Objective:To observe the effect of aerobic exercise on cardiopulmonary fitness, sleep quality, and right ventricular remodeling in patients with pulmonary arterial hypertension (PAH).Methods:Sixty stable PAH patients without regular exercise habits were randomly divided into an observation group and a control group according to a random number table. Both groups received standard targeted drug therapy, but the observation group additionally performed aerobic exercise three times per week for 12 weeks. Before and after the intervention, the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, while echocardiography was performed to measure the end-diastolic volume (RVEDV), end-systolic volume (RVESV), stroke volume (RVSV), and ejection fraction (RVEF) of the participants′ right ventricles. In addition, cardiopulmonary exercise testing was conducted to obtain peak oxygen uptake (VO 2peak), peak heart rate (HR peak), peak work (W peak), and exercise time (ET). Results:In the observation group, the average scores of all items in the PSQI scale, as well as the echocardiography indicators of RVEDV and RVESV decreased significantly compared with before the intervention. VO 2peak, W peak and ET in the cardiopulmonary exercise test, as well as RVSV and RVEF had increased significantly. There was no significant change in HR peak, on average. There was also no significant change in any of these indicators in the control group, on average. The left the observation group′s average VO 2peak, W peak, ET, RVSV and RVEF significantly higher than in the control group, while their PSQI scale scores, RVEDV and RVESV were significantly lower. Conclusions:Regular aerobic exercise can improve sleep quality and promote cardiopulmonary fitness and right ventricular remodeling in PAH patients. That should tend to help reduce mortality, so such therapy is worthy of clinical promotion and application.

Objective To observe the efficacy of Venovo venous stent for treating post-thrombotic syndrome(PTS)after lower extremity deep venous thrombosis(DVT).Methods A total of 61 patients with PTS after lower extremioty DVT who underwent iliac vein stent implantation were retrospectively enrolled,including 33 cases underwent Venovo stent(Venovo stent group)and 28 cases underwent conventional stent implantation(conventional stent group).The technical success rates and perioperative complications,Villalta score and venous clinical severity score(VCSS)before and 6 and 12 months after treatment,as well as the primary stent patency were compared within and between groups.Results The technical success rate was 100%in both groups,and no significant difference of the incidence of perioperative complications was found between groups(P=0.187).There was no significant difference of Villalta score nor VCSS between groups before treatment(both P＞0.05),while significant decrease of Villalta score was noticed before and 6 or 12 months after treatment within both groups(all P＜0.05).No significant difference of Villalta score nor VCSS was found 6 months after treatment between groups(both P＞0.05),while significant difference of Villalta score and VCSS were observed in Venovo stent group compared with those in conventional stent group 12 months after treatment(both P＜0.05).No significant difference of primary stent patency rate was found between groups 6 and 12 months after treatment(both P＞0.05).Conclusion Venovo venous stent could be used to effectively treat PTS after lower extremity DVT.

Objective:To investigate the role of the nuclear factor-kappa B (NF-κB) /nuclear factor E2 related factor 2 (Nrf2) pathway in the occurrence of lung tissue in the pulmonary alveolar proteinosis (PAP) model of rats induced by indium tin oxide nanoprticles (Nano-ITO) .Methods:In October 2019, 120 SD rats were divided into 3, 7, 14, 28, 56, and 84 day Nano ITO exposure groups and corresponding time point control groups, with 10 rats in each group; the exposure group was treated with 6 mg/kg·bw Nano-ITO via non exposed tracheal injection, twice a week. Time-course studies were performed to examine the pulmonary toxicity induced by Nano-ITO. At the end of the experiment, cytokines levels and oxidative stress were analyzed in the bronchoalveolar lavaged fluid (BALF). Rat lung tissues were also harvested for staining with HE, PAS, Masson, and Oil Red O. Ultrastructure of lung tissue cells was observed by transmission electron microscope. The localization and expression of NF-κB p65, IκB-α, IKK-β, Nrf2, NQO1, HO-1 were observed by immunohistochemistry, Western blot and real-time fluorescent quantitative PCR. The comparison between the two groups was analyzed by independent sample T test, and the comparison between the multiple groups was analyzed by one-way ANOVA.Results:Nano-ITO intratracheal instillation caused pulmonary toxicity by inducing acute inflammation, granuloma (nodule) formation, and alveolar proteinosis. ELISA analysis showed that, compared with the corresponding time points control groups, the levels of superoxide dismutase (SOD), total antioxidant capacity (T-AOC), malondialdehyde (MDA), interleukin (IL) -1β, IL-6, tumor necrosis factor alpha (TNF-α), IL-10, total protein (TP), and lactate dehydrogenase (LDH) in BALF of rats exposed to Nano ITO were all increased ( P<0.05) ; The protein expression of Nrf2 and NF-κB p65 was upregulated in rat lung tissue, while the protein expression of KK-β was increased ( P<0.01). Nrf2 and its downstream proteins NQO1 and HO-1 were highly expressed in Nano-ITO-induced PAP rat. Conclusion:NF-κB/Nrf2 signal pathway is involved in the process of Nano-ITO induced pulmonary alveolar proteinosis in rats.

Objective:To evaluate the short-and medium-term therapeutic efficacy of shockwave balloon therapy for TASCⅡ C/D femoropopliteal artery atherosclerosis obliteration.Methods:This retrospective cohort study included 25 patients who received shockwave balloon therapy in five vascular centers from August 2022 to June 2023. All patients were diagnosed with TASC Ⅱ C/D femoropopliteal arteriosclerosis obliterans (13 cases of type C and 12 cases of type D), and underwent intravascular shock wave lithotripsy (IVL) to treat calcified lesions. The immediate effectiveness (residual stenosis<30% and no flow-limiting dissection), safety (whether there were adverse vascular events during the operation) and the rate of salvage stent implantation were recorded. The observation indexes of patients before operation, early postoperative period (immediately after operation or before discharge) and postoperative follow-up period (3, 6, 12 months after operation) were collected. The observation indexes included ankle-brachial index (ABI), Rutherford classification, and minimum lumen diameter (MLD). Repeated measures ANOVA was used to evaluate the changes of observation indexes in the early postoperative and follow-up stages compared with those before operation; Kaplan-Meier survival analysis was used to evaluate the one-stage patency rate at follow-up and the target lesion revascularization rate free from clinical drive.Results:The immediate effectiveness of surgery was 100% in all patients, with no vascular related adverse events occurred, and no remedial stent implantation was performed. The ABI, Rutherford grade and MLD of the patients in the early postoperative period and each follow-up stage were improved compared with those before operation, with statistically significant differences ( P<0.05). Kaplan-Meier survival analysis showed that the primary patency rate at 12 months after surgery was 0.78 (95% CI 0.64-0.84), and the revascularization rate of target lesions free from clinical drive was 0.87 (95% CI 0.85-0.95). Conclusion:Shockwave balloon therapy for complex calcified femoropopliteal artery lesions is safe and reliable, with satisfactory short-and medium-term efficacy.

Objective:To observe the effect of aerobic exercise on cardiopulmonary fitness, sleep quality, and right ventricular remodeling in patients with pulmonary arterial hypertension (PAH).Methods:Sixty stable PAH patients without regular exercise habits were randomly divided into an observation group and a control group according to a random number table. Both groups received standard targeted drug therapy, but the observation group additionally performed aerobic exercise three times per week for 12 weeks. Before and after the intervention, the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, while echocardiography was performed to measure the end-diastolic volume (RVEDV), end-systolic volume (RVESV), stroke volume (RVSV), and ejection fraction (RVEF) of the participants′ right ventricles. In addition, cardiopulmonary exercise testing was conducted to obtain peak oxygen uptake (VO 2peak), peak heart rate (HR peak), peak work (W peak), and exercise time (ET). Results:In the observation group, the average scores of all items in the PSQI scale, as well as the echocardiography indicators of RVEDV and RVESV decreased significantly compared with before the intervention. VO 2peak, W peak and ET in the cardiopulmonary exercise test, as well as RVSV and RVEF had increased significantly. There was no significant change in HR peak, on average. There was also no significant change in any of these indicators in the control group, on average. The left the observation group′s average VO 2peak, W peak, ET, RVSV and RVEF significantly higher than in the control group, while their PSQI scale scores, RVEDV and RVESV were significantly lower. Conclusions:Regular aerobic exercise can improve sleep quality and promote cardiopulmonary fitness and right ventricular remodeling in PAH patients. That should tend to help reduce mortality, so such therapy is worthy of clinical promotion and application.

Objective:To observe the impact of upper limb resistance exercise on the exercise tolerance, muscle strength and life quality of patients with chronic obstructive pulmonary disease (COPD) so as to provide a reference for optimizing their rehabilitation plans.Methods:Fifty-eight COPD patients were randomly divided into an observation group and a control group, each of 29. Both groups were given routine pulmonary rehabilitation training (including lip retraction and abdominal breathing) for 12 weeks, while the observation group also performed upper limb resistance exercises. Before and after the intervention, both groups were evaluated using the 6-minute walk test (6MWT), St. George′s Respiratory Questionnaire (SGRQ) and the modified Medical Research Council Dyspnea Scale (mMRC). Lung function, respiratory muscle strength and upper limb muscle strength were also measured.Results:After the intervention there was a significant increase in the average 6MWT distance, maximum inspiration pressure, maximum expiratory pressure, and upper limb muscle strength among the observation group. In the control group, maximum inspiration pressure and the average the dyspnea mMRC score had improved. The observation group showed a significant decrease in the average heart rate after the 6MWT, and in average dyspnea mMRC and SGRQ scores. So after the intervention there were significant differences between the groups in terms of 6MWT distance (312.3±50.2m), maximum inspiratory pressure (96.8±11.3cmH 2O), maximum expiratory pressure (88.6±11.3cmH 2O), heart rate after the 6MWT (113.8±4.9beats/min) and SGRQ score. Conclusions:Adding upper limb resistance exercise to routine pulmonary rehabilitation can further improve the exercise tolerance, respiratory muscle strength, upper limb muscle strength and life quality of COPD patients. Therefore, such therapy is worthy of clinical promotion and application.

Objective:To observe the impact of upper limb resistance exercise on the exercise tolerance, muscle strength and life quality of patients with chronic obstructive pulmonary disease (COPD) so as to provide a reference for optimizing their rehabilitation plans.Methods:Fifty-eight COPD patients were randomly divided into an observation group and a control group, each of 29. Both groups were given routine pulmonary rehabilitation training (including lip retraction and abdominal breathing) for 12 weeks, while the observation group also performed upper limb resistance exercises. Before and after the intervention, both groups were evaluated using the 6-minute walk test (6MWT), St. George′s Respiratory Questionnaire (SGRQ) and the modified Medical Research Council Dyspnea Scale (mMRC). Lung function, respiratory muscle strength and upper limb muscle strength were also measured.Results:After the intervention there was a significant increase in the average 6MWT distance, maximum inspiration pressure, maximum expiratory pressure, and upper limb muscle strength among the observation group. In the control group, maximum inspiration pressure and the average the dyspnea mMRC score had improved. The observation group showed a significant decrease in the average heart rate after the 6MWT, and in average dyspnea mMRC and SGRQ scores. So after the intervention there were significant differences between the groups in terms of 6MWT distance (312.3±50.2m), maximum inspiratory pressure (96.8±11.3cmH 2O), maximum expiratory pressure (88.6±11.3cmH 2O), heart rate after the 6MWT (113.8±4.9beats/min) and SGRQ score. Conclusions:Adding upper limb resistance exercise to routine pulmonary rehabilitation can further improve the exercise tolerance, respiratory muscle strength, upper limb muscle strength and life quality of COPD patients. Therefore, such therapy is worthy of clinical promotion and application.

Objective To observe the efficacy of Venovo venous stent for treating post-thrombotic syndrome(PTS)after lower extremity deep venous thrombosis(DVT).Methods A total of 61 patients with PTS after lower extremioty DVT who underwent iliac vein stent implantation were retrospectively enrolled,including 33 cases underwent Venovo stent(Venovo stent group)and 28 cases underwent conventional stent implantation(conventional stent group).The technical success rates and perioperative complications,Villalta score and venous clinical severity score(VCSS)before and 6 and 12 months after treatment,as well as the primary stent patency were compared within and between groups.Results The technical success rate was 100%in both groups,and no significant difference of the incidence of perioperative complications was found between groups(P=0.187).There was no significant difference of Villalta score nor VCSS between groups before treatment(both P＞0.05),while significant decrease of Villalta score was noticed before and 6 or 12 months after treatment within both groups(all P＜0.05).No significant difference of Villalta score nor VCSS was found 6 months after treatment between groups(both P＞0.05),while significant difference of Villalta score and VCSS were observed in Venovo stent group compared with those in conventional stent group 12 months after treatment(both P＜0.05).No significant difference of primary stent patency rate was found between groups 6 and 12 months after treatment(both P＞0.05).Conclusion Venovo venous stent could be used to effectively treat PTS after lower extremity DVT.

Objective:To evaluate the short-and medium-term therapeutic efficacy of shockwave balloon therapy for TASCⅡ C/D femoropopliteal artery atherosclerosis obliteration.Methods:This retrospective cohort study included 25 patients who received shockwave balloon therapy in five vascular centers from August 2022 to June 2023. All patients were diagnosed with TASC Ⅱ C/D femoropopliteal arteriosclerosis obliterans (13 cases of type C and 12 cases of type D), and underwent intravascular shock wave lithotripsy (IVL) to treat calcified lesions. The immediate effectiveness (residual stenosis<30% and no flow-limiting dissection), safety (whether there were adverse vascular events during the operation) and the rate of salvage stent implantation were recorded. The observation indexes of patients before operation, early postoperative period (immediately after operation or before discharge) and postoperative follow-up period (3, 6, 12 months after operation) were collected. The observation indexes included ankle-brachial index (ABI), Rutherford classification, and minimum lumen diameter (MLD). Repeated measures ANOVA was used to evaluate the changes of observation indexes in the early postoperative and follow-up stages compared with those before operation; Kaplan-Meier survival analysis was used to evaluate the one-stage patency rate at follow-up and the target lesion revascularization rate free from clinical drive.Results:The immediate effectiveness of surgery was 100% in all patients, with no vascular related adverse events occurred, and no remedial stent implantation was performed. The ABI, Rutherford grade and MLD of the patients in the early postoperative period and each follow-up stage were improved compared with those before operation, with statistically significant differences ( P<0.05). Kaplan-Meier survival analysis showed that the primary patency rate at 12 months after surgery was 0.78 (95% CI 0.64-0.84), and the revascularization rate of target lesions free from clinical drive was 0.87 (95% CI 0.85-0.95). Conclusion:Shockwave balloon therapy for complex calcified femoropopliteal artery lesions is safe and reliable, with satisfactory short-and medium-term efficacy.

Objective:To investigate the role of the nuclear factor-kappa B (NF-κB) /nuclear factor E2 related factor 2 (Nrf2) pathway in the occurrence of lung tissue in the pulmonary alveolar proteinosis (PAP) model of rats induced by indium tin oxide nanoprticles (Nano-ITO) .Methods:In October 2019, 120 SD rats were divided into 3, 7, 14, 28, 56, and 84 day Nano ITO exposure groups and corresponding time point control groups, with 10 rats in each group; the exposure group was treated with 6 mg/kg·bw Nano-ITO via non exposed tracheal injection, twice a week. Time-course studies were performed to examine the pulmonary toxicity induced by Nano-ITO. At the end of the experiment, cytokines levels and oxidative stress were analyzed in the bronchoalveolar lavaged fluid (BALF). Rat lung tissues were also harvested for staining with HE, PAS, Masson, and Oil Red O. Ultrastructure of lung tissue cells was observed by transmission electron microscope. The localization and expression of NF-κB p65, IκB-α, IKK-β, Nrf2, NQO1, HO-1 were observed by immunohistochemistry, Western blot and real-time fluorescent quantitative PCR. The comparison between the two groups was analyzed by independent sample T test, and the comparison between the multiple groups was analyzed by one-way ANOVA.Results:Nano-ITO intratracheal instillation caused pulmonary toxicity by inducing acute inflammation, granuloma (nodule) formation, and alveolar proteinosis. ELISA analysis showed that, compared with the corresponding time points control groups, the levels of superoxide dismutase (SOD), total antioxidant capacity (T-AOC), malondialdehyde (MDA), interleukin (IL) -1β, IL-6, tumor necrosis factor alpha (TNF-α), IL-10, total protein (TP), and lactate dehydrogenase (LDH) in BALF of rats exposed to Nano ITO were all increased ( P<0.05) ; The protein expression of Nrf2 and NF-κB p65 was upregulated in rat lung tissue, while the protein expression of KK-β was increased ( P<0.01). Nrf2 and its downstream proteins NQO1 and HO-1 were highly expressed in Nano-ITO-induced PAP rat. Conclusion:NF-κB/Nrf2 signal pathway is involved in the process of Nano-ITO induced pulmonary alveolar proteinosis in rats.