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1.
J Hazard Mater ; 391: 122254, 2020 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-32062542

RESUMO

In this study, a new barium titanate@polyurethane/polysulfonamide (BaTiO3@PU/PSA) composite nanofibrous membrane with comprehensive properties for high temperature filtration and robust PM2.5 removal was successfully fabricated through the blending spinning of PU and PSA and the introduction of BaTiO3. As a consequence, the BaTiO3@PU/PSA membrane achieved the high capture efficiency of 99.99 % for fine particulates, low pressure drop of 39.4 ± 0.2 Pa, good mechanical property (13.27 MPa), sufficient flexibility, high thermal stability (up to 300 °C), favorable flame-retardancy as well as superior chemical resistance against acid and alkali. Especially, to intuitively reveal the relationship between the fiber structure, high temperature environment, gas velocity and filtration performance of the composite membrane, the filtration processes were carefully investigated through the analog simulation. More importantly, the BaTiO3@PU/PSA membrane exhibited high-efficiency PM2.5 purification capacity, and the removal efficiency kept stable after high temperature, acid or alkali treatment, ascribing to the advantageous structure of PSA, PU and BaTiO3. Overall, the BaTiO3@PU/PSA nanofiber membranes with versatility are a promising high-efficiency candidate for dust removal, particularly in harsh conditions.

2.
J Cell Mol Med ; 24(2): 1541-1552, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31793207

RESUMO

Both PNPLA3 I148M and hepatic inflammation are associated with nonalcoholic fatty liver disease (NAFLD) progression. This study aimed to elucidate whether PNPLA3 I148M is involved in NF-kB-related inflammation regulation in NAFLD. HepG2 cells homozygous for the PNPLA3 I148M mutation were used. The human PNPLA3 promoter sequence was screened for NF-kB binding sites using the MATCH and PATCH tools. NF-kB-mediated transcriptional regulation of the PNPLA3 gene was assessed by luciferase reporter assay, EMSA and ChIP-qPCR. Wild-type (I148I) and mutant (M148M) PNPLA3 were overexpressed using stable lentivirus-mediated transfection. The pCMV vector and siRNA were transiently transfected into cells to direct NF-kB overexpression and PNPLA3 silencing, respectively. A putative NF-kB binding site in the human PNPLA3 promoter was shown to be necessary for basal and NF-kB-driven transcriptional activation of PNPLA3 and protein/DNA complex formation. Supershift analysis demonstrated a protein/DNA complex specifically containing the NF-kB p65 and p50 subunits. ChIP-qPCR confirmed the endogenous binding of NF-kB to the human PNPLA3 promoter in response to NF-kB overexpression and palmitic acid (PA) challenge. The silencing of PNPLA3 blocked the overexpression of NF-kB or PA-induced TNF-α up-regulation. Moreover, mutant PNPLA3 overexpression prevented NF-kB inhibitor-induced down-regulation of TNF-α expression in PA-treated HepG2 cells. Finally, the overexpression of mutant but not wild-type PNPLA3 increased TNF-α expression and activated the ER stress-mediated and NF-kB-independent inflammatory IRE-1α/JNK/c-Jun pathway. Human PNPLA3 was shown to be a target of NF-kB, and PNPLA3 I148M mediated the regulatory effect of NF-kB on inflammation in PA-treated HepG2 cells, most likely via the IRE-1α/JNK/c-Jun ER stress pathway.

3.
J Vasc Surg ; 71(1): 283-296.e4, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31466739

RESUMO

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.

4.
Ann Vasc Surg ; 62: 498.e1-498.e5, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31449935

RESUMO

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.

5.
Comput Methods Biomech Biomed Engin ; 23(1): 33-42, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31805773

RESUMO

This study numerically investigated the hemodynamics of a patient-specific coronary artery fistula (CAF) before and after the fistula closure. The results indicated that the dilated fistula result in inadequate perfusion to other healthy aortas. Disturbed blood flow, aberrant WSSs, local negative pressure gradients and sharp pressure changes are shown in both untreated and occluded fistula. Furthermore, extreme high WSS appeared at the fistula bending after the terminal closure. It was concluded that the fistula closure may effectively improve the phenomenon of stealing blood but worsen the unfavorable hemodyanmics predisposing the thrombosis formation due to its geometrical torturosity.

6.
Artigo em Inglês | MEDLINE | ID: mdl-31822385

RESUMO

OBJECTIVE: To present the pooled quantitative evidence of basic profiles, initial treatment strategies, and clinical outcomes in patients with isolated abdominal aortic dissection (IAAD). METHODS: A comprehensive systematic review and meta-analysis was performed of all available studies reporting IAAD, retrieved from the MEDLINE, Embase, and Cochrane Databases. The logistic normal random effect model was fitted using the generalised linear mixed model with random intercepts to calculate the pooled proportion estimates. RESULTS: Seventeen studies with 482 patients were included in this meta-analysis. Male smokers with hyperlipidaemia and hypertension were the most prominent basic profile. IAADs were predominantly spontaneous and infrarenal, and roughly half were acute and symptomatic. Approximately 67% [95% confidence interval (CI) 42-86%] of patients were managed initially conservatively. In the overall population, the 30 day all cause mortality was 3% (95% CI 1-5%) and the long term mortality during follow up was 8% (95% CI 5-14%). Re-intervention during follow up occurred in 8% (95% CI 5-15%) of patients. In the subgroup analysis, patients with conservative treatment had a 30 day mortality of 1% (95% CI 0-8%), a long term mortality of 5% (95% CI 1-29%), and a re-intervention rate of 18% (95% CI 10-29%). Patients with open surgery had a 30 day mortality of 9% (95% CI 0-82%), a long term mortality of 12% (95% CI 4-31%), and a re-intervention rate of 9% (95% CI 1-44%). Patients with endovascular repair had a 30 day mortality of 2% (95% CI 0-10%), a long term mortality of 5% (95% CI 2-13%), a re-intervention rate of 6% (95% CI 3-13%), and a persistent endoleak rate of 4% (95% CI 2-10%). CONCLUSION: Appropriate initial treatment strategies can be used to obtain acceptable clinical outcomes in patients with IAAD. Invasive intervention is necessary if patients match certain indications for intervention. Regular imaging surveillance should be provided for all patients, especially those treated conservatively.

7.
Medicine (Baltimore) ; 98(49): e18085, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31804318

RESUMO

This was a prospective cohort study with a short-term follow-up. To explore whether age is a factor in the prognosis following high ligation and stripping (HLS) performed in an ambulatory care center. This study included 170 patients who underwent their first HLS for varicose veins in an ambulatory center from November 2016 to October 2017 at West China Hospital. The patients were categorized as two groups: the ≤60 years old group and the >60 years old group. We collected the two age groups data included Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification, Venous Clinical Severity Score (VCSS), Visual Analogue Score (VAS), Aberdeen Varicose Veins Questionnaire (AVVQ), Quality of Recovery (QoR-15), and postoperative complications at predetermined time points. The clinical correlation between age and prognosis following HLS in an ambulatory care center was prospectively studied after adjusting for potential confounders. The distribution of age and prognosis were also compared in the AVVQ improvement and VCSS improvement of patients at 6 weeks and 6 months after surgery. Our research comprised a total of 170 patients (236 limbs), of which 86 (50.6%) patients were female and 66 (38.8%) patients received bilateral procedures. After multivariable risk adjustment for potential confounding factors, we observed that age was not associated with the improvement of AVVQ (OR 0.3, 95%CI (1.3, 0.7), P = .54) and VCSS (OR 0.2, 95%CI (0.2, 0.6) P = .38) at 6 months after HLS, as well as AVVQ (OR 0.5,95%CI (1.2, 2.2), P = .57) at 6 weeks after HLS. However, at 6 weeks after HLS, age was related to the improvement of VCSS (OR -0.6, 95%CI (1.2, 0.1), P = .03), with the >60 years old group having a lower VCSS improvement compared to the 60 years old group. In postoperative complications, there were no significant differences in terms of complications between the two age groups (all P value >.05). Therefore, in our opinion, age is not a barrier for good outcomes following HLS in an ambulatory care center.


Assuntos
Instituições de Assistência Ambulatorial/estatística & dados numéricos , Ligadura/métodos , Qualidade de Vida , Varizes/cirurgia , Adulto , Fatores Etários , Idoso , China , Feminino , Humanos , Ligadura/efeitos adversos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Índice de Gravidade de Doença
8.
Cell Commun Signal ; 17(1): 168, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842909

RESUMO

BACKGROUND: Our previous study has demonstrated that NAD(P)H: quinone oxidoreductase 1 (NQO1) is significantly upregulated in human liver cancer where it potentiates the apoptosis evasion of liver cancer cell. However, the underlying mechanisms of the oncogenic function of NQO1 in HCC have not been fully elucidated. METHODS: Expression of NQO1, SIRT6, AKT and X-linked inhibitor of apoptosis protein (XIAP) protein were measured by western blotting and immunohistochemistry. Additionally, the interaction between NQO1 and potential proteins were determined by immunoprecipitation assays. Furthermore, the effect of NQO1 and SIRT6 on tumor growth was determined in cell model and orthotopic tumor implantation model. RESULTS: We found that NQO1 overexpression in HCC enhanced SIRT6 protein stability via inhibiting ubiquitin-mediated 26S proteasome degradation. High level of SIRT6 reduced acetylation of AKT which resulted in increased phosphorylation and activity of AKT. Activated AKT subsequently phosphorylated anti-apoptotic protein XIAP at Ser87 which determined its protein stability. Reintroduction of SIRT6 or AKT efficiently rescued NQO1 knock-out-mediated inhibition of growth and induction of apoptosis. In orthotopic mouse model, NQO1 knock-out inhibited tumor growth and induced apoptosis while this effect was effectively rescued by SIRT6 overexpression or MG132 treatment partially. CONCLUSIONS: Collectively, these results reveal an oncogenic function of NQO1 in sustaining HCC cell proliferation through SIRT6/AKT/XIAP signaling pathway.

9.
Artigo em Inglês | MEDLINE | ID: mdl-31840608

RESUMO

BACKGROUND: Oxidative stress and mitochondrial dysfunction play a vital role in the pathogenesis of brain aging. Saponins from Panax japonicus (SPJ) have attracted much attention for its potential to attenuate age-related oxidative stress as the main ingredient in rhizomes of Panax japonicus. OBJECTIVE: This study aimed to investigate the neuroprotective effects of SPJ on natural aging rats as well as the underlying mechanisms regarding oxidative stress and mitochondrial pathway. METHODS: Sprague-Dawley rats were divided into control groups (3-, 9-, 15- and 24-month old groups) and SPJ-treated groups. For SPJ-treated groups, SPJ were orally administrated to 18-month old rats at the doses of 10 mg/kg, 30 mg/kg and 60 mg/kg once daily. Control groups were given the same volume of saline. After treatment of SPJ or saline for six months, the cortex and hippocampus were rapidly harvested and deposited at -80°C after the rats were decapitated under anesthesia. The neuroprotective effects of SPJ were estimated by histopathological observation, TUNEL detection, biochemical determination and western blotting. RESULTS: SPJ improved pathomorphological changes in neuronal cells and decreased apoptosis in the cortex and hippocampus of aging rats, increased the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), Na+/K+-ATPase, Ca2+-ATPase and Ca2+/Mg2+-ATPase whereas decreased malondialdehyde (MDA) contents in the cortex of aging rats. Furthermore, SPJ increased silent mating type information regulation 2 homolog-1 (SIRT1) protein expression, decreased acetylated level of peroxisomeproliferator-activated receptor-γ coactivator-1α (PGC-1α) in the cortex and hippocampus of aging rats, reversed the aging-induced decline of Forkhead box O3 (Foxo3a), superoxide dismutase 2 (SOD2), microtubule-associated protein light chain 3 (LC3II) and Beclin1 levels in the cortex and hippocampus. CONCLUSION: Our data showed that SPJ conferred neuroprotection partly through regulation of oxidative stress and mitochondria related pathways in aging rats.

10.
J Vasc Surg ; 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31677943

RESUMO

OBJECTIVE: This systematic review and meta-analysis aimed to compare the clinical outcomes between transarterial and translumbar (direct aneurysm sac puncture) approaches for persistent type II endoleak after endovascular repair of abdominal aortic aneurysm. METHODS: We searched multiple electronic databases (up to October 31, 2018) for eligible trials in patients with type II endoleaks after endovascular abdominal aortic aneurysm repairs that evaluated the outcomes of translumbar embolization vs transarterial embolization. The primary outcome was clinical success (absence of the endoleak on the last examination); the secondary outcomes were technical success and complication rate. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. RESULTS: Among the 904 studies screened, 9 studies with 354 participants were included in this review. None of the studies reported rupture or mortality. The translumbar group had a relatively higher clinical success rate than the transarterial group, but this difference was not statistically significant (OR, 2.29; 95% CI, 1.00-5.25; P = .05; I2 = 52%). The technical success rate was significantly higher in the translumbar group than in the transarterial group (OR, 13.32; 95% CI, 3.41-52.07; P = .0002; I2 = 0%). No significant difference was found in the complication rate of the two groups (OR, 1.15; 95% CI, 0.26-4.96; P = .85; I2 = 0%). We also included five studies that reported the clinical outcomes of open repair. All patients were technically treated by open repair, and 58 of 60 patients owned clinical success during the follow-up period. CONCLUSIONS: The translumbar route was more successful in obliterating the endoleak on follow-up imaging. When repeated endovascular embolizations fail, a laparotomy should follow.

11.
Macromol Rapid Commun ; 40(23): e1900492, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31693258

RESUMO

Fibers have traditionally been made through melt or solution processes from macromolecules. Most of these fibers have crystalline domains where the segregation of different crystalline features is extremely difficult due to the statistical nature of the formation and growth of these domains. A fibrous nano-crystalline sandwich is reported where distinctly different crystalline regions are formed in layers along the continuous fiber direction during the spinning process and locked in place. This approach employs side-by-side bicomponent nanofiber electrospinning where the components are the enantiomeric pair of poly(l-lactic acid) and poly(d-lactic acid). The formation of the poly(lactic acid) (PLA) stereo-complexes at the junction interphase of the two components is demonstrated through diffusion, which subsequently crystallize into continuous sandwich domains. The stereo-complex crystalline core in the fiber possesses a melting point 50 °C higher than, and properties substantially different from, the regular PLAs at the fringe areas of the fiber. This nano-crystalline sandwich fiber structure can be scaled to the micrometers in a commercial bicomponent process.

12.
Medicine (Baltimore) ; 98(48): e17889, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770201

RESUMO

INTRODUCTION: Takayasu arteritis (TA) is a chronic and nonspecific inflammatory disease mainly affecting the aorta and its major branches, resulting in the stenosis or occlusion of target arteries. Approximately 50% to 60% of patients with TA likely have renal artery stenosis (RAS), which results in refractory hypertension (HTN) and renal dysfunction. Aortorenal bypass with saphenous vein graft (SVG) is the classical procedure to relieve patients' symptoms. Graft restenosis is the most common complication during long-term follow-up. However, aortorenal vein graft aneurysm (AVGA) is uncommonly reported, and symptomatic or ruptured AVGA that needs reoperation is even rarer. Long-term follow-up results after AVGA reoperation also remain scare. Here, we introduced the long-term result of a symptomatic AVGA under the reoperation of polytetrafluoroethylene (PTFE) graft replacement and provided a literature review of AVGA reoperation after surgical bypass for RAS. CLINICAL FINDING: An 18-year-old male complained about mild to severe right lumbar pain for 5 days. He underwent right aortorenal bypass with SVG for TA-induced right renal artery stenosis to relieve refractory HTN and renal dysfunction 2 years ago. However, this patient did not proceed with a follow-up after the procedure. Physical examination showed normal vital signs, and an obvious percussion tenderness over the right kidney region was detected. The updated computed tomography angiography (CTA) revealed a right AVGA with a maximum diameter of 26 mm. No restenosis of the proximal and distal anastomoses was detected. DIAGNOSIS: The patient was diagnosed to have right aortorenal vein graft aneurysm at the risk of rupture and Takayasu arteritis. INTERVENTIONS: The AVGA was resected with a 6 mm PTFE graft replacement. An end-to-side proximal anastomosis to the orifice of the original anastomosis on the abdominal aorta and an end-to-end distal anastomosis to the distal normal renal artery were made. OUTCOMES: The patient had an uneventful postoperative clinical course and was discharged from the hospital 5 days after the operation. The 4-year updated CTA revealed no restenosis or aneurysmal degeneration of the prosthetic graft. CONCLUSION: Symptomatic AVGA that needs reoperation is rare. Prosthetic graft replacement is an effective way to eliminate the risk of potential rupture. A 4-year satisfactory result indicative of a prosthetic graft can be the first choice for aortorenal bypass in RAS without active biological inflammation.


Assuntos
Aneurisma da Aorta Abdominal/etiologia , Oclusão de Enxerto Vascular/etiologia , Complicações Pós-Operatórias/etiologia , Obstrução da Artéria Renal/cirurgia , Arterite de Takayasu/complicações , Enxerto Vascular/efeitos adversos , Adolescente , Aorta Abdominal/cirurgia , Aneurisma da Aorta Abdominal/cirurgia , Ruptura Aórtica/etiologia , Oclusão de Enxerto Vascular/cirurgia , Humanos , Masculino , Complicações Pós-Operatórias/cirurgia , Artéria Renal/cirurgia , Obstrução da Artéria Renal/etiologia , Reoperação/métodos , Medição de Risco , Enxerto Vascular/métodos
13.
ACS Appl Mater Interfaces ; 11(46): 43188-43199, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31644871

RESUMO

To address the challenge of high-temperature air filtration, a novel electreted polysulfonamide/polyacrylonitrile-boehmite (PSA/PAN-B) composite nanofiber based filter was developed via electrospinning for effective high-temperature dust removal. In this study, the spinnability of PSA was greatly improved by adding a small amount of PAN as an auxiliary polymer, and the introduction of a boehmite electret further significantly reinforced the properties of PSA fibers. As a result, the PSA/PAN-B membrane exhibited a high filtration efficiency (up to 99.52 ± 0.32%), low pressure drop (45.16 ± 1.39 Pa), excellent flexibility, good mechanical properties, high thermal stability (up to approximately 300 °C), and superior chemical resistance. Through data analysis and 3D simulation, the important benefits of the boehmite electret in the optimization of the PSA fibrous membrane performance were determined: it increases the charge storage capacity, constructs a rough surface morphology, improves the specific surface area, and enhances the mechanical properties. More importantly, the PSA/PAN-B film possessed a robust PM2.5 purification capacity, and the particulate matter removal efficiency was kept unchanged after high-temperature, acid, or alkali treatment-a performance derived from the intrinsic molecular structure of PSA. The PSA/PAN-B composite fibrous membrane, with excellent comprehensive properties, is a promising candidate for air filters, especially in harsh environments, further broadening the applications of PSA and providing new insight into the design of high-performance filters with high-temperature and corrosion resistance.

14.
Chem Commun (Camb) ; 55(88): 13283-13286, 2019 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-31626254

RESUMO

Developing efficient and durable catalysts for methanol oxidation is of great significance for direct methanol fuel cells. Herein, we realized the deposition of ultra-trace Pt nanoparticles by atomic layer deposition (ALD) onto a three-dimensional (3D) titanium nitride (TiN) nanowire array grown on carbon cloth (CC), in which the 3D TiN nanowires provide a stable platform for the Pt nanoparticles, besides the inherent properties of high corrosion resistance and conductivity. Owing to the superior characteristics of the 3D TiN nanostructure as the support material and the strong interaction between Pt and TiN, the Pt nanoparticles on the TiN nanowire array show an enhanced electrocatalytic activity toward methanol oxidation compared to a commercial Pt/C catalyst. This work provides an effective strategy to fabricate 3D high-performance electrocatalysts for future energy applications.

15.
Ann Vasc Surg ; 2019 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-31622754

RESUMO

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.

16.
Artigo em Inglês | MEDLINE | ID: mdl-31558276

RESUMO

OBJECTIVE: Thoracic endovascular aortic repair of type B aortic dissection initiates thrombosis in the false lumen, which eventually results in aortic remodeling. We aimed to determine whether the false lumen thrombosis rate (FLTR) after thoracic endovascular aortic repair can be accurately predicted by an index that expresses the degree of aortic arch angulation. METHODS: The geometry of 48 patients with acute type B aortic dissection (mean age, 48 years) after thoracic endovascular aortic repair was reconstructed from postoperative computed tomography images. We introduced a novel angle-the degree of question mark (φ)-to indicate the aortic morphology. Moreover, how aortic angulation influenced the FLTR was investigated based on hemodynamic parameters. Finally, a predicted mathematical model relating FLTR to aortic angulation was proposed, and 10 patients were chosen to validate the model. RESULTS: The degree of question mark shape was shown to negatively correlate with FLTR (n = 38; P < .001; R = -0.661), and the linear relationship model was created as follows: FLTR (%) = -1.955 × φ + 168.24 (R2 = 0.437; P < .001). In addition, the net flow rate to the false lumen significantly increased with the increase of the degree of the question mark shape of the aorta. Furthermore, the difference and concordance of the proposed prediction model were perfectly validated in the remaining 10 patients using paired-sample t test and the concordance correlation coefficient. CONCLUSIONS: The size of the question mark shape may be a good predictor for FLTR of acute type B aortic dissection following thoracic endovascular aortic repair. The higher the degrees of the question mark, the less likely it was to form a complete thrombus.

17.
World J Clin Cases ; 7(16): 2401-2405, 2019 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-31531337

RESUMO

BACKGROUND: Multiple renal artery aneurysms (RAAs) involving multiple branches in a solitary kidney are rare and present a major challenge to surgeons. Ex vivo or in situ repair combined with renal artery revascularization is the classical procedure for these complicated cases, which are not suitable for endovascular repair. The choice of bypass graft remains controversial because of the risk of aneurysmal degeneration for autologous graft. CASE SUMMARY: A 39-year-old female patient presented with left lumbar pain for more than 3 mo. Computed tomography angiography showed congenital absence of the right kidney and three left RAAs involving multiple distal branches. This patient met the criteria for surgical repair due to symptoms of threatened rupture. According to the anatomy and location of multiple RAAs, ex vivo revascularization with saphenous vein graft (SVG) was performed. At the 3-year follow-up, computed tomography angiography demonstrated the aneurysmal degeneration of the Y-shaped SVG. The patient remained asymptomatic and follow-up ultrasound showed no continuous growth of SVG aneurysm. CONCLUSION: SVG aneurysm in RAA revascularization causes us to reflect on the choice of graft, especially for solitary kidney patients.

18.
Exp Gerontol ; 127: 110721, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31491500

RESUMO

Activation of the unfolded protein response (UPR) in the endoplasmic reticulum (ER) and mitochondrial apoptotic pathway serves as a central regulator for maintaining cell function and survival, and is associated with ageing and spermatogenesis. However, changes in UPR activation and mitochondrial apoptotic pathway in the testis during ageing remain unclear. In this study, we hypothesized that UPR activation declines and the mitochondrial apoptotic pathway is activated in the testis during ageing, and these changes are associated with a decline in testicular function. To test this theory, we utilized 6-, 12-, 18-, and 22-month-old Sprague Dawley rats to evaluate the changes in testicular and epididymal weights and indexes, sperm quality, histology, UPR activation, and mitochondrial apoptotic pathway in testicular tissues. The results showed that there was a progressive decline in testicular and epididymal weights and indexes, sperm count, and sperm viability during ageing. Correspondingly, seminiferous tubule diameters and epithelium heights progressively decreased with ageing. Western blot analysis and immunofluorescence staining results revealed that the expression of UPR-related proteins (GRP78, p-PERK, p-eif2α, ATF4, p-IRE1α, ATF6α, and XBP1) progressively decreased in the testis with ageing. In contrast, the expression of ER stress-related pro-apoptotic proteins CHOP, Caspase 12, and p-JNK progressively increased with advancing age. TUNEL staining further confirmed that testicular germ cell apoptosis was significantly increased from month 6 to 22 in rats. Additionally, the relative expression levels of cytochrome c and its downstream molecules including Capsase 9 and Caspase 3 were significantly increased in the testis during ageing. Collectively, our results suggest that impaired UPR activation and increased germ cell apoptosis partly mediated by the UPR and mitochondrial apoptotic pathway might correlate with an age-related decline in testicular function.

19.
ACS Omega ; 4(1): 1854-1860, 2019 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-31459440

RESUMO

Nonoxidative dehydrogenation of methanol to methyl formate over a CuMgO-based catalyst was investigated. Although the active site is metallic copper (Cu0), the best reaction conditions were obtained by tuning the ratio of Cu/Mg and doping the catalyst with 1 wt % of Pd to achieve a very specific activity for methyl formate synthesis. On the basis of the CO2 temperature-programmed desorption study, the basic strength of the catalyst plays a role in the efficient conversion of methanol to methyl formate via dehydrogenation. These CuMgO-based catalysts show excellent thermal stability during the reaction and the regeneration processes. Approx. 80% methanol conversion with constant selectivity to methyl formate was achieved even after 4 rounds of usage for a total reaction time exceeding 200 h, indicative of their potential for practical applications.

20.
Medicine (Baltimore) ; 98(29): e16494, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335714

RESUMO

RATIONALE: It is difficult to discriminate malignant pheochromocytoma (PCC) from benign PCC. The requirement of abdominal aortic and inferior vena cava reconstruction is extremely rare. PATIENT CONCERNS: We here report a case of a large pheochromocytoma in a 56-year-old woman who complained of only hand trembling and had no hypertension or other symptoms. The operation was difficult because of a tight adhesion to the circumference of great vessels. A replacement of the aortocaval vessels with grafts was necessary to remove the tumor completely. DIAGNOSES: Ultrasonography, computed tomography (CT), and catecholamine assay revealed suspecting the retroperitoneal PCC. INTERVENTIONS: Tumor excision and reconstruction of the abdominal aorta and inferior vena cava by externally supported polytetrafluoroethylene (ePTFE) vessels were successfully performed. OUTCOMES: A follow-up CT angiography showed no recurrence and graft vessels presented good patency after 7years. Catecholamine in urine and serum assay was normal. LESSONS: The complete resection of the tumor and infiltrated great vessels were necessary for the long-term survival of patients with a large PCC. The ePTFE graft is a good substitute for vessel reconstruction.


Assuntos
Aorta Abdominal/cirurgia , Implante de Prótese Vascular , Feocromocitoma/cirurgia , Neoplasias Retroperitoneais/cirurgia , Veia Cava Inferior/cirurgia , Aorta Abdominal/diagnóstico por imagem , Aorta Abdominal/patologia , Angiografia por Tomografia Computadorizada , Epinefrina/análise , Feminino , Humanos , Pessoa de Meia-Idade , Invasividade Neoplásica , Norepinefrina/análise , Feocromocitoma/diagnóstico , Feocromocitoma/patologia , Politetrafluoretileno , Neoplasias Retroperitoneais/diagnóstico , Neoplasias Retroperitoneais/patologia , Resultado do Tratamento , Ultrassonografia , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/patologia
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