Flip-over of blood vessel intima caused by vascular closure device: A case report.

BACKGROUND: Complications of vascular closure devices mainly include bleeding, vascular injury, and trapped device that cannot be removed percutaneously. However, arterial stenosis or occlusion induced by vascular injury is rare. This article introduces a rare case with severe acute limb ischemia after using the vascular closure device (StarClose). CASE SUMMARY: A 54-year-old man was admitted because of necrosis of the second toe of the left foot for 2 mo. Ultrasound showed left femoral artery stenosis, and occlusion of the left popliteal, posterior tibial, peroneal, anterior tibial and dorsalis pedis arteries, suggesting arteriosclerosis obliterans of low extremities, gangrene and type 2 diabetes. He underwent an interventional procedure of drug-eluting balloon in the left lower limb via antegrade puncture of the left common femoral artery. He developed acute limb ischemia after 1 h, and severe pain, numbness, pale skin, low skin temperature and weakened sensation in the left foot. Injury of the common femoral artery intima was considered. Exploratory surgery showed occlusion at the puncture point accompanied with bulged vascular lumen and flipped vascular intima caused by StarClose. The flipped intima was removed. The limb blood supply was restored and the limb was saved post-surgery. He recovered well at final follow-up. CONCLUSION: Incorrect use of the vascular closure device was the main cause of severe acute limb ischemia in this case.

[Research Status and Hot Trends in Atherosclerosis Genomics between 2010 and 2019].

Objective To analyze the research status,hotspots,and frontiers of atherosclerosis genomics from 2010 to 2019.Methods CiteSpace software was used to conduct data statistics and visual analysis on countries,institutions,authors,journals,co-cited papers,and keywords of the related papers published in the Web of Science from 2010 to 2019.Results A total of 1021 papers in English were included,and the annual number of publications generally showed an upward trend.The knowledge base in the research of atherosclerosis mostly focused on the genetic risk sites and biomarkers for coronary artery diseases such as coronary heart disease,myocardial infarction,and dyslipidemia.The related journals mainly involved the fields of molecular biology,biology,genetics,immunology,medicine,pharmacy,and clinical medicine.The latest research in atherosclerosis concentrated on genome-wide association study,DNA methylation,microRNA,messenger RNA and so on.The research frontiers involved long noncoding RNA,DNA methylation,and immune metabolism.Conclusion The studies in atherosclerotic genomics have gradually increased.

[Effect of Simiao Yong'an Decoction on the Expression of Wnt/p-catenin Signaling Pathway in Diabetic Ulcer Model Rats].

Objective To observe the changes of the Wnt/ß-catenin signaling pathway in diabetic ulcer (DU) model rats and to study the effect of Simiao Yong'an Decoction (SYD) on it. Methods Totally 51 female Wistar rats were divided into the normal control group (n =17) and the diabetes mellitus (DM) group (n =34) according to random digit table. Rats in the normal control group were fed with common forage. Those in the DM group were prepared for DM model by high fat high glucose forage +intrap- eritoneal injection of low-dose Streptozotocin (STZ). Successfully modeled rats were then randomly divided into the DU group and the DU-SYD group, 15 in each group. Fifteen rats were randomly selected from the normal control group, and then divided into the ulcer control group (CU). Rats in the DU-SYD group were administered with SYD by gastrogavage. Rats in the CU group and the DU group were administered with normal saline by gastrogavage. The conditions of wound healing were observed, histomorphological changes of the wound tissues were observed by HE staining at day 3, 7, and 14, respectively. Protein and mRNA expressions of p-catenin, GSK-3ß, and Rspo-3 in wound tissues were detected by ELISA and RT-PCR. Results The wound healing rate was sequenced from high to low as Group CU, Group DU- SYD, Group DU at day 3, 7, and 14, respectively (P <0. 05). Compared with CU group, protein contents and mRNA expressions of ß-catenin and Rspo-3 in wound tissues decreased, protein contents and mR- NA expressions of GSK-3ß increased in the DU group at day 3, 7, and 14, respectively (P <0. 05). Compared with the DU group, protein contents and mRNA expressions of ß-catenin in wound tissues increased, protein contents and mRNA expressions of GSK-3ß decreased in the DU-SYD group at day 3, 7, and 14, respectively (P<0. 05). There was no significant difference in protein contents or mRNA ex- pressions of Rspo-3 between the DU group and the DU-SYD group (P >0. 05). Conclusions Down-regulation of Wnt/ß-catenin pathway might result in difficult healing of UC. SYD could promote the healing of DU possibly by regulating Wnt/ß-catenin signaling pathway.