[Endovascular abdominal aortic aneurysm repair with a new stent graft:early results from a multicenter study].

Objective: To examine the safety and effectiveness of a new stent graft system for endovascular repair of abdominal aortic aneurysm(AAA). Methods: This is a prospective,multi-center,single-arm clinical trial. The patients with AAA treated with a new stent graft system were enrolled at 21 centers from September 2018 to September 2019 in China. Follow-up was performed before discharge, and at 30, 180, 360 days after operation, respectively. The primary safety endpoint was the incidence of major adverse events(MAE) within 30 days. The primary efficacy endpoint was the success rate of AAA treatment at 360 days. Secondary safety endpoints were the incidence of perioperative access complications and acute lower limb ischemia,all-cause mortality, AAA related mortality and incidence of serious adverse events (SAE) at 180 and 360 days. Secondary efficacy endpoints were the incidence of type Ⅰ or Ⅲ endoleak,stent displacement,and conversion to open surgery or re-intervention at 180 and 360 days. Results: One hundred and fifty-six patients were enrolled,including 137 males and 19 females. The age was (68.9±6.9) years (range:48.2 to 84.6 years).Maximum aneurysm diameter was (50.8±11.2) mm (range:25.0 to 85.0 mm),diameter of proximal landing zone was (21.2±2.5) mm (range:17.0 to 29.5 mm),and length of proximal landing zone was (31.4±13.0) mm (range:11.0 to 75.0 mm).The incidence of MAE was 1.3% (2/156) at 30 days,both were all-cause death cases. The success rate of AAA treatment was 88.5% (138/156) at 360 days. No perioperative access complication and acute lower limb ischemia occurred. All-cause mortality was 2.0% (3/154) at 180 days and 2.6% (4/153) at 360 days,and there was no AAA related death. The incidence of SAE was 23.0%(35/152) at 180 days and 30.5%(46/151) at 360 days, and no device-related SAE occurred. The incidence of type Ⅰor Ⅲ endoleak was 3.4% (5/147) at 180 days and 3.5% (5/144) at 360 days. Conclusion: The new stent graft system is easy to operate,and early-term safety and effectiveness results are expected.

Effect of lncRNA H19 on the apoptosis of vascular endothelial cells in arteriosclerosis obliterans via the NF-κB pathway.

OBJECTIVE: To explore the effect of long non-coding ribonucleic acid (lncRNA) H19 on the apoptosis of vascular endothelial cells in arteriosclerosis obliterans (ASO) via the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway. PATIENTS AND METHODS: Human umbilical vein endothelial cells (HUVECs) were cultured, and lncRNA H19 was inhibited by Si-H9 and overexpressed by H19-OE. Then, the apoptosis rate was detected by flow cytometry, the target of lncRNA H19 was detected by dual luciferase reporter gene assay, and changes in the protein level were determined via Western blotting (WB). RESULTS: LncRNA H19 exhibited high expression in serum of patients with ASO, and compared with that in congeneric normal mice, the expression of lncRNA H19 in ASO mice rose. Besides, the proliferation ability of cells transfected with H19-OE was markedly strengthened, and H19-OE treatment could down-regulate the expression level of the apoptin, active cysteinyl aspartate-specific proteinase-3 (Caspase-3). In addition, lncRNA H19 bound to micro ribonucleic acid (miR)-19a in a targeted way. After lncRNA H19 was overexpressed, the expression of the NF-κB pathway key factors, p38 and p65, were notably increased, and the nuclear translocation of p65 was significantly enhanced after transfection with miR-19a. CONCLUSIONS: LncRNA H19 promotes the proliferation of vascular endothelial cells in ASO and inhibits the apoptosis of them via the NF-κB pathway.

Effects of folic acid combined with vitamin B12 on DVT in patients with homocysteine cerebral infarction.

OBJECTIVE: To investigate the effects of folic acid combined with vitamin B12 on deep vein thrombosis (DVT) in patients with homocysteine cerebral infarction. PATIENTS AND METHODS: 90 patients with homocysteine cerebral infarction with DVT that were admitted to our hospital from January to July 2015 were selected as study subjects. They were divided into 2 groups randomly, the treatment group (n=45) and the non-treatment group (n=45). The treatment group was administered folic acid and vitamin B12, while the non-treatment group wasn't administered folic acid and vitamin B12. We compared and analyzed the levels of Hcy, folic acid and vitamin B12 of both groups. We investigated the correlation between the groups of patients with Hcy and folic acid and vitamin B12 treatment. We performed a comparative analysis of both groups of patients with an anticoagulant international normalized ratio (INR). The INR was recorded in detail for the first time as standard time, stable value time, obtain stable INR value time, activated partial thromboplastin time (APTT) and Prothrombin Time (PT) by color Doppler ultrasound observation of both groups with recurrent thrombosis. RESULTS: We compared results of the intervention and treatment groups, and the prognosis of Hcy decreased significantly (p<0.05). While in the treatment group, folic acid and vitamin B12 levels increased significantly (p<0.05), the non-treatment difference of Hcy, folic acid, and vitamin B12 levels, before and after the patients in the intervention group, were not statistically significant (p>0.05). In the treatment group, Hcy was negatively correlated with folic acid (r=-0.376, p<0.05) while the Hcy of the treatment group was negatively correlated with vitamin B12 (r=-0.583, p<0.05). The intervention treatment group INR first standard time, stable value time and stable INR values were higher than those of non-treatment group (p<0.05). The treatment group APTT average was lower than in the non-treatment group (p<0.05). The average Pt in the treatment group was lower than non-treatment group (p<0.05). In the treatment group, lower limb deep static vein thrombosis recurrence rate was 4.4%, which was lower than the non-treatment group where the lower limb deep vein thrombosis recurrence rate was 28.9% (p<0.05). CONCLUSIONS: Hcy is negatively correlated to folic acid and vitamin B12. Folic acid and vitamin B12 can reduce the recurrence rate of thrombosis in patients with lower extremity deep venous thrombosis in patients with Hcy disease. The mechanism of action may be to prevent the recurrence of thrombosis by reducing the levels of Hcy.