Comparison of histological characteristics of two experimental mouse abdominal aortic aneurysm models / 西安交通大学学报(医学版)

【Objective】 To compare the histological characteristics of porcine pancreatic elastase （PPE） induced abdominal aortic aneurysms （AAA） and angiotensin Ⅱ （AngⅡ） induced AAA in mice. 【Methods】 In the PPE group， the mouse abdominal aorta segment from the infrarenal abdominal aorta to the iliac artery was isolated and its branch arteries were ligated to avoid leakage during PPE perfusion. We perfused the isolated aorta segment with a PPE solution at a concentration of 1.5 U/mL for 5 min and then closed the abdominal cavity. The diameter of the abdominal aorta was measured before and 14 days after the surgery， and the perfusion segment of the arteries was collected at day 14 after the surgery. The histological characteristics of the aneurysm were analyzed and graded by histological and immunohistochemical methods. In the AngⅡ group， ten apolipoprotein E knockout mice were prepared， and AngⅡ [1 000 ng/(kg·min)] was infused with osmotic pumps for 28 days. The aorta was separated and the aneurysm aorta segment was analyzed. The wild type mice were used as normal health controls. 【Results】 In the PPE group， the diameter of the PPE perfused aorta segments increased and was significantly larger than the basal diameter ［（0.52±0.02） mm vs. （1.23±0.11） mm］ at day 14 after surgery. All the ten mice developed AAA after PPE application. The histological results showed typical pathological features of AAA in PPE perfused mice， such as elastic fiber breakage， smooth muscle exhaustion， and increased inflammation. Six of the ten mice developed aneurysms after AngⅡ infusion （6/10）. The aneurysms/dilatations were mostly in the suprarenal abdominal aorta， but also in the thoracic aorta and aortic arch. The histology analysis showed that the formation of arterial dissection was common after AngⅡ infusion， and the typical vascular “false lumen” was found. The breakage of elastic fibers， the exhaustion of smooth muscle damage， and the inflammatory response were not as typical as the PPE model in AngⅡ perfused animals. 【Conclusion】 The histological characteristics of PPE induced AAA are very typical and well present the inflammatory process in the development of aneurysm. The AngⅡ model is suitable for the study of aneurysms combined with aortic dissection. Both models have their own advantages and can complement each other.

Efficacy and Safety of Benralizumab for Severe Eosinophilic Asthma ：A Meta-analysis / 中国药房

OBJECTIVE：To systematic ally ev aluate the efficacy and safety of benralizumab in the treatment of severe eosinophilic asthma ，and to provide evidenced-based reference for clinical treatment. METHODS ：Retrieved from PubMed ， Embase，Cochrane Library ，ClinicalTrials.gov，CNKI，VIP and Wanfang database ，randomized controlled trials （RCTs）about benralizumab+routine treatment （trial group ）versus placebo+routine treatment （control group ）were collected during the inception to Dec. 2020. The relevant references were also retrieved manually. After data extraction ，the quality of included literatures was evaluated with bias risk evaluation tool 2.0 recommended by Cochrane systematic evaluator manual 6.1. Meta-analysis was conducted by using Rev Man 5.4 software. RESULTS ：Totally 5 studies involving 2 646 patients were included. Results of Meta-analysis showed that acute exacerbation rate of asthma [RR ＝0.67，95％ CI（0.61，0.74），P＜0.000 01]，asthma control questionnaire score [MD ＝－0.29，95％CI（－0.37，－0.21），P＜0.000 01] and the incidence of severe adverse event [RR ＝0.67，95％CI （0.53，0.84），P＝0.000 6] in trial group were significantly lower than control group. FEV 1[MD＝0.13，95％CI（0.09，0.17），P＜0.000 01] and asthma quality of life questionnaire score [MD ＝0.23，95％CI（0.13，0.33），P＜0.000 01] in trial group were significantly higher than control group. There was no statistical significance in the incidence of adverse event between 2 groups [RR ＝0.97，95％CI （0.92，1.02），P＝0.28]. CONCLUSIONS ：Benralizumab is effective and safe in the treatment of severe eosinophilic asthma. Due to the relatively limited data ，this conclusion needs to be confirmed by more studies.

Application of preimplanted angiography catheter with digital subtraction angiography for surgical treatment of acute lower gastrointestinal bleeding / 中华全科医师杂志

To evaluate the application of preimplanted angiography catheter with digital subtraction angiograply(DSA) for surgical treatment of acute lower gastrointestinal bleeding.Clinical data of 17 patients with acute lower gastrointestinal bleeding admitted from June 2011 to December 2014 were retrospectively reviewed.The angiography catheter was implanted and methylene was injected to find the bleeding sites with DSA,then emergency laparotomy was performed.The results showed the bleeding sites in small intestine in 8 cases and in large intestine in 9 cases.Postoperative pathology revealed vascular malformation in 4 cases,2 in small intestine and 2 in colon;ulcerative colitis in 3 cases;colon cancer in 1 case;colonic diverticula in 3 cases and small intestinal stromal tumor in 6 cases.Results indicate that if the conservative therapy is not effective,surgical treatment assisted by preimplanted angiography catheter with DSA is safe and effective for patients with lower gastrointestinal bleeding.

Endovascular treatment of lower extremity arteriosclerosis obliterans of TASC-D type：its current clinical situation / 介入放射学杂志

In 2007, Transatlantic Cooperation Society Consensus Ⅱ(TASCⅡ) Conference Guideline has divided the aortoiliac artery and femoral popliteal artery diseases into 4 types , suggesting that endovascular treatment should be employed for TASC-A type lesions, individualized therapy should be adopted for TASC-B and TASC-C type lesions when a variety of factors are taken into consideration , and surgical treatment should be used for TASC-D type lesions. In recent years, along with the development of imaging technique and material science as well as the improvement of interventional operator ’s skill, the mini-invasive interventional therapy has been more and more performed for the relatively complex TASC-D type aortoiliac artery and femoral popliteal artery occlusive diseases , and satisfactory clinical curative effect has been achieved. This paper aims to make a comprehensive review about the current situation of endovascular treatment for lower extremity arteriosclerosis obliterans of TASC-D type in clinical practice.

The diagnosis and management of penetrating abdominal injury with large vessels damage in 18 cases / 中华普通外科杂志

Objective To investigate the experience of diagnosis and treatment of abdominal penetrating injury with large vessels damage.Methods The clinical data of 18 patients with abdominal large vessels injuries in our hospital from Jan 2003 to oct 2014 were analyzed retrospectively.Results 18 cases of large vessels injuries,accounting for 16.21％ during the same period of all penetrating wounds (18/111),emergency laparotomy was performed.There were 8 cases of arterial injury,4 cases of concurrent arteriovenous injury,6 cases of venous injury,Arterial and venous broken walls were repaired,splenic artery and venous ligation and splenectomy were performed.Vascular repair success rate was 100％,Intraoperative blood loss was 500-6 000 ml,average (3 750 ±670) ml.Operating time varied from 2.5 to 7 h,average (3.9 ±0.8) h.All patients were cured.12 cases were followed-up for 2-36 months,mean follow-up time was (15 ± 7) months,ultrasonography showed normal blood flow without complications.Conclusions Emergency surgical exploration and limited fluid resuscitation is the most effective therapy in abdominal penetrating injury involving large vessels.

An analysis of the causes of death for patients of peripheral arterial disease during the perioperative period / 中华普通外科杂志

Objective To investigate the causes of death and the influencing factors in patients with peripheral arterial disease(PAD) during the perioperative period and reduce the perioperative mortality.Methods A retrospective analysis of the causes of death was performed for PAD during the perioperative period in our hospital from July 2005 to July 2010. Results Nine patients died preoperatively.The causes of death were multible organ failure in 5,heart failure in 2,sudden cardiac death in 1,and respiratory failure in 1.Six patients died postoperatively.The causes of death were acute renal failure in 2,heart failure in 2,cerebral infarction in 1,and hemorrhagic shock in 1.The causes of death which were related to heart,kidney and lung were in 10,6 and 2,respectively.The causes of death which were directly due to heart failure,sudden cardiac death,renal failure,respiratory failure,cerebral infarction and hemorrhagic shock were in 4,1,2,1,1 and 1,respectively.The main causes of death were multible organ failure,heart failure and acute renal failure,which accounted for 73.33％ of all deaths.In this series the overall perioperative mortality was 3.11％ (15/483),Operative mortality was 1.47％ (6/407).Conclusions The influencing factors and the function of organs were closely correlated with the causes of death. To reduce the perioperative mortality of PAD,it is necessary both to intervene in the influencing factors and to monitor and treat the dysfunction of vital organs.

Endovascular procedure for TASC-D type iliac artery lesions / 中华普通外科杂志

Objective To evaluate recanalization for TASC-D type iliac artery lesions.Methods Between June 2006 and June 2010,26 patients with a total of 31 limbs of the TASC-D iliac artery lesions underwent endovascular procedure. Results Technical success rate was 90.3% (28/31).Clinical symptom improvement rate was 100%. Forty-four stents were placed in 28 limbs of the 24 patients.Eleven patients underwent an associated procedure; femoropopliteal endovascular procedures in 8 cases,femoro-popliteal bypass in 3 cases. Eight patients underwent an intravascular ultrasound thrombolysis.Postoperative ankle-brachial index ( ABI) was increased by more than 0. 15 in all patients. Twenty-two patients(26 limbs) were followed-up for 3 -44 mos, the primary patency rate at 12 months was 90% ,and cumulative patency rate was 95%. At 36 months primary patency rate was 70% , and secondary patency rate was 80%. Conclusions Because the technical success rate is high, endovascular techeniques are the choice of therapy in high risk patients with TASC-D type iliac artery lesions.

Cytokines expression in the membranous tissue and organized thrombi in membranous obstruction of Budd Chiari syndrome / 中华普通外科杂志

Objective To explore the relationship between the membranous tissue(MT)and organized thrombus(OT)in membranous obstruction of the inferior vena cava(MOVC),we investigated the related cytokines expression in the membranous tissues in MOVC as well as venous organized thrombi. Methods Using immunohistochemical method the expression of TGFβR,PDGFR,ET-1,FⅧ-rAg, ferritin and α1-antitrypsin were observed in the membranous tissues in 11 cases with MOVC and organized thrombi in 8 cases with deep venous thrombosis(DVT). Results Expression rates of TGFβR,PDGFR,ET-1,FⅧ-rAg, and ferritin in membranous tissues in 11 cases with MOVC and organized thrombi in 8 cases with DVT were as follows: TGFβR:MT 72.3%,OT 50%(P＞0.05);PDGFR:MT 45.5%,OT 100%(P＜0.05＝;ET-1:MT 100%,OT 0(P＜0.05＝;FⅧ-rAg: MT 90.9%,OT 12.5%(P＜0.05＝;ferritin: MT 72.3%,OT 100%(P＞0.05).α1-antitrypasin was not detected in either membranous tissues of MOVC or organized thrombi of DVT. Conclusions ThrovIgh the investigation of the related cytokines expression, it is possible that membranous tissue formation in MOVC is related to the organized thrombus.