1.Analysis of short-and medium-term outcomes of conservative vs.endovascular treatment for spontaneous isolated superior mesenteric artery dissection
Yunpeng DING ; Xiaoliang YIN ; Dehai LANG ; Songjie HU
Chinese Journal of General Surgery 2025;34(6):1171-1177
Background and Aims:Spontaneous isolated superior mesenteric artery dissection(SISMAD)is a relatively common type of visceral artery dissection,typically presenting with acute abdominal pain.In severe cases,it may lead to intestinal ischemia or even necrosis.With the widespread use of imaging techniques such as CT angiography(CTA),the detection rate of SISMAD has significantly increased.However,there is still controversy regarding its optimal treatment strategy,especially in choosing between conservative management and endovascular intervention,as no unified standard currently exists.This study aimed to compare the short-and medium-term outcomes of the two treatment modalities by retrospectively analyzing the clinical data of SISMAD patients treated at our center in order to provide evidence for individualized treatment decisions.Methods:A retrospective analysis was conducted on 174 patients diagnosed with SISMAD at Ningbo Second Hospital between January 2018 and December 2023.Among them,30 patients received conservative treatment,and 144 underwent endovascular intervention(including stent implantation alone or in combination with coil embolization of the false lumen).All patients were diagnosed using CTA or superior mesenteric artery angiography and classified accordingly.Patients were followed up at 1 month and 1 year after treatment to assess clinical symptom relief and radiological outcomes,including dissection remodeling and stent patency.Results:In the conservative group,the symptom relief rate was 90.0%at 1 month and 92.8%at 1 year;in the interventional group,the corresponding rates were 99.3%and 98.6%.The difference in symptom relief at 1 month was statistically significant(P=0.016),while the difference at 1 year was not(P>0.05).Subgroup analysis by classification showed that the interventional group generally had higher symptom relief rates than the conservative group across all types.However,none of the differences reached statistical significance(all P>0.05).The conservative group showed poorer symptom control in type Ⅲpatients,including one death.The technical success rate of endovascular treatment was 99.3%,with no cases of stent displacement or occlusion within 1 year.The complete remodeling rate was 86.8%,and the stent patency rate was 100.0%.Some patients had minor mural thrombus formation within the stent without evidence of flow obstruction.Conclusion:Endovascular intervention offers a high technical success rate and favorable short-and medium-term efficacy in SISMAD patients,particularly for type Ⅱ and Ⅲ cases with compromised true lumen perfusion.Treatment strategies should be tailored based on the dissection type and the degree of true lumen compression to improve clinical outcomes and reduce associated risks.
2.Analysis of short-and medium-term outcomes of conservative vs.endovascular treatment for spontaneous isolated superior mesenteric artery dissection
Yunpeng DING ; Xiaoliang YIN ; Dehai LANG ; Songjie HU
Chinese Journal of General Surgery 2025;34(6):1171-1177
Background and Aims:Spontaneous isolated superior mesenteric artery dissection(SISMAD)is a relatively common type of visceral artery dissection,typically presenting with acute abdominal pain.In severe cases,it may lead to intestinal ischemia or even necrosis.With the widespread use of imaging techniques such as CT angiography(CTA),the detection rate of SISMAD has significantly increased.However,there is still controversy regarding its optimal treatment strategy,especially in choosing between conservative management and endovascular intervention,as no unified standard currently exists.This study aimed to compare the short-and medium-term outcomes of the two treatment modalities by retrospectively analyzing the clinical data of SISMAD patients treated at our center in order to provide evidence for individualized treatment decisions.Methods:A retrospective analysis was conducted on 174 patients diagnosed with SISMAD at Ningbo Second Hospital between January 2018 and December 2023.Among them,30 patients received conservative treatment,and 144 underwent endovascular intervention(including stent implantation alone or in combination with coil embolization of the false lumen).All patients were diagnosed using CTA or superior mesenteric artery angiography and classified accordingly.Patients were followed up at 1 month and 1 year after treatment to assess clinical symptom relief and radiological outcomes,including dissection remodeling and stent patency.Results:In the conservative group,the symptom relief rate was 90.0%at 1 month and 92.8%at 1 year;in the interventional group,the corresponding rates were 99.3%and 98.6%.The difference in symptom relief at 1 month was statistically significant(P=0.016),while the difference at 1 year was not(P>0.05).Subgroup analysis by classification showed that the interventional group generally had higher symptom relief rates than the conservative group across all types.However,none of the differences reached statistical significance(all P>0.05).The conservative group showed poorer symptom control in type Ⅲpatients,including one death.The technical success rate of endovascular treatment was 99.3%,with no cases of stent displacement or occlusion within 1 year.The complete remodeling rate was 86.8%,and the stent patency rate was 100.0%.Some patients had minor mural thrombus formation within the stent without evidence of flow obstruction.Conclusion:Endovascular intervention offers a high technical success rate and favorable short-and medium-term efficacy in SISMAD patients,particularly for type Ⅱ and Ⅲ cases with compromised true lumen perfusion.Treatment strategies should be tailored based on the dissection type and the degree of true lumen compression to improve clinical outcomes and reduce associated risks.
3.Immunosuppressant mycophenolic acid biosynthesis employs a new globin-like enzyme for prenyl side chain cleavage.
Xiwei CHEN ; Lu WANG ; Jinmei ZHANG ; Tao JIANG ; Changhua HU ; Dehai LI ; Yi ZOU
Acta Pharmaceutica Sinica B 2019;9(6):1253-1258
Mycophenolic acid (MPA, ) and its derivatives are first-line immunosuppressants used in organ transplantation and for treating autoimmune diseases. Despite chemical synthetic achievements, the biosynthetic formation of a seven-carbon carboxylic acid pharmacophore side chain of , especially the processes involving the cleavage of the prenyl side chain between DHMP () and DMMPA (), remains unknown. In this work, we identified a membrane-bound prenyltransferase, PgMpaA, that transfers FPP to to yield FDHMP (). Compound undergoes the first cleavage step a new globin-like enzyme PgMpaB to form a cryptic intermediate . Heterologous expression of genes in demonstrates that the second cleavage step (from to ) of is a cluster-independent process . Our results, especially the discovery of the broad tolerance of substrates recognized by PgMpaB, set up a strategy for the formation of "pseudo-isopentenyl" natural products using fungal globin-like enzymes.
4. Analysis of influencing factors on hepatic encephalopathy in patients with non-cirrhotic portal hypertension
Min LIU ; Wentao HE ; Dongsheng CHEN ; Dehai HU
Chinese Journal of Hepatology 2019;27(9):673-676
Objective:
To investigate the incidence of hepatic encephalopathy (HE) in patients with non-cirrhotic portal hypertension (NCPH) and to explore its risk factors.
Methods:
The incidence rate of HE in 150 cases with NCPH was evaluated in two hospitals, and 188 cases of compensated cirrhosis patients were taken as control. Logistic regression was used to screen for independent risk factors for HE in patients with NCPH.
Results:
The incidence of overt hepatic encephalopathy (OHE) in patients with NCPH was not statistically significantly different from that in patients with cirrhosis (4.7% vs. 6.9%,
5.Effect of alterations of the potassium channel on metastasis of human lung adenocarcinoma cell line A-549 and its mechanism
Yuxing CAO ; Lujing QIAN ; Lihua SHANG ; Jing HU ; Fang LIU ; Dehai CHE ; Yan YU
Cancer Research and Clinic 2010;22(10):656-659
Objective To study human lung adenocarcinoma cell line A-549 treated with antagonist and agonist of potassium channel how to affect metastasis of A-549 and its mechanism. Methods Invasion and migration capability of A-549 in vitro was evaluated by using transwell chamber model. Alteration of cytoskeleton was observed through immunofluorescence. Western blotting were used to detect the protein expression of Ezrin and HuR in A-549 cell lines while Glibenclamde and Pinacidil were applied to them. Results In the presence of the antagonist Glibenclamide, migration of A-549 was inhibited by (57.18±5.46)% and invasion was inhibited by (54.92±3.72)% in the transwell assay, meanwhile A-549 manifested disorder of microtubule and more orderly microfilament. And agonist of the potassium channel had an contrary effect on A-549. Ezrin and HuR protein were successfully down-regulated in A-549 treated with Glibenclamide and upregulated in A-549 treated with pinacidil. Conclusion Functional alterations of the potassium channel affects capability of migration and invision of A-549, which is associated with different expression of ezrin and HuR protein that modify cytoskeleton.
6.STUDIES ON DISTRIBUTION AND BEHAVIOR OF ANOPHELES MINIMUS AND ITS ROLE OF MALARIA TRANSMISSION IN HAINAN PROVINCE AT PRESENT
Kaichen WU ; Wenjiang CHEN ; Zhiguang WANG ; Longkun HU ; Zhiyou LIU ; Weiguo ZHU ; Dehai GUAN ; Weikang JIANG ; Guozhi CHEN ; Zhijian TANG ; Shanggan LI ; Cheng MA
Chinese Journal of Parasitology and Parasitic Diseases 1987;0(02):-
Anopheles minimus was once a main malaria vector in Hainan Island and had been e-liminated basically through the campaign of indoor residual spraying launched in 1959. It again became an incriminated vector of some focal malaria outbreaks in recent years. The present study was conducted in a selected county-Danxian and a typical hilly area-Feibar in the west part of Danxian county in 1989-1990.An. minimus was found in 50% and 62. 5 % of the surveyed sites at mountainous and hilly area of Danxian county,but not found in coastal region. An. minimus was found in all 18 sites surveyed in Feibar district constituting 52% of anopheline composition. Man-biting rate made by human-baited collection was 3. 2 before midniaght and 38. 2 when collected through whole night in some sites. However, the behaviour characteristics of An. minimus has changed. It has become exophilic,exophagic, and has an equal preference for man and cattle. The vectorial capacity of An. minimus estimated by quantitative data was in accord with malaria infection rate in Feibar district ,and the malaria infection rate among the inhabitants in three types of residential quarter with different socioeconomic conditions. Malaria infection rates of residential quarter of land-reclamation outcomers, villagers and state farm residents were 10%,2. 9% and 0. 5% respectively during 40 days from July to August,1990.Owing to the fact that An. minimus has become a secondary vector only next to An. dirus, with a wide range of distribution and a considerable different characteristics in behaviour compared to that before spraying campaign , it is suggested that a malaria control programme must be seriously planned to adjust the new problem of malaria epidemiology in Hainan Province.

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