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China Medical Abstracts(Internal Medicine) 2024年第1期41卷 2-3页

作者：钟文新 Dept Radiol Huazhong Univ Sci&Technol Union Shenzhen HospShenzhen 518052

Objective To establish and verify a nomogram model based on MRI liver imaging reporting and data system (LI-RADS) features for predicting microvascular invasion (MVI) in hepatocellular carcinoma (HCC)following the Milan criteria.Methods A retrospective analysis was conducted on data from 118 HCC patients(121 lesions) confirmed by pathology from June 2016 to June 2022 at the Third Affiliated Hospital of Soochow University.

关键词： invasion hepatocellular microvascular

microvascular response to transfusion in elective spine surgery

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世界骨科杂志：英文版 2017年第1期8卷 49-56页

作者： J Matthias Walz Ottokar Stundner Federico P Girardi Bruce A Barton Aimee R Koll-Desrosiers Stephen O Heard Stavros G Memtsoudis Department of Anesthesi-ology and Perioperative Medicine UMass Memorial Healthcare Department of Anesthesiology Hospital for Special SurgeryWeill Cornell Medical Center Department of Anesthesiology PerioperativeMedicine and Intensive Care MedicineParacelsus Medical University Department of Orthopedic Surgery Hospital for Special SurgeryWeill Cornell Medical Center Department of Quantitative Health Sciences University of Massachusetts Medical School

AIM To investigate the microvascular(skeletal muscle tissue oxygenation; SmO_2) response to transfusion in patients undergoing elective complex spine surgery.METHODS After IRB approval and written informed consent, 20 patients aged 18 to 85 years of age undergoing > 3level anterior and posterior spine fusion surgery were enrolled in the study. Patients were followed throughout the operative procedure, and for 12 h postoperatively. In addition to standard American Society of Anesthesiologists monitors, invasive measurements including central venous pressure, continual analysis of stroke volume(SV), cardiac output(CO), cardiac index(CI), and stroke volume variability(SVV) was performed. To measure skeletal muscle oxygen saturation(SmO_2) during the study period, a non-invasive adhesive skin sensor based on Near Infrared Spectroscopy was placed over the deltoid muscle for continuous recording of optical spectra. All administration of fluids and blood products followed standard procedures at the Hospital for Special Surgery, without deviation from usual standards of care at the discretion of the Attending Anesthesiologist based on individual patient comorbidities, hemodynamic status, and laboratory data. Time stamps were collected for administration of colloids and blood products, to allow for analysis of SmO_2 immediately before, during, and after administration of these fluids, and to allow for analysis of hemodynamic data around the same time points. Hemodynamic and oxygenation variables were collected continuously throughout the surgery, including heart rate, blood pressure, mean arterial pressure, SV, CO, CI, SVV, and SmO_2. Bivariate analyses were conducted to examine the potential associations between the outcome of interest, SmO_2, and each hemodynamic parameter measured using Pearson's correlation coeffi-cient, both for the overall cohort and within-patients individually. The association between receipt of packed red blood cells and SmO_2 was performed by running an interrupted time series model, with SmO_2

关键词： Transfusion Complex spine surgery Near infrared spectroscopy microvascular blood flow Hemodynamic monitoring

Shuxuetong injection protects cerebral microvascular endothelial cells against oxygen-glucose deprivation reperfusion

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Neural Regeneration Research 2019年第5期14卷 783-793页

作者： Zuo-Yan Sun Fu-Jiang Wang Hong Guo Lu Chen Li-Juan Chai Rui-Lin Li Li-Min Hu Hong Wang Shao-Xia Wang Tianjin State Key Laboratory of Modern Chinese Medicine Tianjin University of Traditional Chinese Medicine Department of Pharmacy Linyi Central Hospital School of Integrative Medicine Tianjin University of Traditional Chinese Medicine Key Laboratory of Pharmacology of Traditional Chinese Medical Formula Ministry of Education Tianjin University of Traditional Chinese Medicine

Shuxuetong injection composed of leech(Hirudo nipponica Whitman) and earthworm(Pheretima aspergillum) has been used for the clinical treatment of acute stroke for many years in China. However, the precise neuroprotective mechanism of Shuxuetong injection remains poorly understood. Here, cerebral microvascular endothelial cells(bEnd.3) were incubated in glucose-free Dulbecco's modified Eagle's medium containing 95% N_2/5% CO_2 for 6 hours, followed by high-glucose medium containing 95% O_2 and 5% CO_2 for 18 hours to establish an oxygen-glucose deprivation/reperfusion model. This in vitro cell model was administered Shuxuetong injection at 1/32, 1/64, and 1/128 concentrations(diluted 32-, 64-, and 128-times). Cell Counting Kit-8 assay was used to evaluate cell viability. A fluorescence method was used to measure lactate dehydrogenase, and a fluorescence microplate reader used to detect intracellular reactive oxygen species. A fluorescent probe was also used to measure mitochondrial superoxide production. A cell resistance meter was used to measure transepithelial resistance and examine integrity of monolayer cells. The fluorescein isothiocyanate-dextran test was performed to examine blood-brain barrier permeability. Real-time reverse transcription polymerase chain reaction was performed to analyze mRNA expression levels of tumor necrosis factor alpha, interleukin-1β, interleukin-6, and inducible nitric oxide synthase. Western blot assay was performed to analyze expression of caspase-3, intercellular adhesion molecule 1, vascular cell adhesion molecule 1, occludin, vascular endothelial growth factor, cleaved caspase-3, B-cell lymphoma 2, phosphorylated extracellular signal-regulated protein kinase, extracellular signal-regulated protein kinase, nuclear factor-κB p65, I kappa B alpha, phosphorylated I kappa B alpha, I kappa B kinase, phosphorylated I kappa B kinase, claudin-5, and zonula occludens-1. Our results show that Shuxuetong injection increases bEnd.3 cell viability and B-cell lymphoma 2 expression, reduces

关键词： nerve regeneration Shuxuetong injection brain microvascular endothelial cells oxygen-glucose deprivation/reperfusion tight junction proteins mitochondrial function inflammatory factors blood-brain barrier neuroprotection neural regeneration

Rationale and study design for one-stop assessment of renal artery stenosis and renal microvascular perfusion with contrast-enhanced ultrasound for patients with suspected renovascular hypertension

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Chinese Medical Journal 2019年第1期132卷 63-68页

作者： Jun-Hong Ren Na Ma Si-Yu Wang You-Jing Sun Yue-Wei Zhang Fa-Jin Guo Yong-Jun Li Tian-Hui Li Hu Ai Wen-Duo Zhang Peng Li Wei-Hua Ma Department of Sonography Beijing HospitalNational Center of GerontologyBeijing 100730China Vascular Department Beijing HospitalNational Center of GerontologyBeijing 100730China Nephrology Department Beijing HospitalNational Center of GerontologyBeijing 100730China Department of Cardiology Beijing HospitalNational Center of GerontologyBeijing 100730China Beijing Hospital National Center of GerontologyBeijing 100730China

Background:Renal artery stenosis (RAS) is always associated with abnormalities in renal microvascular perfusion (RMP).However,few imaging methods can simultaneously evaluate the degree of luminal stenosis and RMP.Thus,this study will aim to evaluate the feasibility of using contrast-enhanced ultrasound (CEUS) for assessing both RAS and RMP to achieve a one-stop assessment of patients with suspected renovascular hypertension. Methods:This will be a single-center diagnostic study with a sample size of 440.Patients with chronic kidney disease (CKD) and suspected of having resistant hypertension will be eligible.Patients with Stages 1–3 CKD will undergo CEUS and computed tomography (CT) angiography (CTA).Values obtained by CEUS and CTA for diagnosing low-grade (lumen reduced by <60%) and high-grade (lumen reduced by ≥60%) RAS will be compared.Moreover,all patients will also undergo radionuclide imaging.The diagnostic value for RAS will be assessed by the receiver operating characteristic curve,including the accuracy,sensitivity,specificity,positive predictive values,negative predictive values,and area under the ROC.Pearson correlation analysis will be performed to assess the association between CEUS findings for RMP and glomerular filtration rate measured by a radionuclide imaging method. Conclusion:The data gathered from this study will be used to evaluate the feasibility of expanding clinical applications of CEUS for evaluation of patients with suspected renovascular hypertension.

关键词： Renovascular hypertension contrast-enhanced ultrasound renal artery stenosis renal microvascular perfusion

Development and validation of a prediction model for microvascular invasion in hepatocellular carcinoma

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World Journal of Gastroenterology 2020年第14期26卷 1647-1659页

作者： Lin Wang Yue-Xinzi Jin Ya-Zhou Ji Yuan Mu Shi-Chang Zhang Shi-Yang Pan Department of Laboratory Medicine The First Affiliated Hospital of Nanjing Medical UniversityNanjing 210029Jiangsu ProvinceChina National Key Clinical Department of Laboratory Medicine Jiangsu Province HospitalNanjing Medical UniversityNanjing 210029Jiangsu ProvinceChina

BACKGROUND microvascular invasion(MVI)is an important prognostic factor affecting early recurrence and overall survival in hepatocellular carcinoma(HCC)patients after hepatectomy and liver transplantation,but it can be determined only in surgical specimens.Accurate preoperative prediction of MVI is conducive to clinical decisions.AIM To develop and validate a preoperative prediction model for MVI in patients with HCC.METHODS Data from 454 patients with HCC who underwent hepatectomy at the First Affiliated Hospital of Nanjing Medical University between May 2016 and October 2019 were retrospectively collected.Then,the patients were nonrandomly split into a training cohort and a validation cohort.Logistic regression analysis was used to identify variables significantly associated with MVI that were then included in the nomogram.We evaluated the discrimination and calibration ability of the nomogram by using R software.RESULTS MVI was confirmed in 209(46.0%)patients by a pathological examination.Multivariate logistic regression analysis identified four risk factors independently associated with MVI:Tumor size[odds ratio(OR)=1.195;95%confidence interval(CI):1.107–1.290;P400 ng/mL,OR=3.476;95%CI:1.950–6.195;P<0.001).The concordance index was 0.79(95%CI:0.74–0.84)and 0.81(95%CI:0.74–0.89)in the training and validation cohorts,respectively.The calibration curves showed good agreement between the predicted risk by the nomogram and real outcomes.CONCLUSION We have developed and validated a preoperative prediction model for MVI in patients with HCC.The model could aid physicians in clinical treatment decision making.

关键词： microvascular invasion Nomogram Hepatocellular carcinoma Discrimination and calibration Neutrophils Early recurrence

Glucagon-like peptide-1 protects against cardiac microvascular endothelial cells injured by high glucose

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Asian Pacific Journal of Tropical Medicine 2015年第1期8卷 73-78页

作者： Guang-Hao Ge Hong-Jie Dou Shuan-Suo Yang Jiang-Wei Ma Wen-Bo Cheng Zeng-Yong Qiao Yue-Mei Hou Wei-Yi Fang Department of Cardiology Fengxian District Central Hospital Department of Cardiology Shanghai Jiaotong University Affiliated Sixth People's Hospital South campus Department of Intensive Care Unit Fengxian District Central Hospital Department of Intensive Care Unit Department of CardiologyShanghai Jiaotong University Affiliated Sixth People's Hospital South campus Department of Cardiology Shanghai Jiaotong University Affiliated Chest Hospital

Objective:To investigate the protective effect of glucagon-like peptid-1(GLP-l) against cardiac microvascular endothelial cell(GTFCs) injured by high glucose.Methods:CMECs were isolated and cultured.Superoxide assay kit and dihydroethidine(DHE) staining were used to assess oxidative stress.TENEL staining and caspase 3 expression were used to assess the apoptosis of CMECs.H89 was used to inhibit eAMP/PKA pathway:fasudil was used to inhibit Rho/ROCK pathway.The protein expressions of Rho.ROCK uere examined by Western blol analysis.lesults:High glucose increased the production of ROS.the activity of NADPH.the apoptosis rate and the expression level of Rho/ROCK in CMECs.while GLP- 1 decreased high glucose-induced ROS production.the NADPH activity and the apoptosis rate and the expression level of Rho/ROCK in CMECs,the difference were statistically significant(P<0.05).Conclusions:GLP-1 could protect the cardiac microvessels against oxidative stress and apoptosis.The protective effects of GLP-1 are dependent on downstream inhibition of Rho through a cAMP/PKA-dependent manner,resulting in a subsequent decrease in the expression of NADPH oxidase.

关键词： Glucagon-like peptid-1 Cardiac microvascular endothelial cell ROS Rho/ROCK

The Inhibitory Effects of PSS-Loaded Nanoparticles on the Dysfunction of Cardiac microvascular Endothelia in Rats with Diabetic Cardiomyopathy

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Journal of Ocean University of China 2019年第1期18卷 253-259页

作者： AN Nina YU Luyan HU Yi FENG Wenjing SHI Shujuan CHEN Honghua MAO Yongjun Department of Geriatrics the Affiliated Hospital of Qingdao University

Propylene glycol alginate sodium sulfate-loaded nanoparticles(PSS-NP) has been shown potential to prevent the microvascular endothelial injuries caused by diabetic cardiomyopathy(DCM). In this study, we aimed to investigate the effects of PSS-NP on the dysfunction of cardiac microvascular endothelia in streptozotocin(STZ)-induced DCM rat model. Echocardiographic measurements showed a significant improvement of cardiac function in the PSS-NP-treated group. Our results revealed that the abnormalities of cardiac systolic and diastolic functions were suppressed by the treatments of prostaglandin E1(PGE1), low molecular weight heparin(LMWH), PSS and PSS-NP. Our comparison analysis indicated that PSS-NP showed the strongest inhibitory effects on microvascular endothelial injuries. Transmission electron microscopy analysis demonstrated that PSS-NP protected the cardiac microvascular endothelium and further improved endothelium dysfunction in DCM rats. ELISA and Western blot assays further showed a high efficiency of improving cardiac microvascular endothelial dysfunction with PSS-NP. Our results demonstrated that PSS-NP increased the protein expression of phosphatidylinositol 3-kinase(PI3K)-p85 and vascular endothelial growth factor(VEGF)-A, and the phosphorylation of protein kinase B(Akt) and endothelial nitric oxide synthase(eNOS), which were involved in the amelioration of cardiac microvascular endothelial dysfunction. These data suggest that PSS-NP may be a novel approach to the treatment the coronary microcirculation disorder diseases such as DCM.

关键词： PSS-loaded nanoparticles marine drug DCM microvascular endothelial dysfunction

Sex-specific differences in white matter microvascular integrity after ischaemic stroke

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Stroke & Vascular Neurology 2019年第4期4卷 198-205页

作者： Mark R Etherton Ona Wu Pedro Cougo Svetlana Lorenzano Hua Li Lisa Cloonan Mark J R J Bouts Arne Lauer Ken Arai Eng H Lo Steve K Feske Karen L Furie Natalia S Rost Department of Neurology Massachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA Martinos Center for Biomedical Imaging Massachusetts General HospitalCharlestownMAUnited States Department of Radiology Massachusetts General Hospital and Harvard Medical SchoolBostonMAUnited States Medical School of Ribeirao Preto University of Sao PauloSao PauloBrazil Department of Human Neurosciences Sapienza University of RomeRomeItaly Institute of Psychology Leiden UniversityLeidenNetherlands Department of Neuroradiology Goethe-Universitat Frankfurt am MainFrankfurtGermany Department of Neurology Brigham and Women’s Hospital and Harvard Medical SchoolBostonMAUnited States Department of Neurology Warren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA

background and purpose Functional outcomes after ischaemic stroke are worse in women,despite adjusting for differences in comorbidities and treatment approaches.White matter microvascular integrity represents one risk factor for poor long-term functional outcomes after ischaemic stroke.The aim of the study is to characterise sex-specific differences in microvascular integrity in individuals with acute ischaemic stroke.Methods A retrospective analysis of subjects with acute ischaemic stroke and brain MRI with diffusion-weighted(DWI)and dynamic-susceptibility contrast-enhanced(DSC)perfusion-weighted imaging obtained within 9 hours of last known well was performed.In the hemisphere contralateral to the acute infarct,normal-appearing white matter(NAWM)microvascular integrity was measured using the K_(2) coefficient and apparent diffusion coefficient(ADC)values.Regression analyses for predictors of K_(2) coefficient,DWI volume and good outcome(90-day modified Rankin scale(mRS)scoremicrovascular integrity are needed.

关键词： microvascular white coefficient

Clinical Features and microvascular Complications Risk Factors of Early-onset Type 2 Diabetes Mellitus

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Current Medical Science 2019年第5期39卷 754-758页

作者： Jia-xin HUANG Yun-fei LIAO Yu-ming LI Department of Ultrasound Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Department of Endocrinology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China

The aim of this research was to study the clinical features and microvascular complications risk factors of early-onset type 2 diabetes mellitus(T2DM).We analyzed the clinical data from 1421 T2DM inpatients at Wuhan Union Hospital.Subjects were divided into early-onset T2DM group(diagnostic age40 years).All subjects underwent a standardized assessment of microvascular complications.Data were compared with independent-samples t test or Chi-square test.Multiple logistic regression was used to determine the risk factors of microvascular complications.Patients with early-onset T2DM were more inclined to have a lower systolic blood pressure(SBP),a longer duration of diabetes and higher levels of body mass index(BM1),uric acid(UA),fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG)and glycosylated hemoglobin(HbAlc)than those with lateonset T2DM(P<0.05).The prevalence of diabetic retinopathy(DR)was significantly higher and that of diabetic peripheral neuropathy(DPN)was significantly lower in early-onset group than in late-onset group(P<0.05).For DN,UA was an independent risk factor in early-onset T2DM.SBP and TG were independent risk factors in late-onset T2DM.For DR,duration of diabetes and SBP were independent risk factors in early-onset T2DM.Duration of diabetes,SBP and HbAlc were independent risk factors in late-onset T2DM.This study demonstrated that the clinical characteristics of early-onset T2DM were metabolic disorders,including glucose metabolism,lipid metabolism and amino acid metabolism.Early-onset T2DM was more likely to be associated with DR.The potential pathogenesis of early and late-onset T2DM might be different.The management of metabolic risk factors especially HbA1c,SBP,TG and UA is advised to be performed in the early stage of diabetes.

关键词： early-onset type 2 diabetes mellitus diabetic microvascular complication diabetic nephropathy diabetic retinopathy diabetic peripheral neuropathy

Postoperative adjuvant transarterial chemoembolization for multinodular hepatocellular carcinoma within the Barcelona Clinic Liver Cancer early stage and microvascular invasion

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Hepatobiliary Surgery and Nutrition 2018年第6期7卷 418-428页

作者： Han Wang Peng-Cheng Du Meng-Chao Wu Wen-Ming Cong Department of Pathology Eastern Hepatobiliary Surgery HospitalThe Second Military Medical UniversityYangpuShanghai 200438China Key Laboratory of Signaling Regulation and Targeting Therapy of Liver Cancer(Second Military Medical University)Ministry of Education YangpuShanghai 200438China Shanghai Key Laboratory of Hepatobiliary Tumor Biology(Eastern Hepatobiliary Surgery Hospital) YangpuShanghai 200438China Department of Vascular Surgery Changhai Hospital5Department of SurgeryEastern Hepatobiliary Surgery HospitalThe Second Military Medical UniversityYangpuShanghai 200433China

Background:The survival benefit of postoperative adjuvant transcatheter arterial chemoembolization(PA-TACE)remained controversial.We aimed to investigate the prognosis effect of PA-TACE on the Barcelona Clinic Liver Cancer(BCLC)early stage multinodular hepatocellular carcinoma(MHCC)patients with/without microvascular invasion(MVI).Methods:Two hundred and seventy-one patients from January 2010 to December 2014 undergoing curative hepatectomy were included in this study.Disease-free survival(DFS)rates and overall survival(OS)rates as well as prognostic factors were analyzed by the Kaplan-Meier method,the log-rank test and the Cox proportional hazard model.Results:Thirty-four point four percent(44/128)MVI positive and 55.2%(79/143)MVI negative patients underwent PA-TACE.Multivariate analysis revealed that HBV DNA load>103 copy/Ml,>three tumors,MVI,and without PA-TACE were independent risk factors for poor DFS.Higher alkaline phosphatase(ALP),three tumors,MVI,and without PA-TACE were independent risk factors for poor OS.Both DFS and OS were significantly improved in patients with MVI who received PA-TACE as compared to those who underwent hepatic resection alone(5-year DFS,26.3%vs.20.7%,P=0.038;5-year OS,73.6%vs.47.7%,P=0.005).No differences were noted in DFS and OS among MVI negative patients with or without PA-TACE(5-year DFS,33.7%vs.33.0%,P=0.471;5-year OS,84.1%vs.80.3%,P=0.523).Early recurrence was more likely to occur in patients without PA-TACE(P=0.001).Conclusions:PA-TACE was a safe intervention and could effectively prevent tumor recurrence and improve the survival of the BCLC early stage MHCC patients with MVI.

关键词： Hepatocellular carcinoma(HCC) microvascular invasion(MVI) clonal origin postoperative adjuvant transcatheter arterial chemoembolization(PA-TACE)