Anti-Nasopharyngeal carcinoma mechanism of sanguinarine based on network pharmacology and molecular docking.

BACKGROUND: The purpose of this study was to investigate the mechanism of sanguinarine (SAN) against nasopharyngeal carcinoma (NPC) by means of network pharmacology, molecular docking technique, and experimental verification. METHODS: The SAN action targets were predicted using the Swiss Target Prediction database, the related NPC targets were determined using the GEO database, and the intersection of drug and disease pathway targets were considered to be the potential targets of SAN against NPC. The target-protein interaction network map was constructed using the STRING database, and the core target genes of SAN against NPC were obtained via topological network analysis. "R" language gene ontology (GO) function and Kyoto encyclopedia of genes and genome (KEGG) pathway enrichment analyses were used to dock the core target genes with SAN with the help of AutodockVina. Cell proliferation was detected using MTT and xCELLigence real-time cell analysis. Apoptosis was identified via Hoechst 33342 staining, JC-1 mitochondrial membrane staining, and annexin V-FITC/PI double fluorescence staining, while protein expression was quantified using western blotting. RESULTS: A total of 95 SAN against NPC targets were obtained using target intersection, and 8 core targets were obtained by topological analysis and included EGFR, TP53, F2, FN1, PLAU, MMP9, SERPINE1, and CDK1. Gene ontology enrichment analysis identified 530 items, and 42 items were obtained by Kyoto encyclopedia of genes and genome pathway enrichment analysis and were mainly related to the PI3K/AKT, MAPK, and p53 signaling pathways. Molecular docking results showed that SAN had good binding activity to the core target. SAN inhibited the proliferation of NPC cells, induced apoptosis, reduced the expression levels of survivin and Bcl2, and increased the expression levels of Bax and cleaved caspase-8. It also decreased the expression levels of the key proteins p-c-Raf, p-MEK, and p-ERK1/2 in the MAPK/ERK signaling pathway in NPC cells. CONCLUSION: SAN inhibits the proliferation and induces the apoptosis of NPC cells through the MAPK/ERK signaling pathway.

Puerarin prevents sepsis-associated encephalopathy by regulating the AKT1 pathway in microglia.

BACKGROUND: Previous studies have reported that puerarin possesses cardioprotective, vasodilatory, anti-inflammatory, anti-apoptotic, and hypoglycemic properties. However, the impact of puerarin on sepsis-associated encephalopathy (SAE) remains unexplored. In this study, we explored whether puerarin can modulate microglia-mediated neuroinflammation for the treatment of SAE and delved into the underlying mechanisms. METHODS: We established a murine model of SAE through intraperitoneal injection of lipopolysaccharide (LPS). The puerarin treatment group received pretreatment with puerarin. For in vitro experiments, BV2 cells were pre-incubated with puerarin for 2 h before LPS exposure. We employed network pharmacology, the Morris Water Maze (MWM) test, Novel Object Recognition (NOR) test, immunofluorescence staining, enzyme-linked immunosorbent assay (ELISA), Western blotting, and quantitative real-time PCR (qRT-PCR) to elucidate the molecular mechanism of underlying puerarin's effects in SAE treatment. RESULTS: Our findings demonstrate that puerarin significantly reduced the production of inflammatory cytokines (TNF-α and IL-6) in the peripheral blood of LPS-treated mice. Moreover, puerarin treatment markedly ameliorated sepsis-associated cognitive impairment. Puerarin also exhibited inhibitory effects on the release of TNF-α and IL-6 from microglia, thereby preventing hippocampal neuronal cell death. Network pharmacology analysis identified AKT1 as a potential therapeutic target for puerarin in SAE treatment. Subsequently, we validated these results in both in vitro and in vitro experiments. Our study conclusively demonstrated that puerarin reduced LPS-induced phosphorylation of AKT1, with the AKT activator SC79 reversing puerarin's anti-inflammatory effects through the activation of the AKT1 signaling pathway. CONCLUSION: Puerarin exerts an anti-neuroinflammatory effect against SAE by modulating the AKT1 pathway in microglia.

Molecular Assessment of Scutellaria barbata D. Don in the Treatment of Nasopharyngeal Carcinoma Based on Network Pharmacology and Experimental Verification.

OBJECTIVE: To predict the molecular mechanisms behind the benefits of Scutellaria barbata D. Don (S. barbata) in nasopharyngeal carcinoma (NPC) by network pharmacology and experimental verification. METHODS: The active ingredients and targets of S. barbata were searched in the traditional Chinese medicine system pharmacology database and analysis platform, and the disease targets of NPC were obtained by searching the GeneCards database. A common target protein-protein interaction network was constructed by STRING, and then, an active ingredients-NPC-target interaction network map was constructed by Cytoscape 3.7.2 software. The functional enrichment analyses of Gene Ontology and KEGG pathway data were carried out by R software programming. Finally, cell proliferation was assessed by CCK8, apoptosis was detected by Annexin V-FITC/PI double fluorescence staining, and protein expression was analyzed by Western blotting. RESULTS: In this study, 29 active ingredients were found in S. barbata. Among these, the main targets for NPC were baicalein, wogonin, luteolin, and quercetin. The main molecular targets of S. barbata on NPC were EGFR, MYC, CASP3, CCND1, and ESR1. The main biological processes involved the binding of DNA-binding transcription factors, RNA polymerase II-specific DNA-binding transcription factors, ubiquitin-like protein ligases, and ubiquitin-protein ligases. S. barbata mainly affects NPC through the PI3K-Akt, p53, and MAPK signaling pathways. The experimental results showed that baicalein and wogonin could inhibit proliferation and induce apoptosis of NPC cells and downregulate the expression of PI3K, AKT, and p53, the key proteins of the PI3K/AKT and p53 signaling pathway in CNE2 cells. CONCLUSION: Baicalein and wogonin, the main active ingredients of S. barbata, inhibited the proliferation and induced apoptosis of NPC cells through the PI3K/AKT and p53 signaling pathways.

A Digital Microscreen for the Enhanced Appearance of Ocular Prosthetic Motility (an American Ophthalmological Society Thesis).

PURPOSE: This study aims to improve the apparent motility of ocular prosthetic devices using technology. Prevailing ocular prostheses are acrylic shells with a static eye image rendered on the convex surface. A limited range of ocular prosthetic movement and lack of natural saccadic movements commonly causes the appearance of eye misalignment that may be disfiguring. Digital screens and computational systems may obviate current limitations in eye prosthetic motility and help prosthetic wearers feel less self-conscious about their appearance. METHODS: We applied convoluted neural networks (CNNs) to track pupil location in various conditions. These algorithms were coupled to a microscreen digital prosthetic eye (DPE) prototype to assess the ability of the system to capture full ocular ductions and saccadic movements in a miniaturized, portable, and wearable system. RESULTS: The CNNs captured pupil location with high accuracy. Pupil location data were transmitted to a miniature screen ocular prosthetic prototype that displayed a dynamic contralateral eye image. The transmission achieved a full range of ocular ductions and with grossly undetectable latency. Lack of iris and sclera color and detail, as well as constraints in luminosity, dimensionality and image stability limited the real eye appearance. Yet, the digitally rendered eye moved in the same amplitude and velocity as the native, tracked eye. CONCLUSIONS: Real-time image processing using CNNs coupled to microcameras and a miniscreen DPE may offer improvements in amplitude and velocity of apparent prosthetic eye movement. These developments, along with ocular image precision, may offer a next-generation eye prosthesis. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.

Primary Conservative Therapy for Symptomatic Isolated Mesenteric Artery Dissection with Severely Compressed True Lumen or Large Dissecting Aneurysm.

PURPOSE: To investigate the safety and effectiveness of primary conservative therapy for patients with symptomatic isolated mesenteric artery dissection (IMAD) with a severely compressed true lumen and/or a large dissecting aneurysm. MATERIALS AND METHODS: A total of 35 consecutive patients (all men; median age, 53 y) with symptomatic IMAD with a severely compressed true lumen and/or a large dissecting aneurysm but without intestinal necrosis or arterial rupture who were treated with primary conservative therapy between November 2018 and February 2020 were assessed. A severely compressed true lumen was defined as luminal stenosis > 70%. A large dissecting aneurysm was defined as dissecting aneurysm diameter ≥ 1.5 times larger than the normal mesenteric artery diameter. RESULTS: There was a strong positive relationship among abdominal pain, degree of luminal stenosis, and length of dissection (R = 0.811; P < .001). Conservative treatment was successful in all patients. Abdominal pain was eliminated within 4.7 d ± 4.8 (range, 2-31 d) in all patients, within 3.6 d ± 1.2 (range, 2-6) in the 31 patients with minor or moderate abdominal pain, and within 13.3 d ± 11.9 (range, 6-31 d) in the 4 patients with severe abdominal pain. Complete or partial remodeling of the mesenteric artery was achieved in 6 (17.1%) and 29 (82.9%) patients, respectively, during 8.6 mo ± 4.3 of follow-up. CONCLUSIONS: Primary conservative therapy can be used safely and effectively in patients with symptomatic IMAD with a severely compressed true lumen and/or a large dissecting aneurysm but without intestinal necrosis or arterial rupture.

Mesenteric Artery Remodeling after Conservative Management in Patients with Isolated Mesenteric Artery Dissection.

PURPOSE: To retrospectively investigate factors associated with mesenteric artery remodeling after conservative management of isolated mesenteric artery dissection (IMAD) (dissection of the mesenteric arteries in the absence of aortic dissection or other known causes). MATERIALS AND METHODS: A total of 107 patients diagnosed with IMAD between February 2010 and October 2018 were identified. Eighteen patients were excluded because they underwent stent placement (n = 11) or were lost to follow-up (n = 7). A total of 89 patients who underwent conservative management were therefore included in the study. Cox regression analysis was performed to identify factors associated with mesenteric artery remodeling. RESULTS: During 15.9 ± 10.9 months of follow-up, complete remodeling of the mesenteric artery was achieved in 66 patients (74.2%), and partial remodeling was achieved in 23 patients (25.8%). Of the 66 patients with complete remodeling, 6 (9.1%) had type IIa IMAD (visible false lumen, no visible re-entry site), and 60 (90.9%) had type IIb IMAD (thrombosed false lumen). The mean interval between IMAD diagnosis and complete remodeling was 14.4 ± 5.4 months for all patients. The mean intervals for patients with type IIa IMAD were 20.0 ± 6.2 months and 13.9 ± 5.1 months for patients with type IIb IMAD (P = .015). Mesenteric artery remodeling was significantly associated with the presence of symptoms (odds ratio, 10.800; 95% confidence interval, 1.961-59.470; P = .006). CONCLUSIONS: Complete remodeling of the mesenteric artery in patients with IMAD treated with conservative management is common, and the presence of symptoms is associated with complete remodeling.

Factors Associated with Failed Conservative Management in Symptomatic Isolated Mesenteric Artery Dissection.

OBJECTIVE: The aim of this study was to assess factors associated with conservative management failure in patients with symptomatic isolated mesenteric artery dissection. METHODS: Patients with symptomatic isolated mesenteric artery dissection who underwent conservative therapy as first line treatment between February 2010 and May 2018 were included in this retrospective study. Conservative management failure was defined as the persistence or aggravation of symptoms and signs, increasing aneurysmal dilation, or new appearance of a dissecting aneurysm after conservative management. Univariable and multivariable analyses were performed to identify risk factors for failure of conservative management. RESULTS: A total of 123 patients (115 men, 8 women, mean age, 53.7 ± 6.1 years) were included in this study. Conservative management was successful in 89 (72.4%) patients but failed in the remaining 34 (27.6%) patients. Of the 89 for whom conservative management was successful, all of the symptoms were eliminated (n = 81) or relieved (n = 8) within 3.8 ± 0.7 days after conservative management. All of the 34 patients in whom conservative management failed underwent successful endovascular stenting. Failure of conservative management was associated with type II IMADs as defined by the Sakamoto classification (meaning that there is an entry tear, but no re-entry, and still no thrombosis of false lumen, odds ratio: 33.76; 95% confidence interval 8.65-131.85; p < .001) and with ≥90% luminal stenosis (odds ratio 40.70; 95% confidence interval: 3.76-440.07; p < .01). CONCLUSIONS: Conservative management can be used successfully in most patients with symptomatic isolated mesenteric artery dissection. Risk factors for failed conservative treatment were type II IMADs and degree of luminal stenosis ≥90%.

Salvage therapy for subclavian artery perforation resulting in mediastinal hematoma during percutaneous coronary intervention: A case report.

RATIONALE: Transradial access (TRA) is a widely used technique during percutaneous coronary intervention (PCI). However, mediastinal and cervical hematomas, the rare and severe complications of transradial approach, have extremely high mortality rates. To the best of our knowledge, there were no medical literatures about the successful anticoagulation reversal procedure of mediastinal hematoma in PCI till now. PATIENT CONCERNS: We here present a 54-year-old male Han patient who underwent PCI. Immediately after PCI, he reported an episode of neck and chest discomfort, dyspnea, cough recurrence, and cold sweats. Emergency chest computed tomography (CT) revealed a perforation of the subclavian artery resulting in a large mediastinal hematoma with potentially lethal tracheal compression. DIAGNOSIS: A diagnosis of the large mediastinal hematoma was made based on the enhanced computed tomography. INTERVENTIONS: The patient was successfully managed with palliative therapy of anticoagulation reversal instead of a covered stent graft and surgical operation. OUTCOMES: Angiography confirmed the absence of leakage after anticoagulation reversal. The patient had an apparent remission of clinical dyspnea. Follow-up CT confirmed an almost entire absorption of the mediastinal hematoma 35 days postdischarge. LESSONS: The current case highlights the importance of anticoagulation reversal as well as careful guidewire and guide catheter manipulation by the radial approach. Early evaluation, prompt identification, appropriate treatment, and close monitoring are all essential for invasive cardiology.

Fully Automatic White Matter Hyperintensity Segmentation using U-net and Skip Connection.

White matter hyperintensity (WMH) is associated with various aging and neurodegenerative diseases. In this paper, we proposed and validated a fully automatic system which integrated classical image processing and deep neural network for segmenting WMH from fluid attenuation inversion recovery (FLAIR) and T1-weighed magnetic resonance (MR) images. A novel skip connection U-net (SC U-net) was proposed and compared with the classical U-net. Experiments were performed on a dataset of 60 images, acquired from three different scanners. Validation analysis and cross-scanner testing were conducted. Compared with U-net, the proposed SC U-net had a faster convergence and higher segmentation accuracy. The software environment and models of the proposed system were made publicly accessible at Dockerhub.

Prevention of in-stent restenosis with endothelial progenitor cell (EPC) capture stent placement combined with regional EPC transplantation: An atherosclerotic rabbit model.

BACKGROUND: Even with drug-eluting stents, the risk of in-stent restenosis (ISR) remains high. The goal of this study was to investigate the use of an endothelial progenitor cell (EPC) capture stent plus regional EPC transplantation to reduce the ISR rate. METHODS: Endothelial progenitor cell capture stents were fabricated using fibrin gel and anti-CD34 plus anti-VEGFR-2 dual antibodies. Twenty male New Zealand white rabbits established as an atherosclerotic model were randomly divided into two groups: group 1 (n = 10), in which EPC capture stents were deployed into the right iliac artery; and group 2 (n = 10), in which sirolimus-eluting stents were placed. In both groups, EPCs were transplanted into target vessels beyond the stents, with outflow blocked. Radiologic-pathologic correlation outcomes were reviewed after 2 months. RESULTS: The technical success rate of EPC capture stent placement plus EPC transplantation was 100%. The ISR rate in group 1 was lower than in group 2 (1/10 vs. 4/10; p > 0.05). Minimal luminal diameters were larger in group 1 than in group 2 (computed tomographic angiography, 1.85 ± 0.15 mm vs. 1.50 ± 0.20 mm; duplex ultrasound, 1.90 ± 0.10 mm vs. 1.70 ± 0.30 mm; p > 0.05). Transplanted EPCs were tracked positively only in group 1. Pathologic analysis demonstrated neointimal hyperplasia thickness of 0.21 ± 0.09 mm in group 1 vs. 0.11 ± 0.07 mm in group 2 (p < 0.05). CONCLUSION: Endothelial progenitor cell capture stent placement plus local EPC transplant decreases the ISR rate through thrombosis reduction rather than through neointimal hyperplasia inhibition.

Evaluation of Visceral Adipose Tissue Oxygenation by Blood Oxygen Level-Dependent MRI in Zucker Diabetic Fatty Rats.

OBJECTIVE: This study aimed to investigate the feasibility of blood oxygen level-dependent magnetic resonance imaging (BOLD-MRI) to evaluate visceral adipose tissue (VAT) oxygenation in Zucker diabetic fatty (ZDF) rats and its associations with systemic metaflammation. METHODS: Five-week-old ZDF rats and Zucker lean (ZL) rats were fed a high-fat diet (HFD) for 18 weeks. A baseline BOLD-MRI scan of perirenal adipose tissue was performed after 8 weeks of HFD feeding, and then the rats were randomized to receive pioglitazone or a vehicle for the following 10 weeks. At sacrifice, BOLD-MRI scan, Hypoxyprobe-1 injection, and circulating T helper 17 (Th17), regulatory T (Treg) cells, and monocyte subtype flow cytometry analysis were performed. RESULTS: HFD feeding led to a significant increase in VAT BOLD-MRI R2* signals (20.14 ± 0.23 per second vs. 21.53 ± 0.20 per second; P = 0.012), an indicator for decreased oxygenation. R2* signal was significantly correlated with VAT pimonidazole adduct-positive area, insulin resistance, Th17 and Treg cells, CD43 + and CD43+ + monocyte subtypes, and VAT macrophage infiltration. Pioglitazone treatment improved the insulin resistance and was associated with a delayed progression of VAT oxygenation. CONCLUSIONS: This work demonstrated the feasibility of BOLD-MRI for detecting the VAT oxygenation status in ZDF rats, and the BOLD-MRI signals were associated with insulin resistance and systemic metaflammation in ZDF rats during the development of obesity.

Sunitinib versus sorafenib plus transarterial chemoembolization for inoperable hepatocellular carcinoma patients.

PURPOSE: To compare sunitinib vs sorafenib plus transarterial chemoembolization (TACE) for inoperable hepatocellular carcinoma (HCC) patients. METHODS: From January 2010 to December 2016, 104 patients with inoperable stage III HCC were included and randomly divided into two groups. Patients in the sunitinib+TACE (SU+TACE) group received sunitinib orally 37.5 mg daily, while patients in the sorafenib+TACE (SO+TACE) group received sorafenib 400 mg twice daily. The two groups were given sunitinib or sorafenib on an interrupted schedule, with a 4-7 days interval before or after TACE sessions. TACE treatment was repeated every 6-8 weeks. Patients were treated for about 4-6 cycles until the occurrence of toxicity or patient refusal, or progressive disease. RESULTS: The median overall survival (OS) and the median progression-free survival (PFS) in the SO+TACE group were significantly higher than that in the SU+TACE (OS: p=0.017; PFS: p=0.036, respectively). The rates of response and disease control were higher in the SO+TACE group (58%, 79%, respectively) compared to the SU+TACE group (37%, 66%, respectively), although without statistical significance. Regarding the toxicities, we found higher rates of hand-foot skin reaction (HFSR) in the SO+TACE group, while frequent occurrence of thrombocytopenia and neutropenia in the SU+TACE group. CONCLUSIONS: The SO+TACE regimen was more effective and well tolerated in patients with unresectable stage III HCC compared to the SU+TACE regimen. The SO+TACE regimen may be a better alternative to the current standard regimens.

Comparison of CTA and DSA in the diagnosis of superior mesenteric artery dissecting aneurysm.

Objective To compare computed tomography arteriography (CTA) and digital subtraction arteriography (DSA) in the diagnosis of superior mesenteric artery dissecting aneurysm (SMADA). Methods All SMADA patients who underwent CTA and DSA at one of two medical centers between May, 2007 and April, 2017 were identified. The accuracy of CTA and DSA for the depiction of morphologic characteristics of SMADA was analyzed. Results Fourteen patients (12 men; mean age, 55.1 ± 6.4 years) were included in this study. The mean diameter of the dissecting aneurysm was 3.78 ± 1.53 mm on CTA and 3.81 ± 1.54 mm on DSA ( p = 0.96). The luminal stenosis was 0.52 ± 0.27 on CTA and 0.35 ± 0.23 on DSA ( p = 0.09). The thrombosed false lumen was visualized on CTA in 79% (11/14) of patients but in no patients on DSA ( p < 0.001). The entry points of the dissection were visualized on CTA in 64.3% (9/14) of patients and on DSA in 100% (14/14) of patients ( p = 0.041); CTA and DSA did not visualize re-entry points in any patients. The intimal flap was visualized on CTA in 71.4% (10/14) of patients and on DSA in 78.6% (11/14) of patients ( p > 0.05). Branch vessel involvement was visualized in 7.1% (1/14) of patients on CTA but in no patients on DSA ( p > 0.05). Conclusions CTA can be used in place of DSA for the diagnosis of SMADA. Although CTA may exaggerate the degree of luminal stenosis and is weak in depicting the entry points of SMADA, this modality more accurately depicts the thrombosed false lumen and branch vessel involvement.

Effects of TGF-ß on uterine fibroids of women of childbearing age and uterine artery embolization.

PURPOSE: To evaluate the effects of transforming growth factor-ß (TGF-ß) on uterine fibroids of women of childbearing age and uterine artery embolization (UAE) using Embosphere microspheres. MATERIAL AND METHODS: A total of 128 eligible women were randomly divided into an experimental group and a control group (n = 64) who received UAE using Embosphere microspheres and panhysterectomy, respectively. Another 128 healthy women receiving physical examination in the same period were also enrolled. Serum TGF-ß levels were detected by enzyme-linked immunosorbent assay (ELISA). Serum TGF-ß level, size of uterine fibroid and prognosis were followed up. RESULTS: The serum TGF-ß level of patients was significantly higher than that of healthy subjects. After treatment, the red blood cell counts and hemoglobin levels of the two patient groups significantly increased compared with those before (p < .05). After UAE, the diameter of uterine fibroids was significantly smaller than that before treatment, and the TGF-ß level significantly decreased (p < .05). The expression of TGF-ß in uterine fibroids was significantly higher than that in surrounding normal tissue (p < .05). CONCLUSION: With the uterus retained, the therapeutic effect of UAE was similar to that of panhysterectomy. TGF-ß expression level was associated with growth of uterine fibroid in women of childbearing age, which can be used as a target for treatment.

Nonlinear calibration for generalized fringe projection profilometry under large measuring depth range.

A mathematical description of the absolute surface height distribution in generalized fringe projection profilometry under large measuring depth range is presented. Based on least-squares polynomial fitting, a nonlinear calibration to determine the mapping between phase change and surface height is proposed by considering the unequal height arrangement of the projector and the camera. To solve surface height from phase change, an iteration method is brought forward. Experiments are implemented to demonstrate the validity of the proposed calibration and an accuracy of 0.3 mm for surface profile under 300 mm measuring depth can be achieved.

Three-dimensional shape measurement and calibration for fringe projection by considering unequal height of the projector and the camera.

In fringe projection, the CCD camera and the projector are often placed at equal height. In this paper, we will study the calibration of an unequal arrangement of the CCD camera and the projector. The principle of fringe projection with two-dimensional digital image correlation to acquire the profile of object surface is described in detail. By formula derivation and experiment, the linear relationship between the out-of-plane calibration coefficient and the y coordinate is clearly found. To acquire the three-dimensional (3D) information of an object correctly, this paper presents an effective calibration method with linear least-squares fitting, which is very simple in principle and calibration. Experiments are implemented to validate the availability and reliability of the calibration method.

Percutaneous mechanical thrombectomy for acute massive lower extremity deep venous thrombosis.

PURPOSE: To evaluate the clinical safety and effectiveness of percutaneous mechanical thrombectomy in patients with acute massive lower extremity deep venous thrombosis. MATERIALS AND METHODS: Twenty-five consecutive patients with acute massive lower extremity deep venous thrombosis were included in this retrospective study. An inferior vena cava filter was placed prophylactically to protect against pulmonary embolism in each patient. Percutaneous mechanical thrombectomy was performed using a 7F Amplatz thrombectomy device in an angiography suite through ipsilateral popliteal vein access. Anticoagulant therapy lasted for at least 6 months. Follow-up data included 1 year's color duplex sonography and clinical interviews. RESULTS: Successful placement of an inferior vena cava filter was achieved in all 25 (100%) patients. Twenty-two patients (88%) were clinically asymptomatic within 24 hours, whereas the remaining 3 patients (12%) showed moderate improvement within 48 hours. Venogram at discharge showed grade III lysis in 23 patients (92%) and grade II lysis in 2 patients (8%). No serious complications were reported during hospitalization in this study. At 1-year follow-up, no recurrent deep venous thrombosis was reported; 1 patient developed a mild postthrombotic syndrome. CONCLUSION: Percutaneous mechanical thrombectomy is a safe and effective treatment for acute massive lower extremity deep venous thrombosis and shows promising clinical mid-term results.

Seeding endothelial progenitor cells on a self-expanding metal stent: an in vitro study.

PURPOSE: To demonstrate the feasibility of seeding a self-expanding metal stent with endothelial progenitor cells to enhance rapid reendothelialization, which is postulated to prevent local thrombus formation and restenosis after vascular intervention. MATERIALS AND METHODS: Endothelial progenitor cells and fibrinogen were isolated from the peripheral blood of a domestic swine and then cultured and identified. Ten self-expanding nitinol stents were incubated in the culture medium with a cell concentration of 1 x 10(6)/mL with (n = 5, study group) or without (n = 5, control group) fibrin gel (5 mg/mL fibrinogen and 0.10 NIHU/mL thrombin) for 24 hours. The cell coverage of the stents was documented with en face photography and scanning electron microscopy. After simulated use in vitro, the cells were removed from each stent, counted with a cytometer, sequentially cultured for three passages, and identified again to compare their properties with those of the original seeding line. RESULTS: After seeding the stent with the combination of endothelial progenitor cells and the fibrin gel coating, the stents took on a tube-like appearance with a confluent monolayer membrane. After digestion with trypsin, a mean of 2.5 x 10(5) +/- 1.3 cells were obtained from the fibrin gel stent (study group); fewer cells (4 x 10(4) +/- 1.5) were recovered from the bare stents (control group) (P < .01). The recovered cells, after amplification with culture, demonstrated the properties of the original endothelial progenitor cells. CONCLUSIONS: An endothelial progenitor cell-coated stent can be successfully fabricated by using fibrin gel as the bonding agent in vitro. Further in vivo research is warranted.

Transjugular intrahepatic portosystemic shunt with an autologous endothelial progenitor cell seeded stent: a porcine model.

RATIONALE AND OBJECTIVES: To evaluate the efficacy of a self-expanding metal stent seeded with autologous endothelial progenitor cells (EPCs) for preventing in-stent stenoses in transjugular intrahepatic portosystemic shunt (TIPS) in a swine model. MATERIALS AND METHODS: TIPS was performed in 18 young adult pigs, using a self-expanding nitinol stent (control, n = 8) and an autologous EPC-seeded stent (treatment, n = 10). All pigs were sacrificed at 2 weeks post-TIPS procedure. Portography was performed immediately before the euthanasia. Gross, microscopic, and immunohistochemistry of the TIPS tract specimens were examined. The proliferative response of the shunt was quantified histologically. RESULTS: TIPS was performed successfully in 16 swine, 2 animals died during the procedure. Another pig died of unknown causes 2 days post-procedure. At day 14 follow-up, portography and necropsy of the 15 remaining swine demonstrated that five shunts occluded and one shunt was stenotic (80%) in the control group (n = 6). Five shunts remained patent, two shunts were stenosed (50%, 70%), and the remaining two shunts were occluded in the treatment group (n = 9). The patency rate was significantly lower in the control group than in the treatment group, 0% versus 55.6% (P = .03). Histological analyses showed a significantly greater pseudointimal hyperplasia in the TIPS track of the control group than that of the treatment group (P < .05). Intact endothelium was documented in the lumina of all the EPC-implanted stent group. CONCLUSIONS: The EPC-seeded metal stent is feasibly fabricated in vitro and improves the patency in TIPS in a porcine model.