Stimulated Raman Scattering Microscopy Reveals Aberrant Triglyceride Accumulation in Lymphatic Metastasis of Papillary Thyroid Carcinoma.

Lipid metabolic alterations are known to play a crucial role in cancer metastasis. As a key hub in lipid metabolism, intracellular neutral lipid accumulation in lipid droplets (LDs) has become a signature of aggressive human cancers. Nevertheless, it remains unclear whether lipid accumulation displays distinctive features in metastatic lesions compared to the primary ones. Here, we integrated multicolor stimulated Raman scattering (SRS) imaging with confocal Raman spectroscopy on the same platform to quantitatively analyze the amount and composition of LDs in intact human thyroid tissues in situ without any processing or labeling. Inspiringly, we found aberrant accumulation of triglycerides (TGs) in lymphatic metastases but not in normal thyroid, primary papillary thyroid carcinoma (PTC), or normal lymph node. In addition, the unsaturation degree of unsaturated TGs was significantly higher in the lymphatic metastases from patients diagnosed with late-stage (T3/T4) PTC compared to those of patients diagnosed with early-stage (T1/T2) PTC. Furthermore, both public sequencing data analysis and our RNA-seq transcriptomic experiment showed significantly higher expression of alcohol dehydrogenase-1B (ADH1B), which is critical to lipid uptake and transport, in lymphatic metastases relative to the primary ones. In summary, these findings unravel the lipid accumulation as a novel marker and therapeutic target for PTC lymphatic metastasis that has a poor response to the regular radioactive iodine therapy.

Three-Dimensional Printing to Guide Fenestrated/Branched TEVAR in Triple Aortic Arch Branch Reconstruction With a Curative Effect Analysis.

PURPOSE: To summarize experience with and the efficacy of fenestrated/branched thoracic endovascular repair (F/B-TEVAR) using physician-modified stent-grafts (PMSGs) under 3D printing guidance in triple aortic arch branch reconstruction. MATERIALS AND METHODS: From February 2018 to April 2022, 14 cases of aortic arch aneurysms and 30 cases of aortic arch dissection (22 acute aortic arch dissection and 8 long-term aortic arch dissection)were treated by F/B-TEVAR in our department, including 34 males and 10 females, with an average age of 59.84 ± 11.72 years. Three aortic arch branches were affected in all patients. A 3D-printed model was made according to computed tomography angiography images and used to guide the fabrication of PMSGs. All patients were followed up. RESULTS: A total of 132 branches were successfully reconstructed with no case of conversion to open surgery. The average operation time was 4.97 ± 1.40 hours, including a mean 44.05 ± 7.72 minutes for stent-graft customization, the mean postoperative hospitalization duration was 9.91 ± 4.47 days, the average intraoperative blood loss was 480.91 mL (100-2810 mL), and the mean postoperative intensive care unit monitoring duration was 1.02 days (0-5 days). No deaths occurred within 30 days of surgery. Postoperative neurological complications occurred in 1 case (2.3%), and retrograde type A dissection occurred in 1 case (2.3%). CONCLUSION: Compared with conventional surgery, triple aortic arch branch reconstruction under the guidance of 3D printing is a minimally invasive treatment method with the advantages of accurate positioning, rapid postoperative recovery, few complications, and reliable short- to mid-term effects. CLINICAL IMPACT: At present the PMSG usually depend on imaging data and software calculation. With the guidance of 3D printing technology, image data could be transformed into 3D model, which has improved the accuracy of the positioning of the fenestrations. The diameter reduction technique and the internal mini cuff technique have made a complement to the slimed-down fenestration selection process and the low rate of endoleak. As reproducible study, our results may provide reference for TEVAR in different cases.

Accurate Embolization for Endoleak after F-TEVAR of Thoracic Aortic Dissection by Detachable Coils.

OBJECTIVES: To evaluate the efficacy and clinical outcomes of accurate embolization of endoleaks after fenestrated thoracic endovascular aortic repair (F-TEVAR) for thoracic aortic dissections. METHODS: Twenty patients with endoleaks (17 type I and 3 type II) after fenestrated thoracic endovascular aortic repair (F-TEVAR) were embolized using detachable and ordinary coils. We assessed the success rate and complications of the operation, and its effects, through clinical and CT follow-up. RESULTS: The mean clinical follow-up duration was 25.68 ± 11.07 months (3-44 months). During follow-up, all endoleaks were completely embolized and aortic remodeling was improved. Secondary endoleaks occurred in four patients who were embolized twice. No other complications or death were reported. CONCLUSION: Embolization using detachable and ordinary coils is effective and safe for the treatment of endoleaks after fenestrated thoracic endovascular aortic repair.

Breathable and Stretchable Organic Electrochemical Transistors with Laminated Porous Structures for Glucose Sensing.

Dynamic glucose monitoring is important to reduce the risk of metabolic diseases such as diabetes. Wearable biosensors based on organic electrochemical transistors (OECTs) have been developed due to their excellent signal amplification capabilities and biocompatibility. However, traditional wearable biosensors are fabricated on flat substrates with limited gas permeability, resulting in the inefficient evaporation of sweat, reduced wear comfort, and increased risk of inflammation. Here, we proposed breathable OECT-based glucose sensors by designing a porous structure to realize optimal breathable and stretchable properties. The gas permeability of the device and the relationship between electrical properties under different tensile strains were carefully investigated. The OECTs exhibit exceptional electrical properties (gm ~1.51 mS and Ion ~0.37 mA) and can retain up to about 44% of their initial performance even at 30% stretching. Furthermore, obvious responses to glucose have been demonstrated in a wide range of concentrations (10-7-10-4 M) even under 30% strain, where the normalized response to 10-4 M is 26% and 21% for the pristine sensor and under 30% strain, respectively. This work offers a new strategy for developing advanced breathable and wearable bioelectronics.

Mechanism of Astrin in Head and Neck Squamous Cell Carcinoma.

Head and neck squamous cell carcinoma(HNSCC) is a malignant epidermal tumor that seriously threatens human life and health. The main factors affecting the death of patients are local recurrence and lymph node metastasis. Astrin antibody is the basic component of the mitotic spindle required for normal chromosome separation and later development. There are few domestic studies on the mechanism of Astrin in HNSCC. Based on this, this article is studying Astrin in HNSCC. The expression and function of Astrin, and analyze its correlation with clinical pathological parameters and prognosis of patients, and further explore the relevant mechanisms involved in the progression of Astrin in HNSCC. In this experiment, the real-time fluorescent quantitative polymerase chain reaction (PCR) method was used to detect the expression of the Astrin antibody in HNSCC cell lines A and B. Secondly, this article will focus on high metastatic HNSCC cells B. Divided into five groups (blank control group, overexpression positive group, overexpression negative control group, expression suppression positive group, expression suppression negative control group), using real-time fluorescent quantitative PCR technology to detect the expression of Astrin in each group, and then speculate the mechanism of Astrin in HNSCC. Experiments have shown that Astrin is expressed in A and B cells, but its expression in B is significantly higher than its expression in A, and the difference is statistically significant (P<0.001). This shows that the inhibition of Astrin expression has a significant anti-tumor effect and that Astrin plays an important role in the occurrence and development of tumors. It is expected to provide new ideas and reference basis for exploring new therapeutic strategies for targeted therapy of HNSCC.

Solute Carrier Family 27 Member 6 (SLC27A6) Possibly Promotes the Proliferation of Papillary Thyroid Cancer by Regulating c-MYC.

To investigate the expression and mechanism of LSC27A6 in papillary thyroid cancer (PTC). We analyzed the differential expression of SLC27A6 in PTC tissues and normal tissues based on the TCGA database and validated it using immunohistochemistry. Wilcoxon rank sum, chi-square test, or Fisher exact exam were used to analyze the relationship between the expression of SLC27A6 and clinicopathological information. Samples were divided into two groups according to whether BRAF was mutated or not, and Wilcoxon rank sum was used to determine whether the expression of SLC27A6 was related to BRAF mutation. The effects of SLC27A6 on the proliferation, migration, and apoptosis of PTC cells were detected by cell counting kit-8 (CCK8), colony formation assay, transwell assay, and flow cytometry. Spearman correlation analysis was used to evaluate the relationship between SLC27A6 and c-MYC. Protein expression was detected by Western blot. The expression of SLC27A6 was higher in PTC and positively correlated with N stage. SLC27A6 expression was higher in samples with BRAF mutations. Down-regulation of SLC27A6 inhibited cell proliferation, migration, and invasion and induced apoptosis. Spearman correlation analysis showed that SLC27A6 was positively correlated with c-MYC. Knockdown of SLC27A6 inhibited c-MYC expression. Our results suggest that SLC27A6 is overexpressed in PTC tissues and affects the progression of PTC by regulating c-MYC.

Use of 3D Printing to Guide Creation of Fenestrations in Physician-Modified Stent-Grafts for Treatment of Thoracoabdominal Aortic Disease.

Purpose: To summarize the experience and outcomes of total endovascular repair of thoracoabdominal aortic disease using 3-dimensional (3D) printed models to guide on-site creation of fenestrations in aortic stent-grafts. Materials and Methods: From April 2018 to March 2019, 34 patients (mean age 58±14 years; 24 men) with thoracoabdominal aortic disease were treated in our department. Nineteen patients had thoracoabdominal aortic dissection and 15 had thoracoabdominal aortic aneurysm. Preoperatively, a 3D printed model of the aorta was made according to computed tomography images. In the operating room, the main aortic stent-graft was completely released in the 3D printed model, and the position of each fenestration or branch was marked on the stent-graft. The fenestrations were then made using an electric pen. Wires were sewn to the edge of the fenestrations using nonabsorbable sutures. After customization, the aortic stent-graft was reloaded into the delivery sheath and deployed. Results: The printing process took ~5 hours (1 hour for image reconstruction, 3 hours for printing, and 1 hour for postprocessing). The physician-modified stent-grafts had a total of 107 fenestrations secured by 102 bridging stent-grafts, including 73 covered stents and 29 bare stents. The average procedure time was 5.6±1.2 hours, including a mean 1.3 hours for stent-graft customization. No renal insufficiency or paraplegia occurred. Two branch arteries were lost during the operation. One patient (3%) died 1 week after surgery from a retrograde dissection rupture. One patient developed a minor cerebral infarction postoperatively. The mean follow-up time was 8.5 months. There was 1 endoleak from a fenestration (coil embolized) and 4 distal ruptures of the aortic dissection (3 treated and 1 observed). Conclusion: Three-dimensional printing can be used to guide creation of fenestrated stent-grafts for the treatment of thoracoabdominal aortic diseases involving crucial branches. This technique appears to be more accurate than the traditional measurement method, with short-term follow-up demonstrating the safety and reliability of the method. However, further research and development are needed.

Endovascular Repair of Aortic Dissection Involving the Left Subclavian Artery by Castor Stent Graft: A Multicentre Prospective Trial.

OBJECTIVE: The left subclavian artery (LSA) origin can be intentionally covered by stent grafts, to provide adequate proximal landing zones during thoracic endovascular repair for Stanford type B aortic dissections (TBADs). To preserve the LSA, a novel single branched stent graft, named "Castor" was designed and a clinical trial conducted to investigate its suitability. METHODS: From April 2013 to March 2015, 73 patients with TBAD were treated by Castor stent grafts at 11 Chinese tertiary hospitals as part of a single arm prospective clinical trial. There were 50 acute (<2 weeks [68.5%]) and 23 chronic aortic dissections (>2 weeks [31.5%]). RESULTS: The technical success rate was 97% (n = 71/73). The two failures were caused by occlusion of the branch section of the stent graft. There were four intra-operative endoleaks (two type Ia, two type B from the LSA). The endoleak rate was 5% (n = 4/73). There was one in hospital death and no major complications. The median follow up time was 61 months (range 48-72 months). The mortality was 5% (n = 4/73) within one year and 7% within six years (n = 5/73). Two deaths were of unknown cause and three were not related to the aorta. Two new entry tears were found on the proximal or distal edge of the stent graft and were retreated endovascularly. Six occlusions of the branch section of the Castor stent graft were found, and the follow up patency rate of the branch section was 93% (n = 63/68). Two intra-operative endoleaks were left during follow up and eventually disappeared according to the latest computed tomography angiograms. CONCLUSION: For patients with TBADs needing anchoring proximal to the origin of LSA, the Castor single branched stent graft may provide an easily manipulated, safe, and effective endovascular treatment.

A Randomized, Double-Blind, Placebo-Controlled Phase II Study of Hepatocyte Growth Factor in the Treatment of Critical Limb Ischemia.

NL003 is a plasmid engineered to simultaneously express two isoforms of hepatocyte growth factor. This phase II study was performed to assess the clinical safety and efficacy of intramuscular injection of NL003 in critical limb ischemia (CLI) patients for 6 months. Two hundred patients (Rutherford scale 4-5) were randomly assigned: placebo (n = 50), low-dose NL003 (n = 50), middle-dose NL003 (n = 50), or high-dose NL003 (n = 50). The drug was administered in the affected limb of 197 patients on days 0, 14, and 28. No significant differences in the incidence of adverse events (AEs) or serious AEs were found among the groups. At 6 months, pain severity was significantly reduced in all NL003 groups, but not in the placebo group (p < 0.05). The proportion of patients with complete ulcer healing in the high-dose group was significantly higher than that of the placebo group (p = 0.0095). There were no statistically significant differences in transcutaneous oxygen pressure (TcPO2), ankle-brachial index (ABI), or toe-brachial index (TBI) value among the four groups throughout the study period. These results provide the first effective evidence of significant improvements in total healing of ulcers in treated legs, complete pain relief without analgesics, and safety for NL003 in patients with Rutherford stage 4-5.

Three-Dimensional Printing to Guide the Application of Modified Prefenestrated Stent Grafts to Treat Aortic Arch Disease.

BACKGROUND: The aim of this study was to summarize the experience and outcomes of total endovascular repair of aortic arch disease using three-dimensional (3D) printing to guide the application of modified prefenestrated/branched stent grafts. PATIENTS AND METHODS: From April 2018 to March 2019, 17 patients with aortic arch disease were treated in our department. Five patients had an aortic arch aneurysm and 12 had undergone an aortic arch dissection. Thirteen men and 4 were women, with an average age of 57.82 ± 10.47 years. Preoperatively, a 3D-printed model of the aorta was made according to computed tomography data. Then, under the guidance of the 3D-printed aortic model, modified prefenestrated/branched stent grafts were prepared, and the diameter of the stent grafts was reduced intraoperatively by a physician for total endovascular repair. Aortic computed tomography angiography was performed 3 and 6 months after the surgery. RESULTS: All procedures were completed in one stage with no conversions to sternotomy. Among all 17 patients, the operation was successful in 16. One patient was treated with a chimney graft and a stent graft fenestrated in situ because of distortion of the stent. The success rate of the technique was 94.18%. The average operation time was 4.18 ± 1.57 hr, and no patients died. No neurologic complications, such as cerebral infarction or paraplegia, were observed during the follow-up period. CONCLUSIONS: Three-Dimensional printing can be used to help guide the treatment of aortic arch disease using modified prefenestrated/branched stent grafts. This minimally invasive total treatment technique is accurate, allows quick recovery, and has a low complication rate. The short-term follow-up data show the safety and reliability of the method; however, further research and development are needed.

How to get better TAD? Relationship between anteversion angle of nail and position of femoral neck guide pin during nailing of intertrochanteric fractures.

BACKGROUND: To demonstrate the correlation between guide pin-shaft angle (PSA) at the anteroposterior film and anteversion angle of guide pin at the lateral film and investigate whether excellent tip-apex distance (TAD) can be obtained by changing the entry point via axial rotation of the main intramedullary nail. METHODS: Fifty patients with intertrochanteric femoral fractures (IFFs) undergoing internal fixation with intramedullary nails under 2D fluoroscopy were retrospectively enrolled. Both of the PSA at the anteroposterior film and anteversion angle at the lateral film before and after adjustment of the guide pin were collected. Pearson correlation analysis was performed to investigate their correlation. Intraoperative and postoperative outcomes were recorded. Furthermore, the software of Mimics 10.0 and Pro/E were used to establish the 3D models of the proximal femur and main intramedullary nail/guide pin, respectively. Surgery was simulated on the Pro/E software platform and solid geometry analysis was conducted to calculate the correlation between the PSA and the anteversion angle. RESULTS: Pearson correlation analysis indicated there was a positive correlation between PSA and anteversion angle, with the correlation coefficient of 0.902 (p < 0.01). By altering the PSA and anteversion angle, TAD was adjusted to be less than 25 mm in all patients. The mean operative time, fluoroscopy time and length of hospital stay were 65.82 ± 11.16 min, 2.03 ± 0.79 min and 6.66 ± 2.49 d. Thirty-one patients received blood transfusions (3.55 ± 1.95 U). Fracture reduction was considered to be good or acceptable in all patients. Complications occurred only in 6 patients (12.00%). At a 3-month follow-up, the mean Timed Up and Go was 31.54 ± 20.95 s and Harris Hip Score was 72.88 ± 8.79. The 3D surgery model also showed when the main intramedullary nail was externally rotated or internally rotated of 20° at the standard location, the PSA of guide pin at the anteroposterior position and anteversion angle of the guide pin at the lateral position were simultaneously increased or decreased. CONCLUSION: Our findings suggest altering the PSA and anteversion angle may be beneficial for obtaining excellent TAD and achieving superior outcomes.

Estimating and Analyzing Long-Term Multi-GNSS Inter-System Bias Based on Uncombined PPP.

With the development of precise positioning with multi-GNSS, the inter-system bias (ISB) has become an issue that cannot be ignored. ISB is introduced from the differences among satellite reference clocks and different receiver hardware delay biases. To analyze the characteristics of multi-GNSS ISB, the precise point positioning (PPP) with full-rank uncombined model was derived for GLONASS, BDS, GALILEO, while the GPS receiver clock was selected as the reference. In addition, a recommended ISB parameter processing model was adopted. Data of 28-days from the Multi-GNSS Experiment (MGEX) station was used to estimate and analyze the ISB parameters. Based on a statistical analysis of the acquired data, results demonstrate that: (a) The rms of multi-GNSS PPP positional bias can reach 4.6 mm, 3.4 mm and 8.5 mm for E, N and U directions, respectively, which guarantees the reliability and accuracy of the ISB parameter solution. (b) The intra-day ISB time series of the three groups is relatively stable with standard deviations less than 0.6 ns. The ISB parameters between the GALILEO and GPS system are the most stable and the standard deviation was the smallest, at about 0.37 ns, which may be related to the good signal quality of the GALILEO system. (c) The mean of the single-day solution of the ISB parameter is not stable and the amplitude of the jump can be up to 60 ns. However, each station shows a similar variation for the same ISB parameter on the same day. The situation is independent of the type of receiver and antenna; however, it may be affected by the satellite reference clock of different systems. (d) There is a clear relationship between the ISB parameters and receiver types.

A Quantum Expectation Value Based Language Model with Application to Question Answering.

Quantum-inspired language models have been introduced to Information Retrieval due to their transparency and interpretability. While exciting progresses have been made, current studies mainly investigate the relationship between density matrices of difference sentence subspaces of a semantic Hilbert space. The Hilbert space as a whole which has a unique density matrix is lack of exploration. In this paper, we propose a novel Quantum Expectation Value based Language Model (QEV-LM). A unique shared density matrix is constructed for the Semantic Hilbert Space. Words and sentences are viewed as different observables in this quantum model. Under this background, a matching score describing the similarity between a question-answer pair is naturally explained as the quantum expectation value of a joint question-answer observable. In addition to the theoretical soundness, experiment results on the TREC-QA and WIKIQA datasets demonstrate the computational efficiency of our proposed model with excellent performance and low time consumption.

Augmentation of miR-202 in varicose veins modulates phenotypic transition of vascular smooth muscle cells by targeting proliferator-activated receptor-γ coactivator-1α.

In varicose veins, vascular smooth muscle cells (VSMCs) often show abnormal proliferative and migratory rates and phenotypic transition. This study aimed to investigate whether microRNA (miR)-202 and its potential target, peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α), were involved in VSMC phenotypic transition. miR-202 expression was analyzed in varicose veins and in VSMCs conditioned with platelet-derived growth factor. The effect of miR-202 on cell proliferation and migration was assessed. Furthermore, contractile marker SM-22α, synthetic markers vimentin and collagen I, and PGC-1α were analyzed by Western blot analysis. The modulation of PGC-1α expression by miR-202 was also evaluated. In varicose veins and proliferative VSMCs, miR-202 expression was upregulated, with decreased SM-22α expression and increased vimentin and collagen I expression. Transfection with a miR-202 mimic induced VSMC proliferation and migration, whereas a miR-202 inhibitor reduced cell proliferation and migration. miR-202 mimic constrained luciferase activity in HEK293 cells that were cotransfected with the PGC-1α 3'-untranslated region (3'-UTR) but not those with mutated 3'-UTR. miR-202 suppressed PGC-1α protein expression, with no influence on its messenger RNA expression. PGC-1α mediated VSMC phenotypic transition and was correlated with reactive oxygen species production. In conclusion, miR-202 affects VSMC phenotypic transition by targeting PGC-1α expression, providing a novel target for varicose vein therapy.

A Novel Internal and External Bypass Method to Safeguard Cerebral Blood Flow During Aortic Arch Endovascular Repair Requiring Triple In Situ Fenestrations.

Purpose: To report a novel internal and external blood bypass method for cerebral protection during in situ triple-fenestrated stent-graft repair in the aortic arch. Technique: A method was devised to combine internal and external blood bypass circuits to preserve cerebral blood flow when all 3 supra-aortic branches are covered by the stent-graft. Long 14-F to 18-F introducers are placed retrogradely into the right and left common carotid arteries (CCAs). Smaller sheaths are placed antegradely into the internal carotid arteries (ICAs) bilaterally and into the right CCA introducer, which has had an aperture cut into it for flow to pass into the smaller sheath. The right CCA introducer is positioned in the ascending aorta to supply the innominate artery; the smaller sheath in the right CCA introducer is positioned at the aperture. The small sheath in the right CCA is connected to the left ICA sheath, and the left CCA fenestration is made and stented. The left ICA sheath is connected to the right ICA sheath, and the right CCA introducer is pulled back to the origin of the innominate artery and the smaller sheath removed. The fenestrations for the innominate and left subclavian arteries are opened sequentially. In 8 patients, complete bypass to maintain brain perfusion was performed for an average 17.6±6.9 minutes; intraoperative transcranial Doppler monitoring during flow bypass showed no notable decline in intracranial blood flow velocity. Two patients suffered stroke; one recovered completely. Conclusion: A cerebral protection strategy that integrates internal and external blood flow bypass techniques to maintain adequate brain blood flow is simple and feasible for in situ triple-fenestration aortic arch stent-graft repairs. However, neurological complications were not avoided with this method; thus, further research and development are required.

Deformable torso phantoms of Chinese adults for personalized anatomy modelling.

In recent years, there has been increasing demand for personalized anatomy modelling for medical and industrial applications, such as ergonomics device development, clinical radiological exposure simulation, biomechanics analysis, and 3D animation character design. In this study, we constructed deformable torso phantoms that can be deformed to match the personal anatomy of Chinese male and female adults. The phantoms were created based on a training set of 79 trunk computed tomography (CT) images (41 males and 38 females) from normal Chinese subjects. Major torso organs were segmented from the CT images, and the statistical shape model (SSM) approach was used to learn the inter-subject anatomical variations. To match the personal anatomy, the phantoms were registered to individual body surface scans or medical images using the active shape model method. The constructed SSM demonstrated anatomical variations in body height, fat quantity, respiratory status, organ geometry, male muscle size, and female breast size. The masses of the deformed phantom organs were consistent with Chinese population organ mass ranges. To validate the performance of personal anatomy modelling, the phantoms were registered to the body surface scan and CT images. The registration accuracy measured from 22 test CT images showed a median Dice coefficient over 0.85, a median volume recovery coefficient (RCvlm ) between 0.85 and 1.1, and a median averaged surface distance (ASD) < 1.5 mm. We hope these phantoms can serve as computational tools for personalized anatomy modelling for the research community.

Contemporary Results of Endovascular Repair of Isolated Abdominal Aortic Dissection with Unibody Bifurcated Stent Grafts.

OBJECTIVES: To report the midterm safety and efficacy of the Aegis™-B (Microport, Shanghai, China) unibody bifurcated stent graft for endovascular treatment of isolated abdominal aortic dissection (IAAD). BACKGROUND: Isolated abdominal aorta dissection (IAAD) is a rare event. Endovascular stent grafts seem to offer an efficient therapeutic approach to treat IAAD. However, the relatively small diameter of the infrarenal aorta and aortic bifurcation remains the main anatomical limitation to endovascular repair. METHODS: Between 2008 and 2015, we retrospectively evaluated 32 IAAD patients (21 men; mean age 58 ± 18 years), who underwent endovascular repair using Aegis™-B unibody bifurcated stent graft. Narrow proximal landing zone and narrow distal aorta was present in 11 (34.4%) patients and 10 (31.3%) patients, respectively. In the follow-up period, aortic remodeling was observed with computed tomography angiography. RESULTS: All patients were treated by endovascular means, with a primary technical success rate of 100%. During a mean follow-up period of 30.71 ± 16.36 months (range, 8-56 months), no death, rupture, stent fracture, material failure, or device migration was observed. Complete false lumen thrombosis was observed in all patients at 1 year, and all patients were free from false lumen growth in the follow-up. CONCLUSIONS: Endovascular treatment of IAAD using the Aegis™-B system appears to be safe and effective. Results from this study suggest this algorithm can provide stable, secure fixation for IAAD patients with narrow proximal landing zone, and distal aorta.

Wideband Spectrum Sensing Based on Single-Channel Sub-Nyquist Sampling for Cognitive Radio.

Spectrum sensing is an important task in cognitive radio. However, currently available Analog-to-Digital Converters (ADC) can hardly satisfy the sampling rate requirement for wideband signals. Even with such an ADC, the cost is extremely high in terms of price and power consumption. In this paper, we propose a spectrum-sensing method based on single-channel sub-Nyquist sampling. Firstly, a serial Multi-Coset Sampling (MCS) structure is designed to avoid mismatches among sub-ADCs in the traditional parallel MCS. Clocks of the sample/hold and ADC are provided by two non-uniform sampling clocks. The cooperation between these two non-uniform sampling clocks shifts the high sampling rate burden from the ADC to the sample/hold. Secondly, a power spectrum estimation method using sub-Nyquist samples is introduced, and an efficient spectrum-sensing algorithm is proposed. By exploiting the frequency-smoothing property, the proposed efficient spectrum-sensing algorithm only needs to estimate power spectrum at partial frequency bins to conduct spectrum sensing, which will save a large amount of computational cost. Finally, the sampling pattern design of the proposed serial MCS is given, and it is proved to be a minimal circular sparse ruler with an additional constraint. Simulations show that mismatches in traditional parallel MCS have a serious impact on spectrum-sensing performance, while the proposed serial MCS combined with the efficient spectrum-sensing algorithm exhibits outstanding spectrum-sensing performance at much lower computational cost.

Comparison of Foam Sclerotherapy Alone or Combined With Stripping of the Great Saphenous Vein for Treating Varicose Veins.

BACKGROUND: Varicose veins (VVs) have a substantial impact on patients' quality of life. OBJECTIVE: The study aimed to retrospectively compare the short-term clinical outcomes of 2 treatment methods for VVs, namely high ligation and stripping (HL/S) of the great saphenous vein combined with foam sclerotherapy (FS), and FS alone. MATERIALS AND METHODS: Totally, 180 patients with VVs were included and treated with FS alone or HL/S+FS. Assessments included the first injection efficacy, postoperative status, complications, operative time, and recovery time. A follow-up duration was performed. Patient satisfaction was also recorded. RESULTS: No significant differences in the complete occlusion rate of the varicose tributaries, as well as in postoperative complications, were found between the treatment groups (p > 0.05). The complete occlusion rates of the varicose tributaries in the FS and HL/S+FS groups were 90% and 90%, respectively. Although mild phlebitis and local pigmentation were found in both groups, they disappeared during the follow-up period. Operative and recovery times were higher in the HL/S+FS group than in the FS group. CONCLUSION: The HL/S+FS and FS alone showed equivalent efficacy for treating patients with VVs. Considering the increased operative and recovery times, FS alone is recommended to treat VVs in clinical practice.

SDF1-3'A polymorphism is associated with size but not occurrence of abdominal aortic aneurysm in a Chinese population.

OBJECTIVE: Previous studies have suggested that stromal-derived factor 1 (SDF1) plays a pivotal role in abdominal aortic aneurysm (AAA) development. The SDF1-3'A polymorphism (G to A, rs1801157), located in the 3' untranslated region, could influence the expression of SDF1. The aim of our study was to investigate the relationship of SDF1-3'A polymorphism with the risk of AAA occurrence and size. METHODS: A total of 205 AAA patients and 216 age- and sex-matched controls were recruited. The SDF1-3'A polymorphism was evaluated by polymerase chain reaction, followed by restriction enzyme analysis. RESULTS: The frequency of A allele was similar between groups. The genotype distribution also displayed no statistically significant differences under both the dominant model (odds ratio [OR], 0.922; P = .678) and the recessive model (OR, 1.617; P = .300). The multiple logistic regression analysis indicated that the association between the polymorphism and AAA remained insignificant when applied to the dominant model. However, AAA patients with GG genotype were more likely to develop aneurysms larger than 50 mm (OR, 0.497; P = .014). AAA patients with SDF1-3'A allele have reduced plasma SDF1α levels. In addition, plasma SDF1α levels were positively correlated with AAA size. CONCLUSIONS: Our study suggests that SDF1-3'A polymorphism is associated with size but not occurrence of AAA, providing further evidence that SDF1 is implicated in AAA progression.