High-risk factors related to the occurrence and development of abdominal aortic aneurysm

Abdominal aortic aneurysm(AAA) is a common and potentially dangerous vascular disease with many risk factors related to its occurrence and development. This review collects the results from recent studies of different comorbidities including hypertension, diabetes, and hyperlipidemia and summarizes their connections with AAA development and its underlying mechanisms. We believe that hypertension, diabetes, and hyperlipidemia can affect AAA occurrence and development, but more studies are needed to further explore the mechanisms.

Biomarkers in aortic dissection:Diagnostic and prognostic value from clinical research

Aortic dissection is a life-threatening condition for which diagnosis mainly relies on imaging examinations,while reliable biomarkers to detect or monitor are still under investigation.Recent advances in technologies provide an unprecedented opportunity to yield the identification of clinically valuable biomarkers,including proteins,ribonucleic acids(RNAs),and deoxyribonucleic acids(DNAs),for early detection of pathological changes in susceptible patients,rapid diagnosis at the bedside after onset,and a superior therapeutic regimen primarily within the concept of personalized and tailored endovascular therapy for aortic dissection.

A biomaterial-based therapy for lower limb ischemia using Sr/Si bioactive hydrogel that inhibits skeletal muscle necrosis and enhances angiogenesis

Muscle necrosis and angiogenesis are two major challenges in the treatment of lower-limb ischemic diseases.In this study,a triple-functional Sr/Si-containing bioceramic/alginate composite hydrogel with simultaneous bioactivity in enhancing angiogenesis,regulating inflammation,and inhibiting muscle necrosis was designed to treat lower-limb ischemic diseases.In particular,sodium alginate,calcium silicate and strontium carbonate were used to prepare injectable hydrogels,which was gelled within 10 min.More importantly,this composite hydrogel sustainedly releases bioactive Sr^(2+)and SiO_(3)^(2-) ions within 28 days.The biological activity of the bioactive ions released from the hydrogels was verified on HUVECs,SMCs,C2C12 and Raw 264.7 cells in vitro,and the therapeutic effect of the hydrogel was confirmed using C57BL/6 mouse model of femoral artery ligation in vivo.The results showed that the composite hydrogel stimulated angiogenesis,developed new collateral capillaries,and re-established the blood supply.In addition,the bioactive hydrogel directly promoted the expression of muscle-regulating factors(MyoG and MyoD)to protect skeletal muscle from necrosis,inhibited M1 polarization,and promoted M2 polarization of macrophages to reduce inflammation,thereby protecting skeletal muscle cells and indirectly promoting vascularization.Our results indicate that these bioceramic/alginate composite bioactive hydrogels are effective biomaterials for treating hindlimb ischemia and suggest that biomaterial-based approaches may have remarkable potential in treating ischemic diseases.

Adipose-derived stem cell/FGF19-loaded microfluidic hydrogel microspheres for synergistic restoration of critical ischemic limb

The efficacy of stem cell therapy is substantially compromised due to low cell survival rate and poor local retention post-delivery. These issues drastically limit the application of stem cells for ischemic limb therapy, which requires effective blood perfusion and skeletal muscle regeneration. Herein, based on microfluidic technology, an integrated stem cell and cytokine co-delivery system designed for functional ischemic limb salvage was constructed by first incorporating the myogenic cytokine, fibroblast growth factor 19 (FGF19), into microspheres composed of methacrylate gelatin (GelMA). Then adipose-derived stem cells (ADSCs) were highly absorbed into the porous structure of the microspheres, overcoming the insufficient loading efficiency and activities by conventional encapsulation strategy. The fabricated ADSCs/FGF19@μsphere system demonstrated a uniform size of about 180 μm and a highly porous structure with pore sizes between 20 and 40 μm. The resultant system allowed high doses of ADSCs to be precisely engrafted in the lesion and to survive, and achieved sustained FGF19 release in the ischemic region to facilitate myoblast recruitment and differentiation and myofibrils growth. Furthermore, the combination of ADSCs and FGF19 exhibited a positive synergistic effect which substantially improved the therapeutic benefit of angiogenesis and myogenesis, both in vitro and in vivo. In summary, a stem cell and cytokine co-delivery system with the properties of easy preparation and minimal invasiveness was designed to ensure highly efficient cell delivery, sustained cytokine release, and ultimately realizes effective treatment of ischemic limb regeneration.

Minimal vessel area predicts in-stent restenosis in nonthrombotic iliac vein compression syndrome after stenting

To the Editor:Iliac vein compression syndrome(IVCS)is a well-documented anatomic abnormality characterized by the compression of iliac veins from the adjacent artery and vertebra.Depending on whether deep vein thrombosis was co-existing,IVCS could be classified into thrombotic and nonthrombotic lesions.Endovascular procedures have become the mainstream treatment for nonthrombotic IVCS.[1]In most cases.

Long-term outcomes following exclusive use of endovascular aortic repair for ruptured infrarenal abdominal aortic aneurysms

To the Editor:Ruptured abdominal aortic aneurysm(rAAA)is a fatal disease.Emergency surgery is the only way to provide an opportunity for survival.In 1994,endovascular aortic repair(EVAR)was reported as an emergency treatment for rAAA.Compared with traditional open surgery(OS),patients could benefit from its lower perioperative mortality and minimal invasiveness.Although recent guidelines have recommended an EVARfirst approach if suitable as judged by the clinician,the standard of whether to give a priority to EVAR varies among clinicians in practical applications,because hostile aortic morphology and hemodynamic conditions were thought to weaken the benefit of EVAR.Hence,controversies still exist regarding whether EVAR as a priority is applicable to most rAAAs.In addition,a search of the literature found few population-based studies with long-term outcomes.Given this,a population-based study was conducted by Zhongshan Hospital,Fudan University.

Application of "Fabulous" stent system to improve aortic remodeling after TEVAR for type B aortic dissection

It is known that the Proximal Extension To Induce Complete Attachment(PETTICOAT)technique improves the distal aortic remodeling compared with standard thoracic endovascular aortic repair(TEVAR).[1,2]However,the only available Zenith Dissection Endovascular System(Cook Medical Inc.,Bloomington,Ind,USA)has several limitations,including only two sizes(36 mm and 46 mm)and an one-taper design,which may not be suitable for the complex morphology of dissection at distal aorta,particular for the east Asian population.Thus,our center designed the new“Fabulous”stent system and acheieved better early curative effect.

植物生长调节剂通过克隆整合对空心莲子草顶端和基部生长的不同作用

入侵植物不仅对全球生物多样性造成了巨大的威胁,同时也严重影响了农业生产与粮食安全。克隆整合使得相连植株进行资源共享,能促进入侵植物的生长从而获得优势。然而,入侵杂草在植物调节剂(plant growth regulators,PGRs)影响下的克隆整合作用则很少有报道。PGRs被广泛应用于农作物生产上,并能通过土壤淋溶、侵蚀和径流作用,影响分布在作物附近的农田杂草的生长。本研究采用两种PGRs赤霉素(gibberellins,GA)和多效唑(paclobutrazol,PAC)处理恶性入侵杂草空心莲子草(Alternanthera philoxeroides)基端,并保持或者通过剪切达到控制基端与顶端的连通,从而探究克隆整合作用在空心莲子草响应两种农业常用PGRs中的作用。研究结果表明,GA和PAC对空心莲子草生长的作用相反。GA通过克隆整合作用显著促进顶端植株的地上生长。相反地,PAC显著抑制基端和顶端的地上生长,但是能够通过克隆整合作用显著促进基端和顶端的地下生长。这些研究结果解释了克隆整合作用能促进PGRs对空心莲子草生长的促进作用,这很可能是外来杂草能够成功入侵人为干扰较多的农业生态系统的重要原因之一。

A balloon-supported embolism protection technique during vertebral/ subclavian artery angioplasty stenting

With high rates of morbidity and mortality,posterior circulation stroke accounts for 20% of ischemic strokes,and approximately 25% occurs in patients with stenosis in the vertebral and/or basilar arteries.liiOn the other hand,the risk of posterior circulation ischemic stroke reaches 30% in patients with symptomatic vertebral artery(VA)stenosis afterSyears,[2]subclavian artery(SA)occlusion,although with a low prevalence in the general population,is also an important causeof posterior circulation stroke.