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BACKGROUND: Evidence suggests that type 2 diabetes mellitus (T2DM) may protect from abdominal aortic aneurysm (AAA). However, it is unclear whether a causal relationship exists between these 2 conditions and, if so, whether it remains consistent among racial groups. METHODS: Cross-ethnic Mendelian randomization (MR) was used to examine the causal relationships between T2DM, metabolic traits, and AAA. Inverse variance weighted (IVW) was the primary analysis tool, supplemented by MR-Egger, weighted median, and MR Pleiotropy RESidual Sum and Outlier. Heterogeneity and horizontal pleiotropy were assessed using the Cochran's Q test and MR-Egger intercept, respectively. RESULTS: According to IVW, an inverse correlation between T2DM and AAA was detected in Europeans (odds ratio [OR] 0.91, 95% confidence interval [CI] 0.84-0.99; P = 0.034) and East Asians (OR 0.87, 95% CI 0.77-0.99; P = 0.038). Fasting glucose was inversely associated with AAA in Europeans (OR 0.56, 95% CI 0.33-0.96; P = 0.034) but not in East Asians. In Europeans, fasting insulin was a risk factor for AAA (OR 3.03, 95% CI 1.53-6.01; P = 0.001), while 2-hour glucose was protective (OR 0.67, 95% CI 0.49-0.91; P = 0.011). Glycated hemoglobin (HbA1c) had no effect. Insufficient instrumental variables prevented the evaluation of the relationships of fasting insulin, HbA1c, and 2-hour glucose with AAA in East Asians. CONCLUSIONS: T2DM protects against AAA in Europeans and East Asians. The effects of different glucose metabolism characteristics on AAA may inform AAA treatment.
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BACKGROUND AND AIMS: The role of aortic mineralization in the pathogenesis of acute type B aortic dissection (TBAD) is unclear. Whether thoracic aortic calcification (TAC) and circulating alkaline phosphatase (ALP) activity are associated with acute TBAD risk remains elusive. METHODS: Observational and Mendelian randomization (MR) studies were conducted sequentially. Using propensity score matching (1:1) by age and sex, patients with acute TBAD (n = 125) were compared with control patients (n = 125). Qualitative (score) and quantitative (volume) analyses of the TAC burden on different thoracic aortic segments were conducted using non-enhanced computed tomography. Univariate and multivariate analyses were used to identify significant independent risk factors for TBAD and TAC burden, respectively. MR was finally used to determine the causal relationship between elevated ALP activity and TBAD risk. RESULTS: The qualitative and quantitative analyses revealed that TAC burden was significantly higher in the TBAD group, except for in the ascending aortic segment (both p < 0.05). Preoperative circulating ALP was significantly elevated in the TBAD group (p < 0.001). The elevated TAC burden score on the descending thoracic aortic segment (odds ratio [OR] 3.31, 95% confidence interval [CI] 1.31-8.37) and increased ALP activity (OR 1.03, 95% CI 1.01-1.06) was independently associated with TBAD risk. Interestingly, ALP was significantly positively associated with TAC burden, and MR analyses confirmed that ALP genetically predicted TBAD risk. CONCLUSIONS: Elevated ALP may trigger TBAD risk via the increased volume of TAC. Aortic mineralization may not protect the aorta itself.
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Fosfatasa Alcalina , Aneurisma de la Aorta Torácica , Disección Aórtica , Análisis de la Aleatorización Mendeliana , Calcificación Vascular , Humanos , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/etiología , Masculino , Femenino , Persona de Mediana Edad , Factores de Riesgo , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/genética , Calcificación Vascular/diagnóstico por imagen , Fosfatasa Alcalina/sangre , Anciano , Enfermedad Aguda , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/patología , Medición de Riesgo , Estudios de Casos y Controles , Biomarcadores/sangre , Aortografía/métodos , Predisposición Genética a la Enfermedad , Angiografía por Tomografía ComputarizadaRESUMEN
OBJECTIVE: To analyze the distribution characteristics of Rh phenotype in pregnant and postpartum women in Chongqing area, and to explore the clinical significance of Rh phenotype in pregnant and postpartum women and the feasibility of Rh phenotype compatible blood transfusion. METHODS: The ABO blood group and Rh phenotype of 65 161 pregnant and postpartum women were detected by microcolumn gel method, and 48 122 males in the same period were taken as controls. The data were analyzed by Chi-square test. RESULTS: There were 112 870 cases (99.64%) of RhD+ in 113 283 samples. In RhD+ cases, CCDee (48.39%) and CcDEe (32.88%) were the main phenotypes. The first case of D-- phenotype in Chongqing area was detected. 413 cases (0.36%) of RhD- were detected, with ccdee (52.78%) and Ccdee (33.41%) as the main phenotypes. Compared with RhD- group, RhD+ group showed statistically significant difference in Rh phenotype distribution (P < 0.01). Among 65 161 maternal samples, the positive rate of 5 antigens of Rh blood group from high to low was D > e > C > c > E, and there was no significant difference compared with male samples (P >0.05). There was no significant difference in the distribution of Rh phenotype between males and pregnant/postpartum women, as well as between pregnant/postpartum women with different ABO blood groups (P >0.05). In pregnant and postpartum women, there was no significant difference in distribution of Rh phenotype among the normal pregnancy population, the population with adverse pregnancy history, the population using human assisted reproductive technology (ART) and the population with infertility (P >0.05). There was no significant difference in the distribution of Rh phenotype between the 4 populations mentioned above and the inpatients in the local general Grade A hospitals and the blood donors (P >0.05). In RhD positive pregnant and postpartum women, the probability of finding compatible blood for CcDEe phenotype was 100%, the probability of finding compatible blood for CCDee, CcDee and CCDEe phenotypes was 45%-60%, the probability of finding compatible blood for ccDEE, ccDEe and CcDEE phenotypes was 5%-10%, and the probability of finding compatible blood for other phenotypes was lower than 0.5%. The supply of blood with CCDee and ccDEE phenotypes can meet the compatible transfusions requirements of 7 Rh phenotypes in more than 99% of patients. CONCLUSION: Rh phenotype detection should be carried out for pregnant and postpartum women, and it is feasible to carry out Rh phenotype-matched or compatible blood transfusion for pregnant and postpartum women who need blood transfusion.
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Transfusión Sanguínea , Fenotipo , Sistema del Grupo Sanguíneo Rh-Hr , Humanos , Femenino , Embarazo , Periodo Posparto , Sistema del Grupo Sanguíneo ABO , Masculino , Tipificación y Pruebas Cruzadas SanguíneasRESUMEN
PURPOSE: In approximate 40% of thoracic endovascular aortic repair (TEVAR) procedures, the left subclavian artery (LSA) needs to be covered to obtain sufficient proximal sealing zone. To preserve the LSA during the TEVAR for type B aortic dissection (TBAD) adjacent to LSA, our team designed a modular single inner-branched stent graft. This study was performed to evaluate the safety and feasibility of deploying a modular single inner-branched stent graft in a porcine model. MATERIALS AND METHODS: Modular inner-branched stent grafts were implanted in 14 pigs via right femoral and right carotid arterial access. Computed tomography angiography (CTA) and angiography were performed in all pigs to appraise the morphological characteristics of the stent grafts at the end of follow-up. The pigs were then euthanized, and tissues were collected for gross and histological examination. RESULTS: The technical success rate was 100% (14/14). One pig suddenly died 5 hours after operation, and 1 pig died after completing the follow-up CTA. During the follow-up period, all surviving pigs showed good mental state, normal diets and activities. Computed tomography angiography examinations showed that all stent grafts were intact without fracture. All bridging covered stents were patent. Angiography showed that the position, shape, and adhesion of the stent grafts were good, and no obvious endoleaks were found. Histological examination showed that the biocompatibility of the stent grafts was good. CONCLUSIONS: This study's outcomes demonstrate that it is safe and feasible to deploy a modular single inner-branched stent graft in a porcine model. CLINICAL IMPACT: This device is the first modular device designed to treat TBAD adjacent to LSA in China. This device is a modular two-component system consisting of a thoracic aortic stent graft with a retrograde inner branch and a bridging covered stent. The modular design and the retrograde inner branch are the two important innovations of this device. Theoretically, the device could make it easier and safer for clinicians to treat TBAD adjacent to the LSA.
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Breast cancer (BC) has been the focus of numerous studies aimed at identifying novel biological markers for its early detection. PIWI-interacting RNAs (piRNAs), a subset of small non-coding RNAs, have emerged as potential markers due to their aberrant expression in various cancers. PiRNAs have recently gained attention due to their aberrant expression in various cancers, including BC. PiRNAs, exhibit diverse biological activities, such as epigenetic regulation of gene and protein expression and their association with cell proliferation and metastasis has been well-established. As the field of non-coding RNAs rapidly evolves, there is great anticipation that therapies targeting piRNAs will advance swiftly. This review will delve into the various biological functions of piRNAs, such as gene suppression, transposon silencing, and epigenetic regulation of genes. The review will also highlight the role of piRNAs as either progenitors or suppressors in cancers, with a particular focus on BC. Lastly, it will touch upon the potential of piRNAs as biomarkers and therapeutic targets for BC.
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Biomarcadores de Tumor , Neoplasias de la Mama , ARN Interferente Pequeño , Humanos , Neoplasias de la Mama/genética , Neoplasias de la Mama/patología , Neoplasias de la Mama/terapia , Neoplasias de la Mama/metabolismo , Femenino , ARN Interferente Pequeño/uso terapéutico , ARN Interferente Pequeño/genética , Biomarcadores de Tumor/genética , Biomarcadores de Tumor/metabolismo , Regulación Neoplásica de la Expresión Génica/genética , Epigénesis Genética/genética , AnimalesAsunto(s)
Aneurisma de la Aorta Torácica , Disección Aórtica , Procedimientos Endovasculares , Humanos , Disección Aórtica/cirugía , Aneurisma de la Aorta Torácica/cirugía , Procedimientos Endovasculares/métodos , Masculino , Stents/efectos adversos , Implantación de Prótesis Vascular/métodos , Complicaciones Posoperatorias/etiología , Prótesis Vascular/efectos adversos , Persona de Mediana Edad , Reparación Endovascular de AneurismasRESUMEN
Micromixers, as crucial components of microfluidic devices, find widespread applications in the field of biochemistry. Due to the laminar flow in microchannels, mixing is challenging, and it significantly impacts the efficiency of rapid reactions. In this study, numerical simulations of four baffle micromixer structures were carried out at different Reynolds numbers (Re = 0.1, Re = 1, Re = 10, and Re = 100) in order to investigate the flow characteristics and mixing mechanism under different structures and optimize the micromixer by varying the vertical displacement of the baffle, the rotation angle, the horizontal spacing, and the number of baffle, and by taking into account the mixing intensity and pressure drop. The results indicated that the optimal mixing efficiency was achieved when the baffle's vertical displacement was 90 µm, the baffle angle was 60°, the horizontal spacing was 130 µm, and there were 20 sets of baffles. At Re = 0.1, the mixing efficiency reached 99.4%, and, as Re increased, the mixing efficiency showed a trend of, first, decreasing and then increasing. At Re = 100, the mixing efficiency was 97.2%. Through simulation analysis of the mixing process, the structure of the baffle-type micromixer was effectively improved, contributing to enhanced fluid mixing efficiency and reaction speed.
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Utilizing diverse material combinations in heterogeneous structures has become an effective approach for regulating interface characteristics and electronic structures. The g-C3N4/Co3O4 heterostructures were fabricated by uniformly modifying Co3O4 nanoparticles onto discrete clusters of g-C3N4 nanosheets. Then, they were subsequently employed as positive electrode materials for assembling hybrid supercapacitors. According to the first-principles calculation, Co3O4 and g-C3N4 formed Co-N ionic bonds, establishing interfacial space symmetry-broken heterojunction and direct exchange and superexchange between ions at the interface and sub-interface. This resulted in a high-density spin-orbit hybrid heterogeneous polarization interface, significantly improving the quantum capacitance of heterojunction materials. Experimental results showed that the heterojunction had a specific capacitance of 2662 F g-1 at 1 A g-1. When the power density was 750 W kg-1, the energy density reached 128 Wh kg-1. Even when the power density was 16850 W kg-1, it could show an energy density of 62.5 Wh kg-1. The g-C3N4/Co3O4 heterojunction could realize high energy density charge storage as the cathode material of supercapacitors. The construction of heterogeneous polarization interfaces for high-energy quantum capacitors provides a new and effective method for the energy storage field.
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OBJECTIVE: To understand the serological characteristics of irregular antibodies in pregnant women and explore their clinical significance. METHODS: From January 2017 to March 2022, 151 471 pregnant women in Women and Children's Hospital of Chongqing Medical University were enrolled in this study, microcolumn gel card test was used for irregular antibody screening, and antibody specificity identification was further performed in some antibody-positive subjects. RESULTS: The positive rate of irregular antibody screening in the enrolled pregnant women was 0.91% (1 375/151 471), 0.23% (355/151 471) was detected in the first trimester, 0.05% (71/151 471) in the second trimester, and 0.63% (949/151 471) in the third trimester. The positive rate of irregular antibody screening in the third trimester was significantly higher than that in the first and second trimester, and a significant increase in the number of positive cases was found in the third trimester than that in the second trimester. The analysis of agglutination intensity of 1 375 irregular antibody screening positive results showed that the weakly positive agglutination intensity accounted for 50.11% (689/ 1 375), which was the highest, the suspicious positive was 18.69% (257/1 375), and the positive was 31.20% (429/1 375). The significant difference in distribution of agglutination intensity was not observed between the first trimester group and the second trimester group, however, in the third trimester, the proportion of suspicious positive and weakly positive was lower than the first trimester, while, the proportion of positive was higher than the first trimester, and the difference was statistically significant (P < 0.001). Among the irregular antibody screening positive pregnant women, the proportion of pregnant women with pregnancy number ≥ 2 was significantly higher than that with pregnancy ≤ 1. Among 60 pregnant women who underwent antibody identification, the distributions of the antibodies were as follows: Rh blood group system accounted for 23.33% (14/60), Lewis system 43.33% (26/60), Kidd system 3.33% (2/60), MNS system 16.67% (10/60), P1PK system 1.67% (1/60), autoantibodies 1.67% (1/60), and 4 cases was unable to identify (6.67%, 4/60). Among specific antibodies, the anti-Lea was the most common (30.00%), followed by anti-E (16.67%) and anti-M (16.67%). CONCLUSION: The differences of irregular antibody serological characteristics exist in pregnant women from different regions with different genetic backgrounds, understanding the characteristics of irregular antibody in local pregnant women is of great significance for ensuring transfusion safety in pregnant women and preventing hemolytic disease of newborn.
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Antígenos de Grupos Sanguíneos , Mujeres Embarazadas , Recién Nacido , Niño , Femenino , Embarazo , Humanos , Relevancia Clínica , Transfusión Sanguínea , AutoanticuerposRESUMEN
BACKGROUND: Few methods can cocurrently mimic the pathological characteristics and nature history of human abdominal aortic aneurysms (AAAs), especially for the exist of the self-healing tendency of rodents. This study tested a novel method for the AAA rat model induced by retroperitoneal implantation of an osmotic pump system with lipopolysaccharide (LPS) based on the hypothesis that chronic inflammation of perivascular adipose tissue directly influenced the development and progression of AAAs. METHODS: 20 male Sprague-Dawley rats (10-month-old) fed with the Paigen diet were randomly divided into 4 groups: the blank group ×2, the sham group ×4, the empty capsule group ×4, and the LPS capsule group ×10. The LPS capsule group received implantations of the ALZET® osmotic pump capsule with LPS (3.6 µg/day) parallel to the abdominal aorta through a retroperitoneal approach. Two weeks later, 6 rats were randomly selected from the LPS capsule group to form the anti-inflammatory group and received implantations of another osmotic pump capsule with interleukin (IL)-10 (75 ng/day) through the same approach. The changes in abdominal aortic diameter were observed by ultrasound every 2 weeks, and samples were harvested for histopathologic and immunohistochemical analysis 6 weeks later. RESULTS: Within the 6 weeks after modeling, the LPS capsule group showed sustained and significant aortic dilatation (P < 0.01), while the anti-inflammatory group showed a rapid and obvious shrinkage 2 weeks after the IL-10 osmotic pump capsule implantation (P < 0.01). The LPS capsule group presented excellent pathological mimicking of human AAAs and showed severe medial degeneration with the least elastic content among the 5 groups at the end of the sixth week (P < 0.05). Notably, the anti-inflammatory group showed perfect medial preservation with the most elastic content (P < 0.05) and the highest elastin/collagen ratio (P < 0.01) at the end of the study. Matrix metalloproteinases (MMP) 2 and 9 and toll-like receptor 2 showed strong expression in the LPS capsule group at the end of the sixth week, which was significantly higher than that in the blank group and sham group. Interestingly, the anti-inflammatory group showed a slightly higher MMP9 expression than the LPS capsule group though there was no statistical difference between them. CONCLUSIONS: This novel method for the rat AAA model induced by retroperitoneal implantation of an osmotic pump capsule with LPS can concurrently mimic the histological characteristics and natural history of human AAAs. Further studies were needed to improve the osmotic pump system.
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Aneurisma de la Aorta Abdominal , Lipopolisacáridos , Humanos , Ratas , Masculino , Animales , Lactante , Lipopolisacáridos/efectos adversos , Lipopolisacáridos/metabolismo , Ratas Sprague-Dawley , Resultado del Tratamiento , Aneurisma de la Aorta Abdominal/inducido químicamente , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Aorta Abdominal/diagnóstico por imagen , Aorta Abdominal/cirugía , Aorta Abdominal/metabolismo , Antiinflamatorios , Modelos Animales de EnfermedadRESUMEN
While deep learning has found widespread utility in gearbox fault diagnosis, its direct application to wind turbine gearboxes encounters significant hurdles. Disparities in data distribution across a spectrum of operating conditions for wind turbines result in a marked decrease in diagnostic accuracy. In response, this study introduces a tailored dynamic conditional adversarial domain adaptation model for fault diagnosis in wind turbine gearboxes amidst cross-condition scenarios. The model adeptly adjusts the importance of aligning marginal and conditional distributions using distance metric factors. Information entropy parameters are also incorporated to assess individual sample transferability, prioritizing highly transferable samples during domain alignment. The amalgamation of these dynamic factors empowers the approach to maintain stability across varied data distributions. Comprehensive experiments on both gear and bearing data validate the method's efficacy in cross-condition fault diagnosis. Comparative outcomes demonstrate that, when contrasted with four advanced transfer learning techniques, the dynamic conditional adversarial domain adaptation model attains superior accuracy and stability in multi-transfer tasks, making it notably suitable for diagnosing wind turbine gearbox faults.
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The stacking 2D materials, such as molybdenum disulfide (MoS2), are among the most promising candidates for detecting H2S gas. Herein, we designed a series of novel nanocomposites consisting of MoS2 and ZnCo2O4. These materials were synthesized via a simple hydrothermal method. The microstructure and morphology of nanocomposites were studied by different characteristics such as X-ray diffraction, scanning electron microscopy, energy-dispersive X-ray spectroscopy, transmission electron microscopy, high-resolution transmission electron microscopy, Brunauer-Emmett-Teller (BET), and X-ray photoelectron spectroscopy. These nanocomposites were used as gas sensors, and the highest response (6.6) toward 10 ppm of H2S was detected by the gas sensor of MZCO-6 (having MoS2 contents 0.060 g) among all other tested sensors. The response value (Ra/Rg) was almost three times that of pure ZnCo2O4 (Ra/Rg = 2). In addition, the sensor of MZCO-6 exposed good selectivity, short response/recovery time (12/28 s), long-term stability (28 days), and a low detection limit (0.5 ppm) toward H2S gas at RT. The excellent performance of MZCO-6 may be attributed to some features of MoS2, such as stack structure, higher BET and surface area and active sites, a synergistic effect, etc. This simple fabrication sensor provides a novel idea for detecting H2S gas at RT.
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The presence of moisture and air in hydraulic oil will seriously affect the reliability of machines. This paper proposes a new cross-capacitive oil pollution detection sensor, which is based on the Thompson and Lampard theorem. The sensing unit consists of four identical copper electrodes with infinitesimally small gaps. The sensor can effectively distinguish water droplets and air bubble pollutants mixed in the oil through the pulse direction of the signal. Compared with traditional capacitive sensors, the sensor has a significant improvement in detection accuracy and detection throughput. In this paper, the relationship between the cross-capacitance value with the dielectric constant and the frequency in an alternating electric field was deduced, and the best excitation frequency was chosen as 1.9 MHz. Experiments show that the sensor can effectively detect water droplets of 140-160 µm and bubbles of 170-190 µm and has good linearity for detecting water droplets and air bubbles of different sizes. The sensor provides a new method for machine condition monitoring of hydraulic systems.
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Objective: The objective of this study is to investigate whether alcohol exposure and specific alcoholic drinks are independent risk factors for incident knee surgery in knee osteoarthritis (KOA) patients. Methods: We identified all patients who were clinically diagnosed as KOA between January 2010 and January 2018 in our outpatient department. Demographic, clinical, and radiographic data were collected from the database of our hospital. Next, we analyzed the association between alcohol consumption and incident knee surgery. Results: A total of 4,341 KOA patients completed the current study and were included in the final analysis. Incident knee surgery for the purpose of treating osteoarthritis was observed in 242 patients. Incident knee surgery was significantly associated with age (OR [95%CI], 1.023 [1.009-1.039], P = 0.002), BMI (OR [95%CI], 1.086 [1.049-1.123], P < 0.001), baseline K-L grade 3 (OR [95%CI], 1.960 [1.331-2.886], P = 0.001), baseline K-L grade 4 (OR [95%CI], 1.966 [1.230-3.143], P = 0.005), 7.1-14 drinks per week (OR [95%CI], 2.013 [1.282-3.159], P = 0.002), >14 standard drinks per week (OR [95%CI], 2.556 [1.504-4.344], P = 0.001), and the most common alcoholic drink produced by pea (OR [95%CI], 3.133 [1.715-5.723], P < 0.001). Conclusion: KOA patients who consumed more than seven standard drinks per week were at substantial risk of incident knee surgery. In addition, alcoholic drink produced by pea is also an independent risk factor.
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OBJECTIVE: To preliminarily evaluate the safety and efficacy of the WeFlow-JAAA endograft, a novel off-the-shelf device designed for the repair of juxtarenal abdominal aortic aneurysms (JRAAAs) and pararenal abdominal aortic aneurysms (PRAAAs). METHODS: This prospective single-arm first-in-human clinical trial included patients with JRAAAs (infrarenal necks ≤10 mm) or PRAAAs with at least a 5 mm sealing zone below the superior mesenteric artery (SMA) who underwent endovascular repair using the WeFlow-JAAA endograft system. With this system, the celiac artery was addressed with a wide scallop, the renal arteries (RAs) were addressed with 2 standard inner branches, and the SMA was addressed with a "mini-inner-cuff" reinforced fenestration. The primary efficacy endpoint was the clinical success at 12 months. The primary safety endpoint was the freedom from major adverse events (MAEs) in the first 30 days after surgery. RESULTS: Fifteen patients (all men; mean age 68.5±6.0 years) were enrolled between October 2019 and August 2021. The median infrarenal neck length was 0 mm (IQR, 0-4 mm). Technical success was achieved in all patients. No MAEs occurred in the first 30 days. The mean fluoroscopy time was 73.1±27.8 minutes, and the mean volume of contrast media was 130.7±29.4 mL. Clinical success was maintained in all patients at 12 months. No aortic-related deaths, aneurysm rupture, type I or type III endoleak, or open surgery conversion occurred during the follow-up period. The secondary intervention was required only in 1 patient who developed an occluded right RA stent 14 months after the procedure. CONCLUSION: The WeFlow-JAAA endograft device appears to be safe and efficacious in selected patients with JRAAAs or PRAAAs with more than 5 mm sealing zone below SMA. Large-scale, multicenter, and prospective studies with long-term follow-ups are ongoing to validate our findings in China. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT04745546 (URL: Guo's Visceral Arteries Reconstruction: The First in Man Study of WeFlow-JAAA Stent Graft System-Full-Text View-ClinicalTrials.gov). CLINICAL IMPACT: The first-in-human clinical trial of the WeFlow-JAAA endograft system demonstrates promising safety and efficacy in treating juxtarenal abdominal aortic aneurysms (JRAAAs) and partial pararenal abdominal aortic aneurysms (PRAAAs). This innovative off-the-shelf device offers a potential alternative to traditional endovascular aortic repair. The successful outcomes, including technical success in all patients, freedom from major adverse events, and maintenance of clinical success at 12 months, suggest a potential shift in clinical practice towards using the WeFlow-JAAA endograft system for selected patients. This study paves the way for larger-scale, multicenter, prospective studies to further validate its long-term safety and efficacy, offering clinicians a new option for managing complex abdominal aortic aneurysms.
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PURPOSE: The cross-limb (CL) technique is a commonly used endovascular treatment for addressing unfavorable anatomical features in patients with abdominal aortic aneurysm (AAA). The configuration of CL stent-graft plays a critical role in determining the postoperative hemodynamic properties and physiological behaviors, which ultimately impact the efficacy and safety of endovascular AAA treatment. This study aims to investigate the relationship between hemodynamics and CL stent-graft configuration from a hemodynamic perspective. METHODS: Five distinct geometric models of cross-limb (CL) stent-graft configurations were constructed by optimizing the real clinical computed tomography angiography (CTA) data. These models varied in main body lengths and cross angles and were used to perform numerical simulations to analyze various hemodynamic parameters. Flow pattern, distribution of wall shear stress (WSS)-related parameters, localized normalized helicity (LNH), pressure drop, and the displacement force of all models were examined in this paper. RESULTS: In patient-specific cases, helical flow and WSS increase with the main body. However, it also generated secondary flow in localized areas, leading to increased oscillation in the WSS direction. Notably, increasing the stent graft's main body length or decreasing the cross angle reduced the displacement force exerted on the stent-graft. Reducing the cross angle did not significantly alter the hemodynamic characteristics. CONCLUSION: In the clinical practice of CL deployment, it is crucial to carefully consider the stent-graft configuration and the patient specific to achieve optimal postoperative outcomes. This study provides valuable insights for guiding stent selection and treatment planning in patients with abdominal aortic aneurysm undergoing CL techniques, from a hemodynamic perspective.
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The layered 2-D materials, such as molybdenum disulfide (MoS2), are among the most promising candidates for detecting H2S gas at very low concentrations. Herein, we have designed a series of novel nanocomposites consisting of MoS2 and NiO. These materials were synthesized via a simple hydrothermal method. The microstructure and morphology of nanocomposites were studied using different characterization techniques, such as X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), high-resolution transmission electron microscopy (HRTEM), Brunauer-Emmett-Teller (BET) analysis, and X-ray photoelectron spectroscopy (XPS). These nanocomposites were used as gas sensors, and the highest response (6.3) towards 10 ppm H2S was detected by the MNO-10 gas sensor among all the tested sensors. The response value (Rg/Ra) was almost three times that of pure NiO (Rg/Ra = 2). Besides, the MNO-10 sensor exposed good selectivity, short response/recovery time (50/20 s), long-term stability (28 days), reproducibility (6 cycles), and a low detection limit (2 ppm) towards H2S gas at RT. The excellent performance of MNO-10 may be attributed to some features of MoS2, such as a layered structure, higher BET surface area, higher active sites, and a synergistic effect between MoS2 and NiO. This simple fabrication sensor throws a novel idea for detecting H2S gas.
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OBJECTIVE: To investigate the association between the imaging biomarker (volumetric perivascular characterization index [VPCI]) which indicates the aortic wall inflammation by mapping the spatial changes of perivascular fat attenuation on computed tomography angiography (CTA) and the reintervention risk for abdominal aortic aneurysm (AAA) patients after endovascular aortic repair (EVAR). METHODS: This case-control study included AAA patients undergoing EVAR from a single center (n=260). Cases were AAA patients undergoing reintervention after EVAR and a 1:1 frequency-matched control group of AAA patients post-EVAR with a shrunken or ≥3-year stable sac and free of reintervention signs during the follow-up. The predictive variable (VPCI trajectory) was converted to binary variables according to the changing trend of VPCI with follow-up time. As a quasi-complete separation data pattern, least absolute shrinkage and selection operator (lasso) regression was used to screen and prove the VPCI trajectory as the best predictor, and the performance was evaluated by calculating the accuracy, sensitivity, and specificity. RESULTS: Between 2010 and 2021, 15 AAA patients after EVAR with type I/III endoleak, aneurysm rupture, or impending rupture were included. Compared with the 1:1 frequency-matched controls with a shrunken or ≥3-year stable sac and free of reintervention signs during the follow-up, VPCI trajectories of the case group were all upward trends, whereas the controls showed 86.7% downward trends (p<0.001). The best predictive model of lasso regressions included 4 variables, and VPCI trajectory was the most outstanding, followed by the proximal landing zone, the distal landing zone, and the infrarenal ß angle. The accuracy, sensitivity, and specificity of predicting the risk of reintervention were as follows, respectively: 93.3%, 100%, and 86.7%. CONCLUSIONS: The wall inflammation detected by imaging perivascular adipose tissue based on the CTAs was strongly associated with the reintervention risk for AAA patients after EVAR, which might hold major promise as a new imaging biomarker for the mechanism and treatment study of human AAAs before and after EVAR. CLINICAL IMPACT: The study introduces a novel imaging biomarker which indicates the aortic wall inflammation by mapping spatial changes of perivascular fat attenuation on CTA. This biomarker demonstrates a strong association with the reintervention risk in AAA patients after EVAR. Incorporation of VPCI into clinical practice has the potential to enhance the traditional surveillance methods (CT/CTAs) by providing clinicians with a non-invasive method to assess aortic wall inflammation and predict the risk of reintervention. Additionally, this study might offer a valuable tool for mechanism and treatment research in humans with AAAs both pre- and post-EVAR, ultimately improving patient outcomes and refining therapeutic strategies.
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Background and objective: The G-Branch endograft is a novel multibranched "off-the-shelf" device used to repair thoracoabdominal aortic aneurysms (TAAAs). This report describes the hemodynamic and morphological performance of the G-Branch endograft in a human patient with TAAA. Materials and methods: We retrospectively reviewed the computed tomography angiography scans and clinical data of a woman in whom TAAA was treated using a G-Branch endograft. Patient-specific three-dimensional models were reconstructed, and computational fluid dynamics and morphological and hemodynamic indicators were analyzed before and after implantation of the device. Results: From a morphological perspective, there was an increase in cross-sectional area in the G-Branch endograft and all bridging stent grafts over time. Blood flow was redistributed among the renovisceral arteries, with a decrease in flow rate in the celiac artery and an increase in the left renal artery. Laminar blood flow was smoother and more rapid after implantation of the G-Branch device and remained stable during follow-up. In the bridging stent grafts, flow recirculation zones were found in the bridging zones of the celiac artery and superior mesenteric artery as well as the distal sealing zones of both renal arteries. Furthermore, higher time-averaged wall shear stress and a lower oscillatory index and relative resident time were found in the G-Branch endograft and bridging stent grafts. Quantitative analysis showed obvious reduction in the surface area ratio of the elevated time-averaged wall shear stress area and surface area ratio of the relative resident time after G-branch implantation. Conclusion: The revascularization of branch vessels occurred following G-branch implantation, with improvements arising not only from morphological changes but also from hemodynamic alterations. The long-term performance of the G-Branch endograft needs further investigation and clinical validation.