Vascular diseases are the most prevalent cause of ischemic necrosis of tissue and organ,which even result in dysfunction and death.Vascular regeneration or artificial vascular graft,as the conventional treatment modal...Vascular diseases are the most prevalent cause of ischemic necrosis of tissue and organ,which even result in dysfunction and death.Vascular regeneration or artificial vascular graft,as the conventional treatment modality,has received keen attentions.However,small-diameter(diameter<4 mm)vascular grafts have a high risk of thrombosis and intimal hyperplasia(IH),which makes long-term lumen patency challengeable.Endothelial cells(ECs)form the inner endothelium layer,and are crucial for anti-coagulation and thrombogenesis.Thus,promoting in situ endothelialization in vascular graft remodeling takes top priority,which requires recruitment of endothelia progenitor cells(EPCs),migration,adhesion,proliferation and activation of EPCs and ECs.Chemotaxis aimed at ligands on EPC surface can be utilized for EPC homing,while nanofibrous structure,biocompatible surface and cell-capturing molecules on graft surface can be applied for cell adhesion.Moreover,cell orientation can be regulated by topography of scaffold,and cell bioactivity can be modulated by growth factors and therapeutic genes.Additionally,surface modification can also reduce thrombogenesis,and some drug release can inhibit IH.Considering the influence of macrophages on ECs and smooth muscle cells(SMCs),scaffolds loaded with drugs that can promote M2 polarization are alternative strategies.In conclusion,the advanced strategies for enhanced long-term lumen patency of vascular grafts are summarized in this review.Strategies for recruitment of EPCs,adhesion,proliferation and activation of EPCs and ECs,anti-thrombogenesis,anti-IH,and immunomodulation are discussed.Ideal vascular grafts with appropriate surface modification,loading and fabrication strategies are required in further studies.展开更多
Purpose: This study aimed to investigate the morphological characteristics of ascending aortic dissection in detail. Materials and Methods: The ascending aorta was morphologically assessed in a consecutive series of p...Purpose: This study aimed to investigate the morphological characteristics of ascending aortic dissection in detail. Materials and Methods: The ascending aorta was morphologically assessed in a consecutive series of patients between January 2009 and October 2014. A new assessment and evaluation method was used to describe 114 patients with ascending aortic dissection. Results: A large difference was found in the degree of curvature between the ascending aorta with and without dissection. The shape of the former was straighter and steeper(control group R, 47.46 ± 6.40 mm; experimental group R, 59.70 ± 10.27 mm, P < 0.001). In the case of aortic dissection involving the valves, the proximal edge of the first entry was obviously close to the aortic sinus. The orientation of the entries was mainly around the 10 o'clock and 1–2 o'clock positions, and most of their shapes were fusiform(111; 70.02%). The distance of the distal extending dissection was associated with cases involving the branch arteries(involving three branches 441.40 ± 101.13 mm vs 159.85 ± 131.86 mm in others, P < 0.001). Conclusion: The morphological features of the ascending aorta after dissection and the correlations among dissections, entries, and related factors were found.展开更多
The long arm of human chromosome 12 contains a region that has been found to be amplified in a number of different tumors, including osteosarcomas and soft tissue sarcomas. There are more than 5 genes located in this ...The long arm of human chromosome 12 contains a region that has been found to be amplified in a number of different tumors, including osteosarcomas and soft tissue sarcomas. There are more than 5 genes located in this area such as CDK2, CDK4, WNT1, MDM2 and WNTIOb. CDK4 gene consists of eight exons, of which the start codon is located in the beginning of exon 2 and the stop codon in the a member of the Ser-Thr catalytic domain extends beginning of exon 8. CDK4 is protein kinase family and its from amino acid 6 to 295.展开更多
BACKGROUND Primary intimal sarcoma of the pulmonary artery is a rare malignant tumor originating from the pulmonary artery,which has a low incidence rate and is easily misdiagnosed as pulmonary embolism.There is no st...BACKGROUND Primary intimal sarcoma of the pulmonary artery is a rare malignant tumor originating from the pulmonary artery,which has a low incidence rate and is easily misdiagnosed as pulmonary embolism.There is no standard protocol for the treatment of primary intimal sarcoma of the pulmonary artery.CASE SUMMARY This study reports a patient with primary intimal sarcoma of the pulmonary artery who was admitted to our hospital in 2017.The clinical characteristics,diagnosis,treatment and outcome of the patient were retrospectively analyzed.The patient was a Chinese Han male aged 44 years.He had three consecutive episodes of syncope,and was thus admitted to a local hospital.Computed tomography pulmonary angiography showed multiple lesions with abnormal densities in the pulmonary trunk,left pulmonary artery,mediastinum and pericardium,which were consistent with recurrence after tumor resection.He underwent surgery,and was pathologically diagnosed with intimal sarcoma of the pulmonary artery.He relapsed 3 mo after surgery,and apatinib was administered.His condition was stable after 4 mo,with tolerable and controllable adverse reactions.He subsequently died 19 mo after surgery.CONCLUSION Primary intimal sarcoma of the pulmonary artery has no specific clinical or imaging manifestations.The diagnosis of this disease depends on histopathology and immunohistochemistry,and has a poor clinical prognosis.Surgical treatment is currently a favorable option for primary intimal sarcoma of the pulmonary artery,and targeted therapy may provide new insights for the development of effective treatment methods.展开更多
Objective： To investigate the effect and potential mechanisms of rutaecarpine （Rut） in a rat artery balloon-injury model. Methods： The intimal hyperplasia model was established by rubbing the endothelia with a bal...Objective： To investigate the effect and potential mechanisms of rutaecarpine （Rut） in a rat artery balloon-injury model. Methods： The intimal hyperplasia model was established by rubbing the endothelia with a balloon catheter in the common carotid artery （CCA） of rats. Fifty rats were randomly divided into five groups, ie. sham, model, Rut （25, 50 and 75 mg/kg） with 10 rats of each group. The rats were treated with or without Rut （25, 50, 75 mg/kg） by intragastric administration for 14 consecutive days following injury. The morphological changes of the intima were evaluated by hematoxylin-eosin staining. The expressions of proliferating cell nuclear antigen （PCNA） and smooth muscle （SM） oL-actin in the ateries were assayed by immunohistochemical staining. The mRNA expressions of c-myc, extracellular signal-regulated kinase 2 （ERK2）, MAPK phosphatase-1 （MKP-1） and endothelial nitric oxide synthase （eNOS） were determined by real-time reverse chain reaction. The protein expressions of MKP-1 and phosphorylated ERK2 （p-ERK2） were examined by Western blotting. The plasma contents of nitric oxide （NO） and cyclic guanosine 3＇,5＇-monophosphate （cGMP） were also determined. Results： Compared with the model group, Rut treatment significantly decreased intimal thickening and ameliorated endothelial injury （P〈0.05 or P〈0.01）. The positive expression rate of PCNA was decreased, while the expression rate of SM α -actin obviously increased in the vascular wall after Rut （50 and 75 mg/kg） administration （P〈0.05 or P〈0.01）. Furthermore, the mRNA expressions of c-myc, ERK2 and PCNA were downregulated while the expressions of eNOS and MKP-1 were upregulated （P〈0.05 or P〈0.01）. The protein expressions of MKP-1 and the phosphorylation of ERK2 were upregulated and downragulated after Rut （50 and 75 mg/kg） administration （P〈0.05 or P〈0.01）, respectively. In addition, Rut dramatically reversed balloon injury-induced decrease of NO and cGMP 展开更多
BACKGROUND: The purpose of this study was to use point-of-care ultrasound(POCUS) to investigate the relationship between tobacco smoke exposure and the characteristics of the common carotid artery(CCA). The effect of ...BACKGROUND: The purpose of this study was to use point-of-care ultrasound(POCUS) to investigate the relationship between tobacco smoke exposure and the characteristics of the common carotid artery(CCA). The effect of both primary and secondary smoking on CCA properties was evaluated.METHODS: We performed a prospective cross-sectional study across 20 primary care clinics in Bandung, West Java, Indonesia in July 2016. Point of care ultrasound was performed on a convenience sample of Indonesian patients presenting to clinic. The CCA wall stiffness and carotid intima-media thickness(CIMT) were measured during diastole and systole. These measurements were correlated with smoke exposure and cardiovascular disease.RESULTS: We enrolled 663 patients in the study, with 426 patients enrolled in the smoking category and 237 patients enrolled in the second-hand smoke category. There was an overall positive correlation with the measured lifestyle factors and the ultrasound-measured variables in the group of individuals who smoked. For all variables, age seemed to contribute the most out of all of the lifestyle factors for the positive changes in CIMT and CCA wall stiffness.CONCLUSION: Our data yielded correlations between CCA properties and cardiovascular risk, as well as between CIMT and arterial stiffness. We were also able to demonstrate an increase in thickness of the CIMT in patients who have been exposed by tobacco through the use of ultrasound. Further large scale studies comparing patients with multiple cardiac risk factors need to be performed to confi rm the utility of ultrasound fi ndings of cardiovascular disease and stroke.展开更多
Intimal hyperplasia(IH)is a negative vascular remodeling after arterial injury.IH occasionally occurs in elastase-induced abdominal aortic aneurysm(AAA)mouse models.This study aims to clarify the incidence and histolo...Intimal hyperplasia(IH)is a negative vascular remodeling after arterial injury.IH occasionally occurs in elastase-induced abdominal aortic aneurysm(AAA)mouse models.This study aims to clarify the incidence and histological characteristics of IH in aneurysmal mice.A retrospective study was conducted by including 42 male elastaseinduced mouse AAA models.The IH incidence,aortic diameters with or without IH,and hyperplasia lesional features of mice were analyzed.Among 42 elastase-induced AAA mouse models,10 mice developed mild IH(24%)and severe IH was found in only 2 mice(5%).The outer diameters of the AAA segments in mice with and without IH did not show significant difference.Both mild and severe IH lesions show strong smooth muscle cell positive staining,but endothelial cells were occasionally observed in severe IH lesions.There was obvious macrophage infiltration in the IH lesions of the AAA mouse models,especially in mice with severe IH.However,only a lower numbers of T cells and B cells were found in the IH lesion.Local cell-secreted matrix metalloproteinases(MMP)2 was highly expressed in all IH lesions,but MMP9 was only overexpressed in severe lesions.In conclusion,this study is the first to demonstrate the occurrence of aneurysmal IH and its histological characteristics in an elastaseinduced mouse AAA model.This will help researchers better understand this model,and optimize it for use in AAA-related research.展开更多
Clinical use of small-diameter vascular grafts remains a challenging issue in neovessel regeneration in view of thrombosis and intimal hyperplasia.Developing a vascular graft with structure and function similar to tho...Clinical use of small-diameter vascular grafts remains a challenging issue in neovessel regeneration in view of thrombosis and intimal hyperplasia.Developing a vascular graft with structure and function similar to those of the native vessels necessitates a major direction of vascular tissue regeneration.Thus,this study sought to design and fabricate a range of tri-phasic scaffolds(0,2,and 5 wt%gastrodin-polyurethane(PU))with spatiotemporally defined structure and gastrodin-release for regulating the highly coordinated processes in growth of the intima and media.While the small pores of inner layer guided infiltration of human umbilical vein endothelial cells(HUVECs),the bigger pores of medial layer could offer smooth muscle cell(SMC)-friendly habitat,and external fibers conferred adequate mechanical properties.Correspondingly,spatial distribution and differential regulation of key proteins in HUVECs and SMCs were mediated by hierarchical release of gastrodin,of which rapid release in inner layer elicited enhanced HUVEC proliferation and migration against those of the SMC via activated endothelial nitric oxide synthase(eNOS)and heat shock protein 70(HSP70)signal.Of note,superior anti-coagulation was reflected in 2 wt%gastrodin-PU ex vivo extracorporeal blood circulation experiment.After in vivo implantation for 12 weeks,there was no formation of obvious thrombosis and intimal hyperplasia in 2 wt%gastrodin-PU.The scaffold maintained high patency and improved vascular remodeling,including the formation of thin endothelialization in lumen and dense extracellular matrix deposition in medial layer.Taken together,the results demonstrate the positive function of hierarchical releasing system that responded to tri-phasic structure,which not only suppressed intimal thickening but also tightly controlled tissue regeneration.展开更多
A 66-year-old female with a 1-month history of increasing fatigue, dyspnea on exertion, and palpitations presented with clinical signs of heart failure. Chest computed tomography (CT) revealed a large, mobile left atr...A 66-year-old female with a 1-month history of increasing fatigue, dyspnea on exertion, and palpitations presented with clinical signs of heart failure. Chest computed tomography (CT) revealed a large, mobile left atrial (LA) mass attached to the mitral valve causing severe mitral stenosis and mitral regurgitation. The mass was surgically debulked and the mitral valve was replaced. Pathology revealed a poorly differentiated malignant spindle cell neoplasm with diffuse nuclear positivity of MDM2 and multifocal positivity of CDK4, consistent with intimal sarcoma. This case seeks to describe an uncommon presentation of a rare malignancy, and the surgical and medical management of the disease.展开更多
Pulmonary artery intimal sarcoma （PALS） is a very rare but lethal disease, firstly described by Mandelstarnmin 1923.1 Since then, less than 300 cases have been reported worldwide. Due to similar clinical presentatio...Pulmonary artery intimal sarcoma （PALS） is a very rare but lethal disease, firstly described by Mandelstarnmin 1923.1 Since then, less than 300 cases have been reported worldwide. Due to similar clinical presentations, it is very difficult to distinguish with pulmonary thromboembolism （PTE）, leading to inappropriate treatments such as anticoagulation and thrombolysis.2-5Although with improvement of imaging modalities, the diagnosis of PAIS is still based on pathological examination, and the majority of specimens are taken by surgery or autopsy.展开更多
The aims of the present study were to determine the effects of heparin-derived oligosaccharides(HDOs) on vascular intimal hyperplasia(IH) in balloon-injured carotid artery and to elucidate the underlying mechanisms of...The aims of the present study were to determine the effects of heparin-derived oligosaccharides(HDOs) on vascular intimal hyperplasia(IH) in balloon-injured carotid artery and to elucidate the underlying mechanisms of action. An animal model was established by rubbing the endothelia within the common carotid artery(CCA) in male rabbits. The rabbits were fed a high-cholesterol diet. Arterial IH was determined by histopathological changes to the CCA. Serum lipids were detected using an automated biochemical analysis. Expressions of mR NAs for vascular endothelial growth factor(VEGF), basic fibroblast growth factor(bF GF), vascular cell adhesion molecule-1(VCAM-1), monocyte chemoattractant protein-1(MCP-1), scavenger receptor class B type I(SR-BI), and ATP-binding cassette transporter A1(ABCA-1) were analyzed using reverse transcription polymerase chain reaction assays. Expressions of VEGF, VCAM-1, MCP-1, SR-BI and ABCA-1 proteins were analyzed by Western blotting. Enzyme-linked immunosorbent assays were used to quantify expression levels of VEGF and b FGF. Our results showed that administration of HDO significantly inhibited CCA histopathology and restenosis induced by balloon injury. The treatment with HDOs significantly decreased the m RNA and protein expression levels of VEGF, b FGF, VCAM-1, MCP-1, and SR-BI in the arterial wall; however, ABCA-1 expression level was elevated. HDO treatment led to a reduction in serum lipids(total cholesterol, triglycerides, high-density and low-density lipoproteins). Our results from the rabbit model indicated that HDOs could ameliorate IH and underlying mechanism might involve VEGF, b FGF, VCAM-1, MCP-1, SR-BI, and ABCA-1.展开更多
Background Among various treatments preventing vein graft restenosis, external stent is receiving more and more attention. This study aimed to investigate the effect of non-restrictive external stent on the prevention...Background Among various treatments preventing vein graft restenosis, external stent is receiving more and more attention. This study aimed to investigate the effect of non-restrictive external stent on the prevention of vein graft restenosis and the potential mechanisms of platelet-derived growth factor （PDGF） in the process of restenosis.Methods Thirty-six ＂New Zealand white rabbits＂ were randomly divided into two groups, stented group （group S） and control group （non-stented group, group NS）. Each rabbit underwent a reversed autologous external jugular vein into common carotid artery bypass grafting. In group S, the vein grafts were surrounded by a non restrictive stent which was 6 mm in diameter （a kind of Dacron vascular prosthesis）; and in group NS, there was no stent to support the vein grafts.The grafts were harvested at the first week （1W）, second week （2W） and fourth week （4W） after surgery respectively. The dimensions （including the thickness and area of the intima and media, luminal area） were measured by computer-aided image analysis system, and the intimal hyperplasia ratio was defined as the percentage of the area enclosed by the internal elastic lamina occupied by the intima.Results At 1W, the difference of the thickness and area of the intima between groups S and NS was not significant （P 〉0.05）; at 2W and 4W, the thickness and area of the intima and the intimal hyperplasia ratio in group S were less significant than those in group NS （P 〈0.05）; from 1W to 4W, the thickness and area of the media in group S were smaller than those in group NS （P〈0.05）. Immunocytochemistry staining of PDGF-B showed that the percentage of positive cells of intima in both two groups was peaked at 2W, and a significantly smaller percentage was detected in group S compared with that in group NS at 2W and 4W （P 〈0.05）; the percentage of PDGF-B positive cells of media in both two groups was also peaked at 2W, and that in group S was smaller than that in group NS展开更多
<strong><span style="font-family:Verdana;">Background:</span></strong> <span style="font-family:;" "=""><span style="font-family:Verdana;"&...<strong><span style="font-family:Verdana;">Background:</span></strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">The left internal mammary artery (IMA) is widely used as a conduit for coronary revascularization. The incidence of atherosclerosis is known to be lower in the IMA than in the coronary artery. The aim of this study was to evaluate the reliability of the use of the distal section of the IMA as an anastomotic site for bypass grafting and morphometric studies of IMA in patients with proven coronary artery disease and their associated risk factors. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">Patients who underwent Coronary Artery Bypass Graft (CABG) from June 2010 to November 2012 were chosen in this retrospective study and the discarded distal segments of the internal mammary artery were analyzed. The potential risk factors for atherosclerosis considered were age, sex, diabetes mellitus, history of cigarette smoking, hypertension and hypercholesterolemia. The samples were analyzed for the degree of intimal thickening and atherosclerosis by calculating the percentage of Luminal Narrowing, Intimal Thickness Index (ITI) and Intima-to-Media Ratio (IMR). </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">There were seven cases of intimal hyperplasia and two cases of focal medial and intimal hyperplasia with fatty streak and no cases of atherosclerosis and medial calcification. ITI was higher in males when compared to females. There was a strong relationship between IMR and smokers when compared to nonsmokers. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">In our study, when ITI was used as the dependent variable, diabetes was the most important factor. When IMR was used, the strongest predictor was hypercholesterolemia. There was a strong relationship between IMR and smokers when compared to nonsmokers.</span></span>展开更多
Objective To develop a new vascular xenograft and to compare the in vivo behavior of thrombogenicity and intimal hyperplasia in the heparin-treated and the non-heparin-treated decellularized xenografts.Methods Canine ...Objective To develop a new vascular xenograft and to compare the in vivo behavior of thrombogenicity and intimal hyperplasia in the heparin-treated and the non-heparin-treated decellularized xenografts.Methods Canine common carotid arteries were decellularized by enzymatic and detergent extraction procedures.Then a part of decellularized vascular grafts were covalently linked with heparin.Xenografts with(n=24)and without(n=24)heparin treatment were implanted in rabbits' left and right carotid artery respectively as bypass grafts.Graft patency were checked by Duplex ultrasonography at 3 and 6 months after implantation.Twelve rabbits were euthanized randomly at 3 and 6 months respectively and bilateral grafts were explanted.Histological examination and immunohistochemical staining were performed to observe the vascular remodeling.The efficiency of heparin release was demonstrated with toluidine blue staining.HE staining and micrograph analysis system were used for valuating the intima hyperplasia(IH)of bilateral grafts.Results During implantation,thrombosis rate was 4% in the heparin-treated xenografts and 25% in the non-heparin-treated xenografts after 3 weeks(P<0.05).After 6 months,it was 8% versus 58% respectively(P<0.01).Both xenografts of two groups harvested at the end of 3 or 6 months showed a satisfactory cellular reconstruction of either smooth muscle cells or endothelial cells.Intimal hyperplasia in the heparin-treated vascular was less than in the non-heparin treated xenografts.In addition,intimal hyperplasia was liable to appear close to the proximal and distal anastomotic stoma.Toluidine blue staining demonstrated that heparin was slowly released during 6 months.Conclusion This study provides a new strategy to develop a small-caliber vascular xenograft through enzymatic-detergent extraction and heparin treatment.Heparin treatment of the decellularized xenograft is helpful for improving bypass graft patency and reducing intimal hyperplasia.If there was no thrombus,bilateral bypass grafts will undergo a 展开更多
Aim: To present a rare occurrence of aortopulmonary fistula due to rupture of proximal aortic dissection in a 48-year-old woman. Introduction: Aortic dissection is defined as disruption of the medial layer provoked by...Aim: To present a rare occurrence of aortopulmonary fistula due to rupture of proximal aortic dissection in a 48-year-old woman. Introduction: Aortic dissection is defined as disruption of the medial layer provoked by intramural bleeding, resulting in separation of aortic wall layers and subsequent formation of a true lumen and a false lumen with or without communication. Case Report: A 48-year-old female presented with vague anterior chest discomfort, high blood pressure, systolic-diastolic murmur in the left sternal border with ECG changes of myocardial ischemia. Echocardiography revealed a dilated aortic root with intimal flaps, a leak into the pulmonary artery and regional hypokinesis with contractile dysfunction suggesting a proximal aortic dissection with rupture into the main pulmonary artery. Discussion: The etiology of aortic dissection was mostly hypertension in 80% of cases and aortopathies such as connective tissue disorders, inflammatory and idiopathic. Aortic wall stress is a major trigger of intimal tear and two-dimensional transthoracic echocardiography is an excellent, initial diagnostic gold standard to detect the dissecting flaps, especially in proximal aortic dissection. Conclusion: Blood pressure control is the mainstay of treatment and urgent surgery is indicated in proximal aortic dissection since there is higher chance of rupture with an increase in mortality.展开更多
Objective: To explore the alleviation of arterial intimal hyperplasia and improvement of outflow by inserting an autogenous vein cuff between poly tetraflu oroethylene (PTFE) graft and arteri al an astomosis. Methods:...Objective: To explore the alleviation of arterial intimal hyperplasia and improvement of outflow by inserting an autogenous vein cuff between poly tetraflu oroethylene (PTFE) graft and arteri al an astomosis. Methods: Twenty-four hindlimbs of 12 mongrel dogs were randomly divided into control group and experimental group. Sole PTFE bypasses were made in the control group, an autologous vein cuff was inserted in the distal anastomosis in the experimental group. Eight weeks after operation, angiography was made and specimens were harvested, histomorphological studies under microscope and picture analysis with computer were carried out, scanning electromicroscopy on the vein cuff was made. Results: Angiography demonstrated the patency of control and experimental group was 16. 7% and 66. 7%, respectively; Computer gave the intimal thickness: (483. 5 ± 67. 3) μm and (147. 4 ± 38. 6) μm, respectively; no obvious change was seen in medial thickness; area of intimal hyperplasia was (5217 ± 1 123) (pixel) and (31 17 ± 890) (pixel), respectively, accounting (80. 9 ± 17. 2)% and (47. 7 ± 13. 7)% of the sectional area of vessel lumen. The interpositional vein was arteriolization. Conclusion: The interpositional autologous vein cuff can obviously mitigate the arterial intimal hyperplasia after PTFE bypasses, improving postoperative patency of vascular surgery.展开更多
基金This work was funded by the National Natural Science Foundation of China(82072396,81871490,81571022)Shanghai Collaborative Innovation Center for Translational Medicine(TM202010)+2 种基金Program of Shanghai Academic/Technology Research Leader(19XD1434500)Double Hundred Plan(20191819)the Research Fund of Medicine and Engineering of Shanghai Jiao Tong University(YG2017MS06).
文摘Vascular diseases are the most prevalent cause of ischemic necrosis of tissue and organ,which even result in dysfunction and death.Vascular regeneration or artificial vascular graft,as the conventional treatment modality,has received keen attentions.However,small-diameter(diameter<4 mm)vascular grafts have a high risk of thrombosis and intimal hyperplasia(IH),which makes long-term lumen patency challengeable.Endothelial cells(ECs)form the inner endothelium layer,and are crucial for anti-coagulation and thrombogenesis.Thus,promoting in situ endothelialization in vascular graft remodeling takes top priority,which requires recruitment of endothelia progenitor cells(EPCs),migration,adhesion,proliferation and activation of EPCs and ECs.Chemotaxis aimed at ligands on EPC surface can be utilized for EPC homing,while nanofibrous structure,biocompatible surface and cell-capturing molecules on graft surface can be applied for cell adhesion.Moreover,cell orientation can be regulated by topography of scaffold,and cell bioactivity can be modulated by growth factors and therapeutic genes.Additionally,surface modification can also reduce thrombogenesis,and some drug release can inhibit IH.Considering the influence of macrophages on ECs and smooth muscle cells(SMCs),scaffolds loaded with drugs that can promote M2 polarization are alternative strategies.In conclusion,the advanced strategies for enhanced long-term lumen patency of vascular grafts are summarized in this review.Strategies for recruitment of EPCs,adhesion,proliferation and activation of EPCs and ECs,anti-thrombogenesis,anti-IH,and immunomodulation are discussed.Ideal vascular grafts with appropriate surface modification,loading and fabrication strategies are required in further studies.
文摘Purpose: This study aimed to investigate the morphological characteristics of ascending aortic dissection in detail. Materials and Methods: The ascending aorta was morphologically assessed in a consecutive series of patients between January 2009 and October 2014. A new assessment and evaluation method was used to describe 114 patients with ascending aortic dissection. Results: A large difference was found in the degree of curvature between the ascending aorta with and without dissection. The shape of the former was straighter and steeper(control group R, 47.46 ± 6.40 mm; experimental group R, 59.70 ± 10.27 mm, P < 0.001). In the case of aortic dissection involving the valves, the proximal edge of the first entry was obviously close to the aortic sinus. The orientation of the entries was mainly around the 10 o'clock and 1–2 o'clock positions, and most of their shapes were fusiform(111; 70.02%). The distance of the distal extending dissection was associated with cases involving the branch arteries(involving three branches 441.40 ± 101.13 mm vs 159.85 ± 131.86 mm in others, P < 0.001). Conclusion: The morphological features of the ascending aorta after dissection and the correlations among dissections, entries, and related factors were found.
文摘The long arm of human chromosome 12 contains a region that has been found to be amplified in a number of different tumors, including osteosarcomas and soft tissue sarcomas. There are more than 5 genes located in this area such as CDK2, CDK4, WNT1, MDM2 and WNTIOb. CDK4 gene consists of eight exons, of which the start codon is located in the beginning of exon 2 and the stop codon in the a member of the Ser-Thr catalytic domain extends beginning of exon 8. CDK4 is protein kinase family and its from amino acid 6 to 295.
文摘BACKGROUND Primary intimal sarcoma of the pulmonary artery is a rare malignant tumor originating from the pulmonary artery,which has a low incidence rate and is easily misdiagnosed as pulmonary embolism.There is no standard protocol for the treatment of primary intimal sarcoma of the pulmonary artery.CASE SUMMARY This study reports a patient with primary intimal sarcoma of the pulmonary artery who was admitted to our hospital in 2017.The clinical characteristics,diagnosis,treatment and outcome of the patient were retrospectively analyzed.The patient was a Chinese Han male aged 44 years.He had three consecutive episodes of syncope,and was thus admitted to a local hospital.Computed tomography pulmonary angiography showed multiple lesions with abnormal densities in the pulmonary trunk,left pulmonary artery,mediastinum and pericardium,which were consistent with recurrence after tumor resection.He underwent surgery,and was pathologically diagnosed with intimal sarcoma of the pulmonary artery.He relapsed 3 mo after surgery,and apatinib was administered.His condition was stable after 4 mo,with tolerable and controllable adverse reactions.He subsequently died 19 mo after surgery.CONCLUSION Primary intimal sarcoma of the pulmonary artery has no specific clinical or imaging manifestations.The diagnosis of this disease depends on histopathology and immunohistochemistry,and has a poor clinical prognosis.Surgical treatment is currently a favorable option for primary intimal sarcoma of the pulmonary artery,and targeted therapy may provide new insights for the development of effective treatment methods.
基金Supported by National Natural Science Foundation of China(No.81160528)Administration of Traditional Chinese Medicine of Guizhou Province foundation,China(No.2009-79)
文摘Objective： To investigate the effect and potential mechanisms of rutaecarpine （Rut） in a rat artery balloon-injury model. Methods： The intimal hyperplasia model was established by rubbing the endothelia with a balloon catheter in the common carotid artery （CCA） of rats. Fifty rats were randomly divided into five groups, ie. sham, model, Rut （25, 50 and 75 mg/kg） with 10 rats of each group. The rats were treated with or without Rut （25, 50, 75 mg/kg） by intragastric administration for 14 consecutive days following injury. The morphological changes of the intima were evaluated by hematoxylin-eosin staining. The expressions of proliferating cell nuclear antigen （PCNA） and smooth muscle （SM） oL-actin in the ateries were assayed by immunohistochemical staining. The mRNA expressions of c-myc, extracellular signal-regulated kinase 2 （ERK2）, MAPK phosphatase-1 （MKP-1） and endothelial nitric oxide synthase （eNOS） were determined by real-time reverse chain reaction. The protein expressions of MKP-1 and phosphorylated ERK2 （p-ERK2） were examined by Western blotting. The plasma contents of nitric oxide （NO） and cyclic guanosine 3＇,5＇-monophosphate （cGMP） were also determined. Results： Compared with the model group, Rut treatment significantly decreased intimal thickening and ameliorated endothelial injury （P〈0.05 or P〈0.01）. The positive expression rate of PCNA was decreased, while the expression rate of SM α -actin obviously increased in the vascular wall after Rut （50 and 75 mg/kg） administration （P〈0.05 or P〈0.01）. Furthermore, the mRNA expressions of c-myc, ERK2 and PCNA were downregulated while the expressions of eNOS and MKP-1 were upregulated （P〈0.05 or P〈0.01）. The protein expressions of MKP-1 and the phosphorylation of ERK2 were upregulated and downragulated after Rut （50 and 75 mg/kg） administration （P〈0.05 or P〈0.01）, respectively. In addition, Rut dramatically reversed balloon injury-induced decrease of NO and cGMP
文摘BACKGROUND: The purpose of this study was to use point-of-care ultrasound(POCUS) to investigate the relationship between tobacco smoke exposure and the characteristics of the common carotid artery(CCA). The effect of both primary and secondary smoking on CCA properties was evaluated.METHODS: We performed a prospective cross-sectional study across 20 primary care clinics in Bandung, West Java, Indonesia in July 2016. Point of care ultrasound was performed on a convenience sample of Indonesian patients presenting to clinic. The CCA wall stiffness and carotid intima-media thickness(CIMT) were measured during diastole and systole. These measurements were correlated with smoke exposure and cardiovascular disease.RESULTS: We enrolled 663 patients in the study, with 426 patients enrolled in the smoking category and 237 patients enrolled in the second-hand smoke category. There was an overall positive correlation with the measured lifestyle factors and the ultrasound-measured variables in the group of individuals who smoked. For all variables, age seemed to contribute the most out of all of the lifestyle factors for the positive changes in CIMT and CCA wall stiffness.CONCLUSION: Our data yielded correlations between CCA properties and cardiovascular risk, as well as between CIMT and arterial stiffness. We were also able to demonstrate an increase in thickness of the CIMT in patients who have been exposed by tobacco through the use of ultrasound. Further large scale studies comparing patients with multiple cardiac risk factors need to be performed to confi rm the utility of ultrasound fi ndings of cardiovascular disease and stroke.
基金supported by Shaanxi Provincial Natural Science Foundation(2023-CX-PT-17 to Sihai Zhao)Natural Science Foundation of Xi'an Jiaotong University Foundation(YXJLRH2022073 to Sihai Zhao)Project of Key Laboratory of Medical Large Animal Models of Guangdong Province(Klmlam 202204 to Sihai Zhao)。
文摘Intimal hyperplasia(IH)is a negative vascular remodeling after arterial injury.IH occasionally occurs in elastase-induced abdominal aortic aneurysm(AAA)mouse models.This study aims to clarify the incidence and histological characteristics of IH in aneurysmal mice.A retrospective study was conducted by including 42 male elastaseinduced mouse AAA models.The IH incidence,aortic diameters with or without IH,and hyperplasia lesional features of mice were analyzed.Among 42 elastase-induced AAA mouse models,10 mice developed mild IH(24%)and severe IH was found in only 2 mice(5%).The outer diameters of the AAA segments in mice with and without IH did not show significant difference.Both mild and severe IH lesions show strong smooth muscle cell positive staining,but endothelial cells were occasionally observed in severe IH lesions.There was obvious macrophage infiltration in the IH lesions of the AAA mouse models,especially in mice with severe IH.However,only a lower numbers of T cells and B cells were found in the IH lesion.Local cell-secreted matrix metalloproteinases(MMP)2 was highly expressed in all IH lesions,but MMP9 was only overexpressed in severe lesions.In conclusion,this study is the first to demonstrate the occurrence of aneurysmal IH and its histological characteristics in an elastaseinduced mouse AAA model.This will help researchers better understand this model,and optimize it for use in AAA-related research.
基金funded by National Natural Science Foundation of China(grant no.82260088,81960251,82260366)Yunnan Provincial Innovative Research Team in Basic and Clinical Study of Coronary Heart Disease of Yunnan Revitalization Talent Support Program(202305AS350030)+2 种基金Yunnan Science and Technology Program(202401AY070001-030,202201AT070136,202301AY070001-032,202001AY070001-014)Bai Xiaochun expert workstation(YSZJGZZ-2020040)Major Program of Kunming Science and Technology Innovation Center(2019-1-N-25318000003568).
文摘Clinical use of small-diameter vascular grafts remains a challenging issue in neovessel regeneration in view of thrombosis and intimal hyperplasia.Developing a vascular graft with structure and function similar to those of the native vessels necessitates a major direction of vascular tissue regeneration.Thus,this study sought to design and fabricate a range of tri-phasic scaffolds(0,2,and 5 wt%gastrodin-polyurethane(PU))with spatiotemporally defined structure and gastrodin-release for regulating the highly coordinated processes in growth of the intima and media.While the small pores of inner layer guided infiltration of human umbilical vein endothelial cells(HUVECs),the bigger pores of medial layer could offer smooth muscle cell(SMC)-friendly habitat,and external fibers conferred adequate mechanical properties.Correspondingly,spatial distribution and differential regulation of key proteins in HUVECs and SMCs were mediated by hierarchical release of gastrodin,of which rapid release in inner layer elicited enhanced HUVEC proliferation and migration against those of the SMC via activated endothelial nitric oxide synthase(eNOS)and heat shock protein 70(HSP70)signal.Of note,superior anti-coagulation was reflected in 2 wt%gastrodin-PU ex vivo extracorporeal blood circulation experiment.After in vivo implantation for 12 weeks,there was no formation of obvious thrombosis and intimal hyperplasia in 2 wt%gastrodin-PU.The scaffold maintained high patency and improved vascular remodeling,including the formation of thin endothelialization in lumen and dense extracellular matrix deposition in medial layer.Taken together,the results demonstrate the positive function of hierarchical releasing system that responded to tri-phasic structure,which not only suppressed intimal thickening but also tightly controlled tissue regeneration.
文摘A 66-year-old female with a 1-month history of increasing fatigue, dyspnea on exertion, and palpitations presented with clinical signs of heart failure. Chest computed tomography (CT) revealed a large, mobile left atrial (LA) mass attached to the mitral valve causing severe mitral stenosis and mitral regurgitation. The mass was surgically debulked and the mitral valve was replaced. Pathology revealed a poorly differentiated malignant spindle cell neoplasm with diffuse nuclear positivity of MDM2 and multifocal positivity of CDK4, consistent with intimal sarcoma. This case seeks to describe an uncommon presentation of a rare malignancy, and the surgical and medical management of the disease.
文摘Pulmonary artery intimal sarcoma （PALS） is a very rare but lethal disease, firstly described by Mandelstarnmin 1923.1 Since then, less than 300 cases have been reported worldwide. Due to similar clinical presentations, it is very difficult to distinguish with pulmonary thromboembolism （PTE）, leading to inappropriate treatments such as anticoagulation and thrombolysis.2-5Although with improvement of imaging modalities, the diagnosis of PAIS is still based on pathological examination, and the majority of specimens are taken by surgery or autopsy.
基金supported by the National Basic Research Funds(Nos.JKYJ2013044 and JKZ2011013)the Significant New Drugs Innovation Support Program of the National Science and Technology Project of China(No.2012ZX09502001-004)the Priority Academic Program Development of Jiangsu Higher Education Institution
文摘The aims of the present study were to determine the effects of heparin-derived oligosaccharides(HDOs) on vascular intimal hyperplasia(IH) in balloon-injured carotid artery and to elucidate the underlying mechanisms of action. An animal model was established by rubbing the endothelia within the common carotid artery(CCA) in male rabbits. The rabbits were fed a high-cholesterol diet. Arterial IH was determined by histopathological changes to the CCA. Serum lipids were detected using an automated biochemical analysis. Expressions of mR NAs for vascular endothelial growth factor(VEGF), basic fibroblast growth factor(bF GF), vascular cell adhesion molecule-1(VCAM-1), monocyte chemoattractant protein-1(MCP-1), scavenger receptor class B type I(SR-BI), and ATP-binding cassette transporter A1(ABCA-1) were analyzed using reverse transcription polymerase chain reaction assays. Expressions of VEGF, VCAM-1, MCP-1, SR-BI and ABCA-1 proteins were analyzed by Western blotting. Enzyme-linked immunosorbent assays were used to quantify expression levels of VEGF and b FGF. Our results showed that administration of HDO significantly inhibited CCA histopathology and restenosis induced by balloon injury. The treatment with HDOs significantly decreased the m RNA and protein expression levels of VEGF, b FGF, VCAM-1, MCP-1, and SR-BI in the arterial wall; however, ABCA-1 expression level was elevated. HDO treatment led to a reduction in serum lipids(total cholesterol, triglycerides, high-density and low-density lipoproteins). Our results from the rabbit model indicated that HDOs could ameliorate IH and underlying mechanism might involve VEGF, b FGF, VCAM-1, MCP-1, SR-BI, and ABCA-1.
文摘Background Among various treatments preventing vein graft restenosis, external stent is receiving more and more attention. This study aimed to investigate the effect of non-restrictive external stent on the prevention of vein graft restenosis and the potential mechanisms of platelet-derived growth factor （PDGF） in the process of restenosis.Methods Thirty-six ＂New Zealand white rabbits＂ were randomly divided into two groups, stented group （group S） and control group （non-stented group, group NS）. Each rabbit underwent a reversed autologous external jugular vein into common carotid artery bypass grafting. In group S, the vein grafts were surrounded by a non restrictive stent which was 6 mm in diameter （a kind of Dacron vascular prosthesis）; and in group NS, there was no stent to support the vein grafts.The grafts were harvested at the first week （1W）, second week （2W） and fourth week （4W） after surgery respectively. The dimensions （including the thickness and area of the intima and media, luminal area） were measured by computer-aided image analysis system, and the intimal hyperplasia ratio was defined as the percentage of the area enclosed by the internal elastic lamina occupied by the intima.Results At 1W, the difference of the thickness and area of the intima between groups S and NS was not significant （P 〉0.05）; at 2W and 4W, the thickness and area of the intima and the intimal hyperplasia ratio in group S were less significant than those in group NS （P 〈0.05）; from 1W to 4W, the thickness and area of the media in group S were smaller than those in group NS （P〈0.05）. Immunocytochemistry staining of PDGF-B showed that the percentage of positive cells of intima in both two groups was peaked at 2W, and a significantly smaller percentage was detected in group S compared with that in group NS at 2W and 4W （P 〈0.05）; the percentage of PDGF-B positive cells of media in both two groups was also peaked at 2W, and that in group S was smaller than that in group NS
文摘<strong><span style="font-family:Verdana;">Background:</span></strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">The left internal mammary artery (IMA) is widely used as a conduit for coronary revascularization. The incidence of atherosclerosis is known to be lower in the IMA than in the coronary artery. The aim of this study was to evaluate the reliability of the use of the distal section of the IMA as an anastomotic site for bypass grafting and morphometric studies of IMA in patients with proven coronary artery disease and their associated risk factors. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">Patients who underwent Coronary Artery Bypass Graft (CABG) from June 2010 to November 2012 were chosen in this retrospective study and the discarded distal segments of the internal mammary artery were analyzed. The potential risk factors for atherosclerosis considered were age, sex, diabetes mellitus, history of cigarette smoking, hypertension and hypercholesterolemia. The samples were analyzed for the degree of intimal thickening and atherosclerosis by calculating the percentage of Luminal Narrowing, Intimal Thickness Index (ITI) and Intima-to-Media Ratio (IMR). </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">There were seven cases of intimal hyperplasia and two cases of focal medial and intimal hyperplasia with fatty streak and no cases of atherosclerosis and medial calcification. ITI was higher in males when compared to females. There was a strong relationship between IMR and smokers when compared to nonsmokers. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">In our study, when ITI was used as the dependent variable, diabetes was the most important factor. When IMR was used, the strongest predictor was hypercholesterolemia. There was a strong relationship between IMR and smokers when compared to nonsmokers.</span></span>
文摘Objective To develop a new vascular xenograft and to compare the in vivo behavior of thrombogenicity and intimal hyperplasia in the heparin-treated and the non-heparin-treated decellularized xenografts.Methods Canine common carotid arteries were decellularized by enzymatic and detergent extraction procedures.Then a part of decellularized vascular grafts were covalently linked with heparin.Xenografts with(n=24)and without(n=24)heparin treatment were implanted in rabbits' left and right carotid artery respectively as bypass grafts.Graft patency were checked by Duplex ultrasonography at 3 and 6 months after implantation.Twelve rabbits were euthanized randomly at 3 and 6 months respectively and bilateral grafts were explanted.Histological examination and immunohistochemical staining were performed to observe the vascular remodeling.The efficiency of heparin release was demonstrated with toluidine blue staining.HE staining and micrograph analysis system were used for valuating the intima hyperplasia(IH)of bilateral grafts.Results During implantation,thrombosis rate was 4% in the heparin-treated xenografts and 25% in the non-heparin-treated xenografts after 3 weeks(P<0.05).After 6 months,it was 8% versus 58% respectively(P<0.01).Both xenografts of two groups harvested at the end of 3 or 6 months showed a satisfactory cellular reconstruction of either smooth muscle cells or endothelial cells.Intimal hyperplasia in the heparin-treated vascular was less than in the non-heparin treated xenografts.In addition,intimal hyperplasia was liable to appear close to the proximal and distal anastomotic stoma.Toluidine blue staining demonstrated that heparin was slowly released during 6 months.Conclusion This study provides a new strategy to develop a small-caliber vascular xenograft through enzymatic-detergent extraction and heparin treatment.Heparin treatment of the decellularized xenograft is helpful for improving bypass graft patency and reducing intimal hyperplasia.If there was no thrombus,bilateral bypass grafts will undergo a
文摘Aim: To present a rare occurrence of aortopulmonary fistula due to rupture of proximal aortic dissection in a 48-year-old woman. Introduction: Aortic dissection is defined as disruption of the medial layer provoked by intramural bleeding, resulting in separation of aortic wall layers and subsequent formation of a true lumen and a false lumen with or without communication. Case Report: A 48-year-old female presented with vague anterior chest discomfort, high blood pressure, systolic-diastolic murmur in the left sternal border with ECG changes of myocardial ischemia. Echocardiography revealed a dilated aortic root with intimal flaps, a leak into the pulmonary artery and regional hypokinesis with contractile dysfunction suggesting a proximal aortic dissection with rupture into the main pulmonary artery. Discussion: The etiology of aortic dissection was mostly hypertension in 80% of cases and aortopathies such as connective tissue disorders, inflammatory and idiopathic. Aortic wall stress is a major trigger of intimal tear and two-dimensional transthoracic echocardiography is an excellent, initial diagnostic gold standard to detect the dissecting flaps, especially in proximal aortic dissection. Conclusion: Blood pressure control is the mainstay of treatment and urgent surgery is indicated in proximal aortic dissection since there is higher chance of rupture with an increase in mortality.
文摘Objective: To explore the alleviation of arterial intimal hyperplasia and improvement of outflow by inserting an autogenous vein cuff between poly tetraflu oroethylene (PTFE) graft and arteri al an astomosis. Methods: Twenty-four hindlimbs of 12 mongrel dogs were randomly divided into control group and experimental group. Sole PTFE bypasses were made in the control group, an autologous vein cuff was inserted in the distal anastomosis in the experimental group. Eight weeks after operation, angiography was made and specimens were harvested, histomorphological studies under microscope and picture analysis with computer were carried out, scanning electromicroscopy on the vein cuff was made. Results: Angiography demonstrated the patency of control and experimental group was 16. 7% and 66. 7%, respectively; Computer gave the intimal thickness: (483. 5 ± 67. 3) μm and (147. 4 ± 38. 6) μm, respectively; no obvious change was seen in medial thickness; area of intimal hyperplasia was (5217 ± 1 123) (pixel) and (31 17 ± 890) (pixel), respectively, accounting (80. 9 ± 17. 2)% and (47. 7 ± 13. 7)% of the sectional area of vessel lumen. The interpositional vein was arteriolization. Conclusion: The interpositional autologous vein cuff can obviously mitigate the arterial intimal hyperplasia after PTFE bypasses, improving postoperative patency of vascular surgery.
