Objective:To investigate the clinical application value of a novel filter's retraction hook capture technique of pull-assisted method for the endovascular retrieval of conical inferior vena cava (IVC) filters whose hook attached to the wall.Methods:From January 2020 to December 2024, patients with conical filters whose hook attached to the wall admitted at Beijing Jishuitan Hospital were enrolled consecutively.Results:A total of 46 patients underwent filter retrieval using filter's retraction hook capture technique of pull-assisted method. Among these patients, 39 cases (84.8%) were successful in filter retrieval, with the penetration distance of cranial anchor vertex of 3.3(2.5, 4.4) mm, and 13 (33.3%) filters were deformed. The other 7 cases were unsuccessful, with a penetration distance of cranial anchor vertex of 5.0 (4.3, 5.0) mm, and 6 (85.7%) filters were deformed. There was a statistically significant difference between the two groups ( P<0.05). One case (2.2%) had IVC injury, one case (2.2%) experienced filter fracture, and no symptomatic pulmonary embolism occurred. Logistic regression analysis showed that filter deformation was an independent dangerous factor for filter's retraction. Conclusions:Filter's retraction hook capture technique of pull-assisted method is effective in removing conical filters whose hook attached to the wall, with no symptomatic PE occurring. This method can be considered as a new adjuvant technique for filter retrieval.

Background and Aims:Acute inferior vena cava thrombosis(IVCT)commonly occurs secondary to inferior vena cava filter(VCF)implantation.If not promptly treated,it may lead to serious complications such as bilateral lower limb swelling and pulmonary embolism and can also reduce the likelihood of successful filter retrieval.Percutaneous mechanical thrombectomy(PMT)and catheter-directed thrombolysis(CDT)are currently the main interventional treatments for IVCT,but comparative studies evaluating their efficacy and safety remain limited.This study was to conduct a prospective randomized controlled trial to compare the clinical efficacy and safety of AngioJet mechanical thrombectomy versus conventional CDT in the treatment of acute IVCT and to explore factors influencing filter retrieval rates,thereby providing evidence-based guidance for clinical decision-making.Methods:From January 2022 to December 2024,patients diagnosed with acute IVCT following VCF implantation were prospectively enrolled at the Department of Vascular Surgery,Beijing Jishuitan Hospital,Capital Medical University.Patients were randomly assigned to either the CDT group(n=46)or the PMT group(n=48)according to the interventional procedure used.The two groups were compared in terms of filter retrieval rates,thrombus clearance outcomes,operative time,thrombolytic drug dosage,and incidence of complications.Logistic regression analysis was used to identify factors associated with primary filter retrieval.Results:A total of 94 patients were enrolled,with 46 in the CDT group and 48 in the PMT group.Compared to the CDT group,the PMT group demonstrated a significantly higher primary filter retrieval rate(77.1%vs.43.5%),grade Ⅲ thrombus clearance rate(70.8%vs.37.0%),and better postoperative thrombus scores.Additionally,the PMT group required lower urokinase doses and shorter thrombolysis duration(all P<0.05).The overall filter retrieval rate and 3-month IVC patency were similar between groups,both exceeding 93%.Regarding safety,the CDT group had a higher incidence of catheter-related infections and medical adhesive-related skin injury,while vagal reflex symptoms were more frequent in the PMT group.Logistic regression analysis identified thrombus clearance rate as an independent factor significantly associated with primary filter retrieval in the PMT group(OR=190.773,P<0.05).Conclusion:Compared to CDT,AngioJet mechanical thrombectomy combined with manual aspiration achieves higher thrombus clearance and primary filter retrieval rates in the treatment of acute IVCT while also reducing thrombolysis duration and drug dosage.However,attention should be paid to the increased risk of vagal reflex symptoms.There was no significant difference between the two groups in secondary filter retrieval rates or long-term IVC patency.The choice of intervention should be based on the patient's condition,timing of filter retrieval,and individualized clinical considerations.

Objective To investigate the mechanism by which suppressor of cytokine signaling 3(SOCS3)regulates microglial inflammation through nuclear factor-kappaB(NF-κB),providing novel mechanistic insights into microglial involvement in Parkinson's disease(PD)pathogenesis.Methods ① Ten male C57BL/6 mice(12 weeks old,weighing 20～25 g)were subjected to intraperitoneal injection of 15 mg/kg MPTP to establish a PD model.Rotarod test was used to assess motor function.Western blotting was employed to detect the protein expression of tyrosine hydroxylase(TH)and ionized calcium-binding adapter molecule 1(IBA-1)in the substantia nigra.RT-qPCR was utilized to measure the mRNA level of SOCS3 in the substantia nigra.Immunohistochemistry was performed to assess NF-κB p65 subunit expression.The expression of SOCS3,NF-κB and p-NF-κB was measured with Western blotting.② Microglial cell line BV2 was stimulated with 1 000 ng/mL lipopolysaccharide(LPS)for 6 h to establish an inflammatory model.Subsequently,SOCS3 was knocked down.NF-κB inhibitor BAY 11-7082 was used to treat the cells.RT-qPCR and Western blotting were used to measure the expression of SOCS3 at mRNA and protein levels.Western blotting was also applied to detect the expression of NF-κB and p-NF-κB,and ELISA was conducted to measure TNF-α and IL-1β levels in the culture supernatant.Immunofluorescence assay was carried out to localize NF-κB(nuclear vs cytoplasmic).③ A co-culture system of BV2 microglia and N2a neuroblastoma cells was established to investigate the regulatory effects of microglia on neuronal cells.MTT assay and TUNEL staining were used respectively to determine cell viability and apoptosis of N2a cells.Results ① Compared to the control mice,the PD mouse model exhibited reduced rotarod fall latency,down-regulation in TH and SOCS3(P<0.01),up-regulation in IBA-1 and increased p-NF-κB/NF-κB ratio(P<0.01).② In BV2 cells,LPS stimulation increased TNF-α,IL-1β,and p-NF-κB/NF-κB ratio(P<0.01),while down-regulated SOCS3 expression(P<0.01).SOCS3 knockdown in LPS-stimulated BV2 cells further increased the p-NF-κB/NF-κB ratio(P<0.01),increased nuclear localization of NF-κB,and elevated TNF-α and IL-1β levels(P<0.01).BAY 11-7082 treatment in these SOCS3-knockdown,LPS-stimulated cells resulted in reduced p-NF-κB/NF-κB ratio,TNF-α,and IL-1β(P<0.01),and decreased NF-κB nuclear distribution.③ LPS-stimulated BV2 cells reduced cell viability and increased cell apoptosis in N2a cells(P<0.01).SOCS3 knockdown in BV2 cells exacerbated the reduction in N2a cell viability(P<0.01)and the increase in cell apoptosis in N2a cells(P<0.01).BAY 11-7082 treatment of these SOCS3-knockdown BV2 microglia attenuated the reduction in N2a cell viability and decreased apoptosis in N2a cells(P<0.01).Conclusion SOCS3 inhibits microglia inflammatory response through down-regulation of NF-kB activity,and in turn attenuates neuronal cell death and ameliorates PD nerve injury.

Objective To demonstrate that neferine(Nef)alleviates Parkinson's disease(PD)by inhibiting microglial pyroptosis mediated through the reactive oxygen species(ROS)/NOD-like receptor protein 3(NLRP3)/Caspase-1 pathway.Methods BV2 microglial cells were divided into:control group,lipopolysaccharides(LPS)-adenosine triphosphate(ATP)group,and LPS-ATP+Nef group.Pyroptosis was induced by 1 μg/mL LPS+5 mmol/L ATP,with 2 mmol/L Nef pretreatment.Eighteen 10-12-week-old male C57BL/6 mice(22～25 g)were randomly assigned to:control(n=6),1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)(n=6),and MPTP+Nef(n=6)groups.Detection methods included:flow cytometry for pyroptosis,Cell Counting Kit-8(CCK-8)for viability,2',7'-dichlorodihydrofluorescein diacetate(DCFH-DA)for ROS,commercial kits for malondialdehyde(MDA),superoxide dismutase(SOD),glutathione(GSH),ELISA/Western blot for interleukin-1β(IL-1β)/IL-18,immunofluorescence/immunohistochemistry for NLRP3/Caspase-1,tyrosine hydroxylase(TH)immunohistochemistry,hematoxylin-eosin staining for neuropathology,and modified neurological severity score(mNSS).Results Versus control,LPS-ATP group showed decreased viability(P=0.002),increased pyroptosis(P<0.001),elevated ROS(P<0.001)/MDA(P<0.001)/IL-1β(P<0.001)/IL-18(P<0.001),upregulated NLRP3(P<0.001)/Caspase-1(P<0.001),and reduced GSH(P<0.001)/SOD(P<0.001).Nef treatment reversed these effects(all P<0.05).According to the results of murine studies,compared with the control group,the MPTP group had increased mNSS(P<0.001)/tissue ROS(P<0.001),downregulated TH(P<0.001),upregulated NLRP3(P<0.001)/Caspase-1(P<0.001).Nef treatment significantly attenuated the MPTP-induced deleterious effects(P<0.05).Histopathological analysis revealed that control group exhibited uniformly distributed hippocampal neurons with distinct nuclear morphology;MPTP group showed neuronal swelling,interstitial edema,and nuclear atrophy;MPTP+Nef group demonstrated ameliorated neuronal damage.Conclusion Nef inhibits microglial pyroptosis via ROS/NLRP3/Caspase-1 axis,ameliorating PD neuroinflammation and pathology.

Objective:To investigate the clinical application value of a novel filter's retraction hook capture technique of pull-assisted method for the endovascular retrieval of conical inferior vena cava (IVC) filters whose hook attached to the wall.Methods:From January 2020 to December 2024, patients with conical filters whose hook attached to the wall admitted at Beijing Jishuitan Hospital were enrolled consecutively.Results:A total of 46 patients underwent filter retrieval using filter's retraction hook capture technique of pull-assisted method. Among these patients, 39 cases (84.8%) were successful in filter retrieval, with the penetration distance of cranial anchor vertex of 3.3(2.5, 4.4) mm, and 13 (33.3%) filters were deformed. The other 7 cases were unsuccessful, with a penetration distance of cranial anchor vertex of 5.0 (4.3, 5.0) mm, and 6 (85.7%) filters were deformed. There was a statistically significant difference between the two groups ( P<0.05). One case (2.2%) had IVC injury, one case (2.2%) experienced filter fracture, and no symptomatic pulmonary embolism occurred. Logistic regression analysis showed that filter deformation was an independent dangerous factor for filter's retraction. Conclusions:Filter's retraction hook capture technique of pull-assisted method is effective in removing conical filters whose hook attached to the wall, with no symptomatic PE occurring. This method can be considered as a new adjuvant technique for filter retrieval.

Background and Aims:Acute inferior vena cava thrombosis(IVCT)commonly occurs secondary to inferior vena cava filter(VCF)implantation.If not promptly treated,it may lead to serious complications such as bilateral lower limb swelling and pulmonary embolism and can also reduce the likelihood of successful filter retrieval.Percutaneous mechanical thrombectomy(PMT)and catheter-directed thrombolysis(CDT)are currently the main interventional treatments for IVCT,but comparative studies evaluating their efficacy and safety remain limited.This study was to conduct a prospective randomized controlled trial to compare the clinical efficacy and safety of AngioJet mechanical thrombectomy versus conventional CDT in the treatment of acute IVCT and to explore factors influencing filter retrieval rates,thereby providing evidence-based guidance for clinical decision-making.Methods:From January 2022 to December 2024,patients diagnosed with acute IVCT following VCF implantation were prospectively enrolled at the Department of Vascular Surgery,Beijing Jishuitan Hospital,Capital Medical University.Patients were randomly assigned to either the CDT group(n=46)or the PMT group(n=48)according to the interventional procedure used.The two groups were compared in terms of filter retrieval rates,thrombus clearance outcomes,operative time,thrombolytic drug dosage,and incidence of complications.Logistic regression analysis was used to identify factors associated with primary filter retrieval.Results:A total of 94 patients were enrolled,with 46 in the CDT group and 48 in the PMT group.Compared to the CDT group,the PMT group demonstrated a significantly higher primary filter retrieval rate(77.1%vs.43.5%),grade Ⅲ thrombus clearance rate(70.8%vs.37.0%),and better postoperative thrombus scores.Additionally,the PMT group required lower urokinase doses and shorter thrombolysis duration(all P<0.05).The overall filter retrieval rate and 3-month IVC patency were similar between groups,both exceeding 93%.Regarding safety,the CDT group had a higher incidence of catheter-related infections and medical adhesive-related skin injury,while vagal reflex symptoms were more frequent in the PMT group.Logistic regression analysis identified thrombus clearance rate as an independent factor significantly associated with primary filter retrieval in the PMT group(OR=190.773,P<0.05).Conclusion:Compared to CDT,AngioJet mechanical thrombectomy combined with manual aspiration achieves higher thrombus clearance and primary filter retrieval rates in the treatment of acute IVCT while also reducing thrombolysis duration and drug dosage.However,attention should be paid to the increased risk of vagal reflex symptoms.There was no significant difference between the two groups in secondary filter retrieval rates or long-term IVC patency.The choice of intervention should be based on the patient's condition,timing of filter retrieval,and individualized clinical considerations.

Background and Aims:Acute lower extremity deep vein thrombosis (DVT) is a common clinical condition. In the acute phase,it can lead to secondary complications such as acute pulmonary embolism (PE) and limb swelling,while in the chronic phase,it may result in post-thrombotic syndrome (PTS),posing significant health risks. Early mechanical thrombectomy can restore venous patency,alleviate symptoms,and reduce the incidence of PTS. AngioJet percutaneous mechanical thrombectomy (PMT) offers the advantages of rapid and efficient thrombectomy with fewer complications,making it widely used in clinical practice. However,there are currently no standardized guidelines at home or abroad regarding the choice of access route for PMT. This study was performed to compare the clinical outcomes and effects on venous valve function of antegrade versus retrograde AngioJet PMT for treating acute lower extremity DVT,aiming to explore the optimal surgical approach for thrombectomy.Methods:A prospective,randomized controlled study was conducted,enrolling 96 patients with acute lower extremity DVT treated at the Department of Vascular Surgery,Beijing Jishuitan Hospital,Capital Medical University,from January 2022 to June 2024. Patients were divided into an antegrade group and a retrograde group based on the direction of operation and valve opening. Surgical outcomes and risks were evaluated for both groups,and factors influencing the 3-month postoperative venous patency rate were analyzed.Results:A total of 92 patients were finally included,with 47 cases in the antegrade group (51.1％) and 45 cases in the retrograde group (48.9％),all treated with AngioJet PMT. Baseline characteristics showed no significant differences between the two groups (all P>0.05). In the antegrade group,14 cases (29.8％) had thrombus interception by filters,with 7 cases (14.9％) being effective;4 cases (8.5％) developed new or worsened PE. In the retrograde group,18 cases (40.0％) had thrombus interception by filters,with 8 cases (17.8％) being effective;5 cases (11.1％) developed new or worsened PE. No significant differences were observed between the two groups in these or other safety and laboratory variables (all P>0.05). The antegrade group had a higher proportion of intraoperative manual aspiration thrombectomy compared to the retrograde group (68.1％ vs. 26.7％,P<0.001). However,there were no significant differences in thrombus grade Ⅲ clearance rate (61.7％ vs. 68.9％),3-month venous patency rate (93.6％ vs. 91.1％),or other perioperative variables (all P>0.05). Regression analysis of factors affecting 3-month venous patency showed that immediate venous patency (OR=3.043,95％ CI=0.993-1.209) and radiation dose (OR=0.868,95％ CI=-0.001-0.000) in the antegrade group,as well as immediate venous patency (OR=2.333,95％ CI=0.655-0.980) in the retrograde group,were significantly associated with 3-month patency rate (all P<0.001). Regression analysis also showed a significant linear relationship between immediate venous patency and VCSS/Villalta scores in both groups (all P<0.001). Conclusion:Both antegrade and retrograde AngioJet PMT procedures are equally safe and effective for treating acute lower extremity DVT. However,the risk of intraoperative thrombus detachment remains high,warranting the use of inferior vena cava filters to prevent fatal PE. Patients with immediate venous patency require standardized postoperative management and follow-up to prevent PTS.

Background and Aims:Acute lower extremity deep vein thrombosis (DVT) is a common clinical condition. In the acute phase,it can lead to secondary complications such as acute pulmonary embolism (PE) and limb swelling,while in the chronic phase,it may result in post-thrombotic syndrome (PTS),posing significant health risks. Early mechanical thrombectomy can restore venous patency,alleviate symptoms,and reduce the incidence of PTS. AngioJet percutaneous mechanical thrombectomy (PMT) offers the advantages of rapid and efficient thrombectomy with fewer complications,making it widely used in clinical practice. However,there are currently no standardized guidelines at home or abroad regarding the choice of access route for PMT. This study was performed to compare the clinical outcomes and effects on venous valve function of antegrade versus retrograde AngioJet PMT for treating acute lower extremity DVT,aiming to explore the optimal surgical approach for thrombectomy.Methods:A prospective,randomized controlled study was conducted,enrolling 96 patients with acute lower extremity DVT treated at the Department of Vascular Surgery,Beijing Jishuitan Hospital,Capital Medical University,from January 2022 to June 2024. Patients were divided into an antegrade group and a retrograde group based on the direction of operation and valve opening. Surgical outcomes and risks were evaluated for both groups,and factors influencing the 3-month postoperative venous patency rate were analyzed.Results:A total of 92 patients were finally included,with 47 cases in the antegrade group (51.1％) and 45 cases in the retrograde group (48.9％),all treated with AngioJet PMT. Baseline characteristics showed no significant differences between the two groups (all P>0.05). In the antegrade group,14 cases (29.8％) had thrombus interception by filters,with 7 cases (14.9％) being effective;4 cases (8.5％) developed new or worsened PE. In the retrograde group,18 cases (40.0％) had thrombus interception by filters,with 8 cases (17.8％) being effective;5 cases (11.1％) developed new or worsened PE. No significant differences were observed between the two groups in these or other safety and laboratory variables (all P>0.05). The antegrade group had a higher proportion of intraoperative manual aspiration thrombectomy compared to the retrograde group (68.1％ vs. 26.7％,P<0.001). However,there were no significant differences in thrombus grade Ⅲ clearance rate (61.7％ vs. 68.9％),3-month venous patency rate (93.6％ vs. 91.1％),or other perioperative variables (all P>0.05). Regression analysis of factors affecting 3-month venous patency showed that immediate venous patency (OR=3.043,95％ CI=0.993-1.209) and radiation dose (OR=0.868,95％ CI=-0.001-0.000) in the antegrade group,as well as immediate venous patency (OR=2.333,95％ CI=0.655-0.980) in the retrograde group,were significantly associated with 3-month patency rate (all P<0.001). Regression analysis also showed a significant linear relationship between immediate venous patency and VCSS/Villalta scores in both groups (all P<0.001). Conclusion:Both antegrade and retrograde AngioJet PMT procedures are equally safe and effective for treating acute lower extremity DVT. However,the risk of intraoperative thrombus detachment remains high,warranting the use of inferior vena cava filters to prevent fatal PE. Patients with immediate venous patency require standardized postoperative management and follow-up to prevent PTS.

Objective:To investigate the effect of AngioJet thrombectomy on proximal iliofemoral vein thrombosis after trauma.Methods:The clinical data of patients with proximal iliofemoral vein thrombosis treated with AngioJet thrombectomy were retrospectively analyzed at Vascular Surgery Department of our hospital in 2019.Results:A total of 76 patients were enrolled. After PMT 20 patients had grade Ⅲ thrombolysis clearance(26.3%), 41 patients (53.9%) had grade Ⅱ clearance, and 15 cases (19.7%) had grade Ⅰ clearance. Thirty four cases (44.7%) of grade Ⅲ were cleared after catheter aspiration or catheter thrombolysis, 35 cases (46.1%) of grade Ⅱ, 7 cases (9.2%) of grade Ⅰ were cleared, thrombus clearance rate increased significantly ( P<0.05). Cerebral hemorrhage occurred in 1 case (1.3%), and thrombosis recurred in 2 cases (2.6%). The patency rate was 91.8% at 3 months follow-up. Conclusions:AngioJet thrombectomy is a safe and effective method for treating post-traumatic proximal iliac femoral vein thrombosis. Intraoperative application of urokinase thrombolysis, catheter aspiration and catheter-directed thrombolysis can increase thrombus clearance effect.

OBJECTIVE: To understand the exposure of occupational hazards, occupational and mental health status of high-speed railway locomotive drivers. METHODS: A total of 150 male high-speed railway locomotive drivers from Nanchang Railway administration were selected as experimental group, and 80 male ordinary train drivers were selected as control group by using a judgment sampling method. The occupational disease hazard testing and occupational health examinations were conducted in drivers of these two groups. The mental health status survey was conducted using the Symptom Checklist 90(SCL-90). RESULTS: The noise, power frequency electric field, formaldehyde, benzene, toluene, xylene and carbon dioxide in all the work place of these two groups were in line with the national occupational health standards. The exposure noise intensity of the experimental group was lower than that of the control group [(70.5±3.7) vs(77.4±4.1) dB(A), P<0.05]. The detection rates of hypertension and chronic gastritis were higher in the experimental group(18.7% vs 34.7%, 26.2% vs 42.0%, P<0.05). The detection rate of high frequency hearing loss decreased in the experimental group compared with the control group(22.5% vs 10.7%, P<0.05). The total score of SCL-90 in the experimental group was higher than that in the control group [(169.5±6.1) vs(148.0±6.0) score, P<0.01]. The positive rate of psychological symptoms was higher in the experimental group than that of the control group(41.3% vs 23.8%, P<0.01). CONCLUSION: The concentration/intensity of occupational disease hazards in the workplace of high-speed railway locomotives drivers is within normal limit. The occupational health status of high-speed railway locomotive drivers is generally good, but attention should be paid to their occupational mental health hazards.