二甲双胍联合糖皮质激素治疗伴糖耐量异常的系统性红斑狼疮患者的临床研究

目的: 探究二甲双胍联合糖皮质激素治疗伴糖耐量异常(IGT)的系统性红斑狼疮(SLE)患者的临床疗效及对胰岛功能、Th17/Treg细胞失衡的影响。方法: 本院84例伴IGT的SLE患者随机分为联用组和对照组各42例,均给予生活、饮食指导,对照组给予糖皮质激素治疗,联用组联合二甲双胍治疗,1个月后观察疗效,并评估胰岛功能和Th17/Treg细胞失衡情况。结果: 联用组总有效率明显高于对照组(90.48% vs. 71.43%,P<0.05),SLE活动指数评分为(2.6±0.3)分,红细胞沉降率(ESR)为(18±4)mm/h,显著低于对照组的(3.9±0.8)分、(23±4)mm/h(P<0.05)。治疗后联用组空腹血糖(FBG)、空腹胰岛素(Fins)、稳态模型-胰岛素抵抗指数(HOMA-IR)、胰岛β功能细胞指数(HOMA-β)显著改善(P<0.05),且与对照组相比差异有统计学意义(P<0.05);联用组正常糖耐量(NGT)占比明显高于对照组(73.81% vs. 30.95%,P<0.05)。治疗后联用组Th17、Treg细胞比例为(6.2±0.9)个/μL、(31±7)个/μL,Th17/Treg为(0.20±0.05),与对照组的(7.4±1.3)个/μL、(28±7)个/μL、(0.26±0.06)相比有统计学差异(P<0.05)。治疗后SLE活动指数评分与HOMA-IR、HOMA-β及Th17细胞、Treg细胞、Th17/Treg明显相关(P<0.05),且HOMA-IR、HOMA-β与Th17细胞、Treg细胞、Th17/Treg也明显相关(P<0.05)。2组不良反应均轻微,发生率无统计学差异(P>0.05)。结论: 二甲双胍联合糖皮质激素治疗伴IGT的SLE患者疗效显著,可控制疾病活动性,降低血糖水平、改善胰岛功能及纠正Th17/Treg细胞失衡,且安全性高。     

Analysis based on EU Regulation No 517/2014 of new HFC/HFO mixtures as alternatives of high GWP refrigerants in refrigeration and HVAC systems

The EU Regulation No 517/2014 is going to phase-out most of the refrigerants commonly used in refrigeration and air conditioning systems (R134a, R404A and R410A) because of their extended use and their high GWP values. There are very different options to replace them; however, no refrigerant has yet imposed. In this paper we review and analyze the different mixtures proposed by the AHRI as alternative refrigerants to those employed currently. These mixtures are composed by HFC refrigerants: R32, R125, R152a and R134a; and HFO refrigerants: R1234yf and R1234ze(E). It is concluded, from the theoretical analysis, that most of the new HFO/HFC mixtures perform under the HFC analyzed (although some experimental studies show the contrary) and, in most cases, do not meet the GWP restrictions approved by the European normative. Furthermore, some of the mixtures proposed would have problems due to their flammability.     

An experimental investigation of refrigerant mixture R32/R290 as drop-in replacement for HFC410A in household air conditioners

In the present paper, the refrigerant mixture R32/R290 (68%/32% by weight) is investigated as the drop-in replacement for R410A in household air conditioners. The GWP of it is only 22% of that of R410A. Theoretical and experimental investigations are conducted on the performance of the air conditioners working with both R32/R290 and R410A. Experimental results show that the refrigerant charge amount of R32/R290 is reduced by 30.0%–35.0%; the cooling and heating capacities are increased by 14.0%–23.7%. For further reducing charge amount and flammability, the micro-channel heat exchanger (condenser) is employed to replace the finned tube one. Compared with the R32/R290 system using finned tube heat exchanger, the R32/R290 charge amount and the power consumption are reduced by 34.1% and 0.4%, respectively; the cooling capacity and the COP are increased by 6.4% and 6.8%, respectively.     

Refrigerant charge reduction in vapor compression refrigeration cycles via liquid-to-suction heat exchange

This short communication reports a study of the potential for refrigerant charge reduction in vapor compression refrigeration systems by means of a liquid-to-suction heat exchanger. The analysis was carried out on purely thermodynamic grounds for refrigerants of current interest, such as R134a, R22, R290, R600a and R717, assuming the cooling capacity as a constraint so that the evaporating pressure is free to vary. It was found that the minimum amount of refrigerant can be reduced depending on the thermophysical properties of the refrigerant, the working conditions, and the charge inventory.     

Development and validation of a micro-fin tubes evaporator model using R134a and R1234yf as working fluids

This paper presents a model of shell and tube evaporator with micro-fin tubes using R1234yf and R134a. The model developed for this evaporator uses the ε-NTU method to predict the evaporating pressure, the refrigerant outlet enthalpy and the outlet temperature of the secondary fluid. The model accuracy is evaluated using different two-phase flow boiling correlations for micro-fin tubes and comparing predicted and experimental data. The experimental tests were carried out for a wide range of operating conditions using R134a and R1234yf as working fluids. The predicted parameter with maximum deviations, between the predicted and experimental data, is the evaporating pressure. The correlation of Akhavan– Behabadi et al. was used to predict flow boiling heat transfer, with an error on cooling capacity prediction below 5%. Simulations, carried out with this validated model, show that the overall heat transfer coefficient of R1234yf has a maximum decrease of 10% compared with R134a.     

Regenerated air cycle potentials in heat pump applications

Air (reversed Brayton) cycle has been utilized in the area of refrigeration and cryogenics for several decades, but its potentials in heat pump applications were longtime underestimated. In this paper, a thermodynamic model for the regenerated air heat pump cycle with practical compressor, expander and regenerated heat exchanger was developed. Based on the model, the relations between the system performance and the operating parameters were analyzed. The optimal heating COP (coefficient of performance) and the corresponding pressure ratio were derived. Then, air heat pump cycles (regenerated cycle and basic cycle) and vapor-compression heat pump cycles (CO₂ trans-critical cycle and R410A subcritical cycle) were numerically compared. The results indicated that the regenerated air heat pump cycle not only gets the heating capacity in line with the heating load under different operating conditions but also achieves higher COP over trans-critical CO₂ heat pump cycle in applications of large temperature difference.     

Maldistribution in air–water heat pump evaporators. Part 1: Effects on evaporator,heat pump and system level

This paper presents an approach to quantify the effect of evaporator maldistribution on operating costs of air–water heat pumps. In the proposed simulation model maldistribution is induced by two parameters describing refrigerant phase and air flow distribution. Annual operating costs are calculated based on heat pump performance at distinct operating conditions. Results show that percentage increase of operating costs is similar for the three considered climate zones, even though the effect of maldistribution on heat pump performance varies with operating conditions. Differences in terms of absolute cost increase for the climate zones arise mainly due to a varying number of operating hours. Absolute cost increase is considerable in the average and especially colder climate zone and can only partly be reduced by enlarging the evaporator.     

Experimental study on the heat transfer and flow characteristics of nanorefrigerants inside a corrugated tube

The heat transfer and flow characteristics of MWCNT-R141b nanorefrigerant with different mass fractions have been studied through experiments. Experimental results were compared with existing correlations. A two-step method was used to prepare the nanorefrigerants. Span-80 was used as surfactant with an average particle diameter of 20 nm. Transmittance method was used to evaluate the stability of nanorefrigerants. Results showed that the stability of MWCNT-R141b nanorefrigerant, which is the added dispersant, was good during the experiments. The 0.3 wt% MWCNT-R141b nanorefrigerants had optimal heat transfer enhancement effects compared with pure refrigerants. The maximum Nusselt number increased by 40%. The specific pressure drop of nanorefrigerant increased as the Reynolds number (Re) increased, and the specific pressure drop of the pure refrigerant was minimum, which is similar to R141b.     

Pertussis Toxin Inhibits Encephalitogenic T-Cell Infiltration and Promotes a B-Cell-Driven Disease during Th17-EAE

Pertussis toxin (PTX) is a required co-adjuvant for experimental autoimmune encephalomyelitis (EAE) induced by immunization with myelin antigen. However, PTX’s effects on EAE induced by the transfer of myelin-specific T helper cells is not known. Therefore, we investigated how PTX affects the Th17 transfer EAE model (Th17-EAE). We found that PTX significantly reduced Th17-EAE by inhibiting chemokine-receptor-dependent trafficking of Th17 cells. Strikingly, PTX also promoted the accumulation of B cells in the CNS, suggesting that PTX alters the disease toward a B-cell-dependent pathology. To determine the role of B cells, we compared the effects of PTX on Th17-EAE in wild-type (WT) and B-cell-deficient (µMT) mice. Without PTX treatment, disease severity was equivalent between WT and µMT mice. In contrast, with PTX treatment, the µMT mice had significantly less disease and a reduction in pathogenic Th17 cells in the CNS compared to the WT mice. In conclusion, this study shows that PTX inhibits the migration of pathogenic Th17 cells, while promoting the accumulation of pathogenic B cells in the CNS during Th17-EAE. These data provide useful methodological information for adoptive-transfer Th17-EAE and, furthermore, describe another important experimental system to study the pathogenic mechanisms of B cells in multiple sclerosis.     

Th17 Cells as Potential Probiotic Therapeutic Targets in Inflammatory Bowel Diseases

Inflammatory bowel diseases (IBD) are characterized by wasting and chronic intestinal inflammation triggered by various cytokine-mediated pathways. In recent years, it was shown that T helper 17 (Th17) cells are involved in the pathogenesis of IBD, which makes them an attractive therapeutic target. Th17 cells preferentially produce interleukin (IL)-17A–F as signature cytokines. The role of the interplay between host genetics and intestinal microbiota in the pathogenesis of IBD was demonstrated. Probiotics are live microorganisms that when orally ingested in adequate amounts, confer a health benefit to the host by modulating the enteric flora or by stimulating the local immune system. Several studies indicated the effectiveness of probiotics in preventing and treating IBD (ulcerative colitis, and Crohn’s disease). Furthermore, there is mounting evidence of probiotics selectively targeting the Th17 lineage in the prevention and management of inflammatory and autoimmune diseases such as IBD. This review highlights critical roles of Th17 cells in the pathogenesis of IBD and the rationale for using probiotics as a novel therapeutic approach for IBD through manipulation of Th17 cells. The potential molecular mechanisms by which probiotics modulate Th17 cells differentiation and production are also discussed.