TNF-α and LPS led to upregulation of VEGF and SIRT1, and subsequent upregulation of MMP-2 and MMP-9 production, and promote angiogenesis via pathways involving PI3K, p38, ERK, JNK and NF-κB. The results suggest that inhibition of SIRT1 and VEGF might attenuate pro-inflammatory mediator-induced pulpal disease.
solution or sliding-scale subcutaneous administrations. CSII can improve glycaemia safely as well as quality of life in patients on TPN [12,16]. Formal guidelines in this area remain limited. Acknowledging the absence of clinical trials testing the effect of glycaemic control on outcomes in patients on TPN, CSII is an option for glycaemic control.We suggest that clinicians consider the possibility of primary adrenal insufficiency and other endocrine gland involvement in patients with Gardner's syndrome. As there are no guidelines to guide therapy with CSII in this setting, clinical trials are needed that compare insulin regimes or glycaemic targets with respect to clinical outcomes. In the meantime, CSII provides an option for glycaemic control in complex TPN-dependent patients.
Background/Aims : We used flexible starting doses and early titration of atorvastatin to determine the rate of achievement of a low-density lipoprotein cholesterol (LDL-C) target for hyperlipidemic patients with type 2 diabetes mellitus.Methods : This study was a multicenter, open-label, prospective trial of atorvastatin therapy in hyperlipidemic patients with type 2 diabetes. The patients were divided into three groups according to initial LDL-C levels (130-149, 150-159 and≥160 mg/dL), and 10, 20, and 40 mg of atorvastatin was administered to each group, respectively. If LDL-C did not reach the 100 mg/dL target level at four weeks after initiation of treatment, the doses were increased by one step. Endothelial function tests and plasminogen activator inhibitor (PAI)-1 levels were measured in 41 patients.Results : Groups of 62, 18, and 69 patients were started on 10, 20, and 40 mg of atorvastatin, respectively, and 91% of the patients achieved the LDL-C target after four weeks of treatment. The overall percentage of patients achieving the LDL-C target after eight weeks of treatment was 89.3%: 87.5% in the 10 mg group, 86.4% in the 20 mg group, 93.9% in the 40 mg group, and 66.7% in the 80 mg group. A statistically significant reduction was observed in the mean percentage change in flow-mediated endothelium-dependent dilatation after eight weeks of treatment (p<0.0001).Conclusions : Flexible initial dosing and early aggressive titration of atorvastatin according to LDL-C levels is an efficient and safe strategy for achieving the target level and for improving endothelial dysfunction in hyperlipidemic patients with type 2 diabetes.
The well-known mathematical modeling and neural networks (NNs) methods have limitations to incorporate the key process characteristics at the wastewater treatment plants (WWTPs) which are complex, non-stationary, temporal correlation, and nonlinear systems. In this study, a systematic methodology of NNs modeling which can be efficiently included in the key modeling information of the WWTPs is performed by selecting the temporal effect of the hydraulics based on multi-way principal components analysis (MPCA). The proposed method is applied for modeling wastewater quality of a full-scale plant, which is a Daewoo nutrient removal (DNR) process. Through the experimental results in a full-scale plant, the efficiency of the proposed method is evaluated and the prediction capability is highly improved by the inclusion of the hydraulics term due to the optimized structure of neural networks.
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