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1.
Eur J Radiol ; 124: 108849, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32028066

RESUMO

PURPOSE: To compare volumetric interpolated breath-hold examination (VIBE) with different slice thicknesses to T1-weighted turbo-echo (T1 TSE) for identification of sacroiliac joint structural lesions in patients suspected of spondyloarthritis (SpA) using CT as the gold standard. METHODS: 192 sacroiliac joints (including VIBE with both 1.2 mm and 3 mm slice thickness, T1 TSE) from 96 patients suspected of SpA were included. Joint space changes and sclerosis were evaluated for each joint. Erosions were assessed both at the level of the individual sacral and iliac bones and at the level of the entire joint for calculation of sensitivity, specificity, and accuracy. MRI and CT correlation was performed and inter-reader reliability was determined. Fat infiltration on MRI was scored. RESULTS: VIBE with a 1.2 mm slice thickness was the most sensitive and accurate for erosion detection at the bone level followed by 3 mm thickness VIBE and then T1 TSE (p < 0.05). At the whole-joint level, only the 1.2 mm slice thickness VIBE was superior to T1 TSE in sensitivity and accuracy (p > 0.05). For joint space changes, both VIBE sequences were superior to T1 TSE in sensitivity and accuracy (p < 0.05) and had more consistency with CT. T1 TSE was slightly more sensitive for detection of sclerosis (p < 0.05). The MR sequences did not differ in detection of fat infiltration. CONCLUSION: A VIBE sequence with 1.2 mm slice thickness and less than one-minute acquisition time was superior to T1 TSE for detection of sacroiliac joint space changes and erosions in patients with suspected SpA, while the utility of the 3 mm slice thickness VIBE remains questionable.

2.
Am J Pathol ; 2020 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-32035882

RESUMO

Along with the recognition of a crucial role played by endothelial dysfunction secondarily igniting cardiovascular, pulmonary, and renal complications, investigational focus has extended toward endothelial glycocalyx. This delicate coating of cells, including the vascular endothelium, regulates permeability, leukocyte traffic, nitric oxide production, coagulation, and harbors diverse growth and survival factors. In this brief overview, we discuss metabolic signatures of sepsis as they relate to the loss of glycocalyx integrity and highlight the contribution of several proteases, heparanase, and hyaluronidase to shedding of glycocalyx. Clinical manifestations of glycocalyx degradation in unraveling acute respiratory distress syndrome, cardiovascular, microcirculatory, and renal complications of sepsis are concisely presented. Finally, we list therapeutic strategies to prevent the degradation and restore glycocalyx.

3.
Artigo em Inglês | MEDLINE | ID: mdl-32062793

RESUMO

PURPOSE: Drugs inhibiting the platelet P2Y12 receptor, such as clopidogrel and prasugrel, are potent antithrombotic agents and are widely used in cardiovascular disease. However, the adverse effects of these drugs have limited their clinical use. For example, clopidogrel resistance occurs in approximately one third of patients, while prasugrel increases the risk of major bleeding. Therefore, new generations of such drugs are of clinical interest. METHODS: In this study, the pharmacodynamics of a new P2Y12 antagonist, CN-218, was compared with that of clopidogrel and prasugrel in rats and mice. The differences between CN-218 and clopidogrel include deuteration of the 7-position methyl carboxylate and the introduction of cinnamate in the 2-position of thiophene. RESULTS: CN-218 had an antiaggregatory efficacy that was at least five times more potent than that of clopidogrel but not as potent as that of prasugrel. It had a significant impact on activated partial thromboplastin time (APTT), whereby the APTT of CN-218-treated rats was approximately 9 s longer than that of the vehicle- or clopidogrel-treated group, while it had no impact on prothrombin time (PT) in rats. CN-218 had a similar potent antithrombotic effect to that of prasugrel and clopidogrel and also reduced the risk of bleeding compared to prasugrel. CONCLUSION: CN-218 may be a promising antithrombotic agent, with potent antiplatelet and significant anticoagulant activity, as well as a lower risk of bleeding compared to clopidogrel and prasugrel.

4.
Artigo em Inglês | MEDLINE | ID: mdl-32033145

RESUMO

Benzo[a]pyrene (BaP) is a common environmental disrupting chemical that can cause endocrine disorders in organisms. However, the continued interference effects of BaP on multi-generation fish needs further research. In this study, we performed different periods (G1F1-3, G2F2-3, G3F3) of BaP exposure on marine medaka. We determined the embryo toxicity, and analyzed relative reproductive genes (ERα, cyp19a and vtg1) to predict the sexual differentiation of marine medaka. The results showed that high concentrations of BaP (200 µg·L-1) significantly delayed the hatching time of embryos. Moreover, medium/high concentrations of BaP (20 and 200 µg·L-1) prolonged the sexual maturity time of marine medaka. The relative gene expression of ERα, cyp19a and vtg1 were measured at 5 dpf of embryos. We found that BaP had significantly inhibited the expression of the genes related to female fish development. Consequently, there were more males in the offspring sex ratio at BaP exposure. Overall, BaP can cause embryonic toxicity and abnormal sexual differentiation, while the expression of related reproductive genes can effectively indicate the sex ratio.

5.
Adv Mater ; : e1907288, 2020 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31977113

RESUMO

In a modern electronics system, charge-coupled devices and data storage devices are the two most indispensable components. Although there has been rapid and independent progress in their development during the last three decades, a cofunctionality of both sensing and memory at single-unit level is yet premature for flexible electronics. For wearable electronics that work in ultralow power conditions and involve strains, conventional sensing-and-memory systems suffer from low sensitivity and are not able to directly transform sensed information into sufficient memory. Here, a new transformative device is demonstrated, which is called "sen-memory", that exhibits the dual functionality of sensing and memory in a monolithic integrated circuit. The active channel of the device is formed by a carbon nanotube thin film and the floating gate is formed by a controllably oxidized aluminum nanoparticle array for electrical- and optical-programming. The device exhibits a high on-off current ratio of ≈106 , a long-term retention of ≈108 s, and durable flexibility at a bending strain of 0.4%. It is shown that the device senses a photogenerated pattern in seconds at zero bias and memorizes an image for a couple of years.

6.
Cell Death Differ ; 2020 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-31907392

RESUMO

Vps35 (vacuolar protein sorting 35) is a key component of retromer that regulates transmembrane protein trafficking. Dysfunctional Vps35 is a risk factor for neurodegenerative diseases, including Parkinson's and Alzheimer's diseases. Vps35 is highly expressed in developing pyramidal neurons, and its physiological role in developing neurons remains to be explored. Here, we provide evidence that Vps35 in embryonic neurons is necessary for axonal and dendritic terminal differentiation. Loss of Vps35 in embryonic neurons results in not only terminal differentiation deficits, but also neurodegenerative pathology, such as cortical brain atrophy and reactive glial responses. The atrophy of neocortex appears to be in association with increases in neuronal death, autophagosome proteins (LC3-II and P62), and neurodegeneration associated proteins (TDP43 and ubiquitin-conjugated proteins). Further studies reveal an increase of retromer cargo protein, sortilin1 (Sort1), in lysosomes of Vps35-KO neurons, and lysosomal dysfunction. Suppression of Sort1 diminishes Vps35-KO-induced dendritic defects. Expression of lysosomal Sort1 recapitulates Vps35-KO-induced phenotypes. Together, these results demonstrate embryonic neuronal Vps35's function in terminal axonal and dendritic differentiation, reveal an association of terminal differentiation deficit with neurodegenerative pathology, and uncover an important lysosomal contribution to both events.

7.
Cell Biol Int ; 44(2): 549-559, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31642560

RESUMO

In this study, we determined whether multilineage-differentiating stress-enduring (Muse) cells exist in rat bone marrow and elucidated their effects on protection against the injury of intestinal epithelial cells associated with inflammation. Rat Muse cells were separated from bone marrow mesenchymal stem cells (BMMSCs) by trypsin-incubation stress. The group of cells maintained the characteristics of BMMSCs; however, there were high positive expression levels of stage-specific embryonic antigen-3 (SSEA-3; 75.6 ± 2.8%) and stage-specific embryonic antigen-1 (SSEA-1; 74.8 ± 3.1%), as well as specific antigens including Nanog, POU class 5 homeobox 1 (OCT 3/4), and SRY-box 2 (SOX 2). After inducing differentiation, α-fetoprotein (endodermal), α-smooth muscle actin and neurofilament medium polypeptide (ectodermal) were positive in Muse cells. Injuries of intestinal epithelial crypt cell-6 (IEC-6) and colorectal adenocarcinoma 2 (Caco-2) cells as models were induced by tumor necrosis factor-α stimulation in vitro. Muse cells exhibited significant protective effects on the proliferation and intestinal barrier structure, the underlying mechanisms of which were related to reduced levels of interleukin-6 (IL-6) and interferon-γ (IFN-γ), and the restoration of transforming growth factor-ß (TGF-ß) and IL-10 in the inflammation microenvironment. In summary, there were minimal levels of pluripotent stem cells in rat bone marrow, which exhibit similar properties to human Muse cells. Rat Muse cells could provide protection against damage to intestinal epithelial cells depending on their anti-inflammatory and immune regulatory functionality. Their functional impact was more obvious than that of BMMSCs.

8.
J Mot Behav ; 52(2): 214-225, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31023152

RESUMO

Backward walking (BW) has been extensively used in athletic training and orthopedic rehabilitation as it may have value for enhancing balance. This study identified the differences in foot intersegment kinematics (forward walking (FW) vs. time-reversed BW) and plantar pressure parameters of 16 healthy habitually shod individuals walking FW and BW using flexible shoes (SH) and under barefoot conditions (BF). BW was found to have shorter stride length (SL) and higher stride frequency (SF) under BF conditions compared with SH, which indicates a better BW gait stability under BF conditions. Decreased HX/FF dorsiflexion at HO in BW induces less plantar aponeurosis tension which may inhibit the windlass mechanism compared to FW walking. Increased forefoot relative to hindfoot (FF/HF) pronation and sequentially hindfoot relative to tibia (HF/TB) eversion combined with medially distributed plantar pressure and a higher plantar contact area in the medial side in BW-BF maybe beneficial in maintaining balance. These results indicate that BW training may be more reliable under BF conditions compared to the SH conditions based on greater sensory information feedback from the plantar area resulting in better biomechanical behavior.

9.
Skeletal Radiol ; 49(2): 231-240, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31289901

RESUMO

OBJECTIVE: To compare the extent of cartilage deterioration in knees with prior meniscal resection related to trauma versus knees with resection related to degenerative disease, and to compare cartilage deterioration in knees with meniscal surgery to knees without meniscal surgery, controlling for prior knee trauma. MATERIALS AND METHODS: In this cross-sectional study, we assessed cartilage deterioration in right knees of Osteoarthritis Initiative participants: (i) with meniscal surgery due to injury (n = 79); (ii) matched control knees with a prior injury but without meniscal surgery (n = 79); (iii) with meniscal surgery but without preceding injury (n = 36); and (iv) matched control knees without meniscal surgery or prior knee injury (n = 36). Cartilage composition was measured using T2 measurements derived using semi-automatic cartilage segmentation of the right. Linear regression analysis was used to compare compartmental values of T2 between groups. RESULTS: Comparing the mean T2 values in surgical cases with and without injury our results did not show significant differences (group i vs. iii, p > 0.05). However, knees with previous meniscal surgery showed significantly (p < 0.001) higher mean T2 values across all compartments (i.e., global T2) when compared to those without meniscal surgery for both knees with a history of trauma (group i vs. ii) and knees without prior trauma (group iii vs. iv). Similar results were obtained when analyzing the compartments separately. CONCLUSIONS: Cartilage deterioration, assessed by T2, is similar in knees undergoing meniscal surgery after trauma and for degenerative conditions. Both groups demonstrated greater cartilage deterioration than nonsurgical knees, controlling for prior knee injury.

10.
Lab Chip ; 20(2): 373-383, 2020 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-31850469

RESUMO

Electrical stimulation (ES) as an easy and effective inducing method has been widely used in induction differentiation of stem cells, e.g. osteogenic differentiation of mesenchymal stem cells (MSCs) for bone healing and bone tissue therapies. However, the micro-effect of an inhomogeneous electric field has rarely been investigated for ES in induction differentiation, and conventionally used ex situ assays may preclude accurate assessment due to variation from cell inoculation and treatments. Here, a novel electrical stimulation method with a microelectrode array chip is proposed for osteogenic differentiation of MSCs. The electric field applied onto the MSCs by the microelectrode array is designed similarly with a natural aggregation distribution of differentiated MSCs. The proposed ES method accelerates osteoblast proliferation and differentiation in the electrode array region and generates a larger amount of mineralized deposits, which are assayed via in situ alizarin red staining and morphology observation as well as immunocytochemistry. In addition, this method allows a direct in situ assessment to compare the osteogenic differentiation of MSCs with and without ES on a single chip to avoid culture environment difference. The method provides a fundamental platform for investigating induced differentiation of stem cells and allows integration with multifunctional cell assays to achieve in situ tracking for the differentiation process of stem cells.

11.
IEEE Trans Vis Comput Graph ; 26(1): 579-589, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31425087

RESUMO

Production planning in the manufacturing industry is crucial for fully utilizing factory resources (e.g., machines, raw materials and workers) and reducing costs. With the advent of industry 4.0, plenty of data recording the status of factory resources have been collected and further involved in production planning, which brings an unprecedented opportunity to understand, evaluate and adjust complex production plans through a data-driven approach. However, developing a systematic analytics approach for production planning is challenging due to the large volume of production data, the complex dependency between products, and unexpected changes in the market and the plant. Previous studies only provide summarized results and fail to show details for comparative analysis of production plans. Besides, the rapid adjustment to the plan in the case of an unanticipated incident is also not supported. In this paper, we propose PlanningVis, a visual analytics system to support the exploration and comparison of production plans with three levels of details: a plan overview presenting the overall difference between plans, a product view visualizing various properties of individual products, and a production detail view displaying the product dependency and the daily production details in related factories. By integrating an automatic planning algorithm with interactive visual explorations, PlanningVis can facilitate the efficient optimization of daily production planning as well as support a quick response to unanticipated incidents in manufacturing. Two case studies with real-world data and carefully designed interviews with domain experts demonstrate the effectiveness and usability of PlanningVis.

12.
ACS Nano ; 2019 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-31820929

RESUMO

Quantum interference gives rise to the asymmetric Fano resonance line shape when the final states of an electronic transition follow within a continuum of states and a discrete state, which has significant applications in optical switching and sensing. The resonant optical phenomena associated with the Fano resonance have been observed by absorption spectra, Raman spectra, transmission spectra, etc., but have rarely been reported in photoluminescence (PL) spectroscopy. In this work, we performed spectroscopic studies on layered chromium thiophosphate (CrPS4), a promising ternary antiferromagnetic semiconductor with PL in the near-infrared wavelength region and observed a Fano resonance when CrPS4 experiences phase transition into the antiferromagnetic state below the Néel temperature (38 K). The photoluminescence of the continuum states results from the d band transitions localized at Cr3+ ions, whereas the discrete state is formed by an impurity level, the electronic transition of which is enabled by symmetry breaking. Our findings provide insights into the photon-emitting coherent electronic transitions of CrPS4 and their connection to the magnetism-related broken symmetry.

13.
Artigo em Inglês | MEDLINE | ID: mdl-31831429

RESUMO

The accurate delivery of precise amounts of drugs to a specific location can considerably affect various clinical applications. The precise control of drug amount and position is crucial to a successful drug delivery. This paper proposes the use of poly(lactide-co-glycolicacid) (PLGA)-based microspheres to contain precise amounts of drugs and an optical tweezer manipulator to transport these drug-containing microspheres to their targeted sites in vivo. The drugs were delivered by the PLGA-based microspheres to the yolk sac of zebrafish embryos, and a sustained drug release was observed to examine the anti-angiogenesis and angiogenesis activities. The PLGA-based microspheres degraded in zebrafish, thereby verifying that these microspheres can be used as drug carriers in vivo to ensure good biocompatibility and biodegradation. The proposed precise drug delivery approach can be used in protein tests and drug property characterization in vivo.

14.
Sci Rep ; 9(1): 18475, 2019 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-31811159

RESUMO

A combined anterior and posterior (AP) surgical approach is a popular treatment modality of lumbosacral tuberculosis, but it is often traumatic and complicated. The present study aims to find whether the anterior only approach with the ARCH plate system is less invasive than the AP approach in treating lumbosacral tuberculosis. The ARCH plate system is an innovative anatomic lumbosacral anterior multi-directional locking plate system which was devised with due consideration to the anatomic features of the lumbosacral spine and irregular destruction of involved vertebral endplates. In this retrospective study, 32 patients with lumbosacral tuberculosis underwent surgeries via either the anterior only approach (ARCH group, 18 patients) using the ARCH system or the conventional combined anterior and posterior approach (AP group, 14 patients). American Spinal Injury Association (ASIA) scores, Visual Analogue Scale (VAS) scores, Oswestry Disability Index (ODI), bone union status, ESR, CRP, intervertebral foraminal height between L5 and S1, the vertical height between the anterior upper edge of L5 and S1 vertebral body, lumbosacral angle, and the physiological lordosis of between L1 and S1 from both groups were recorded and compared. All patients were followed up for at least two years. The average duration of operation, blood loss, and length of hospital admission of the ARCH group (154.6 min, 361.1 ml&18.3days) was significantly smaller and shorter(p < 0.001, p < 0.001 & p = 0.008) that those of the AP group(465.5 min, 814.3 ml & 24.6days). The ODI score(p = 0.08, 0.471, 0.06, 0.07, 0.107), the VAS score(p = 0.099, 0.249, 0.073, 0.103, 0.273), the intervertebral foraminal height between L5 and S1(p = 0.826, 0.073, 0.085), L5-S1 height(p = 0.057, 0.234, 0.094), lumbosacral angle(p = 0.052, 0.242, 0.825), and L5-S1 lordosis(p = 0.146, 0.129, 0.053) of both groups showed no significant difference in any of the time points. The anterior only approach using the ARCH system is as effective as the combined anterior and posterior approach and is less traumatic in treating lumbosacral tuberculosis.

15.
Nat Commun ; 10(1): 5736, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31844067

RESUMO

Photosensing and energy harvesting based on exotic properties of quantum materials and new operation principles have great potential to break the fundamental performance limit of conventional photodetectors and solar cells. Weyl semimetals have demonstrated novel optoelectronic properties that promise potential applications in photodetection and energy harvesting arising from their gapless linear dispersion and Berry field enhanced nonlinear optical effect at the vicinity of Weyl nodes. In this work, we demonstrate robust photocurrent generation at the edge of Td-WTe2, a type-II Weyl semimetal, due to crystalline-symmetry breaking along certain crystal fracture directions and possibly enhanced by robust fermi-arc type surface states. This edge response is highly generic and arises universally in a wide class of quantum materials with similar crystal symmetries. The robust and generic edge current response provides a charge separation mechanism for photosensing and energy harvesting over broad wavelength range.

16.
Hepatology ; 2019 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-31867749

RESUMO

Heparin-binding epidermal growth factor (EGF)-like growth factor (HB-EGF), a member of the EGF family, plays a pivotal role in the progression of several malignancies, but its role and regulatory mechanisms in hepatocellular carcinoma (HCC) remain obscure. Here, we report that transmembrane protease serine 4 (TMPRSS4) significantly enhanced the expression and proteolytic cleavage of HB-EGF to promote angiogenesis and HCC progression. A mechanistic analysis revealed that TMPRSS4 not only increased the transcriptional and translational levels of HB-EGF precursor (pro-HB-EGF) but also promoted its proteolytic cleavage by enhancing matrix metallopeptidase 9 (MMP9) expression through the EGF receptor (EGFR)/AKT/mammalian target of rapamycin (mTOR)/hypoxia-inducible factor 1 α (HIF-1α) signaling pathway. In addition, HB-EGF promoted HCC proliferation and invasion by the EGFR/phosphoinositide 3-kinase (PI3K)/AKT signaling pathway. The level of HB-EGF in clinical samples of serum or HCC tissues from HCC patients was positively correlated with the expression of TMPRSS4 and the microvessel density (MVD), and was identified as a prognostic factor for overall survival (OS) and recurrence-free survival (RFS), which suggests that HB-EGF can serve as a potential therapeutic target for HCC. More importantly, we provide the first demonstration that treatment with the HB-EGF inhibitor cross-reacting material 197 (CRM197) alone or in combination with sorafenib can significantly suppress angiogenesis and HCC progression. Conclusion: HB-EGF can be regulated by TMPRSS4 to promote HCC proliferation, invasion, and angiogenesis, and the novel combination of the HB-EGF inhibitor CRM197 with sorafenib might be used for individualized treatment of HCC.

17.
Artigo em Inglês | MEDLINE | ID: mdl-31869776

RESUMO

OBJECTIVE: The application of in vivo microrobot navigation has received considerable attention from the field of precision therapy, which uses microrobots in living organisms. METHODS: This study investigates the navigation of microrobots in vivo using optical coherence tomography (OCT) imaging feedback. The electromagnetic gradient field generated by a home-made electromagnetic manipulation system is magnetically modeled. With this model, the magnetic force acting on the microrobot is calculated, and the relationship between this force and the velocity of the microrobot is characterized. RESULTS: Results are verified through in vitro experiments wherein microrobots are driven in three types of fluid, namely, normal saline, gastric juice, and mouse urine. In vivo experiments are performed to navigate the microrobot in a mouse portal vein in which the OCT imaging system tracks the microrobot in vivo. CONCLUSIONS: Experimental results demonstrate the effectiveness of the proposed approach. The microrobots can be magnetically driven in the in vivo environment using the OCT imaging feedback. SIGNIFICANCE: The significance of this study lies in providing a new method of driving microrobots in vivo.

18.
Injury ; 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31771787

RESUMO

INTRODUCTION: Our aim was to observe the efficacy of the induced membrane technique in the treatment of extremity osteomyelitis and to analyse the causes of infection recurrence and its risk factors. METHODS: We retrospectively analysed 424 cases of extremity osteomyelitis treated with the induced membrane technique in our department between May 2013 and June 2017. Infection recurrence time, recurrence sites and other relevant information were collected, summarized, and analysed. RESULTS: A total of 424 patients were considered as "cured" of osteomyelitis after the first stage and the induced membrane technique was performed to rebuild the bone defects. After a mean follow-up of 31.6 (16-63) months, 52 patients had recurrence of infection, including 42 tibias and 10 femurs. The recurrence rate was 12.26%. Symptoms were relieved in 16 patients after intravenous antibiotic treatment. In the remaining 36 cases (8.49%), the infection was uncontrolled by intravenous antibiotics and surgical debridement was performed. The recurrence rate of infection of the tibia (16.22%) was higher than that of the femur (8.70%). The recurrence rate of post-traumatic osteomyelitis (14.66%) was significantly higher than that of hematogenous osteomyelitis (2.41%). Patients in whom Pseudomonas aeruginosa was isolated at the first stage had a recurrence rate of 28% (7/25), which was higher than that with the other isolated bacteria. Logistic regression analysis showed that repeated operations (≥3), post-traumatic osteomyelitis, and internal fixation at the first stage were risk factors for recurrence of infection, with odds ratios (ORs) of 2.30, 5.53 and 5.28 respectively. CONCLUSIONS: The induced membrane technique is an effective method in the treatment of extremity osteomyelitis, although infection recurs in some cases. Repeated operations, post-traumatic osteomyelitis, and internal fixation at the first stage were risk factors for recurrence of infection. P. aeruginosa isolated at the first stage, tibia osteomyelitis, the presence of sinus, or flaps may also be associated with recurrence of infection.

19.
World Neurosurg ; 134: 120, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31698128

RESUMO

Failure of stent retrieval and periprocedural embolization of plaque are rare complications of carotid artery stenting, which need emergency surgical treatment. In Video 1, we demonstrate failed stent retrieval with acute middle cerebral artery occlusion that was treated with carotid endarterectomy and stent-assisted thrombectomy in a hybrid operating room. A 65-year-old man underwent carotid artery stenting for symptomatic left internal carotid artery stenosis with severe calcification. Immediately after placement of the open-cell carotid stent, left middle cerebral artery M1 segment occlusion was detected. A self-expanding retrievable intracranial stent was used for mechanical thrombectomy. However, the retrievable stent was blocked by the carotid stent and could not be retrieved. We attempted various ways to retrieve the device to avoid embolic complications, including neck rotation and neck compression, but they all failed. Therefore, we decided to perform surgical retrieval. Surgery was performed in a hybrid operating room under general anesthesia, and intraoperative neuromonitoring was used. The surgical field was deployed according to standard procedure. A longitudinal incision was then made through the adventitia on the anterolateral surface of the carotid artery. We pulled both stents out of the vessel and mobilized the plaque from the adventitia. The arteriotomy was closed with a double 6/0 monofilament suture. Angiogram was performed after vessel suturing to confirm there was not vessel wall damage or flow problems. After carotid endarterectomy, the stent-assisted thrombectomy was performed. Postoperative digital subtraction angiography confirmed the recanalization of the middle cerebral artery. The patient's neurologic function dramatically improved after hybrid treatment.

20.
Stem Cell Res ; 41: 101605, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31706095

RESUMO

Adipose-derived mesenchymal stem cells (AMSCs) are a type of adult stem cell from the mesoderm with the capacity to migrate and differentiate into other cell lineages. As a morphogenetic state of stem cells, glial-derived neurotrophic factor (GDNF) has been found to promote cell proliferation and differentiation of stem cells. The aims of our study were to investigate the biological activity of AMSCs and whether the GDNF gene can enhance the anti-inflammatory properties of stem cells. In this study, stable proliferative GDNF-overexpressing AMSC lines were successfully established and the AMSCs/GDNF-AMSCs were cocultured with macrophages (Mφ) derived from THP-1 cells in a transwell system. The mRNA expression levels of tumor necrosis factor-alpha (TNF-α), inducible nitric oxide synthase (iNOS), interleukin (IL)-10 and IL-4 were detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR). In addition, the expressions of CD163 and CD206, two markers of M2 macrophages, were detected with flow cytometric analysis. In animal experiments, AMSCs/GDNF-AMSCs (5 × 105) were administered to unilateral ureteral obstruction (UUO) nude mice for 3 or 7 days. The expression levels of cyclooxygenase-2 (COX-2), IL-6, transforming growth factor ß1 (TGF-ß1) and α-Smooth muscle actin (α-SMA) were determined by Western blotting. Renal pathological changes of all groups were observed by hematoxylin and eosin (HE) and Masson staining. In conclusion, in vitro cultured AMSCs induced a shift in macrophage phenotype from the inflammatory (M1) phenotype to the reparative (M2) phenotype. In the UUO model, AMSC treatment was conducive to the recovery of renal function and interstitial fibrosis. Therefore, we determined that AMSC therapy could promote the phenotypic transformation of macrophages and reduce the progression of renal fibrosis by suppressing inflammation. GDNF could enhance the anti-inflammatory effect of AMSCs.

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