Hybrid Repair of Complicated Type B Aortic Dissection Aneurysm With Dissected Kommerell Diverticulum Without Thoracotomy.

PURPOSE: The coincidence of aberrant right subclavian artery (ARSA) and Kommerell diverticulum (KD) with type B aortic dissection (TBAD) is a rare but dangerous disease. Currently, there are no well-established guidelines for treatment. Most authors seem to agree that surgical treatment is warranted. However, a hybrid repair technique as we performed is flexible, and a promising approach should be considered. CASE REPORT: Here, we summarized a case report of successful single-stage hybrid repair of a complicated TBAD combined with ARSA and KD without thoracotomy. CONCLUSION: Hybrid repair is a flexible and promising technique that has the potential to replace most open operation procedures in the future with a developed technique and more evidence-based medicine. CLINICAL IMPACT: As for ARSA and KD with TBAD patients, open surgical repair has been historically the treatment of choice; however, hybrid repair without thoracotomy means less invasion, simpler operation and faster recovery, which provides a flexible and promising technique that has the potential to replace most open operation procedures in the future with more evidence-based medicine.

[Effects of Astragalus Membranaceus Injection on TNF-alpha-induced release of inflammatory factors from HUVECs and the molecular mechanisms].

OBJECTIVE: To investigate the protective effect of Astragalus Membranaceus Injection on human umbilical vein endothelial cells (HUVECs) against tumor necrosis factor alpha (TNF-alpha). METHODS: Cultured passage 2 HUVECs were stimulated with TNF-alpha with or without a 2-h Astragalus Membranaceus Injection treatment. The expression of nuclear factor-kappaB (NF-kappaB) subunit p65 were evaluated by immuncytochemistical method, and the levels of p65 in the nuclei and the protein Ikappabetaalpha in the cytoplasm were evaluated by Western blotting. The levels of interleukin-6 (IL-6) and soluble intracellular adhesion molecule-1 (sICAM-1) in the cell culture were determined with ELISA. RESULTS: TNF-alpha induced the activation of NF-kappaB and increased the expressions of IL-6 and sICAM-1 in HUVECs. The activation of NF-kappabeta by TNF-alpha was suppressed by Astragalus Membranaceus Injection in a dose-dependent manner. CONCLUSION: Astragalus Membranaceus Injection can inhibit the TNF-alpha-induced expression of IL-6 and sICAM-1 by suppressing NF-kappabeta activation, suggesting its protective effect on the endothelial function.