BACKGROUND:Peripheral artery disease (PAD) impairs foot perfusion, whereas successful restoration of macroscopic arterial patency does not necessarily indicate normalization of distal foot microcirculation. OBJECTIVE:To evaluate the feasibility, interobserver reproducibility, and postprocedural responsiveness of foot dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with extended Tofts modeling for assessing distal foot microcirculatory changes after technically successful endovascular therapy (EVT) in symptomatic PAD. METHODS:In this prospective single-center pilot study, symptomatic PAD patients who underwent technically successful EVT and completed paired pre- and post-EVT foot DCE-MRI were included. Baseline clinical characteristics and ankle-brachial index (ABI) were collected. DCE-MRI pharmacokinetic parameters, including Ktrans, Kep, and Ve, were quantified in predefined foot soft-tissue regions of interest (ROIs). Interobserver reproducibility was assessed using intraclass correlation coefficients (ICCs). Pre- and post-EVT values were compared using paired t-tests or Wilcoxon signed-rank tests according to normality. Exploratory associations between DCE-MRI parameters and ABI were assessed using Spearman correlation. Sensitivity analysis was performed after excluding patients with chronic limb-threatening ischemia (CLTI) and ulceration. RESULTS:Fourteen patients were included in the final paired analysis. ABI improved post-EVT (0.48 [interquartile range (IQR) 0.37-0.58] vs. 0.69 [IQR 0.56-0.76], p = 0.004). In the treated limb, Ktrans increased significantly post-EVT (0.0102 [IQR 0.0078-0.0121] vs. 0.0224 [IQR 0.0186-0.0263] min-1, p = 0.001), whereas Kep and Ve did not. No significant treatment-related changes were observed in the untreated limb. Ktrans showed exploratory positive associations with ABI pre-EVT (ρ = 0.56, p = 0.037) and post-EVT (ρ = 0.66, p = 0.011). In sensitivity analysis excluding the two patients with CLTI and ulceration, Ktrans remained significantly increased post-EVT (0.0100 [IQR 0.0058-0.0112] vs. 0.0200 [IQR 0.0158-0.0244] min-1, p = 0.003). CONCLUSIONS:Foot DCE-MRI was feasible and reproducible in this pilot PAD cohort. Ktrans showed the most consistent post-EVT increase and may represent a candidate imaging marker of post-EVT microcirculatory change.

Background and Objective: Carotid plaque instability and subsequent rupture are primary drivers of ischemic stroke, yet the precise hemodynamic mechanisms and their interaction with vascular geometry remain incompletely characterized. This study aims to bridge this gap by integrating patient-specific geometric reconstruction, high-fidelity CFD simulations, and multi-scale histopathological analysis to elucidate the biomechanical triggers of plaque vulnerability.Methods: The study cohort comprised sixty patients scheduled for carotid endarterectomy. Preoperative CTA data were utilized to reconstruct precise three-dimensional vascular models for patient-specific CFD simulations under physiological flow conditions. Advanced geometric quantification was performed for parameters including bifurcation angle, curvature radius, and vascular tortuosity. These indices were systematically correlated with hemodynamic metrics, specifically time-averaged wall shear stress (TAWSS) and peak systolic wall shear stress (PeakWSS). Following surgery, excised plaque specimens underwent rigorous histopathological analysis and transmission electron microscopy (TEM) to quantify fibrous cap thinning and identify ultrastructural markers of cellular damage.Results: Quantitative analysis revealed that unstable plaques were independently associated with significantly larger bifurcation angles (51.4° ± 12.9° vs. 34.3° ± 13.2°, p < 0.001), greater tortuosity (0.28 ± 0.06 vs. 0.18 ± 0.07, p < 0.001), and smaller curvature radii (22.8 mm ± 5.8 mm vs. 30.2 mm ± 6.0 mm, p < 0.001). CFD analysis demonstrated that these pro-inflammatory geometric features exposed unstable lesions to significantly higher TAWSS (17.9 Pa ± 6.4 Pa vs. 10.1 Pa ± 4.3 Pa, p < 0.001) and markedly elevated PeakWSS (205.5 Pa ± 94.7 Pa vs. 112.5 Pa ± 50.0 Pa, p < 0.001) compared to stable lesions. Critically, spatial mapping confirmed that regions of geometry-induced high shear stress co-localized with sites of histopathological fibrous cap thinning and ultrastructural evidence of mitochondrial fragmentation, confirming a biomechanical pathway to tissue failure.Conclusions: This study demonstrates a robust mechanistic link between specific carotid geometry, locally elevated high-shear environments, and histological markers of plaque vulnerability. By integrating computational modeling with multi-scale validation, this framework provides a powerful tool for the non-invasive prediction of plaque rupture risk, offering a promising methodology for personalized clinical risk assessment and precision surgical planning.

BACKGROUND:CRLM (Colorectal liver metastasis), a prevalent form of distant metastasis in colorectal cancer, is a leading cause of mortality in affected patients. Despite advancements in immunotherapy for colorectal cancer, clinical benefits in CRLM patients remain limited. The immunosuppressive liver microenvironment plays a pivotal role in facilitating metastatic colonization and disease progression. METHODS:We performed fecal metabolomics in ABX (antibiotic-treated) mice and single-cell RNA sequencing on hepatic tissues from four cohorts: CRC (colorectal cancer) , CRLM, LCA-fed CRC, and LCA-fed CRLM mice, to delineate intergroup immune heterogeneity. Cellular and molecular profiling across groups was conducted via Luminex multiplex assays, flow cytometry, and immunofluorescence. Integrated multi-omics analyses elucidated LCA-driven pathways modulating metastatic progression RESULTS: We demonstrated that LCA (lithocholic acid), a gut microbiota-derived metabolite, activates TGR5 in hepatic CAFs (cancer-associated fibroblasts) to upregulate CCL3 secretion. Elevated CCL3 levels subsequently recruit MDSCs (myeloid-derived suppressor cells) into metastatic niches. While MDSCs primarily suppress T-cell activation, we identified a paradoxical role of MDSC-derived CCL2 in attenuating immunosuppression via CCR2 signaling, suggesting a compensatory pro-inflammatory axis within the tumor microenvironment CONCLUSIONS: These findings suggest new immunotherapeutic strategies for the treatment of CRLM.

Indoleamine-2,3-dioxygenase 1 (IDO1) is the rate-limiting enzyme in tryptophan (Trp) catabolism along kynurenine (Kyn) pathway. Increased IDO1 activity has been noticed in patients with sepsis, while IDO1's involvement in sepsis, especially in the initial cytokine storm phase is not yet completely understood. Using the GEO database and clinical samples of sepsis, current study revealed that IDO1-AHR-CYP1A1 axis was significantly upregulated and closely related to cytokine storm in septic patients. With cell models of cytokine storm, it was found that IDO1 promoted cytokine storm and the apoptosis of model cells via AHR-CYP1A1, and IDO1-AHR-CYP1A1 axis correlated classic cytokine storm signal pathway including STAT3, NF-κB/STAT1, JNK/p38. With mouse models of septic cytokine storm, it was shown that IDO1 inhibitors could block the upregulated IDO1-AHR-CYP1A1 axis, reduce the enhanced inflammatory cytokine levels, decrease the phosphorylation of classic cytokine storm signal pathway, rescue organ damage, and increase survival rate. It was also found that IDO1 activation occurred after the increase of inflammatory cytokine levels. Therefore, classic cytokine storm signal pathways, inflammatory cytokines and IDO1-AHR-CYP1A1 axis form a tripartite interaction loop to promote cytokine storm. IDO1 inhibitors were able to block this process.

This study utilized data from the Global Burden of Disease (GBD) 2021 database to comprehensively analyze the global burden of laryngeal cancer (LC) attributable to high alcohol use from 1990 to 2021, and projections to 2050. Data on death, disability adjusted of life years (DALYs), age-standardized death rate (ASDR), and age-standardized DALYs rate of LC attributable to high alcohol use were retrieved from the GBD 2021. Trend analysis used the estimated annual percentage change (EAPC). Death and DALYs were stratified according to social demographics index (SDI), age, gender, region, and countries. Auto-regressive integrated moving average (ARIMA) models provided future projections. By 2021, global deaths of LC attributable to high alcohol use had slightly increased compared to 1990.The EAPCs for ASDR and age-standardized DALYs rate were − 1.48 and − 1.70, respectively. Males were high-risk populations and low-middle SDI regions was high-risk areas. The disease burden of LC attributable to high alcohol use varied considerably across the GBD regions and the countries. ARIMA model predicted results showed that the global deaths and DALYs cases would still increase from 2022 to 2050. Between 1990 and 2021, while the overall burden of high alcohol use-related LC was gradually decreasing, marked regional and gender disparities persist. The annual number of LC deaths attributed to high alcohol use continues to rise, particularly in males and low-middle SDI regions. Highlights the need for more effective public health policies targeting high-risk regions and populations to reduce alcohol-related LC burden.

Background Although Lonicera japonica extract (LJE) has been widely used in traditional medicine for treating conditions such as heat-clearing, detoxification, and anti-bacterial purposes, its specific effects on allergic rhinitis (AR) remain underexplored. Purpose This study aimed to elucidate how LJE influences nerve growth factor (NGF) levels and associated inflammatory pathways in AR modeling of mice. Materials and Methods Chlorogenic acid, a key component of LJE, was isolated and optimized using orthogonal experiments and chromatographic techniques. An AR mouse modeling was established and divided into three groups: control group (no treatment), modeling group (LJE intervention), and modeling control group (model control group, saline intervention). Post-intervention, AR symptoms were evaluated, and serum and nasal mucosa tissues were analyzed. Western blotting was used to measure levels of PI3K, AKT, and NF-kappa B p65 proteins. At the same time, enzyme-linked immunosorbent assays (ELISA) quantified NGF, tumor necrosis factor (TNF)-alpha, interferon (IFN)-gamma, interleukin (IL)-4, and IL-10 in serum and nasal mucosal tissue. Results Chlorogenic acid was successfully extracted with optimal conditions being 70% ethanol, pH 5, a solvent-to-material ratio of 10:1, and an extraction time of 1.5 h. The AR symptoms in the modeling group and model control group were significantly more severe compared to the control group (p < .05). Treatment with LJE notably reduced symptom severity in the modeling group relative to the model control group (p < .05). Additionally, the levels of PI3K, AKT, and NF-kappa B p65 in nasal mucosal tissue of the modeling group were comparable to those in the control group and lower than in the model control group (p < .05). NGF, TNF-alpha, and IFN-gamma levels in the modeling group and control group were significantly lower than those in the model control group (p < .05), while IL-4 and IL-10 levels were higher in the modeling group and control group compared to the model control group (p < .05). Conclusion LJE effectively reduced NGF expression and alleviated AR symptoms in a mouse model, potentially through regulation of PI3K/Akt and NF-kappa B signaling pathways. This highlights LJE's therapeutic potential for managing AR-related inflammation.

The pathogenesis of benign prostatic hyperplasia(BPH)is commonly regarded as androgen-dependent.The first FDA-approved androgen-targeted medication for BPH,finaste-ride,achieves its therapeutic effect by selectively inhibit-ing type Ⅱ 5-alpha reductase(SRD5A2).

Circular RNAs play an important role in the development of gastric cancer (GC). circ-LDLRAD3 has been confirmed to be related to GC progression. miR-137 is also a suppressor in GC. However, the impact of the interaction between circ-LDLRAD3 and miR-137 on the progression of gastric cancer remains unclear at present.

Objective This study aims to assess the clinical results of endovascular intervention for spontaneous isolated superior mesenteric artery dissection (SISMAD) and its impact on superior mesenteric artery (SMA) remodeling in comparison to solely medical management. Methods All patients with SISMAD between January 2015 and August 2023 were included. The primary endpoints were the absence of major adverse events (MAEs), including dissection-related mortality, recurrence of mesenteric ischemia symptoms, and the necessity for intervention. The secondary endpoints were stenosis or occlusion of the SMA and morphologic remodeling of the dissections. Results A total of 217 SISMAD patients were included. In this study, 127 (58.5 %) patients received medical management alone (conservative group), and 90 (41.5 %) underwent endovascular therapy (EVT group). In the EVT group, the technical success rate was 94.4 % (85/90). During follow-up, 13 (6.0 %) patients experienced MAEs, and 1 patient in the conservative group death related to SISMAD. The patients in EVT group showed more complete remodeling than those in the conservative group (76 (84.4 %) vs 66 (52.0 %), P < .0001). Survival analysis showed that the estimated MAEs-free survival rates were97.8 %, 95.6 %, and 95.6 % in EVT group and 98.4 %, 94.5 %, 92.9 % in conservative group at one, two, and three years, respectively. No significant difference was observed in both groups. Conclusion The findings indicate that both endovascular treatment and medical management alone yield comparable rates of MAE-free survival among patients with SISMAD. Additionally, endovascular therapy exhibits a higher rate of complete remodeling and greater freedom from stenosis or occlusion of the SMA.

Endovascular aneurysm repair (EVAR) has become a cornerstone of modern vascular practice, offering a minimally invasive alternative to conventional open surgery for the treatment of abdominal aortic pathologies. Its efficacy can be undermined by limb invasive alternatives. However, its graft occlusion (LGO) is a complication characterized by thrombotic obstruction. To investigate the hemodynamic and morphological characteristics of LGO-affected limbs, we performed morphological measurements and hemodynamic simulations on 22 patient-specific geometries collected from a tertiary center. Logistic regression models were applied to identify prognostic factors. In addition, using computer-aided design technology, we modeled two different intervention strategies to explore the impact of virtual surgery on the progression of thrombosis in occluded limbs. Our analysis revealed that the LGO group exhibited significantly higher values for relative residence time, oscillatory shear index (OSI), and endothelial cell activation potential (ECAP), alongside significantly lower time-averaged wall shear stress (p < 0.001). Morphological assessments showed significantly increased limb cannulation stenosis rates (p < 0.001) in the LGO group. Multivariate regression analysis identified OSI and limb cannulation stenosis rate as independent predictors of LGO. Building on this, a predictive nomogram incorporating these two parameters was developed. These findings highlight the importance of combining hemodynamic and morphological assessments to predict and prevent LGO, and the nomogram we developed can effectively support this process. In addition, combining virtual surgery with hemodynamic simulation can be a novel paradigm in the perioperative management of EVAR patients. (c) 2025 Author(s). All article content, except where otherwise noted, is licensed under a Creative Commons Attribution-Non Commercial 4.0International (CC BY-NC) license

Background:Circular RNAs play an important role in the development of gastric cancer (GC). circ-low-density lipoprotein receptor class A domain containing 3 (LDLRAD3) has been confirmed to be related to GC progression. miR-137 is also a suppressor in GC. However, the impact of the interaction between circ-LDLRAD3 and miR-137 on the progression of GC remains unclear at present.Methods:The study identified expression level differences of circ-LDLRAD3, miR-137, and COL4A5 in GC pathological specimens compared to normal tissue samples. Furthermore, through in vitro experiments, including flow cytometry, cell counting kit-8 (CCK-8) assays, wound healing, Western blotting, and colony formation assays, we further explored the molecular regulatory mechanisms by which these factors promote the progression of GC.Results:In this study, circ-LDLRAD3 was confirmed to have higher expression, and miR-137 had lower expression in GC tissues and cell lines. circ-LDLRAD3 knockdown and miR-137 overexpression promoted apoptosis and inhibited proliferation, migration, and invasion in GC cell lines. Further experiments validated that COL4A5 had a positive relationship with GC and that circ-LDLRAD3 promoted the expression of COL4A5. circ-LDLRAD3 could be sponged and inhibited by miR-137 in GC cells. As a result, the promotional effect of circ-LDLRAD3 on COL4A5 was counteracted by miR-137.Conclusion:Our study showed that the knockdown of circ-LDLRAD3 suppressed the development of GC by regulating the miR-137/COL4A5 axis.

Endovascular Aortic Aneurysm Repair (EVAR) can effectively prevent the continuous growth and rupture of Abdominal Aortic Aneurysms (AAA), but endoleak is a serious complication after the EVAR operation. Innovative techniques are presented in this work to solve this problem: (i) Local multi-dimensional anatomical features and global morphological features are conceptualized and extracted based on a statistical shape model (SSM), and (ii) Combined with morphological features and different machine learning (ML) methods, the occurrence of endoleak type I and II can be effectively predicted. The results show that the model using XGBoost achieves the best prediction performance for the occurrence of endoleak, with an AUC of 0.93 and accuracy of 0.85; further in type I and II endoleak predictions, the AUC achieves 0.90 and 0.80, and the accuracy of 0.81 and 0.74, respectively. Compared with the SOTA technologies, our ML-enabled multi-modal morphological feature extraction outperforms in predicting endoleak occurrence before surgery, avoiding excessive follow-up, and improving long-term management of patients in clinical practices.

Abstract Background Because the cases are quite scarce, we aimed to review cases of foreign body impaction penetrating the neck through the esophagus to analyze the characteristics of these cases. The open surgery skills of the surgeon, the treatment procedure and the surgeons’ experience in the rare diseases were analyzed. Methods We collected and analyzed all cases from 2015–2020 in our hospital. Surgical skills and procedures for fasting and anti-infection treatment were reviewed retrospectively. Follow-up was telephone communication. Results Our series included 15 cases. Tenderness in the pre-cervical site was a physical sign for screening. Thirteen cases underwent a lateral neck open surgery with the incision including the left side of neck and only two cases were incised from the right side of the neck. Pus was found 3 days after the impaction in one case, the shortest time observed in our series. The esophageal laceration was only sutured primarily in 5 cases (33.33%) among all fifteen cases. After sufficient drainage (average more than 9 days), antibiotic treatment and fasting (normally 2–3 weeks), patients gradually began to switch to solid foods from fluids after complete blood counts and confirmations from esophageal radiography result. No severe complications occurred, and all the patients have no swallowing dis-function and recovered well. Conclusion Surgery should be performed as soon as possible after impaction. Lateral neck approach surgery and the therapeutic procedure described in this article are safe and effective treatments.

Myeloid-derived suppressor cells (MDSCs) expand during sepsis and contribute to the development of persistent inflammation-immunosuppression-catabolism syndrome. However, the underlying mechanism remains unclear. Exploring the mechanisms of MDSCs generation may provide therapeutic targets for improving immune status in sepsis. Here, a sepsis mouse model is established by cecal ligation and perforation. Bone marrow cells at different sepsis time points are harvested to detect the proportion of MDSCs and search for differentially expressed genes by RNA-sequence. In lethal models of sepsis, polymorphonuclear-MDSCs (PMN-MDSCs) decrease in early but increase and become activated in late sepsis, which is contrary to the expression of metastasis-associated lung adenocarcinoma transcript 1 （Malat1）. In vivo, Malat1 inhibitor significantly increases the mortality in mice with late sepsis. And in vitro, Malat1 down-regulation increases the proportion of PMN-MDSCs and enhanced its immunosuppressive ability. Mechanistically, Malat1 limits the differentiation of PMN-MDSCs by accelerating the degradation of phosphorylated STAT3. Furthermore, Stattic, an inhibitor of STAT3 phosphorylation, improves the survival of septic mice by inhibiting PMN-MDSCs. Overall, the study identifies a novel insight into the mechanism of sepsis-induced MDSCs and provides more evidence for targeting MDSCs in the treatment of sepsis.

Background. Coronary heart disease (CHD) is the leading cause of death and disability worldwide. Accumulating evidence reveals that atherosclerosis (AS), characterized by systemic, chronic, and multifocal disease, and is the primary pathological basis of cardiovascular diseases, including CHD. However, the molecular underpinnings of CHD are still far from well understood. Our study attempted to identify aberrant plasma exosome-derived circRNAs and key exosomal circRNA biomarkers for CHD. Methods. The expression profiles of mRNAs, circRNAs, and lncRNAs in the blood exosomes of CHD patients and healthy controls were obtained from the exoRBase database. The corresponding miRNAs of the differentially expressed mRNAs, circRNAs, and lncRNAs were predicted via ENCORI and the miRcode database. LncRNAs/circRNAs and mRNAs with the cotargeted miRNAs were selected to construct an interaction network. Multiple machine learning algorithms have been used to explore potential biomarkers, followed by verification in patients with CHD using real-time quantitative reverse transcription-polymerase chain reaction (RT-qPCR). Results. Based on the cutoff criterion of P<0.05, we identified 85 differentially expressed circRNAs (4 upregulated and 81 downregulated), 43 differentially expressed lncRNAs (24 upregulated and 19 downregulated), and 312 differentially expressed mRNAs (55 upregulated and 257 downregulated). Functional enrichment analysis revealed that the differentially expressed mRNAs were involved mainly in neutrophil extracellular trap (NET) formation and the nucleotide-binding oligomerization domain- (NOD-) like receptor signaling pathway. Further analysis revealed that the DEGs in the circRNA/lncRNA-miRNA-mRNA interaction network were closely related to lipid and atherosclerotic signaling pathways. Hsa_circ_0001360 and hsa_circ_0000038 were identified as potential biomarkers for CHD based on three machine learning algorithms. The relative expression levels of hsa_circ_0001360 and hsa_circ_0000038 were significantly altered in plasma exosomes from patients with CHD. ROC curve analysis revealed that the areas under the curve (AUCs) were 0.860, 0.870, and 0.940 for hsa_circ_0001360, hsa_circ_0000038, and the two-gene combination, respectively. Conclusion. The circRNA/lncRNA-miRNA-mRNA interaction network might help to elucidate the pathogenesis of CHD. Hsa_circ_0001360 combined with hsa_circ_0000038 might be an important diagnostic biomarker.

Aortic dissection is a major aortic catastrophe with a high morbidity and mortality risk, and thoracic endovascular repair (TEVAR) has recently been established as the preferred treatment option for promoting false lumen (FL) remodeling and improving hemodynamics in the true lumen. Complete thrombosis of the FL has been thought to be a prerequisite for healing of the aorta postdissection, whereas flow and pressurization of the FL caused by partial thrombosis are thought to contribute to late dilation and rupture. Therefore, it is important to anticipate FL remodeling outcomes of different TEVAR procedures to determine which one will favor complete FL thrombosis. In this paper, a spatio-temporal mathematical model is proposed to simulate thrombosis in dissection. Blood is treated as a multi-constituent mixture consisting of a linear fluid phase and a thrombus (solid) phase. The transport and reactions of chemical and biological species are incorporated using a system of coupled convection-reaction-diffusion equations to represent two interacting sub-processes in thrombosis: coagulation cascade and platelet activity. Computational fluid dynamic simulations of two in vivo problems were performed using the libraries of OpenFOAM: thrombus growth in an injured straight blood vessel and TEVAR induced thrombosis in a patient-specific acute type B aortic dissection for which multiple follow-up scans are available. For both problems, the simulated thrombus formation was consistent with experimental or clinical observations, indicating the potential applicability of this modeling approach to predict the progression of dissection in patient-specific phantoms and its further use to help surgeons personalize treatment strategy for dissection patients in the future.

AIM:To compare the prognostic value of tumor-infiltrating lymphocytes (TILs) and CD3 + cells and CD20 + cells between schistosomal colorectal cancer (SCRC) and non-schistosomal CRC (NSCRC). BACKGROUND:Although schistosomiasis has been basically eliminated, it has not been completely extinction in China, and occasional outbreaks occur in Europe recently. The role of immune cells in the immune microenvironment of SCRC and NSCRC is remaining obscure, and the inflammation-based prognostic systems of SCRC has rarely been reported. METHODS:HE-stained sections of 349 colorectal cancer (CRC) tumors, which were completely resected, were evaluated for density of TILs. Meanwhile, we evaluated CD3 + T lymphocytes and CD20 + B lymphocytes by immunochemistry. The relationship of these infiltrating immune cells with clinicopathological features, including schistosomiasis, and clinical outcomes was evaluated, and the prognostic roles of TILs in SCRC and NSCRC were explored. RESULTS:Except for age (P < 0.0001), there were no significant differences between NSCRC and SCRC patients in clinicopathological features (P > 0.05). Beside, the positive expression pattern of sTILs, iTILs, CD3, and CD20 between NSCRC and SCRC patients was also similar (P > 0.05). In the whole cohort, sTILs and CD3 were defined as independent prognostic factors (P = 0.031 and P = 0.003, respectively). CD3 was an independent prognostic factor both in the NSCRC and SCRC set (P = 0.026 and P = 0.045, respectively). Higher sTILs, CD3, and CD20 were correlated with less aggressive tumor characteristics in the whole cohort and in subgroups. CONCLUSION:Although CD3 was an independent prognostic factor for both NSCRC and SCRC set, there were no significant differences between SCRC and NSCRC patients in sTILs, CD3, CD20, and in other clinicopathological features.

Background: To evaluate the safety and efficacy of the conformable thoracic aortic endograft (Conformable TAG Thoracic Endoprosthesis [CTAG]; W. L. Gore & Associates, Flagstaff, Ariz) and Valiant Captivia thoracic stent graft (Medtronic Inc., Santa Rosa, CA) for acute type B aortic dissection (TBAD). Methods: The early and mid-term outcomes were analyzed for 413 patients undergoing TEVAR using conformable TAG thoracic endoprosthesis and Valiant Captivia thoracic stent graft for acute TBAD. 100 propensity-matched pairs of patients were generated, including 100 patients in the CTAG group and 200 patients in the Valiant Captivia group. Results: Operative mortality were 2.33% (3 of 129) in the CTAG group and 1.76% (5 of 284) in the Valiant Captivia group. The median follow-up was 41.67 (26.00-60.67) months. No significant difference in mortality (9 [7.00%] vs. 36 [12.68%], P = 0.95) or re-intervention rate (3 [2.33%] vs. 20 [7.04%], P = 0.29) was observed between two groups. CTAG group have a lower incidence rate of distal stent graft-induced new entry tear than Valiant Captivia group (2.33% vs. 9.86%, P = 0.045). Lower incidence of type Ia endoleak was identified in the CTAG group (2.22%) than the Valiant Captivia group (14.41%) in patients with type III arch (P = 0.039). Conclusions: Both Valiant Captivia thoracic stent graft and CTAG thoracic endoprosthesis can be safely performed for acute TBAD with low operative mortality, favorable mid-term survival and freedom from reintervention. CTAG thoracic endoprosthesis had fewer dSINE even with larger oversizing and potentially suitable for type III arch with fewer type Ia endoleaks.

Background Although schistosomiasis has been basically eliminated, it has not been completely extinction in China and occasional outbreaks occur in Europe in recent years. The relationship between inflammation caused by Schistosoma japonicum and colorectal cancer (CRC) is still obscure, and the inflammation based prognostic systems of schistosomal colorectal (SCRC) has rarely been reported. Aim To explore the different roles of tumor infiltrating lymphocytes (TILs) and C-reactive protein (CRP) in SCRC and in Non-schistosomal CRC (NSCRC), providing a possible predictive system to evaluate outcomes and to improve the risk stratification for CRC patients, especially for CRC patients with schistosomiasis . Methods Three hundred fifty-one CRC tumors were evaluated for density of CD4 + , CD8 + T cells and CRP in intratumoral and stromal compartments by immunohistochemical using tissue microarray. Results There were no association between TILs and CRP and schistosomiasis . Multivariate analysis identified stromal CD4 (sCD4) ( p = 0.038), intratumoral CD8 (iCD8) ( p = 0.003), schistosomiasis ( p = 0.045) as independent prognostic factors for overall survival (OS) in the whole cohort; and sCD4 ( p = 0.006) and iCD8 ( p = 0.020) were independent prognostic factors for OS in the NSCRC and SCRC set, respectively. Besides, we found that there were no differences of TILs and CRP, which were distributed in different areas of tumor tissue, between CRC patients with and without schistosomiasis . Conclusion The results remind us that different subtypes of TILs have distinguished biological behavior and prognosis value in the immune microenvironment of NSCRC and SCRC patients. Meanwhile, the findings require us to stratify patients with schistosomiasis and this might facilitate patient counseling and management.

Distal stent graft-induced new entry tear (dSINE) is an important complication of thoracic endovascular aortic repair (TEVAR) for the treatment of type B aortic dissection (TBAD). This study aims to explore whether the aorta distal to the stent plays an important role in the occurrence of dSINE. Sixty-nine patient-specific geometrical models of twenty-three enrolled patients were reconstructed from preoperative, postoperative, and predSINE computed tomography scans. Computational fluid dynamics (CFD) simulations were performed to calculate the von Mises stress in the CFD group. Meanwhile, morphological measurements were performed in all patients, including measurements of the inverted pyramid index at different follow-up time points and the postoperative true lumen volume change rate. In the CFD study, the time-averaged von Mises stress of the true lumen distal to the stent in dSINE patients was significantly higher than that in the CFD controls (20.42 kPa vs. 15.47 kPa). In the morphological study, a special aortic plane (plane A) with an extremely small area distal to the stent was observed in dSINE patients, which resulted in an inverted pyramid structure in the true lumen distal to the stent. This structure in dSINE patients became increasingly obvious during the follow-up period and finally reached the maximum value before dSINE occurred (mean, 3.91 vs. 1.23). At the same time, enlargement of the true lumen distal to the stent occurs before dSINE, manifesting as a continuous increase in the true lumen volume (mean, 0.70 vs. 013). A new theory of what causes dSINE to occur has been proposed: the inverted pyramid structure of the true lumen distal to the stent caused an increase in the von Mises stress in this region and aortic enlargement, which ultimately led to the occurrence of dSINE.