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Objective:To investigate an accurate and quantitative method to measure the eyeball morphological parameters of guinea pigs through a method that combines programmed digital techniques and mathematical geometric principles.Methods:Twenty-two three-week-old clean-grade male tricolor guinea pigs were selected and sacrificed by anesthesia overdose.Eyeballs were enucleated.The horizontal and sagittal images of the eyeball were taken with the high-speed photographic model of 13 million pixels macro meter, and the pictures were imported into pycharm programming software.Using the pre-written analysis program of Python 3.9, the conversion coefficient between the photo pixel and the actual length was obtained by a scale, and then the corneal surface was fitted by arc fitting and conic curve fitting.The results of arc fitting were converted to calculate the corneal radius of curvature.The corneal eccentricity was calculated according to the general conic equation (Ax 2+ Bxy+ Cy 2+ Dx+ Ey+ F=0). The corneal asphericity was evaluated by curve fitting between the central 3-mm and the whole cornea.The use and care of the animals complied with Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.The study protocol was approved by the Ethics Committee of Shanghai Public Health Clinical Center (No.2022-A009-01). Results:The digital method of Python programming can show the corneal contour of guinea pigs completely and clearly.In the transverse plane, there was no significant difference in the corneal curvature measurements among the digital fitting in central 3-mm cornea, digital fitting in whole cornea and curvature meter ( F=1.693, P=0.190). In the sagittal plane, there was a significant difference in the corneal curvature measurements among the three methods ( F=3.500, P=0.030), and the corneal curvature measurements of the whole cornea measured by the curvature meter were significantly greater than those measured by the digital fitting ( P<0.05). There was no statistical significance in the measurements of corneal curvature radius among the three methods in the transverse plane and the sagittal plane ( F=1.817, P=0.170; F=2.050, P=0.133). The horizontal and sagittal corneal eccentricity measured by digital fitting in central 3-mm cornea were 0.55±0.15 and 0.53±0.17, which were lower than 0.66±0.10 and 0.64±0.14 measured by digital fitting in whole cornea, and the differences were statistically significant ( t=-4.860, -5.210; both at P<0.01). Conclusions:It is feasible to use Python programming digital method to measure the corneal curvature and eccentricity of guinea pigs.
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Objective To analyze the risk factors and build a clinical prediction model for hemodynamic depression (HD) after carotid artery stenting (CAS). Methods A total of 116 patients who received CAS in the Department of Vascular Surgery,Drum Tower Clinical College of Nanjing Medical University and the Department of Vascular Surgery,the Affiliated Suqian First People's Hospital of Nanjing Medical University from January 1,2016 to January 1,2022 were included in this study.The patients were assigned into a HD group and a non-HD group.The clinical baseline data and vascular disease characteristics of each group were collected,and multivariate Logistic regression was employed to identify the independent predictors of HD after CAS and build a clinical prediction model.The receiver operating characteristic (ROC) curve was drawn,and the area under the ROC curve (AUC) was calculated to evaluate the predictive performance of the model. Results The HD group had lower proportions of diabetes (P=0.014) and smoking (P=0.037) and higher proportions of hypertension (P=0.031),bilateral CAS (P=0.018),calcified plaque (P=0.001),eccentric plaque (P=0.003),and the distance<1 cm from the minimum lumen level to the carotid bifurcation (P=0.009) than the non-HD group.The age,sex,coronary heart disease,symptomatic carotid artery stenosis,degree of stenosis,and length of lesions had no statistically significant differences between the HD group and the non-HD group (all P>0.05).Based on the above predictive factors,a clinical prediction model was established,which showed the AUC of 0.807 and the 95% CI of 0.730-0.885 (P<0.001).The model demonstrated the sensitivity of 62.7% and the specificity of 87.7% when the best cut-off value of the model score reached 12.5 points. Conclusions Diabetes,smoking,calcified plaque,eccentric plaque,and the distance<1 cm from the minimum lumen level to the carotid bifurcation are independent predictors of HD after CAS.The clinical prediction model built based on the above factors has good performance in predicting the occurrence of HD after CAS.
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Humans , Carotid Stenosis , Depression , Models, Statistical , Prognosis , Stents , Hemodynamics , Plaque, AmyloidABSTRACT
In recent years, the therapeutic concepts and surgical methods of the meandering mesenteric artery involved in atherosclerosis have been reported in the literature, and the importance of this lateral branch circulation in the field of vascular surgery has received more attention. With the improvement of imaging techniques, the discovery rate of this collateral circulation increased. In the presence of major iliac artery occlusion, the meandering mesenteric artery may serve as an important collateral circulation to relieve ischemia in the visceral or lower extremities. The meandering mesenteric artery may also lead to type Ⅱ internal leakage after endovascular repair, while the embolization of inferior mesenteric artery may be performed through the meandering mesenteric artery. The role of meandering mesenteric arteries in vascular surgery needs further study.
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Objective:To evaluate the efficacy and safety of of rivaroxaban for different doses in the treatment of isolated distal deep vein thrombosis.Methods:The clinical data of 853 patients of isolated distal deep vein thrombosis attending Nanjing Drum Tower Hospital from Jan 2018 to Dec 2020 was retrospectively analyzed.Results:Thrombotic recurrence rate increased with increasing follow-up in the standard and low dose groups, and it was significantly lower in the standard dose group than in the low dose group (HR=0.44, 95% CI: 0.25-0.78, P=0.005) with most thrombosis occurring within the first year of follow-up. There was no statistical difference between the two groups in terms of major bleeding events (HR=1.70,95%CI 0.56-5.14, P=0.530) and the incidence of clinically relevant non-major bleeding events was significantly higher in the standard dose group than in the low dose group (HR=2.36, 95%CI 1.26-4.44, P=0.020). Subgroup analysis on anticoagulation duration found when anticoagulation duration was longer than 1.5 months, the risk of thrombosis was lower in the standard dose group than the low dose group (1.5-3 months:HR=0.11, 95%CI 0.01-0.87, >3 months: HR=0.19, 95%CI 0.04-0.95), there was an interaction between anticoagulation duration and dose ( P=0.007). Conclusions:Based on the risk of thrombosis recurrence and bleeding events, the standard dose of rivaroxaban (20 mg qd) is recommended for patients with isolated distal deep vein thrombosis, and the anticoagulant duration should be maintained for 1.5 months or more.
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Objective:To evaluate the mid-term results of fenestrated/branched endovascular aortic repair (f/b EVAR) for the treatment of thoracoabdominal aortic aneurysms. M ethods The clinical data of 105 thoracoabdominal aortic aneurysm patients treated with f/b EVAR at the Department of Vascular Surgery of Nanjing Drum Tower Hospital from 2018 to 2019 were retrospectively analyzed. Results:There were 43 cases of thoracoabdominal aortic aneurysm and 62 cases of thoracoabdominal aortic aissection.A total of 336 branch arteries were reconstructed,and technical success rate was 94.3%. 100 cases (95.2%) were followed-up, 6 cases (5.7%) received reoperation interventions, and 11 cases (10.5%) died. During the follow-up period, 69 cases had complete imaging data. Based on the recent CT date of the thoracoabdominal aorta, 58 patients hael positive aortic remodeling and 11 patients hael negative and indeterminate remodeling; there were 31 cases (29.5%) of endoleaks, including 7 cases (6.7%) of type Ⅰb endoleaks, 8 cases (7.6%) of type Ⅱ, 1 case (0.95%) of type Ⅲa, 13 cases (12.4%) of type Ⅲc endoleaks and 2 cases (1.9%) of type Ⅳ. Conclusions:The mid-term follow-up results were satisfactory for TAAA treated with f/b EVAR. Internal leakage remains key point for f/b EVAR.
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Primary aortic mural thrombus(PAMT) is a relatively rare clinical disease with unclear pathogenesis. In addition to hypercoagulability as a recognized risk factor, other related factors have been mentioned in the literatures. Aortic isthmus is the most common site of thrombosis, which may be related to its anatomical characteristics and hemodynamics. The onset of this disease is insidious, but the complications are dangerous. At present, the best treatment strategy for this disease is not clear, and simple anticoagulant therapy, aortic open surgery and endovascular treatment have been reported successfully. This article reviews the research progress of primary aortic mural thrombosis and reports as follows.
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Aberrant right subclavian artery is considered as more common congenital malformations of aortic arch, which is caused by dorsal aortic roots dysplasia in early embryonic stage. Kommerell′s diverticulum occurred in 60% of aberrant right subclavian artery patients approximately. Surgical intervention is needed when patients with vagus right subclavian artery have tumor-like dilatation of the subclavian artery opening or have compression symptoms. With the development of intraluminal technology, the treatment method has developed from traditional open surgery to hybridization and intracavity. This article will briefly introduce the surgical methods and intraoperative precautions of hybridization and intracavity treatment.
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Objective To evaluate the safety and efficacy of fenestrated endovascular aortic repair (fEVAR) using physician-modified stent grafts(PMSGs) to repair aortic dissection aneurysm.Methods Nine consecutive patients who underwent fEVAR using PMSGs from Jan 2018 to Jun 2018 were retrospectively reviewed.Results Nine PMSGs (6 Ankura stent grafts,3 COOK Zenith stent grafts) were deployed.Initial technical success rate was 97.0％ (32 of 33).Mean operative time was (303 ± 51) min.There were no in-hospital death and no perioperative neurology complications.All the patients survived at a median follow-up of 6.1 mouths (ranging 3-10 months).During follow up,no postoperative complications occurred,all target vessels remained patent and no fenestration-related type Ⅰ endoleak were observed.There are 3 cases of type Ⅱ and 2 cases of type Ⅲ endoleaks respectively.Conclusions FEVAR using PMSGs may be a viable alternative for patients with post aortic dissection aneurysm.
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Due to limited availability of autologous blood vessels (blood vessels from the same recipient used for vascular transplantation materials) and inadequate growth ability of non-autologous blood vessels (artificial blood vessel transplantation materials), more and more attention has been paid to tissue engineering blood vessels. In this study, we constructed an ammonium phosphate zwitterion modified acellular vascular scaffold with highly biocompatible bone marrow-derived endothelial progenitor cells as the inner layer of a new vascular transplantation material. The vascular acellular scaffolds were modified by a simple method-co-precipitation method. The platelet adhesion test, hemolysis test, recalcification test and cytotoxicity of acellular vascular scaffolds in vitro were evaluated. Ammonium phosphate zwitterions modified endothelial progenitor cells on the surface of acellular scaffolds with concave and convex structure on the surface of natural vascular lumen can be effectively promoted by improving anticoagulant activity. Modified acellular scaffolds have similar mechanical properties to natural blood vessels and can effectively construct endothelialization in vitro. The results of this study provide a preliminary exploration for the modification of vascular acellular scaffolds to achieve anti-thrombosis and endothelialization in vitro.
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Humans , Blood Vessel Prosthesis , Phosphates , Thrombosis , Tissue Engineering , Tissue ScaffoldsABSTRACT
OBJECTIVE@#To analyze the clinical presentation and gene of 2 pedigrees with suspected oculocutaneous albinism(OCA), and provide basis for clinical classification, genetic counseling and prenatal diagnosis.@*METHODS@#Variants were identified using next-generation sequencing(NGS) and confirmed by Sanger sequencing in 2 pedigrees with suspected OCA. The pathogenicity of the variants was analyzed according to the American College of Medical Genetics and Genomics (ACMG) standard.@*RESULTS@#Two compound heterozygous mutations of TYR and OCA2 genes were identified respectively in 2 pedigrees with suspected OCA. The mutation of c.819+3insATATGCC in TYR and the mutation of c.1870G>C in OCA2 are first reported in this study. The pathogenicity analysis shows that two novel mutations are likely pathogenic by combination of prediction of SIFT, Polyphen-2 and Human Splicing Finder.@*CONCLUSION@#The findings of this study expand the mutational spectrum of OCA. Compound heterozygous mutations in the TYR and OCA2 gene may be responsible for clinical manifestations of 2 pedigrees with suspected OCA.
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Female , Humans , Pregnancy , Albinism, Oculocutaneous , DNA Mutational Analysis , High-Throughput Nucleotide Sequencing , Membrane Transport Proteins , Monophenol Monooxygenase , Mutation , PedigreeABSTRACT
[Objective] To investigate the HIV infection status and behavioral characteristics of men who have sex with men (MSM) over the age of 50 in Taizhou during 2010-2017 HIV sentinel surveillance, analyze the related factors of HIV infection, and provide basis for developing targeted intervention strategies. [Methods] HIV sentinel surveillance data from 2010 to 2017 in Taizhou was used to analyze the demographic characteristics, HIV awareness, and sexual behaviors of MSM over the age of 50. Also, HIV infection status and related factors were analyzed by multivariate regression analysis. [Results]A total of 334 MSM aged over 50 were surveyed by HIV sentinel surveillance in 2010-2017, and the HIV positive rate was 14.1％. The average age of the 334 MSM was (59.6 ± 7.2) years, and those with junior high school education and below accounted for 76.0％, with awareness of AIDS knowledge being 85.6％. And78.7％ of them had anal sex with men in the past 6 months. Among them, 30.4％ used condoms each time. And 4.8％ of them had commercial sex with men and 37.1％ had sex with women in the past 6months. Multivariate analysis showed that syphilis-positiveness was a risk factor for HIV infection and awareness of HIV-related knowledge proved to be a protective factor for HIV infection. [Conclusion] The MSM over 50 years old in Taizhou has a high rate of HIV-positiveness and high-risk behaviors exist. It is imperative to strengthen dynamic HIV surveillance for this population and behavioral intervention to reduce HIV related risky behavior.
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Aortic dissection is one of the most common vascular emergent disease. Thoracic endovascular aortic repair (TEVAR) therapy which created the new era of treatment of Stanford type B aortic dissection (TBAD) has gradually replaced the surgical treatment and becomes the gold standard for treatment of TBAD. Aortic remodeling after TEVAR is the key factor to evaluate the mid-term survival rate and successful treatment of the aortic dissection victims. However, there are few studies on aortic remodeling and lack of unified criteria to evaluate it. This article was to summarize the domestic and abroad research advances which focused on the morphological changes, the regularity, and the evaluation criteria of aorta remodeling after TEVAR.
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This paper summarized key points of nursing care of 14 patients with acute iliofemoral vein thrombosis undergoing endovascular therapy via rheolytic thrombectomy system,including:assessing risk of acute pulmonary artery embolism with amendatory Geneva scale,perioperative refined management of hydrotherapy and protecting renal function,nursing care to prevent tissue and organ bleeding at different levels during catheterdirected thrombolytic therapy,and evaluating clinical effects of treatment and nursing with patented circumference measurer of lower extremity.The average duration of hospitalization was 4.42 d.Ten patients had hemoglobinuria and one had renal function impairment.Acute pulmonary artery embolism happened in one patient before surgery and catheter-directed thrombolytic therapy were performed in four patients due to unsatisfactory results of thrombectomy.
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Objective To evaluate the effect of perioperative nutritional support on the prognosis of lung transplant.Methods Retrospective analysis was carried out on nutritional support for 6 lung transplant recipients in the Department of Thoracic Surgery in Henan Provincial People's Hospital between September 2015 and September 2016.The recipients were all males,with ages ranging from 28 to 60 (40± 12.1).The recipients' body mass index (BMI),serum albumin and pulmonary function at the first test after admission (t1),the last test before surgery (t2) and the last test after surgery (t3) were compared.The recipients' nutritional status was assessed with subjective global assessment.Results The 6 patients had successful single-lung transplant,without mortality or severe complications.At t3,all of them had increases in BMI by (2.4±1.4) kg/m2,weight by (3.2±1.2) kg,deltoid skin-fold thickness by (3.0±0.35) mm,prealbumin by (30±10.4) g/L,total protein (15.2±6.4) g/L,albumin by (6.4±4.1) g/L,triglyceride by (0.2± 1.4) mmoL/L,and total cholesterol by (1.4± 0.9) mmol/L (P＜0.01).The patients were followed up for 6 to 12 months.SGA results suggested no abnormality in their nutrition,and the patients were well able to function independently.Conclusion Nutritional support is vital for patients with severe malnutrition during the perioperative period of lung transplant,and can significantly improve the patient's quality of life.
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Objective To investigate the effect of prolonged stroboscopic illumination exposure on the growth of eyeball of guinea pig. Methods Thirty 2-week-old guinea pigs were randomized into three groups ( n=10 for each) . Two strobe-reared groups were raised with 20 Hz sinusoidal and 20 Hz square wave stroboscopic illumination, respectively. The control group received usual light illumination. The illumination intensity was 500 lux. All animals underwent refraction and biometric measurements prior to and after 2, 4, 6 and 8 weeks of treatment. Finally, flash electroretinograms were com-pared, and retinal microstructures were examined. Results There was a significant correlation between refractive errors and axial eye elongation, and myopia increasing was observed with eye elongation. After 8 weeks of treatment, the animals raised in 20 Hz sinusoidal and 20 Hz square wave stroboscopic illumination were (-0. 75 ± 0. 79)D and (-1. 50 ± 0. 91) D more myopic than the group raised in continuous illumination. The implicit time of the a-wave was delayed by 3. 8 and 7. 9 ms, respectively. No significant difference was found in retinal ultrastructures among the three groups. Conclusions Chronic exposure to 20 Hz sinusoidal or square wave stroboscopic illumination alters the emmetropization of the guinea pig eye to some extent.
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Objective To establish the atherosclerosis (AS) cell model,to study the relationship between the iron metabolism and AS,and to explore the molecular mechanisms of iron metabolism disorders within the macrophages in AS plaques so as to provide theoretical basis for clinical intervention of iron metabolism and for the prevention and treatment of AS.Methods RAW264.3 cells were used to prepare foam cells through oxidized low density lipoprotein (ox-LDL) induced oxidation.In order to verify the foam cells,oil red staining and enzyme-linked immunosorbent were employed to assay the total lipids and free lipids (including total cholesterol and free cholesterol) in the foam cells.Western blotting was adopted to test the levels of iron metabolism-associated ferritin (FT) and ferroportin1 (FPN1);immunohistochemistry and immunofluorescence methods were used to determine and locate the expressions of FPN1 in foam cells.Results Large amounts of red lipid granules could be seen within the cytoplasm of ox-LDL-induced foam cells,and a great quantity of lipid fused into the form of large oil droplets,which was consistent with the morphological characteristics of foam cells.Massive lipid was accumulated in the foam cells,and the proportion of cholesterol ester (CE) in the foam cells was significantly higher than that in the normal cells (P＜ 0.05).Compared with the normal control group,FT content in the foam cells was obviously higher than that in the normal cells;the content of FPN1 was increased,and the increased content of FPN1 mainly existed in cytoplasm.Conclusion In the foam cells the iron metabolism is disordered and a great quantity of FPN1 is accumulated in cytoplasm.The non-cell-membrane localization of FPN1 can prevent iron from being effectively discharged from macrophages and can increase the accumulation of iron in foam cells,which may aggravate the formation and development of AS plaques.
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Objective To investigate the effect of prolonged stroboscopic illumination exposure on the growth of eyeball of guinea pig. Methods Thirty 2-week-old guinea pigs were randomized into three groups ( n=10 for each) . Two strobe-reared groups were raised with 20 Hz sinusoidal and 20 Hz square wave stroboscopic illumination, respectively. The control group received usual light illumination. The illumination intensity was 500 lux. All animals underwent refraction and biometric measurements prior to and after 2, 4, 6 and 8 weeks of treatment. Finally, flash electroretinograms were com-pared, and retinal microstructures were examined. Results There was a significant correlation between refractive errors and axial eye elongation, and myopia increasing was observed with eye elongation. After 8 weeks of treatment, the animals raised in 20 Hz sinusoidal and 20 Hz square wave stroboscopic illumination were (-0. 75 ± 0. 79)D and (-1. 50 ± 0. 91) D more myopic than the group raised in continuous illumination. The implicit time of the a-wave was delayed by 3. 8 and 7. 9 ms, respectively. No significant difference was found in retinal ultrastructures among the three groups. Conclusions Chronic exposure to 20 Hz sinusoidal or square wave stroboscopic illumination alters the emmetropization of the guinea pig eye to some extent.
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<p><b>OBJECTIVE</b>To investigate the theraputic effects of carotid endarterectomy (CEA) on cognitive function in patients with carotid stenosis (CAS) and congnitive impairment.</p><p><b>METHODS</b>CEA was performed on 38 patients with CAS from December 2011 to July 2013. There were 26 male and 12 female patients, with an average age of (70 ± 7) years. Patients was underwent neuropsychological examinations (NPEs) including Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) at 1 week before and 6 weeks after treatment. Cerebral perfusion was assessed with MR perfusion-weighted imaging and diffusion-weighted inmaging at 1 week before and 6 weeks after treatment.</p><p><b>RESULTS</b>All of the 38 patients completed NPEs and MRI at baseline and 6 weeks after CEA. After therapy, the parameters and the extents of abnormal perfusion was improved, including the decrease of time to peak (29 ± 9 vs. 23 ± 4), relative mean transit time (22 ± 8 vs. 14 ± 6), arrive time (21 ± 8 vs. 15 ± 4) and relative cerebral blood volume (11.6 ± 3.5 vs. 7.5 ± 3.2) (t = 1.31 to 5.24, all P < 0.05). Significant improvement in MoCA (20.4 ± 1.5 vs. 22.0 ± 1.6, t = -4.25, P = 0.000) but MMSE (26.16 ± 1.35 vs. 26.47 ± 1.52, t = -0.96, P = 0.341) was observed. CEA significantly improved the assessment of visuospacial/constructive abilities (2.4 ± 0.9 vs. 2.8 ± 0.7), naming (2.0 ± 0.7 vs. 2.3 ± 0.6), abstraction (1.2 ± 0.7 vs. 1.6 ± 0.6) and attention (2.3 ± 0.6 vs. 2.6 ± 0.5) (t = 0.015 to 0.029, P = 0.015).</p><p><b>CONCLUSION</b>CEA can improve the cognitive function of patients with carotid stenosis as well as the cerebral perfusion of patients and has therapeutic effects on vascular mild cognitive impairment.</p>
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Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Carotid Stenosis , General Surgery , Cognition , Cognitive Dysfunction , Endarterectomy, Carotid , Neuropsychological Tests , Prospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To evaluate the feasibility and efficacy of hybrid procedure for the treatment of multi-level iliac and common femoral occlusive disease.</p><p><b>METHODS</b>From January 2008 to June 2011, 36 lower limbs with sever iliac and common femoral occlusive diseases were treated by iliac artery stenting combined with open femoral endarterectomy. The mean age of the whole study population was 65 years (range 49 to 87 years) with a male predominance (26 males, 72.2%). The early clinical results were determined by ankle brachial index and intermittent claudication distance. Patency analyses were performed using Kaplan-Meier life tables. Univariate and multivariate analysis were used to assess the influence of various risk factors on primary patency.</p><p><b>RESULTS</b>All lower limbs underwent successful hybrid surgical and endovascular therapy. Clinical improvement was seen in 94.4% of patients. The mean duration of follow-up was 24.2 months, overall, the primary patency rates, primary assisted patency rates and second patency rates were 72.2%, 83.3% and 94.4% respectively. The primary patency rate for intermittent claudication was significantly higher than that for critical limb ischemia (P = 0.041, 0.012). Cox regression analysis did not reveal any independent predictor of primary patency.</p><p><b>CONCLUSION</b>Hybrid procedures provided an effective treatment management of multilevel iliac-femoral arterial occlusive disease.</p>
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Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Angioplasty, Balloon , Arterial Occlusive Diseases , General Surgery , Endarterectomy , Feasibility Studies , Femoral Artery , General Surgery , Follow-Up Studies , Iliac Artery , General Surgery , Retrospective Studies , Treatment OutcomeABSTRACT
Venous valve plays an important role in regulating the venous flow,especially in preventing the blood backflow.It has heen observed that when deep vein thrombosis and dissolved,the valves in the lesions had been destroied or dysfunction.The mechanism of damage of vein valve has not been fully clarified,but as we know,it's common that the inflammatory reaction,due to many unfavorable factors,can cause thrombosis.On the other hand,deep vein thrombosis could bring out the inflammatory reaction as well.So the author will review the development of researching of the destruction of venous valves in recent years.