Clinical application of AI-based PET images in oncological patients.

Based on the advantages of revealing the functional status and molecular expression of tumor cells, positron emission tomography (PET) imaging has been performed in numerous types of malignant diseases for diagnosis and monitoring. However, insufficient image quality, the lack of a convincing evaluation tool and intra- and interobserver variation in human work are well-known limitations of nuclear medicine imaging and restrict its clinical application. Artificial intelligence (AI) has gained increasing interest in the field of medical imaging due to its powerful information collection and interpretation ability. The combination of AI and PET imaging potentially provides great assistance to physicians managing patients. Radiomics, an important branch of AI applied in medical imaging, can extract hundreds of abstract mathematical features of images for further analysis. In this review, an overview of the applications of AI in PET imaging is provided, focusing on image enhancement, tumor detection, response and prognosis prediction and correlation analyses with pathology or specific gene mutations in several types of tumors. Our aim is to describe recent clinical applications of AI-based PET imaging in malignant diseases and to focus on the description of possible future developments.

Tailoring linear and nonlinear plasmons of metal/MoS2/metal nanostructures.

We investigated the linear and nonlinear response of the localized surface plasmons (LSPs) and surface plasmon polaritons (SPPs) in metal and MoS2 nanostructures. The results show that the response of LSPs and SPPs has an important influence on the energy exchange. SPPs with unique non-radiative characteristics can be used as energy recovery tanks to reuse the radiated energy of LSPs and promote the production of hot carriers. The energy exchange through plasmon modes can promote the transfer of hot electrons in the Au grating, the MoS2 layer, and the metal film. The fundamental field induces the increase of the second harmonic wave by introducing the second-order nonlinear source. In addition, the evolution of the lifetime of linear and nonlinear plasmonic modes is also investigated to study the underlying mechanism of the micro process in the plasmonic-photonic interaction. The plasmonic energy exchanging configuration overcomes the challenge by utilizing hot carriers. It is instructive in terms of improving the linear and nonlinear performance of plasmonic opto-electronic devices.

Fast-Track Management of Concurrent Percutaneous Coronary Intervention in Patients Scheduled for Endovascular Abdominal Aortic Aneurysm Repair.

PURPOSE: To investigate the safety and efficacy of fast-track management of concurrent percutaneous coronary intervention (PCI) in patients with abdominal aortic aneurysm scheduled for endovascular aortic aneurysm repair (EVAR). MATERIALS AND METHODS: Eligible patients with abdominal aortic aneurysm who received EVAR from January 2011 to December 2019 were included in this retrospective cohort study. Propensity score (PS)-matched analysis was used to balance the baseline between the fast-track and standard control (EVAR without significant coronary artery disease) groups. Effects of fast-track management on short-term and midterm outcomes were evaluated via Cox proportional hazard regression and logistic regression analyses with corresponding hazard ratio (HR) or odds ratio (OR) and associated 95% confidence intervals (95% CIs), respectively. RESULTS: The study included 669 patients (73 fast-track and 596 standard control). Compared with the standard control group, no significant difference was found regarding major adverse cardiac events (HR 0.78, 95% CI [0.36, 1.68], p=0.519), overall mortality (HR 0.63, 95% CI [0.25, 1.55], p=0.315), and 30-day major hemorrhage events (OR 1.01, 95% CI [0.99, 1.03], p=0.514). The results were consistent in the PS-matched cohorts regarding major adverse cardiac events (HR 0.57, 95% CI [0.25, 1.29], p=0.176), overall mortality (HR 0.43, 95% CI [0.17, 1.11], p=0.820), and 30-day major hemorrhage events (OR 1.00, 95% CI [0.05, 10.61], p=0.999). Similar results were found in the subgroup analyses concerning fast-track management of 2-week intervals and patients with high age-adjusted Charlson comorbidity index. CONCLUSIONS: Under appropriate perioperative care, shortening the time interval between PCI and EVAR to 1 month, or even 2 weeks, seemed to be safe and effective. Short-term and midterm cardiovascular and survival outcomes were comparable with patients who underwent standard EVAR without significant coronary artery disease.

A systematic review and meta-analysis of the clinical effectiveness and safety of unilateral versus bilateral iliac branch devices for aortoiliac and iliac artery aneurysms.

OBJECTIVE: Iliac branch devices (IBDs) have been used in the treatment of aortoiliac and isolated iliac artery aneurysms. The aim of this systematic review and meta-analysis was to investigate the clinical effectiveness and safety of IBDs. METHODS: A systematic review of the literature was conducted by identifying studies in the Medline, EMBASE, and Cochrane databases regarding the outcomes of IBDs in aortoiliac or isolated iliac artery aneurysms between May 2006 and December 2020. Individual studies were evaluated for the following major outcomes: technical success, 30-day mortality, primary patency, endoleak, reintervention, and rates of pelvic ischemia. Furthermore, subgroup meta-analyses were performed to compare the pelvic ischemic events in patients with bilateral IBDs, unilateral IBDs, and bilateral internal iliac artery (IIA) embolization/coverage. RESULTS: Forty-five studies with a total of 2736 patients undergoing unilateral or bilateral IBDs met inclusion criteria and were included in the analysis. The pooled technical success rate of IBDs was 98.0% (confidence interval [CI]: 97.3%-98.7%). After IBD treatment, the 30-day mortality rate was 0.4% (CI: 0.07%-0.70%); 30-day patency was 98.4% (CI: 97.7%-99.0%); buttock claudication developed in 1.84% (CI: 1.26%-2.41%); and endoleak occurred in 11.9% (CI: 9.2%-14.7%) and reintervention in 7.6% (CI: 5.65%-9.58%). Furthermore, in patients with bilateral iliac artery involvement, the pooled estimate rates of buttock claudication were 0.7% in the bilateral IBD group, 7.9% in unilateral IBD with contralateral IIA embolization patients, and 33.8% in bilateral IIA embolization/coverage patients, which were statistically significant among the three groups. Sexual dysfunction was 5.0% in the bilateral IIA occlusion group, which was significantly higher than that in IBD groups. CONCLUSIONS: The utilization of IBDs in the treatment of aortoiliac or isolated iliac artery aneurysms is associated with high technical success rates as well as low incidences of pelvic ischemia. The risk of postoperative buttock claudication can be further decreased with both IIA preservation if patients are anatomically suitable for bilateral IBDs.

The Predictive Value of Elliptical Neck Parameters and Oversizing Ratio for Type Ia Endoleaks after Endovascular Aneurysm Repair.

PURPOSE: To assess the predictive value of geometric parameters for type Ia endoleak (T1AEL) after endovascular abdominal aortic aneurysm repair and to determine the range of optimal oversizing ratio (OSR) in patients with an elliptical cross-section of the aneurysm neck. MATERIALS AND METHODS: A propensity score-matched case-control study was conducted. Case patients were those who were diagnosed with T1AEL and control patients were those who did not have T1AEL after endovascular aneurysm repair during the period from 2012 to 2018. Geometric and oversizing parameters were compared based on both 2-dimensional (2D) and 3-dimensional measurements. Net reclassification improvement was used to measure the prediction increment of an elliptical model (major axis OSR, neck length, and severe neck angulation) compared with that of the conventional model (OSR 2D, neck length, and severe neck angulation). RESULTS: Nineteen case patients and 111 control patients were included. The median OSR 2D of patients with T1AEL was 17% (interquartile range, 15%-22%), but the median major axis OSR was only 7% (interquartile range, 5%-12%). For the geometric parameters, axis difference had the highest area under the curve (AUC) (0.74; 95% CI, 0.63-0.84) for predicting T1AEL. For the elliptical oversizing parameters, the major axis OSR had an AUC of 0.89 (95% CI, 0.78-0.97), with a cutoff value of 13%. The elliptical model had a higher discriminating ability for T1AEL than the conventional model (AUC 0.91 vs 0.86, respectively; P = .045), with an improved reclassification ability (net reclassification improvement, 27.93%; 95% CI, 19.22%-36.64%; P < .0001). CONCLUSIONS: Elliptical aneurysm neck cross-section, assessed by the difference between axis dimensions in the plane orthogonal to the centerline, was associated with an increased risk of T1AEL. The prescription of major axis oversizing of at least 13% can significantly reduce the risk of T1AEL formation in patients with an elliptical aneurysm neck.

Systematic Review and Meta-analysis of the Outcomes of Drug-Eluting Stent Versus Drug-Coated Balloon Angioplasty for Lower Extremity Peripheral Artery Diseases.

BACKGROUND: Recent evidence raised the concern that paclitaxel-containing therapy was associated with an increased risk of mortality in patients with peripheral artery diseases (PADs). However, it is unclear whether drug-eluting stent (DES) versus drug-coated balloon (DCB) have a different effect on mortality of PAD patients. Our study aimed to systematically review current literature comparing clinical outcomes of patients treated with DES versus DCB for PAD. METHODS: MEDLINE and Embase were searched for eligible studies from January 2000 to December 31, 2020. Randomized controlled trials (RCTs) or cohort studies that reported outcomes of DES versus DCB were included in our study. The primary outcome was 12-month all-cause mortality. A random-effect model was used to pool the odds ratios (ORs) and related 95% confidence intervals (CIs). RESULTS: Our review included 7 studies, involving 2 RCTs and 5 cohort studies. A total of 4,237 patients with DES and 9,234 patients with DCB were analyzed. All included cohort studies were of high quality with Newcastle-Ottawa scores from 7 to 8. No significant difference in 12-month all-cause mortality was found between DES and DCB without significant heterogeneity (OR 1.02, 95% CI 0.91-1.14, I2 = 0%). As for primary patency, no significant difference between treatments was observed (OR 1.27, 95% CI 0.75-2.15, I2 = 55%). Similar results were observed for freedom from target lesion revascularization (OR 0.94, 95% CI 0.64-1.40, I2 = 0%). CONCLUSIONS: This systematic review and meta-analysis suggest that no significant difference in 12-month all-cause mortality was found between DES and DCB. Primary patency and freedom from target lesion revascularization of lower extremity PAD were also comparable between the 2 groups.

[Single-Center Experience of Treating Chronic Limb-Threatening Ischemia of Lower Limbs Combined with Diabetes].

Objective: To summarize our hospital's single-center experience of and reflections on the treatment of chronic limb-threatening ischemia (CLTI) of lower limbs combined with diabetes in the past 5 years. Methods: We retrospectively analyzed cases of lower limb CLTI combined with diabetes diagnosed at our hospital from March 2017 to June 2021. The baseline data, surgical information, and follow-up results of the patients were collected. The primary outcome indicator was the patency rate of lower limb target artery within 1 year post-op, and the secondary indicators were the reoperation rate within 1 year post-op and the amputation rate within 1 year post-op. Results: A total of 89 patients with lower limb CLTI combined with diabetes were included in the study. A total of 85 patients underwent percutaneous transluminal angioplasty and the operation of 7 patients ended in failure, with the operation success rate reaching 91.76% (78/85). Three patients underwent femoral popliteal artery bypass grafting with artificial blood vessels and one patient underwent iliac femoral artery bypass grafting with artificial blood vessels, with the success rate of the operations reachign 100% (4/4). Among 78 patients who successfully underwent percutaneous transluminal angioplasty, the median follow-up time was 33 months (13, 64). Two patients died within one year after operation, with the post-op one-year survival rate being 97.44% (76/78). The post-op 1-year reoperation rate was 19.23% (15/78), the 1-year target vascular patency rate (deaths not included) was 85.53% (65/76), and the 1-year amputation rate was 3.85% (3/78). Among the patients who underwent bypass surgery, the follow-up period was 13-48 months. No thrombosis in or re-occlusion of the artificial blood vessels were observed during the follow-up period, and the artificial blood vessels remained unoccluded. Conclusion: Transluminal angioplasty has a relatively ideal rate of postoperative vascular patency. In addition, it is a minimally invasive procedure involving low perioperative risks and is performed under local anesthesia. Therefore, it can be used as the preferred treatment for patients with CLTI. On the other hand, bypass surgery has good long-term patency rate, but it involves higher perioperative risks and the procedure is more invasive. Therefore, bypass surgery can be used as an alternative when transluminal angioplasty ends in failure.

A systematic review and meta-analysis of the risk of death and patency after application of paclitaxel-coated balloons in the hemodialysis access.

OBJECTIVE: The comparison between paclitaxel-coated balloon (PCB) angioplasty and plain balloon angioplasty (PBA) for hemodialysis (HD) access stenosis or occlusion has not been well investigated. The objectives of this systematic review and meta-analysis were to compare all-cause mortality, HD access primary patency, and circuit primary patency after endovascular maintenance procedures using PCB angioplasty vs PBA. METHODS: MEDLINE, Embase, and Cochrane Databases were systematically searched to identify all the relevant studies on paclitaxel-coated devices for stenosis or thrombosis of HD access. A random effects model was applied to pool the effect measures. Dichotomous data were presented using an odds ratio (OR). Effect data were presented using pooled hazard ratio (HR) with 95% confidence interval (CI). RESULTS: A total of 16 studies were included in this meta-analysis, 12 randomized controlled trials and 4 cohort studies involving 1086 patients who underwent endovascular treatment for HD access stenosis or occlusion. All-cause mortality rates at 6, 12, and 24 months after intervention were similar between the PCB and PBA groups (6 months: OR, 1.06 [95% CI, 0.38-2.96; P = .907; I2 = 19.2%]; 12 months: OR, 1.20 [95% CI, 0.66-2.16; P = .554; I2 = 0%]; 24 months: OR, 1.43 [95% CI, 0.83-2.45; P = .195; I2 = 0%]). There was a significant improvement of primary patency in the PCB group compared with the PBA group (HR, 0.47; 95% CI, 0.33-0.69; P < .001; I2 = 67.3%). This benefit was consistent with the analysis of randomized controlled trials, whereas cohort studies were excluded. Further subgroup analysis of target lesions demonstrated that primary patency was significantly higher in the PCB group than in the PBA group, not only for arteriovenous fistula (HR, 0.54; 95% CI, 0.30-0.98; P = .041; I2 = 76.8%) but also for central venous stenosis (HR, 0.39; 95% CI, 0.22-0.71; P = .002; I2 = 0%). The PCB group was associated with higher 6-month (OR, 0.40; 95% CI, 0.27-0.59; P < .001) and 24-month lesion primary patency (OR, 0.28; 95% CI, 0.11-0.72; P = .009) than PBA and was marginally associated with 12-month lesion primary patency (OR, 0.52; 95% CI, 0.26-1.03; P = .06). Circuit primary patency analysis showed a marginal trend toward better outcome in the PCB group (HR, 0.63; 95% CI, 0.40-1.00) but no statistical significance (P = .052). CONCLUSIONS: This systematic review and meta-analysis demonstrated that PCB angioplasty is associated with significantly improved primary patency of arteriovenous fistula and central venous stenosis for HD access maintenance, with no evidence of increasing all-cause mortality based on short-term and midterm follow-up. Further large cohort study is needed to investigate long-term mortality.

Systematic review and meta-analysis of sex differences in outcomes after endovascular aneurysm repair for infrarenal abdominal aortic aneurysm.

OBJECTIVE: Women face distinctive challenges when they receive endovascular aneurysm repair (EVAR) treatment, and according to the previous studies, sex differences in outcomes after EVAR for infrarenal abdominal aortic aneurysm (AAA) remains controversial. This study aimed to compare the short-term and long-term outcomes between women and men after EVAR for infrarenal AAA. METHODS: We conducted a comprehensive systematic review and meta-analysis of all available studies reporting sex differences after EVAR for infrarenal AAA, which were retrieved from the MEDICINE, Embase, and Cochrane Database. The pooled results were presented as odds ratios (ORs) for dichotomous data and hazard ratios for time-to-event data using a random effect model. RESULTS: Thirty-six cohorts were included in this meta-analysis. The pooled results showed that women were associated with a significantly increased risk of 30-day mortality (crude OR, 1.67; 95% confidence interval [CI], 1.50-1.87; P < .001; adjusted OR, 1.73; 95% CI, 1.32-2.26; P < .001), in-hospital mortality (OR, 1.90; 95% CI, 1.43-2.53; P < .001), limb ischemia (OR, 2.44; 95% CI, 1.73-2.43; P < .001), renal complications (OR, 1.73; 95% CI, 1.12-2.67; P = .028), cardiac complications (OR, 1.68; 95% CI, 1.01-2.80; P = .046), and long-term all-cause mortality (hazard ratio, 1.23; 95% CI, 1.09-1.38; P = .001) compared with men; however, no significant sex difference was observed for visceral/mesenteric ischemia (OR, 1.62; 95% CI, 0.91-2.88; P = .098), 30-day reinterventions (OR, 1.37; 95% CI, 0.95-1.98; P = .095), late endoleaks (OR, 1.18; 95% CI, 0.88-1.56; P = .264), and late reinterventions (OR, 1.05; 95% CI, 0.78-1.41; P = .741). In the intact AAA subgroup, women had a significantly increased risk of visceral/mesenteric ischemia (OR, 1.85; 95% CI, 1.01-3.39; P = .046) and an equivalent risk of cardiac complications (OR, 1.64; 95% CI, 0.85-3.17; P = .138) compared with men. CONCLUSIONS: Compared with male sex, female sex is associated with an increased risk of 30-day mortality, in-hospital mortality, limb ischemia, renal complications, cardiac complications, and long-term all-cause mortality after EVAR for infrarenal AAA. Women should be enrolled in a strict and regular long-term surveillance after EVAR.

A reliable method for renal volume measurement and its application in fenestrated endovascular aneurysm repair.

OBJECTIVE: Renal volume has been shown to correlate with renal function. Renal volume and renal function both decline steadily in the sixth decade of life and beyond. We sought to assess (1) the inter-rater reliability for manually measuring renal volume using computed tomography and (2) change in renal volume over time as it relates to renal function in fenestrated endovascular aortic aneurysm repair (FEVAR). METHODS: This study was conducted as part of a physician-sponsored investigational new device (#NCT01538056). First, 30 consecutive kidneys of preoperative FEVAR patients were independently measured by two raters using manual segmentation and three-dimensional modeling software. Renal volumes were calculated and compared. Intraclass correlation was calculated between the two observers. Second, renal volumes were then recorded for 85 patients undergoing FEVAR with follow-up out to 5 years. Demographic data, comorbidities, creatinine, glomerular filtration rate (GFR), renal artery stenosis or occlusion, and bilateral renal volume measurements were analyzed. Multivariate analysis was performed to delineate association of these variables with total renal volume (TRV). RESULTS: The intraclass correlation coefficient for our renal volume measurements was 0.97 (95% confidence interval, 0.81-0.99), indicating excellent correlation. Renal volume was strongly correlated with GFR. Our multivariate analysis model predicts a 17.9 mL/min increase in GFR with each 20% increase in TRV. After adjustment for all other known correlates of renal function, renal volume remained as the only significant predictor of renal function. CONCLUSIONS: Renal volume can be measured with high reliability using manual segmentation and computed tomography scans. In our baseline analysis, TRV was strongly correlated with renal function. These findings support the potential for renal volume as a surrogate for renal function.

Stripped Electrode Based Electrowetting-on-Dielectric Digital Microfluidics for Precise and Controllable Parallel Microdrop Generation.

Microdrop generation with excellent controllability and volume precision is of paramount significance for a large variety of microfluidic applications. In this work, we propose a new configuration comprising only stripped electrodes of rectangular shape for the closed electrowetting-on-dielectric digital microfluidic (EWOD DMF) system and investigate its parallel microdrop generation outcomes via a numerical approach. The microfluidic droplet motion is solved by a finite-volume scheme on a fixed computational domain. The numerical model is verified by an experimental study of microdrop production from an EWOD DMF device with three different electrode designs. After model verification, we examine the influences of the equilibrium contact angle and the spacing of the microchannel on stripped electrode based microdrop generation outcomes and discover five different regimes including the phenomena of satellite droplet formation and separation cessation. Despite the various generation outcomes, the daughter droplet size is found to vary linearly with a dimensionless EWOD parameter κ*. More importantly, for all successful generations, the deviation of the daughter droplet size from that of the stripped electrode is smaller than 3.5%, which even reaches zero in proper conditions. This new configuration can be utilized as a convenient alternative for electrowetting-induced parallel microdrop production with excellent precision and controllability.

Duodenal Necrosis Associated with a Threatened Ruptured Gastroduodenal Artery Pseudoaneurysm Complicated by Chronic Pancreatitis: Case Report.

Visceral artery pseudoaneurysm (PSA) complicated by pancreatitis is a relatively rare and potentially life-threatening condition. The formation of pancreatic PSA is mainly attributed to continuous inflammation response, which induces the enzymatic autodigestion of the adjacent artery wall. The spleen artery is the most affected vessel, and other vessels such as gastroduodenal artery (GDA) and pancreaticoduodenal artery are usually involved. The treatment options for pancreatic PSA include conservative therapy, open surgery (OS), and endovascular procedure. Currently, no broad consensus on the indications for pancreatic PSA treatment is available because of the rarity of the disease. We report an urgent case of a threatened ruptured GDA PSA with duodenal necrosis complicated by chronic pancreatitis that has been treated successfully with OS. The treatment choice, puzzles, and reflections of this case were all discussed in this paper.

Restenosis of Bilateral Aorta-Renal Saphenous Vein Grafts after the Surgical Repair of Takayasu Arteritis-induced Bilateral Renal Arteries Stenosis: Case Report.

Takayasu arteritis (TA) is a nonspecific and chronic inflammatory vasculitis that mainly affects the aorta and its main branches, resulting in stenosis or occlusion of the aorta or its main branches with related symptoms. Up to 60% of TA patients have renal artery involvement, which often lead to refractory hypertension and impaired renal function. Surgical repair and endovascular intervention are commonly employed in clinical practice. Surgical bypass with prosthetic or autologous vein graft is preferred for complicated lesions not suitable for endovascular intervention or patients who are allergic to contrast. Restenosis of bypass graft is one of the complications that vascular surgeons need to fix. Restenosis of graft is consistently eliminated by angioplasty based on the current studies. Limited literature reported surgical repair of restenosis of bypass graft. We report a patient with TA-induced bilateral renal arteries stenosis who underwent aorta-renal artery bypass and suffered from restenosis of bilateral grafts in a short period. Twice surgical bypass with saphenous vein graft for the initial treatment and with prosthetic graft for the second restenosis elimination was performed. The details of procedures, choice of graft, and analysis of restenosis will be discussed.

Giant Hypogastric Aneurysm Induced by Type-II Endoleak Presenting 4 Years after Endovascular Repair: A Case Report.

Bilateral isolated hypogastric aneurysm (HA) is a rare type of abdominal aneurysm. Endovascular repair has become predominant compared with surgical repair because of its minimal invasiveness. However, type-II endoleak after procedure may lead to continuous enlargement of HA and rupture. Herein, we report a rare case involving a very large HA induced by type-II endoleak after endovascular repair. A 68-year-old male patient underwent endovascular repair of bilateral isolated HAs 4 years ago. Stent grafts were used to block the orifices of bilateral HAs, and main distal outflows were embolized with coils. In the absence of a 4-year follow-up, he returned to the clinic with symptoms of lower abdominal pain and frequent urination. Computer tomography angiography revealed a giant left HA with a maximum diameter of 18 cm combined with the enlargement of the left common iliac artery (CIA) induced by type-II endoleak. The right isolated HA decreased from 5.5 cm to 3 cm. Angiography was performed, and multiple arteries from the middle sacral and external iliac arteries were detected as the sources of type-II endoleak. Considering the compression effect, surgical repair of the left giant HA was performed. Thrombus was removed from the giant aneurysm, and the distal outflows of HA were sutured. As the left CIA was enlarged, a prosthetic graft was interposed through the inner side of the previous cover stent to revascularize the external iliac artery. The patient had an uneventful postoperative clinical course and was discharged from the hospital 7 days after operation. Treatments of HA induced by type-II endoleak require regular patient follow-ups to monitor specific conditions, particularly the embolization of distal outflows. Surgical repair remains the first choice for HA with compression symptoms.

Meta-analysis of the outcomes of revascularization after intentional coverage of the left subclavian artery for thoracic endovascular aortic repair.

OBJECTIVE: Coverage of the left subclavian artery (LSA) is often required to achieve complete proximal sealing during thoracic endovascular aortic repair. However, whether LSA revascularization should be performed remains controversial. METHODS: MEDLINE, Embase, and Cochrane databases were systematically searched to identify all the relevant studies. A random-effects model was applied to pool the effect measures. Dichotomous data were presented using an odds ratio (OR). RESULTS: There were 32 studies included for qualitative analysis and 31 studies for quantitative analysis. We found that patients who underwent LSA revascularization had a significantly decreased risk of spinal cord ischemia (OR, 0.62; 95% confidence interval [CI], 0.41-0.92; P = .02; I2 = 0%), cerebrovascular accident (OR, 0.63; 95% CI, 0.42-0.95; P = .03; I2 = 22%), and left upper extremity ischemia (OR, 0.18; 95% CI, 0.09-0.36; P < .00001; I2 = 0%). However, no significant differences were found in the risk of paraplegia (OR, 0.91; 95% CI, 0.55-1.51; P = .71; I2 = 0%) and 30-day mortality (OR, 0.89; 95% CI, 0.59-1.36; P = .60; I2 = 21%) between the groups of patients with and without LSA revascularization. CONCLUSIONS: Revascularization of the LSA is associated with decreased risks of cerebrovascular accident, spinal cord ischemia, and left upper limb ischemia in thoracic endovascular aortic repair with LSA coverage at the cost of higher local complications, such as possible vocal cord paresis.

High-Throughput Identification of Putative Antimicrobial Peptides from Multi-Omics Data of the Lined Seahorse (Hippocampus erectus).

Lined seahorse (Hippocampus erectus), the most widely cultivated seahorse in China, has been in short supply because of its important medicinal value; meanwhile, unnatural deaths caused by various diseases (especially enteritis) have limited their practical large-scale aquaculture. Antimicrobial peptides (AMPs), as the best alternative to antibiotics, have been extensively applied in agricultural practices. In this study, we identified 290 putative AMP sequences from our previously published genome and transcriptome data of the lined seahorse. Among them, 267 are novel, and 118 were validated by our proteome data generated in the present study. It seems that there is a tissue preference in the distribution of AMP/AMP precursor transcripts, such as lectins in the male pouch. In addition, their transcription levels usually varied during development. Interestingly, the representative lectins kept extremely high levels at the pre-pregnancy stage while at relatively lower levels at other stages. Especially Lectin25, with the highest transcription levels and significant developmental changes, has been reported to be involved in seahorse and human pregnancy. The comparison of transcriptome data between one-day and three-month juveniles indicated that Hemoglobin2 (Hemo2) was significantly upregulated in the body, haslet, and brain. Our proteome data of female and male individuals revealed three putative AMP precursors with sexual specificity, including two male-biased cyclin-dependent kinases (CDK-like16 and CDK-like23) and one female-biased bovine pancreatic trypsin inhibitor 2 (BPTI2). In conclusion, our present high-throughput identification of putative AMP sequences from multi-omics (including genomics, transcriptomics, and proteomics) data provides an overview of AMPs in the popular lined seahorse, which lays a solid foundation for further development of AMP-based fish food additives and human drugs.

Whole Genome Sequencing of the Blue Tilapia (Oreochromis aureus) Provides a Valuable Genetic Resource for Biomedical Research on Tilapias.

Blue tilapia (Oreochromis aureus) has been an economically important fish in Asian countries. It can grow and reproduce in both freshwater and brackish water conditions, whereas it is also considered as a significant invasive species around the world. This species has been widely used as the hybridization parent(s) for tilapia breeding with a major aim to produce novel strains. However, available genomic resources are still limited for this important tilapia species. Here, we for the first time sequenced and assembled a draft genome for a seawater cultured blue tilapia (0.92 Gb), with 97.8% completeness and a scaffold N50 of 1.1 Mb, which suggests a relatively high quality of this genome assembly. We also predicted 23,117 protein-coding genes in the blue tilapia genome. Comparisons of predicted antimicrobial peptides between the blue tilapia and its close relative Nile tilapia proved that these immunological genes are highly similar with a genome-wide scattering distribution. As a valuable genetic resource, our blue tilapia genome assembly will benefit for biomedical researches and practical molecular breeding for high resistance to various diseases, which have been a critical problem in the aquaculture of tilapias.

Whole Genome Sequencing of the Giant Grouper (Epinephelus lanceolatus) and High-Throughput Screening of Putative Antimicrobial Peptide Genes.

Giant groupers, the largest grouper type in the world, are of economic importance in marine aquaculture for their rapid growth. At the same time, bacterial and viral diseases have become the main threats to the grouper industry. Here, we report a high-quality genome of a giant grouper sequenced by an Illumina HiSeq X-Ten and PacBio Bioscience Sequel platform. A total of 254 putative antimicrobial peptide (AMP) genes were identified, which can be divided into 34 classes according to the annotation of the Antimicrobial Peptides Database (APD3). Their locations in pseudochromosomes were also determined. Thrombin-, lectin-, and scolopendin-derived putative AMPs were the three largest parts. In addition, expressions of putative AMPs were measured by our transcriptome data. Two putative AMP genes (gapdh1 and gapdh2) were involved in glycolysis, which had extremely high expression levels in giant grouper muscle. As it has been reported that AMPs inhibit the growth of a broad spectrum of microbes and participate in regulating innate and adaptive immune responses, genome sequencing of this study provides a comprehensive cataloging of putative AMPs of groupers, supporting antimicrobial research and aquaculture therapy. These genomic resources will be beneficial to further molecular breeding of this economically important fish.

Aneurysmal Degeneration of an Aortorenal Bypass for Takayasu Renal Artery Stenosis: A Novel Endovascular Intervention.

We report an aneurysm degeneration of a vein graft in a previous aortorenal bypass performed 5 years earlier for severe right renal artery stenosis due to Takayasu arteritis. The patient was a 31-year-old woman who suffered from refractory hypertension. The autogenous bypass adopting great saphenous vein was performed from her infrarenal abdominal aorta to her right renal artery. Five years after the operation, the patient complained vague discomfort in her abdomen. Three-dimensional computed tomography angiography reconstruction demonstrated the existence of an aneurysm with a maximum diameter of 1.5 cm at the distal portion of a previous aortorenal vein graft, and >75% stenosis of the right renal artery. The replacement of a previous vein graft bypass with autograft or artificial graft is reported in literature. In this case, we attempted endovascular procedures by embolization of the aneurysm and revascularization of the right renal artery using coils and Viabahn stents.

[Two Methods of Internal Iliac Artery Exclusion in Endovascular Aorta Repair: a Middle-long Term Follow-up Study].

OBJECTIVE: To compare the middle and long term results of two internal iliac artery exclusionmethods (with or without coils) in endovascular aorta repair (EVAR). METHODS: Clinical data of patients who underwent EVAR from January 2006 to December 2013 were analyzed retrospectively. The participants were divided into two group: coils were not used in Group A, but were used in Group B. The patients were followed up from June 2006 to June 2014. RESULTS: A total of 137 patients (74 in Group A, 63 in Group B) were included in this study, with a mean age of 71. 6 years. The majority (124) of participants were men. Postoperative 30-day mortality of the participants was 0. 73%. None of the participants developed pelvic and spinal ischemia. Claudication appeared in 9 patients (3 in Group A and 6 in Group B). Ischemia in lower extremity happened in 5 patients (2 in Group A and 3 in Group B). Gluteal sore was reported by 5 patients (1 in Group A and 4 in Group B). One patient from Group B developed gluteal skin necrosis. No statistical difference in ischemia and stent occlusion was found between the two groups (P=0. 301, P=0. 108). However, patients in Group B stayed in hospitals longer (P<0. 001) than those in group A. One patient in Group B developed severe ischemic complication: skin and gluteus necrosis. CONCLUSION: Internal iliac artery exclusions with and without coilsresult in similar middle and long term outcomes measured by ischemic complications.