Dual Suture Versus Suture and Plug Closure Devices for Large Bore Access Haemostasis During Percutaneous Access Endovascular Aneurysm Repair.

PURPOSE: This study aimed to compare a dual Proglide strategy versus a combination of one Proglide and dual Exoseal for large-bore access closure during percutaneous access endovascular aneurysm repair (pEVAR). MATERIALS AND METHODS: We retrospectively analyzed 97 patients who underwent pEVAR at our center between January 2021 and February 2023. The patients were divided into two groups: dual Proglide (P + P) and one Proglide with dual Exoseal (P + E). The primary outcome measures were technical success and access-related vascular complications. Technical success was defined as achieving complete hemostasis without a bailout strategy. Postprocedural follow-up for access-related vascular complications was evaluated at 30 and 60 days using computed tomography angiography and ultrasonography. Severity was graded according to the Cardiovascular Interventional Radiological Society of Europe (CIRSE) Classification. RESULTS: Overall, a dual Proglide strategy was used in 46 patients (47.4%) with 65 groins (46.4%), and a combination of one Proglide and dual Exoseal was used in 51 patients (52.6%) with 75 groins (53.6%). The baseline characteristics were similar between the groups. The total technical success rate was 96.4%, and no significant differences were observed (95.4% vs. 97.3%; p = 0.870). Minor bleeding treatable through compression occurred significantly more often in the P group (CIRSE 1, 10.8% vs. 1.3%, p = 0.042). Hemostasis time, procedural time, length of stay in the hospital, closure device failure, and incidence of unplanned intervention did not differ significantly between the groups. CONCLUSIONS: A combined Proglide and Exoseal strategy is safe and effective for large-bore access closure during pEVAR and can be considered an alternative. However, it should be supported by larger prospective studies.

Dual targeted extracellular vesicles regulate oncogenic genes in advanced pancreatic cancer.

Pancreatic ductal adenocarcinoma (PDAC) tumours carry multiple gene mutations and respond poorly to treatments. There is currently an unmet need for drug carriers that can deliver multiple gene cargoes to target high solid tumour burden like PDAC. Here, we report a dual targeted extracellular vesicle (dtEV) carrying high loads of therapeutic RNA that effectively suppresses large PDAC tumours in mice. The EV surface contains a CD64 protein that has a tissue targeting peptide and a humanized monoclonal antibody. Cells sequentially transfected with plasmid DNAs encoding for the RNA and protein of interest by Transwell®-based asymmetric cell electroporation release abundant targeted EVs with high RNA loading. Together with a low dose chemotherapy drug, Gemcitabine, dtEVs suppress large orthotopic PANC-1 and patient derived xenograft tumours and metastasis in mice and extended animal survival. Our work presents a clinically accessible and scalable way to produce abundant EVs for delivering multiple gene cargoes to large solid tumours.

Safety and Effectiveness of a Sequential Suture and Plug Vascular Closure Devices Technique for Large-Bore Access Closure after Percutaneous Endovascular Aneurysm Repair.

PURPOSE: To evaluate the safety and effectiveness of sequential sutures and plugged vascular closure devices (VCDs) for large-bore access closure during percutaneous access endovascular aneurysm repair (PEVAR). MATERIALS AND METHODS: Data on 16 patients who underwent PEVAR at the authors' center from January 2022 to May 2022 were retrospectively reviewed. The median age was 72 years (interquartile range [IQR], 59-75 years), with a male-to-female ratio of 3:1. All patients received sequential suture and plug VCDs using dual Exoseal after 1 Proglide for access closure. Success was defined as the ability to achieve complete hemostasis and was confirmed by ultrasonography. The patients were followed up for access-related adverse events at 30 and 90 days after the procedure, and the severity was graded according to the Society of Interventional Radiology (SIR) classification. RESULTS: Overall, 24 access sites were included. The median sheath size was 21 F (IQR, 18-23 F). The median hemostasis time was 11.0 minutes (IQR, 9.3-13.0 minutes), the median procedural time was 133.5 minutes (IQR, 102.5-151.0 minutes), and the median length of stay was 5 days (IQR, 4.0-6.8 days). The success rate was 95.8%, and a pseudoaneurysm (SIR Grade 2) developed in 1 patient, which was treated by a percutaneous injection of thrombin. No other access-related adverse events occurred, and the total adverse event rate was 4.2%. CONCLUSIONS: Placement of sequential suture and plug VCDs using 1 Proglide and dual Exoseal is a safe and effective method and may be an option for access closure during PEVAR.

Overexpression of synaptic vesicle protein Rab GTPase 3C promotes vesicular exocytosis and drug resistance in colorectal cancer cells.

Rab GTPase 3C (RAB3C) is a peripheral membrane protein that is involved in membrane trafficking (vesicle formation) and cell movement. Recently, researchers have noted the exocytosis of RAB proteins, and their dysregulation is correlated with drug resistance and the altered tumor microenvironment in tumorigenesis. However, the molecular mechanisms of exocytotic RABs in the carcinogenicity of colorectal cancer (CRC) remain unknown. Researchers have used various in silico datasets to evaluate the expression profiles of RAB family members. We confirmed that RAB3C plays a key role in CRC progression. Its overexpression promotes exocytosis and is related to the resistance to several chemotherapeutic drugs. We established a proteomic dataset based on RAB3C, and found that dystrophin is one of the proteins that is upregulated with the overexpression of RAB3C. According to our results, RAB3C-induced dystrophin expression promotes vesicle formation and packaging. A connectivity map predicted that the cannabinoid receptor 2 (CB2) agonists reverse RAB3C-associated drug resistance, and that these agonists have synergistic effects when combined with standard chemotherapy regimens. Moreover, we found high dystrophin expression levels in CRC patients with poor survival outcomes. A combination of the dystrophin and RAB3C expression profiles can serve as an independent prognostic factor in CRC and is associated with several clinicopathological parameters. In addition, the RAB3C-dystrophin axis is positively correlated with the phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit alpha isoform (PIK3CA) genetic alterations in CRC patients. These findings can be used to provide novel combined therapeutic options for the treatment of CRC.

Deposition Mechanism and Characterization of Plasma-Enhanced Atomic Layer-Deposited SnOx Films at Different Substrate Temperatures.

The promising functional tin oxide (SnOx) has attracted tremendous attention due to its transparent and conductive properties. The stoichiometric composition of SnOx can be described as common n-type SnO2 and p-type Sn3O4. In this study, the functional SnOx films were prepared successfully by plasma-enhanced atomic layer deposition (PEALD) at different substrate temperatures from 100 to 400 °C. The experimental results involving optical, structural, chemical, and electrical properties and morphologies are discussed. The SnO2 and oxygen-deficient Sn3O4 phases coexisting in PEALD SnOx films were found. The PEALD SnOx films are composed of intrinsic oxygen vacancies with O-Sn4+ bonds and then transformed into a crystalline SnO2 phase with increased substrate temperature, revealing a direct 3.5−4.0 eV band gap and 1.9−2.1 refractive index. Lower (<150 °C) and higher (>300 °C) substrate temperatures can cause precursor condensation and desorption, respectively, resulting in reduced film qualities. The proper composition ratio of O to Sn in PEALD SnOx films near an estimated 1.74 suggests the highest mobility of 12.89 cm2 V−1 s−1 at 300 °C.

Implementation of sodium alginate-Fe3O4 to localize undiagnosed small pulmonary nodules for surgical management in a preclinical rabbit model.

Many methods are used to locate preoperative small pulmonary nodules. However, deficiencies of complications and success rates exist. We introduce a novel magnetic gel for small pulmonary nodules localization in rabbit model, and furtherly evaluate its safety and feasibility. Rabbits were used as the experimental objects. A magnetic gel was used as a tracer magnet, mixed as sodium alginate-Fe3O4 magnetic fluid and calcium gluconate solution. In short-term localization, a coaxial double-cavity puncture needle was applied to inject the gel into the lung after thoracotomy, and a pursuit magnet made of Nd-Fe-B permanent magnetic materials was used to attract the gel representing location of the nodule. In long-term localization, the gel was injected under X-ray guidance. Imaging changes to the lung were observed under X-ray daily. Thoracotomy was performed to excise tissue containing the gel, and hematoxylin-eosin staining was used to observe the tissue on postoperative days 1, 3, 5, and 7. Observe tissues morphology of heart, liver, spleen, and kidney in the same way. The gel was formed after injection and drew lung tissue to form a protrusion from the lung surface under the applied magnetic field. No complication was observed. The shape and position of the gel had not changed when viewed under X-ray. Pathological analysis showed the gel had a clear boundary without diffusion of magnetic fluid. All tissues retained good histologic morphology and no magnetic fluid was observed. Our study preliminarily suggested that the technique using sodium alginate-Fe3O4 magnetic gel to locate small pulmonary nodules with guidance of X-ray, and to search for them under an applied magnetic field during the operation is safe and feasible.

Deposition and Characterization of RP-ALD SiO2 Thin Films with Different Oxygen Plasma Powers.

In this study, silicon oxide (SiO2) films were deposited by remote plasma atomic layer deposition with Bis(diethylamino)silane (BDEAS) and an oxygen/argon mixture as the precursors. Oxygen plasma powers play a key role in the quality of SiO2 films. Post-annealing was performed in the air at different temperatures for 1 h. The effects of oxygen plasma powers from 1000 W to 3000 W on the properties of the SiO2 thin films were investigated. The experimental results demonstrated that the SiO2 thin film growth per cycle was greatly affected by the O2 plasma power. Atomic force microscope (AFM) and conductive AFM tests show that the surface of the SiO2 thin films, with different O2 plasma powers, is relatively smooth and the films all present favorable insulation properties. The water contact angle (WCA) of the SiO2 thin film deposited at the power of 1500 W is higher than that of other WCAs of SiO2 films deposited at other plasma powers, indicating that it is less hydrophilic. This phenomenon is more likely to be associated with a smaller bonding energy, which is consistent with the result obtained by Fourier transformation infrared spectroscopy. In addition, the influence of post-annealing temperature on the quality of the SiO2 thin films was also investigated. As the annealing temperature increases, the SiO2 thin film becomes denser, leading to a higher refractive index and a lower etch rate.

Properties and Mechanism of PEALD-In2O3 Thin Films Prepared by Different Precursor Reaction Energy.

Indium oxide (In2O3) film has excellent optical and electrical properties, which makes it useful for a multitude of applications. The preparation of In2O3 film via atomic layer deposition (ALD) method remains an issue as most of the available In-precursors are inactive and thermally unstable. In this work, In2O3 film was prepared by ALD using a remote O2 plasma as oxidant, which provides highly reactive oxygen radicals, and hence significantly enhancing the film growth. The substrate temperature that determines the adsorption state on the substrate and reaction energy of the precursor was investigated. At low substrate temperature (100-150 °C), the ratio of chemically adsorbed precursors is low, leading to a low growth rate and amorphous structure of the films. An amorphous-to-crystalline transition was observed at 150-200 °C. An ALD window with self-limiting reaction and a reasonable film growth rate was observed in the intermediate temperature range of 225-275 °C. At high substrate temperature (300-350 °C), the film growth rate further increases due to the decomposition of the precursors. The resulting film exhibits a rough surface which consists of coarse grains and obvious grain boundaries. The growth mode and properties of the In2O3 films prepared by plasma-enhanced ALD can be efficiently tuned by varying the substrate temperature.

Chemical Reaction and Ion Bombardment Effects of Plasma Radicals on Optoelectrical Properties of SnO2 Thin Films via Atomic Layer Deposition.

In this study, the effect of radical intensity on the deposition mechanism, optical, and electrical properties of tin oxide (SnO2) thin films is investigated. The SnO2 thin films are prepared by plasma-enhanced atomic layer deposition with different plasma power from 1000 to 3000 W. The experimental results show that plasma contains different amount of argon radicals (Ar*) and oxygen radicals (O*) with the increased power. The three deposition mechanisms are indicated by the variation of Ar* and O* intensities evidenced by optical emission spectroscopy. The adequate intensities of Ar* and O* are obtained by the power of 1500 W, inducing the highest oxygen vacancies (OV) ratio, the narrowest band gap, and the densest film structure. The refractive index and optical loss increase with the plasma power, possibly owing to the increased film density. According to the Hall effect measurement results, the improved plasma power from 1000 to 1500 W enhances the carrier concentration due to the enlargement of OV ratio, while the plasma powers higher than 1500 W further cause the removal of OV and the significant bombardment from Ar*, leading to the increase of resistivity.

A Preference Biobjective Evolutionary Algorithm for the Payment Scheduling Negotiation Problem.

The resource-constrained project scheduling problem (RCPSP) is a basic problem in project management. The net present value (NPV) of discounted cash flow is used as a criterion to evaluate the financial aspects of RCPSP in many studies. But while most existing studies focused on only the contractor's NPV, this article addresses a practical extension of RCPSP, called the payment scheduling negotiation problem (PSNP), which considers both the interests of the contractor and the client. To maximize NPVs of both sides and achieve a win-win solution, these two participants negotiate together to determine an activity schedule and a payment plan for the project. The challenges arise in three aspects: 1) the client's NPV and the contractor's NPV are two conflicting objectives; 2) both participants have special preferences in decision making; and 3) the RCPSP is nondeterministic polynomial-time hard (NP-Hard). To overcome these challenges, this article proposes a new approach with the following features. First, the problem is reformulated as a biobjective optimization problem with preferences. Second, to address the different preferences of the client and the contractor, a strategy of multilevel region interest is presented. Third, this strategy is integrated in the nondominated sorting genetic algorithm II (NSGA-II) to solve the PSNP efficiently. In the experiment, the proposed algorithm is compared with both the double-level optimization approach and the multiobjective optimization approach. The experimental results validate that the proposed method can focus on searching in the region of interest (ROI) and provide more satisfactory solutions.

Suppression of Oxygen Vacancy Defects in sALD-ZnO Films Annealed in Different Conditions.

Zinc oxide (ZnO) has drawn much attention due to its excellent optical and electrical properties. In this study, ZnO film was prepared by a high-deposition-rate spatial atomic layer deposition (ALD) and subjected to a post-annealing process to suppress the intrinsic defects and improve the crystallinity and film properties. The results show that the film thickness increases with annealing temperature owing to the increment of oxide layer caused by the suppression of oxygen vacancy defects as indicated by the X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS) spectra. The film transmittance is seldom influenced by annealing. The refractive index increases with annealing temperature at 300-700 °C, possibly due to higher density and crystallinity of the film. The band gap decreases after annealing, which should be ascribed to the decrease in carrier concentration according to Burstein-Moss model. The carrier concentration decreases with increasing annealing temperature at 300-700 °C since the oxygen vacancy defects are suppressed, then it increases at 800 °C possibly due to the out-diffusion of oxygen atoms from the film. Meanwhile, the carrier mobility increases with temperature due to higher crystallinity and larger crystallite size. The film resistivity increases at 300-700 °C then decreases at 800 °C, which should be ascribed primarily to the variation of carrier concentration.

Improving the Performance and Stability of Perovskite Light-Emitting Diodes by a Polymeric Nanothick Interlayer-Assisted Grain Control Process.

CsPbBr3 is a promising light-emitting material due to its wet solution processability, high photoluminescence quantum yield (PLQY), narrow color spectrum, and cost-effectiveness. Despite such advantages, the morphological defects, unsatisfactory carrier injection, and stability issues retard its widespread applications in light-emitting devices (LEDs). In this work, we demonstrated a facile and cost-effective method to improve the morphology, efficiency, and stability of the CsPbBr3 emissive layer using a dual polymeric encapsulation governed by an interface-assisted grain control process (IAGCP). An eco-friendly low-cost hydrophilic polymer poly(vinylpyrrolidone) (PVP) was blended into the CsPbBr3 precursor solution, which endows the prepared film with a better surface coverage with a smoothened surface. Furthermore, it is revealed that inserting a thin PVP nanothick interlayer at the poly(3,4-ethylenedioxythiophene):poly(4-styrenesulfonate) (PEDOT:PSS)/emissive layer interface further promotes the film quality and the performance of the derived LED. It is mainly attributed to three major consequences: (i) reduced grain size of the emissive layer, which facilitates charge recombination, (ii) reduced current leakage due to the enhanced electron-blocking effect, and (iii) improved color purity and air stability owing to better defect passivation. As a result, the optimized composite emissive film can retain the luminescence properties even on exposure to ambient conditions for 80 days and ∼62% of its initial PL intensity can be preserved after 30 days of storage without any encapsulation.

CO-releasing molecules-2 attenuates ox-LDL-induced injury in HUVECs by ameliorating mitochondrial function and inhibiting Wnt/ß-catenin pathway.

Oxidized low-density lipoprotein (ox-LDL) is well known to disrupt normal functionality of endothelium, which plays a prominent role in endothelial dysfunction in many cardiovascular diseases. CO-releasing molecule 2 (CORM-2) is a promising candidate for treatment of cardiovascular diseases. However, it has not been defined whether CORM-2 might improve endothelial injury induced by ox-LDL. The present study was undertaken to determine the regulatory role of CORM-2 in cell injury of ox-LDL-treated human umbilical vein endothelial cells (HUVECs). Our results showed that ox-LDL inhibited the cell proliferation, but promoted apoptosis and release of cytochrome c (cytc) from mitochondrion into cytoplasm, stimulated the cleavage of caspase-3 and mitochondrial permeability transition pore (MPTP) opening. In addition, ox-LDL-incubated HUVECs exhibited excessive reactive oxygen species (ROS), increased protein levels of NADPH oxidase subunits p22phox, p47phox, NOX-2 and activation of Wnt/ß-catenin signaling pathway. However, pretreatment with CORM-2 significantly reduced cell apoptosis, release of cytc from mitochondrion into cytoplasm, MPTP opening and cleavage of caspase-3, suppressed the superoxide anion generation and Wnt/ß-catenin pathway activation in HUVECs response to ox-LDL. Collectively, we provide the evidence that CORM-2 attenuated ox-LDL-mediated endothelial apoptosis and oxidative stress by recovering the mitochondrial function and blocking Wnt/ß-catenin pathway.

A prediction model for lymph node metastases using pathologic features in patients intraoperatively diagnosed as stage I non-small cell lung cancer.

BACKGROUND: There is little information on which pattern should be chosen to perform lymph node dissection for stage I non-small-cell lung cancer. This study aimed to develop a model for predicting lymph node metastasis using pathologic features of patients intraoperatively diagnosed as stage I non-small-cell lung cancer. METHODS: We collected pathology data from 284 patients intraoperatively diagnosed as stage I non-small-cell lung cancer who underwent lobectomy with complete lymph node dissection from 2013 through 2014, assessing various factors for an association with metastasis to lymph nodes (age, gender, pathology, tumour location, tumour differentiation, tumour size, pleural invasion, bronchus invasion, multicentric invasion and angiolymphatic invasion). After analysing these variables, we developed a multivariable logistic model to estimate risk of metastasis to lymph nodes. RESULTS: Univariate logistic regression identified tumour size >2.65 cm (p < 0.001), tumour differentiation (p < 0.001), pleural invasion (p = 0.034) and bronchus invasion (p < 0.001) to be risk factors significantly associated with the presence of metastatic lymph nodes. On multivariable analysis, only tumour size >2.65 cm (p < 0.001), tumour differentiation (p = 0.006) and bronchus invasion (p = 0.017) were independent predictors for lymph node metastasis. We developed a model based on these three pathologic factors that determined that the risk of metastasis ranged from 3% to 44% for patients intraoperatively diagnosed as stage I non-small-cell lung cancer. By applying the model, we found that the values y > 0.80, 0.43 < y ≤ 0.80, y ≤ 0.43 plus tumour size >2 cm and y ≤0.43 plus tumour size ≤2 cm yielded positive lymph node metastasis predictive values of 44%, 18%, 14% and 0%, respectively. CONCLUSIONS: A non-invasive prediction model including tumour size, tumour differentiation and bronchus invasion may be useful to give thoracic surgeons recommendations on lymph node dissection for patients intraoperatively diagnosed as Stage I non-small cell lung cancer.

Salusin-ß Is Involved in Diabetes Mellitus-Induced Endothelial Dysfunction via Degradation of Peroxisome Proliferator-Activated Receptor Gamma.

The pathophysiological mechanisms for vascular lesions in diabetes mellitus (DM) are complex, among which endothelial dysfunction plays a vital role. Therapeutic target against endothelial injury may provide critical venues for treatment of diabetic vascular diseases. We recently identified that salusin-ß contributed to high glucose-induced endothelial cell apoptosis. However, the roles of salusin-ß in DM-induced endothelial dysfunction remain largely elusive. Male C57BL/6J mice were used to induce type 2 diabetes mellitus (T2DM) model. Human umbilical vein endothelial cells (HUVECs) were cultured in high glucose/high fat (HG/HF) medium. We demonstrated increased expression of salusin-ß in diabetic aortic tissues and high-glucose/high-fat- (HG/HF-) incubated HUVECs. Disruption of salusin-ß by shRNA abrogated the reactive oxygen species (ROS) production, inflammation, and nitrotyrosine content of HUVECs cultured in HG/HF medium. The HG/HF-mediated decrease in peroxisome proliferator-activated receptor γ (PPARγ) expression was restored by salusin-ß shRNA, and PPARγ inhibitor T0070907 abolished the protective actions of salusin-ß shRNA on endothelial injury in HG/HF-treated HUVECs. Salusin-ß silencing obviously improved endothelium-dependent vasorelaxation, oxidative stress, inflammatory response, and nitrative stress in diabetic aorta. Taken together, our results highlighted the essential role of salusin-ß in pathological endothelial dysfunction, and salusin-ß may be a promising target in treatment of vascular complications of DM.

[Effect of nitric oxide derived from endothelial nitric oxide synthase on tumor angiogenesis].

BACKGROUND AND OBJECTIVE: Studies have shown that nitric oxide (NO) derived from endothelial nitric oxide synthase (eNOS) is expressed widely in tumor tissues and regulates tumor angiogenesis. However, the results are controversial. This study was to investigate the effect of NO on tumor angiogenesis and its mechanism. METHODS: C57BL/6 mice inoculated with Lewis lung cancer cells were randomly divided into three groups. Mice in the NO group were inoculated with lung cancer cells transfected with eNOS gene, mice in the L-NAME group with L-NAME, an eNOS antagonist, and mice in the control group with normal saline. Plasma concentration of NO and the number of endothelial progenitor cells (EPCs) in peripheral blood were detected . Tumor vessel density, CD133+ cells, and the expression of VEGF-VEGFR in tumor tissues were also measured. RESULTS: Four weeks after inoculation of Lewis cells, tumor volume was significantly larger in control group [ (3022 +/- 401) mm(3)] than in the L-NAME group [ (1204 +/-97) ) mm(3)] and in the eNOS group [(1824 +/- 239) mm(3)] (P<0.01). eNOS protein and NO production increased significantly in Lewis lung cancer cells transfected with eNOS gene. But the number of CD133-positive cells and vessel density in tumors were significantly lower in the eNOS group than in the control group [(48+/-19) / HPF vs. ( 103 +/- 27)/ HPF, (19+/- 7) HPF vs. (31 +/- 9) HPF, P<0.05]. The number of EPCs in peripheral blood was not statistically different between each group. The levels of NO in blood and tumor tissue significantly decreased after the treatment of L-NAME, while the tumor vessel density reduced to 12+/- 5/ HPF (P<0.01, vs. the control group; P<0.05, vs the eNOS transfected group). The number of EPCs in blood and that of CD133-positive cells in tumor tissue were significantly smaller in the L-NAME group than in the control group (P<0.05). CONCLUSION: No derived from eNOS inhibits angiogenesis and tumor growth, which may be due to its suppression on either the mobilization or homing of EPCs via VEGF binding to VEGFR.