Exosomes derived from oxLDL-stimulated macrophages induce neutrophil extracellular traps to drive atherosclerosis.

This study aimed to investigate the role and underlying mechanism of exosomes secreted by oxidized low-density lipoprotein (oxLDL)-stimulated macrophages in the progression of atherosclerosis (AS). Exosomes from peripheral blood of AS patients or oxLDL-treated macrophages were co-cultured with human neutrophils. Neutrophil extracellular traps (NETs) were detected by immunofluorescence staining. The levels of inflammatory cytokines were quantified by enzyme-linked immunosorbent assay (ELISA). The expression levels of miR-146a and superoxide dismutase 2 (SOD2) were determined by quantitative real-time PCR (qRT-PCR) and western blot. The generation of intracellular reactive oxygen species (ROS) was observed by using dichlorofluorescin diacetate (DCFH-DA). ApoE-deficient mice were fed with high-fat diet (HFD) to induce AS. Atherosclerotic plaques were evaluated by Oil red O (ORO) and hematoxylin-eosin (HE) staining. Our results showed that miRNA-146a was enriched in serum-derived exosomes of AS patients and oxLDL-treated macrophage THP-1-derived exosomes. Importantly, exosomal miR-146a secreted by oxLDL-treated macrophages promoted ROS and NETs release via targeting SOD2. In addition, intravenous administration of oxLDL-treated THP-1 cells-derived exosomes into AS mice significantly deteriorated AS in vivo. Our findings indicate that exosomal miR-146a derived from oxLDL-treated macrophages promotes NETs formation via inducing oxidative stress, which might provide a novel scientific basis for the understanding of AS progression.

Diagnosis and Treatment of Vascular Surgery Related Infection.

Surgical site infection (SSI) is an important component of infections acquired from hospital. The most significant feature of vascular surgery different from other surgeries is frequent application of artificial grafts. Once SSI occurs after vascular operations with grafts, it might results in a serious disaster. Staphylococcus aureus and coagulase-negative Staphylococcus are the most common pathogenic bacteria for SSI after vascular surgery. Although SSI in vascular surgery often lacks of typical clinical characters, some clinical symptoms, laboratory data and certain imaging procedures may help to diagnose. In most cases of SSI after vascular procedures, the artificial grafts must be removed and sensitive antibiotics should be administered. However, for different cases, personalized management plan should be made depending on the severity and location of SSI.

[Cardiac hemodynamics after suprarenal ligation of the inferior vena cava and the resection of the right kidney or injection of ligustrazine in rats].

BACKGROUND & OBJECTIVE: Primary retroperitioneal tumor often invades large vessels; the difficulty of operation is the management of the vessels, especially the inferior vena cava (IVC). The suprarenal ligation of the IVC was considered to be dangerous. The aim of this study was to investigate the cardiac hemodynamics following suprarenal ligation of the IVC and the resection of the right kidney or injection of ligustrazine in rats, and to provide theories and guides for the clinical operations. METHODS: The rats were divided into six groups of seven. The groups were control group, false operation group, suprarenal ligation of the IVC group, suprarenal ligation of IVC and resection of right kidney group, ligustrazine group, and placebo group. All rats were determined for heart rate, ejection fraction, cardiac output, stroke volume, arterial pressure at 1st, 6th, 24th, 48th hour after the operations. RESULTS: The indexes of the false operation group had no change. CO(0.018+/-0.002 L/min), SV(0.054+/-0.008 ml), AP(H)(173+/-12 mmHg), AP(L)(161+/-11 mmHg) decreased to the lowest point at 1st hour following the suprarenal ligation of the IVC, but compensated completely at 48th hour after the operation. All rats in this group survived during the study period. CO(0.012+/-0.002 L/min), SV(0.038+/-0.005 ml), AP(H)(138+/-8 mmHg), AP(L)(131+/-9 mmHg)decreased to the lowest point at 1st hour following the suprarenal ligation of the IVC and resection of the right kidney, CO and SV were not compensated completely at 48th hour after the operation, two rats died in this group. CO (0.025+/-0.004 L/min), SV(0.063+/-0.009 ml), AP(H)(190+/-14 mmHg), AP(L)(163+/-9 mmHg)decreased to the lowest point at 1st hour following the suprarenal ligation of the IVC, but compensated quickly at 24th hour after the operation, all rats survived in this group. The placebo group, compared with the ligustrazine group, had no obvious change. CONCLUSION: Cardiac function was affected by low returned blood volume following the suprarenal ligation of the IVC, but compensated completely at 48th hour after the operation. The suprarenal ligation of the IVC and injection of ligustrazine could improve cardiac function of the experimental rats. The suprarenal ligation of the IVC and resection of the right kidney, which not only increased the operative difficulty but also reduced cardiac functional compensation and appeared the death of rats, were not appropriate. We suggest to ligate the suprarenal IVC and to inject ligustrazine after resecting the tumor and infiltrated IVC, not to resect normal right kidney. To infuse solution by upper limb to increase returned blood volume in early phase after the operation.