Application of Insect Medicines in Treatment of Coronary Microvascular Dysfunction Based on Comorbidity Theory of "Blood-Vessel-Cardiac Collaterals" / 中国实验方剂学杂志

Coronary microvascular dysfunction （CMD） is one of the important causes of myocardial ischemia and non-obstructive coronary artery ischemic symptoms. However， effective diagnostic methods and targeted treatment strategies for CMD are currently lacking. According to traditional Chinese medicine （TCM）， the comorbidity theory of "blood-vessel-cardiac collaterals" plays a central role throughout the entire development process of CMD. It suggests that in the clinical diagnosis and treatment of CMD， the treatment of blood， vessels， and cardiac collaterals should not be neglected. In light of this， insect medicines， known for their efficacy in promoting blood circulation， resolving stasis， and alleviating spasms， hold promise as a potential treatment for CMD. However， there is currently no research or summary on the use of insect medicines for the treatment of CMD. Therefore， this article took the comorbidity theory of "blood-vessel-cardiac collaterals" as the starting point and divided the pathogenesis of CMD into five evolution stages： Beginning in the blood （changes in blood components and hemorheology）， progressing in the vessels （atheromatous plaque formation and unstable plaques）， occurring in the cardiac collaterals （microvascular endothelial damage and microvascular constriction and spasms）， ending in the cardiac collaterals （microvascular remodeling）， and resulting in energy metabolism disorders throughout the process， so as to explore the pathogenesis and evolution of CMD. In addition， based on the modern pharmacological research on insect medicines， this article discussed the clinical application of insect medicines in the treatment of CMD from four aspects： Promoting blood circulation and removing blood stasis to relieve vessels' obstruction， relieving spasms to alleviate pain， combating poison with poison to disperse stagnation， and tonifying cardiac collaterals to nourish the heart， which aims to provide a theoretical basis for the use of TCM in treating CMD， broaden the scope of medication， and improve clinical efficacy.

Mechanism by which Notch1 interference regulates the apoptosis of pulmonary microvascular endothelial cells / 中国基层医药

Objective:To investigate the mechanism of how Notch1 interference regulates the apoptosis of pulmonary vascular endothelial cells.Methods:During January to December 2022, human pulmonary microvascular endothelial cells were transfected with Notch1 siRNA, and the cell viability in each group was evaluated using the Cell Counting Kit-8 assay. The level of reactive oxygen species was determined using flow cytometry, while cell apoptosis was assessed using the same technique. After treatment with Notch1 siRNA, the protein expression levels of Notch1, Bcl-2, and Caspase-3 in the human pulmonary microvascular endothelial cells were detected using western blot assay.Results:The expression level of Notch1 mRNA in human pulmonary microvascular endothelial cells was significantly lower in the blank control and si-Notch1 groups than that in the siNC group ( t = 11.25, 9.47, both P < 0.05). Additionally, the optical density value and Bcl-2 protein expression level in the lipopolysaccharide (LPS) + Notch1 siRNA group were significantly higher than those in the LPS and LPS + siRNA groups ( t = 11.26, 11.68, both P < 0.05). The level of reactive oxygen species and the apoptosis rate of cells were significantly lower in the LPS + Notch1 siRNA group compared with the LPS and LPS + siRNA groups ( t = 11.68, 11.87, both P < 0.05). Furthermore, the protein expression levels of Notch1 and Caspase-3 were also significantly lower in the LPS + Notch1 siRNA group compared with the LPS and LPS + siRNA groups ( t = 5.08, 6.60, 3.84, 5.83, all P < 0.05). Conclusion:Notch1 interference may interference in the apoptosis of human pulmonary microvascular endothelial cells through regulating the level of reactive oxygen species, downregulating the protein expression of Notch1 and Caspase-3, and upregulating the protein expression of Bcl-2. These actions may contribute to the treatment of chronic obstructive pulmonary disease.

Ultrasound vector flow imaging combined with singular value decomposition filtering for depicting deep microvasculature flow velocity of liver / 中国医学影像技术

Objective To observe the value of ultrasound vector flow imaging(VFI)combined with singular value decomposition(SVD)filtering for depicting deep microvasculature flow velocity of liver.Methods Grayscale ultrasound,CDFI and contrast-enhanced ultrasound(CEUS)were prospectively performed in a patient with suspected liver hemangioma.Images of CEUS were dealt with SVD filtering.Cross-correlation algorithm was used to obtain images of VFI based on grayscale ultrasound,original CEUS and SVD filtered CEUS,respectively,and the ability of the above images for depicting liver microvascular flow direction and velocity were compared.Results The signal-to-noise ratio(SNR)of liver grayscale ultrasound,original CEUS and SVD filtered CEUS images was 7.56,17.65 and 22.43 dB,respectively,while their contrast-to-issue ratio(CTR)was 1.12,7.56 and 16.34 dB,respectively.Compared with VFI based on grayscale ultrasound and original CEUS,VFI based on SVD filtered CEUS could display faster velocity and more uniform direction of blood flow.Before and after SVD filtering,liver microvascular flow velocity measured with VFI was 1.91(0.81,4.11)and 6.83(4.25,9.41)mm/s,respectively,which were significantly different(Z=-10.671,P＜0.001).Conclusion Combined with SVD filtering could significantly improve the efficiency of VFI for depicting liver deep microvasculature flow velocity.

Treatment For Infected Frozen Elephant Trunk Prosthesis Caused by Propionibacterium acnes: A Surgical Challenge

ABSTRACT In this article, we present the case of a 47-year-old man who underwent Bentall-Bono procedure and frozen elephant trunk prosthesis implantation due to severe aortic regurgitation and aortic dilatation with a second-time endovascular stent-graft repair in descending aorta. Over eight years, a subacute graft infection by Propionibacterium acnes was developed, culminating in cardiogenic shock secondary to severe aortic regurgitation due to a complete aortic root dehiscence because of multiple aortic pseudoaneurysms. The patient underwent emergency surgery in which the replacement of the graft by a biological valve tube was performed accompanied by a complete debranching of the three supra-aortic vessels.

Evaluation of the mesenteric arterial vasculature by computed tomography angiography and its implications for colorectal cancer surgery / Avaliação da vasculatura arterial mesentérica pela angiotomografia computadorizada e suas implicações na cirurgia do câncer colorretal

Abstract Objective: To determine the branching patterns of the inferior mesenteric artery (IMA) and to describe the clinical applicability of computed tomography (CT) angiography in the evaluation of these vessels to facilitate the planning of colorectal cancer surgery. Materials and Methods: We included 100 patients who underwent CT angiography of the abdomen and pelvis. The branching patterns of the IMA were examined and classified as type 1 (bifurcated), including 1A (sigmoid and left colic arteries arising from a common trunk), 1B (sigmoid and superior rectal arteries arising from a common trunk) and 1C (sigmoid arteries arising from both trunks); type 2 (trifurcated); and type 3 (no left colic branch). Results: Among the 100 patients evaluated, we found the variant to be type 1A in 9%, type 1B in 47%, type 1C in 24%, type 2 in 16%, and type 3 in 4%. Conclusion: Preoperative CT angiography for evaluating the IMA branching pattern could inform decisions regarding the surgical approach to colorectal cancer.

Resumo Objetivo: Determinar os padrões de ramificação da artéria mesentérica inferior (AMI) e descrever a aplicabilidade clínica da angiografia por tomografia computadorizada na avaliação desses vasos na elaboração das estratégias pré-operatórias de cirurgia de câncer colorretal. Materiais e Métodos: Foram incluídos 100 pacientes submetidos a angiografia por tomografia computadorizada abdominal e pélvica. Os padrões de ramificação da AMI foram examinados e classificados como tipo 1 (bifurcado), incluindo 1A (artérias sigmoide e cólica esquerda originando-se de um tronco comum), 1B (artérias sigmoide e retal superior originando-se de um tronco comum) e 1C (artérias sigmoide originando-se de ambos os troncos); tipo 2 (trifurcado); e tipo 3 (sem ramo cólico esquerdo). Resultados: Do total de participantes incluídos no estudo, a variante do tipo 1A foi observada em 9%, a do tipo 1B em 47%, e a do tipo 1C em 24%. Com relação à variante tipo 2, esta foi observada em 16% dos pacientes, e a do tipo 3, em 4% dos casos. Conclusão O uso da angiografia por tomografia computadorizada pré-operatória para avaliar o padrão de ramificação da AMI pode ajudar a escolher a abordagem cirúrgica no câncer colorretal.

Variaciones morfológicas de la glándula submandibular en ratas obesas por acción de glutamato monosódico / Morphological variations of the submandibular gland in obese rats by the action of monosodium glutamate

Este estudio tuvo como objetivo demostrar la existencia de variaciones morfológicas en el tejido conectivo de la glándula submandibular de ratas obesas expuestas a glutamato monosódico (GMS). Se utilizaron 12 ratas Sprague Dawley machos recién nacidas (6 ratas para el grupo 1, control; 6 ratas para el grupo 2 (GMS), 4 mg/g de glutamato monosódico de peso (5 dosis) mantenidas por 16 semanas respectivamente con una dieta y agua ad libitum. En el estudio se realizó un análisis estereológico e histológico, demostrándose una variación en el tejido conectivo presentando una disminución del volúmen glandular, mayor fibrosis, y disminución de adipocitos a nivel periférico siendo reemplazado por tejido rico en colágeno. Los vasos sanguíneos observados a nivel estereológico no presentan mayores cambios en cuanto a volumen, superficie y área.

SUMMARY: This study aims to demonstrate the existence of morphological variations in the connective tissue of the submandibular gland of obese rats exposed to MSG. Twelve male newborn Sprague Dawley rats were used (6 rats for group 1, control; 6 rats for group 2 (MSG), 4 mg/g of monosodium glutamate of weight (5 doses) maintained for 16 weeks respectively with a diet and water ad libitum. In the study, a stereological and histological analysis was carried out, demonstrating a variation in the connective tissue, presenting a decrease in the glandular volume, greater fibrosis, and a decrease in adipocytes at the peripheral level, being replaced by tissue rich in collagen. Blood cells observed at the stereological level do not present major changes in terms of volume, surface and area, but in the histological study greater vascularization is observed.

Effects of Coating Method on Fabrication Quality of Flexible Silicone Blood Vessels / 医用生物力学

Objective To investigate the effect of different coating methods on production quality of complex and flexible silicone vascular replicas. Methods Based on models of anterior communicating artery aneurysms, several patient-specific models were made by using spray-coating method and brush-spin-coating method respectively, and two methods for making the same vascular structure were quantitatively compared in terms of thickness growth, circumferential uniformity and light transmittance. Results Brush-spin-coating method was better than spray-coating method in the thickness control and coating uniformity for fabrication of vessels with large curvature, variable diameter and straight tube, and the model had preferably light transmittance and surface smoothness. The relative deviation of thickness by brush-spin-coating method was decreased by 8. 9% , 10. 8% and 16. 9% respectively compared with spray-coating method. Conclusions At present stage, the brush-spin coating method has the advantage of thickness uniformity and light transmittance over the spray-coating method in making silicone phantoms, and it has promising application prospects in fluid mechanics field of in vitro experiment on large vessels.

Preparation of vascular endothelial cell hypoxia/reoxygenation model / 国际外科学杂志

The vascular endothelial cells (VECs) hypoxia/reoxygenation(H/R) model is a classic cell model that simulates vascular endothelial ischemia/reperfusion (I/R) injury and related diseases. It has the advantages of convenient operation, intuitive image, and good stability, and can accurately reflect pathological changes at the cellular level of diseases. It is widely used in the study of molecular mechanisms of drugs and diseases.There are many similarities in the mechanism and formation between the H/R model and the I/R injury model, but the I/R model is more complex. Therefore, in recent years, many scholars have used the H/R model to simulate the I/R model for experimental research, and believe that the H/R model is also an ideal model for studying I/R. By implementing intervention measures on the established H/R model of VECs, the potential effects of the intervention measures in clinical practice can be verified, which has guiding significance for how to prevent, treat, and how to exacerbate I/R injury in clinical practice. This article introduces the different methods used by scholars in recent years, such as medium deoxygenation and mixed gas culture method, to construct H/R models using VECs cultured in vitro to simulate I/R models. The differences in methods used and the subtle differences between the same methods are also discussed. At the same time, due to the relatively single method of constructing H/R models at present, how to find new, more efficient and affordable methods based on scientific and reasonable experiments has also become a focus of attention.

Research advances in role of angiogenesis in diabetic ulcer and traditional Chinese medicine intervention / 中国中药杂志

Diabetic ulcer(DU) is one of the common complications of diabetes often occurring in the peripheral blood vessels of lower limbs or feet with a certain degree of damage. It has high morbidity and mortality, a long treatment cycle, and high cost. DU is often clinically manifested as skin ulcers or infections in the lower limbs or feet. In severe cases, it can ulcerate to the surface of tendons, bones or joint capsules, and even bone marrow. Without timely and correct treatment, most of the patients will have ulceration and blackening of the extremities. These patients will not be able to preserve the affected limbs through conservative treatment, and amputation must be performed. The etiology and pathogenesis of DU patients with the above condition are complex, which involves blood circulation interruption of DU wound, poor nutrition supply, and failure in discharge of metabolic waste. Relevant studies have also confirmed that promoting DU wound angiogenesis and restoring blood supply can effectively delay the occurrence and development of wound ulcers and provide nutritional support for wound healing, which is of great significance in the treatment of DU. There are many factors related to angiogenesis, including pro-angiogenic factors and anti-angiogenic factors. The dynamic balance between them plays a key role in angiogenesis. Meanwhile, previous studies have also confirmed that traditional Chinese medicine can enhance pro-angiogenic factors and down-regulate anti-angiogenic factors to promote angiogenesis. In addition, many experts and scholars have proposed that traditional Chinese medicine regulation of DU wound angiogenesis in the treatment of DU has broad prospects. Therefore, by consulting a large number of studies available, this paper expounded on the role of angiogenesis in DU wound and summarized the research advance in traditional Chinese medicine intervention in promoting the expression of angiogenic factors [vascular endothelial growth factor(VEGF), fibroblast growth factor(FGF), and angiopoietin(Ang)] which played a major role in promoting wound angiogenesis in the treatment of DU to provide ideas for further research and new methods for clinical treatment of DU.

Mechanism of hydrogen sulfide in tumorigenesis and development and its donor-mediated anti-tumor effects / 国际肿瘤学杂志

Hydrogen sulfide is a gas signaling molecule in the human body that can influence angiogenesis, regulate tumor cell apoptosis and autophagy, and interact with other signaling molecules in the tumor microenvironment. It plays a role in inhibiting tumorigenesis and development through various pathways. Hydrogen sulfide donors primarily exhibit anti-tumor effects, and many studies are focused on using various donors to release hydrogen sulfide in a controlled manner and maintain therapeutic concentrations. Traditional Chinese medicine shows great potential. The mechanisms of hydrogen sulfide action are complex and diverse, and further research is needed to explore and confirm them, providing a theoretical basis for the development of therapeutic drugs regulating hydrogen sulfide.

Effects of Yishen Ruanjian Powder on endometrial vascular remodeling in a mouse model of dysfunctional uterine bleeding / 中成药

AIM To explore the effects of Yishen Ruanjian Powder on endometrial vascular remodeling in a mouse model of dysfunctional uterine bleeding(DUB).METHODS Forty female pregnant mice were randomly divided into the control group,the model group,Gongxuening Capsule group and Yishen Ruanjian Powder group,with 10 mice in each group.The mouse models were given mifepristone(8.5 mg/kg)and misoprostol(100 μg/kg)by gavage to prepare DUB mouse model,in contrast to those of the control group given the same volume of normal saline.On the first day after successful modeling,the control group and model group were given normal saline,and the other two groups went on with their 7-day regime of Gongxuening Capsule(0.07 g/kg)and Yishen Ruanjian Powder decoction(28.9 g/kg),respectively.After the administration,the mice had their endometrial pathological changes observed by HE staining;their endometrial expression of α-SMA protein detected by immunohistochemistry;their endometrial activities of Ang Ⅱ and NO,and serum levels of FSH,LH,E2 and P hormones detected by ELISA;their endometrial protein expressions of VEGF,bFGF,MMP-9 and TGF-β detected by Western blot;and theirendometrial apoptosis detected by TUNEL.RESULTS Compared with the control group,the model group displayed disordered arrangement in the endometrial epithelial cells;thinner endometrium thickness(P<0.01);decreased endometrial NO activity and the expressions of α-SMA and VEGF(P<0.01);increased Ang Ⅱ activity,apoptosis rate and protein expressions of bFGF,MMP-9 and TGF-β(P<0.01);increased serum levels of E2,FSH,and P hormones(P<0.01);and decreased LH level(P<0.01).Compared with the model group,Yishen Ruanjian Powder and Gongxuening Capsule groups displayed superior efficacy in terms of the improvements in all aforementioned incices levels(P<0.05,P<0.01).CONCLUSION Yishen Ruanjian Powder may improve endometrial vascular remodeling disorder in mouse models of DUB by regulating the level of vasoactive substances and the expression of growth factors.

Research progress on vascularization of organoids / 生物医学工程学杂志

Organoids are three-dimensional structures formed by self-organizing growth of cells in vitro, which own many structures and functions similar with those of corresponding in vivo organs. Although the organoid culture technologies are rapidly developed and the original cells are abundant, the organoid cultured by current technologies are rather different with the real organs, which limits their application. The major challenges of organoid cultures are the immature tissue structure and restricted growth, both of which are caused by poor functional vasculature. Therefore, how to develop the vascularization of organoids has become an urgent problem. We presently reviewed the progresses on the original cells of organoids and the current methods to develop organoids vascularization, which provide clues to solve the above-mentioned problems.

Scaffolds Vasculares Descelularizados Provenientes de Vasos Sanguíneos de Placenta Bovina / Decellularized Vascular Scaffolds Derived from Bovine Placenta Blood Vessels

Resumo Fundamento As doenças associadas ao aparelho circulatório são as principais causas de morbidade e mortalidade em todo o mundo, implicando a necessidade de implantes vasculares. Assim, a produção de biomateriais vasculares tem se mostrado uma alternativa promissora às terapias utilizadas em estudos e pesquisas relacionados à fisiologia vascular. Objetivos O presente projeto visa ao desenvolvimento artificial de vasos sanguíneos pela recelularização de scaffolds vasculares derivados de vasos placentários bovinos. Métodos A superfície corioalantoide da placenta bovina foi utilizada para produzir biomateriais descelularizados. Para a recelularização, 2,5 x 104 células endoteliais foram semeadas acima de cada fragmento de vaso descelularizado durante três ou sete dias, quando a cultura foi interrompida e os fragmentos foram fixados para análise de adesão celular. Biomateriais descelularizados e recelularizados foram avaliados por histologia básica, microscopia eletrônica de varredura e imuno-histoquímica. Resultados o processo de descelularização produziu vasos que mantiveram a estrutura natural e o conteúdo de elastina, e não foram observadas células e gDNA remanescentes. Além disso, células precursoras endoteliais se ligaram ao lúmen e à superfície externa do vaso descelularizado. Conclusão nossos resultados mostram a possibilidade de usos futuros desse biomaterial na medicina cardiovascular, como, por exemplo, no desenvolvimento de vasos artificiais.

Background Diseases associated with the circulatory system are the main causes of worldwide morbidity and mortality, implying the need for vascular implants. Thus, the production of vascular biomaterials has proven to be a promising alternative to therapies used in studies and research related to vascular physiology. Objectives The present project aims to achieve the artificial development of blood vessels through the recellularization of vascular scaffolds derived from bovine placental vessels. Methods The chorioallantoic surface of the bovine placenta was used to produce decellularized biomaterials. For recellularization, 2.5 x 104 endothelial cells were seeded above each decellularized vessel fragment during three or seven days, when culture were interrupted, and the fragments were fixed for cell attachment analysis. Decellularized and recellularized biomaterials were evaluated by basic histology, scanning electron microscopy, and immunohistochemistry. Results The decellularization process produced vessels that maintained natural structure and elastin content, and no cells or gDNA remains were observed. Endothelial precursor cells were also attached to lumen and external surface of the decellularized vessel.Conclusion: Our results show a possibility of future uses of this biomaterial in cardiovascular medicine, as in the development of engineered vessels.

Diretrizes brasileiras de diagnóstico e tratamento de lesões vasculares traumáticas / Brazilian guidelines on diagnosis and management of traumatic vascular injuries

Resumo Trauma é uma causa importante de morbimortalidade, que acomete principalmente jovens. A hemorragia incoercível é o principal mecanismo de óbito precoce nessas vítimas, e as lesões vasculares não compressíveis representam grandes desafios para os cirurgiões. O traumatismo vascular impacta diretamente a viabilidade de membros traumatizados, aumentando o risco de amputação. Nas últimas décadas, muitas condutas de diagnóstico e tratamento de lesões vasculares traumáticas foram modificadas. A angiotomografia suplantou a angiografia como padrão ouro para diagnóstico, as técnicas endovasculares foram incorporadas ao arsenal terapêutico e o conceito de "controle de danos" foi estabelecido. No entanto, há lacunas na literatura nacional sobre a normatização de condutas em trauma vascular, principalmente considerando as limitações do Brasil. Por isso, a Sociedade Brasileira de Angiologia e de Cirurgia Vascular e a Sociedade Brasileira de Atendimento Integrado ao Traumatizado revisaram a literatura disponível sobre trauma vascular e organizaram diretrizes sobre o diagnóstico e tratamento dessas lesões.

Abstract Trauma is a leading cause of death, permanent disability, and health care cost worldwide. The young and economically active are the most affected population. Exsanguination due to noncompressible torso hemorrhage is one of the most frequent causes of early death, posing a significant challenge to trauma and vascular surgeons. The possibility of limb loss due to vascular injuries must also be considered. In recent decades, the approach to vascular injuries has been significantly modified. Angiotomography has become the standard method for diagnosis, endovascular techniques are currently incorporated in treatment, and damage control, such as temporary shunts, is now the preferred approach for the patients sustaining physiological derangement. Despite the importance of this topic, few papers in the Brazilian literature have offered guidelines on vascular trauma. The Brazilian Society of Angiology and Vascular Surgery has developed Projetos Diretrizes (Guideline Projects), which includes this publication on vascular trauma. Since treating trauma patients is a multidisciplinary effort, the Brazilian Trauma Society (SBAIT) was invited to participate in this project. Members of both societies reviewed the literature on vascular trauma management and together wrote these guidelines on vascular injuries of neck, thorax, abdomen, and extremities.

Endometrial blood vessel morphometry in patients presenting with abnormal uterine bleeding

Background: Abnormal uterine bleeding (AUB) is one of the most common problems encountered in gynecological practice. Various benign and malignant disorders of the endometrial tissue show vascular changes such as congestion, dilatation, and vessel wall irregularities. Aim: To evaluate the vascular morphometry of the endometrial tissue in AUB. Materials and Methods: A descriptive cross-sectional study of the endometrial tissue in patients presented with AUB was undertaken for vascular morphometric analysis. Histopathological processing of the endometrial tissue samples was done as per the standard format, and the slides were evaluated for vascular morphometry. Results: Out of 150 cases of endometrial tissue in patients presented with AUB, 80 cases were reported as proliferative phase, 41 as secretory phase, 15 as disordered proliferative endometrium, 6 as atrophic phase endometrium, and 4 each of endometrial hyperplasia without atypia and endometrial carcinoma. An average number of endometrial blood vessels and large-sized blood vessels were more in endometrial carcinoma and endometrial hyperplasia without atypia as compared to proliferative phase, secretory phase, atrophic endometrium, and disordered proliferative endometrium. Vessel shape irregularities and vascular congestion were observed in all the cases of atrophic endometrium, endometrial carcinoma, and endometrial hyperplasia without atypia. Endometrial carcinoma showed severe dilatation of the endometrial blood vessels. Conclusion: Vascular morphometry changes were noted in endometrial hyperplasia, endometrial carcinoma, disordered proliferative endometrium, and atrophic phase endometrium. These findings suggest that studies or trials related to anti-angiogenic therapy may help to plan anti-angiogenic therapy in patients with AUB.

Correlation between myopia and choroidal thickness / 国际眼科杂志(Guoji Yanke Zazhi)

@#Myopia is a global public problem that causes visual impairment. Its occurrence and development are often accompanied by changes in the various structures of the eye, especially pathological myopia, which involves degenerative changes in the sclera, choroid, and retina. In recent years, with the increasing prevalence of myopia, the exploration of pathological mechanism and the prevention and treatment of myopia have become an important issue that cannot be ignored in the world. The occurrence and development of myopia involves the participation of many factors and can cause serious visual damage. As an important vascular tissue in the eye, the thickness change of choroid has been proved to play a vital role in the occurrence and development of myopia. In order to comprehensively and effectively prevent and control the occurrence and development of myopia, especially high myopia, the change of myopic choroidal thickness and its related mechanisms should be one of the main directions of the pathological mechanism of myopia. This article reviews the research of changes of myopia choroidal thickness by domestic and foreign scholars in recent years, to discuss the relationship between choroidal thickness, choroidal vasculature, choroidal molecular changes and myopia, myopia-related complications, and myopia-related visual impairment. Provide new ideas on prevention and intervention of myopia.

The clinical value of 5.0 T ultra-high field MRI in assessing intracranial arteries and branches / 中华放射学杂志

Objective:To evaluate the clinical value of 5.0 T ultra-high filed MRI system in assessing intracranial arteries segments and vessel branchers.Methods:This study was a prospective study. Totally 40 consecutive healthy volunteers were recruited from Zhongshan Hospital, Fudan University from September 1, 2021 to November 30, and all participants who underwent either 3.0 T or 5.0 T time-of-flight MR angiography (TOF-MRA) in random order were divided into 3.0 T MR group and 5.0 T MR group with 20 volunteers for each group. Image quality was assessed by Likert 5 scoring systems and signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR),and score in visualization of intracranial arteries [middle cerebral artery (MCA) and its segments, anterior cerebral artery (ACA) and its segments, posterior cerebral artery (PCA) and its segments, lenticulostriate arteries (LA) and pontine artery (PA)] were assessed from 0 to 3 (≥2: good depiction of vessel segment). Quantitative indicators were compared between 2 groups using independent t test or Mann-Whitney U test. Results:Among the 40 subjects, there were 29 males and 11 females, aged 20-69 (50±12) years. SNR and CNR were both significantly higher in 5.0 T MR group than those in 3.0 T MR group (SNR: 187±9 vs 91±4, t=31.59, P<0.001; CNR: 156±7 vs 70±4, t=31.45, P<0.001), but there was no significant difference in subjective scores of image quality between the 5.0 T MR and 3.0 T MR groups [5.0 (4.0, 5.0), 5.0 (5.0, 5.0) points, respectively, Z=-1.23, P=0.218]. In the evaluation of cerebral arteries, the visualizations of the proximal and middle segments of MCA, ACA and PCA was better than those in the 3.0 T MR group, and there was no significant difference in the scores ( P>0.05), while the visualizations of proximal arteries in the 5.0 T MR group were significantly better than those in the 3.0 T MR group ( P<0.05). Furthermore, small vessel branches such as LA and PA in 5.0 T MR group were visualized better than those in 3.0 T MR group ( P<0.001). Conclusion:TOF-MRA by ultra-high filed 5.0-T provides an optimal choice in visualization of distal large arteries and small vessel branches, which could be useful for the diagnosis on cerebral vascular disease.

Surgical treatment strategy for pancreatic cancer with invasion of spleno-mesenterico-portal cofluence / 中华肝胆外科杂志

Pancreatic cancer is one of the most common malignant digestive tumors with high malignancy and poor five-year survival. Due to the biological behavior of tumor and local adjacency, pancreatic cancer is frequently invaded to adjacent portal vein, superior mesenteric vein, and splenic vein, making surgical resection difficult. For pancreatic cancer with invasion of spleno-mesenterico-portal confluence, the difficulty of surgical R 0 resection is further increased, so it is important to reasonably resect the invaded vessels and complete vascular reconstruction. In this research, we summarized the different revascularization approaches in our center, aiming to analyze the surgical treatment strategy for pancreatic cancer with invasion of spleno-mesenterico-portal confluence.