Experience with aortic arch inclusion technique using artificial blood vessel for type A aortic dissection: an application study.

BACKGROUND: This study aimed to elucidate the methodology and assess the efficacy of the aortic arch inclusion technique using an artificial blood vessel in managing acute type A aortic dissection (ATAAD). METHODS: We conducted a retrospective review of 18 patients (11 males and 7 females, average age: 56.2 ± 8.6 years) diagnosed with ATAAD who underwent total aortic arch replacement (TAAR) using an artificial vascular "inclusion" between June 2020 and October 2022. During the operation, deep hypothermic circulatory arrest (DHCA) and selective antegrade cerebral perfusion (ACP) of the right axillary artery were employed for brain protection. The 'inclusion' total aortic arch replacement and stented elephant trunk (SET) surgery were performed. RESULTS: Four patients underwent the Bentall procedure during the study, with one additional patient requiring coronary artery bypass grafting (CABG) due to significant involvement of the right coronary orifice. Three patients died during postoperative hospitalization. Other notable complications included two cases of postoperative renal failure necessitating continuous renal replacement therapy (CRRT), one case of postoperative double lower limb paraplegia, and one case of cerebral infarction resulting in unilateral impairment of the left upper limb. Eleven patients underwent computed tomography angiography (CTA) examinations of the aorta three months to one-year post-operation. The CTA results revealed thrombosis in the false lumen surrounding the aortic arch stent in seven patients and complete thrombosis of the false lumen around the descending aortic stent in eight patients. One patient had partial thrombosis of the false lumen around the descending aortic stent, and another patient's false lumen in the thoracic and abdominal aorta completely resolved after one year of follow-up. CONCLUSIONS: Incorporating vascular graft in aortic arch replacement simplifies the procedure and yields promising short-term outcomes. It achieves the aim of total arch replacement using a four-branch prosthetic graft. However, extensive sampling and thorough, prolonged follow-up observations are essential to fully evaluate the long-term results.

Bioinformatics analysis to reveal key biomarkers for early and late hepatocellular carcinoma.

BACKGROUND: The aim of this study was to find the long non-coding RNAs (lncRNAs) and mRNAs acting as biomarker of early and late hepatocellular carcinoma (HCC). METHODS: The Cancer Genome Atlas (TCGA) dataset was used to identify shared differentially expressed lncRNAs (DElncRNAs) and mRNAs (DEmRNAs) between early and late HCC and normal tissue. Functional annotation and protein-protein interaction network of shared DEmRNAs were performed. Furthermore, DElncRNAs-DEmRNAs co-expression network of early and late HCC were also performed. The expression of selected candidate genes were validated by the quantitative real time polymerase chain reaction (qRT-PCR). RESULTS: A total of 1,201 shared DEmRNAs and 162 shared DElncRNAs were identified in both early and late HCC compared with normal controls. Cell cycle, p53 signaling pathway, retinol metabolism and metabolism of xenobiotics by cytochrome P450 were four significantly enriched pathways. Base on the protein-protein interaction network, CDK1, AURKA, CDC20, PLK1, AURKB, HIST1H2BG, BUB1B, CCNA2, CCNB1 and CDT1 were key protein. CTD-2510F5.4 and HAND2-AS1 were hub lncRNAs in both early and late HCC. Overall, the confirmation results of qRT-PCR were generally consistent with our integrated analysis. CONCLUSIONS: A total of 4 DEmRNAs (CDK1, KIFC1, CENPF and ECM1) and 2 DElncRNAs (CTD-2510F5.4 and HAND2-AS1) were identified as key biomarkers for HCC. This study may contribute to reveal the pathogenesis of early and late HCC and provide new and accurate therapeutic targets for HCC.