Objectives:To evaluate the clinical outcome of acute respiratory distress syndrome (ARDS) in patients with Stanford Type A aortic dissection (AAD).Methods:A total of 212 patients diagnosed with AAD and receiving surgical treatment in the Affiliated Hospital of Jining Medical University from January 2016 to December 2021 were included. The patients were divided into ARDS group and non-ARDS group based on the definition of ARDS Berlin after surgery. The preoperative general clinical data of the two groups were compared by univariate analysis, and the preference-matching variables were screened. The patients were divided into ARDS group ( n=63) and non-ARDS group ( n=63) by using propensity matching score, and the clinical outcome indexes of ARDS group and non-ARDS group were compared after matching. Results:A total of 63 patients (29.7%) were diagnosed with ARDS after AAD. A total of 63 pairs of patients were successfully matched using propensity score to adjust preoperative confounding factors. After matching, the proportion of total arch surgery, operation time, perioperative blood loss, red blood cell transfusion and plasma transfusion in the ARDS group were significantly higher than those in the non-ARDS group, with statistical significance (all P<0.05). After the match, In the ARDS group, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score [18(14-24)points vs 13(12-15)points], mechanical ventilation time [86.0(57.3-158.0)h vs 41.5(23.8-60.4)h], intensive care unit (ICU) stay time [7.0(6.0-11.5)d vs 4.0(3.0-6.0)d] and hospital stay [18.0(14.0-24.5)d vs 13.5(10.8-18.0)d] were significantly higher than those in the non-ARDS group, with statistical significance (all P<0.05). There was no significant difference in in-hospital mortality (3.2% vs 1.6%) or within 30 days after discharge (6.3% vs 3.2%) between the two groups (all P>0.05). Conclusions:The incidence of ARDS is higher in patients diagnosed with AAD based on the Berlin definition, but there is no increase in the mortality rate within 30 days of hospital and discharge in ARDS group. The Berlin definition of ARDS may have some limitations in the application of ARDS in patients with AAD after surgery.

Objectives:To evaluate the clinical outcome of acute respiratory distress syndrome (ARDS) in patients with Stanford Type A aortic dissection (AAD).Methods:A total of 212 patients diagnosed with AAD and receiving surgical treatment in the Affiliated Hospital of Jining Medical University from January 2016 to December 2021 were included. The patients were divided into ARDS group and non-ARDS group based on the definition of ARDS Berlin after surgery. The preoperative general clinical data of the two groups were compared by univariate analysis, and the preference-matching variables were screened. The patients were divided into ARDS group ( n=63) and non-ARDS group ( n=63) by using propensity matching score, and the clinical outcome indexes of ARDS group and non-ARDS group were compared after matching. Results:A total of 63 patients (29.7%) were diagnosed with ARDS after AAD. A total of 63 pairs of patients were successfully matched using propensity score to adjust preoperative confounding factors. After matching, the proportion of total arch surgery, operation time, perioperative blood loss, red blood cell transfusion and plasma transfusion in the ARDS group were significantly higher than those in the non-ARDS group, with statistical significance (all P<0.05). After the match, In the ARDS group, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score [18(14-24)points vs 13(12-15)points], mechanical ventilation time [86.0(57.3-158.0)h vs 41.5(23.8-60.4)h], intensive care unit (ICU) stay time [7.0(6.0-11.5)d vs 4.0(3.0-6.0)d] and hospital stay [18.0(14.0-24.5)d vs 13.5(10.8-18.0)d] were significantly higher than those in the non-ARDS group, with statistical significance (all P<0.05). There was no significant difference in in-hospital mortality (3.2% vs 1.6%) or within 30 days after discharge (6.3% vs 3.2%) between the two groups (all P>0.05). Conclusions:The incidence of ARDS is higher in patients diagnosed with AAD based on the Berlin definition, but there is no increase in the mortality rate within 30 days of hospital and discharge in ARDS group. The Berlin definition of ARDS may have some limitations in the application of ARDS in patients with AAD after surgery.

Liver is the central hub regulating energy metabolism during feeding-fasting transition. Evidence suggests that fasting and refeeding induce dynamic changes in liver size, but the underlying mechanisms remain unclear. Yes-associated protein (YAP) is a key regulator of organ size. This study aims to explore the role of YAP in fasting- and refeeding-induced changes in liver size. Here, fasting significantly reduced liver size, which was recovered to the normal level after refeeding. Moreover, hepatocyte size was decreased and hepatocyte proliferation was inhibited after fasting. Conversely, refeeding promoted hepatocyte enlargement and proliferation compared to fasted state. Mechanistically, fasting or refeeding regulated the expression of YAP and its downstream targets, as well as the proliferation-related protein cyclin D1 (CCND1). Furthermore, fasting significantly reduced the liver size in AAV-control mice, which was mitigated in AAV Yap (5SA) mice. Yap overexpression also prevented the effect of fasting on hepatocyte size and proliferation. Besides, the recovery of liver size after refeeding was delayed in AAV Yap shRNA mice. Yap knockdown attenuated refeeding-induced hepatocyte enlargement and proliferation. In summary, this study demonstrated that YAP plays an important role in dynamic changes of liver size during fasting-refeeding transition, which provides new evidence for YAP in regulating liver size under energy stress.

More and more researches demonstrate that astrocytes display the markers of neural stem cells or progenitor cells and have the potential of neural differentiation.Thus,it is possible that astrocytes,especially overactive astrocytes,could replace injured neurons and repair the damaged function by transdifferenting and gene reprogramming.Here,we summarize recent progresses of various transcription factors and their regulation in astrocytes-to-neurons transdifferentiation.

OBJECTIVETo compare quantitatively the enhanced thin CT section with pathologic findings in pulmonary carcinoma, pulmonary inflammatory pseudotumor (IPT) and pulmonary tuberculoma so as to demonstrate the relation of degree of enhancement and the vascular structure within the lesion with special emphasis on pulmonary carcinoma.

METHODSEnhanced thin CT sections were obtained in 35 cases with nodular or patchy lesions in the peripheral lung field which are difficult to differentiate clinically. There were pulmonary carcinoma 21, inflammatory pseudotumor 7 and tuberculoma 7. The number of small vessels (inner diameter 0.02 approximately 0.1 mm), relatively large vessels (inner diameter > 0.1 mm) and their vascular bed areas were analyzed by computed image analyzing system. The relation between CT average attenuation and the number of vessels or the vascular bed areas were statistically evaluated.

RESULTS1. The differences of average attenuation in carcinoma, inflammatory pseudotumor and tuberculoma were statistically significant (P < 0.05). 2. The differences in number of small vessels, relatively large vessels and vascular bed areas among these three types of lesion were also significant (P < 0.05). 3. A positive correlation was found in the average CT affenuation of lung carcinoma and its number of small vessels and relatively large vessels and 4. A positive correlation was found between the average CT attenuation in these three lesions and the relatively large vessels, total vascular amount and vascular bed areas.

CONCLUSIONS1. The average degree of attenuation, being divided into four degrees, is of practical value in the differentiation of lung carcinoma, inflammatory pseudotumor and tuberculoma. 2. The average CT attenuation of lung carcinoma, inflammatory pseudotumor and tuberculoma is in direct proportion to the number of vessels and vessel bed areas and 3. The characteristic CT enhancement in lung carcinoma reflexes the condition of vessels and blood supply within the tumor.

Adult ; Aged ; Female ; Humans ; Lung ; blood supply ; diagnostic imaging ; pathology ; Lung Neoplasms ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Plasma Cell Granuloma, Pulmonary ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; methods ; Tuberculoma ; diagnostic imaging ; pathology ; Tuberculosis, Pulmonary ; diagnostic imaging ; pathology