A computed tomography algorithm for crossing coronary chronic total occlusions: riding on the wave of the proximal cap and distal vessel segment

With wider adoption of coronary computed tomography angiography (coronary CTA), chronic total occlusions (CTOs) are being increasingly identified and characterised by non-invasive angiography. In particular, the ability of coronary CTA to clearly delineate atherosclerotic plaque, as well as to display three-dimensional vessel trajectories, has garnered particular attention in the context of preprocedural planning and periprocedural guidance of CTO percutaneous coronary intervention (PCI). Single CTO features and combined scoring systems derived from CTA (mostly exceeding the diagnostic performance of the angiographic J‑CTO score) have been used to predict time-efficient guidewire crossing, and thus grade the CTO difficulty level prior to PCI. In addition, the introduction of three-dimensional CTA/fluoroscopy co-registration for periprocedural navigation during CTO PCI offers the unprecedented opportunity to resolve proximal cap ambiguity and clearly visualise the distal CTO segment, thereby potentially influencing CTO PCI strategies and techniques. In this review, the potential advantages of non-invasive evaluation of CTO by coronary CTA are described, and a CTA-based hybrid algorithm is introduced for further enhancing the efficiency of CTO PCI. Further studies are clearly needed to verify the proposed approach. However, several luminary operators have already implemented coronary CTA for planning and periprocedural guidance of CTO interventions using the hybrid algorithm.

     

湘西“蒿菜粑粑”原料植物鼠麴草总黄酮提取物体外抗氧化活性研究

为了解湘西特色食品“蒿菜粑粑”原料植物鼠麴草(Gnaphalium affine)总黄酮提取物体外抗氧化能力,采用DPPH、ABTS自由基清除实验,还原力实验和抑制β-胡萝卜素褪色实验等方法,测定鼠麴草总黄酮抗氧化活性。结果显示,鼠麴草总黄酮母液中总黄酮浓度为7.01 mg·mL–1mg/mL;总黄酮提取物对DPPH、ABTS自由基有较好的清除能力,其半数抑制浓度(IC50)分别为16.30 mg·L–1、30.16 mg·L–1,将胡萝卜素相对吸光度降为50%的时间延长至67.49 min,在还原能力、延缓胡萝卜素褪色和抑制脂质过氧化上也有较好效果。鼠麴草总黄酮提取物具有良好的体外抗氧化活性,可作为优质食用植物资源进一步开发与推广。     

外源NO对不同UV-B辐射天数处理的小麦叶片总蛋白的影响

研究外源NO对不同UV-B辐射天数处理的小麦叶片总蛋白的影响.采用蒸馏水和0.1 mmol/L 硝普钠（SNP,一种NO供体）浸种24 h,试验设置不同的处理组：CK、CK＋B、SNP、SNP＋B.待幼苗生长7天后取其叶片进行总蛋白的提取及SDS-PAGE凝胶图像的分析.不同处理对叶片总蛋白含量、电泳图谱及电泳条带数目的影响不同;外源NO能显著增加不同UV-B处理天数下小麦叶片总蛋白的含量,且SNP和SNP＋B处理组的电泳条带均较CK和CK＋B处理组的电泳条带变宽且颜色变深.外源NO能显著增加UV-B辐射下小麦叶片的总蛋白含量.同时,不同处理组电泳条带数目的变化反应出一些蛋白的降解和合成,最终也体现了不同处理组蛋白含量的变化.     

The influence of uncemented femoral stem length and design on its primary stability: a finite element analysis

One of the crucial factors for short- and long-term clinical success of total hip arthroplasty cementless implants is primary stability. Indeed, motion at the bone–implant interface above 40 μm leads to partial bone ingrowth, while motion exceeding 150 μm completely inhibits bone ingrowth. The aim of this study was to investigate the effect of two cementless femoral stem designs with different lengths on the primary stability. A finite element model of a composite Sawbones^® fourth generation, implanted with five lengths of the straight prosthesis design and four lengths of the curved prosthesis design, was loaded with hip joint and abductor forces representing two physiological activities: fast walking and stair climbing. We found that reducing the straight stem length from 146 to 54 mm increased the average micromotion from 17 to 52 μm during fast walking, while the peak value increased from 42 to 104 μm. With the curved stem, reducing length from 105 to 54 mm increased the average micromotion from 10 to 29 μm, while the peak value increased from 37 to 101 μm. Similar findings are obtained for stair climbing for both stems. Although the present study showed that femoral stem length as well as stem design directly influences its primary stability, for the two femoral stems tested, length could be reduced substantially without compromising the primary stability. With the aim of minimising surgical invasiveness, newer femoral stem design and currently well performing stems might be used with a reduced length without compromising primary stability and hence, long-term survivorship.     

Time-dependent elastohydrodynamic lubrication analysis of total knee replacement under walking conditions

This work is concerned with the lubrication analysis of artificial knee joints, which plays an increasing significant role in clinical performance and longevity of components. Time-dependent elastohydrodynamic lubrication analysis for normal total knee replacement is carried out under the cyclic variation in both load and speed representative of normal walking. An equivalent ellipsoid-on-plane model is adopted to represent an actual artificial knee. A full numerical method is developed to simultaneously solve the Reynolds and elasticity equations using the multigrid technique. The elastic deformation is based on the constrained column model. Results show that, under the combined effect of entraining and squeeze-film actions throughout the walking cycle, the predicted central film thickness tends to decrease in the stance phase but keeps a relatively larger value at the swing phase. Furthermore, the geometry of knee joint implant is verified to play an important role under its lubrication condition, and the length of time period is a key point to influence the lubrication performance of joint components.     

A novel cross-shear metric for application in computer simulation of ultra-high molecular weight polyethylene wear

Wear testing of polyethylene in total joint replacements is common and required for any new device. Computational wear modelling has obvious utility in this context as it can be conducted with much greater economy than physical testing. Archard's law has become the accepted standard for wear simulation in total joints but it does not account for cross-shear, which is known to increase wear significantly relative to unidirectional sliding. The purpose of this study was to develop a robust cross-shear model applicable to any interface geometry under any kinematic conditions. The proposed metric, x ^*, is distinguished from existing cross-shear models by the fact that it measures cross-path motion incrementally throughout a motion cycle and quantifies cross-shear based on incremental changes in sliding direction. Validation showed strong support for the predictive capability of x ^* when applied to pin-on-disc test data.     

Wear analysis in anatomical and reversed shoulder prostheses

This paper describes the development of a computational model to calculate wear rates in total shoulder prostheses, for a 5–150 degrees arm abduction. Anatomical keeled and pegged prosthesis as well as reversed prosthesis were the studied implants. The bone models were built based on computed tomography (CT) images and using a computer aided design-based modelling pipeline. The finite element method was used to solve the contact problem between the surface of the polyethylene (PE) components and the corresponding articular component. The aim of this work was to determine linear and volumetric PE wear, for several radial mismatches, in conditions of pathological (rheumatoid arthritis) and non-pathological bone. Results showed that contact pressures and linear wear developed in anatomical prosthesis were higher than those visualised in reversed prosthesis. However, anatomical prosthesis exhibited a better volumetric wear performance. Moreover, our findings indicated higher values of volumetric wear in higher congruent models and on pathological bone conditions.     

The association between the total antioxidant potential of plasma and the presence of coronary heart disease and renal dysfunction in patients with NIDDM

Oxidative stress may be an important pathogenetic factor in the development of diabetic vascular complications. The total antioxidative potential of plasma reflects the ability of an individual to resist oxidative stress. We measured the plasma total peroxyl radical-trapping potential (TRAP) and the concentrations of four plasma chain-breaking antioxidants in 81 patients with non-insulin-dependent diabetes mellitus (NIDDM) nine years after diagnosis and in 102 well-matched non-diabetic control subjects. The association between the total antioxidative potential and the presence of coronary heart disease (CHD) and diabetic kidney disease were also studied. There were no significant differences in plasma TRAP between NIDDM patients and control subjects (1250 ± 199 vs. 1224 ± 198 μM). Nor were there any significant differences in the concentrations of plasma uric acid, ascorbic acid, α-tocopherol, and protein thiols between NIDDM patients and control subjects. Patients with a low glomerular filtration rate and/or high urinary albumin excretion had elevated plasma uric acid. Plasma TRAP was not, however, associated with renal dysfunction. The plasma of NIDDM patients with CHD had a significantly higher value of unidentified antioxidative potential than that of patients without CHD. This relation was strongly dependent upon smoking. In conclusion, these data demonstrate that there are no major defects in the antioxidative potential of plasma caused by NIDDM per se. CHD and diabetic renal dysfunction were not associated with changes in plasma TRAP.     

Indices of oxidative stress in pregnancy with fetal growth restriction

Intrauterine fetal growth restriction (IUGR), the main cause of premature delivery and fetal mortality, has been suggested to involve oxidative stress. We found elevated values of indices of oxidative stress in the blood serum of pregnant women with IUGR: increased levels of malondialdehyde and 4-hydroxyalkenals, decreased activity of α-1-antitrypsin and decreased total antioxidant capacity of the serum, with respect to healthy pregnancy. Twenty day treatment with 3 g of l-arginine and 75 mg of acetylsalicylic acid daily resulted in a decrease of the level of lipid peroxidation products and augmentation of α-1-antitrypsin activity. This study confirms the occurrence of oxidative stress in IUGR and demonstrates the beneficial effect of arginine/acetylsalicylic acid therapy in reducing oxidative stress in IUGR.     

Ultrasound-assisted aqueous extraction of total flavonoids and hydroxytyrosol from olive leaves optimized by response surface methodology

Abstract

Olive leaves were often extracted with methanol or ethanol at different proportions. In this study, ultrasound-assisted aqueous extraction was adopted for olive leaf extraction. The yields of total flavonoids (TF) and hydroxytyrosol (HT) were optimized by central composite experimental design. Two second-order polynomial equations were established to quantify the relationship between the responses and the processing parameters. Under the optimal condition of extracting at 60?°C for 60?min with the solvent-to-material ratio of 40, TF and HT amounted to 57.31?±?0.35 and 1.80?±?0.02?mg/g dry leaves (DL), respectively. The scavenging rate of all extracts against α, α-diphenyl-β-picrylhydrazyl (DPPH) and hydroxyl free radicals was screened. The integrated scores, representing both active ingredients and antioxidant capacity of the extracts, were calculated by principle component analysis (PCA). The optimal extract gained the highest score in PCA. In addition, compared to the extracts from 80% methanol to 44% ethanol, the ultrasound-assisted aqueous extract was richer in TF, HT, and polyphenols, while it also presented stronger ferric reducing antioxidant power (FRAP), but poorer strength to quench hydroxyl radicals. The study indicated that the aqueous extract of olive leaves may present broad potential opportunities in health-care sector.