National Natural Science Foundation of China (41571225)the National Key Research and Development Program of China (2016YFC0501702, 2015BAC01B01)
文摘As a soil amendment, biochar can reduce soil bulk density, increase soil porosity, and alter soil aggregates and thus affect the infiltration. Researchers have proposed and revised several theoretical models to describe the process of soil infiltration. Although these models have been successfully used to evaluate the soil infiltration in different scenarios in agricultural fields, little effort has been devoted to assess their performances in arid and semi-arid soils after the addition of biochar. A laboratory experiment was performed to study the infiltration characteristics of two typical Loess Plateau soils at three particle sizes(2–1, 1–0.25, and 〈0.25 mm) and five biochar application amounts(0, 10, 50, 100, and 150 g/kg). The performance of five models(i.e., the Philip model, Kostiakov model, Mezencev model, USDA-NRCS model, and Horton model) in simulating the infiltration process was then evaluated based on the adjusted coefficient of determination and a reduced Chi-Square test. Results indicated that the Horton model best simulated the water-infiltration process in an aeolian sandy soil with added biochar. However, the Mezencev model best simulated the infiltration process in a loamy clay soil(Eum-Orthic Anthrosol). The three-parameter model, i.e., Mezencev and Horton models can better describe the relationship between cumulative infiltration and infiltration time. In conclusion, biochar reduced the soil infiltration capacity of the aeolian sandy soil and increased that of the Eum-Orthic Anthrosol.