[Stent placement for filter-related chronic occlusion of the inferior vena cava].

Objective: To assess the technical success rate, stent patency, clinical efficacy and complications of stent placement for filter-related chronic occlusion of the inferior vena cava. Methods: A retrospective analysis was carried out for 12 patients with filter-related chronic occlusion of the inferior vena cava associated with severe post-thrombotic syndrome, who underwent stent placement after ineffective conservative therapy at Nanjing First Hospital from March 2016 to December 2018,9 males and 3 females, aged from 48 to 77 years, mean age 60 years, six had bilateral lower extremity symptoms and six had unilateral lower extremity symptoms.Technical success rate, stent patency, clinical efficacy and complications of stent placement were recorded. Clinical success was defined as relief of symptoms and a decrease in clinical, etiology, anatomy, and pathophysiology (CEAP) score for at least grade 1. Results: Stent placement in the unilateral or bilateral iliocaval occlusion was successful in 11 patients. The cause of technical failure in the single patient with failed stent placement was an inability to cross the occluded left iliacvein and the patient was treated with stent placement in the right iliocaval vein.There were 7 patients with inferior vena cava and unilateral iliocaval stent placement; 5 patients with inferior vena cava and bilateral iliocaval stent placement. Acute stent thrombosis occlusion occurred in 1 case after the operation, the blood flow recanalized after catheter-directed thrombolysis and re-stenting. All patients were followed up for 6 to 24 months, with an average of (13±6) months. During the follow-up period, CTV or venography of lower limbs showed that the blood flow in the stent was unobstructed. At the last follow-up, 12 patients were evaluated as clinically effective. Three patients had transient treatment of lateral lumbar pain during operation, which alleviated by themselves.No significant abdominal pain, severe hemorrhage, symptomatic pulmonary embolism and other complications related to treatment occurred in all patients during perioperative period and follow-up. Conclusion: Stent placement is safe and feasible in the treatment of filter-related chronic occlusion of the inferior vena cava, which can alleviate the clinical symptoms of severe post-thrombotic syndrome.

[A retrospective cohort study of long-term nitrogen dioxide exposure and incident hypertension].

Objective: To investigate the effect of long-term exposure of nitrogen dioxide on the incidence of hypertension. Methods: From March to December 2009, 37 386 eligible residents from four cities in northern China (Tianjin, Shenyang, Taiyuan, and Rizhao) were enrolled in a follow-up study by using the random cluster sampling method. Demographic characteristics, lifestyle, history of diseases, and self-report situation of hypertension were collected by using questionnaire. Based on the average annual concentration of NO2 during the period from the cohort to the onset of hypertension as an estimate of exposure, the effect of NO2 exposure on hypertension was analyzed by employing Cox proportional hazards model. The interactions between NO2 exposure and different characteristics (age, sex, body mass index, smoking, alcohol consumption, education, economy, exercise, and fruit intake) were also examined. Results: The baseline age of residents was (43.74±13.78) years, and the body mass index (BMI) was (22.56±2.92) kg/m(2). During an average follow-up time of 11.40 years, 2 619 (7.0%) new cases of hypertension were reported. The overall mean environmental pollution levels during the study period for the entire cohort was (40.74±17.07) µg/m(3). After adjusting for age, sex, BMI, family history of hypertension, socio-economic information, and lifestyle, the hazard ratio (HR) of incident hypertension with a 10 µg/m(3) increase of NO2 was 1.21 (95%CI: 1.18-1.25). Compared with residents aged 60 years and over (HR=1.19, 95%CI: 1.14-1.26), former and current smoking (HR=1.20, 95%CI: 1.14-1.25), and high-frequency fruit consumption (HR=1.17, 95%CI: 1.13-1.21), residents younger than 60 years (HR=1.28, 95%CI: 1.25-1.32), non-smoker (HR=1.23, 95%CI: 1.19-1.27), and low-frequency fruit consumption (HR=1.27, 95%CI: 1.20-1.35) had stronger interaction effect with NO2 (all P values for interaction<0.05). Conclusion: NO2 exposure may lead to the onset of hypertension, which has a stronger effect on people younger than 60 years old, without smoking history and with low-frequency fruit consumption.

[Application of percutaneous AngioJet thrombectomy in patients with acute symptomatic portal and superior mesenteric venous thrombosis].

Objective: To evaluate the clinical value of percutaneous AngioJet thrombectomy in treatment of acute symptomatic portal and superior mesenteric venous thrombosis venous thrombosis (PVMVT) . Method: From January 2014 to January 2016, a total of 8 patients in Nanjing First Hospital with PVMVT verified by color Doppler ultrasound and computed tomographic angiography (CTA) were analyzed retrospectively. Under ultrasound guidance , the branch of the right portal vein(PV) was punctured with a micropuncture set and a 4-F infusion catheter was advanced to the superior mesenteric vein(SMV). The venogram demonstrated the thrombosis in the PV/SMV and a 6-F AngioJet Xpeeedior catheter was advanced over the guidewire and positioned in the distal SMV. Percutaneous thrombectomy was performed after a mixture of 250 000 U of urokinase in 100 ml of normal saline for mechanical pulse spray of thrombus in all patients for approximately 15 minutes. 2 patients underwent PTA and stent implantation after the thrombectomy procedure, 1 of them and the others 6 patients received continuous transcatheter infusion of urokinase (500 000 U/d) for 24 or 48 hours until the thrombosis was completely dissolved confirmed by angiography at 24 and 48 hours.After procedure and the thrombolytic therapy was discontinued, removal of the infusion catheter and the sheath from the liver, the transhepatic tract was embolized with coils or gelfoam to reduce the risk of bleeding. The patency rate of PV /SMV was assessed by CTA at 1 and 6 months after the procedure. Patients were discharged with oral anticoagulation regimen for at least 6 months.The following criteria were used in evaluation of thrombolysis: grade Ⅰ<50% thrombus removal; grade Ⅱ 50%~90% thrombus removal, and grade Ⅲ>90% thrombus removal. Results: All 8 patients with PVMVT were treated by AngioJet thrombectomy. Angiography after the thrombectomy procedure showed complete thrombus removal (>90%) was in 3 cases, substantial thrombus removal (50%~90%) in 5 cases. Grade Ⅲ (complete) thrombolysis was achieved in 7 cases and grade Ⅱ (50%~90%) lysis in 1 case post thrombolytic therapy for 24 or 48 hours. 2 patients had underwent PTA and stent implantation. Large volume intraperitoneal hemorrhage was discovered in 1 patient after removal of the catheter and sheath from the liver. The patient restored stability after a blood transfusion.Venous patency was comfirmed in all 8 patients at 1 or 6 months after the treatment. There was no patient with major complications death related to the procedure. Conclusion: Percutaneous AngioJet thrombectomy with adjunctive thrombolytic therapy is an effective and safe treatment modality in patients with acute symptomatic PVMVT.

[Immunoreactivity of chimeric proteins carrying poliovirus epitopes on the VP6 of rotavirus as a vector].

Rotavirus and poliovirus continue to present significant risks and burden of disease to children in developing countries. Developing a combined vaccine may effectively prevent both illnesses and may be advantageous in terms of maximizing compliance and vaccine coverage at the same visit. Recently, we sought to generate a vaccine vector by incorporating multiple epitopes into the rotavirus group antigenic protein, VP6. In the present study, a foreign epitope presenting a system using VP6 as a vector was created with six sites on the outer surface of the vector that could be used for insertion of foreign epitopes, and three VP6-based PV1 epitope chimeric proteins were constructed. The chimeric proteins were confirmed by immunoblot, immunofluorescence assay, and injected into guinea pigs to analyze the epitope-specific humoral response. Results showed that these chimeric proteins reacted with anti-VP6F and -PV1 antibodies, and elicited antibodies against both proteins in guinea pigs. Antibodies against the chimeric proteins carrying PV1 epitopes neutralized rotavirus Wa and PV1 infection in vitro. Our study contributes to a better understanding of the use of VP6-based vectors as multiple-epitope delivery vehicles and the epitopes displayed in this form could be considered for development of epitope-based vaccines against rotavirus and poliovirus.

Moxibustion attenuates inflammatory response to chronic exhaustive exercise in rats.

Exercise is recognized as an activator to elicit an inflammatory response whilst moxibustion in traditional Chinese medicine has been previously found to modulate immune functioning. However, whether moxibustion can alleviate the inflammatory cytokines response to chronic exhaustive exercise remains unknown. In the present study, rats were randomly assigned to a sedentary control group (Sed), a sedentary moxibustion group (Sed + Moxa), and 2 trained groups- one submitted to a 3-week exhaustive swimming (Trained), and the other a trained moxibustion group (Trained + Moxa). We found that chronic exhaustive exercise significantly increased the serum levels of pro-inflammatory cytokines (IL-1ß, TNF-α, IFN-γ) and the IFN-γ/IL-4 ratio, and decreased the anti-inflammatory cytokines (IL-4, IL-10). Moxibustion treatment markedly reduced the serum levels of IL-1ß, IFN-γ and the IFN-γ/IL-4 ratio, while elevated the IL-4 and IL-10 productions in trained rats. However, TNF-α level was not significantly affected. Our results suggested that an excessive inflammatory response and a potential inflammatory damage may be involved during chronic exhaustive exercise. Moxibustion could attenuate the inflammatory impairment and have an anti-inflammatory effect. The beneficial effects of moxibustion might be mediated by reducing the pro-inflammatory cytokines, increasing the anti-inflammatory cytokines, and modulating the balance between pro- and anti-inflammatory cytokines.

Prolyl isomerase Pin1 stabilizes and activates orphan nuclear receptor TR3 to promote mitogenesis.

Pin1 regulates a subset of phosphoproteins by isomerizing phospho-Ser/Thr-Pro motifs via a 'post-phosphorylation' mechanism. Here, we characterize TR3 as a novel Pin1 substrate, and the mitogenic function of TR3 depends on Pin1-induced isomerization. There are at least three phospho-Ser-Pro motifs on TR3 that bind to Pin1. The Ser95-Pro motif of TR3 is the key site through which Pin1 enhances TR3 stability by retarding its degradation. Pin1 can also catalyze TR3 through phospho-Ser431-Pro motif, which is phosphorylated by extracellular signal-regulated kinase 2 (ERK2), resulting in enhanced TR3 transactivation. Furthermore, Pin1 not only facilitates TR3 targeting to the promoter of cyclin D2, a novel downstream target of TR3, but also promotes TR3 to recruit p300, thereby inducing cell proliferation. Importantly, we found that Pin1 is indispensable for TR3 to promote tumor growth both in vitro and in vivo. Our study thus suggests that Pin1 has an important role in cell proliferation by isomerizing TR3.

Degradation of 2,4-dichlorophenol in aqueous solution by a hybrid oxidation process.

A hybrid photoelectroreaction system has been developed in this study, which consists of three functional electrodes: a TiO2/Ti sheet as the anode, a steel (Fe) sheet as another anode in parallel and a piece of graphite felt (GF) as the cathode. While an electrical current is applied between the Fe anode and GF cathode and UV light is irradiated on the surface of TiO2/Ti anode, both of E-Fenton reaction and photoelectrocatalytic (PEC) reaction are involved simultaneously. The integration of E-Fenton and PEC reactions was evaluated in terms of 2,4-dichlorophenol (2,4-DCP) degradation in aqueous solution. In the meantime, the current distribution between two anodes and pH influence on the 2,4-DCP degradation were studied and optimized. Experimental results confirmed that 2,4-DCP in aqueous solution was successfully degraded by 93% and mineralized by 78% within 60 min in such a hybrid oxidation process. When a current intensity of 3.2 mA was applied, the current efficiency for H2O2 generation on the GF cathode was determined to be 61%. Furthermore, the experiments demonstrated that combination of E-Fenton reaction with photocatalytic reaction let the process be less pH sensitive and would be more favorable to water and wastewater treatment in practice.

2,4-dichlorophenol degradation by an integrated process: photoelectrocatalytic oxidation and E-Fenton oxidation.

A new reactor system was designed for an integrated process involving photoelectrocatalytic oxidation (PECO) and electro-Fenton (E-Fenton) oxidation. Its efficiency was evaluated in terms of 2,4-dichlorophenol (2,4-DCP) degradation in aqueous solution. In this process, a TiO2 electrode and an iron (Fe) electrode were used as anodes in parallel, while graphite felt (GF) was used as a cathode. When an electrical current is applied between the anodes and the cathode, the iron anode can release Fe2+ and the GF cathode can generate H2O2 continuously in the reaction solution. Under UV-A illumination, while a H2O2-assisted PECO reaction occurs on the surface of the TiO2 photo anode, an E-Fenton reaction takes place in the solution. The experimental results demonstrated that 2,4-DCP degradation in aqueous solution was greatly enhanced because of the interaction between the two types of reactions. Moreover, the effect of pH as an important factor was investigated. It was found that the combined reaction becomes less pH sensitive than the typical E-Fenton reaction and may be suitable for application in a wide pH range.

[Course and prognosis of multiple sclerosis. Report of 90 cases].

90 cases of multiple scleroses were studied in connexion with the course and prognosis of the disease. The course of this disease may be classified into 4 type: benign, remitting progressive, and chronic progressive types. Relapse took place in 75% of the patients. The frequency of relapse was on the average 0.45 time per year. Severe disability occurred mostly during the first five years. The present study suggested that the factors indicating relatively poor prognosis would be the onset at the age over 40 years, chronic insidious onset, early severe impairment of the pyramidal tract function and multiple involvement of the different systems in the CNS.

Multiple sclerosis. A clinical study of 70 cases.

70 cases of multiple sclerosis were seen at the Department of Neurology of the Capital Hospital in 1949--1977. There were 25 males and 45 females averaging 30.6 years of age. The most frequent sites of the lesions based on the clinical symptomatology were the spinal cord and optic nerve, the cerebellum was much less frequently involved. The onset of the disease was acute or subacute in 63 cases. Remission and relapse were observed in 62 cases. There were 9 deaths. The survival times of these 9 cases after onset of illness was 1/4--4 years, 5 surviving less than 2 years. The clinical manifestations and pathologic findings noted in the present series support the opinion that optic neuromyelitis is but a variant of multiple sclerosis.