OBJECTIVE:A carotid body tumor (CBT) located near the skull base presents considerable challenges for revascularization. This study presents a 15-year experience using a novel sutureless anastomotic technique for carotid artery revascularization, aimed at minimizing blood flow interruption and reducing the risk of cerebral ischemia. METHODS:This multicenter retrospective cohort study included patients with Shamblin class III CBTs who underwent tumor excision and carotid revascularization (CR) at three medical centers. Patients were categorized based on the technique used: traditional CR with artificial or saphenous vascular graft and CR with self-expanded covered stents. Patients were monitored through follow-up evaluations over a 1-year period. The primary end point was defined as graft occlusion within 1-year after surgery. Secondary end points encompassed recurrence of CBT, temporary and persistent cranial nerve damage (CND), and stroke. RESULTS:There were 93 Shamblin class III CBT patients included during a mean follow-up time of 2.35 years. In comparison with the CR with artificial or saphenous vascular graft group (n = 57), the CR with self-expanded covered stents group (n = 36) demonstrated a statistically significant reduction in operation duration (P < .001), intraoperative blood flow interruption time (P < .001), incidence of temporary CND symptoms (P = .002), and rate of persistent CND (P < .001). Additionally, there was a statistically significant increase in graft patency (P = .003). CONCLUSIONS:Our study demonstrated the safety, rapid revascularization, and favorable patient outcomes of this novel technique. Long-term observation is warranted to prove the durability.

Purpose: Postpancreatectomy hemorrhage (PPH) is a life-threatening complication after pancreatoduodenectomy. Stent-graft implantation is an emerging treatment option for PPH. This study reports the outcome of PPH treated with stent-graft implantation. Methods: This was a single-center, retrospective study. Between April 2020 and December 2023, 1723 pancreatectomy cases were collected while we screened 12 cases of PPH after pancreatoduodenectomy treated with stent-graft implantation. Patients' medical and radiologic images were retrospectively reviewed. Technical and clinical success, complications, and stent-graft patency were evaluated. Continuous data are reported as means ± standard deviation when normally distributed or as median (Q1, Q3) when the data is non-normal distributed. Categorical data are reported as n (%). A p < 0.05 was considered statistically significant. Kaplan-Meier estimates were used for stent patency and patients’ survival. Results: Pancreatic fistula was identified in 6 cases (50.0%), and pseudoaneurysm was identified in 3 cases (25.0%), including pancreatic fistula together with pseudoaneurysm in 1 case (8.3%). All pseudoaneurysm or contrast extravasation sites were successfully excluded with patent distal perfusion, thus technical success was achieved in all cases. The overall survival rate at 6 months and 1 year was 91.7% and 78.6%, respectively. One patient had herniation of the small intestine into the thoracic cavity, which caused a broad thoracic and abdominal infection and died during hospitalization. Rebleeding occurred at the gastroduodenal artery stump in 1 case after stent-graft implantation for the splenic artery and was successfully treated with another stent-graft implantation. Two cases of asymptomatic stent-graft occlusion were observed at 24.6 and 26.3 after the operation, respectively. Conclusions: With suitable anatomy, covered stent-graft implantation is an effective and safe treatment option for PPH with various bleeding sites and causes.

Background: There is currently no consensus regarding the optimal perioperative antiplatelet strategy for carotid artery surgery. This multicentre study aimed to analyse the association between preoperative aspirin monotherapy following postoperative dual antiplatelet therapy (DAPT) and the risk for stroke and death after carotid endarterectomy (CEA). Methods: This cohort study included 821 patients with carotid artery stenosis who underwent CEA. Primary outcomes included any stroke or death up to the one-month postoperative follow-up. Multilevel multivariate regression analyses and descriptive statistics were performed. Results: Patients were predominantly male (53 %), with a mean age of 66.2 years. The primary outcome occurred in 1.6 % of patients. Univariate and multivariate analyses revealed that patients with chronic obstructive pulmonary disease (COPD) exhibited a high risk for stroke or death (P = 0.011). The occurrence of any local complications in the neck was accompanied by an increase in diastolic blood pressure (DBP) (P = 0.007). Patients with a high systolic blood pressure (SBP) (P = 0.002) experienced a longer operative duration. The length of hospital stay was longer in the patients with COPD (P = 0.020), minor stroke (P = 0.011), and major stroke (P = 0.001). A positive linear correlation was found between SBP and operative duration in the overall population (β 0.4 [95 % confidence interval (CI) 0.1–0.7]; P = 0.002). The resultant curve for DBP and any local complications in the neck exhibited a two-stage change and one breakpoint in the entire population (k = 68 mmHg, <68; odds ratio [OR] 0.9 [95 % CI 0.7–1.1], P = 0.461; ≥68: OR 1.1 [95 % CI 1.0–1.1], P = 0.003). Conclusions: Preoperative aspirin monotherapy and postoperative DAPT were safe and effective antiplatelet treatments for patients who underwent CEA.

Atherosclerosis (AS) is a prevalent cardiovascular disease that greatly increases mortality in the aging population and imposes a heavy burden on global healthcare systems. The purpose of this study is to examine the research structure and current trends of monoclonal antibodies (mAbs) against AS from a bibliometric perspective, since the development of these drugs is currently booming. This study collected articles and reviews on mAbs against AS from the Web of Science Core Collection, spanning from 2003 to 2022. Biblioshiny was utilized to analyze and visualize the characteristics of countries, regions, authors, institutions, and journals included in this collection. We used VOS viewer to illustrate the frequency of country co-occurrence, and CiteSpace to visualize co-cited reference, keywords co-occurrence, keywords citation bursts, keywords clustering and timeline plots. The study included 1325 publications, with the United States emerging as a leading contributor to the field. ATHEROSCLEROSIS, CIRCULATION and ARTERIOSCLEROSISTHROMBOSIS AND VASCULAR BIOLOGY are core journals that publish high-quality literature on the latest advances in the field. Noteworthy authors with numerous high-quality publications include Witztum JL and Tsimikas S. Currently, lipid metabolism and inflammation are the main research areas of interest in this field. The mAbs against AS is an evolving field, and ongoing research continues to advance our understanding. This paper provides a comprehensive overview of the current state of knowledge in this area, highlighting two primary research directions: inflammation and lipid metabolism. Additionally, the paper identifies emerging research hotspots, which will provide researchers with useful insights to guide future investigations and anticipate research directions.

Plaque vulnerability has been the subject of several recent studies aimed at reducing the risk of stroke and carotid artery stenosis. Atherosclerotic plaque development is a complex process involving inflammation mediated by macrophages. Plaques become more vulnerable when the equilibrium between macrophage recruitment and clearance is disturbed. Lipoperoxides, which are affected by iron levels in cells, are responsible for the cell death seen in ferroptosis. Ferroptosis results from lipoperoxide-induced mitochondrial membrane toxicity. Atherosclerosis in ApoE(-/-) mice is reduced when ferroptosis is inhibited and iron intake is limited. Single-cell sequencing revealed that a ferroptosis-related gene was substantially expressed in atherosclerosis-modeled macrophages. Since ferroptosis can be regulated, it offers hope as a non-invasive method of treating carotid plaque. In this study, we discuss the role of ferroptosis in atherosclerotic plaque vulnerability, including its mechanism, regulation, and potential future research directions.

OBJECTIVE: The objective is to explore the correlation between carotid artery calcification score and cerebral hyperperfusion syndrome (CHS) after carotid artery stenting (CAS) in patients with carotid artery stenosis. METHODS: Consecutive patients treated for carotid artery stenosis from October 2016 to August 2021 from two centers were studied. Carotid artery calcification score was manually segmented on multi-detector row spiral computed tomography angiography scans before CAS. The associations between carotid artery calcification score and the occurrence of CHS during the in-hospital time were assessed. RESULTS: A total of 175 patients were enrolled in the study. The mean age was 72.12 ± 7.51 years. All patients were undergone CAS treatment successfully. There were 46 cases that occurred CHS (26.29%). Univariate logistic regression analyses showed that for every 1 unit (100-score) increase in carotid artery calcification score, the risk of CHS increased by 1937% (odds ratio [OR] = 20.37, 95% confidence interval [CI]: 7.54–55.03, P < 0.01). In addition, the increasing rate was significantly different between the open-cell group (OR = 261.7, P < 0.01) and the closed-cell group (OR = 11.4, P < 0.01). The area under curve of predictiong model of carotid artery calcification score to CHS was 0.84 (95% CI, 0.75–0.93). CONCLUSION: Carotid artery calcification score was an independent risk factor for CHS in patients who underwent CAS. The application of carotid artery calcification score as risk factor in clinical screening of carotid artery stenosis patients may have beneficial effects on the management of CAS.

颈动脉体瘤（carotid body tumor，CBT）是一种相对罕见的疾病，大部分起源自颈动脉分叉处的化学细胞感受器，临床少见。目前CBT的治疗以手术切除为主，但其解剖位置特殊，病灶血供丰富，导致手术难度大，放化疗等治疗方法亦有报道。本综述从CBT的发病机制、临床表现、临床分型、治疗等方面予以总结。

目的 探讨基于思维导图的主动学习模式在重大灾害卫勤保障教学中应用的效果和价值.方法 采用随机数字表法选取海军军医大学2016级临床医学本科生90名学生作为研究对象,将其分为观察组和对照组.对照组45名学生采用传统的教学模式,观察组45名学生采用基于思维导图的主动学习模式进行重大灾害救援卫勤保障教学.两组教学课时数均为12学时,比较两组学生在教学后的重大灾害救援卫勤保障知识理论考试及实践技能操作成绩,并调查学生对基于思维导图的教学模式在重大灾害救援卫勤保障教学应用中的满意度.采用EmpowerStats(易侕统计)与R软件进行t检验和卡方检验.结果 观察组男24名、女21名,年龄(21.40±0.69)岁;对照组男22名、女23名,年龄(21.71±0.55)岁.观察组理论成绩(91.38±4.37)高于对照组(84.91±3.98)(P<0.001);观察组实践技能成绩(92.98±3.24)高于对照组(87.38±3.80)(P<0.001).同时,观察组学生对教学效果的满意度为82.2％(37/45),高于对照组的37.8％(17/45).结论 基于思维导图的主动学习侧重于培养学生的自主学习、互动探索及临床思维能力,在重大灾害卫勤保障教学中有广泛的应用前景.

Isolated superior mesenteric artery dissection (ISMAD) has attracted more and more clinicians' attention in recent years. Patients onset of ISMAD often present with abdominal pain. The misdiagnosis or miss diagnosis is common because of the non-specific symptoms and signs, which even can endanger lives in serious cases. Imaging classification is of great significance for diagnosis and treatment of ISMAD. The Sakamoto classification and the Yun classification are two classical classified methods. However, with the further study of ISMAD, various new classifications emerge. Conservative treatment was once considered as the preferred. As the rapid development of endovascular therapy and the great progress of new devices, stenting therapy can significantly improve symptoms and achieve satisfactory long-term effects, and be even expected to become the preferred method for clinical therapy of ISMAD. However, the long-term effects of endovascular therapy still need a large number of follow-up data, and complications after stent implantation can't be ignored.

Background:To quantify the association between the free distal segment length of the internal carotid artery (FDS-ICA) and permanent cranial nerve injury (p-CNI) following carotid body tumor (CBT) resection.Methods:This study is a case-control study. We surveyed 109 consecutive patients who underwent CBT resection between June 2015 and June 2020 at our single center. A total of 89 patients met the inclusion criteria and were selected for analysis. The FDS-ICA was measured by image post-processing software for computed tomography angiography (CTA). Postoperative p-CNI complications were evaluated using comprehensive statistical approaches.Results:The cohort was divided into 2 groups depending on the presence of p-CNI, namely the p-CNI group (n=17) and the non-CNI group (n=79). The average FDS-ICA of patients with p-CNI complications was shorter than that of those without p-CNI complications (P<0.001). For every 1 mm increase in FDS-ICA, there was an associated decrease of 8% in the risk of p-CNI (0.92, 95% CI: 0.85 to 0.98, P<0.05). Threshold effect analysis of the FDS-ICA on p-CNI identified that the FDS-ICA was 28.7 (95% CI: 23.8 to 30.9) mm.Conclusions:The results of this study revealed a significant independent association between FDS-ICA and permanent postoperative cranial nerve injury complications of CBTs. Further study is warranted to confirm these results in a larger patient cohort.

BackgroundCarotid body tumor (CBT) is the most common head and neck paraganglioma. Whether preoperative embolization benefits CBT patients who will receive surgical resection is still controversial.MethodsIn this multi-center retrospective study, we collected data from patients with CBT who received surgical treatment without (group A) or with preoperative embolization (group B) from 2011 to 2019. The primary outcome was the rate of death or stroke after 3 years of follow-up. The secondary outcomes of the study were length of operation (LOO), intraoperative blood loss (IBL), length of stay (LOS), rate of recurrence, and rate of cranial nerve (CN) injuries. Descriptive statistics were used to analyze the demographics, clinical characteristics, complications, and follow-up results of the patients.ResultsBetween January 2011 and October 2019, 261 consecutive patients (107 male and 154 female) entered analysis. After 3 years of follow-up, no patient died in both groups. Only three patients with stroke were detected: 2/226 (0.9%) in group A vs. 1/35 (2.9%) in group B (p = .308). The LOO in group A was 132.6 ± 64.6 min compared with 152.9 ± 40.4 min in group B (p = .072). IBL in group A was 375.4 ± 497.8 ml compared with 448.0 ± 270.8 ml in group B (p = .400). LOS in group A was 8.3 ± 2.0 days compared with 7.4 ± 1.7 days in group B (p = .016). Seventy-two CN injuries were detected: 65/226 (28.8%) in group A vs. 7/35 (20.0%) in group B (p = .281). There were 65 temporary CN injuries (59 in group A vs. 6 in group B) (p = .254) and seven permanent CN injuries (6 in group A vs. 1 in group B) (p = .945). Three most frequently injured cranial nerves were the pharyngeal branch and superior laryngeal nerve (12.3%), recurrent laryngeal nerve (7.7%) and vagus nerve (7.3%).ConclusionThere was insufficient evidence to support the efficacy of preoperative embolization. CBT resection alone had a similar rate of stoke, recurrence, and CN injuries when compared with CBT resection with preoperative arterial embolization. Meanwhile, CBT resection alone did not increase LOO and IBL.

Abstract Background Neutrophil-lymphocyte ratio (NLR) is a significant indicator of inflammation, which is associated with adverse outcomes of various surgeries. The objective of this study was to investigate the relationship between NLR and postoperative length of stay(PLOS) in carotid body tumor(CBT) resection. Methods This retrospective observational study was performed of 231 patients undergoing CBT resection between November 2008 to December 2020. Univariate and multivariate analyses using logistic regression models were conducted to confirm NLR as the independent factor affecting PLOS in CBTs. Smooth curve fitting and stratified analysis were conducted to calculate effect index of NLR to PLOS. Results Medium PLOS group was larger than the other two groups(31.2% vs. 44.6% vs. 24.2%). The PLOS in patients with a low NLR was significantly smaller than that in patients with a high NLR(2.37 ± 2.41 vs. 2.67 ± 2.76 vs. 4.35 ± 5.91, p < 0.01). After adjusted other factors influenced PLOS, each additional 1 of NLR, the PLOS increased by increase 0.12days (0.12,(0.06, 0.18), p < 0.01). After adjusting all other variables, the associations of NLR and PLOS in Shamblin II had statistical significance(0.19 (0.09, 0.29), p < 0.01). Conclusions NLR as an indicator of inflammation, was a routinely collected but overlooked biomarker shows the relationship between inflammation and PLOS in patients suffered from CBT. Patients with a higher NLR had a longer PLOS.

目的 总结脑保护装置下行颈动脉支架成形术的术中精细化护理经验,为提升介入护理人员的业务水平提供参考.方法 分析2019年1月—2021年6月海军军医大学第一附属医院血管外科收治的189例脑保护装置下行颈动脉支架成形术的颈动脉狭窄患者的临床资料.结果 手术期间通过术前指导、心理护理、保暖护理、病情观察、静脉给药等精细化护理后,189例手术患者均成功,手术时间缩短至66±24 min,造影剂用量减少至186±50 ml,出血量减少至37±22 ml.其中58例患者术中出现一过性颈动脉窦反射,予以阿托品处理后恢复;2例患者术中因支架置入后压迫颈动脉窦压力感受器而引起血压下降,经予以血管活性药物对症处理后,术后第2天均恢复;所有患者在手术期间未出现脑梗死、严重高灌注等相关并发症.结论 护士在手术期间除了做好患者的术前指导、用药指导、心理护理、保暖护理等精细化护理外,还需在术中密切观察患者的血压、心率、神经系统症状,以及静脉给药后的反应,不但可以减少术中造影剂的使用剂量和手术期间脑梗死、严重高灌注等并发症的发生,而且也可以缩短手术时间,减少出血量,促进患者的术后恢复.

目的 评估自主研发的Castor分支型主动脉覆膜支架（简称Castor支架）治疗累及左锁骨下动脉（LSA）的Stanford B型主动脉夹层的中期治疗效果。方法 选择2018年12月—2020年6月间在海军军医大学第一附属医院使用Castor支架行胸主动脉腔内修复术（TEVAR）的Stanford B型主动脉夹层患者70例，其中男64例、女6例，年龄为（60.02±13.03）岁。所有患者均于全身麻醉下行TEVAR。记录围手术期和随访期间主要观察指标和次要观察指标。主要观察指标为患者全因死亡及夹层逆撕、脑梗死等主动脉夹层相关不良事件。次要观察指标：术前测量主动脉夹层近端锚定区主动脉直径、LSA开口与主动脉夹层近端裂口距离、LSA开口与主动脉夹层近端边缘距离、LSA起始部直径、左颈总动脉（LCA）开口远端与LSA开口近端距离，手术完成情况、手术时间、术中对比剂使用量，住院时间、随访时间，内漏、支架闭塞等并发症情况，Castor支架主体近端及远端直径、分支支架直径，主动脉主体支架近端和远端放大率。结果 主要观察指标：围手术期3例患者发生主动脉夹层相关不良事件（夹层逆撕1例，脑梗死2例）,随访期间5例患者死亡（夹层逆撕破裂1例，呼吸衰竭1例，心力衰竭1例，脑出血2例）。次要观察指标：主动脉夹层近端锚定区主动脉直径为（31.63±3.16） mm, LSA开口与主动脉夹层近端裂口距离为（45.79±19.60）mm, LSA开口与主动脉夹层近端边缘距离为（8.14±14.37） mm, LSA起始部直径为（11.35±1.45） mm, LCA开口远端与LSA开口近端距离为（8.44±2.44） mm。所有患者均顺利完成手术。手术时间为（109.63±44.65） min,术中对比剂使用量为（200.79±35.11） mL,住院时间为（8.57±3.22） d,随访时间为（11.64±6.77）个月，6例患者失访。随访期间发生Ⅰb型内漏1例，分支支架闭塞1例。Castor支架主体近端直径为（32.43±3.45）mm、远端直径为（26.46±3.40）mm,分支支架直径为（10.92±4.08） mm。主动脉主体支架近端放大率为2.48%（0,3.45%）,主动脉主体支架远端放大率为0（-7.14%,4.35%）。结论 Castor分支型主动脉覆膜支架能够安全、有效地用于累及LSA的Stanford B型主动脉夹层的腔内治疗。

BackgroundCarotid body tumor (CBT) is a rare paraganglioma located at the carotid bifurcation. The red blood cell count, hemoglobin, and hematocrit are indexes to be evaluated in blood routine tests. The purpose of this study was to clarify their predictive value for temporary postoperative complications in patients that had undergone CBT surgery.MethodsThis retrospective trial included data from 169 patients received surgical treatment for CBT from October 2008 to September 2018 in this retrospective study. Postoperative follow-up was conducted under the guidance of both vascular surgeon and neurologist. The symptoms existed less than 2 years postoperatively were regarded as temporary injuries. The red blood cell count, hemoglobin, and hematocrit were obtained from the complete blood count results of the participants. Analyses of multilevel multivariable regression and descriptive statistics were conducted.ResultsThe baseline data showed no significant difference. Patients were predominantly women (53.8%), with a mean age of 42.6 years. The total incidence of temporary postoperative complications was 22 (13.0%), including transient ischemic attack (8, 4.7%), tongue bias (7, 4.1%), dysphagia (2, 1.2%), hoarseness (4, 1.8%), and eyelid ptosis (1, 2.4%). The univariate and multivariate regression analysis results revealed that the occurrence of temporary postoperative complications was increased with age [odd ratio (OR, 0.09; 95% CI (CI), 0.9–1.0; P = 0.014], length of operation time (OR, 1.0; 95% CI, 1.0–1.0; P = 0.005), Shamblin type II vs. I (OR, 0.1; 95% CI, 0.0–0.5; P = 0.008), red blood cell count postoperative (OR, 0.2; 95% CI, 0.1–0.8; P = 0.026), hemoglobin (OR, 0.9; 95% CI, 0.9–1.0; P = 0.011), and hematocrit (OR, 0.8; 95% CI, 0.7–1.0; P = 0.025). The smooth curve fitting showed that the trend of complications occurrence rate was reduced with the increase of patients’ postoperative red blood cell count, hemoglobin, and hematocrit. Gender, weight, length of operation, Shamblin type, postoperative red blood cell count, hemoglobin, and hematocrit were included in the risk model with AUC = 0.86.ConclusionThese patients with CBT who received surgical resection with low postoperative red blood cell, hemoglobin, or hematocrit had a high risk of temporary postoperative complications. The risk prediction model established for predicting temporary postoperative complications showed satisfactory prediction effects.

Background Aortic dissection is one of the most common emergency condition leading to internal organs or lower limb ischemia and aortic rupture. Herein, we described a reverse "cheese wire" endovascular fenestration repair (CWFER) in a patient with complicated abdominal aortic dissection which had never been reported. Case presentation A 62-year-old male presented abdominal tear-like pain and acute ischemia of the right lower extremity during the endovascular treatment of celiac trunk aneurysms. Computed tomography angiography (CTA) and digital subtraction angiography (DSA) showed abdominal aortic type B dissection with acute ischemia of the right lower extremity preoperatively. After a detailed preoperative examination, the patient then was performed a reverse CWFER. So far, the patient has been followed-up for 6 months, postoperative CTA demonstrated good stent-graft expansion and perfusion of bilateral common iliac arteries; also, no endoleak was detected. Conclusions The right iliac artery in this patient supplied by false lumen, which lead to acute ischemia of the right lower extremity, needed to be treated as an emergency and dealt with promptly. CWFER is a very high-risk treatment that requires the rich experience of vascular surgeon and accurate assessment of aortic dissection. After interventional treatment, the patient recovered uneventfully after 6 months' follow-up.

颈动脉粥样硬化与缺血性卒中关系密切,而斑块易损性对脑卒中的发生有重要影响.在动脉粥样硬化发展过程中,巨噬细胞全程参与斑块内炎症反应过程,是影响斑块稳定性改变的重要因素之一.巨噬细胞可通过分泌促炎因子等维持斑块内局部炎症反应;同时与T细胞和血管平滑肌细胞等相互作用,增强炎症反应,促进脂蛋白潴留[1].在颈动脉粥样硬化斑块内的巨噬细胞迁移能力降低,不利于炎症消退,持续的炎症会导致过多的巨噬细胞凋亡,凋亡细胞的内容物过度积累,斑块中坏死核心形成,即为动脉硬化晚期病变的特征[2].凋亡释放的基质金属蛋白酶(matrix metalloproteinase , MMP)可能导致血栓形成和斑块破裂[3],最终导致缺血性卒中事件的发生.因此,针对斑块微环境内的巨噬细胞,研究其作用并调控功能,进而影响斑块的稳定性,对于防治缺血性脑血管事件有重要意义.

目的 探讨支架辅助栓塞术(SAE)治疗宽基底型肾动脉瘤(RAA)患者的安全性和中远期疗效.方法 收集2011年2月至2019年5月于海军军医大学第一附属医院(上海长海医院)行SAE治疗的90例RAA患者的临床资料.观察患者的肾动脉瘤形态参数、肾小球滤过率(GFR)等临床资料,并对患者进行术后随访,了解患者术后生存、并发症等情况.结果 90例患者共有116个RAA瘤体.手术成功率为100％,围手术期间无死亡病例.13例患者出现并发症,其中发生主要围手术期并发症者3例,发生次要并发症者10例.围手术期未发生多脏器功能衰竭、急性心肌梗死等并发症.90例均获得1、12、24个月的随访,随访率100％.90例患者中,1例患者在术后1个月出现肾功能不全,2例患者分别在术后3、4个月时出现肾功能衰竭,2例患者在术后1个月检查时发现穿刺点假性动脉瘤,3例患者在术后12个月时复查出现肾动脉支架再狭窄.结论 SAE可以安全、有效地治疗宽基底RAA或位于肾动脉分支动脉的RAA患者,技术成功率高,具有良好的中远期结果.

Objective:To explore the role and mechanism of Talin-1 in mouse aortic dissection.Methods:Sixty male FVB mice were evenly divided into groups of blank, model, Talin-1 up-regulation, Talin-1 up-regulation control, Talin-1 down-regulation, and Talin-1 down-regulation control. Except mice in the blank group, mice were treated with β-aminopropionitrile (BAPN) combined with angiotensin to construct a mouse aortic dissection model. Hematoxylin-eosin and vascular elastic fiber staining (EVG) were used to observe the aorta and elastic fiber morphology and structure. Western blot was used to detect the phosphorylation levels of FAK and ERK1 / 2 in mouse aortic tissue.Results:The success rate of aortic dissection in model mice was 70%, and there was no aortic dissection appeared in the blank group.No mice died during the experiment. The incidence of aortic dissection in the Talin-1 down-regulated group was 100%, which was significantly higher than that in the Talin-1 down-regulated control group( P<0.05). The incidence of aortic dissection in the Talin-1 up-regulated group was 20%, significantly lower than that in the Talin-1 up-regulated control group. The wall thickness of the aorta of mice in the Talin-1 down-regulated group was accompanied by hematoma or pseudocavity formation. The median elastic fiber content was higher than that in the Talin-1 downregulation control group( P<0.05). The content of elastic fibers in the blood vessel wall of mice in the Talin-1 up-regulation group was significantly higher than that in the Talin-1 up-regulation control group.The down-regulation of Talin-1 significantly inhibited FAK phosphorylation, and instead promoted ERK1/2 phosphorylation( P<0.05). Conclusions:Down-regulation of Talin-1 may reduce the elastic fiber content in the aorta of mice by activating the ERK1/2 signaling pathway, leading to vascular remodeling of the aortic wall and promoting the occurrence of aortic dissection.

目的 探索颈动脉钙化分数与颈动脉狭窄患者行CAS术后发生脑高灌注综合征(cerebral hyperperfusion syndrome,CHS)的相关性.方法 回顾性分析2017年3月至2019年10月上海长海医院收治的颈动脉狭窄行CAS手术的127例患者临床资料,通过术前CTA检查资料以钙化积分评估患者颈动脉钙化程度,根据患者术后CHS的发生情况分为CHS组(33例)和对照组(94例)并进行比较.结果 CHS组颈动脉钙化评分显著高于对照组,差异有统计学意义(P<0.05).钙化积分在低于458分时,每增加10分CAS术后CHS风险降低4％;在≥458分时,每增加10分CAS术后CHS风险增加13％.使用糖尿病分层后的单因素分析发现,颈动脉钙化积分每增加10分,CAS术后CHS发生风险增加24％,差异有统计学意义(P<0.001).结论 早期钙化可能是CAS术后CHS的保护因素,而晚期颈动脉钙化程度越高,术后发生CHS的风险越大.