Objective To analyze the changes in optical coherence tomography angiography (OCTA) parameters in patients with essential hypertension，and to explore the effect of blood pressure on OCTA parameters. Methods A total of 164 patients with essential hypertension were selected and divided into controlled blood pressure group (n=92) and uncontrolled blood pressure group (n=72). OCTA examination was performed on the optic disc and macula of all patients, and the right eyes were selected for analysis. Results There were no significant differences in retinal nerve fiber layer (RNFL) thickness, radial peripapillary capillary (RPC) total vascular density, RPC total small vessel density, perifovea superficial capillary plexus (SCP) vascular density, and perifovea deep capillary plexus (DCP) vascular density between the two groups of patients. There were no significant differences in foveal avascular zone (FAZ) area, FAZ diameter, and fovea retinal thickness between the two groups of patients. The density of the parafovea SCP, parafovea DCP, and fractal dimension (FD) in the uncontrolled blood pressure group were significantly lower than those in the controlled blood pressure group (P＜0.05). Multiple linear regression analysis showed that elevation of blood pressure was a independently related factor of reduced parafovea DCP density (P＝0.026), while there was no correlation between the uncontrolled blood pressure and parafovea SCP density and FD level. Conclusions The blood pressure level is correlated with the parafovea DCP density, while has no correlation with other OCTA parameters in hypertension patients.

Objective : To investigate the effect and mechanism of M2 macrophage polarization induced by HCT116 with highly metastatic colorectal cancer cells on immune escape in colorectal cancer. Methods : After the co-culture of colorectal cancer cells conditioned medium(CM) and PMA-induced M0 macrophages, the polarization of M2 macrophages was observed by flow cytometry, real-time polymerase chain reaction(qPCR) and enzyme-linked immunosorbent assay(ELISA) experiments. The CMM0, CMSW480-Mφ and CMHCT116-Mφ were co-cultured with HCT116 cells, and the expression of programmed death-ligand 1(PD-L1) was detected by Western blot and qPCR. At the same time, the stimulated HCT116 cells were co-cultured with human T lymphocytes to detect the survival of HCT116 cells and the levels of tumor necrosis factor-α(TNF-α) and interferon-γ(IFN-γ). The difference of kruüppel-like factor 4(KLF4) expression between SW480 and HCT116 cells was detected by Western blots, qPCR and ELISA. After pretreatment of HCT116 cells with KFL4 inhibitor Kenpaullone(Ken), the CMHCT116 and CMHCT116+Ken were co-cultured with M0 macrophages and the polarization of M2 macrophages was observed by flow cytometry, qPCR and ELISA. The CMHCT116-Mφ and CM_((HCT116+Ken)-Mφ) was co-cultured with HCT116 cells, and the PD-L1 expression of HCT116 cells was detected by Western blot and qPCR. Results: After the stimulation of M0 macrophages with CM, the proportion of CD11b+CD206+ cells in HCT116-Mφ cells was higher, and the expression of M2 macrophage markers interleukin(IL-10) and transforming growth factor-β(TGF-β) were higher. Compared with the CMSW480-Mφ group, the PD-L1 protein expression level was higher in the CMHCT116-Mφ group. After co-culture with T lymphocytes, the cell survival rate are the most in CMHCT116-Mφ group, while the levels of TNF-α and IFN-γ were the lowest. After the addition of Ken, the polarization ratio and markers of M2 macrophages decreased. Compared with CMHCT116-Mφ group, the expression of PD-L1 in HCT116 cells of the CM_((HCT116+Ken)-Mφ) group decreased. Conclusion Highly metastatic colorectal cancer cells induce polarization of M2 macrophages by secreting KLF4, promote PD-L1 expression in colorectal cancer cells, facilitate tumor immune escape, and provide potential targets for clinical immunotherapy.

To develop a new type of moxibustion treatment equipment based on moxibustion heat,light and smoke factors.It was composed of three parts:upper cylinder,middle cylinder and lower cylinder,which integrated multiple functions such as temperature control,ash collection,adsorption,and anti-scalding,and all parts could be disassembled.It is convenient to use,convenient for clinical treatment and health care,can overcome the problem of not being able to adjust the temperature of moxibustion therapy and easy to burn in the process of moxibustion,reduce the irritation and pollution of moxa smoke smell and smoke dust on doctors,patients and the diagnosis and treatment environment,and make moxibustion therapy more convenient,efficient and safe.

Objective:To construct the clinical management model of a new type of smoke-purifying temperature-controlled moxibustion device based on the whole life cycle theory,and to explore its management effect on the new type of smoke-purifying temperature-controlled moxibustion device.Methods:The clinical management model of a new type of smoke purification and temperature-controlled moxibustion device was constructed based on the whole life cycle theory with the architecture of the basic layer,access layer,service layer,data layer and application layer.Eighteen new type of smoke purification and temperature-controlled moxibustion devices in clinical use in the Shijiazhuang Pingan Hospital from 2021 to 2022 were selected,and the conventional new smoke-purifying temperature-controlled moxibustion device management scheme(referred to as the conventional management mode)and the new smoke purification and temperature-controlled whole life cycle management model(referred to as the whole life cycle management mode)were adopted respectively according to different management modes.The management effect of the new smoke-purifying temperature-controlled moxibustion therapy device and the satisfaction of the relevant management personnel were compared between the two management modes.Results:The average scores of the management quality,temperature control effect,smoke control effect and moxa smoke purification effect of the new smoke purification moxibustion device using the whole life cycle management mode were(89.37±3.48)points,(93.53±4.26)points,(0.13±0.04)points and(0.11±0.03)points,respectively,the average scores of management quality and temperature control effect were higher those of the conventional management mode,and the average scores of smoke control effect and moxa smoke purification effect were lower than those of the conventional management mode,the difference was statistically significant(t=11.744,14.850,11.266,24.593,P<0.05).The satisfaction scores of engineers,medical staff and patients in the use of the new smoke purification and temperature control moxibustion therapy device adopting the whole life cycle management model were(95.69±6.62)points,(96.82±5.87)points and(95.34±5.14)points,respectively,which were higher than those of conventional management mode,the difference was statistically significant(t=9.334,19.549,33.694,P<0.05).Conclusion:The application of the clinical management model of a new type of smoke-purifying temperature-controlled moxibustion device based on the whole life cycle theory to new type of smoke purification and temperature control moxibustion therapy device can effectively improve the quality of equipment management,improve the temperature control effect of the new smoke and temperature control moxibustion device,and improve the satisfaction of relevant users.

Objective:To compare the effectiveness and safety of in vitro fenestration and in situ fenestration for reconstruction of the left subclavian artery in patients with aortic arch diseases.Methods:A retrospective analysis was conducted on 80 patients with thoracic aortic dissection, aortic aneurysm, and aortic intramural hematoma involving the left subclavian artery at our center from Jan 2020 to Oct 2023.Results:Thirty-eight patients underwent in vitro fenestration to reconstruct the left subclavian artery, while 42 patients underwent in situ laser fenestration to reconstruct the left subclavian artery. The technical success rates were 97.4% and 97.6% respectively, without statistically significance ( P>0.05). Postoperative CTA examination showed that the primary rupture of the dissection was completely closed, 3 cases had type Ⅱ endoleak in vitro fenestration, and 2 cases had type Ⅱ endoleak in laser in situ fenestration. The blood flow inside the fenestration stent was fluent. During the perioperative period, one patient in the in vitro fenestration group experienced mild cerebral infarction (2.6%), one patient had mild paraplegia, and no related complications occurred in the other patients. Conclusion:For patients with aortic arch diseases, both in situ laser fenestration and in vitro fenestration are safe and effective.

Objective:To evaluate the safety and efficacy of 3D printing-assisted pre-fenestration and branch stent endovascular repair (F/b EVAR) in the treatment of thoracoabdominal aortic aneurysms.Methods:The clinical data of 26 patients treated with 3D printing-assisted F/b EVAR for complicated thoracic and abdominal aortic diseases at the Department of Vascular Surgery, the Ninth People's Hospital,Shanghai Jiaotong University School of Medicine from May 2019 to Sep 2022 were retrospectively analyzed.Results:The success rate in these 26 cases of TAAA with 3D printing combined with F/b EVAR was 97.89%, and the mean follow-up time was (8.03±4.15) months. Four cases had Ⅲc internal leakage and disappeared during the follow-up. One case of type Ⅲ leakage were narrowed during follow-up. Ic type internal leakage occurred in 1 patient and disappeared after the addition of a stent at the distal end. During the follow-up period, aortic CTA indicated that 1 patient had renal artery stent occlusion and smooth blood in other visceral branches. No complications such as organ ischemia, lower limb ischemia and all-cause death occurred during follow-up.Conclusion:3D printing-assisted F/b EVAR minimally invasive repair of TAAA is a feasible, effective and safe technique, with high success rate and low complication rate of visceral branch artery reconstruction.

OBJECTIVE：To study the spectrum-effect relationship of HPLC finger print of different polar parts of Ampelopsis grossedentata with its in vivo anti-inflammatory effect. METHODS ：A. grossedentata was reflux extracted with 70％ ethanol，then extracted with petroleum ether ，chloroform，ethyl acetate and water saturated n-butanol；or it was directly decocted with water and then concentrated to obtain different polar parts. The xylene-induced mice ear swelling model was established ；using dexamethasone as positive control ，anti-inflammatory activity of different polar parts of A. grossedentata was investigated. Fingerprints of different polar parts of A. grossedentata were established by HPLC. The determination was performed on Poroshell 120 EC-C18 column with mobile phase consisted of acetonitrile- 0.1％ phosphoric acid solution （gradient elution ）at the flow rate of 1 mL/min. The column temperature was 25 ℃. The detection wavelength was set at 365 nm，and sample size was 5 μL. The grey ralational analysis method was used to analyze the spectrum-effect relationship of HPLC fingerprint common peaks of different polar parts of A. grossedentata with its anti-inflammatory effect. The correlation coefficient and correlation degree were calculated and ranked. RESULTS：Anti-inflammatory experiment showed that the anti-inflammatory effects of 70％ ethanol extraction part ，ethyl acetate extraction part and water extraction part were the most significant （inhibitory rates of ear swelling were 54.07％，30.54％， 30.45％）. Five common peaks were determined in HPLC fingerprints of different polar parts from A. grossedentata . The spectrum-effect analysis results showed that the correlation of5 common peaks were higher than 0.6；among them ，peak 3 and peak 2 （dihydromyricetin） had the strongest anti- inflammatory effect ，and their correlation degrees were both mail：123745789@qq.com greater than 0.8. CONCLUSIONS ： The anti-inflammatory effect of A. grossedentata on xylene-induced ear swelling in mice is the result of multi-comp onent synergy ； unknown substance of peak 3 and dihydromyricetin may be the main active components of A. grossedentata .

With the continuous development of endovascular surgery, thoracic endovascular aortic repair (TEVAR) has gradually replaced traditional open surgery and has become the preferred treatment strategy for Stanford type B aortic dissection. However, the disadvantage of the short proximal landing zone greatly limited the indication of TEVAR surgery and affected the prognosis. In recent years, many strategies such as hybrid surgery, in vitro fenestrated and branched aortic endo-graft, chimney technique, in-situ fenestration technique, etc., have been developed, which greatly broadens the TEVAR indication and improved the prognosis.

Objective To evaluate the application value of diode laser in situ fenestration in the thoracic endovascular aortic repair (TEVAR) for the treatment of aortic arch disease.Methods The retrospective crosssectional study was conducted.The clinical data of 110 patients with aortic arch disease who underwent TEVAR using diode laser in situ fenestration in the Ninth People's Hospital of Shanghai Jiaotong University School of Medicine from January 2014 to June 2017 were collected.TEVAR using diode laser in situ fenestration was performed according to the lesion involving the three branches of aortic arch.Observation indicators:(1) surgical and intraoperative situations;(2) follow-up.All patients were followed up by outpatient examination,inpatient examination and telephone interview up to May 2017.CT angiography was performed to evaluate the patency of the stents and presence of endoleak at 3,6,and 12 months postoperatively.Measurement data with normal distribution were represented as x ±s.Results (1) Surgical and intraoperative situations:106 of 110 patients underwent successful TEVAR using diode laser in situ fenestration.Intraoperative digital subtraction angiography (DSA) showed that primary aortic dissection incisions were completely closed,with a patency of all stents and no fenestration-related endoleaks.The surgical success rate was 96.36％ (106/110).Two patients died of intraoperative pericardial tamponade and 2 received chimney stent implantation after complex anatomic configuration of the aortic arch inducing to failure of the innominate artery fenestration.Of 106 patients,70 received left subclavian arterial fenestration,30 received 3 aortic branches fenestration and 6 received both left subclavian arterial and left common carotid arterial fenestrations.The operation time and dose of contrast agent in 110 patients were respectively (140±9)minutes and (185±-5)mL.Four patients had postoperative complications,1 died of severe pulmonary infection and 3 with cerebral infarction were improved by anti-platelet,brain nerve nutrition and other symptomnatic treatment.Other patients had no transient ischemic attack,stroke,brain infarction,myocardial infarction or other neurological complications.Duration of hospital stay of the 110 patients was (15 ± 7)days.(2) Follow-up:99 of 107 patients were followed up for 2-17 months,with a median time of 10 months.During the follow-up,there were patencies of all stents,and endoleaks of 4 patients occurred and were closely followed up and observed.Conclusion The diode laser in situ fenestration is safe and feasible in the TEVAR for the treatment of aortic arch disease,with satisfactory short-term outcomes.

Objective To prepare quercetin ( QUE) loaded chitosan nanoparticles ( CS-NPs), evaluate its physicochemical properties and antioxidation activity in vitro.Methods Quercetin chitosan nanoparticles were prepared by ionic crosslinking method and self-assembly method.The preparation method was optimized using entrapment efficiency (EE), drug loading (DL) and size as indexes.The best formulation and preparation conditions were optimized by orthogonal test based on single-factor test, evaluation indicator as particle size and EE.The physicochemical properties of the obtained QUE-CS-NPs were characterized by the following methods: the transmission electron microscope (TEM), dynamic light scattering (DLS) analysis for morphology, size distribution and Zeta potential.In vitro release behavior in 0.5% SDS solution was evaluated by dialysis tube method.In vitro antioxidant activity assays were performed by evaluating the abilities of the microspheres for hydroxide radicals and superoxide anions .Results TEM results revealed QUE-CS-NPs with round and uniform.Particle-size analysis showed that the diameters and Zeta potential of the QUE-CS-NPs were (282.9 ±20) nm and (30.5 ±2) mV, with uniform distribution (polydispersity below 0.185).DL and EE of QUE-CS-NPs were (8.81 ±0.65) %and (80.02 ±1.04) %, respectively.QUE-CS-NPs showed extended administration times with 66.2% cumulative release within 72 h.QUE-CS-NPs showed pronounced antioxidant activity and a concentration dependent, even more substantial than that of pure QUE.Conclusion QUE-CS-NPs show a good size, sustain release effect and pronounce antioxidant activity.