The RNA-binding zinc finger protein 36 (ZFP36) family participates in numerous physiological processes including transition and differentiation through post-transcriptional regulation. ZFP36L1 is a member of the ZFP36 family. This study aimed to evaluate the role of ZFP36L1 in restenosis. We found that the expression of ZFP36L1 was inhibited in VSMC-phenotypic transformation induced by TGF-β, PDGF-BB, and FBS and also in the rat carotid injury model. In addition, we found that the overexpression of ZFP36L1 inhibited the proliferation and migration of VSMCs and promoted the expression of VSMC contractile genes; whereas ZFP36L1 interference promoted the proliferation and migration of VSMCs and suppressed the expression of contractile genes. Furthermore, the RNA binding protein immunoprecipitation and double luciferase reporter gene experiments shows that ZFP36L1 regulates the phenotypic transformation of VSMCs through the posttranscriptional regulation of KLF16. Finally, our research results in the rat carotid balloon injury animal model further confirmed that ZFP36L1 regulates the phenotypic transformation of VSMCs through the posttranscriptional regulation of KLF16 and further plays a role in vascular injury and restenosis in vivo.

Abdominal aortic aneurysm (AAA) is a life-threatening disease and there is currently a lack of effective treatment to prevent it rupturing. ScRNA-seq studies of AAA are still lacking. In the study, we analyzed the published AAA scRNA-seq datasets from the mouse elastase-induced model, CaCl2 treatment model, Ang II-induced model and human by using bioinformatic approaches and in silico analysis. A total of 26 cell clusters were obtained and 11 cell types were identified from multiple mouse AAA models. Also, the proportion of Mφ/Mo increased in the AAA group and Mφ/Mo was divided into seven subtypes. There were significant differences in transcriptional regulation patterns of Mφ/Mo in different AAA models. The enrichment pathways of upregulated or downregulated genes from Mφ/Mo in the three mouse datasets were different. The actived regulons of Mφ/Mo had strong specificity and the repressed regulons showed high consistency. The co-upregulated genes as well as actived regulons and co-downregulated genes as well as repressed regulons were closely correlated and formed regulatory networks. Mφ/Mo from human AAA dataset was divided into five subtypes. The proportion of three macrophage subpopulations increased but the proportion of two monocyte subpopulations decreased. In the AAA group, the upregulated or downregulated genes of Mφ/Mo were enriched in different pathways. After further analyzing the genes in Mφ/Mo of both mouse and human scRNA-seq datasets, two genes were upregulated in the four datasets, IL-1B and THBS1. In conclusion, in silico analysis of scRNA-seq revealed that Mφ/Mo and their regulatory related genes as well as interaction networks played an important role in the pathogenesis of AAA.

Objective:To investigate the risk factors associated with post-thrombotic syndrome (PTS) within 2 years after the first diagnosis of deep venous thrombosis (DVT) of the lower extremities.Methods:The clinical data and 2-year follow-up data of 260 patients who were first diagnosed with DVT at our department from Jan 2017 to May 2019 were retrospectively analyzed.By Villalta score, the patients were divided into non-PTS group, mild PTS group and moderate-severe PTS group. Ordered multiple classification logistic regression was used to analyze the risk factors for the development of PTS.Results:The incidence of mild and moderate-severe PTS was 22.7% and 15.8%, respectively. Multivariate Logistic regression analysis showed that recurrence history of DVT ( OR=4.754, 95% CI 1.84-12.01, P=0.001), duration of oral anticoagulation treatment ≤6 months (0-3 months: OR=7.791, 95% CI 1.79-33.90, P=0.006; 4-6 months: OR=4.242, 95% CI 1.13-15.99, P=0.033), time length of stretch sock wearing≤ 12 months (0-6 months: OR=9.708, 95% CI 1.81-52.14, P=0.008; 7-12 months: OR=4.899, 95% CI 1.42-16.88, P=0.012) and exercise frequency ≤4 times/week (1-2 times/week: OR=7.691, 95% CI 1.92-30.72, P=0.004; 3-4 times/week: OR=4.284, 95% CI 1.33-13.80, P=0.015) were risk factors for PTS. Catheterized thrombolytic therapy ( OR=0.436, 95% CI 0.20-0.96, P=0.039) and low body mass index (BMI<18.5 kg/m 2: OR=0.142, 95% CI 0.02-0.81, P=0.028), central thrombus ( OR=0.322, 95% CI 0.15-0.72, P=0.005) and peripheral thrombus ( OR=0.020, 95% CI 0.01-0.07, P<0.001) were protective factors for PTS. Conclusions:Patients with DVT have a high risk of developing PTS within 2 years. Catheter-directed thrombolysis, no history of recurrence of DVT, low BMI (<18.5 kg/m 2), central or peripheral thrombosis, long-term oral anticoagulant therapy (≥7 months), longer wearing time of elastic socks (≥1 year), and higher exercise frequency (≥ 5-6 times/week) can be conducive to the reduction of incidence and severity of PTS.

目的 分析不同的腔内治疗方式在短段股腘动脉硬化闭塞症患者中的临床效果.方法 收集2018年1月至2021年6月郑州大学第一附属医院血管外科收治的74例应用不同腔内治疗方式的短段股腘动脉硬化闭塞症患者的临床资料,其中血管腔内治疗方式包括药物涂层球囊(DCB)、金属裸支架植入术(BMS)、普通球囊扩张成形术(POBA)3种方式.根据腔内治疗方式将其分为DCB组、BMS组、POBA组,对比术前术后不同时间的Rutherford分级、踝肱指数、一期通畅率及再狭窄率、不良事件发生率、再干预率.结果 3组术后踝肱指数及Rutherford分级均较术前改善(P<0.05);术后12个月,DCB组、BMS组的Rutherford分级、踝肱指数、一期通畅率均优于POBA组(P<0.05);术后12个月,DCB组、BMS组较POBA组一期通畅率高,DCB组较BMS组、POBA组再狭窄率低(P<0.05);3组不良事件发生率、术后12个月内再干预率比较,差异无统计学意义(P>0.05).结论 DCB与BMS治疗短段股腘动脉硬化闭塞症的近期效果相当且均优于POBA,DCB相较于BMS与POBA能够降低再狭窄率.

Autophagy is a process in which lysosome-mediated intracellular damage or aging organelles and proteins are degraded to produce amino acids, fatty acids, ATP, etc., and then reused by cells. Under normal physiological conditions, cardiomyocytes maintain low levels of autophagy. However, autophagy is activated during myocardial ischemia-reperfusion (MI/R), and autophagosomes increase significantly, indicating that autophagy plays an important role in myocardial ischemia-reper fusion injury (MI/RI). Studies have shown that autophagy has protective and detrimental effects on MI/RI and is regulated by a variety of factors. This article reviews the relationship between autophagy and MI/RI.

The molecular mechanism of AAA formation is still poorly understood and has not been fully elucidated. The study was designed to identify the immune-related genes, immune-RAS in AAA using bioinformatics methods. The GSE175683 datasets were downloaded from the GEO database. The DEseq2 software was used to identify differentially expressed genes (DEGs). SUVA pipeline was used to quantify AS events and RAS events. KOBAS 2.0 server was used to identify GO terms and KEGG pathways to sort out functional categories of DEGs. The CIBERSORT algorithm was used with the default parameter for estimating immune cell fractions. Nine samples from GSE175683 were used to construct the co-disturbed network between expression of SFs and splicing ratio of RAS events. PCA analysis was performed by R package factoextra to show the clustering of samples, and the pheatmap package in R was used to perform the clustering based on Euclidean distance. The results showed that there were 3,541 genes significantly differentially expressed, of which 177 immune-related genes were upregulated and 48 immune-related genes were downregulated between the WT and WTA group. Immune-RAS events were mainly alt5P and IR events, and about 60% of it was complex splicing events in AAA. The WT group and the WTA group can be clearly distinguished in the first principal component by using the splicing ratio of immune-RAS events. Two downregulated genes, Nr4a1 and Nr4a2, and eight upregulated genes, Adipor2, Akt2, Bcl3, Dhx58, Pparg, Ptgds, Sytl1, and Vegfa were identified among the immune-related genes with RAS and DEGs. Eighteen differentially expressed SFs were identified and displayed by heatmap. The proportion of different types of cells and ratio of the average ratio of different cells were quite different. Both M1 and M2 types of macrophages and plasma cells were upregulated, while M0 type was downregulated in AAA. The proportion of plasma cells in the WTA group had sharply increased. There is a correlation between SF expression and immune cells/immune-RAS. Sf3b1, a splicing factor with significantly different expression, was selected to bind on a mass of immune-related genes. In conclusion, our results showed that immune-related genes, immune-RAS, and SFs by genome-wide identification were involved in AAA.

目的:探讨Straub Aspirex机械性血栓清除术(PMT)联合导管接触性溶栓治疗(CDT)对下肢深静脉血栓(DVT)的有效性和安全性.方法:回顾性分析郑州大学第一附属医院血管外科2019-01-2021-08期间66例下肢DVT的临床资料,其中采用PMT+CDT联合治疗33例(PMT+CDT组),单纯CDT治疗33例(CDT组).分别记录两组的肢体消肿率、血栓清除率、并发症、尿激酶应用剂量、住院时间、住院花费以及随访过程中Villalta评分与血栓复发情况等的差异.结果:PMT+CDT组与CDT组的临床成功率无统计学差异(100％vs 93.48％,P＞0.05).术后PMT+CDT组较CDT组大腿消肿率(63.7±19.3％vs 34.7±17.7％)以及小腿消肿率[65.60(47.70-79.20)％vs 42.50(25.00-64.60)％]更高,差异具有统计学意义(P＜0.01).同时 PMT+CDT 组血栓清除率更高[82.60(75.00-100.00)％vs 65.20(52.70-77.50)％,P＜0.01],尿激酶使用量更低[(322.60±244.20)×104U vs(552.00±193.00)×104U,P＜0.01],住院时间更短[12.60(11.00-14.50)天 vs 15.70(12.00-18.50)天,P＜0.05],但住院费用更高[986 288.30(3 265.30-111 681.20)元 vs 67 301.70(60 768.10-79 575.70)元,P＜0.01].两组出血事件差异无统计学意义(P＞0.05).在随访期内,PMT+CDT组和CDT组分别有2例和7例发生血栓后综合症(PTS),差异无统计学意义(P＞0.05),但PMT+CDT组Villalta评分低于CDT组[1.55(0.50-2.00)分 vs 3.09(1.50-4.00)分,P＜0.05].PMT+CDT 组再狭窄发生率少于 CDT 组(0％vs 15.15％,P＜0.05).结论:PMT联合CDT与单纯CDT治疗DVT均具有良好的疗效和安全性.前者在血栓溶解率、肢体消肿率、尿激酶使用量以及住院时间等方面优势明显,再狭窄发生率也更低,值得推广应用.

目的 观察下肢深静脉血栓(LDVT)患者发病特点及红细胞各项指标的分布情况,探讨红细胞与血栓解剖位置的关系.方法 收集郑州大学第一附属医院2016年1月-2016年12月1 421例诊断LDVT患者,根据血栓的解剖位置分为三组,回顾性收集并分析红细胞相关指标的数据.结果 下肢静脉血栓患者总体偏向中老年(60.0±15.2岁),无论是B组(周围型除外孤立性肌间静脉血栓)与A组(肌间静脉血栓)比较,还是C组(中央型+混合型)与A组比较,回归分析显示年龄越大,患者越倾向于肌间静脉血栓(OR值分别为0.979和0.964,95％CI分别为0.970,0.988,0.954,0.974);B组与A组相比,女性患者更倾向于肌间静脉血栓(OR值为1.666,95％CI为1.286,2.158);红细胞相关指标在三组之间无明显统计学差异(P＞0.05),仅血红蛋白方面,A组和B组明显高于C组(P＜0.05),但在对三组进行回归分析时,结果显示Hb无明显统计学差异(P＞0.05).结论 红细胞相关指标在三组间无明显统计学差异;结合三组间数据对比及回归分析结果,可见高龄女性患者,出现下肢肿胀或疼痛,应警惕下肢肌间静脉血栓形成的可能.

目的:评估俯卧位超声引导腘动脉穿刺入路治疗复杂股浅动脉慢性闭塞性(CTO)病变的安全性和有效性.方法:回顾性分析2016年1月至2019年1月采用俯卧位超声引导腘动脉逆行穿刺入路进行血管腔内治疗的复杂股浅动脉CTO病变患者的临床资料.符合条件的126例患者中男性81例,女性45例,平均年龄(65.3±9.7)岁,共178条股浅动脉,平均闭塞长度(17.3±7.8)cm.所有患者均采用俯卧位超声引导腘动脉穿刺入路,导丝配合导管逆向开通股浅动脉闭塞段,必要时行对侧腘动脉穿刺使用SAFARI双向开通技术,建立轨道导丝并全身肝素化后行球囊并支架置入.结果:178条股浅动脉CTO病变中172条血管开通成功,技术成功率96.6％.术后踝肱指数(ABI)较术前明显提高(0.93±0.21 vs 0.38±0.19,P<0.01),提高幅度>0.15;随访1年ABI值均明显高于术前(P<0.05).191处穿刺点共31处(16.2％)发生并发症,均不需要手术或介入处理.随访1年累计一期通畅率82.8％,辅助通畅率93.1％,二期通畅率97.4％.结论:俯卧位超声引导腘动脉穿刺入路治疗复杂股浅动脉CTO病变安全有效,可作为股动脉的替代入路选择.

Metformin has been shown to protect myocardial ischaemia/reperfusion or hypoxia/reoxygenation injury. In our current study, we investigated the effects of metformin on autophagy and its possible underlying mechanisms in in vivo myocardial infarction (MI) model and in vitro oxygen-glucose deprivation (OGD) model. A rat model of MI was made by ligating coronary artery in vivo study. Metformin (200 mg/kg/day) could improve cardiac function, prevent rats from MI-induced injury by reducing myocardial infarct size and apoptosis. Moreover, metformin furtherly promoted autophagy by increasing the protein expression of LC3-II, ATG5, ATG7 and Beclin1, and by involving AMPK pathway during MI. H9c2 cells were treated with metformin (4 mM) in vitro study to assess its effects after exposure to OGD. Metformin increased cell viability and inhibited OGD-induced LDH synthesis and cell apoptosis. Furthermore, metformin increased autophagosome formations as well as expression of autophagy-related proteins, promoted autophagic flux. In addition, metformin augmented the protein level of Bcl-2 and diminished the protein levels of Bax and cleaved caspase-3. Metformin also upregulated p-AMPK expression. Nevertheless, the above-mentioned effects of metformin on H9c2 cells were remarkably eliminated by compound C (an AMPK inhibitor). In summary, we displayed that metformin protected cardiomyocytes against OGD-induced injury and apoptosis by promoting autophagic flux through the AMPK pathway.

回顾性分析我院2002年9月至2017年8月诊治的6例颈内静脉瘤患者的临床资料。2例囊状瘤体内合并血栓形成，行瘤体部分切除加侧壁吻合术；1例梭状瘤体保守治疗过程中直径进行性增大，行瘤体切除加颈内静脉结扎术。3例患者接受了保守治疗，1例2岁患者保守治疗过程中颈内静脉恢复正常，另2例保守治疗过程中未发生相关并发症。我们认为对于颈内静脉瘤有症状、变大或影响美观的病例必要时可行手术治疗。

目的 观察经腘动脉入路逆行开通股浅动脉慢性闭塞性(chronic total occlusion,CTO)病变的安全性和有效性.方法 回顾性分析2012年3月至2019年3月本院收治的股浅动脉CTO病变患者的病历及1年随访资料.经传统股动脉(femoral artery,FA)入路顺行开通为FA组(2265例),俯卧位经腘动脉(popliteal artery,PA)入路逆行开通为PA组(216例).结果 两组技术成功、支架置入及围手术期(30 d)不良事件(死亡、动脉夹层、远端栓塞及穿刺相关并发症)发生率差异无统计学意义.FA组CTO设备使用率、手术操作及透射时间均明显高于PA组(P<0.05).1年随访一期通畅率、保肢生存率及主要不利于心脑血管事件(心肌梗死、脑卒中及任何原因的死亡)发生率差异均无统计学意义.结论 相比传统股动脉入路经腘动脉入路治疗股浅动脉CTO病变同样安全有效,可作为股动脉入路的替代选择.

Congenital dysfibrinogenemia is characterized with undetectable or low fibrinogen level by Clauss assay complicated by bleeding and/or thrombosis. These may lead to a diagnostic problem to some clinicians unfamiliar with this disease. We reported a case of congenital dysfibrinogenemia manifested as hemorrhage, repeated thrombosis, low fibrinogen levels through Clauss assay and but normal levels of fibrinogen through PT-derived tests. In conclusion, to patients with thrombosis complicated by decreased fibrinogen level, clinicians and laboratory physicians should be alert to the possibility of congenital dysfibrinogenemia.

目的 分析孤立性髂内动脉瘤(IIIAA)血管腔内治疗的安全性和有效性.方法 回顾性分析2008—2018年接受血管腔内治疗的21例IIIAA患者的临床资料,包括基础疾病、手术时间、手术方式、围手术期并发症等情况.结果 手术成功率为100％,平均手术时间(65.7±22.5)min,术后均恢复良好.术后平均住院时间(10.2±1.2)d,平均随访时间(24.1±10.2)个月,随访期间无IIAA相关死亡率和支架/支架移植相关并发症发生.21例CT随访中,动脉瘤直径稳定18例(85.71％),2例缩小(9.52％),1例(4.76％)增大.21例经增强CT评估,1例(4.76％)发生继发性内漏,1例需要继发性干预(4.76％).结论 IIIAA患者的血管腔内治疗是可行和安全的,且其创伤小、恢复快,可行性高,可替代传统开放手术治疗.

目的 对比同期与分期手术治疗非血栓性髂静脉受压综合征(NIVCS)的手术疗效.方法 回顾性分析2015年5月至2016年7月郑州大学第一附属医院收治的77例NIVCS患者的临床资料.其中同期经大隐静脉途径置入髂静脉支架并完成浅静脉手术36例,分期手术治疗41例.对比两组患者基本特征、手术细节、术后疗效、围手术期管理以及住院时间.结果 两组77例患者均成功完成手术治疗.同期手术组手术时间、住院时间短于分期手术组(均P＜0.05).同期组发生深静脉损伤及股动脉损伤较少,但差异无统计学意义(P＞0.05).同期与分期手术组手术中放置支架数量,术后3个月CEAP下降级别,术后6个月及12个月髂静脉通畅率比较,差异无统计学意义(均P＞0.05).结论 同期与分期手术治疗NIVCS安全性、有效性相近,但能缩短患者手术时间及住院时间.

The aim of the present study was to investigate the potential role of GAS8 antisense RNA 1 (GAS8-AS1) in papillary thyroid carcinoma (PTC). PcDNA3.1-GAS8-AS1 and si-GAS8-AS1, miR-135b-5p mimic and si-CCND2 were transfected into PTC cells. Cell proliferation was evaluated by Cell Counting Kit-8 (CCK-8). QRT-PCR was used to determine expressions of GAS8-AS1, miR-135b-5p, and CCND2, and Western blot were detected protein level of CCND2. The miRNA target gene prediction site TargetScan was used to predict potential targets of GAS8-AS1 and miR-135b-5p. Cell cycle progression was analyzed by flow cytometry. We found that GAS8-AS1 was down-regulated in PTC cell lines and inhibited proliferation and cycle of PTC cell. GAS8-AS1 directly targets miR-135b-5p, and GAS8-AS1 could regulate a downstream target of miR-135b-5p, Cyclin G2 (CCNG2), in an miR-135b-5p-mediated manner. In addition, we also proved that overexpressed GAS8-AS1 inhibited tumor formation in vivo. GAS8-AS1 suppresses PTC cell growth through the miR-135b-5p/CCND2 axis.

目的 对比分析药物涂层球囊(DCB)联合斑块旋切术与单纯DCB治疗下肢动脉硬化闭塞症(ASO)的有效性.方法 回顾性分析2016年9月至2017年12月收治的125例确诊为ASO的患者临床资料,根据手术方式分为DCB扩张联合silverhawk斑块旋切40例(A组)和单纯DCB扩张85例(B组),比较术后6和12个月Rutherford分级、ABI、靶血管最小管腔直径(MLD)、远期管腔丢失(LLL)、再狭窄率、靶血管血运重建率(TLR).结果 剔除死亡及失访者后,最终A组38例,B组79例.两组患者一般情况、危险因素、靶病变长度差异无统计学意义(P>0.05),术后6、12个月随访A组Rutherford分级、再狭窄率、LLL均低于B组,ABI、MLD均高于B组(P<0.05),TLR差异无统计学意义(P>0.05).结论 对于ASO,DCB联合斑块旋切术相比单纯DCB具有更好的近中期疗效.

OBJECTIVE:In this study, the diagnosis and treatment of patients with femoral vein compression from a synovial cyst of the hip joint were investigated. METHODS:A retrospective study was conducted to review hospital records from March 2010 to July 2017 of patients with femoral vein compression from a synovial cyst of the hip joint. The diagnostic procedure, duplex ultrasound results, computed tomography (CT), and magnetic resonance imaging (MRI) were recorded. The method and treatment outcomes were also documented. RESULTS:Fifteen patients with femoral vein compression resulting from a synovial cyst of the hip joint were identified. The mean age was 47.5 years, and nine of the patients (60%) were female. All patients had unilateral lower extremity edema. In 11 patients (73.3%), the mass in the groin area could not be palpated; 2 (13.3%) patients had venous insufficiency; and 2 (13.3%) patients had venous thrombosis. All patients received a duplex ultrasound examination, 4 (26.7%) patients received CT, and 11 (73.3%) patients received MRI. One patient received a duplex ultrasound-guided percutaneous needle aspiration; however, the cyst recurred 1 month later. The remaining 14 patients received surgical excision and had no cyst recurrence during the follow-up period (mean, 22.6 months). CONCLUSIONS:Duplex ultrasound should be selected as the first choice for screening of synovial cyst of the hip joint with femoral vein compression. Moreover, it can be used as the first choice for follow-up of these patients. MRI or CT can provide more anatomic information for surgical treatment. Surgical excision of the cyst is the preferred treatment method, with a lower rate of cyst recurrence compared with needle aspiration.

Objective To analyze the clinical features and risk factors of isolated calf deep vein thrombosis (ICDVT).Methods Age,gender,locations,clinical symptoms,and risk factors of the hospitalized patients who diagnosed with ICDVT in the Department of Vascular Surgery,the First Affiliated Hospital of Zhengzhou University in 2015 were retrospectively analyzed.Results 122 hospitalized ICDVT patients were enrolled,accounting for 25.7％ of the patients with lower extremity deep vein thrombosis.Among them,41 cases (33.6％) were male,81 cases(66.4％) were female.The average age was 56.41 ±13.87 years.49 cases (40.0％) had left lower limb ICDVT,39 cases (32.0％) had right lower limb ICDVT;34 cases (28.0％) had both two lower limbs involved.Muscular calf vein thrombosis accounted for 77.9％ (95 cases).76 cases (62.3％) were painful.91 cases (74.6％) had swelling.Common risk factors included age (≥ 45 years) (85.2％),deficiency of natural anticoagulants (83.0％),surgery (45.9％) and malignant tumors (28.7％).Conclusions Pain and swelling were the main clinical symptoms of ICDVT.Age ≥ 45 years,deficiency of natural anticoagulants,surgery,and malignancy were main risk factors of ICDVT.

目的 探讨激光联合大隐静脉高位结扎术治疗老年下肢静脉曲张的疗效.方法 选择2011年1月至2014年12月来该院治疗的下肢静脉曲张患者150例,均为单侧患肢,随机分成对照组和观察组各75例.对照组患者采用大隐静脉高位结扎术联合分段抽剥术进行治疗.观察组患者采用大隐静脉高位结扎术联合激光共同治疗.结果 观察组患者术中出血量、手术时间少于对照组,切口数量＞1个的患者少于对照组,术后疼痛程度优于对照组,术后下床活动时间、住院时间短于对照组(均P＜0.01).结论 采用激光联合大隐静脉高位结扎术治疗老年患者下肢静脉曲张疗效显著,能有效缩短住院时间,减轻患者疼痛,减少患者术中出血量.