Variation in microbial feature perception in the Rutaceae family with immune receptor conservation in citrus.

Although much is known about the responses of model plants to microbial features, we still lack an understanding of the extent of variation in immune perception across members of a plant family. In this work, we analyzed immune responses in Citrus and wild relatives, surveying 86 Rutaceae genotypes with differing leaf morphologies and disease resistances. We found that responses to microbial features vary both within and between members. Species in 2 subtribes, the Balsamocitrinae and Clauseninae, can recognize flagellin (flg22), cold shock protein (csp22), and chitin, including 1 feature from Candidatus Liberibacter species (csp22CLas), the bacterium associated with Huanglongbing. We investigated differences at the receptor level for the flagellin receptor FLAGELLIN SENSING 2 (FLS2) and the chitin receptor LYSIN MOTIF RECEPTOR KINASE 5 (LYK5) in citrus genotypes. We characterized 2 genetically linked FLS2 homologs from "Frost Lisbon" lemon (Citrus ×limon, responsive) and "Washington navel" orange (Citrus ×aurantium, nonresponsive). Surprisingly, FLS2 homologs from responsive and nonresponsive genotypes were expressed in Citrus and functional when transferred to a heterologous system. "Washington navel" orange weakly responded to chitin, whereas "Tango" mandarin (C. ×aurantium) exhibited a robust response. LYK5 alleles were identical or nearly identical between the 2 genotypes and complemented the Arabidopsis (Arabidopsis thaliana) lyk4/lyk5-2 mutant with respect to chitin perception. Collectively, our data indicate that differences in chitin and flg22 perception in these citrus genotypes are not the results of sequence polymorphisms at the receptor level. These findings shed light on the diversity of perception of microbial features and highlight genotypes capable of recognizing polymorphic pathogen features.

12th Japan-US Seminar in Plant Pathology Meeting Report.

The 12th iteration of the Japan-US Seminar in Plant Pathology was held in Ithaca, New York at Cornell University in the fall of 2022. Presentations covered a range of topics under the theme "Remodeling of the Plant-Microbe Environment During Disease, Defense, and Mutualism," and the meeting included a panel discussion of best practices in science communication. This report presents highlights of the meeting, from the perspective of early career participants of the seminar. [Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

Insights into Interfacial Mechanism of CeO2/Silicon and Atomic-Scale Removal Process during Chemo-Mechanical Grinding of Silicon.

Chemo-mechanical grinding (CMG) is a valid processing method to achieve a low-damage surface of silicon. However, the atomic interfacial mechanism during the CMG is still unclear. Herein, the CMG process of silicon was investigated using first principles and frictional wear tests in which the effects of pressure and speed on the interfacial reaction were comprehensively analyzed. Simulations showed that the formation and breakage of chemical bonds occurred at the CeO2/silicon interface during CMG, and the newly formed chemical bonds were stronger than those on the silicon surface. Also, it was found that the pressure and speed improved the materials removal rate by means of accelerating the interfacial chemical reactions, which is also verified by frictional wear tests. This study provides new insights into the atomic interfacial mechanism during silicon CMG.

Data Downlink System in the Vast IOT Node Condition Assisted by UAV, Large Intelligent Surface, and Power and Data Beacon.

The future development of communication systems will create a great demand for the internet of things (IOT), where the overall control of all IOT nodes will become an important problem. Considering the essential issues of miniaturization and energy conservation, in this study, a new data downlink system is designed in which all IOT nodes harvest energy first and then receive data. To avoid the unsolvable problem of pre-locating all positions of vast IOT nodes, a device called the power and data beacon (PDB) is proposed. This acts as a relay station for energy and data. In addition, we model future scenes in which a communication system is assisted by unmanned aerial vehicles (UAVs), large intelligent surfaces (LISs), and PDBs. In this paper, we propose and solve the problem of determining the optimal flight trajectory to reach the minimum energy consumption or minimum time consumption. Four future feasible scenes are analyzed and then the optimization problems are solved based on numerical algorithms. Simulation results show that there are significant performance improvements in energy/time with the deployment of LISs and reasonable UAV trajectory planning.

Percutaneous mechanical thrombectomy using Rotarex catheter in peripheral artery occlusion diseases - Experience from a single center.

AIMS: The aim of this retrospective single-center study was to analyze the immediate results, failures and complications of percutaneous mechanical thrombectomy using the Rotarex catheter in the treatment of peripheral artery occlusion. METHODS: In this study, we identified a total of 42 patients who underwent mechanical thrombectomy using Rotarex catheter at our institution. Procedural outcomes and complications were evaluated. RESULTS: The cohort consisted of 42 patients (31 men and 11 women), aged 32-93 years (median 68 years). The number of external iliac artery occlusion was 5, with common femoral artery 5, superficial femoral artery 28, femoral profound artery 2, popliteal artery 12, and brachial artery 2. The causes of occlusion were thrombosis (29 cases, 69%), embolism (6 cases, 14%), and reocclusion after percutaneous intervention (7 cases, 17%). We achieved primary success in 100% of the patients with mechanical thrombectomy, associated with balloon angioplasty (40/42, 95.2%) and stent deployment (16/42, 38.1%). The median time of the interventional procedure was 145 min. We encountered lower percentage of distal embolization (2.4%) and artery dissection (2.4%) during usage of Rotarex catheter in our cohort. CONCLUSIONS: Rotarex thrombectomy was a useful tool to recanalize occluded vessels with additional treatment such as balloon angioplasty or stent deployment, with a low rate of failures and complications. And prospective studies in this issue are recommended.

Gapless Spin Excitations in the Field-Induced Quantum Spin Liquid Phase of α-RuCl_{3}.

α-RuCl_{3} is a leading candidate material for the observation of physics related to the Kitaev quantum spin liquid (QSL). By combined susceptibility, specific-heat, and nuclear-magnetic-resonance measurements, we demonstrate that α-RuCl_{3} undergoes a quantum phase transition to a QSL in a magnetic field of 7.5 T applied in the ab plane. We show further that this high-field QSL phase has gapless spin excitations over a field range up to 16 T. This highly unconventional result, unknown in either Heisenberg or Kitaev magnets, offers insight essential to establishing the physics of α-RuCl_{3}.

Detection of Two Drug-Resistance Mutants of the Cytomegalovirus by High-Resolution Melting Analysis.

BACKGROUND: Human cytomegalovirus (CMV) is an opportunistic pathogen that can be treated with ganciclovir. Mutations in the UL97 gene of CMV render the virus ganciclovir resistance. These include H520Q and C603W mutations, against which we developed a novel genotyping assay for their identification. METHODS: PCR reactions were performed to amplify fragments of the UL97 gene containing H520Q or C603W mutations. High resolution melting analysis (HRMA) coupled with unlabeled DNA probes was employed to identify the shift in melting temperature of the probe-template complex, which reflexes the presence of point mutations. RESULTS: Melting point analysis performed on the dimeric DNA of PCR products of UL97 gene could not identify mutations in the gene. When coupled to unlabeled probes, point mutations in UL97 can be identified by analyzing the melting curve of probe-template complex. When WT and mutant UL97 DNAs were mixed together to mimic heterogeneous viral population in clinical samples, the genotyping assay is sensitive enough to detect H520Q and C603W mutants that constitute 10% of total DNA input. CONCLUSION: Probe-based HRMA is effective in detecting H520Q and C603W mutations in the UL97 gene of CMV.

[Percutaneous transluminal angioplasty versus stent implantation for treatment of femoral and popliteal artery lesion resulted from arteriosclerosis obliterans].

OBJECTIVE: To study the clinical effects of percutaneous transluminal angioplasty (PTA) versus stent implantation (ST) after PTA for the treatment of femoral and popliteal artery lesion resulted from arteriosclerosis obliterans. METHODS: One hundred and three patients (119 limbs) treated for femoral and popliteal artery lesion resulted from arteriosclerosis obliterans for ten years were reviewed, of whom 60 limbs were treated by PTA and the other 47 by PTA combined with stent implantation. RESULTS: Among the 60 limbs of the PTA group, there were 22 limbs involved only in femoral and popliteal artery; 13 limbs combined with iliac artery lesion; 17 limbs combined with infrapopliteal artery lesion; 8 limbs combined with iliac and infrapopliteal artery lesion. Among the 47 limbs of the ST group, there were 18 limbs involved only in femoral and popliteal artery; 8 limbs combined with iliac artery lesion; 15 limbs combined with infrapopliteal artery lesion; 6 limbs combined with iliac and infrapopliteal artery lesion. There was no significant difference between the two groups on age, sex, concomitant disease, ankle brachial index(ABI) before treatment and Rutherford classification (P>0.05). The patients' Trans-atlantic inter-society consensus (TASC) C/D was lower in the PTA group than that in the ST group (58.3% vs.76.6%, P=0.047).The follow-up periods were 48.0 (5.0,108.0) and 40.0 (3.0,96.0) months respectively (P=0.064). Compared with the PTA group, the ST group had a better short-term total effective rate (93.6% vs.80.0%, P=0.044) and a higher cost [(33 882.7 ± 8 695.6) yuan vs. (17 754.8 ± 3 654.2) yuan, P<0.001]. The short-term marked effective rate of the ST group was higher than that of the PTA group, but the difference was not significant (31.9% vs.21.7%, P=0.231). There was no significant difference between the two groups on short-term efficiency, and complication rates (58.3% vs. 58.3%, P=0.724; 1.7% vs.2.1%, P=1.000). There was no death during perioperative period and no short-term deterioration in both the groups. The long-term marked effective rate was lower and the deterioration rate was higher in the ST group than that in the PTA group, but the difference was not significant (8.5% vs. 15.0%, P=0.381; 14.9% vs. 5.0%, P=0.081).There was no significant difference between the two group on long term total effective rate,accumulative limb salvage rate and reoperation rate (66.0% vs. 66.7%, P=0.939; 94.7% vs. 94.1%, P=0.884; 31.9% vs. 31.7%, P=1.000), and the 1 to 10 years primary and secondary patency rates were similar (P=0.837, P=0.622).When compared based on TASC classification, TASC A/B patients in the ST group had a higher short-term marked effective rate, a higher short-term total effective rate and a higher long-term deterioration rate than those in the PTA group, but the difference was not significant (36.4% vs. 24.0%, P=0.353; 100.0% vs. 88.0%, P=0.322; 18.2% vs. 4.0%, P=0.216). TASC C/D patients had a similar result (30.6% vs. 20.0%, P=0.307; 91.7% vs. 74.3%, P=0.050; 13.9% vs. 5.7%, P=0.226). Both TASC A/B and TASC C/D patients in the ST group had a similar accumulative limb salvage rate with that in the PTA group (90.9% vs. 90.6%, P=0.920; 97.1% vs. 94.1%, P=0.796). CONCLUSION: Stent implantation can increase the cost and short term effective rate at the same time and is not superior to PTA on the long term effective rate and limb salvage rate for femoral and popliteal artery lesion resulted from arteriosclerosis obliterans.

[Comparison of the clinical efficacy of endovascular reconstruction versus bypass surgery for transatlantic inter-society consensus II C/D femoropopliteal artery lesion resulted from arteriosclerosis obliterans].

OBJECTIVE: To study the clinical effects of endovascular reconstruction versus bypass surgery for TASC II(trans-atlantic inter-society consensus II) C/D femoropopliteal artery lesion resulted from arteriosclerosis obliterans. METHODS: One hundred and three patients(119 limbs)accepted bypass surgery or endovascular therapy for TASCII C/D femoropopliteal artery lesion between January 2002 and December 2012 at our institution were retrospectively assessed.All the patients were diagnosed with arteriosclerosis obliterins, and all their Rutherford classifications were from 2 to 5 degrees.Among them there were 71 limbs treated by endovascular reconstruction and the other 48 limbs were treated with bypass surgery.We evaluated the short term clinical effect according to the condition when patients left the hospital, and evaluated the long term clinical effect according to the results of the patients' latest follow-up in 2014. Their clinical data before treatment, complication rates, death rates, hospital stays, short term and long term effects, reoperation rates, 1 to 10 years primary and secondary accumulative patency rates and limb salvage rates were compared. RESULTS: There was no significant difference between the bypass group and the endovascular group on the mean age and ankle brachial index before treatment [(67.1 ± 7.1) years(51 to 80 years) vs. (68.0 ± 9.4) years (49 to 91 years), P=0.561;(0.41 ± 0.23) vs. (0.40 ± 0.26), P=0.928]. There were more TASCII D patients in the bypass group than those in the endovascular group (P<0.001), and the rutherford classification was higher in the endovascular group than that in the bypass group. The difference in the mean follow-up between the bypass group and the endovascular group was not significant [(41.7 ± 23.6) months vs. (59.5 ± 41.6) months, P=0.065]. Five peri-operative complication cases occurred in the bypass group, including 2 cases of acute thrombosis,1 case of infection and 2 cases of heart failure, and only 1 complication case occurred in the endovascular group that was heart failure.The complication rate was higher in the bypass group than that in the endovascular group [10.4% vs. 1.4%, P=0.039]. And there was no death in both the groups.Compared with the endovascular group, the bypass group had a longer hospital stays [(13.2 ± 4.7) d vs.(6.5 ± 3.1) d, P<0.001], a higher reoperation rate (58.3% vs.31.0%,P=0.003), a better short term, obvious, and effective rate (25.0% vs. 9.9%, P=0.027), a worse long term deterioration rate (37.5% vs. 18.3%, P=0.019) and higher 1 to 10 years primary and secondary accumulative patency rates(P=0.001, P=0.001).There was no significant difference between the two groups on the increase of ankle brachial index [(0.34 ± .28) vs. (0.31 ± 0.23), P=0.371], and short term and long term total effective rates (89.6% vs.84.5%, P=0.426; 45.8% vs. 56.3%, P=0.260), and limb salvage rate (83.3% vs.94.4%, P=0.051). CONCLUSION: Endovascular therapy is a safe, effective and minimally invasive therapy for TASCII C/D femoropopliteal artery lesion resulted from arteriosclerosis obliterans.

[Relative factors of type II endoleak after endovascular aneurysm repair].

OBJECTIVE: To study the relative factors of type II endoleak after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms. METHODS: Twenty-eight cases of abdominal aortic aneurysms treated by EVAR were retrospectively analyzed. The characteristics of the inferior mesentery arteries (IMA), the arc Riolan and the lumbar arteries of the cases with or without type II endoleak were analyzed. RESULTS: Type II endoleak was found in 8 (28.6%) cases, of which, 2 were type IIa and 6 were type IIb. The diameter of the IMA originating part of the cases with type II endoleak [(4.03 ± 1.00) mm] was significantly bigger than that without endoleak [(2.89 ± 0.50) mm, P=0.007]. The number of the lumbar arteries originating from the aneurysm sac in cases with type II endoleak (3.4 ± 0.8) was significantly more than that without endoleak (1.9 ± 1.5, P=0.017). However, type II endoleak was irrelevant to the diameter of originating part of the lumbar arteries and the form of the arc Riolan. After the average 14.5 months follow-up, the aneurysm sac was found with shrinkage in 1 case, no change in 2 cases, and augment in 5 cases. Secondary transarterial embolization was performed for only 1 case. CONCLUSION: Type II endoleak was much easily found in cases with bigger diameter of originating part of the IMA, or in cases with more lumbar arteries originating from the aneurysm sac.

[Related factors of hemodynamic damage after carotid artery stenting].

OBJECTIVE: To analyze correlation factors of hemodynamic damage after carotid artery stenting. METHODS: In this study, 66 cases (71 lesions) who undertook carotid artery stenting were collected and the correlation factors of hemodynamic damage were analyzed. RESULTS: Hemodynamic damage emerged in 23 cases (32.4%), of which, 11.3% developed hypotension. The distance between bifurcation and lesions (P=0.0020), plaque distribution (P=0.0002), plaque character (P=0.0019), post-dilation (P=0.0026) were associated with hemodynamic damage by single factor analysis. However, only eccentric plaque (P=0.0153) and calcified plaque (P=0.0097) were associated with hemodynamic damage by multiple factors analysis. All the patients could reach stable circulation by drugs during operation, and no cerebral ischemic events (transient ischemic attack or stroke) and cardiovascular ischemic events happened. CONCLUSION: The distance between bifurcation and lesions, eccentric plaques, calcified plaques are correlation factors of hemodynamic damage.

[Technological modification of transjugular intrahepatic portosystemic shunt: the precise covering of parenchymal shunt with stent-graft].

OBJECTIVE: To introduce the technological modification of stents placement with combined naked self-expanding stent and stent-graft for the construction of portosystemic shunt during transjugular intrahepatic portosystemic shunt (TIPS). METHODS: In the study, 17 patients who suffered from upper digestive tract hemorrhage due to portal hypertension post liver cirrhosis underwent modified TIPS. The shunts were constructed with stepwise placement of naked self-expanding stent and a stent-graft other than stent-graft only for the purpose of precisely covering the parenchymal segment of the shunt and the active control of portosystemic gradient (PSG). The feasibility, safety, and clinical application results of the new technique were analyzed. RESULTS: Technically, the success rate of operation was 100%. The mean PSG before and after TIPS was (28.2 ± 7.6) mmHg, (12.1 ± 3.5) mmHg, respectively (1 mmHg = 0.133 kPa, P < 0.001). One patient died 6 days after operation. The median follow-up period was 181 days (ranging from 32 days to 563 days) for all the other 16 cases, during which period 3 patients died because of encephalopathy, liver failure and septicemia, respectively, and 2 cases of encephalopathy occurred and were relieved with medical treatment. The shunts patency rate was 100% and no chance of digestive re-bleeding occurred. The mean Child-Pugh score before TIPS and at the end of the follow-up was (7.8 ± 2.0) points and (7.5 ± 1.7) points, respectively (P = 0.584). CONCLUSION: The technological modification of TIPS with combined naked self-expanding stent and stent-graft for the precise covering of the parenchymal segment of the shunts was relatively simple to apply, and was helpful for the adjustment of PSG. The preliminary clinical application indicated that it had satisfying results in the matter of shunts patency, incidence of encephalopathy, and the relapse of digestive bleeding during the short-term follow-up.

PAC-Net: Multi-pathway FPN with position attention guided connections and vertex distance IoU for 3D medical image detection.

Automatic medical image detection aims to utilize artificial intelligence techniques to detect lesions in medical images accurately and efficiently, which is one of the most important tasks in computer-aided diagnosis (CAD) systems, and can be embedded into portable imaging devices for intelligent Point of Care (PoC) Diagnostics. The Feature Pyramid Networks (FPN) based models are widely used deep-learning-based solutions for automatic medical image detection. However, FPN-based medical lesion detection models have two shortcomings: the object position offset problem and the degradation problem of IoU-based loss. Therefore, in this work, we propose a novel FPN-based backbone model, i.e., Multi-Pathway Feature Pyramid Networks with Position Attention Guided Connections and Vertex Distance IoU (abbreviated as PAC-Net), to replace vanilla FPN for more accurate lesion detection, where two innovative improvements, a position attention guided connection (PAC) module and Vertex Distance IoU Vertex Distance Intersection over Union loss, are proposed to address the above-mentioned shortcomings of vanilla FPN, respectively. Extensive experiments are conducted on a public medical image detection dataset, i.e., Deeplesion, and the results showed that i) PAC-Net outperforms all state-of-the-art FPN-based depth models in both evaluation metrics of lesion detection on the DeepLesion dataset, ii) the proposed PAC module and VDIoU loss are both effective and important for PAC-Net to achieve a superior performance in automatic medical image detection tasks, and iii) the proposed VDIoU loss converges more quickly than the existing IoU-based losses, making PAC-Net an accurate and also highly efficient 3D medical image detection model.

A Metamaterial Computational Multi-Sensor of Grip-Strength Properties with Point-of-Care Human-Computer Interaction.

Grip strength is a biomarker of frailty and an evaluation indicator of brain health, cardiovascular morbidity, and psychological health. Yet, the development of a reliable, interactive, and point-of-care device for comprehensive multi-sensing of hand grip status is challenging. Here, a relation between soft buckling metamaterial deformations and built piezoelectric voltage signals is uncovered to achieve multiple sensing of maximal grip force, grip speed, grip impulse, and endurance indicators. A metamaterial computational sensor design is established by hyperelastic model that governs the mechanical characterization, machine learning models for computational sensing, and graphical user interface to provide visual cues. A exemplify grip measurement for left and right hands of seven elderly campus workers is conducted. By taking indicators of grip status as input parameters, human-computer interactive games are incorporated into the computational sensor to improve the user compliance with measurement protocols. Two elderly female schizophrenic patients are participated in the real-time interactive point-of-care grip assessment and training for potentially sarcopenia screening. The attractive features of this advanced intelligent metamaterial computational sensing system are crucial to establish a point-of-care biomechanical platform and advancing the human-computer interactive healthcare, ultimately contributing to a global health ecosystem.

Spatiotemporal trends of carbon stock in wood and bamboo products in China during 1987-2020.

Harvested wood/bamboo products (HWP/HBP) constitute a large global carbon stock. However, the contribution of HBP to carbon stocks has been neglected in mixed wood and bamboo data, especially in China. Therefore, the production approach and the first-order decay method were used to estimate the spatiotemporal carbon stock change in HWP/HBP based on provincial production data from the China Forestry Statistical Yearbooks for 1987-2020. The results showed that China's total carbon stocks of HWP and HBP were 328.7 teragram carbon (TgC) and 129.7 TgC between 1987 and 2020. Of this, the HWP carbon stock was mainly sourced from three provinces across the north and south: Guangxi (60.8 TgC), Heilongjiang (37.2 TgC), and Fujian (24.2 TgC), and HBP carbon stock was mainly sourced from three southern provinces: Fujian (33.4 TgC), Guangxi (20.3 TgC), and Zhejiang (13.7 TgC). The proportion of the HBP carbon stock in the total carbon stock increased from 20% in 2010 to 28% in 2020, indicating that bamboo products play an important role in the accumulation of carbon stocks in China. The differences in contributions to spatiotemporal trends between the provinces provide more specific information to make precise decisions about forest management and carbon sequestration.

CD34+ cell-derived fibroblast-macrophage cross-talk drives limb ischemia recovery through the OSM-ANGPTL signaling axis.

CD34+ cells improve the perfusion and function of ischemic limbs in humans and mice. However, there is no direct evidence of the differentiation potential and functional role of these cells in the ischemic muscle microenvironment. Here, we combined the single-cell RNA sequencing and genetic lineage tracing technology, then provided exact single-cell atlases of normal and ischemic limb tissues in human and mouse, and consequently found that bone marrow (BM)-derived macrophages with antigen-presenting function migrated to the ischemic site, while resident macrophages underwent apoptosis. The macrophage oncostatin M (OSM) regulatory pathway was specifically turned on by ischemia. Simultaneously, BM CD34+-derived proregenerative fibroblasts were recruited to the ischemia niche, where they received macrophage-released OSM and promoted angiopoietin-like protein-associated angiogenesis. These findings provided mechanisms on the cellular events and cell-cell communications during tissue ischemia and regeneration and provided evidence that CD34+ cells serve as fibroblast progenitors promoting tissue regeneration.

Angiojet System Used in the Treatment of Submassive Pulmonary Embolism: A Case Report of Two Patients.

Background: Massive or submassive pulmonary embolism (PE) carries a high mortality. Percutaneous mechanical thrombectomy using the Angiojet system is accepted for the treatment of PE. Here, we reported two submassive PE cases who were treated with the Angiojet system successfully, to provide some advice for the therapy of submassive PE. Method: Two patients with suffocation were admitted to our hospital. One patient was accompanied by lower blood pressure (20% lower than basal blood pressure) and higher pulmonary artery pressure (89 mmHg); the other patient had larger right ventricular transverse diameter (46 mm), decreased left ventricular end diastolic anteroposterior diameter (34 mm), and higher heartbeats (107 heartbeats per minute). Pulmonary artery computed tomography angiography showed bilateral pulmonary embolism. Result: The Angiojet system with a high-pressure jet spray pattern (urokinase 25 wiu + sodium chloride injection 50 ml) was used. Intravascular thrombolysis by urokinase (100 wiu/day for 1 day) was done after being back in the ward. And low molecular weight heparin was used in hospitalization, and rivaroxaban was used after discharge. Both patients were treated successfully. However, the level of platelet was significantly lower in one patient after Angiojet system usage and recovered to the preoperative level the next day. Another patient suffered from bradyarrhythmias during the usage of Angiojet, and bradyarrhythmias disappeared when the Angiojet system stopped. Pulmonary embolism was cured after 3 months in both patients. Conclusion: Angiojet could be a simple, safe, and well-tolerated treatment for massive or submassive PE. And hematocrit, platelet, kidney function, and heart rhythm should be monitored during perioperation.

T lymphocyte-derived extracellular vesicles aggravate abdominal aortic aneurysm by promoting macrophage lipid peroxidation and migration via pyruvate kinase muscle isozyme 2.

T lymphocyte and macrophage infiltration in the aortic wall is critical for abdominal aortic aneurysm (AAA). However, how T lymphocytes interact with macrophages in the pathogenesis of AAA remains largely uncharacterized. In an elastase-induced murine AAA model, we first found that the expression of pyruvate kinase muscle isozyme 2 (PKM2), the last rate-limiting enzyme in glycolysis, was increased in infiltrated T lymphocytes of vascular lesions. T lymphocyte-specific PKM2 deficiency in mice (LckCrePKM2fl/fl) or intraperitoneal administration of the sphingomyelinase inhibitor GW4869 caused a significant attenuation of the elastase-increased aortic diameter, AAA incidence, elastic fiber disruption, matrix metalloproteinases (MMPs) expression, and macrophage infiltration in the vascular adventitia compared with those in PKM2fl/fl mice. Mechanistically, extracellular vesicles (EVs) derived from PKM2-activated T lymphocytes elevated macrophage iron accumulation, lipid peroxidation, and migration in vitro, while macrophages treated with EVs from PKM2-null T lymphocytes or pretreated with the lipid peroxidation inhibitors ferrostatin-1 (Fer-1), liproxstatin-1 (Lip-1), or the iron chelating agent deferoxamine mesylate (DFOM) reversed these effects. In vascular lesions of elastase-induced LckCrePKM2fl/fl mice with AAA, the oxidant system weakened, with downregulated 4-hydroxynonenal (4-HNE) levels and strengthened antioxidant defense systems with upregulated glutathione peroxidase 4 (GPX4) and cystine/glutamate antiporter solute carrier family 7 member 11 (Slc7a11) expressions in macrophages. High-throughput metabolomics showed that EVs derived from PKM2-activated T lymphocytes contained increased levels of polyunsaturated fatty acid (PUFA)-containing phospholipids, which may provide abundant substrates for lipid peroxidation in target macrophages. More importantly, upregulated T lymphocyte PKM2 expression was also found in clinical AAA subjects, and EVs isolated from AAA patient plasma enhanced macrophage iron accumulation, lipid peroxidation, and migration ex vivo. Therefore, from cell-cell crosstalk and metabolic perspectives, the present study shows that PKM2-activated T lymphocyte-derived EVs may drive AAA progression by promoting macrophage redox imbalance and migration, and targeting the T lymphocyte-EV-macrophage axis may be a potential strategy for early warning and treating AAA.

Avoiding revascularization strategy versus revascularization with drug-coated balloon for the treatment of superficial femoral artery occlusive disease.

OBJECTIVE: The aim of this study was to compare the efficacy, safety and treatment costs of superficial femoral artery revascularization (SFA) with drug-coated balloon(DCB) versus avoiding revascularization strategy for the treatment of symptomatic SFA disease. METHODS: This retrospective single-center study reviewed 96 patients (113 limbs) with severe stenosis and occlusive SFA disease. All patients underwent either DCB(Group 1: n â€‹= â€‹55 limbs) or nonrevascularization (Group 2: n â€‹= â€‹58 limbs) between March 2015 and June 2019. The improvement of Rutherford class, walking impairment questionnaire score(WIQ), target limb reintervention, perioperative major adverse events, the catheterization laboratory cost and length of hospital stay were compared. The limb salvage and survival rates were calculated using the Kaplan-Meier method. Univariate and multivariate logistic regression analysis were performed to assess the association between factors and the improvement of Rutherford category at 12 months. RESULTS: The median follow-up time of Groups 1 and 2 was 17 and 33 months, respectively. At 12 months, the Rutherford category significantly decreased in both groups (P â€‹< â€‹0.001), with no significant difference (79.7% vs. 64.3%, P â€‹= â€‹0.074). Furthermore, multivariate analysis showed that the selected therapeutic method was not an influential factor for the improvement of Rutherford class at 12 months. The WIQ overall score as well as three subscales scores (distance, speed and stair-climbing), the survival rate, limb salvage rate and the length of stay between the two groups were comparable. The perioperative adverse events rate and catheterization laboratory cost in Group 2 was significantly lower compared to Group 1 [(34253.69 â€‹± â€‹28172.87) yuan vs. (56936.76 â€‹± â€‹41278.36) yuan, P â€‹= â€‹0.001]. CONCLUSIONS: This study suggests that avoiding superficial femoral artery revascularization strategy has favorable efficacy and safety outcomes compared to combining revascularization with DCB in selected patients.

Drug-coated balloons used in peripheral artery disease: experience from a single center.

OBJECTIVE: This retrospective single-center study aimed to analyze immediate and follow-up results of using drug-coated balloons (DCBs) for treating peripheral arterial disease. METHODS: In this study, we identified a total of 75 patients who underwent DCB therapy at our institution. The ankle-brachial index (ABI) was measured before and after intervention. Intermittent claudication and whether there was healing of ulcers were determined by telephone. RESULTS: The cohort consisted of 56 men and 19 women aged 38 to 87 years (68 ± 12 years). Twenty-three patients had Rutherford grade III, 15 had Rutherford grade IV, and 37 had Rutherford grade V. Seventeen patients had stents and 18 had the Rotarex system used. The postoperative ABI was significantly greater than the preoperative ABI (0.911 ± 0.173 vs 0.686 ± 0.249). Good results for treatment were obtained. Intermittent claudication and rest pain did not occur in subjects with Rutherford grades III and IV during follow-up. The amputation rate was 4.1% among all patients using DCB therapy during follow-up. CONCLUSIONS: DCB therapy is safe and effective for treating peripheral arterial disease in real-world patients. Future prospective studies on this issue are recommended.