Morphological features and endovascular repair for type B multichanneled aortic dissection: A case report.

BACKGROUND: Among the various types of aortic dissection, multichanneled aortic dissection (MCAD) differs from classic double-channeled aortic dissection and involves the formation of an additional false lumen in the aortic wall or the flaps. It is considered a relatively rare condition with high perioperative mortality and morbidity. However, the morphological characteristic and the optimal therapeutic strategy for MCAD has not been fully determined. CASE SUMMARY: A 64-year-old man presented to our hospital with severe epigastric abdominal pain radiating to the back that was associated with nausea without emesis. A computed tomography angiogram was performed that revealed a type B aortic dissection with multiple channels extending from the level of the left subclavian artery to the bilateral femoral arteries. We used a medical three-dimensional modeling (3D) modeling system to identify the location and extension of multiple lumens from different angles. It also precisely located the two primary entries leading to the false lumens, which helped us to exclude the two false lumens with one stent-graft. CONCLUSION: By applying medical 3D modeling system, we discover the fragility of aortic wall and the collapse of true lumen caused by the multiple false lumens are the two morphological features of MCAD.

Prognostic value of osteopontin expression in breast cancer: A meta-analysis.

Osteopontin (OPN) has been implicated in tumor development and progression over the last few years. However, the prognostic value of OPN overexpression in patients with breast cancer remains controversial. We performed a meta-analysis to investigate the association of OPN expression in the tumor with the clinicopathological characteristics and survival of breast cancer patients. A total of 8 studies met the inclusion criteria and were entered in the meta-analysis. The data analysis demonstrated that OPN expression was positively associated with lymph node metastasis [pooled odds ratio = 2.026, 95% confidence interval (CI): 1.199-3.425, P=0.008, random-effects model]. We also found that OPN expression was positively associated with overall survival [hazard ratio (HR) = 3. 69, 95% CI: 1. 45-9.42, P=0.000, random-effects model) and disease -free survival (pooled HR=2.40, 95% CI: 1.27-4.55, P=0.007, fix ed -effects model). Based on the results of this study, we concluded that OPN overexpression in the tumor is a candidate positive prognostic biomarker for breast cancer patients.

[Detection of microvasculature in rat hind limb using synchrotron radiation].

OBJECTIVE: To detect deep-level microvascular structure in rat hind limb by synchrotron radiation and microangiographic technique. METHODS: Microangiography in vivo and ex vivo was performed by synchrotron radiation based absorption imaging and phase contrast imaging, with omnipaque and barium sulfate solution as contrast media, respectively, and synchrotron radiation-based micro-computed tomography (SRmCT) was also performed to reveal three-dimensional morphology of the blood vessel in rat hind limb. RESULTS: Using microangiographic technique in vivo and in vitro (with barium sulfate), blood vessels in the rat limb muscle could be visualized with high resolution, and the fourth branches of iliac artery in rat hind limb could be detected with the minimum visualized blood vessels about 40 µm and 9 µm in diameter, respectively. In addition, the vascular network could be defined and analyzed at the micrometer scale from the 3D renderings of limb vessel as shown by SRmCT. CONCLUSION: Synchrotron radiation-based microangiography and SRmCT thus provided a practical and effective means to observe the microvasculature of rat hindlimb, which might be useful in assessment of angiogenesis in lower limbs.

[Clinical observation on the long-term effect of warming-promotion acupuncture on lumbar spinal stenosis].

OBJECTIVE: To observe the difference effects between warming-promotion acupuncture and normal acupuncture on lumbar spinal stenosis (LSS). METHODS: Sixty cases of LSS were randomly divided into a normal acupuncture group (30 cases) and a warming-promotion acupuncture group (30 cases). The two groups both chose Dazhui (GV 14), Mingmen (GV 4), Jiaji (EX-B 2),etc. Normal method without special manipulation was used in normal acupuncture group, while the warming-promotion manipulation was used in warming-promotion acupuncture group, all once daily, 10 treatments made one session. Compare the symptoms and spinal cord function of LSS, quality of life (QOL)and clinical effect in the two groups. RESULTS: The comprehensive score of symptoms of LSS in warming-promotion group 3 months after treatment was 6.30 +/- 1.92, while that in normal acupuncture group was 4.67 +/- 13.70. The score of spinal cord function in warming-promotion group after treatment was 7.03 +/- 1.03, while that in normal acupuncture group was 6.33 +/- 1.12. The score of QOL in warming-promotion group after treatment was 53.67 +/- 8.91, while that in normal acupuncture group was 64.50 +/- 16.69. All the differences between these scores in two groups were statistically significant (all P < 0.05). The total effective rate was 90.0% (27/30)in warming-promotion group, and 80.0% (24/30) in normal acupuncture group. The effect of warming-promotion group was better than that in normal acupuncture group (P < 0.05). CONCLUSION: In the field of treating LSS, the effect of warming-promotion acupuncture is better than normal acupuncture.

The antithrombotic effect of a novel hirudin derivative after reconstruction of carotid artery in rabbits.

INTRODUCTION: Hirudin is a direct thrombin inhibitor that has potential mechanistic advantages over indirect inhibitors. Peptides containing the RGD motif competitively inhibit binding of fibrinogen to glycoprotein IIb/IIIa on platelets, thus inhibiting platelet aggregation. A novel hirudin derivative, recombinant RGD-hirudin (r-RGD-hirudin), was engineered by fusing the tripeptide RGD sequence to the native hirudin. We tested the antithrombotic effect of r-RGD-hirudin using a carotid artery reconstruction model in rabbits. MATERIALS AND METHODS: A fusion gene encoding r-RGD-hirudin was constructed and expressed at high levels in Pichia pastoris. Following traumatic injury and anastomosis, 42 New Zealand White rabbits were randomized to receive normal saline, abciximab, wild-type hirudin, or r-RGD-hirudin. Fibrinogen concentration, aPTT, TT, PT, and PAGm were measured prior to and following the operation. Carotid angiography and pathological examination of the anastomotic site were performed to compare patency rates among the groups. RESULTS: The r-RGD-hirudin significantly prolonged aPTT, TT, PT and inhibited PAGm following carotid anastomosis in rabbits. The median dose of r-RGD-hirudin (0.5 mg/kg) had a therapeutic effect equal to that of wild-type hirudin (1.0 mg/kg) and higher than that of abciximab (0.2 mg/kg) with regard to patency rates. CONCLUSIONS: Compared to wild-type hirudin or antiplatelet agent, the novel anticoagulant, r-RGD-hirudin was capable of inhibiting both thrombin activity and platelet aggregation, and was demonstrated to be effective in the prevention of thrombosis.