Proteomics analysis of distinct proteins in human atherosclerosis obliterans: identification and verification / 中华外科杂志

<p><b>OBJECTIVE</b>To identify distinct proteins involved in human atherosclerosis obliterans (ASO) by a differential proteomic approach.</p><p><b>METHODS</b>Eight atherosclerotic femoral arteries with a mean age of 68.6 years (6 male and 2 female) and 5 normal femoral arteries with a mean age of 44.2 years (3 male and 2 female) were obtained from high amputation patients. Then the first 2-dimensional maps of the proteome of human femoral arteries was plotted to compare ASO and control specimens. Proteomic profiling was to differentiate and identify histological proteins that were associated with ASO. The differentially expressed proteins were sequenced by matrix assisted laser desorption/ionization mass spectrometry (MALDI-TOF-MS). The result was verified by immunohistochemistry (IHC) and Western blot.</p><p><b>RESULTS</b>ASO was associated with distinct patterns of protein expression in the femoral arteries. A total of 25 distinct spots corresponding to 13 different proteins were identified by MALDI-TOF-MS using the NCBI and IPI databases. These proteins were mainly involved in the pathogenetic mechanisms such as inflammation, oxidative stress, proliferation and transformation of SMCs. The low level of heat shock protein 27 (HSP27) in ASO was verified by IHC and western-blot in accord with the result of MS.</p><p><b>CONCLUSION</b>Proteomic analysis can be used to investigate differentially expressed proteins, which may provide new insights into ASO pathogenesis, such as HSP27.</p>

Endovascular angioplasty for the treatment of long iliac artery chronic total occlusions / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effectiveness, safety and feasibility of endovascular angioplasty in treating long iliac artery chronic total occlusions (CTO).</p><p><b>METHODS</b>The clinical data from a consecutive series of patients with long (> 5 cm) iliac artery CTO who treated by endovascular angioplasty from January 2006 to December 2010 was retrospectively analyzed. There were 139 patients (157 limbs) with long iliac artery CTO treated by endovascular angioplasty in this study [male 93 and female 46, mean age (77 ± 10) years]. According to TASC II classification, there were 18 patients in type B, 89 patients in type C and 32 patients in type D. Recanalization of the occluded lesions was attempted with the left brachial and/or femoral access.</p><p><b>RESULTS</b>The ankle brachial index increased from 0.42 ± 0.19 before treatment to 0.81 ± 0.26 after treatment. The rate of technical success was 96.2% (151/157) and the patency rate of iliac artery was 94.1% (111/118) during the follow-up. Significant restenosis or reocclusion was found in 7 iliac lesions and there were no major interventional complications, such as iliac artery rupture, stent displacement, pseudoaneurysms, and arteriovenous fistula.</p><p><b>CONCLUSIONS</b>Endovascular angioplasty is an effective, safe and feasible method in treating long iliac CTO with high patency rate. Combined left brachial and femoral access can increase the technical success rate significantly.</p>

Surgical treatment of visceral artery aneurysms / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the experience with diagnosis and surgical treatment of visceral artery aneurysms (VAAs).</p><p><b>METHODS</b>From June 2003 to December 2008, 8 patients (2 male and 6 female) with 9 VAAs underwent surgical treatment. Mean age was 49 years (ranged from 30 to 72 years). The site of aneurysmal disease was splenic artery in 4 cases, superior mesenteric artery in 2 cases, renal artery in 2 cases (3 aneurysms). In 1 patient of splenic artery aneurysm, portal vein hypertension coexisted. All the VAAs of preoperative diagnostic workup consisted of a ultrasound, computed tomography (CT) scan, and digital subtraction angiography. Six patients were operated on and two patients was treated with endovascular procedures. Only one small VAAs was treated with follow-up.</p><p><b>RESULTS</b>No deaths or major complications occurred in the perioperative period. All the patients remained symptom free during a follow-up of 26.5 months (ranged from 2 to 60 months). Follow-up consisted of clinical and ultrasound scan examinations or CT scan at 1 and 6 months, and yearly thereafter.</p><p><b>CONCLUSIONS</b>Aggressive approach to the treatment of VAAs is essential. Elective open surgical treatment and an endovascular procedure of visceral artery aneurysms are both safe and effective, and offers satisfactory early and long term results. There is some evidence that small (< 2 cm) and asymptomatic VAAs may be safely observed.</p>

Gene expression difference analysis between abdominal aorta aneurysm and normal abdominal artery / 中华外科杂志

<p><b>OBJECTIVE</b>To identify gene expression differences between abdominal aorta aneurysm (AAA) and normal abdominal artery.</p><p><b>METHODS</b>Five AAA specimens and five normal abdominal artery specimens were collected. Total RNA was extracted and purified from the samples independently. Then isolated RNA was labeled and hybridized onto the Affymetrix Genechip.</p><p><b>RESULTS</b>One thousand nine hundreds and sixty-two differently expressed genes were identified in AAA compared with normal abdominal artery, of which 554 genes were up-regulated and 1408 genes were down-regulated. Functional analysis revealed that genes involved in immune response, inflammatory response and chemokines were significantly up-regulated in AAA.</p><p><b>CONCLUSION</b>The differently expressed genes may be useful in providing new insights and foster a better understanding of the mechanism of AAA.</p>