Neurovascular implants for stroke intervention face a critical dilemma: permanent devices (e.g., nitinol stents, platinum coils) often trigger chronic inflammation and recurrence, whereas biodegradable alternatives (Mg, Fe, Zn alloys) lack radiopacity or raise neurotoxicity concerns. Here, we introduce φ50 µm molybdenum (Mo) wire braided implants that integrate procedural efficacy with biological safety. Mo demonstrates negligible hemolysis (<5%), platelet-inert surfaces, and preserved coagulation kinetics, together with robust cytocompatibility across neurovascular unit cells (endothelia, astrocytes, neurons) under both physiological and ischemia-reperfusion conditions. In vivo, Mo stent wires implanted in rodent carotids maintained blood homeostasis, organ integrity, and neurological function without systemic toxicity. Moreover, braided 2D Mo coils achieved durable aneurysm occlusion with controlled inflammatory resolution and progressive endothelialization, closely resembling clinical performance. Importantly, Mo ions showed no detectable accumulation in brain, kidney, lung, or spleen, attributable to renal clearance and blood-brain barrier selectivity. By coupling intrinsic radiopacity with homogeneous, moderate corrosion, Mo addresses long-standing limitations of existing biodegradable alloys. These findings position Mo as a transformative candidate for next-generation neurovascular devices, harmonizing biodegradability, safety, and imaging precision to redefine the management of both ischemic and hemorrhagic stroke.

Inflammatory bowel disease (IBD) is characterized by excessive generation of reactive oxygen species and reactive nitrogen species (RONS) within the pro-inflammatory microenvironment. Conventional treatments often have serious side effects, making IBD management challenging. Here, a new cerium cluster, Ce12, with a formula of [Ce12(μ 3-O)8(μ 3-OH)8(μ 2-OH)6(ADA)18]∙3H2O∙3CH3CN (ADA- = 1-adamantanecarboxylate) was prepared and capped with β-cyclodextrin (β-CD) through self-assembly process involving the adamantane moiety of Ce12 and β-CD, resulting in Ce12@CD nanoparticles (NPs). Ce12@CD NPs, with good stability and biocompatibility, exhibit excellent reactive RONS scavenging activities due to the presence of a fraction of Ce3+ ions, offering potential for treating inflammatory diseases. Treatment significantly alleviated body weight loss, colon length reduction, and pathological injury of colon in mice with dextran sodium sulfate (DSS)-elicited colitis, thereby repairing the intestinal mucosal barrier and reducing inflammation. RNA sequence analysis revealed that the therapeutic effects of Ce12@CD NPs are highly correlated with IL-17 and TNF signaling pathways, thereby reducing inflammatory factors such as IL-1β and TNF-α, and alleviating intestinal inflammation. Additionally, Ce12@CD NPs successfully modulated DSS-induced gut microbiota imbalances. This work highlights the unique catalytic activity of Ce12@CD NPs in removing RONS and mimicking biological enzymes, showcasing their potential therapeutic applications for inflammatory disorders.

It is desirable to develop a free radical generator that is neither dependent on hydrogen peroxide nor external stimuli-triggered to achieve effective tumor treatment. Herein, the free radical generator MNPs-mCPBA was constructed with Zn 0.4 Co 0.6 F e2 O 4 @Zn 0.4 Mn 0.6 Fe 2 O 4 nanoparticles (MNPs) and 3chloroperbenzoic acid (mCPBA). We believe that the iron (II) on the surface of MNPs-mCPBA maybe represent high reactive activity and promote the generation of a large number of organic free radicals (C 6 H 4 ClCOOO & BULL;) in an acidic tumor microenvironment, which realizes the acid-dependent tumor treatment strategy independent on the H 2 O 2 level in tumors. In addition, the generated organic free radicals (C 6 H 4 ClCOOO & BULL;) effectively induced immunogenic cell death (ICD) and increased T cell infiltration. Under the synergetic treatment with an anti-PD-L1 antibody ( & alpha;-PD-L1), a favorable anti-tumor effect was achieved. & COPY; 2023 Published by Elsevier Ltd on behalf of The editorial office of Journal of Materials Science & Technology.

Singlet oxygen (1O2), an excellent reactive oxygen species (ROS) for tumor therapy, has garnered significant attention recently. However, its production is hindered by the low oxygen content in solid tumors characterized by hypoxia. Consequently, it is urgent to develop an O2-independent generator. In this study, we present a novel nano-assembly composed of manganese (III) phthalocyanine complex (MnClPc) encapsulated by human serum albumin (MnClPc@HSA). MnClPc@HSA serves as a conventional sonosensitizer, facilitating the conversion of O2 to 1O2 under ultrasonic stimulation (US). Moreover, MnClPc@HSA enables the conversion of endogenous hydrogen peroxide (H2O2) within tumor to superoxide radical (center dot O2-) and 1O2 and further enhanced by US. This O2-independent generation of multiple ROS by MnClPc@HSA overcomes the limitations imposed by tumor hypoxia, while inducing immunogenic cell death (ICD) and enhancing the infiltration of T cells as well. When combined with conventional PD-L1 immunotherapy, this approach effectively inhibits the proliferation of distal and lung-metastatic tumors, while concurrently eliminating primary tumors in the bilateral-tumor model of 4 T1 tumor-bearing mice.

Magnetic resonance imaging (MRI) is instrumental in the noninvasive evaluation of tumor tissues in patients subjected to chemotherapy, thereby yielding essential diagnostic data crucial for the prognosis of tumors and the formulation of therapeutic strategies. Currently, commercially available MRI contrast agents (CAs) predominantly consist of mononuclear gadolinium(III) complexes. Because there is only one Gd(III) atom per molecule, these CAs often require administration in high doses to achieve the desired contrast quality, which inevitably leads to some adverse events. Herein, we develop a six-nuclei, apoptosis-targeting T-1 CA, Gd-6-ZnDPA nanoprobe, which consists of a hexanuclear gadolinium nanocluster (Gd-6) with an apoptosis-targeting group (ZnDPA). The amplification of Gd(III) by the hexanuclear structure generates its high longitudinal relaxivity (44.67 mM(-1) s(-1), 1T) and low r(1)/r(2) ratio (0.68, 1T). Based on the Solomon-Bloembergen-Morgan (SBM) theory, this notable improvement is primarily ascribed to a long correlation tumbling time (tau(R)). More importantly, the Gd-6-ZnDPA nanoprobe shows excellent tumor apoptosis properties with an enhanced MR signal ratio (similar to 74%) and a long MRI imaging acquisition time window (similar to 48 h) in 4T1 tumor-bearing mice. This study introduces an experimental gadolinium-based CA for the potential imaging of tumor apoptosis in the context of MRI.

Acute ischemic stroke (AIS) afflicts millions of individuals worldwide. Despite the advancements in thrombolysis and thrombectomy facilitating proximal large artery recanalization, the resultant distal hypoperfusion, referred to "no-reflow" phenomenon, often impedes the neurological function restoration in patients. Over half a century of scientific inquiry has validated the existence of cerebral "no-reflow" in both animal models and human subjects. Furthermore, the correlation between "no-reflow" and adverse clinical outcomes underscores the necessity to address this phenomenon as a pivotal strategy for enhancing AIS prognoses. The underlying mechanisms of "no-reflow" are multifaceted, encompassing the formation of microemboli, microvascular compression and contraction. Moreover, a myriad of complex mechanisms warrant further investigation. Insights gleaned from mechanistic exploration have prompted advancements in "no-reflow" treatment, including microthrombosis therapy, which has demonstrated clinical efficacy in improving patient prognoses. The stagnation in current "no-reflow" diagnostic methods imposes limitations on the timely application of combined therapy on "no-reflow" post-recanalization. This narrative review will traverse the historical journey of the "no-reflow" phenomenon, delve into its underpinnings in AIS, and elucidate potential therapeutic and diagnostic strategies. Our aim is to equip readers with a swift comprehension of the "no-reflow" phenomenon and highlight critical points for future research endeavors.

Endovascular treatment (EVT) using stents has become the primary option for severe cerebrovascular stenosis. However, considerable challenges remain to be addressed, such as in-stent restenosis (ISR) and late thrombosis. Many modified stents have been developed to inhibit the hyperproliferation of vascular smooth muscle cells (SMCs) and protect vascular endothelial cells (VECs), thereby reducing such complications. Some modified stents, such as those infused with rapamycin, have improved in preventing acute thrombosis. However, ISR and late thrombosis, which are long-term complications, remain unavoidable. Panax notoginsengsaponin (PNS), a traditional Chinese medicine consisting of various compounds, is beneficial in promoting the proliferation and migration of VECs and inhibiting the proliferation of SMCs. Herein, a 3D-printed polycaprolactone (PCL) stent loaded with PNS (PNS-PCL stent) was developed based on a previous study. In vitro studies confirmed that PNS promotes the migration and proliferation of VECs, which were damaged, by increasing the expression levels of microRNA-126, p-AKT, and endothelial nitric oxide synthase. In vivo, the PNS-PCL stents maintained the patency of the carotid artery in rabbits for up to three months, outperforming the PCL stents. The PNS-PCL stents may present a new solution for the EVT of cerebrovascular atherosclerotic stenosis in the future.

Biodegradable stents are considered a promising strategy for the endovascular treatment of cerebrovascular diseases. The visualization of biodegradable stents is of significance during the implantation and long-term follow-up. Endowing biodegradable stents with X-ray radiopacity can overcome the weakness of intrinsic radioparency of polymers. Hence, this work focuses on the development of an entirely X-ray visible biodegradable stent (PCL-KIO3) composed of polycaprolactone (PCL) and potassium iodate via physical blending and 3D printing. The in vitro results show that the introduction of potassium iodate makes the 3D-printed PCL stents visualizable under X-ray. So far, there is inadequate study about polymeric stent visualization in vivo. Therefore, PCL-KIO3 stents are implanted into the rabbit carotid artery to evaluate the biosafety and visibility performance. During stent deployment, the visualization of the PCL-KIO3 stent effectively helps to understand the position and dilation status of stents. At 6-month follow-up, the PCL-KIO3 stent could still be observed under X-ray and maintains excellent vessel patency. To sum up, this study demonstrates that PCL-KIO3 stent may provide a robust strategy for biodegradable stent visualization.

Histopathology evaluation and lymphadenectomy of node-positive patients is the usual procedure in clinical therapy. However, it requires days for the histopathology result analysis, which impedes intraoperative decision-making and immediate treatment. Noninvasive real-time imaging of metastatic lymph nodes can overcome these defects and help medical workers evaluate lymph nodes and make the operation decision more efficiently. Herein we developed iridium(iii)-cyanine complex/bovine serum albumin (BSA)-based nanoparticles which are conjugated with folic acid (FA) (IrCy-FA NPs). The synthesized IrCy-FA NPs exhibit good biocompatibility, strong near-infrared absorption, and impressive lymph node accumulation and can serve as a photoacoustic (PA) imaging probe for lymph node imaging. Besides, the lymph nodes enriched with IrCy-FA NPs showing green color are easily visible to the naked eye, suggesting their potential as an intraoperative indicator. The real-time PA imaging with excellent contrast and high spatial resolution can promote efficient and reliable quantitative analysis of lymph nodes in vivo. By employing IrCy-FA NPs as the PA agent for lymph node imaging, we achieve effective pre-operative and post-operative evaluations of metastatic lymph nodes in lymphadenectomy. This study may provide helpful information for PA imaging guided colocalization and evaluation of lymph nodes and facilitate this method towards clinical trials.

BACKGROUND:Posterior communicating artery (PcomA) aneurysms are more likely to recanalize than anterior communicating artery (AcomA) aneurysms. However, it is still unclear whether the recanalization rate of these aneurysms is a result of involvement from the fetal posterior cerebral artery (fPCA) in PcomA aneurysms and variation of the unilateral A1 segment in AcomA aneurysms. The purpose of this study is to retrospectively evaluate the different recanalization rates between PcomA aneurysms with fPCA and AcomA aneurysms with a variation of the unilateral A1 segment.METHODS:We retrospectively collected information regarding 214 patients, each with communicating segment aneurysms between January 2013 and January 2020. Follow-up documentation on clinical and imaging data was comparatively analyzed between variant types, and recanalization rates of the variant and normal types were analyzed by stratification.RESULTS:Of the 84 variant-type aneurysms (PcomA with fPCA and AcomA with a variation of the unilateral A1 segment, 41/43), complete recanalization occurred in 23 patients (27.4%), and it was significantly more likely to occur in PcomA aneurysms with fPCA (39.1%) than in AcomA aneurysms with a variation of the unilateral A1 segment (16.3%). Stent-assisted coil embolization (SACE) has been shown to reduce recanalization (OR =0.092, 95% CI: 0.011 to 0.790, P=0.03). Additionally, variant types and the normal type (non-fetal, 106, and bilateral A1 symmetry, 24) have different odds ratios (OR) of recanalization (P=0.04), and the OR of the variant subtypes was significant, unlike the normal type (P=0.49).CONCLUSIONS:This study suggests that PcomA aneurysms with fPCA are more likely to recanalize than AcomA aneurysms with a variation of the unilateral A1 segment.

Biodegradable stents have become the focus of attention in the field of interventional medicine. Compared to non-biodegradable stents, these stents are designed to degrade, leaving behind regenerating healthy arteries. In addition to biodegradability, customizability and anticoagulation are also important for stent treatments. The combination of magnetic resonance angiography (MRA) and 3D printing can customize coronary stents according to different vascular geometries of patients. Therefore, this work focused on the rapid fabrication of stents composed of polycaprolactone (PCL) by 3D printing and then functionalized the stents with heparin via covalent grafting. The 3D printed stents were implanted into the abdominal aorta of rabbits to evaluate the feasibility of implantation and biocompatibility. Mechanical tests showed that 3D printed stents have good mechanical properties. In vitro data demonstrated that the stents had excellent blood compatibility and cytocompatibility. The heparinized PCL(PCL-NH2-Hep) stent can promote the adhesion, spreading and proliferation of human umbilical vein endothelial cells (HUVECs) and inhibit the excessive proliferation of smooth muscle cells (SMCs). Presently, there is insufficient study about 3D printed stent implantation in rabbit arteries. Hence, personalized stents were prepared via MRA and 3D printing, which tailored to the patient's unique anatomy. A 3D printed stent-balloon delivery system was employed to deliver stents to the abdominal aorta. At 3-month follow-up, the PCL-NH2-Hep stent maintained good vascular patency. Moreover, the heparinized stents showed rapid endothelialization and prevention of neointimal restenosis in vivo. This study demonstrated that personalized PCL-NH2-Hep stent may have the potential in the field of biodegradable coronary artery stents.

Purpose: The study of Willis covered stent implantation on life-threatening hemorrhage from Radiation Internal Carotid Blowout Syndrome (RICBS) in patients with Nasopharyngeal Cancer (NPC) was evaluated in our hospital. Materials and Methods: Five NPC patients (3 male and 2 female patients) received Willis covered stent implantation from April 2011 to March 2017, in which radiation induced hemorrhage occurred in Internal Carotid Artery (ICA) was included in this study. The median age in the patient cohort was 56 (47-63). All patients were previously treated with radiotherapy (4 received IMRT and 1receivedheavy-ion RT). The median time was four years before the ICA ruptures after irradiation. The RICBS involved the C2 segment of the ICA in three patients and C3 in two patients. Results: All five patients’ ICA bleeding stopped immediately after the operation of Willis covered stent implantation. Follow-up mean time is 10 months. One patient died of suffocation (nasal hematorrhea) 2 weeks after the operation, in which the skull base is involved from recurrent lesions and associated dysphagia. One patient had rehaemorrhagia a week after the operation. One patient died of other accident 15 months after the operation. No adverse effects such as stroke and ischemia were found in all five patients during the follow-up period. Conclusion: The Willis covered stent implantation can immediately stop the bleeding caused by RICBS to save lives immediately. It is an effective and practical method to treat RICBS in NPC patients or other head and neck cancers patients, especially for the radiation-induced vascular events

Yong-Dong Li (  dr_liyongdong@sina.com ) Shanghai Jiao Tong University A liated Sixth People's Hospital, Shanghai, China Yue-Qi Zhu Shanghai Jiao Tong University A liated Sixth People's Hospital, Shanghai, China Bing Zhao Renji Hospital, Shanghai Jiao Tong University, School of Medicine Yu He Shanghai Jiao Tong University A liated Sixth People’s Hospital Bin-Xian Gu Shanghai Jiao Tong University A liated Sixth People’s Hospital Hao-Tao Lu Shanghai Jiao Tong University A liated Sixth People’s Hospital Yi Gu Shanghai Jiao Tong University A liated Sixth People’s Hospital Li-Ming Wei Shanghai Jiao Tong University A liated Sixth People’s Hospital Yao-Hua Pan Renji Hospital, Shanghai Jiao Tong University, School of Medicine Zheng-Nong Chen Shanghai Jiao Tong University A liated Sixth People’s Hospital Yong-Ning Sun Shanghai Jiao Tong University A liated Sixth People’s Hospital Wu Wang Shanghai Jiao Tong University A liated Sixth People’s Hospital

颅内动脉粥样硬化性狭窄(ICAS)是缺血性脑卒中的主要病因.随着脑血管介入治疗理念和材料不断发展,脑血管介入支架已成为ICAS首选治疗策略.但支架植入后支架内再狭窄(ISR)问题异常突出,其原因和机制较为复杂,涉及内皮细胞和平滑肌细胞过度增殖及再次动脉粥样硬化形成.目前ICAS介入治疗的重点和难点仍然是术后ISR预防和治疗.该文主要综述ICAS支架植入术后ISR机制和血管内再介入治疗研究进展及展望,旨在为临床治疗决策提供新思考和方向.

目的 探讨自适应统计迭代重组(ASIR)不同水平设定对于肺功能定量CT参数测定影响.方法 搜集2016年2月至2016年3月28例吸烟患者,男20例,女8例;年龄(58.43±17.26)岁.高分辨率CT检查数据,间隔10％设定ASIR进行图像重组,利用机器自带肺功能软件进行定量分析,观察10％～90％ ASIR水平肺内低密度区(＜-950 HU)比例以及全肺体积变化.不同ASIR水平肺功能定量参数[肺内低密度区占比(LAA％)、全肺体积(ILV)]间采用Friedman检验或单因素重复测量方差分析方法.P＜0.05为差异具有统计学意义.结果 ASIR水平对于LAA％结果具有明显影响,随着ASIR数值提高,LAA％呈下降趋势(x2=29.426,P＜0.001).不同ASIR水平之间TLV不存在明显统计学差异(F=1.046,P=0.325).结论 不同ASIR水平对于肺功能定量CT参数LAA％具有明显影响,在利用CT对小气道病变进行定量分析,或者不同研究中心数据进行对比时,需考虑到ASIR水平可能带来的影响.

BACKGROUND:Symptomatic vertebral artery dissecting aneurysm (VADA) is a challenging disease with controversy on treatment strategy due to anatomic configuration and their nature. Moreover, the outcomes of reconstructive treatment have not been well established. OBJECTIVE:To evaluate the safety and efficacy of reconstructive endovascular treatment (EVT) for symptomatic VADAs with Willis covered stent. METHODS:We evaluated retrospectively 13 patients with symptomatic VADAs who treated with Willis covered stent, compared with stent-assisted coiling (SAC) on the characteristics, posttreatment course, angiographic and clinical follow-up outcomes at an average of 14.4 months (range, 3-48 months). RESULTS:A total of 33 patients with symptomatic VADAs were reviewed, 23 of these patients with ruptured VADAs. The technical successful rate is 100% respectively in Willis covered stent (Group A) and SAC (Group B, n ​= ​20). The initial complete occlusion rate was significant higher in group A (100%) than group B (30%) (p ​< ​0.01). Major procedure-related complications were not significant different in the two groups. Serial follow-up angiograms revealed 5 recurrent VADAs in group B and no recurrence in group A (p ​> ​0.05). No obvious in-stent stenosis and no re-hemorrhage and delayed ischemic symptoms during the follow-up period. The final angiograms of all survived patients demonstrated the complete occlusion rate was higher in group A (100%) than group B (80%), but no significant statistical difference (p ​> ​0.05). Clinical outcomes were favorable in 31 (93.9%), severe disability occurred in one in group B, and only one death in group A. The final clinical outcomes were also not significant difference in the two groups (p ​> ​0.05). CONCLUSIONS:Our initial result demonstrated reconstructive EVT with Willis covered stent provides a viable approach for selected symptomatic VADAs involving the intracranial and extracranial segments, which is similar to favorable results with SAC. However, an expanded clinical experiences and larger cohort studies are needed.

Aneurysmal subarachnoid hemorrhage caused by intracranial aneurysm is one of the common cerebrovascular diseases can lead to hemorrhagic stroke, brain damage and death. To prevent thrombosis, rapid endothelialization of the lumen of stent is the most critical approaches. In this study, we explored a controlled release covered stent with core-shell nanofibers via emulsion electrospinning for treating aneurysms. By encapsulating atorvastatin calcium (Atv) within the core of poly (L-lactide-co-caprolactone) (PLCL) nanofibers, the release period of Atv was effectively extended. The morphology and inner-structure of the core-shell nanofibers were respectively observed by scanning electron microscopy and transmission electron microscopy. The release of atorvastatin calcium from the nanofiber lasted for more than 10 weeks without serious initial burst release. The nanofiber films could keep complete morphology after degraded for 3 months. The study demonstrated that atorvastatin calcium promoted the synthesis of nitric oxide (NO) in HUVECs and further the proliferation of HUVECs in vitro. Animal studies showed that PLCL-Atv covered stent could separate the aneurysm dome from the blood circulation and obliterate aneurysm. Moreover, the release of Atv could promote the proliferation of HUVECs on nanofiber films and induction of rapid endothelialization.

Aneurysmal subarachnoid hemorrhage is a common complication caused by an intracranial aneurysm that can lead to hemorrhagic stroke, brain damage, and death. Knowing this clinical situation, the purpose of this study was to develop a controlled-release stent covered with a core-shell nanofiber mesh, fabricated by emulsion electrospinning, for the treatment of aneurysms. By encapsulating atorvastatin calcium (AtvCa) in the inner of poly (L-lactide-co-caprolactone) (PLCL) nanofibers, the release period of AtvCa was effectively extended. The morphology and inner structure of the core-shell nanofibers were observed by scanning electron microscopy (SEM) and transmission electron microscopy (TEM), respectively. The release of AtvCa from the nanofiber system continued for more than ten weeks without a significant initial burst release. The nanofiber mesh structure degraded gradually but maintained its fiber morphology before neovascularization. The results of this study further elucidated the reendothelialization mechanism of AtvCa by analyzing the nitric oxide (NO) expression from seeded HUVECs. The in vivo studies demonstrated that the PLCL-AtvCa covered stents were capable of separating the aneurysm dome from the blood circulation, leading to the abolishment of the aneurysm. Moreover, the AtvCa controlled release promoted the in vitro proliferation of HUVECs on the nanofiber meshes, and the PLCL-AtvCa covered stents induced in vivo neovascularization. STATEMENT OF SIGNIFICANCE: Intracranial aneurysms are pathological dilatations of blood vessels that have developed an abnormally weak wall structure, thus prone to rupture. Covered stents had been demonstrated to be a method for the treatment of intracranial aneurysm. We prepared a controlled-release stent covered with a core-shell nanofiber mesh, fabricated by emulsion electrospinning, which encapsulated atorvastatin calcium in the inner portion of nanofibers. The results of this study further elucidated the reendothelialization mechanism of AtvCa by analyzing the nitric oxide (NO) expression from seeded HUVECs. The generated AtvCa-load covered stents separated the aneurysm dome from the blood circulation, and keep long-term patency of the parent artery. But also induced neovascularization, thus provide further protection against recurrence of aneurysms after nanofiber meshes degradation.

目的 探讨3D高分辨率磁共振成像(HRMRI)评估症状性基底动脉粥样硬化性重度狭窄重构模式的价值.方法 搜集2015年1月至2017年12月经颅脑磁共振血管造影(MRA)显示症状性基底动脉重度狭窄(70～99％)的患者44例,使用VISTA技术对颅内动脉进行轴位扫描,获得容积数据进行后处理重建,得到基底动脉最窄层面、近端参考层面的短轴横断面图像,并分别测量其血管面积和管腔面积,计算重构指数(RI)(最窄层面血管面积/参考层面血管面积),RI≥1为阳性重构,RI＜1为阴性重构.然后比较阳性重构和阴性重构组之间临床资料及血管参数的差异.结果 2例患者因图像质量差而被排除,最终42例患者纳入分析.其中22例(52.4％)为阳性重构,20例(47.6％)为阴性重构.在最窄层面,阳性重构组比阴性重构组有更大的血管面积、管壁面积、斑块面积及斑块负荷(P均＜0.05).临床基线数据无统计学差异(P均＞0.05).结论 3D HRMRI可以准确评估症状性基底动脉粥样硬化性狭窄的血管重构模式,具有重要的临床意义.