Objective The efficacy of prophylactic aneurysmal sac embolization is still unclear.The purpose of this study is to evaluate the safety and efficacy of prophylactic aneurysmal sac embolization with N-butyl cyanoacrylate(NBCA)during endovascular aortic repair(EVAR)in patients with abdominal aortic aneurysms(AAA)so as to prevent the occurrence of type Ⅱ endoleak.Methods The clinical data of patients with AAA,who received EVAR from January 2019 to January 2022 at Gansu Provincial Hospital,were retrospectively analyzed.According to the strict inclusion and exclusion criteria,a total of 74 AAA patients were enrolled in this study.Of the 74 AAA patients,intraoperative prophylactic injection of NBCA into the aneurysmal sac to embolize the sac cavity during EVAR was performed in 36(study group),while standard EVAR treatment was carried out in 38(control group).The clinical data of the 74 patients,mainly including age,gender,underlying diseases,diameter of the aneurysm,hospitalization cost,time spent for surgery,type of stent,mode of anesthesia,etc.were collected.The primary endpoint was the incidence of endoleak during follow-up period,and the secondary endpoints included the rate of endoleak-related re-intervention,adverse events,and mortality during follow-up period.Results Before surgery,there were no statistically significant differences in gender,age,diameter of the aneurysm[55.46(15.60)mm vs 63.15(24.00)mm],and underlying diseases between the study group and the control group,and no intraoperative complications occurred.The technical success rate was 100％in both groups.Three months after EVAR treatment,the incidence of type Ⅱ endoleak in the study group was significantly lower than that in the control group(2.86％vs 21.05％,P＜0.01);six months after EVAR treatment,the incidence of type Ⅱ endoleak in the study group and the control group was 8.82％and 28.95％respectively(P＜0.01);and 12 months after EVAR treatment,the incidence of type Ⅱ endoleak in the study group and the control group was 8.82％and 31.43％respectively(P＜0.01).In the study group a total of 4 times of re-intervention were carried out,one of which was associated with type Ⅱ endoleak.In the control group a total of 8 times of re-intervention were conducted,6 of which were associated with type Ⅱ endoleak.No statistically significant difference in the overall re-intervention rate existed between the two groups(P=0.224).The type Ⅱ endoleak-related re-intervention rate in the study group was slightly lower than that in the control group,but the difference was not statistically significant(P=0.106).Conclusion Prophylactic injection of NBCA into the aneurysmal sac cavity of AAA during EV AR procedure is a simple,safe and effective method,which can significantly reduce the occurrence of type Ⅱ endoleak in the early-middle stage and prevent the enlargement of the aneurysmal sac after EVAR,besides,it has no significant effect on the re-intervention rate and mortality,does not significantly prolong the operation time,and does not increase the dosage of contrast agent.

Objective:To investigate the mechanism of PLD2 alleviating panapoptosis during pancreatic cell injury through Nrf2-NFκB pathway.Methods:Rat pancreatic AR42J cells purchased from ATCC were used for experimental study. The cultured and treated cells were divided into the following groups: CON group (AR42J cells cultured under conventional conditions), CER group (AR42J cells were added with 10 nM cerulein in order to establish the in vitro pancreatitis model), CER+pcDNA group (non-target plasmid negative control PcDNA was established on the basis of the in vitro pancreatitis model), and CER+ PLD2-OE group (based on in vitro pancreatitis model, PLD2-OE of PcDNA PLD2-overexpression plasmid was established). PLD2 expression was detected by RT-qPCR. The levels of inflammatory factors in cell supernatant were detected by RT-qPCR. The expression of Nrf2-NFκB signaling pathway was analyzed by protein imprinting. The expressions of apoptosis-related, pyrodeath related and necrotic proteins were analyzed by protein imprinting.Results:The expression of PLD2 mRNA in CER+ PLD2-OE group (1.79±0.12) was higher than that in CON group (0.54±0.01) and CER+pcDNA group (0.62±0.01). The expressions of TNF-α mRNA (2.95±0.21), IL-6 mRNA (2.35±0.18) and IL-10 mRNA (3.22±0.20) in CER+PLD2-OE group were higher than those in CER+ pcDNA group (4.25±0.25; IL-6 mRNA: 3.64±0.21; IL-10 mRNA: 3.22±0.20). The expression of Nrf2 protein (0.49±0.01) in CER group was lower than that in CON group (1.02±0.01), and the expression of NFκB protein (2.52±0.21) in CER group was higher than that in CON group (1.01±0.01). The expression of Nrf2 protein (1.24±0.03) in CER+PLD2-OE group was higher than that in CER+ pcDNA group (0.50±0.01), and the expression of NFκB protein (1.68±0.14) in CER+PLD2-OE group was lower than that in CER+ pcDNA group (2.46±0.22). The expression of Bax protein in CER group (1.83±0.14) was higher than that in CON group (1.04±0.02), and the expression of Bcl-2 protein in CER group (0.31±0.01) was lower than that in CON group (1.02±0.01). The expression of Bcl-2 protein (0.75±0.02) in CER+PLD2-OE group was higher than that in CER+ pcDNA group (0.30±0.01), and the expression of Bax protein (1.42±0.11) in CER+PLD2-OE group was lower than that in CER+ pcDNA group (1.85±0.13). The expression of Gasdermins protein (1.72±0.13), Caspase-1 protein (1.88±0.15) and NLRP3 protein (1.77±0.13) in CER group was higher than that in CON group (Gasdermins: 1.13±0.04; Caspase-1:1.08 ±0.02; NLRP3:1.05±0.03). The expression of Gasdermins protein (1.24±0.05), Caspase-1 protein (1.16±0.04) and NLRP3 protein (1.17±0.05) in CER+PLD2-OE group was higher than that in CER+pcDNA group (Gasdermins: 1.69±0.12; Caspase-1:1.75±0.13; NLRP3:1.80±0.14). The expressions of RIPK1/RIPK3 protein (0.52±0.01), MLKL protein (0.48±0.01) and TNFR1 protein (0.51±0.01) in CER group were higher than those in CON group (RIPK1/RIPK3:1.04 ±0.02; MLKL: 1.03±0.01; TNFR1:1.01±0.01), and CER+PLD2-OE RIPK1/RIPK3 proteins (0.65±0.02), MLKL proteins (0.54±0.01) and TNFR1 proteins (0.63±0.01) were more expressed than CER+pcDNA group (RIPK1/RIPK3: 1.72±0.15; MLKL: 1.65±0.13; TNFR1:1.81±0.16) .Conclusion:PLD2 plays a key role in the regulation of panapoptosis (apoptosis, pyrodeath and necrosis), and effectively alleviates pancreatic cell damage by activating Nrf2 antioxidant pathway and inhibiting NFκB inflammatory pathway.

Objective:To analyze the predictive value of miR-155-5p, miR-16 and miR-129-5p on the efficacy of continuous renal replacement therapy (CRRT) in children with septic shock.Methods:A total of 179 children with severe sepsis admitted to Shanxi Provincial Children′s Hospital from January 2021 to January 2022 were selected, 89 children with septic shock were selected as group A, 90 children with non-septic shock were selected as group B, and 80 healthy children were selected as group C. The expressions of miR-155-5p, miR-16 and miR-129-5p were measured and compared. The patients in the group A were divided into the effective group and the ineffective group according to the curative effect of CRRT treatment. The expressions of miR-155-5p, miR-16 and miR-129-5p in the two groups were compared, and its predictive value for the efficacy of CRRT treatment was analyzed.Results:Compared with group C and group B, the expressions of miR-155-5p in group A was higher: 2.56 ± 0.98 vs. 1.41 ± 0.35, 0.53 ± 0.11; and the expressions of miR-16 and miR-129-5p were lower: 1.00 ± 0.27 vs. 2.23 ± 0.98, 3.38 ± 1.01; 0.65 ± 0.17 vs.1.39 ± 0.22, 2.25 ± 0.76, there were statistical differences ( P<0.05). The results of Logistic regression analysis showed that the sequential organ failure assessment(SOFA) scores, white blood cell count, C reactive protein, procalcitonin, interleukin-6, tumor necrosis factor-alpha , N-terminal B-type natriuretic peptide precursor and the expressions of miR-155-5p, miR-16, miR-129-5p were independent risk factors for the efficacy of CRRT treatment in the children with septic shock. The results of Pearson correlation analysis showed that miR-155-5p was negative correlation with miR-16 and miR-129-5p ( r = - 0.411, - 0.369, P<0.05); and miR-16 was positive correlation with miR-129-5p ( r = 0.444, P<0.05). The results of receiver operating characteristic curve showed that the combination of the three items had a higher predictive value for the efficacy of CRRT in children with septic shock ( P<0.05). Children with high expression of miR-155-5p and low expression of miR-16 and miR-129-5p had higher mortality ( P<0.05). Conclusions:The expressions of miR-155-5p, miR-16 and miR-129-5p are abnormally in children with septic shock and are related to the efficacy of CRRT, which can be used for early prediction of the efficacy of CRRT.

Objective To evaluate the clinical effects of nasal continuous positive airway pressure (NC-PAP) and surfactant administration in preterm infants with neonatal respiratory distress syndrome(NRDS) Methods A prospective randomized study was conducted, in which infants <32 weeks' gestation with NRDS were random-ized to the aurfactant-NCPAP (S-N) group or the surfactant-mechanical ventialtion (S-M) group. Results At 7 days after birth, 1 infant (6.25%) in the S-N group and 8 infants (47.00%) in the S-M group were still undergo-ing mechanical ventilation. The duration of oxygen therapy, NCPAP and mechanical ventilation,the need for a sec-ond dose of surfactant, and the days of staying in the intensive care unit were significantly greater in the S-M group. Conclusions The immediate application of NCPAP after surfactant administration for infants with NRDS is safe and beneficial.