Endovascular repair has gained worldwide popularity for the treatment of aortic dissection and aortic aneurysm.The non-tapered stents are selected usually.The aortic diameters vary in different level.High incidence of distal stent-induced complications is closely related to the aortic taper angle.According to several published studies,the aortic taper angle could be evaluated by establishing geometric model.Applications of tapered stents can significantly reducing the incidence of distal stent-induced comnplications.This review summaries the latest researches in the studies of the progress and the application of the aortic taper angle and the tapered stents,providing a reference for endovascular stent-graft selecting in the treatment of aortic dissection and aortic aneurysm.

Neural cell adhesion molecule (NCAM) is a glycoprotein expressing on the surface of neurons, glial cells, bone cells and natural killer cells. NCAM plays an important role in the process of cell - cell adhesion and cell migration, and is also a model protein to study polysialic acid. In this paper, NCAM gene from mouse mammary gland cells (NMuMG) was cloned into eukaryotic expression vectors pcDNA3.1(+) and transfected into mutant Chinese hamster ovary cells ldlD-14. The stable transfection over-expressing NCAM was obtained through the G418 selection and confirmed by Western blotting. Due to unique characters of ldlD-14 cells, carbohydrate chain of NCAM molecule can be easily manipulated with or without adding galactose in the serum free medium, and this modification can provide the basis for further studies on the effect of glycosylation on NCAM molecular function.
Animals ; CHO Cells ; Cloning, Molecular ; Cricetinae ; Cricetulus ; Female ; Galactose ; Glycosylation ; Mammary Glands, Animal ; cytology ; Mice ; Neural Cell Adhesion Molecules ; biosynthesis ; Polysaccharides ; chemistry ; Sialic Acids ; chemistry ; Transfection

BACKGROUND:The micro-ecological environment has been broken when the ocular prosthesis was inset into the conjunctival sac. The recede of self cleaning function is more conducive to the microbial growth and colonization. The cleaning of plaque biofilm on ocular prosthesis surface affects the patient's wearing comfort and quality of life. It is necessary to seek an effective cleaning method. OBJECTIVE:To compare the clearance effect of five cleaning methods on the palque biofilm on ocular prosthesis surface. METHODS: The conjunctival secretions from 84 patients who were subjected to ocular prosthesis repair were taken for bacterial culture and identification. Fifty pieces of self-curing resin and thermosetting resin artificial eyes were produced. The artificial eyes in each group were randomly divided into five groups, and were cleaned respectively with clear water, volume fraction of 75% ethanol, Boston SIMPLUS, polident and toothpaste. After the completion of the cleaning, the test piece was conducted residual biofilm culture. The clearance effects of different processing modes were evaluated using colony counting method. RESULTS AND CONCLUSION: Eighty-four specimens were submitted for inspection, of which 49 were positive. The Staphylococcusaureus separation rate was 14.29%.Staphylococcus epidermidis separation rate accounted for 13.10%. Maxwel Corynebacterium separation rate accounted for 7.14%. When water, Boston SIMPLUS and toothpaste were used for cleaning, theStaphylococcus aureus colony number in the self-curing resin group was higher than that in the thermosetting resin group (P< 0.05); when ethanol and polident were used for cleaning, there was no difference in the Staphylococcus aureus colony number between these two groups. In self-curing resin, the colony count in the clear water treatment group was higher than that in the other treatment groups (P < 0.05). The colony count in the ethanol treatment group was lower than that in the Boston SIMPLUS group (P < 0.05). There was no significant difference in the colony count between other groups. In thermosetting resin, the colony count in the clear water treatment group was higher than that in the other treatment groups (P < 0.05). There was no significant difference in the colony count between other groups. These results demonstrate that ethanol, Boston SIMPLUS, polident and toothpaste have better cleaning effects onStaphylococcus aureusbiofilms on the surface of two kinds of ocular prostheses than the clear water rinse. Overal, it is encouraged to clean the artificial eyes using polident and Boston SIMPLUS, in order to avoid the occurrence of microbial infection in the conjunctival sac after wearing ocular prosthesis.

Objective To explore the relationship between the endovascular aortic repair (EVAR)in patients with abdominal aortic aneurysm (AAA) and postoperative systemic inflammatory response syndrome (SIRS).Methods In this study,93 AAA patients undergoing EVAR were enrolled.Analysis was performed to evaluate the incidence of SIRS during peri-operation period.Logistic multiple regression analysis was performed to determine the parameters predicting SIRS.Results The incidence of SIRS was 58.1％.Aneurysm size,mural thrombus,iliac artery lesion,number of stent,operating time,volume of contrast agent,blood loss and length of stay were all significantly correlated with SIRS (P ＜ 0.05).In a logistic regression model,history of kidney disease or operation,aneurysm size,ruptured aneurysm and number of stents were strongly and independently associated with SIRS.Conclusions SIRS is common in AAA patients after EVAR.Optimizing treatment strategies avoiding risk factors for SIRS benefits AAA patients.

Objective To probe into the reasons for and results of remedial surgical therapy in thoracic aortic dissection patients after first endovascalar repair.Methods From July 2000 to December 2012,12 cases received second interventional surgery.The average time from second therapy to first surgery was ( 14 ± 11 ) months.Main reasons for second endovascular therapy were sustained type Ⅰ endoleak at proximal landing zone and type A dissection caused by retrograde tear.Therapies included hybrid operations in 8 cases and absnlute endovascular therapy in 4 cases.Results The 30 day mortality after the second intervention was 5.6％ ( 1/12),total mortality rate was 16.7％ (2/12).In 7 cases with endoleak,small endoleak remained after remedial therapy (57.1％ ) in 4 cases.Among 4 cases with secondary type A aortic dissection,successful staged hybrid operation with mid-sternal thoracotomy was adopted in 3 cases,one died of pulmonary emtbolism during follow-up period,1 case with Bebcet disease still had proximal type Ⅰ endoleak after second hybrid operation,and died from tear of aorta.Conclusions Endoleak and secondary type A aortic dissection are the main cause necessitating second intervention after primary endovascular therapy for thoracic aortic dissection.Hybrid operation remains the best choice to treat postoperative complications after endovascular therapy for thoracic aortic dissection.

Objective To evaluate early results of Endurant stent-graft in the treatment of abdominal aortic aneurysms (AAAs).Methods From July 2010 to June 2011,68 patients (57 men,11 women; mean age 74.3 years) were treated with Endurant stent-graft at our center.26 cases had hostile proximal neck in the anatomy.According to ASA classification,15 cases were class Ⅱ ; 32 cases were class Ⅲ and 21 cases were class Ⅳ.Results Intraoperative immediate technical success was achieved in all cases.At completion angiography,a type Ⅱ endoleak was detected in 18 (26％) of the 68 patients.The mean operation time was (96 ± 29) min,the mean blood loss was (99 ± 68 ) ml,and the mean contrast usage was (122 ± 65) ml.No intraoperative conversion to open surgery,stent migration,types Ⅰ/Ⅲ endoleak,other major complications,or death was encountered.49 patients (72％) had a postimplantation syndrome with fever,leukocytosis,and increase of C-reactive protein levels,which completely resolved within two weeks.The mean follow-up time was (8 ± 5) months.Conclusions Endurant stent-graft seems to be safe and effective in endovascular aneurysm repair,even in patients with hostile aortoiliac anatomy.

Objective To evaluate aneurysm sac pressure monitoring during endovascular repair (EVAR)of abdominal aortic aneurysm. Methods From April 2006 to May 2007,12 patients with abdominal aorta aneurysm underwent endovascular aneurysm repair.The average max-diameter of the aneurysm WR8(5.83±0.95)cm.The sac pressure was monitored during the whole process of the operation.The correlation between the pressure and endoleaks and long-term outcomes was observed during follow-up.Results Before the stentgraft was delivered.sac pressure was equal to the systemic blood pressure in all the 12 cases.After the EVAR wag finished,the sac systolic pressure dropped by＞40% in 11 cases,among which sac blood pressure bropped by ≥50% in 7 cases.sac pressure did not change in 1 case.In all the 12 cases,pulse pressure diminished by＞30%,and＞75%in 6 cages.During the follow-up,there were no endoleaks and death.In 5 Cases.with sac systolic pressure drop＞50%,the max-diameter of the aneurysm decreased by 1.6～3.1 mm,while in one c88e,in which sac pressure had no change the postoperative maxdiameter of the aneurysm has increased by 3.2 nma. Conclusion Abdominal aorta aneurysm sac pressure monitoring during EVAR helps to predict the change of the sac pressure after EVAR,and to detect the endoleaks.

Objective To study the anatomical characteristics of ascending aortic and aortic arch in adult Chinese. Methods From Sep 2006 to Sep 2007, we retrospectivly reviewed 388 volunteers undergoing thoracic aorta CTA in our institution. We measured the diameter of ascending aorta, aortic arch, and branch vessels of aortic arch respectively in AW4.2 work station. CHESS statistical software was used to analyze data. Results The aortic diameter above coronary artery (CA) (D1), the level at origin of brachiocephalie trunk (BCT) ( D3 ), the halfway of the AA( D2 ), the level at origin of LCCA( D4 ) , the level at origin of LSA ( D5 ) and the level at distal origin of LSA ( D6 ) respectively are: ( 34 ± 5 ) mm; ( 33 ± 4) mm; ( 34 ± 5 ) mm; ( 30 ± 4) mm; ( 28 ± 3 ) mm; ( 26 ± 3 ) mm. The diameters of two level between the origin of BCT and RSA are ( 13. 1 ± 1.9) mm, ( 12. 8±2. 3) mm, respectively. The diameter of two level at LCCA is ( 8. 7 ± 1.5 )mm and ( 7. 9 ± 1. 0) mm respectively. The diameter of two level between the origin of LSA and L-vertebral arteryis (10.7±1.7) mm,(9.3±1.3) mm, respectively. Conclusion The data of the diameter and length of ascending aort and vasculature arising from the arch abtained by CT topography in Chinese volunteers are very useful for clinical practice.

Objective To compare the therapeutic effect of endovascular repair (EVAR) and open surgical repair(OSR) of abdominal aortic aneurysm in high-risk patients. Methods The clinical data of 55 patients from 1998 to 2008 with infrarenal abdominal aortic aneurysm who received surgical treatment were analyzed by using the customized probability index. The perioperative and short term advantages and disadvantages of OSR group (n=20) were compared with EVAR group (n=35). Results All patients in OSR group were followed up, 94% patients in EVAR group were followed up, the mean follow up time were 75 and 70 months respectively. (1) Compared to OSR group, the EVAR group had shorter operation time [(3.1±0.6) h vs (4.9±0.9) h, P<0.05], (2) EVAR group had shorter ICU and hospital stay after operation and less blood loss (P<0.01), (3) Compared to OSR group, the EVAR group had lower mortality within 30 d(2.86% vs 15%), (4)the EVAR group had lower peri-operative complications(17% vs 40%), (5) The main complications of EVAR were endoleak (8.57%), (6) The main complications of OSR was cadiovascular incidence(25%). Conclusions Endovascular treatment, indicated for AAA in high-risk patients, can cut down the perioperative incidence of cadiovascular events, mortality and complications. CPI is useful to estimate the perioperative incidence of cadiovascular events, mortality and complications, and can be used to guide the therapeutic method.

Objective:To summarize the midterm to long-term outcomes and experiences of endovascular treatment (ET) of spontaneous isolated superior mesenteric artery dissection (SISMAD).Methods:The clinical data of 31 SISMAD patients from Jan 2011 to Dec 2019 treated with ET was retrospectively analyzed.Results:Successful ET was achieved in 29 patients with a technical success rate of 93.5%. A total of 36 self-expandable bare stents were planted in 28 patients and plain old balloon angioplastry (POBA) was performed in 1 patient. Abdominal pain disappeared within 24 hours in 89.3% of the patients after stenting. The rate of perioperative complication was 3.2%. There was no SMA dissection rupture bleeding, nor perioperative death occurred. The mean follow-up time was 53.5 (range, 6 to 110) months. There was no dissecting aneurysm formation, no SMA rupture and bleeding, and no stent rupture during the follow-up. The post ET 1-year, 3-year, and 5-year free from reintervention rate were 100%, 100%, and 91.7%, respectively.Conclusions:ET for SISMAD is safe and effective with satisfactory perioperative and midterm to long-term outcomes.