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1.
Food Chem ; 452: 139564, 2024 May 06.
Article in English | MEDLINE | ID: mdl-38718455

ABSTRACT

High internal phase Pickering emulsions (HIPPEs) prepared from natural polymers have attracted much attention in the food manufactures. However, single zein-stabilized HIPPEs are poorly stable and prone to flocculation near the isoelectric point. To address this issue, in this study, zein and whey protein nanofibrils (WPN) complex nanoparticles (ZWNPs) were successfully prepared using a pH-driven method, and ZWNPs were further used as HIPPEs stabilizers. The results showed that zein and WPN were combined together through hydrogen bonding and hydrophobic interaction to form ZWNPs, and the HIPPEs stabilized by ZWNPs had excellent stability, which could effectively protect the internally encapsulated lycopene and improve the bioaccessibility of lycopene. In conclusion, this study provides a new strategy for the preparation of stable hydrophobic protein-based HIPPEs, represented by zein.

2.
Micromachines (Basel) ; 15(4)2024 Apr 22.
Article in English | MEDLINE | ID: mdl-38675365

ABSTRACT

The five-hole pressure probe based on Micro-Electro-Mechanical Systems (MEMS) technology is designed to meet the needs of engine inlet pressure measurement. The probe, including a pressure-sensitive detection unit and a five-hole probe encapsulation structure, combines the advantages of a five-hole probe with fiber optic sensing. The pressure-sensitive detection unit utilizes silicon-glass anodic bonding to achieve the integrated and batch-producible manufacturing of five pressure-sensitive Fabry-Perot (FP) cavities. The probe structure and parameters of the sensitive unit were optimized based on fluid and mechanical simulations. The non-scanning correlation demodulation technology was applied to extract specific cavity lengths from multiple interference surfaces. The sealing platform was established to analyze the sealing performance of the five-hole probe and the pressure-sensitive detection unit. The testing platform was established to test the pressure response characteristics of the probe. Experimental results indicate that the probe has good sealing performance between different air passages, making it suitable for detecting pressure from multiple directions. The pressure responses are linear within the range of 0-250 kPa, with the average pressure sensitivity of the five sensors ranging from 11.061 to 11.546 nm/kPa. The maximum non-linear error is ≤1.083%.

3.
Front Cardiovasc Med ; 11: 1341663, 2024.
Article in English | MEDLINE | ID: mdl-38590698

ABSTRACT

Introduction: Dyslipidemia is common in patients with abdominal aortic aneurysm (AAA). However, there is insufficient research on the impact of dyslipidemia on the postoperative outcomes of patients with AAA after endovascular aortic aneurysm repair (EVAR). This study aimed to determine the impact of dyslipidemia on the prognosis of patients with AAA treated with EVAR. Method: We retrospectively reviewed patients with AAA who underwent EVAR at our hospital between 2010 and 2020. The baseline characteristics and prognoses of patients in the dyslipidemia and non-dyslipidemia groups were analyzed. Results: A total of 641 patients were included; the prevalence of dyslipidemia in patients with AAA was 42.3% (271/641), and the mean follow-up time was 63.37 ± 26.49 months. The prevalence of diabetes (10.0% vs. 15.1%, P = 0.050), peripheral arterial disease (17.3% vs. 25.8%, P = 0.018), and chronic kidney disease (3.0% vs. 6.3%, P = 0.043) was higher in the dyslipidemia group. The three-year all-cause mortality rate after EVAR was 9.98% (64/641), and there was no difference in the incidence of all-cause mortality (10.27% vs. 9.59%, P = 0.778) between the two groups. A total of 36 (5.62%) major adverse cardiovascular and cerebrovascular events (MACCEs) were observed within 3 years and were more common in patients with dyslipidemia (2.97% vs. 9.59%, P < 0.001). The incidence of stent-related complications in all patients was 19.97% (128/641), and there was no difference in the incidence of stent-related complications between the two groups (22.16% vs. 16.97%, P = 0.105); however, the incidence of type I endoleak in the dyslipidemia group was lower than that in the non-dyslipidemia group (9.19% vs. 4.06%, P = 0.012). Cox-regression analysis showed that high level of high-density lipoprotein cholesterol (HDL-C) was the protective factor (HR, 0.203, 95% CI, 0.067-0.616, P = 0.005) for MACCES, but it was the risk factor for type I endoleak (HR, 2.317, 95% CI, 1.202-4.466, P = 0.012). Conclusion: Dyslipidemia did not affect the mortality of patients with AAA who underwent EVAR; however, it may increase the incidence of MACCEs. Dyslipidemia may decrease the incidence of type I endoleaks after EVAR; however, further studies are warranted. We should strengthen the postoperative management of patients with dyslipidemia, prevent the occurrence of MACCEs.

4.
Quant Imaging Med Surg ; 14(4): 2800-2815, 2024 Apr 03.
Article in English | MEDLINE | ID: mdl-38617138

ABSTRACT

Background: Thoracoabdominal aortic aneurysms (TAAAs) are rare but complicated aortic pathologies that can result in high morbidity and mortality. The whole-aorta hemodynamic characteristics of TAAA survivors remains unknown. This study sought to obtain a comprehensive view of flow hemodynamics of the whole aorta in patients with TAAA using four-dimensional flow (4D flow) magnetic resonance imaging (MRI). Methods: This study included patients who had experienced TAAA or abdominal aortic aneurysm (AAA) and age- and sex-matched volunteers who had attended China Hospital from December 2021 to December 2022 in West. Patients with unstable ruptured aneurysm or other cardiovascular diseases were excluded. 4D-flow MRI that covered the whole aorta was acquired. Both planar parameters [(regurgitation fraction (RF), peak systolic velocity (Vmax), overall wall shear stress (WSS)] and segmental parameters [pulse wave velocity (PWV) and viscous energy loss (VEL)] were generated during postprocessing. The Student's t-test or Mann-Whitney test was used to compare flow dynamics among the three groups. Results: A total of 11 patients with TAAA (mean age 53.2±11.9 years; 10 males), 19 patients with AAA (mean age 58.0±11.7 years; 16 males), and 21 controls (mean age 55.4±15.0 years; 19 males) were analyzed. The patients with TAAA demonstrated a significantly higher RF and lower Vmax in the aortic arch compared to healthy controls. The whole length of the aorta in patients with TAAA was characterized by lower WSS, predominantly in the planes of pulmonary artery bifurcation and the middle infrarenal planes (all P values <0.001). As for segmental hemodynamics, compared to controls, patients with TAAA had a significantly higher PWV in the thoracic aorta (TAAA: median 11.41 m/s, IQR 9.56-14.32 m/s; control: median 7.21 m/s, IQR 5.57-7.79 m/s; P<0.001) as did those with AAA (AAA: median 8.75 m/s, IQR 7.35-10.75 m/s; control: median 7.21 m/s, IQR 5.57-7.79 m/s; P=0.024). Moreover, a greater VEL was observed in the whole aorta and abdominal aorta in patients with TAAA. Conclusions: Patients with TAAA exhibited a stiffer aortic wall with a lower WSS and a greater VEL for the whole aorta, which was accompanied by a higher RF and lower peak velocity in the dilated portion of the aorta.

6.
Front Cardiovasc Med ; 11: 1351358, 2024.
Article in English | MEDLINE | ID: mdl-38385133

ABSTRACT

Phlegmasia cerulea dolens (PCD) is a rare yet severe complication of deep vein thrombosis (DVT), characterized by a high amputation rate and mortality. Early diagnosis and treatment are crucial in managing this condition. PCD predominantly affects the lower extremities rather than the upper extremities. We herein present a rare upper extremity PCD case accompanied with supra vena cava and pulmonary embolism in a cervical cancer patient, who presented to our institution with severe pain, edema and irreversible venous gangrene of right upper limb with no response to anticoagulation therapy. Emergency fasciotomy and amputation were performed due to the progressed venous gangrene, however, the patient developed severe infection and coagulation disorders, gastrointestinal bleeding and disseminated intravascular coagulation after the surgery. Despite medical interventions, her family chose to withdraw treatment and the patient died in ICU at the fourth day following emergency surgery.

7.
Vascular ; : 17085381241236543, 2024 Feb 23.
Article in English | MEDLINE | ID: mdl-38395425

ABSTRACT

OBJECTIVE: To establish a prediction model of upper extremity deep vein thrombosis (UEDVT) associated with peripherally inserted central catheter (PICC) based on machine learning (ML), and evaluate the effect. METHODS: 452 patients with malignant tumors who underwent PICC implantation in West China Hospital from April 2021 to December 2021 were selected through convenient sampling. UEDVT was detected by ultrasound. Machine learning models were established using the least absolute contraction and selection operator (LASSO) regression algorithm: Seeley scale model (ML-Seeley-LASSO) and ML model. The information of patients with and without UEDVT was randomly allocated to the training set and test set of the two models, and the prediction effect of machine learning and existing prediction tools was compared. RESULTS: Machine learning training set and test set were better than Seeley evaluation results, and ML-Seeley-LASSO performance in training set was better than ML-LASSO. The performance of ML-LASSO in the test set is better than that of ML-Seeley-LASSO. The use of ML model (ML-LASSO and ML-Seeley-LASSO) in PICC-related UEDVT shows good effectiveness (the area under the subject's working characteristic curve is 0.856, 0.799), which is superior to the currently used Seeley assessment tool. CONCLUSION: The risk of PICC-related UEDVT can be estimated and predicted relatively accurately by using the method of ML modeling, so as to effectively reduce the incidence of PICC-related UEDVT in the future.

8.
J Colloid Interface Sci ; 662: 760-773, 2024 May 15.
Article in English | MEDLINE | ID: mdl-38377695

ABSTRACT

Nanoscale drug delivery systems derived from natural bioactive materials accelerate the innovation and evolution of cancer treatment modalities. Morusin (Mor) is a prenylated flavonoid compound with high cancer chemoprevention activity, however, the poor water solubility, low active pharmaceutical ingredient (API) loading content, and instability compromise its bioavailability and therapeutic effectiveness. Herein, a full-API carrier-free nanoparticle is developed based on the self-assembly of indocyanine green (ICG), copper ions (Cu2+) and Mor, termed as IMCNs, via coordination-driven and π-π stacking for synergistic tumor therapy. The IMCNs exhibits a desirable loading content of Mor (58.7 %) and pH/glutathione (GSH)-responsive motif. Moreover, the photothermal stability and photo-heat conversion efficiency (42.8 %) of IMCNs are improved after coordination with Cu2+ and help to achieve photothermal therapy. Afterward, the released Cu2+ depletes intracellular overexpressed GSH and mediates Fenton-like reactions, and further synergizes with ICG at high temperatures to expand oxidative damage. Furthermore, the released Mor elicits cytoplasmic vacuolation, expedites mitochondrial dysfunction, and exerts chemo-photothermal therapy after being combined with ICG to suppress the migration of residual live tumor cells. In vivo experiments demonstrate that IMCNs under laser irradiation could excellently inhibit tumor growth (89.6 %) through the multi-modal therapeutic performance of self-enhanced chemotherapy/coordinated-drugs/ photothermal therapy (PTT), presenting a great potential for cancer therapy.


Subject(s)
Hyperthermia, Induced , Mitochondrial Diseases , Nanoparticles , Neoplasms , Humans , Indocyanine Green/pharmacology , Copper/pharmacology , Phototherapy , Photothermal Therapy , Flavonoids , Cell Line, Tumor
9.
BMJ Open ; 14(2): e080073, 2024 Feb 13.
Article in English | MEDLINE | ID: mdl-38355193

ABSTRACT

INTRODUCTION: The best lifestyle for small abdominal aortic aneurysms (sAAA) is essential for its conservative management. Physical exercise can improve the cardiopulmonary function of the patients, but it remains unclear which specific type of exercise is most beneficial for individuals with sAAA. The current study was designed to investigate the effect of physician-guided enhanced physical exercise programme on the aorto-cardiac haemodynamic environment, aneurysm sac wall, cardiac function and growth rate of sAAA by multimodality MRI. METHODS AND ANALYSIS: AAA MOVE study is a prospective, parallel, equivalence, randomised controlled trial. Eligible individuals will be recruited if they are diagnosed with sAAA (focal dilation of abdominal aorta with maximum diameter <5 cm), without contraindication for MRI scanning, or severe heart failure, or uncontrolled arrhythmia. Participants will be randomly allocated to intervention group (physician-guided enhanced physical exercise programme: mainly aerobic training) and control group (standard clinical care) separately in a 1:1 ratio. The primary outcome is 12-month growth rate of sAAA. The first set of secondary outcomes involve multimodality MRI parameters covering flow haemodynamics, aortic wall inflammation and cardiac function. The other secondary outcome (safety end point) is a composite of exercise-related injury, aneurysm rupture and aneurysm intervention. Follow-up will be conducted at 6 and 12 months after intervention. ETHICS AND DISSEMINATION: This study was approved by the Ethics Committee on Biomedical Research of West China Hospital (approval number: 2023-783) on 16 June 2023. Main findings from the trial will be disseminated through presentations at conferences, peer-reviewed publications and directly pushed to smartphone of participants. TRIAL REGISTRATION NUMBER: ChiCTR2300073334.


Subject(s)
Aortic Aneurysm, Abdominal , Humans , Prospective Studies , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortic Aneurysm, Abdominal/pathology , Exercise , Magnetic Resonance Imaging , Hemodynamics , Aorta, Abdominal/diagnostic imaging , Aorta, Abdominal/pathology , Magnetic Resonance Spectroscopy , Randomized Controlled Trials as Topic
10.
Heliyon ; 10(3): e25517, 2024 Feb 15.
Article in English | MEDLINE | ID: mdl-38333831

ABSTRACT

Hybrid thoracic endovascular aortic repair (TEVAR) has been proved to be an effective and reliable treatment option for aortic arch diseases requiring extension of the proximal landing zone. However, hybrid TEVAR was associated with potential risk of post-operative complications, including cerebral infarction, endoleaks and paraplegia. Here we reported a rare case of bypass graft infection complicated with mitral valve aneurysm and perforation following landing zone 2 hybrid TEVAR procedure, who presented with symptoms of fever, major bleeding and anastomotic pseudoaneurysm and received emergency bypass graft removal and stent implantation with acceptable short and midterm follow-up results.

11.
Int J Biol Macromol ; 259(Pt 1): 129257, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38191111

ABSTRACT

This study evaluated the influence of chestnut powder, produced using ball mill superfine grinding (BMSG), jet superfine grinding (JSG), and ordinary grinding (OG), on wheat flour properties. Blending wheat flour with chestnut powder resulted in a darker flour blend (3 % decline of L*), with decreased the tap density and increased water holding capacity. Adding appropriate proportion of superfine chestnut powder can bolster the mixed flour's thermal stability (15 % BMSG/JSG) and freeze-thaw stability (10 % BMSG/JSG), while significantly enhancing the anti-aging properties of flour products. The proposition of 5 % superfine BMSG/JSG did not significantly affect the tensile resistance of the dough, and even improve the dough's tensile strength. In addition, the hardness, adhesiveness, springiness and pH of fermentation increased due to the addition of chestnut powder, as supported by the dough texture analyses and fermentation characteristics findings. However, the excessive addition of chestnut powder affected the dough network's structural integrity to some extent. Further study can focus on the influencing mechanism of chestnut powder on gluten formation and related nutritional properties. Overall, this research underscores the potential of utilizing chestnut powder to enhance the nutritional and functional qualities of wheat-based products.


Subject(s)
Flour , Triticum , Triticum/chemistry , Powders/chemistry , Flour/analysis , Glutens/chemistry , Hardness
12.
Int J Biol Macromol ; 256(Pt 1): 128307, 2024 Jan.
Article in English | MEDLINE | ID: mdl-37992941

ABSTRACT

Films with simultaneously excellent mechanical and anti-fog properties are of great importance for food packaging. A novel strategy is described here to prepare long-lasting anti-fog film with antibacterial and antioxidant capabilities via a simple, green approach. The CMC (carboxymethyl chitosan) gel was integrated with CNF/TA (cellulose nanofibers/tannic acid) composite solution based on layer-by-layer assembly to form a membrane with a bilayer structure. The anti-fog performance of the bilayer film could be adjusted by regulating the CNF/TA layer thickness. On the whole, the developed anti-fog film had high mechanical strength and excellent UV shielding properties, as well as good antibacterial and antioxidant properties, and could be non-fogging for a long time under water vapor (40 °C). The effect of double layer anti-fog film (3%CmFT-3) on the fresh-keeping effect of white Hypsizygus marmoreus was compared at room temperature (28 °C) with commercially available anti-fog PVC film. The results showed that the bilayer anti-fog film could effectively prevent the generation of fog, delay the Browning, inhibit mildew, improve the overall acceptability, and effectively extend the shelf life of white Hypsizygus marmoreus. This biomass-based anti-fog film offers great potential for the development of multifunctional green food packaging.


Subject(s)
Agaricales , Chitosan , Nanofibers , Polyphenols , Chitosan/pharmacology , Chitosan/chemistry , Cellulose/pharmacology , Cellulose/chemistry , Nanofibers/chemistry , Antioxidants/pharmacology , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/chemistry , Food Packaging
13.
Am Surg ; 90(4): 575-584, 2024 Apr.
Article in English | MEDLINE | ID: mdl-37728273

ABSTRACT

BACKGROUND: Current evidence regarding gender difference in retroperitoneal liposarcoma (RLPS) is scarce, so we sought to investigate whether gender may affect prognosis after primary resection of RLPS. METHODS: We used the Surveillance, Epidemiology, and End Results (SEER) database to identify RLPS patients from January 1973 to December 2015. Multivariate cox proportional hazard analysis was adopted to generate adjusted hazard ratio (AHR) and 95% confidence intervals (CIs) of survival outcomes. RESULTS: In total, 2108 RLPS patients, including 971 women and 1137 men, were identified, with a median follow-up of 45.0 (17.0-92.0) months. The 5-year and 10-year overall survival rates were 50.5% and 31.5% for men and 60.4% and 42.5% for women. The 5-year and 10-year disease-specific survival rates for men and women were 71.5%, 57.3% and 76.3%, 62.1%, respectively. We found men were associated with an increased risk of all-cause mortality (AHR 1.3, 95% CI 1.0-1.6, P = .017) but not disease-specific mortality (AHR 1.2, 95% CI .9-1.6, P = .246). The subgroup analyses revealed that men were associated with an increased risk of all-cause mortality in patients with low-grade tumors (AHR 1.8, 95% CI 1.3-2.5) or patients who received non-radical resection (AHR 1.6, 95% CI 1.2-2.1). In the subgroup of low-grade tumors, men were also associated with an increased risk of disease-specific mortality (AHR 2.0, 95% CI 1.2-3.3). CONCLUSION: Men may have worse survival after primary resection of RLPS compared with women, especially in patients with low-grade tumors or patients who received non-radical resection. Gender-based disparities may deserve more attention in patients with RLPS.


Subject(s)
Liposarcoma , Retroperitoneal Neoplasms , Male , Humans , Female , Sex Factors , Prognosis , Liposarcoma/surgery , Retroperitoneal Neoplasms/surgery
14.
J Clin Med ; 12(23)2023 Dec 04.
Article in English | MEDLINE | ID: mdl-38068553

ABSTRACT

Consideration for oversizing the proximal stent graft is suggested in endovascular aortic repair. However, a special recommendation for the proximal oversizing ratio (OSR) in patients with ruptured abdominal aortic aneurysm (rAAA) is ambiguous. This study aims to evaluate the effect of different degrees of the proximal oversizing ratio (OSR) on risk of type IA endoleak (TIAEL) in hemodynamically stable and unstable patients with rAAA undergoing emergency endovascular aortic repair (EVAR). Our study included 134 rAAA patients undergoing emergent EVAR, and we did not observe a significant association between hemodynamic instability and risk of T1AEL (HR 3.89, 95%CI 0.40-37.75, p = 0.24). All three T1AELs in the hemodynamically unstable subgroup were observed in patients with OSR ≤ 30%, but no significant difference was found regarding T1AEL between patients with OSR > 30% and OSR ≤ 30% (0.00% vs. 11.11%, p = 0.19). As for hemodynamically stable patients, OSR > 20% was associated with a significantly decreased risk of T1AEL (HR 0.03, 95%CI 0.01-0.53, p = 0.016). In conclusion, a proximal OSR > 20% is associated with a decreased risk of T1AEL in hemodynamically stable patients, while an OSR > 30% did not add an additional advantage of lowering the risk of T1AEL in hemodynamically unstable patients.

15.
Food Res Int ; 174(Pt 1): 113650, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37986488

ABSTRACT

To investigate the colonization and impact of the specific Lactiplantibacillus plantarum strains, four isolated strains were applied in pickled Suancai which is a traditional pickled mustard (Brassica juncea). Results showed that strain-8 with the highest lactic acid bacteria (LAB) counts and acetic acid (p < 0.05). There were 11.42 % ∼ 32.35 % differential volatile compounds detected, although nitriles, esters, and acids were predominant. L. plantarum disturbed the microbial community, in which the microbial composition of strain-11 was most similar to the naturally fermented sample. Amino acids, carbohydrate metabolism, and metabolism of cofactors and vitamins were the main functional classes because of the similar dominant microbes (Lactiplantibacillus and Levilactobacillus). The functional units were separated based on NMDS analysis, in which bacterial chemotaxis, amino acid-related units, biotin metabolism, fatty acid biosynthesis, and citrate cycle were significantly different calculated by metagenomeSeq and Benjamin-Hochberg methods (p < 0.05). The contents of most flavor compounds were consistent with their corresponding enzymes. In particular, glucosinolates metabolites were different and significantly related to the myrosinase and metabolic preference of LAB. Therefore, this study revealed the impact mechanism of the specific L. plantarum strains and provided a perspective for developing microbial resources to improve the flavor diversity of fermented vegetables.


Subject(s)
Lactobacillales , Vegetables , Acetic Acid , Amino Acids , Citrates
16.
Foods ; 12(20)2023 Oct 14.
Article in English | MEDLINE | ID: mdl-37893673

ABSTRACT

Hippocrates, the father of medicine, claimed that "All disease begins in the gut", while modern scientific studies show that a lot of diseases are at least correlated to the gut, which contains trillions of microbes [...].

17.
BMC Surg ; 23(1): 275, 2023 Sep 12.
Article in English | MEDLINE | ID: mdl-37700246

ABSTRACT

BACKGROUND AND AIM: Surgery is the mainstay of treatment and completeness of surgical resection is critical to achieve local control for retroperitoneal sarcoma (RPS). En-bloc resection of adjacent organs, including major abdominal vessels, is often required to achieve negative margins. The aim of this review was to summarise the available evidence to assess the relative benefits and disadvantages of an aggressive surgical approach with vascular resection in patients with retroperitoneal sarcoma (RPS). METHODS: We searched PubMed, the Cochrane Library, and EMBASE for relevant studies published from inception up to August 1, 2022. We performed a systematic review of the available studies to assess the safety and long-term survival results of vascular resection for RPS. RESULTS: We identified a total of 23 studies for our review. Overall postoperative in-hospital or 30-day mortality rate of patients with primary iliocaval leiomyosarcoma was 3% (11/359), and the major complication rate was 13%. The recurrence-free survival (RFS) rates after the follow-up period varied between 15% and 52%, and the 5-year overall survival (OS) rates ranged from 25 to 78%. Overall postoperative in-hospital or 30-day mortality rate of patients with RPSs receiving vascular resection was 3%, and the major complication rate was 27%. The RFS rates after the follow-up period were 18-86%, and the 5-year OS rates varied between 50% and 73%. There were no significant differences in the rates of RFS (HR: 0.97; 95% CI: 0.74-1.19; p = 0.945) and OS (HR: 1.01; 95% CI: 0.66-1.36; p = 0.774) between the extended resection group and tumour resection alone group. CONCLUSIONS: With adequate preparation and proper management, for patients with RPSs involving major vessels, aggressive surgical approach with vascular resection can achieve R0/R1 resection and improve survival.


Subject(s)
Retroperitoneal Neoplasms , Sarcoma , Soft Tissue Neoplasms , Humans , Retroperitoneal Neoplasms/surgery , Sarcoma/surgery , Hospitals , Postoperative Period
18.
Front Cardiovasc Med ; 10: 1210248, 2023.
Article in English | MEDLINE | ID: mdl-37636305

ABSTRACT

Objective: The aims of the present study were to explore the risk factors for type 2 endoleaks (T2ELs) after endovascular aneurysm repair (EVAR) and the association between T2ELs and the iliolumbar artery. Materials and methods: A single-center, retrospective case-control study in West China Hospital was conducted among patients with infrarenal abdominal aortic aneurysm (AAA) who underwent EVAR between June 2010 and June 2019. The associations of patient characteristics, anatomical factors, internal iliac artery embolization, and ILA with the primary outcome were analyzed. The secondary objective was to analyze survival and reintervention between the T2EL group and the non-T2EL group. Kaplan-Meier survival, propensity matching analysis and multivariate logistic regression analysis were used. Results: A total of 603 patients were included. The median follow-up was 51 months (range 5.0-106.0). There was a significant difference in the diameter of the lumbar artery (LA), middle sacral artery (MSA) and inferior mesentery artery (IMA), proportion of thrombus and LA numbers. The univariate analysis showed that T2ELs were more likely to develop more thrombus in aneurysm cavity (OR = 0.294, p = 0.012), larger MSA (OR = 1.284, p = 0.04), LA (OR = 1.520, p = 0.015), IMA (OR = 1.056, p < 0.001) and more LAs (OR = 1.390, p = 0.019). The multivariate analysis showed that the number of LAs (HR: 1.349, 95% CI: 1.140-1.595, p < .001) and the diameter of the IMA (HR: 1.328, 95% CI: 1.078-1.636, p = 0.008) were significantly associated with T2ELs. There were no new findings from the propensity score matching. The reintervention-free survival rates were significantly different between the two groups (p = 0.048). Overall survival and AAA-related death rates were not different between the two group. This was consistent with the PSM analysis. Conclusion: The iliolumbar artery and the different internal iliac artery interventions may not increase the incidence of T2ELs. But the numbers of LAs and IMA diameter were independent risk factors for T2Els. T2ELs was associated with the reintervention but did not affect long-term survival or increase aneurysm-related mortality after EVAR.

19.
Int J Surg ; 109(9): 2689-2695, 2023 Sep 01.
Article in English | MEDLINE | ID: mdl-37578462

ABSTRACT

BACKGROUND: Venous thromboembolism (VTE) is a common postoperative complication; however, the incidence and risk stratification of postoperative VTE in patients with retroperitoneal tumor remains unclear. The authors aim to quantify the incidence, identify risk factors, and determine the outcomes of VTE in patients undergoing retroperitoneal tumor surgery. METHODS: The authors retrospectively reviewed the characteristics, perioperative outcomes, and overall survival (OS) of patients (VTE and non-VTE) who underwent retroperitoneal tumor surgery between 2015 and 2020. Perioperative and oncologic outcomes were compared using propensity-matching and Cox analyses. RESULTS: Of 1223 patients with retroperitoneal tumor surgery, 2.1% had VTE. Age [odds ratio (OR) 1.140, 95% CI: 1.053-1.239, P =0.004], recurrence (OR 1.851, 95% CI: 1.241-2.761, P =0.003), and vascular resection (OR 2.036, 95% CI: 1.054-3.934, P =0.034) were independent risk factors, with significant between-group differences regarding age, recurrence, sarcoma, organ resection, vascular resection, and operation time. No between-group differences in 30-day all-cause mortality (8 vs. 4%, OR 0.657, 95% CI: 0.375-1.151, P =0.427) and major complications (12 vs. 8%, OR 0.775, 95% CI: 0.483-1.244, P =0.572) were observed. Mean hospitalization duration (20.1 vs. 22.9 days, OR 1.153, 95% CI: 1.022-1.386, P =0.033) and ICU stay (3.2 vs. 5.5 days, OR 1.193, 95% CI: 1.034-1.347, P =0.012) were shorter in non-VTE versus VTE, respectively, with inferior OS (hazard ratio 2.090, 95% CI: 1.014-4.308, P =0.046) in VTE. CONCLUSIONS: Age, recurrence, and vascular resection are positively associated with VTE, which is associated with inferior OS.


Subject(s)
Retroperitoneal Neoplasms , Venous Thromboembolism , Humans , Venous Thromboembolism/epidemiology , Venous Thromboembolism/etiology , Retrospective Studies , Retroperitoneal Neoplasms/surgery , Incidence , Risk Factors , Postoperative Complications/epidemiology , Postoperative Complications/etiology
20.
BJS Open ; 7(4)2023 07 10.
Article in English | MEDLINE | ID: mdl-37498966

ABSTRACT

BACKGROUND: The aim of this study was to compare the vascular complications of ProGlide and Prostar in percutaneous transfemoral transcatheter aortic valve replacement. METHODS: Electronic databases were searched in July 2022 for studies that compared the vascular complications of ProGlide and Prostar for percutaneous closure in transcatheter aortic valve replacement. The primary outcome was major vascular complications and the secondary outcomes were minor vascular complications, types of access-site vascular complications, device failure, and additional intervention. Estimates of relative effects were pooled to generate ORs and their 95 per cent c.i. using a random-effects model. The risk of bias in non-randomized comparative studies was assessed using the Risk Of Bias In Non-randomized Studies - of Interventions ('ROBINS-I') tool. RESULTS: Nine studies were identified and a total of 7529 patients were included. Among them, 4144 patients received ProGlide and 3385 received Prostar. The pooled data showed that the risk of major vascular complications was significantly lower with ProGlide versus Prostar (OR 0.50, 95 per cent c.i. 0.32 to 0.78). Regarding the types of vascular complications, vascular trauma was the most common complication and the risk was similar between groups (OR 1.02, 95 per cent c.i. 0.55 to 1.91). ProGlide had a lower risk of bleeding complications (OR 0.46, 95 per cent c.i. 0.22 to 0.94), but a higher risk of ischaemia complications (OR 1.90, 95 per cent c.i. 1.10 to 3.27). The risk of device failure was lower in the ProGlide group (OR 0.45, 95 per cent c.i. 0.21 to 0.95). Both groups had a similar risk of having additional interventions for vascular complications (OR 1.02, 95 per cent c.i. 0.75 to 1.39). The use of ProGlide was associated with a lower risk of additional surgical treatments (OR 0.52, 95 per cent c.i. 0.34 to 0.80), but a higher risk of endovascular treatments (OR 2.69, 95 per cent c.i. 1.29 to 5.63). CONCLUSION: In percutaneous transfemoral transcatheter aortic valve replacement procedures, ProGlide has superior safety and efficacy when compared with Prostar; it is associated with fewer major vascular complications and device failures. The vascular complications of ProGlide are more likely to be dealt with using endovascular treatments than surgical treatments.


Subject(s)
Aortic Valve Stenosis , Cardiovascular Diseases , Transcatheter Aortic Valve Replacement , Vascular Closure Devices , Humans , Transcatheter Aortic Valve Replacement/adverse effects , Transcatheter Aortic Valve Replacement/methods , Aortic Valve Stenosis/surgery , Vascular Closure Devices/adverse effects , Treatment Outcome , Aortic Valve/surgery
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