RESUMEN
Fatty liver grafts are susceptible to ischemia reperfusion injury (IRI), increasing the risk of biliary complications after liver transplantation (LT). Ferroptosis, a newly recognized programmed cell death, is expected to be a novel therapeutic target for IRI. We investigated whether exosomes derived from heme oxygenase 1-modified bone marrow mesenchymal stem cells (HExos) relieve ferroptosis and protect biliary tracts from IRI in a rat fatty liver transplantation model. Rats were fed with a methionine choline deficient (MCD) diet for 2 weeks to induce severe hepatic steatosis. Steatotic grafts were implanted and HExos were administered after liver transplantation. A series of functional assays and pathological analysis were performed to assess ferroptosis and biliary IRI. The HExos attenuated IRI following liver transplantation, as demonstrated by less ferroptosis, improved liver function, less Kupffer and T cell activation, and less long-term biliary fibrosis. MicroRNA (miR)-204-5p delivered by HExos negatively regulated ferroptosis by targeting a key pro-ferroptosis enzyme, ACSL4. Ferroptosis contributes to biliary IRI in fatty liver transplantation. HExos protect steatotic grafts by inhibiting ferroptosis, and may become a promising strategy to prevent biliary IRI and expand the donor pool.
Asunto(s)
Exosomas , Hígado Graso , Ferroptosis , Trasplante de Hígado , Células Madre Mesenquimatosas , Daño por Reperfusión , Ratas , Animales , Hígado/patología , Trasplante de Hígado/efectos adversos , Exosomas/patología , Hígado Graso/terapia , Hígado Graso/complicaciones , Hígado Graso/patología , Daño por Reperfusión/prevención & controlRESUMEN
Rice is an important food crop throughout the world. Rice bran, the outer layer of rice grain, is a by-product generated during the rice milling process. Rice bran oil (RBO) is extracted from rice bran and has also become increasingly popular. RBO is considered to be one of the healthiest cooking oils due to its balanced proportion of fatty acids, as well as high content of γ-oryzanol together with phytosterols, vitamin E, wax ester, trace and macro elements, carotenoids, and phenolics. The existence of these compounds provides RBO with various functions, including hypotensive and hypolipidemic functions, antioxidant, anticancer, and immunomodulatory functions, antidiabetic function, anti-inflammatory and anti-allergenic functions, hepatoprotective activity function, and in preventing neurological diseases. Recently, research on the nutrients in RBO focused on the detection of nutrients, functions, and processing methods. However, the processing and utilization of rice bran remain sufficiently ineffective, and the processing steps will also affect the nutrients in RBO to different degrees. Therefore, this review focuses on the contents and nutritional functions of different nutrients in RBO and the possible effects of processing methods on nutrients.
RESUMEN
BACKGROUND: Traumatic proximal tibiofibular fracture and dislocation (PTFD) have been rarely studied and are easily missed in clinical practice. PTFD is considered a marker of severely traumatized knees. The purpose of this study was to retrospectively analyze the incidence and impact of PTFD in traumatized knees with vascular injury. METHODS: Patients with knee trauma and vascular injury were included from January 2022 to October 2023. X-rays and CT scans of included patients were retrospectively analyzed to determine the presence of PTFD. Patients were further divided into PTFD group and non-PTFD group for further comparative analysis. RESULTS: A total of 27 patients (28 limbs) were included. Incidence of PTFD was 39.3% (11/28) in traumatic knee with vascular injury, including 8 anterolateral dislocations and 3 posteromedial dislocations. PTFD group had significantly more limbs with open injuries compared with non-PTFD group (10/11 VS 7/17, p<0.05). Amputation rate of PTFD group was as high as 40% (4/10), compared to 23.5% (4/17) in non-PTFD group. However, the difference between two groups was not statistically significant (p>0.05). CONCLUSIONS: PTFD was easily overlooked or missed. In traumatized knees with vascular injury, incidence of PTFD was high. The presence of PTFD might indicate severe knee trauma and the possibility of open injury. Although there was no significant difference compared with non-PTFD group, PTFD group had a relatively high amputation rate of 40%.
Asunto(s)
Peroné , Luxación de la Rodilla , Fracturas de la Tibia , Humanos , Masculino , Femenino , Estudios Retrospectivos , Adulto , Persona de Mediana Edad , Fracturas de la Tibia/diagnóstico por imagen , Fracturas de la Tibia/epidemiología , Luxación de la Rodilla/epidemiología , Luxación de la Rodilla/diagnóstico por imagen , Peroné/lesiones , Peroné/diagnóstico por imagen , Incidencia , Adulto Joven , Tomografía Computarizada por Rayos X , Lesiones del Sistema Vascular/epidemiología , Lesiones del Sistema Vascular/diagnóstico por imagen , Lesiones del Sistema Vascular/etiología , Amputación Quirúrgica/estadística & datos numéricos , Anciano , Traumatismos de la Rodilla/diagnóstico por imagen , Traumatismos de la Rodilla/epidemiología , AdolescenteRESUMEN
Mono-2-ethylhexyl phthalic acid (MEHP) is the most toxic metabolite of the plasticizer di-2-ethylhexyl phthalic acid (DEHP), and studies have shown that MEHP causes serious reproductive effects. However, its exact mechanisms of action remain elusive. In this study, we aimed to investigate the reproductive effects of MEHP and preliminarily explore its underlying molecular mechanisms. We found that TM3 cells gradually secreted less testosterone and intracellular free cholesterol with increasing MEHP exposure. MEHP exposure inhibited lipophagy and the Sirt1/Foxo1/Rab7 signaling pathway in TM3 cells, causing aberrant accumulation of intracellular lipid droplets. Addition of the Sirt1 agonist SRT1720 and Rab7 agonist ML-098 alleviated the inhibition of lipophagy and increased free cholesterol and testosterone contents in TM3 cells. SRT1720 alleviated the inhibitory effect of MEHP on the Sirt1/Foxo1/Rab7 signaling pathway, whereas ML-098 only alleviated the inhibition of Rab7 protein expression by MEHP and had no effect on Sirt1 and Foxo1 protein expression. This suggests that MEHP inhibits lipophagy in TM3 cells by suppressing the Sirt1/Foxo1/Rab7 signaling pathway, ultimately leading to a further decrease in cellular testosterone secretion. This study improves our current understanding of the toxicity and molecular mechanisms of action of MEHP and provides new insights into the reproductive effects of phthalic acid esters.
Asunto(s)
Dietilhexil Ftalato , Transducción de Señal , Sirtuina 1 , Testosterona , Proteínas de Unión a GTP rab7 , Sirtuina 1/metabolismo , Transducción de Señal/efectos de los fármacos , Animales , Ratones , Dietilhexil Ftalato/análogos & derivados , Dietilhexil Ftalato/toxicidad , Línea Celular , Proteínas de Unión al GTP rab/metabolismo , Proteína Forkhead Box O1/metabolismo , Plastificantes/toxicidad , ColesterolRESUMEN
In this paper, we demonstrated the direct amplification of femtosecond pulses with the Yb:CaYAlO4 crystal for the first time. A compact and simple two-stage amplifier delivered amplified pulses with the average powers of 55.4 W for σ-polarization and 39.4 W for π-polarization at the center wavelengthes of 1032â nm and 1030â nm, corresponding to 28.3% and 16.3% optical-to-optical efficiencies, respectively. These are to the best of our knowledge the highest value achieved with a Yb:CaYAlO4 amplifier. Upon using a compressor consisting of prisms and GTI mirrors, a pulse duration of 166-fs was measured. Thanks to the good thermal management, the beam quality (M2) parameters <1.3 along each axis were maintained in each stage.
RESUMEN
We report on the demonstration of a pure Kerr-lens mode-locked Yb:CALYO laser which can directly deliver sub-200 fs pulses with more than 20-W average power. With an incident pump power of 89 W, 153-fs pulses were generated with an average power of 21.5â W at a repetition rate of 77.9â MHz. The corresponding peak power and single pulse energy were 1.6â MW and 0.27â µJ, respectively. The stable operation of the mode-locking was confirmed by very small fluctuations in both spectrum and output power recorded over an hour. Second harmonic generation (SHG) was conducted with 59% conversion efficiency, which indicated that the high-power mode-locking pulses are of good quality. Stable Kerr-lens mode-locking (KLM) with 156-fs pulse duration and 27.2-W average power was also achieved with 109-W pump power. To the best of our knowledge, this is the highest average output power ever reported from a femtosecond mode-locked bulk oscillator.
RESUMEN
BACKGROUND AND AIMS: Intracranial atherosclerotic stenosis (ICAS) is an important cause of ischemic stroke and transient ischemic attack. We aimed to synthesize relevant evidence on the associations of hematological and biochemical markers with ICAS in stroke-free populations. METHODS AND RESULTS: We searched MEDLINE and EMBASE for articles reporting associations of hematological and biochemical markers with ICAS presence in stroke-free populations. Weighted mean difference (WMD) and 95% confidence interval (CI) for each biomarker were pooled using fixed- or random-effects models. Among 32 studies included in the systematic review, 23 studies (48,326 subjects) with 22 biomarkers were meta-analyzed. Compared with subjects without ICAS, those with ICAS had significantly higher white blood cell (4118 subjects, WMD 0.28 per 109/L, 95% CI 0.01-0.56), neutrophil (4326 subjects, WMD 0.24 per 109/L, 0.10-0.38), neutrophil/lymphocyte ratio (4326 subjects, WMD 0.16, 0.07-0.26), low-density lipoprotein (28,606 subjects, WMD 0.12 mmol/L, 0.05-0.19), non-high-density lipoprotein (3671 subjects, WMD 0.17 mmol/L, 0.08-0.25), C-reactive protein (CRP; 5355 subjects, WMD 0.06 mg/dL, 0.04-0.07), high-sensitivity CRP (9383 subjects, WMD 0.07 mg/dL, 0.01-0.13), uric acid (5966 subjects, WMD 17.91 µmol/L, 11.16-24.66), creatinine (5731 subjects, WMD 4.03 µmol/L, 0.77-7.29), and homocysteine (7053 subjects, WMD 2.25 µmol/L, 1.02-3.48), but lower lymphocyte (4326 subjects, WMD -0.12 per 109/L, -0.19--0.04). Sensitivity analyses showed similar results. CONCLUSIONS: Several hematological and biochemical markers easily accessible were associated with ICAS presence in stroke-free populations. This can facilitate early identification of subjects at a high risk of ICAS, who may benefit from ICAS screening and prevention. PROSPERO REGISTRATION NUMBER: CRD42021247990.
Asunto(s)
Arteriosclerosis Intracraneal , Accidente Cerebrovascular , Humanos , Constricción Patológica/complicaciones , Factores de Riesgo , Arteriosclerosis Intracraneal/diagnóstico , Accidente Cerebrovascular/diagnóstico , BiomarcadoresRESUMEN
Three-dimensional NAND flash memory is widely used in sensor systems as an advanced storage medium that ensures system stability through fast data access. However, in flash memory, as the number of cell bits increases and the process pitch keeps scaling, the data disturbance becomes more serious, especially for neighbor wordline interference (NWI), which leads to a deterioration of data storage reliability. Thus, a physical device model was constructed to investigate the NWI mechanism and evaluate critical device factors for this long-standing and intractable problem. As simulated by TCAD, the change in channel potential under read bias conditions presents good consistency with the actual NWI performance. Using this model, NWI generation can be accurately described through the combination of potential superposition and a local drain-induced barrier lowering (DIBL) effect. This suggests that a higher bitline voltage (Vbl) transmitted by the channel potential can restore the local DIBL effect, which is ever weakened by NWI. Furthermore, an adaptive Vbl countermeasure is proposed for 3D NAND memory arrays, which can significantly minimize the NWI of triple-level cells (TLC) in all state combinations. The device model and the adaptive Vbl scheme were successfully verified by TCAD and 3D NAND chip tests. This study introduces a new physical model for NWI-related problems in 3D NAND flash, while providing a feasible and promising voltage scheme as a countermeasure to optimize data reliability.
RESUMEN
BACKGROUND: There is a paucity of data regarding the prevalence of preoperative deep vein thrombosis (DVT) in patients with long bone (including femur, tibia and fibula) fractures of the lower limbs. We performed a meta-analysis to address the issue. METHODS: Electronic databases, including PubMed, EMBASE, the Web of Science, the Cochrane Library, the VIP database, CNKI, and the Wanfang database, were systematic searched for original articles that reported the prevalence of preoperative DVT in long bone fractures of the lower limbs from January 2016 to September 2021. The prevalence of preoperative DVT was pooled using random-effects models, and subgroups were established according to study type, detection method, sample size and fracture site. RESULTS: Twenty-three articles reporting on 18,119 patients were eligible. The overall pooled preoperative DVT prevalence was 24.1% (95% CI 19.3-28.8%). In different subgroups, the preoperative DVT prevalences were 18.2-27.3%, 15.2-28.6%, 23.1-24.9%, 18.2-26.0% and 23.2-23.4% for different study designs, sample sizes, age groups, detection methods and fracture sites, respectively. CONCLUSIONS: Despite the heterogeneity among studies, this systematic review suggests that the prevalence of preoperative DVT, which may seriously affect the prognosis of patients, is high. Therefore, greater efforts should be devoted to the improvement of screening and prevention strategies for preoperative DVT in lower-extremity long bone fractures. LEVEL OF EVIDENCE: Level III. Trial Registration The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database with the registration number CRD42022324706.
Asunto(s)
Fracturas Óseas , Trombosis de la Vena , Humanos , Trombosis de la Vena/epidemiología , Trombosis de la Vena/etiología , Trombosis de la Vena/diagnóstico , Prevalencia , Fracturas Óseas/complicaciones , Fracturas Óseas/cirugía , Extremidad Inferior/cirugía , Factores de Riesgo , Estudios RetrospectivosRESUMEN
Adhesive hydrogels have been considered as one of the most ideal materials for wound dressing. However, most existing adhesive hydrogels still have disadvantages such as low mechanical properties, poor biological activity (antibacterial and hemostatic ability), and low biocompatibility, which largely limit their application. Thus, it is highly desired to prepare a hydrogel-based wound dressing with good self-healing, ideal adhesive properties, rapid hemostasis, and excellent wound infection prevention activity. In this study, a simple method was presented to prepare a PAM-Lignin-CS-Laponite-SA hydrogel for wound dressing. The obtained hydrogel displayed excellent self-healing ability and repeatable adhesive performance, benefiting from the introduction of hydrogen bonding and electrostatic interactions inside the hydrogel network. In addition, the PAM-Lignin-CS-Laponite-SA hydrogel also exhibited low cell cytotoxicity, good antibacterial activity, and outstanding hemostatic properties. In conclusion, the PAM-Lignin-CS-Laponite-SA hydrogel demonstrated good tissue adhesion, excellent self-healing ability, effective bleeding control, and good antibacterial activity to prevent wound infection, which provides a new idea for developing a multifunctional hydrogel-based tissue adhesive hemostatic dressing.
Asunto(s)
Hemostáticos , Infección de Heridas , Humanos , Hidrogeles/farmacología , Adhesivos/farmacología , Cicatrización de Heridas , Antibacterianos/farmacología , Hemostáticos/farmacología , Polisacáridos/farmacología , HemostasisRESUMEN
OBJECTIVES: We aimed to investigate the correlation between an overall cerebral small vessel disease (CSVD) burden and outcomes after endovascular treatment (EVT) for patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). METHODS: In a multicenter registry study, we enrolled patients with EVT for anterior-circulation LVO-stroke. In 3.0-T MR imaging, we assessed 4 CSVD imaging markers, lacunes, white matter hyperintensities, cerebral microbleeds, and enlarged perivascular spaces, each assigned a score of 0 or 1 and summed up to an overall CSVD burden score of 0-4. We dichotomized the overall CSVD severity as none to mild (score 0-2) and moderate to severe (3-4). Primary outcome was 90-day functional dependence or death (modified Rankin Scale (mRS) 3-6). Secondary outcomes included increase in NIH Stroke Scale ≥ 4 within 24 h (early neurological deterioration (END)) and within 7 days, symptomatic intracranial hemorrhage, 90-day mRS 2-6, and 90-day mortality. RESULTS: Among 311 patients (63.0% male; mean age 65.1 ± 12.7 years), 260 (83.6%) had none-to-mild and 51 (16.4%) had moderate-to-severe overall CSVD burden. Moderate-to-severe CSVD burden was not significantly associated with the primary outcome (47.1% versus 45.4%; p > 0.05 in univariate and multivariate logistic regression), or the secondary outcomes except for a higher risk of END (11.8% versus 3.1%; p < 0.05 in multivariate analyses). Sensitivity analyses with 0-1 versus 2-4 of the CSVD burden score, and the score as an ordinal variable, showed similar results. CONCLUSIONS: An overall moderate-to-severe CSVD burden was not associated with 90-day functional dependence or death, after EVT for anterior-circulation LVO. TRIAL REGISTRATION: ChiCTR1900022154 KEY POINTS: ⢠Moderate-to-severe cerebral small vessel disease burden on MRI should not be an exclusion indicator in determining the eligibility of an acute ischemic stroke patient for endovascular treatment.
Asunto(s)
Isquemia Encefálica , Enfermedades de los Pequeños Vasos Cerebrales , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Humanos , Masculino , Persona de Mediana Edad , Anciano , Femenino , Enfermedades de los Pequeños Vasos Cerebrales/diagnóstico por imagen , Trombectomía , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/complicaciones , Costo de Enfermedad , Isquemia Encefálica/diagnóstico por imagen , Isquemia Encefálica/cirugía , Isquemia Encefálica/complicacionesRESUMEN
BACKGROUND: Steatotic livers tolerate ischemia-reperfusion injury (IRI) poorly, increasing the risk of organ dysfunction. Ferroptosis is considered the initiating factor of organ IRI. Heme oxygenase oxygen-1 (HO-1)-modified bone marrow mesenchymal stem cells (BMMSCs) (HO-1/BMMSCs) can reduce hepatic IRI; however, the role of ferroptosis in IRI of steatotic grafts and the effect of HO-1/BMMSCs-derived exosomes (HM-exos) on ferroptosis remain unknown. METHODS: A model of rat liver transplantation (LT) with a severe steatotic donor liver and a model of hypoxia and reoxygenation (H/R) of steatotic hepatocytes were established. Exosomes were obtained by differential centrifugation, and the differentially expressed genes (DEGs) in liver after HM-exo treatment were detected using RNA sequencing. The expression of ferroptosis markers was analyzed. microRNA (miRNA) sequencing was used to analyze the miRNA profiles in HM-exos. RESULTS: We verified the effect of a candidate miRNA on ferroptosis of H/R treated hepatocytes, and observed the effect of exosomes knockout of the candidate miRNA on hepatocytes ferroptosis. In vitro, HM-exo treatment reduced the IRI in steatotic grafts, and enrichment analysis of DEGs suggested that HM-exos were involved in the regulation of the ferroptosis pathway. In vitro, inhibition of ferroptosis by HM-exos reduced hepatocyte injury. HM-exos contained more abundant miR-124-3p, which reduced ferroptosis of H/R-treated cells by inhibiting prostate six transmembrane epithelial antigen 3 (STEAP3), while overexpression of Steap3 reversed the effect of mir-124-3p. In addition, HM-exos from cell knocked out for miR-124-3p showed a weakened inhibitory effect on ferroptosis. Similarly, HM-exo treatment increased the content of miR-124-3p in grafts, while decreasing the level of STEAP3 and reducing the degree of hepatic ferroptosis. CONCLUSION: Ferroptosis is involved in the IRI during LT with a severe steatotic donor liver. miR-124-3p in HM-exos downregulates Steap3 expression to inhibit ferroptosis, thereby attenuating graft IRI, which might be a promising strategy to treat IRI in steatotic grafts.
Asunto(s)
Exosomas , Ferroptosis , Trasplante de Hígado , Células Madre Mesenquimatosas , MicroARNs , Daño por Reperfusión , Animales , Exosomas/metabolismo , Ferroptosis/fisiología , Hemo-Oxigenasa 1/genética , Hemo-Oxigenasa 1/metabolismo , Donadores Vivos , Masculino , Células Madre Mesenquimatosas/metabolismo , MicroARNs/genética , MicroARNs/metabolismo , Ratas , Daño por Reperfusión/metabolismo , Daño por Reperfusión/prevención & controlRESUMEN
OBJECTIVES: Permanent filter placement may result in numerous complications. Filter removal is recommended if there are no risks of pulmonary embolism. This study aimed to explore the feasibility of placing a new filter when the embolized nonconical filter is removed. METHODS: This study included patients who had received a new filter between 2018 and 2019 before the nonconical filters were removed. Patient characteristics, new filter types, thrombus interception rate, filter removal rate, feasibility, and safety were analyzed retrospectively. Feasibility was defined as the successful placement of new filters and the removal of the nonconical filters. Safety was defined as the absence of symptomatic pulmonary embolism and inferior vena cava hemorrhage after removing the nonconical filters, as well as the successful removal of new filters without symptomatic pulmonary embolism. RESULTS: The average indwelling period of the nonconical filters was 29 (range, 17-30) days among the 13 patients. The removal rate of the nonconical filters was 100%. Five patients (38.5%) received new Denali filters, one (7.7%) received a new Celect filter, and 7 (53.8%) received new temporary filters. Thrombi were intercepted in 10 of the patients (76.9%). The removal rate of the replaced new filters was 100%. No rupture or shifting of the new filters occurred. No symptomatic pulmonary embolism was found after the removal of both the nonconical filters and the new filters. The patients were followed up for 3 months after the surgeries, and the inferior vena cavae of 12 (92.3%) patients were patent, and no new embolic events were found. CONCLUSIONS: Placing a new replacement filter before removal of the embolized nonconical filter may be a feasible approach to prevent pulmonary embolism. Both the nonconical filter and the new filter could be removed subsequently after the thrombi were treated.
Asunto(s)
Embolia Pulmonar , Filtros de Vena Cava , Remoción de Dispositivos/efectos adversos , Humanos , Embolia Pulmonar/etiología , Embolia Pulmonar/prevención & control , Estudios Retrospectivos , Resultado del Tratamiento , Filtros de Vena Cava/efectos adversos , Vena Cava InferiorRESUMEN
We reported a high-power pure Kerr-lens mode-locked Yb:CALYO laser based on the dual-confocal cavity delivering sub-100-fs pulses. The output pulses at 81 MHz have an average power of 10.4 W and the pulse duration of 98 fs, corresponding to the peak power of 1.14 MW. This is, to the best of our knowledge, the highest average power ever reported for a Kerr-lens mode-locked Yb-bulk oscillator. Analysis of the dual-confocal cavity was also conducted, which indicates a way to achieve higher average power. We believe the result described in this Letter may pave a way to develop Kerr-lens mode-locked bulk lasers with much higher average power.
RESUMEN
BACKGROUND: Leiomyosarcoma (LMS) is an uncommon mesenchymal neoplasm, which infrequently metastasizes to pancreas and thigh. Clinical presentation and imaging findings of metastatic broad ligament LMS are often nonspecific. Complete excision plays an important role in treatment of patients with localized LMS. CASE PRESENTATION: Here, we report a case of a 33-year-old woman with recurrent broad ligament LMS metastasizing to pancreas and thigh. Previously, she was diagnosed with broad ligament LMS and underwent hysterectomy, bilateral salpingo-oophorectomy. The disease-free interval was 2.5 years until metastases were found. Computerized tomography (CT) of abdomen and thighs, magnetic resonance imaging (MRI) of thighs and whole-body 18-fluorodeoxyglucose positron emission tomography - computed tomography (PET-CT) performed, revealed pancreatic and thigh metastasis. Ultrasonography-guided biopsy and histological examinations confirmed LMS at both the sites. Pancreatic metastasis was completely resected first. Then the patient underwent surgical resection of thigh metastasis when both chemotherapy and radiotherapy failed. She recovered well and remained free of disease recurrence in the 2 years follow-up. CONCLUSIONS: Though imaging lacks specificity, it is a valuable asset in assessing the burden of disease and characterizing lesions while histological examination with immunohistochemistry is helpful for the diagnosis of LMS. Complete surgical resection of all metastatic sites where-ever feasible should be strongly considered in a treated case of broad ligament LMS with a durable disease-free interval.
Asunto(s)
Ligamento Ancho/cirugía , Neoplasias de los Genitales Femeninos/cirugía , Leiomiosarcoma/cirugía , Neoplasias Pancreáticas/cirugía , Muslo/cirugía , Adulto , Antineoplásicos/administración & dosificación , Ligamento Ancho/diagnóstico por imagen , Terapia Combinada , Femenino , Estudios de Seguimiento , Neoplasias de los Genitales Femeninos/diagnóstico por imagen , Neoplasias de los Genitales Femeninos/patología , Neoplasias de los Genitales Femeninos/terapia , Humanos , Histerectomía , Leiomiosarcoma/diagnóstico por imagen , Leiomiosarcoma/secundario , Leiomiosarcoma/terapia , Pancreatectomía , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Pancreáticas/secundario , Radioterapia Adyuvante , Salpingooforectomía , Muslo/diagnóstico por imagen , Resultado del TratamientoRESUMEN
PURPOSE: To discuss and share the experience of treatment of traumatic innominate arterial injury. METHODS: A retrospective analysis was performed on patients with innominate arterial injuries admitted from January 2016 to July 2018 at the department of vascular surgery, Beijing Jishuitan Hospital, China. All the arterial injuries were confirmed by arteriography. Clinical data including mechanism of injury, type of injury, demographics, concomitant injuries, time interval from trauma to blood flow reconstruction, and operation methods were collected. Follow-up program included outpatient visit and duplex-ultrasonography. SPSS version 23.0 was adopted for data analysis. Categorical variables are presented as number and/or frequency and continuous variables as mean ± standard deviation. RESULT: Altogether 7 patients were included and 6 (85.7%) were male. The mean age of patients was (29.43 ± 7.98) years, range 19-43 years. Six patients had isolated innominate arterial injuries and the rest 1 combined innominate arterial and vein injuries. The injury causes were road accidents in 3 patients, stab wound in 2, gunshot wound in 1, and crush injury in 1. All the 7 patients presented hemorrhagic shock at admission, which was timely and effectively corrected. No perioperative death or technical complications occurred. Intimal injury (n = 2) and partial transaction (n = 2) of the innominate artery were treated with covered stents. Two patients with complete transection of artery received vascular reconstruction by artificial grafts. One patient with partial transaction received balloon dilation and open surgical repair (hybrid operation). The mean time interval from trauma to blood flow reconstruction was (4.27 ± 0.18) h, range 4.0-4.5 h; while the operation time was (48.57 ± 19.94) min, range 25-75 min. Cerebral infarction occurred in one patient with brain injury due to anticoagulation contraindication. The average follow-up was (13.29 ± 5.65) months, range 6-24 months. No severe stenosis, occlusion, and thrombosis of covered stents or artificial vessels were found by color Doppler ultrasound. CONCLUSION: Urgent control of hemorrhage and restoration of blood supply are critical for the treatment of traumatic innominate arterial injury. Endovascular therapy is a feasible and effective method with short operation time and less trauma.
Asunto(s)
Tronco Braquiocefálico/lesiones , Tronco Braquiocefálico/cirugía , Adulto , Angiografía , Tronco Braquiocefálico/diagnóstico por imagen , Procedimientos Endovasculares/métodos , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Hemorragia/etiología , Hemorragia/terapia , Humanos , Masculino , Tempo Operativo , Rotura/diagnóstico por imagen , Rotura/cirugía , Factores de Tiempo , Adulto JovenRESUMEN
PURPOSE: To explore the significance of traditional vascular reconstruction and covered stent for limb salvage after subclavian artery injury. METHODS: Patients with subclavian artery injury admitted to Beijing Jishuitan Hospital from January 2010 to December 2018 were retrospectively analyzed. All the injuries have been confirmed by intraoperative exploration, computed tomography angiography or digital subtraction angiography. Complete or partial amputation injuries were excluded. Mild artery defect or partial intimal damage was treated by interventional implantation, while other patients received open surgeries, including direct suture of small defect less than 2 cm and transplantation with autologous vein or artificial blood when the defect was more than 2 cm. Patients were divided into open surgery group and stent implantation group based on the treatment they received. Patients were followed up at 2 weeks (first stage) and 6 months (second stage) after operation to investigate limb salvage. Student's t-test was used to compare the general data between two groups and Chi-square test to analyze the rate of limb salvage. RESULTS: Altogether 50 cases of subclavian artery injury were treated, including 36 cases of open surgery and 14 cases of stent implantation. Combination of nerve injury was observed in 27 cases (75.0%) in open surgery group and 12 cases (85.7%) in stent implantation group. Amputation developed in 3 cases with open surgery and 1 case with stent implantation. Consequently the rate of successful limb salvage was respectively 91.7% (33/36) and 92.9% (13/14), revealing no significant difference (p > 0.05). CONCLUSION: Rapid reconstruction of blood circulation is crucial following subclavian artery injury, no matter what kinds of treatment strategies have been adopted. Interventional stent implantation can achieve a good effect for limb salvage.
Asunto(s)
Procedimientos de Cirugía Plástica/métodos , Stents , Arteria Subclavia/lesiones , Arteria Subclavia/cirugía , Procedimientos Quirúrgicos Vasculares/métodos , Adolescente , Adulto , Angiografía por Tomografía Computarizada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Arteria Subclavia/diagnóstico por imagen , Adulto JovenRESUMEN
Traumatic peripheral vascular injury is a significant cause of disability and death either in civilian environments or on the battlefield. Penetrating trauma and blunt trauma are the most common forms of vascular injuries. Besides, iatrogenic arterial injury (IAI) is another pattern of vascular trauma. The management of peripheral vascular injuries has been improved in different environments and wars. There are different types of vascular injuries, such as vasospasm, contusion, intimal flaps, intimal disruption or hematoma, external compression, laceration, transection and focal wall defects, etc. The main clinical manifestations of vascular injuries are shock following massive hemorrhage and limb necrosis due to tissue and organ ischemia. Ultrasound, computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are most valuable for assessment of peripheral vascular injuries. Angiography remains the gold standard for diagnosing vascular trauma. Immediate hemorrhage control and rapid restoration of blood flow are the primary goals of vascular trauma treatment. There are many operative treatment methods for vascular injuries, such as vascular suture or ligation, vascular wall repair and vascular reconstruction with blood vessel prostheses or vascular grafts. Embolization, balloon dilation and covered stent implantation are the main endovascular techniques. Surgical operation is still the primary treatment for vascular injuries. Endovascular treatment is a promising alternative, proved to be safe and effective, and preferred selection for patients. In summary, rapid diagnosis and timely surgical intervention remain the mainstays of the treatment. However, many issues need to be resolved by further studies.
Asunto(s)
Procedimientos de Cirugía Plástica/métodos , Procedimientos Quirúrgicos Vasculares/métodos , Lesiones del Sistema Vascular , Implantación de Prótesis Vascular/métodos , Angiografía por Tomografía Computarizada , Diagnóstico Precoz , Procedimientos Endovasculares/métodos , Hemorragia/etiología , Hemorragia/terapia , Humanos , Enfermedad Iatrogénica , Angiografía por Resonancia Magnética , Lesiones del Sistema Vascular/clasificación , Lesiones del Sistema Vascular/complicaciones , Lesiones del Sistema Vascular/diagnóstico por imagen , Lesiones del Sistema Vascular/cirugía , Heridas no Penetrantes , Heridas PenetrantesRESUMEN
The electricity consumption forecasting (ECF) technology plays a crucial role in the electricity market. The support vector regression (SVR) is a nonlinear prediction model that can be used for ECF. The electricity consumption (EC) data are usually nonlinear and non-Gaussian and present outliers. The traditional SVR with the mean-square error (MSE), however, is insensitive to outliers and cannot correctly represent the statistical information of errors in non-Gaussian situations. To address this problem, a novel robust forecasting method is developed in this work by using the mixture maximum correntropy criterion (MMCC). The MMCC, as a novel cost function of information theoretic, can be used to solve non-Gaussian signal processing; therefore, in the original SVR, the MSE is replaced by the MMCC to develop a novel robust SVR method (called MMCCSVR) for ECF. Besides, the factors influencing users' EC are investigated by a data statistical analysis method. We find that the historical temperature and historical EC are the main factors affecting future EC, and thus these two factors are used as the input in the proposed model. Finally, real EC data from a shopping mall in Guangzhou, China, are utilized to test the proposed ECF method. The forecasting results show that the proposed ECF method can effectively improve the accuracy of ECF compared with the traditional SVR and other forecasting algorithms.
RESUMEN
Manganese and ammonium pollution in surface water sources has become a serious issue. In this study, a pilot-scale filtration system was used to investigate the effect of ammonium on manganese removal during the simultaneous removal of ammonium and manganese from surface water using a manganese co-oxide filter film (MeOx). The results showed that the manganese removal efficiency of MeOx in the absence of ammonium was high and stable, and the removal efficiency could reach 70% even at 5.5⯰C. When the influent ammonium concentration was lower than 0.7â¯mg/L, ammonium and manganese could be removed simultaneously. However, at an ammonium concentration of 1.5â¯mg/L, the manganese removal efficiency of the filter gradually decreased with time (from 96% to 46.20%). Nevertheless, there was no impact of manganese on ammonium removal. The mechanism by which ammonium negatively affected manganese removal was investigated, demonstrating that ammonium affected manganese removal mainly through two possible mechanisms. On one hand, the decreased pH caused by ammonium oxidation was unfavorable for the oxidation of manganese by MeOx; on the other hand, the presence of ammonium slowed the growth of new MeOx and retarded the increase in the specific surface area of the MeOx-coated sand, and induced changes in the morphology and crystal structure of MeOx. Consequently, the manganese removal efficiency of the filter decreased when ammonium was present in the inlet water.